Telemedicine project RATEMA--radiation accident telecommunication medical assistance system.
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
B Fischer
Publications and source records attributed to B Fischer.
Three-dimensional helical CT of the tracheobronchial tree: evaluation of imaging protocols and assessment of suspected stenoses with bronchoscopic correlation.
OBJECTIVE: To assess the accuracy of three-dimensional (3D) helical CT of normal airways, we evaluated different imaging protocols in test objects and patients. The clinical value of 3D helical CT was composed with bronchoscopy in patients with suspected stenoses, especially before and after endobronchial procedures. SUBJECTS AND METHODS: Solid test objects--one of central airways and one of peripheral airways--were scanned and assessed for volume defects and stairstep artifacts. Fifty helical studies were performed in 36 patients. We evaluated these images for visualization of segmental bronchi; frequency of artifacts; and presence, localization, and degree of stenoses. Bronchoscopic correlation was available for 40 CT examinations. Follow-up 3D helical CT after endobronchial procedures was performed in nine patients. RESULTS: In test objects, thin sections reduced volume artifacts. Overlapping sections mainly diminished stairstep artifacts. In vivo, overlapping sections were superior to contiguous sections for good visualization of the origin (96% versus 89%, p < .01) and of the course (75% versus 54%, p < .001) of segmental bronchi. Three-dimensional helical CT allowed us to assess accurately 36 of 36 central stenoses that were seen on bronchoscopy; however, on 3D helical CT, we missed two of three segmental stenoses. At bronchoscopy, 18 stenoses could not be passed, whereas 3D helical CT provided details for possible endobronchial procedures: length of stenosis, patency (12/18), and spatial orientation of distal bronchi. Follow-up 3D helical CT documented the efficacy of endobronchial treatment. CONCLUSION: Three-dimensional helical CT based on thin overlapping sections accurately visualized the normal airways down to the origin of the segmental bronchi and central stenoses. When it complements bronchoscopy, 3D helical CT allows visualization beyond stenoses, supports planning of endobronchial procedures, and may even substitute for bronchoscopy after endobronchial procedures.
Adult↗
Less common orbital fracture patterns: the role of computed tomography in the management of depression of the inferior oblique origin and lateral rectus involvement in blow-in fractures.
During the past decade, advances in radiographic imaging have made it possible for the surgeon managing orbital fractures to adopt a rational therapeutic strategy based on a knowledge of alterations in surgical anatomy secondary to traumatic injury. To illustrate the value of computed tomography in the surgeon's armamentarium for management of orbital fractures, cases are presented in which imaging proved decisive in planning a course of therapy. Two patients presented with two types of isolated lateral blow-in fracture, an uncommon fracture pattern. The other cases underscore the value of defining involvement of the inferior oblique origin and lateral rectus muscles in imaging complex orbital fractures, issues not emphasized in earlier literature. Although diplopia alone does not always warrant surgical intervention, diplopia in the context of computed tomography-defined muscle entrapment or muscle origin displacement justifies operative therapy. These cases demonstrate the value of computed tomography in directing surgical therapy with resolution of diplopia and prevention and correction of enophthalmos.
Accidental Falls↗
[Modern methods for detecting exocrine pancreas insufficiency in mucoviscidosis].
Explore the source record for details and available documents.
Cystic Fibrosis↗
[Therapy and prognosis of tuberculosis].
Treatment and prognosis of tuberculosis. Worldwide the so-called short-course chemotherapy has become the standard treatment for tuberculosis. The 6-month regimen consists of isoniazid, rifampin, and pyrazinamid given for 2 month followed by isoniazid and rifampin for 4 month. Ethambutol or streptomycin is added in the first 2 month in patients with advanced disease. This recommendation applies to both HIV-infected and uninfected persons. The major determinant of the outcome of treatment is patient adherence to the drug regimen. In susceptible strains the success rate with the 6-month regimen in sputum conversion is far beyond 90% within the first two month of therapy. The relapse rate after 3 to 5 years is about 0-3%. Multiple-drug-resistant tuberculosis (i.e., resistance to at least two drugs) presents difficult treatment problems. Treatment must be individualized and based on susceptibility studies. For patients with tuberculosis that is resistant to rifampin and isoniazid, even the best available treatment is often unsuccessful. The role of new agents such as the quinolone derivatives and amikacin in the treatment of multidrug-resistant disease is not known, although these drugs are commonly being used in such cases.
