Search PubMed⌕ Search

Biomedical subjects

A Wagner

Publications and source records attributed to A Wagner.

At least 91 records · Page 5Linked to original sources
PubMed2003

Physical activity patterns in 50-59 year men in France and Northern Ireland. Associations with socio-economic status and health behaviour.

BACKGROUND: This study aimed to compare physical activity patterns and their associations with socio-economic status (SES) and health behaviour in two countries at contrasting risk for coronary heart disease (CHD). METHODS: This paper is a cross-sectional analysis of 7359 French and 2398 Northern Irish 50-59 year men of the PRIME cohort. Net energy expenditure due to physical activity (PAE) was assessed by means of the MOSPA-Q taking high-intensity recreational activities into account. SES was evaluated by educational attainment and material conditions. Different behavioural factors (smoking, alcohol intake and healthy eating patterns) were considered. RESULTS: The prevalence of walking or cycling to work was greater in Northern Ireland (p < 10(-5)) whereas leisure PAE (p < 10(-5)) and high-intensity leisure-time activity (p < 10(-5)) were higher in France. Education was positively associated with leisure-time PAE in Northern Ireland but negatively in France. However education in both countries and material conditions in France were favourably associated with the regular practice of high-intensity recreational activities. Alcohol consumption was positively associated with leisure PAE in France only (p < 10(-3)). A weak negative association was also observed between smoking and leisure-time activities while healthy eating patterns were associated with greater physical activity in both countries. CONCLUSIONS: Physical activity patterns and their relationships with SES and alcohol consumption differ in France and in Northern Ireland. Our results underline the need to focus on low socio-economic groups for health promotion but, also, to adapt strategies to promote physical activity according to cultural differences between countries. Our results also show that healthy behaviours tend to cluster in middle-aged men.

Coronary Disease↗
PubMed2003

The radial free forearm flap--prelaminated versus non-prelaminated: a comparison of two methods.

In the present work two methods of harvesting the RFFF (radial free forearm flap) are compared: the prelaminated fasciomucosal and the non-prelaminated fasciocutaneous version. The flaps were employed for intraoral reconstruction after radical oncological surgery of the oral cavity. In most cases a squamous cell carcinoma was the present malignant tumour. A total of 32 patients were included in the study, 16 in each group. The design was retrospective. Data were obtained by clinical follow up, chart review and compiled database. Analysis included the amount of shrinkage of the flaps during the follow-up period, early postoperative complications, following function improving operations and early and late donor site difficulties. Prelaminated fasciomucosal flaps showed a higher shrinkage rate than fasciocutaneous non-prelaminated flaps. Due to this circumstance the number of following function improving operations was higher in the prelaminated flap group. Early wound healing difficulties were also seen more often in the prelaminated flap group, whereas donor site problems occurred more frequently in the non-prelaminated group. Mucosal prelamination of the RFFF is a promising method for a most physiological reconstruction of intraoral defects resulting from tumour surgery. Postoperative shrinkage is a problem in prelaminated RFFF. Our aim is to improve the prelamination technique in order to prevent shrinkage. The almost complete absence of donor site difficulties in prelaminated RFFF may represent a solution to this common and yet unsolved problem.

Adult↗
PubMed2003

Follow-up study of treatment of orbital floor fractures: relation of clinical data and software-based CT-analysis.

This retrospective study quantifies isolated orbital floor fractures using software-based CT-analysis and compares the clinical outcome across surgical and non-surgical treatment groups. Depending on the surgeon's interpretation of the clinical and radiological appearance, 10 fractures were treated non-surgically and 20 fractures surgically, either with antral balloon catheter alone or in combination with an orbital implant. Ophthalmologic findings were evaluated until 12 weeks after injury. Fracture area, and volume of displaced tissue (VDT) were assessed by software-based CT-analysis. VDT was marginally significantly smaller in non-surgically than in surgically-treated patients (P=0.08). Ophthalmologic findings improved in all groups during follow-up and no statistical difference was found between the groups. Diplopia remained moderate in three patients with balloon catheter alone, and minimal in four patients in both surgical groups. In one patient with non-surgical treatment, diplopia remained minimal after 12 weeks. Although CT-analysis revealed no significant difference between both surgical groups, patients treated with balloon catheter alone presented more diplopia after 12 weeks. Using balloon catheters for fracture repair a combined approach should be performed when large fractures involve the orbital floor to achieve sufficient reduction of orbital content and placement of an orbital implant. Software-based CT-analysis is helpful for objective interpretation in managing of orbital fractures.

