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Biomedical subjects

A Wolf

Publications and source records attributed to A Wolf.

At least 217 records · Page 12Linked to original sources
PubMed1992

[Comparison of different blood flow parameters for evaluating blood flow spectra in fetal growth retardation].

Uteroplacental and foetoplacental vascular resistance is generally high in pregnancies complicated by intrauterine growth retardation. Assessment of flow velocity curves using angle-independent indices as A/B ratio, resistance index (RI) or pulsatility index (PI) cannot classify all cases with pathological flow velocity profiles. Beneath the pulsatility the maximum frequency outline of the flow velocity waveform offers additional clinical information. The evaluation of flow velocity curves using polynome analysis (including III degrees) provides additional data including occurrence of diastolic notching and can be used as a more sensitive indicator of impaired uteroplacental blood flow. In such pregnancies accurate evaluation of the maximum flow velocity outline with polynome analysis has been shown to be an important qualitative criterion in the assessment of blood flow velocity waveforms.

Blood Flow Velocity↗
PubMed1992

Frequency of intra-abdominal injury in cases of blunt trauma to the cervical spinal cord.

Historically, early management of the blunt trauma victim with hemodynamic instability and cervical spinal cord injury has been hampered by the physician's inability to perform an accurate physical examination. Invasive and time-consuming diagnostic tests are often run to check for the presence of occult intra-abdominal injuries. For this reason, we decided to study these patients by reviewing a clinical registry to assess the frequency of intra-abdominal injuries in cases of cervical spinal cord trauma. We hypothesized that intra-abdominal injury would occur infrequently in cases of blunt trauma to the cervical spinal cord. In fact, data from the Maryland Institute for Emergency Medical Services Systems revealed that blunt trauma victims with cervical cord injury rarely (2.6%) sustained intra-abdominal wounds. Further analysis of this population revealed that specific mechanisms of trauma and the presence of hemodynamic instability and other major injuries were factors strongly associated with occult intra-abdominal injury. In light of these findings, we have outlined a protocol for management of these patients that is geared toward more rapid stabilization of the injured spinal column.

Abdominal Injuries↗
PubMed1992

Isolated granulocytic sarcoma of the ovary: histologic, electron microscopic, and immunohistochemical findings.

An isolated granulocytic sarcoma (myelosarcoma) of the right ovary occurred in the absence of leukemia in a 49-year-old woman. The diagnosis of this tumor, which occurs extremely rarely in the ovary, was established by light microscopic, immunohistochemical, and electron microscopic investigations. The major cell population consisted of immature myeloid cells; scattered megakaryocytes were also seen. The tumor exhibited a prominent cellular stroma with scattered follicle-like collections of B-lymphocytes and many fibroblasts, giving the initial impression that the tumor could be of mesenchymal origin. Twelve months after operation, the patient still exhibits no evidence of leukemia.

B-Lymphocytes↗
PubMed1992

Optic nerve decompression surgery improves visual function in patients with pseudotumor cerebri.

Papilledema from pseudotumor cerebri can cause severe loss of visual acuity and visual field. We performed optic nerve decompression surgery on 17 patients with pseudotumor cerebri who, despite maximum conventional therapy, developed progressive loss of visual acuity and/or visual field. Postoperatively, visual acuity improved or stabilized in 33 of 34 eyes (97%). Visual fields improved in 20 of 21 eyes that underwent surgery. Optic nerve decompression surgery relieves local cerebrospinal fluid pressure on the optic nerve. Progressive loss of visual function associated with pseudotumor cerebri can be reversed or stabilized with optic nerve sheath decompression surgery.

Adolescent↗
PubMed1992

Uteroplacental diastolic notching in 510 uneventful pregnancies.

In a collective of 510 patients with uneventful pregnancies and deliveries the rate of waveform notching in the uteroplacental flow velocity pattern was examined. Notching appeared to be significantly more frequent in the uterine than arcuate artery. It was unilateral and mainly affected placenta-contralateral sites. Bilateral notching or notching on placental site were the exception. In both flow patterns notching was seen to increase as pregnancy progressed and was slightly higher in the third compared to the second trimester.

