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Biomedical subjects

B Bauer

Publications and source records attributed to B Bauer.

252 records · Page 14Linked to original sources
PubMedDate not supplied

Deterioration in myocardial blood flow following relief of sustained ischemia is not associated with release of endothelin into the coronary sinus.

Numerous studies have described a progressive deterioration in resting myocardial blood flow following relief of sustained ischemia in both necrotic and salvaged myocardium (termed "no reflow" and "low reflow", respectively). We sought to determine whether release of the potent vasoconstrictor peptide endothelin-1 may play a role in these phenomena. As part of a previous study in our laboratory, 14 anesthetized open-chest dogs underwent 1 h of coronary artery occlusion and 4 h of reperfusion, while 2 dogs served as time-matched sham-operated controls (artery isolated but not occluded). Regional myocardial blood flow was measured by injection of radiolabeled microspheres at 30 min and 4 h post reflow; endothelin-1 concentrations in the coronary sinus were determined by radioimmunoassay at baseline, during coronary occlusion and at 30 min and 4 h after reperfusion; and the extent of myocardial necrosis was delineated by post-mortem tetrazolium staining. As expected, in dogs subjected to ischemia/reperfusion, regional myocardial blood flow deteriorated between 30 min and 4 h post reflow in both the subendocardium (1.40 +/- 0.30 versus 0.48 +/- 0.06 ml/min/g; p = 0.003; reflecting a mixture of no reflow and low reflow) and subepicardium (0.84 +/- 0.08 versus 0.64 +/- 0.07 ml/min/g; p = 0.03; due to low reflow). However, endothelin levels showed only a modest and nonsignificant increase during the protocol (4.1 +/- 0.5, 4.7 +/- 0.2 and 4.9 +/- 0.6 pg/ml plasma at baseline, 30 min and 4 h post reflow; p = NS), and regression analysis revealed no correlation between release of endothelin and deterioration in blood flow in either myocardial layer. Moreover, the sham-operated controls showed a similar modest increase in endothelin levels, with no change in myocardial perfusion during the course of the protocol. We therefore conclude that deterioration in myocardial blood flow following relief of sustained ischemia in the anesthetized open-chest dog is not associated with release of endothelin-1 into the coronary sinus.

Animals↗
PubMedDate not supplied

Quality of life as an indicator for successful geriatric inpatient rehabilitation-a validation study of the 'Vienna List'.

Quality of life (QoL) appears as an adequate outcome measure of geriatric rehabilitation since it reflects its major goals in terms of improvement in self-service, mobility, interpersonal behavior and communication. The objective of the present study was the application of a newly developed instrument, the 'Vienna List', in this context. Its sensitivity to detect changes during geriatric rehabilitation and the ability to differentiate between various diseases and disturbances of functional abilities has been investigated. The total population of patients of one geriatric rehabilitation clinic of 1 year (from November 2001 to October 2002; N=683) was evaluated at admission and discharge by means of this proxy rating. Several reasonable differences appeared between seven diagnostic groups as well as between admission and discharge concerning crucial areas, which are the focus of geriatric rehabilitation such as communication and mobility and which reflect an improved QoL. On the other hand, some factors remained mostly unaffected, e.g. negative affect and bodily contact. The 'Vienna List' which was originally developed for the assessment of QoL in severely demented patients, proved to be a useful, differentiating, less time-consuming and practical tool for the documentation of the outcome of geriatric inpatient rehabilitation.

Aged↗
PubMedDate not supplied

Headache caused by a sphenoid mucocele but presenting as an ergotamine-induced headache.

In a 65-year-old woman, symptomatic headache caused by a mucocele of the sphenoid sinus led to ergotamine abuse and subsequent ergotamine-induced headache. Since there were no neurological symptoms initially and the patient previously suffered from migraine, the mucocele was not recognized. Only after unsuccessful drug withdrawal therapy and an MRI, was the correct diagnosis made. Surgical removal of the mucocele led to complete relief of headache within 3 weeks. We conclude that ergotamine-induced headache can develop on the basis of symptomatic headache. In spite of the effectiveness of ergotamine tartrate, an MRI should be performed if focal neurological symptoms occur.

Aged↗
PubMedDate not supplied

Effects of nifedipine and indomethacin on leukotriene C4- and D4-induced coronary constriction at normal and reduced coronary perfusion in dogs.