Adult↗
PubMed2003

An Asia-Pacific, double blind, placebo controlled, randomised study to evaluate the efficacy, safety, and tolerability of tegaserod in patients with irritable bowel syndrome.

BACKGROUND: Tegaserod has been shown to be an effective therapy for the multiple symptoms of irritable bowel syndrome (IBS) in Western populations. However, little information is available regarding the use of tegaserod in the Asia-Pacific population. AIMS: To evaluate the efficacy, safety, and tolerability of tegaserod versus placebo in patients with IBS from the Asia-Pacific region. PATIENTS: A total of 520 patients from the Asia-Pacific region with IBS, excluding those with diarrhoea predominant IBS. METHODS: Patients were randomised to receive either tegaserod 6 mg twice daily (n=259) or placebo (n=261) for a 12 week treatment period. The primary efficacy variable (over weeks 1-4) was the response to the question: "Over the past week do you consider that you have had satisfactory relief from your IBS symptoms?" Secondary efficacy variables assessed overall satisfactory relief over 12 weeks and individual symptoms of IBS. RESULTS: The mean proportion of patients with overall satisfactory relief was greater in the tegaserod group than in the placebo group over weeks 1-4 (56% v 35%, respectively; p<0.0001) and weeks 1-12 (62% v 44%, respectively; p<0.0001). A clinically relevant effect was observed as early as week 1 and was maintained throughout the treatment period. Reductions in the number of days with at least moderate abdominal pain/discomfort, bloating, no bowel movements, and hard/lumpy stools were greater in the tegaserod group compared with the placebo group. Headache was the most commonly reported adverse event (12.0% tegaserod v 11.1% placebo). Diarrhoea led to discontinuation in 2.3% of tegaserod patients. Serious adverse events were infrequent (1.5% tegaserod v 3.4% placebo). CONCLUSIONS: Tegaserod 6 mg twice daily is an effective, safe, and well tolerated treatment for patients in the Asia-Pacific region suffering from IBS and whose main bowel symptom is not diarrhoea.

Adult↗
PubMed2003

Carrier risk status changes resulting from mutation testing in hereditary non-polyposis colorectal cancer and hereditary breast-ovarian cancer.

CONTEXT: In hereditary cancer syndrome families with an identified cancer associated mutation, mutation testing changes the carrier risk status of the tested person and may change the carrier risk status of relatives. OBJECTIVE: This study aimed to describe the change in the distribution of carrier risk status resulting from testing in hereditary breast-ovarian cancer (HBOC) and hereditary non-polyposis colorectal cancer (HNPCC) families. DESIGN: This was an observational cohort study. PATIENTS: The cohort included members of 75 HBOC and 47 HNPCC families. Of the 10 910 cohort members, 1408 were tested for a mutation and learned their test results. OUTCOME MEASURE: Carrier risk for all cohort members was assessed before and after mutation testing. RESULTS: There was a change in carrier risk status in 2906 subjects after testing of 1408 family members. The most common type of carrier risk change, from at risk to non-carrier status, accounted for 77% of the risk changes; 12% were a change to known carrier status from a lower risk. Sixty percent of persons with a carrier risk status change were not themselves tested; their risk status changed because of a relative's test result. CONCLUSIONS: Carrier risk status changes from uncertainty to certainty (that is, to carrier or to non-carrier) account for 89% of risk changes resulting from testing. These risk changes affect cancer prevention recommendations, most commonly reducing their burden. Current practices do not ensure that untested family members are informed about changes in their carrier risk status which result from mutation testing of their relatives.

Adaptor Proteins, Signal Transducing↗
PubMed2003

Acetabular revision in total hip replacement with a press-fit cup.

The need for supplementary screw fixation in acetabular revisions is still widely debated. We carried out 439 acetabular revisions over an eight-year period. In 171 hips with contained or small segmental defects, the Morscher press-fit cup was used. These revisions were followed prospectively. No screws were used for additional fixation. A total of 123 hips with a mean follow-up of 7.4 years (5 to 10.5) were available for clinical and radiological review. There was no further revision of a press-fit cup for aseptic loosening. Radiological assessment revealed osteolysis in three hips. Of the original 171 hips there was cranial and medial migration of up to 6 mm at two years in 44 (26%). No further migration was seen after the second post-operative year. Acetabular revision without screws is possible with excellent medium-term results in well selected patients.