Blood Flow Velocity↗
PubMed1992

[Uteroplacental circulation in growth retardation--experiences with the clinical use of continuous-wave Doppler].

Doppler ultrasound measurement of blood flow velocity represents a non-invasive method of studying uteroplacental and feto-placental haemodynamics. Using a continuous-wave Doppler device, the blood flow velocity was examined in the uterine and arcuate arteries, as well as in the umbilical artery in 81 patients demonstrating fetal growth retardation. An increase in vessel resistance was found in the uterine and arcuate arteries in most of the patients. In addition, patients with fetal retardation showed a significantly higher rate of diastolic notching and incomplete registration of uterine and arcuate wave forms, especially in pregnancies complicated by hypertension. The implementation of the continuous-wave technique as a simple Doppler system allows differential evaluation of placental function and provides information on the nutritional supply to the fetus.

Blood Flow Velocity↗
PubMed1992

[Evaluation of the pulsatile curve of the placental blood flow profile by polynomial analysis].

The analysis of uterine and umbilical blood flow velocities using A/B ratio, resistance index and pulsatility index has shown to be a highly specific and sufficiently sensitive method in the evaluation of high risk pregnancies. In situations of high peripheral vascular resistance diastolic velocities are low and index values are high. Additional information of flow velocities curves, as diastolic notching, is not represented in the indices commonly used. A mathematical model was established using polynom analysis of blood flow velocity curves. In a group of 78 patients with intrauterine growth retardation polynome analysis of uteroplacental flow velocity curves was more sensitive than resistance index and pulsatility index.

Blood Flow Velocity↗
PubMed1992

[Obstetric cw-Doppler--results of a study of normal values. Effect of different variables on results].

Using a 4 MHz continuous wave Doppler device reference values for resistance index (RI) and pulsatility index (PI) of uterine and arcuate arteries as well as umbilical artery were established based on 510 patients with uneventful pregnancies and deliveries. Percentiles are more suitable localisation gauge than are standard deviations. Neither RI nor PI of maternal arteries proved to be dependent on gestational age in the observation period. If the heart rate are in physiological ranges no clinically relevant effect on the results were observed in either the maternal of the foetal copartment. By contrast umbilical artery shows a definite linear relation between the indices measured and gestational age. A significant effect of placental site on the measurement was found in both, uterine and arcurate arteries, but only the differences found in arcuates were of clinical value. An increase of diastolic notching was observed in both, uterine and arcuate arteries during pregnancy. Mostly only one vessel showed diastolic notching when observed in normal pregnancy. With a lateralized placenta the condition was more probable on the contralateral site.

Blood Flow Velocity↗
PubMed1992

[Ovarian stimulation with clomiphene is not a risk factor for extrauterine pregnancy].

In a retrospective cohort study of 252 patients with ectopic pregnancies the possible association between use of clomiphene citrate and the occurrence of an ectopic pregnancy was examined. Seventeen out of 252 patients had been treated with clomiphene. Epidemiologic data and animal experiments suggest, that there may be a role of clomiphene in the etiology of ectopic pregnancy. Marchbanks et al. [6] reported that patients who used clomiphene were found to have a relative risk of 10.0 for ectopic pregnancy. The analysis of our own data show an accumulation of classic risk factors as history of pelvic inflammatory disease or of microsurgery for treatment of tubal disease in the clomiphene group. The higher rate of ectopic pregnancies in patients who have been treated with clomiphene is more likely associated with the diagnosis of infertility than with the use of ovulatory-inducing agents. Clomiphene treatment is no independent risk factor in the etiology of ectopic pregnancy.

Clomiphene↗
PubMed1991

In vitro studies of multiple impact injury to mammalian CNS neurons: prevention of perikaryal damage and death by ketamine.

