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Biomedical subjects

A Weber

Publications and source records attributed to A Weber.

At least 289 records · Page 16Linked to original sources

[The recognition of osteofibrous dysplasia Campanacci. Morphology, radiology, clinical picture and therapy].

Radiologically osteofibrous dysplasia of the tibia is characterized by an eccentrically localized osteolytic lesion in the diaphysis with the appearance of ground glass. However, this is a very rare lesion, making a correct diagnosis difficult, especially since fibrous dysplasia and adamantinoma of the tibia have to be taken into account in the differential diagnosis of the disease. A definitive diagnosis can only be made histologically. The rather aggressive growth pattern of osteofibrous dysplasia as compared to fibrous dysplasia that has been reported in literature should not be generalized and it must be taken into consideration that surgery may be performed too early during the growth phase.

Child↗

Functional characterization of the cloned human ACTH receptor: impaired responsiveness of a mutant receptor in familial glucocorticoid deficiency.

The putative ACTH receptor gene has been identified on the basis of its tissue specific expression, structure, and limited expression data. We have expressed this gene in COS-7 cells and measured cAMP production in response to ACTH. An EC50 of 5.5 x 10(-9) M for ACTH (1-24) was determined. The S74I mutant ACTH receptor gene that associates with the syndrome of familial glucocorticoid deficiency had an EC50 of 67 x 10(-9) M. This discrepancy is consistent with the clinical data, and supports the hypothesis that this point mutation could account for the syndrome.

Adrenocorticotropic Hormone↗

CA 494--a new tumor marker for the diagnosis of pancreatic cancer.

In 59 patients with ductal pancreatic cancer the monoclonal antibody (MAb) BW 494, which detects the CA 494 glycoprotein antigen, was analyzed in comparison with the reference tumor markers CA 19-9 and CEA. Eighty-one patients with non-pancreatic malignancies of the gastrointestinal (GI) tract, 95 with chronic pancreatitis, 124 with benign non-pancreatic GI diseases, 30 with diabetes mellitus (type I or type II) and 114 healthy blood donors served as controls. The sensitivity of pancreatic cancer was 90%, 44% and 90% for CA 19-9, CEA and CA 494, respectively. In chronic pancreatitis, as the most important control population for pancreatic cancer, the specificity was 85%, 72% and 94% for CA 19-9, CEA and CA 494, respectively.

Adolescent↗

Experimental basis of shockwave-induced renal trauma in the model of the canine kidney.

Using the new electromagnetic shockwave source of the Modulith SL 20 shockwave-induced renal trauma was evaluated by acute and chronic studies in the the canine kidney model. In a further study the electromagnetic shockwave source of the Lithostar Plus Overhead module was tested. Overall, 92 kidneys were exposed to shock waves coupled either by water bath (Modulith lab type) or by water cushion (Modulith prototype, Lithostar Overhead) under ultrasound localization. The generator voltage ranged between 11 and 21 kV, the number of impulses between 25 and 2500. After application of 1500/2500 shocks the extent of the renal lesion depended strictly on the applied generator voltage and was classified into 4 grades: Grade 0, no macroscopic trauma detectable (at 11-12 kV); grade 1, petechial medullary bleeding (at 13 kV); grade 2, cortical hematoma (at 14-16 kV); and grade 3, perirenal hematoma (17-20 kV). Whereas at low and medium energy levels the number of shocks played only a minor role, at maximal generator voltage (20 kV) even 25 impulses induced a grade 2 and 600 shocks a grade 3 lesion, emphasizing the importance of shockwave limitation in the upper energy range. In shockwave-induced renal trauma a vascular lesion was predominant and cellular necrosis was secondary. Coupling with a water cushion resulted in a 15%-20% decrease in the disintegrative and traumatic effect, which was compensated for by increasing the generator voltage by 2 kV. Long-term studies showed complete restitution following grade 1 and 2 trauma, whereas after a grade 3 lesion a small segmental and capsular fibrosis without hyperplasia of the juxtaglomerular apparatus was observed. Based on the characteristic ultrasound pattern found in the first study, the threshold for induction of grade 1 lesion was investigated. With both lithotripters a wide range for induction of a grade 1 lesion (Modulith 234-411, Lithostar Plus 220-740) and also a significant overlapping with grade 0 and 2 lesions was seen at low energy settings (levels 2-4). In contrast, the range of shocks (Modulith 96-150, Lithostar Plus 90-142) and overlapping was minimal when high energy was used (levels 7-9). Finally, the disintegration-trauma coefficient combining the results obtained in a standard stone model with those of the canine kidney model was introduced.