Acetabulum↗
PubMed2003

[Clinical significance of the Krogh-Poulsen bite test in mandibular dysfunction].

INTRODUCTION: The bite test was initially described as the Krogh-Poulsen test consists of biting a flat and thin wedge placed unilaterally between the molars. Temporomandibular joint (TMJ) pain located on the ipsilateral side is considered as muscular, when on the contralateral side pain signifies a joint problem. Although this test is widely used, no scientific evaluation of its real clinical value has been published. MATERIAL AND METHOD: A prospective study is conducted in 32 patients exhibiting temporomandibular pain (n=40) at the bite test. The results of the bite test were compared with results of computed tomography of the TMJ. Several criteria are studied: joint space narrowing, retrusion of the mandibular condyle in occlusal position, bony signs of joint degeneration. Chi-square and Student's t test were used for statistical analysis of correlations between clinical findings and radiological abnormalities. RESULTS: Significant results demonstrated a high degree of radiologically detectable disorders in patients with joint pain as defined by the bite test. All of these patients presented at least one radiological sign of joint disease. There was also a low degree of radiologically detected joint disturbance in patients with muscular pain according to the bite test, 70% of them presenting no radiological abnormality. DISCUSSION: It is concluded that the bite test is of significant value for evaluation of TMJ disorders and can be useful for the indication of complementary radiological examinations.

Adolescent↗
PubMed2002

Early biochemical and histological changes during hyperbaric or normobaric reoxygenation after in vitro ischaemia in primary corticoencephalic cell cultures of rats.

In a first series of experiments, the morphological changes of corticoencephalic cells by ischaemia were determined by staining with celestine blue-acid fuchsin in order to classify cells as intact, dark basophilic (supposedly reversibly injured) and preacidophilic or acidophilic (profoundly injured). Hypoxia and glucose-deprivation (in vitro ischaemia) markedly decreased the number of intact cells and correspondingly increased the number of both reversibly and profoundly damaged cells. The morphological characteristics indicated a partial recovery during reoxygenation either in the absence or presence of glucose and irrespective of whether normobaric or hyperbaric oxygen was used. In a second series of experiments, nucleoside triphosphate and diphosphate levels were determined in corticoencephalic cultures by high-performance liquid chromatography. Hypoxia in combination with glucose-deficiency markedly decreased the ATP:ADP, GTP:GDP and UTP:UDP ratios. A still larger fall of these ratios was observed both after normobaric and hyperbaric reoxygenation. In contrast, both normobaric and hyperbaric reoxygenation in the presence of glucose led to an almost complete recovery near the control normoxic values. In conclusion, the histological changes were not adequately reflected by changes in the nucleoside triphosphate:diphosphate ratios and, in addition, hyperbaric oxygen had neither favourable nor unfavourable effects on the early morphological and functional restitution of ischaemically damaged cells under the conditions of the present study.

Adenine Nucleotides↗
PubMed2002

Reproducability and transferability of topological properties; experimental charge density of the hexapeptide cyclo-(D,L-Pro)2-(L-Ala)4 monohydrate.

The charge density of a hexapeptide was determined from high-resolution CCD area-detector experiments at 100 K. Two datasets, one from a rotating anode and a second one from synchrotron radiation, were measured and the results are compared. The data are interpreted in terms of the 'rigid pseudoatom' model. The topology of the experimental density is analyzed and compared with the topology of the constituting amino acids, and shows good agreement. All critical points of the electron density at the covalent and hydrogen bonds, as well as those of the Laplacian, were located. With respect to the transferability of electronic and bond topological properties the six peptide bonds were compared with values given in the literature.

Models, Molecular↗
PubMed2002

Intra- and intermolecular topological properties of amino acids: a comparative study of experimental and theoretical results.

The charge densities rho(r) of the six amino acids L-Asn.H(2)O, DL-Glu.H(2)O, DL-Lys.HCl, DL-Pro.H(2)O, DL-Ser, and DL-Val were determined from high-resolution X-ray diffraction experiments at 100 K using synchrotron radiation and area detection (CCD) techniques. Bond topological parameters derived from these densities and from those of six additional amino acids published earlier are compared to each other and to the results of ab initio calculations. Experimental and theoretical properties for each chemically equivalent bond are in a fair agreement, and their variances are of similar magnitude. A noticeable outlier is the positive curvature of the density at the bond critical point, for which no correlation between the experimental and theoretical values can be established. The location of nonbonded valence shell charge concentrations derived from the crystalline densities scatter in a wider range than those obtained for the isolated molecules.