We have developed an in vitro model of rapid acceleration injury (RAI) to study the effects of multiple impact (220 g/impact, 3-5 s intervals) trauma on cultures of mammalian CNS cells. Our initial investigations have shown that: (1) multiple impacts delivered tangential to the plane of growth caused neuronal death while normal impacts did not; (2) glia were not affected by tangential or normal RAI; (3) most neuronal death occurred within 15 min; (4) the threshold for neuronal death was above 440 g (cumulative); (5) neuronal death reached a maximum of 50% at cumulative accelerations greater than or equal to 1100 g; (6) somal swelling and increased nuclear prominence were often observed after tangential RAI, and the frequency of these changes increased with the cumulative acceleration; and (7) ketamine prevented neuronal death and morphological changes during tangential RAI. We hypothesize that neuronal sensitivity to multiple impact RAI depends on the density of N-methyl-D-aspartate (NMDA) complexes in the dendrosomatic membranes. We also hypothesize that the events leading to neuronal death during multiple impact injury are: (1) calcium leakage through NMDA channels causes weakening of the cytoskeleton; (2) loss of cytoskeletal integrity allows nuclear shifting during impact; and (3) nuclear pressure disrupts the plasmalemma causing a lethal influx of calcium.

Animals↗
PubMed1991

The effect of lysophosphatidylcholine on coronary and renal circulation in the rabbit.

It has been shown that different lysophosphatidylcholines (LPC) possess relaxing properties in vascular strips. We report on the effect of intraatrial injection of LPC micelles into white New Zealand rabbits. Changes in renal and coronary flow were determined by radioactive microspheres. Coronary blood flow increased significantly following administration of LPC, while no significant changes were observed in renal blood flow, cardiac output and myocardial contractility. Coronary, renal and total vascular resistance, as well as mean arterial pressure, dropped significantly. Cardiac arrhythmia and hemolysis were not noted. The results demonstrate the vasorelaxant effect of LPC in vivo.

Animals↗
PubMed1991

Effects of polychlorinated biphenyls in rat liver: correlation between primary subcellular effects and promoting activity.

In the present study the promoting activity of various PCB and PBB isomers and congeners in rat liver has been studied and compared with a variety of primary xenobiotic-mediated enzymatic changes in this target organ. Female Wistar rats were given diethylnitrosamine (DEN; 10 mg/kg body wt for 10 days) and were subsequently treated once weekly with polychlorinated biphenyls (150 or 15 mumol/kg body wt) for a total of 8 weeks. Additional groups of rats were administered 3,3',4,4'-tetrabromobiphenyl or 3-methylcholanthrene (8 weekly injections of 15 or 150 mumol/kg body wt, respectively) or were given phenobarbital (0.05% in the diet) until the end of the experiment. Reference groups were treated with the various test compounds without prior initiation. One week and 9 weeks after cessation of promoter treatment rats were killed and the volumetric fraction of enzyme-altered foci characterized by changes in adenosine triphosphatase and gamma-glutamyl transpeptidase activity was determined as a means to quantitatively assess the extent of preneoplastic response in this organ. Out of the series of polyhalogenated biphenyls tested, promoting effects were seen with the following compounds: 2,2',4,5'-tetrachlorobiphenyl, 3,3',4,4'-tetrachlorobiphenyl, 2,3,4,4',5-pentachlorobiphenyl, and 3,3',4,4'-tetrabromobiphenyl, whereas no significant effects were obtained with 4-monochlorobiphenyl. In rats not treated with DEN, the two strongly promoting agents 2,3,4,4',5-pentachlorobiphenyl and 3,3',4,4'-tetrachlorobiphenyl also significantly increased the volume fraction of enzyme-altered foci over the respective controls when analyzed at the second time point of investigation. In parallel experiments, induction of liver growth and of microsomal cytochrome P450 content in liver was found to correlate well with the promoting activity of the various xenobiotics, suggesting that these parameters may be used to predict the promoting activity of polyhalogenated biphenyls in a short term assay.

Adenosine Triphosphatases↗
PubMed1991

The use of anterior Caspar plate fixation in acute cervical spine injury.