Animals↗

Lack of effect of oxytocin on the numbers of "synaptic" ribbons, cyclic guanosine monophosphate and serotonin N-acetyltransferase activity in organ-cultured pineals of three strains of rats.

In addition to the stimulating influence of the sympathetic system on the function of the mammalian pineal gland, neuropeptides such as neuropeptide Y, vasoactive intestinal polypeptide and arginine-vasopressin (AVP) are thought to function as modulators. Since AVP has been shown to influence pineal melatonin synthesis, the aim of the present study was to investigate the possible effects of the second hypothalamic nonapeptide oxytocin (OT), which likewise has been detected in the pineal gland. We therefore studied "synaptic" ribbon (SR) numbers, N-acetyltransferase (NAT) activity and the intracellular concentration of cyclic guanosine monophosphate (cGMP) following in vitro incubation of rat pineals in media containing OT (10(-5) M), noradrenaline (NA, 10(-5) M) or both NA and OT. Pineal glands were derived from rats of three different strains (Sprague-Dawley, Long-Evans and the AVP-deficient strain Brattleboro). Neither morphological nor biochemical analyses showed a difference between control and OT-incubated organs in any of the strains tested. In Brattleboro rats, but not in the other strains, noradrenaline slightly increased the number of SR which was not observed when NA and OT were combined. The addition of NA resulted in distinct augmentation of NAT activity and cGMP content, which were not affected by additional OT application. These results suggest that oxytocin is not crucially involved in the regulation of pineal gland function.

Animals↗

Aerosol penetration and leakage characteristics of masks used in the health care industry.

BACKGROUND: Historically, surgical masks have been worn to protect patients from being infected by large, pathogen-containing aerosol droplets emitted by health care personnel. Today, emphasis has shifted from solely protecting the patient to protecting the health care worker as well. As a result of new procedures used in operating rooms and clinical areas, aerosolized hazardous agents in the submicrometer size range are being produced, posing a potential threat to health care workers. METHODS: Eight surgical masks were tested for aerosol particle penetration through their filter media and through induced face-seal leaks. RESULTS: The percentage of filter penetration ranged from 20% to nearly 100% for submicrometer-sized particles. In comparison, a dust-mist-fume respirator used in industrial settings had significantly less penetration through its filter medium. When the surgical masks had artificially induced face-seal leaks, the concentration of submicrometer-sized particles inside the mask increased slightly; in contrast, the more protective dust-mist-fume respirator showed a fourfold increase in aerosol penetration into the mask with an artificial leak 4 mm in diameter. CONCLUSION: We conclude that the protection provided by surgical masks may be insufficient in environments containing potentially hazardous submicrometer-sized aerosols.

Aerosols↗

Improvement of visual acuity after surgery for nystagmus.

PURPOSE: The authors compared the preoperative and postoperative binocular visual acuities and eye movement recordings of patients who underwent eye muscle surgery consisting of the Anderson-Kestenbaum procedure or the artificial divergence procedure modeled after Cüppers, or a combination of both procedures, for the treatment of infantile nystagmus with head turn. METHODS: Binocular visual acuities and eye movement recordings by electro-oculography (EOG) were compared preoperatively with those done within 3 weeks postoperatively. Shifting and broadening of the minimal intensity zone and foveation time and changing of the waveform were measured. The treatment of 6 of 18 patients was based on the artificial divergence principle; for 7 patients, treatment was in accordance with the Anderson-Kestenbaum principle; and 5 patients had combined procedures. RESULTS: The improvement in binocular visual acuities was two Snellen lines or more in one of six patients in the artificial divergence group and four of five patients in the combined treatment group. The EOG recordings showed shifting of the minimal intensity zone toward the primary position in all three groups. A broadening of the minimal intensity zone occurred mostly in the artificial divergence and combined groups. Increases in foveation time and changes in waveforms from jerk to jerk with foveation were found in three of six patients in the artificial divergence group and in two of five patients in the combined group. CONCLUSION: With less muscle surgery, the artificial divergence and combined operations gave better vision improvement than the Anderson-Kestenbaum operation.

Adolescent↗

Double gallbladder treated successfully by laparoscopy.

A rare case of true duplication of the gallbladder is herein reported on a young male patient with other congenital abnormalities. Both gallbladders had unequivocal signs of chronic inflammatory disease and lithiasis. The patient was diagnosed preoperatively as having acute cholecystitis but the diagnosis of an accessory gallbladder was made only at the time of surgery. Emphasis is placed on the use of a complete cholangiographic evaluation before proceeding with the operation in order to prevent inadvertent damage to the biliary ductal system. The accessory gallbladder must then be removed to avoid an unnecessary reoperation. All of this can be accomplished readily by laparoscopic surgery.