The effects of intracoronary leukotriene C4 (LTC4) and D4 (LTD4) (both 0.1 microgram/kg) were studied in 23 anesthetized open-chest dogs at normal (= mean aortic pressure) and reduced (51 +/- 2 and 32 +/- 2 mm Hg) coronary perfusion pressures. The left anterior descending coronary artery was cannulated and blood flow measured. Subendocardial fiber segment length was obtained with ultrasonic crystals. At normal coronary perfusion pressure, LTC4 and LTD4 reduced coronary blood flow from 81 +/- 6 and 78 +/- 7 ml/min per 100 g by 41 +/- 4% and 41 +/- 4% (both p less than 0.0005), respectively. However, segment length shortening was not depressed by LTC4 or LTD4. At reduced coronary perfusion pressure, LTC4 and LTD4 diminished coronary blood flow from 35 +/- 5 and 32 +/- 3 ml/min per 100 g, by 28 +/- 5% (p less than 0.0025) and 30 +/- 5% (p less than 0.005). Thus, reduction of coronary blood flow was less by both LTC4 (p less than 0.01) and LTD4 (p less than 0.05) at reduced rather than at normal coronary perfusion pressure. Segment length shortening was depressed by LTC4 from 6.5 +/- 1.2% to 2.4 +/- 1.6% (p less than 0.05) and by LTD4 from 5.6 +/- 1.4% to 3.1 +/- 0.9% (p less than 0.05), respectively. Indomethacin (5 mg/kg, i.v.) and nifedipine (10 micrograms/kg, i.v.) did not abolish the LT-induced coronary artery constriction. However, in animals pretreated with indomethacin or nifedipine, reduction of coronary blood flow by LTs was not attenuated at reduced coronary perfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Retinopathy and nephropathy in insulin-dependent diabetics: an inconsistent relationship?

The association between retinopathy and nephropathy was investigated in a retrospective study of 52 insulin-dependent diabetics with preproliferative or proliferative retinopathy and in 48 patients without or with background retinopathy. The duration of diabetes was 23.2 +/- 1.0 years (mean +/- SEM) and 22.0 +/- 1.2 years in the two groups. Patients in the retinopathy group showed a higher frequency of detectable nephropathy and were more often treated with antihypertensive drugs. However, a high proportion (35%) of patients with proliferative retinopathy did not show any detectable signs of nephropathy. Furthermore, nephropathy did not seem to develop in patients with retinopathy during an observation period of up to 9 years. The data suggest that the factors underlying the development of retinal and renal microangiopathy might be of different origin.

Adolescent↗
PubMedDate not supplied

Sumatriptan and ergotamine overuse and drug-induced headache: a clinicoepidemiologic study.

Drug-induced headache, particularly ergotamine-induced headache, is a common problem in migraine treatment. Some case reports suggest that even the new serotonergic antimigraine drugs such as sumatriptan can lead to overuse and subsequent drug-induced headache. We performed a controlled study to identify the rate of sumatriptan overuse and sumatriptan-induced headache and compared it to the rate of ergotamine overuse and ergotamine-induced headache. Two thousand sixty-five consecutive heachache patients, all experienced in intake of sumatriptan (n = 631) or ergotamine (n = 620), were enrolled over a three-year study period. The rates of overuse and drug-induced headache and the clinical features of the subgroups were compared. Risk factors for sumatriptan overuse were identified. The rates of ergotamine and sumatriptan overuse were 14.2% and 3.5%, respectively (p < 0.001). Drug-induced headache could be found more frequently in cases of ergotamine overuse than in cases of sumatriptan overuse (68% versus 32%; p < 0.01). Development of sumatriptan overuse was most common in patients with previous drug-induced headache (68%), combined headache as the primary headache type (45%), and subcutaneous application of sumatriptan (45%). We conclude that sumatriptan intake can lead to overuse and subsequent drug-induced headache. The risk for overuse and drug-induced headache is significantly lower than in patients with ergotamine intake. This might be caused in part by the relatively short period of sumatriptan availability on the market. The new generation of serotonin-1B/D-receptor agonists in the treatment of headache should have a potential for overuse similar to that of traditional headache drugs.

Adult↗
PubMedDate not supplied

Median cleft face syndrome: MR and CT data from 11 children.

Examination (including CT and magnetic resonance studies) of 11 unrelated children with median cleft face syndrome revealed 6 (55%) with dense calcification of the falx and 5 (45%) with interhemispheric lipoma. Of the 11 children, 3 exhibited Sedano facies type A, 4 exhibited Sedano facies type B, and 4 exhibited Sedano facies type D. Type A patients had no calcification or lipoma. Two of three type A patients were products of separate twin gestations, the only twins in the series. Type B patients had frequent falx calcification (three of four) and interhemispheric lipoma (two of four). Two of the four type B patients had concurrent Goldenhar syndrome, the only such patients in the series. Type D patients also had frequent falx calcification (three of four) and interhemispheric lipoma (three of four). Patients with median cleft face syndrome and Sedano facies type B or D should be examined radiologically for concurrent intracranial pathology.

Brain Neoplasms↗