AIDS-Related Opportunistic Infections↗
Catheter ablation of permanent junctional reciprocating tachycardia with radiofrequency current.
OBJECTIVES: This study evaluated accessory pathway location, its relation to retrograde P wave polarity on the surface electrocardiogram and radiofrequency ablation efficacy and safety in a large group of patients with permanent junctional reciprocating tachycardia. BACKGROUND: Permanent junctional reciprocating tachycardia is an uncommon form of reciprocating tachycardia, almost incessant from infancy and usually refractory to drug therapy. It is characterized by RP > PR interval and usually by negative P waves in leads II, III, aVF and V4 to V6. Retrograde conduction occurs through an accessory pathway with slow and decremental properties. Although this accessory pathway has been classically located in the posteroseptal zone, other locations have been recently reported. METHODS: The study included 32 patients (20 men, 12 women, mean [+/- SD] age 29 +/- 15 years) with a diagnosis of permanent junctional reciprocating tachycardia confirmed at electrophysiologic study. Seven patients had depressed left ventricular function. Radiofrequency energy was applied at the site of the earliest retrograde atrial activation during tachycardia. RESULTS: There were 33 accessory pathways. The site of the earliest retrograde atrial activation was posteroseptal in 25 patients (76%), midseptal in 4 (12%), right posterior in 1 (3%), right lateral in 1 (3%), left posterior in 1 (3%) and left lateral in 1 (3%). Thirty pathways were ablated with a right approach; in 11 patients with posteroseptal pathway the ablation was performed through the coronary sinus. Three pathways were ablated with a left approach. Positive retrograde P wave in lead I suggested that ablation could be performed from the right side; if negative, it did not exclude ablation from this approach. All the accessory pathways were successfully ablated, with a median of 3 and a mean of 5.6 +/- 5 radiofrequency applications of 70 +/- 26 s in duration. In two patients with the accessory pathway in the midseptal zone, a transient second- and third-degree atrioventricular block, respectively, was observed after ablation. At a mean follow-up of 18 +/- 12 months, 31 patients (97%) are asymptomatic without antiarrhythmic therapy (95% confidence interval [CI] 84% to 99%). Recurrences were observed in four patients (13%) (95% CI 4% to 29%), three of whom had the accessory pathway ablated successfully at a second session. All patients with depressed left ventricular function showed a marked improvement after successful ablation. CONCLUSIONS: In our experience, most of the patients with permanent junctional reciprocating tachycardia had posteroseptal pathways; all these pathways were ablated from the right side. P wave configuration may be helpful in suggesting the approach to the site of ablation. Catheter ablation using radiofrequency energy is an effective therapy for permanent junctional reciprocating tachycardia.
Adolescent↗
Purification of recombinant human coagulation factors II and IX and protein S expressed in recombinant Vaccinia virus-infected Vero cells.
Recombinant human coagulation factors II and IX and recombinant human protein S were expressed by the Vaccinia virus expression system in Vero cells and isolated from the serum-free media. All three recombinant proteins were purified by the same universal strategy. After concentration by anion exchange chromatography, recombinant coagulation factors were purified by anion exchange filtration in the presence of Ca2+. The addition of Ca2+ to the vitamin K-dependent coagulation factors modified their physico-chemical behavior during anion exchange chromatography and resulted in the separation of the recombinant coagulation proteins from contaminating proteins.
Animals↗
The three-loop model: a neural network for the generation of saccadic reaction times.