Amino Acids↗
PubMed2002

Measurement of the beam-helicity asymmetry in the p((-->)e,e'p)pi(0) reaction at the energy of the Delta(1232) resonance.

In a p((-->)e,e'p)pi(0) out-of-plane coincidence experiment at the three-spectrometer setup of the Mainz Microtron MAMI, the beam-helicity asymmetry has been precisely measured around the energy of the Delta(1232) resonance and Q(2) = 0.2(GeV/c)(2). The results are in disagreement with three up-to-date model calculations. This is interpreted as a lack of understanding of the nonresonant background, which in dynamical models is related to the pion cloud.

Journal Article↗
PubMed2002

[Cerebral MRI and evoked potentials in Wilson disease. Comparison of findings in patients with neurological follow-up].

Wilson's disease is caused by toxic copper accumulation, which leads predominantly to hepatic and basal ganglia damage. Characteristic findings in MRI and electrophysiologic examinations are described according to the occurrence of neurological symptoms. In the present study, 28 patients suffering from Wilson's disease (neurological type) were investigated. The results of MRI are compared with abnormalities of evoked potentials (BAEP, MSEP, T-VEP, MEP). All patients show hypodensities in the basal ganglial area (putamen and GI. pallidus) regularly combined with atrophy of the cerebrum and cerebellum in MRI. Signal abnormalities in the mesencephalic region (46% occurrence) and Nc. dentatus (36% occurrence) are combined with the other findings in variable patterns. Only slight changes are found in the pontine region. BAEP are disturbed in 71% of all cases and MSEP in 46%. Combined abnormalities of BAEP and MSEP were found in 39%. Pathological values occurred with a lower frequency in T-VEP (36%) and MEP (39%). The comparison of MRI findings with electrophysiological data done separately for each patient reveals no strong correlation between both methods. Individual MRI findings do not correspond with the patterns of disturbed evoked potentials and vice versa. Therefore we conclude that these methods, MRI and electrophysiological evaluation, supplement each other. Magnetic resonance imaging and electrophysiological evaluation should be performed simultaneously for therapy monitoring.

Adult↗
PubMed2002

[Diagnosis of aphasia on the stroke unit].

The first weeks of aphasia are called the acute stage. The rapid change and possible fluctuation of language deficits at that stage as well as concurrent phenomena such as drive disturbances, apraxia, or perseveration pose particular requirements for aphasia diagnosis. Professional language diagnosis in a stroke unit is necessary for detailed description of the language deficits, differential diagnosis of concomitant cognitive or functional disturbances, and a description of the dynamics of the deficits to start with specific therapeutical interventions as soon as the patient's health status allows. There are three published German aphasia test batteries especially constructed for diagnosis of acute aphasia language deficits. They differ with respect to content and pragmatic aspects and offer a range of applications, including the diagnosis of aphasia, recommendations for therapy, and the use in scientific studies.

Aphasia↗
PubMed2002

Comparison of clinical types of Wilson's disease and glucose metabolism in extrapyramidal motor brain regions.

In Wilson's disease a disturbed glucose metabolism especially in striatal and cerebellar areas has been reported. This is correlated with the severity of extrapyramidal motor symptoms (EPS). These findings are only based on a small number of patients. Up to now it is unknown whether EPS are caused by various patterns of disturbed basal ganglia glucose metabolism. We investigated 37 patients and 9 normal volunteers to characterize the disturbed glucose metabolism in Wilson's disease more precisely. The glucose metabolism was determined in 5 cerebellar and cerebral areas (putamen, caput nuclei caudati, cerebellum, midbrain and thalamic area) by using (18)F-Fluorodesoxyglucose-Positron-Emission-Tomography ( [(18)F]FDG-PET). The database was evaluated by a cluster analysis. Additionally, the severity extrapyramidal motor symptoms were judged by a clinical score system. Three characteristic patterns of glucose metabolism in basal ganglia were obtained. Two of them may be assigned to patients with neurological symptoms whereas the third cluster corresponds to most patients without EPS or normal volunteers. The clusters can be identified by characteristic consumption rates in this 5 brain areas. The severity of EPS can not clearly be assigned to one of the clusters with disturbed glucose metabolism. However, the most severe cases are characterized by the lowest consumption in the striatal area. When there is marked improvement of EPS impaired glucose consumption reveals a persistent brain lesion. Finally, the neurological symptoms in Wilson's disease are caused by (at least) two different patterns of disturbed glucose metabolism in basal ganglia and cerebellum. The severity of EPS seems to be determined by a disturbed consumption in the striatal area.