Optimal management of cervical cord injury in the presence of documented instability and/or compression of neural elements remains a controversial topic. Surgery and internal stabilization of cervical spine fracture/dislocations are effective and well accepted, but controversy exists on the relative merits of the anterior versus the posterior approach as well as the optimal timing of surgical intervention. We report our experience with the Caspar technique and instrumentation for anterior stabilization in 54 patients for acute cervical spine injury. Our series consists of 38 male and 16 female patients whose ages ranged from 16 to 68 years, with a mean age of 29.2 years. Thirty-two of these patients had complete neurological sensory/motor deficits at the time of presentation, eight were neurologically intact, and 14 had preservation of some motor and sensory function. All 54 patients had radiographic evidence of posterior instability as well as anterior disruption of either a vertebral body or intervertebral disk. We found that "early" intervention (less than 24 hours after injury) was performed frequently in the neurologically compromised patients. Twelve of the 22 patients undergoing surgery less than 24 hours after admission regained significant neurological function, with 13 of 22 developing postoperative complications. In the "delayed" group (surgery more than 24 hours after injury, mean 14.3 days), 14 patients experienced postoperative complications, with 15 of 24 demonstrating neurological improvement. The eight patients who were intact did uniformly well. There was no mortality during the follow-up. All 54 patients showed a solid fusion (clinically and radiologically) within 6 months of surgery. In two cases the plates had to be removed, without risking the fusion. Our experience suggests that although anterior cervical fusion and Caspar plating remain appropriate for patients with documented anterior compromise of the canal, it should not substitute for more traditional posterior stabilization procedures. Because this route has the potential for more serious complications, it should be reserved for the cases in which anterior decompression is deemed necessary or posterior fusion was unsuccessful. With appropriate selection of patients, no adverse effect of early surgery was demonstrated. In fact, neurologically compromised patients had the benefits of increased ease of patient care and early transfer to rehabilitation.

Adolescent↗
PubMed1991

Effect of orotic acid on the generation of reactive oxygen and on lipid peroxidation in rat liver.

The pyrimidine precursor orotic acid (OA) is a constituent of dairy products and therapeutic drugs. Several recent publications point towards a tumor promoting activity of OA in rat liver. An increased production of reactive oxygen has been discussed as a possible mechanism, leading to lipid peroxidation and DNA single strand breaks. In view of contradictory results, this postulated prooxidative action of OA was reexamined with new experimental techniques. Weanling Sprague-Dawley rats were fed 1% OA in different diets for 4-35 days. The NADPH-mediated lipid peroxidation in liver homogenate and microsomes was determined in vitro by analysis of low-level chemiluminescence (CL) and the strongly correlated formation of malondialdehyde (MDA). In no case did treatment with OA result in an increase of lipid peroxidation in vitro nor did such treatment enhance the generation of reactive oxygen as measured by lucigenin CL. In accordance, the total cytochrome P-450 content as well as the activity of individual P-450 isoenzymes were unchanged. Treatment with OA did not elevate the MDA content of fresh liver homogenate when butylated hydroxytoluene (BHT) was present in the test system. However, when the antioxidant was omitted, increased levels of thiobarbituric acid reactive material were found which correlated with the triglyceride content. This could explain some published data that have been taken as indication for a prooxidative action of OA. Evidence against an increased lipid peroxidation in vivo is given by the analysis of ethane exhalation. Furthermore, no increase in DNA single strand breaks by OA treatment could be observed by the alkaline elution technique. These results do not support the hypothesis of a prooxidative activity of OA. The observed reversible decrease of the GSH/GSSG ratio is assumed to result from the reduced size of the phosphopyridine nucleotide pool due to purine deficiency and an increased consumption of NADPH by the enhanced reductive degradation of pyrimidines.

Administration, Oral↗
PubMed1991

[Continuous-wave Doppler ultrasound in the 2d and 3d trimester of pregnancy--normal values].

Based on 427 patients with uneventful pregnancies and deliveries standard rates were established for the resistance index (RI) and the pulsatility index (PI) of the uterine, arcuate, and umbilical arteries. Percentiles, above all the 90th percentile, are more suitable localisation gauge than are standard deviations. In the observation period, i.e. from 18th to 42nd week of gestation, neither resistance nor pulsatility Index in the utero-placental compartment proved to be dependent on gestational age to any significant degree. By contrast, the umbilical artery showed a definite linear relation between the indices measured and gestational age. If the heart rates are in physiological ranges no clinically relevant effects of the heart rate on the measurement results were observed in either the maternal or the foetal compartment.

Blood Flow Velocity↗