This paper presents a computer simulation of the three-loop model for the temporal aspects of the generation of visually guided saccadic eye movements. The intention is to reproduce complex experimental reaction time distributions by a simple neural network. The operating elements are artificial but realistic neurones. Four modules are constructed, each consisting of 16 neural elements. Within each module, the elements are connected in an all-to-all manner. The modules are working parallel and serial according to the anatomically and physiologically identified visuomotor pathways including the superior colliculus, the frontal eye fields, and the parietal cortex. Two transient-sustained input lines drive the network: one represents the visual activity produced by the onset of the saccade target, the other represents a central activity controlling the preparation of saccades, e.g. the end of active fixation. The model works completely deterministically; its stochastic output is a consequence of the stochastic properties of the input only. Simulations show how multimodal distributions of saccadic reaction times are produced as a natural consequence of the model structure. The gap effect on saccadic reaction times is correctly produced by the model: depending only on the gap duration (all model parameters unchanged) express, fast-regular, and slow-regular saccades are obtained in different numbers. In agreement with the experiments, bi- or trimodal distributions are produced only for medium gap durations (around 200 ms), while for shorter or longer gaps the express mode disappears and the distributions turn bi- or even unimodal. The effect of varying the strength of the transient-sustained components and the ongoing activity driving the hierarchically highest module are considered to account for the interindividual variability of the latency distributions obtained from different subjects, effects of different instructions to the same subject, and the observation of express makers (subjects who produce exclusively express saccades). How the model can be extended to describe the spatial aspects of the saccade system will be discussed as well as the effects of training and/or rapid adaptation to experimental conditions.
Computer Simulation↗
Complement C1q and C3 mRNA expression in the frontal cortex of Alzheimer's patients.
The levels and cellular localization of mRNA for complement C1q and C3 were examined by RNA gel blot and nonradioactive in situ hybridization in the frontal cortex of patients with Alzheimer's disease (AD) and age-matched controls. We found that the hybridization signal for C1q mRNA was markedly increased (approx. 3.5-fold) in the frontal cortex of AD patients compared to that in age-matched controls. In contrast to previous reports we also found that the levels of C3 mRNA, although well expressed, did not differ significantly between AD cases and age-matched controls. Nonradioactive in situ hybridization using digoxigenin-labeled ribo-probes revealed that transcripts coding for both C1q and C3 were closely associated with neurons. These results support the hypothesis that complement could play a role in neuronal degeneration which has been observed in the brain of AD patients.
Aged↗
Molecular probes for muscarinic receptors: functionalized congeners of selective muscarinic antagonists.
The muscarinic agonist oxotremorine and the tricyclic muscarinic antagonists pirenzepine and telenzepine have been derivatized using a functionalized congener approach for the purpose of synthesizing high affinity ligand probes that are suitable for conjugation with prosthetic groups, for receptor cross-linking, fluorescent and radioactive detection, etc. A novel fluorescent conjugate of TAC (telenzepine amine congener), an n-decylamino derivative of the m1-selective antagonist, with the fluorescent trisulfonated pyrene dye Cascade Blue may be useful for assaying the receptor as an alternative to radiotracers. In a rat m3 receptor mutant containing a single amino acid substitution in the sixth transmembrane domain (Asn507 to Ala) the parent telenzepine lost 636-fold in affinity, while TAC lost only 27-fold. Thus, the decylamino group of TAC stabilizes the bound state and thus enhances potency by acting as a distal anchor in the receptor binding site. We have built a computer-assisted molecular model of the transmembrane regions of muscarinic receptors based on homology with the G-protein coupled receptor rhodopsin, for which a low resolution structure is known. We have coordinated the antagonist pharmacophore (tricyclic and piperazine moieties) with residues of the third and seventh helices of the rat m3 receptor. Although the decylamino chain of TAC is likely to be highly flexible and may adopt many conformations, we located one possible site for a salt bridge formation with the positively charged -NH3+ group, i.e. Asp113 in helix II.