Adult↗
PubMed2002

[Male breast cancer: 19 case reports].

Breast cancer is rarely encountered in men. In developed countries, it accounts for less than 1% of cancers in men, whereas in women it represents about 23% of all cancers. A retrospective review was performed on 19 cases of men who underwent surgery for breast carcinoma between 1989 and 2000. The aim of this work was to analyse epidemiological and etiological aspects, circumstances of discovery, pathological characteristics, therapy modalities as well as prognostic factors. The mean age was 65.3 years. A high incidence of overweight, diabetes, hypertension and hypercholesterolemia was found. The most frequent clinical presentation was a firm subareolar lump, at a low stage (stage I 23% and stage II 41%). The most common pathological type was an infiltrating ductal carcinoma (89%). Hormone receptors where most often positive (92% for oestrogen and 100% for progesterone receptors). 84% of patients underwent simple mastectomy and axillary dissection, 74% chest wall irradiation after surgery, 26% received chemotherapy and 42% hormonal therapy. Median follow-up was 52 months. The estimated 2-year overall survival (OS) and disease-free survival (DFS) was respectively 93% and 87.5% and the 5-year OS and DFS respectively 86% and 75%. The management of male and female breast carcinoma is identical, as well as their prognosis at equal stages. However male breast carcinoma is more often diagnosed at a more advanced stage, thus a breast screening in men would permit a sooner diagnosis and a better prognosis.

Adult↗
PubMed2002

Alterations of purine and pyrimidine nucleotide contents in rat corticoencephalic cell cultures following metabolic damage and treatment with openers and blockers of ATP-sensitive potassium channels.

Rat corticoencephalic cell cultures were investigated by high performance liquid chromatography for changes in the levels of adenosine 5'-triphosphate (ATP), guanosine 5'-triphosphate (GTP), uridine 5'-triphosphate (UTP), cytidine 5'-triphosphate (CTP), and the respective nucleoside diphosphates. Hypoxia was induced by gassing the incubation medium for 30 min with 100% argon. Removal of glucose was caused by washing the cultures in glucose-free medium at the beginning of the 30 min incubation period. Whereas hypoxia or glucose-deficiency alone failed to alter the nucleotide levels, the combination of these two manipulations was clearly inhibitory. Diazoxide (300 microM) an opener of ATP-dependent potassium channels (K(ATP)) did not alter the nucleotide contents either in a normoxic and glucose-containing medium, or a hypoxic and glucose-free medium. By contrast, the K(ATP) channel antagonist tolbutamide (300 microM) aggravated the hypoxic decrease of nucleotide levels in a glucose-free medium, although it was ineffective in a normoxic and glucose-containing medium. Hypoxia and glucose-deficiency decreased the ATP/ADP and UTP/UDP ratios, but failed to change the GTP/GDP ratio. Diazoxide and tolbutamide (300 microM each) had no effect on the nucleoside triphosphate/diphosphate ratios either during normoxic or during hypoxic conditions. In conclusion, corticoencephalic cultures are rather resistant to in vitro ischemia. Although they clearly respond to the blockade of plasmalemmal K(ATP) channels (plasmaK(ATP)) by tolbutamide, these channels appear to be maximally open as a consequence of the fall in intracellular nucleotides and, therefore, diazoxide has no further effect.

Animals↗
PubMed2002

[Physiology and pathophysiology of the vascular endothelin system: clinical implications].

The endothelium-derived 21 amino acid peptide endothelin-1 is one of the most potent vasoconstrictors. Endothelin-1 exerts its effects upon a variety of vascular and non-vascular cells through a direct interaction with specific receptors. Beyond its vasoconstrictive action on vascular smooth muscle cells endothelin-1 has mitogenic and pro-inflammatory properties. The present review deals with current experimental and clinical evidence for the involvement of endothelin-1 in several cardiovascular disorders with inflammatory components. We further discuss the potential clinical relevance of the endothelin system and therapeutical perspectives of anti-endothelin strategies in the treatment of cardiovascular disease.

Cardiovascular Diseases↗