Adult↗

Low-dose octreotide treatment is not effective in patients with advanced pancreatic cancer.

Octreotide (SMS 201-995), a long-acting somatostatin analogue, has been shown to decelerate growth of human pancreatic cancer in vitro and in vivo. We analyzed the efficacy of octreotide treatment in 22 patients (14 men, 8 women) with histologically verified ductal pancreatic cancer. All patients had advanced tumor stages (stage III: 13 patients; stage IV: 9 patients). Octreotide was given by self-administered subcutaneous injection (3 x 100 micrograms/day). When there was evidence of tumor progression, the dose of octreotide was increased to 3 x 200 micrograms/day. A monthly follow-up, including clinical status, CT scan or ultrasonography, and tumor marker carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 determination was carried out. There were no severe side effects apart from slight burning sensation at the injection site. No partial or complete remission was seen. Eighteen patients showed tumor progression with a median survival time of 17 weeks (range 3-42 weeks). In three patients a "no change" evaluation with a median survival time of 46 weeks (range 40-68 weeks) was registered. In these three patients the serum tumor markers CA 19-9 and CEA did not show an increase to more than twice the baseline value during this time. One patient discontinued the octreotide treatment because of tumor progression. The results of the analysis indicate that low-dose octreotide treatment is not effective in patient suffering from advanced tumor stages of pancreatic cancer.

Adenocarcinoma↗

Skin prick tests with solutions of acid anhydrides in acetone.

Various low molecular acid anhydrides can act as haptens and induce type I allergies. Immunoglobulin E can be detected by radioallergosorbent test (RAST) with the protein conjugates of the respective anhydrides, which are commercially available for some substances. Being almost nonsoluble in water, these species cannot be applied in a skin prick test as a water solution. We will introduce a practicable skin prick test using acetonic solutions of the haptens. 136 persons were tested with acetone for negative control and histamine for positive control. Tests were carried out with 1 and 5% acetonic solutions of phthalic anhydride (PA). The RASTs with conjugates of the PA were performed with 111 subjects who had been exposed to acid anhydrides and with 5 people who possibly had been exposed. In 14 cases, when immediate-type allergy was suspected clinically, a test was performed in addition to the respective anhydride used at the workplace. In order to avoid unspecific histamine liberation, we tested 20 volunteer control persons who had not been occupationally exposed to acid anhydrides. In the prick test performed with acetonic PA solutions, 10 of the occupationally exposed subjects, who had also had a positive result in the RAST with protein conjugates of the PA, showed positive skin reactions, and in 2 further cases, in which the skin reaction was positive, the results of the RAST were just below the limit of a positive evaluation. The skin reaction was positive in 4 cases, in spite of a negative RAST result, while the prick test was reported to be negative in 3 cases although the RAST results were considered to be positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetone↗

Effects of a bronchoprovocation challenge test with cigarette sidestream smoke on sensitive and healthy adults.

In order to study the acute effects of environmental tobacco smoke on lung function, a cigarette sidestream smoke provocation test (analogous to a nonspecific bronchial provocation test) was performed. Ten persons with airways hyperreactive to methacholine and ten normoreactive persons were tested. A dose-response relationship was found for symptoms. The lung function of the normoreactive persons was not altered by short-time inhalation of sidestream smoke. The hyperreactive subjects, however, experienced significant decreases in FEV1, FVC, and MEF50. The decrease was most pronounced after the lowest dose of 2 ppm smoke-induced CO, leading to a mean fall of 6.3 percent in FEV1. Five of ten subjects with hyperreactive airways showed a decrease in FEV1 of more than 10 percent during the sidestream smoke provocation, one of them a decrease of over 20 percent after inhalation of 16 ppm CO sidestream smoke. We conclude that even short exposure to low concentrations of cigarette sidestream smoke causes significant impairment of lung function in sensitive persons.

Adult↗

Sinus CT scan: an essential in sinus disorders and surgery.

This paper stresses the importance of CT scans in the evaluation of sinus disorders and in providing valuable anatomic information to the sinus surgeon to reduce the risks of surgical complications. The scans may also detect discreet pathology, otherwise missed, that may be responsible for unexplained symptoms like headache, facial pains, cough, midfacial congestion and postnatal drip. The CT technique and limitations are briefly discussed. The MRI is not recommended as a routine study in sinus disorders.

Chronic Disease↗