Animals↗
Gap duration and location of attention focus modulate the occurrence of left/right asymmetries in the saccadic reaction times of human subjects.
Five human subjects were trained in a single target gap saccade task (fixation point offset precedes target onset, target presentation random at 4 deg to the left or right of the fixation point). Four of them produced different distributions of saccadic reaction times (SRT) for left vs right directed saccades. These asymmetries consisted mostly in different numbers of express saccades, which the subjects produced to the left and to the right side. Using different gap durations (0, 100, 200, 300 and 400 msec) and an overlap task, we found a systematic modulation of the frequency of express saccades: for the shortest and longest gap durations, and in the overlap task, express saccades tended to decline. As a consequence of this effect asymmetric SRTs became rather symmetric for these gap durations. In a gap task where the central fixation point was replaced by a peripheral attention target the occurrence of express saccades was strongly modulated by the location of the attention target relative to the saccade target: for all subjects the frequency of express saccades decreased when the saccade target occurred in the close vicinity of the peripheral attention target. This effect resulted again in clear modifications of the observed asymmetries. We suggest that the occurrence of express saccades can be influenced in a dynamic way by the permanent allocation of the subject's visual attention. Moreover, the phenomenon of direction asymmetry in the SRT distributions can be modulated by such manipulations of the attentional focus.
Adult↗
Intertrial effects of randomization on saccadic reaction times in human observers.
We investigated the effect of randomizing different spatial and temporal parameters on saccadic reaction times (SRTs) in five human subjects, to explore the relative occurrence of express and regular saccades. Parameters randomized in various test sessions were: target direction (right/left), intertrial interval, fixation foreperiod and gap duration (two or three 400 msec) in gap and overlap trials. For the sake of comparison the parameters under consideration were kept constant in non-random control sessions. We found that express saccades were still present in the random test sessions but their relative frequency (and the number of regular saccades) obtained in a given test session depends on the type of randomized parameters: randomizing the intertrial interval or the fixation foreperiod in the gap task yielded modest but significant changes in the SRT distributions, express and fast regular saccades being present in both the control and the random conditions. Randomization of the fixation foreperiod in the overlap task, on the other hand, caused a quite drastic increase in the SRTs. Randomization of gap and overlap trials did not cause considerable effects on express and fast regular saccades in the gap trials, and the SRTs in the overlap trials were significantly increased only in two subjects. When two or three gap durations were randomly interleaved, we found effects that ranged from "negligible" (usually for the longest gap in a given test session) to highly significant differences as compared with the corresponding control condition. The results suggest that express saccades--as fast regular saccades--are visually guided saccades which occur when a certain state of saccade preparation has been reached before target onset. This state depends on the amount of activation in the brain structures involved in the control of attention and fixation, and the decision processes involved in saccade preparation.
Adult↗
Radiofrequency catheter ablation of common atrial flutter in 80 patients.
OBJECTIVES: The purpose of this study was to evaluate the efficacy and safety of radiofrequency catheter ablation of common atrial flutter and to determine the optimal target sites in a large series of patients. BACKGROUND: Recent studies report the efficacy of radiofrequency current application in the low right atrial region to interrupt and prevent recurrences of common atrial flutter. However, larger groups of patients are required to confirm the efficacy of this technique and to specify the target sites. METHODS: Two different approaches were used to target the ablation site in 80 consecutive patients. In the first 50 patients, target sites were localized using both anatomic landmarks and electrophysiologic variables. Three anatomic landmarks were used: area 1 = between the tricuspid valve and inferior vena cava orifice; area 2 = between the tricuspid valve and coronary sinus ostium; area 3 = between the inferior vena cava and coronary sinus. The electrophysiologic criterion was to ablate when there was a stable atrial electrogram during the plateau phase. In the next 30 patients we assessed the effect of application of radiofrequency energy in a single line in area 1, 2 or 3 in groups of 10 patients. RESULTS: Overall atrial flutter was interrupted and rendered noninducible after a single session in 72 patients (90%) and could not be interrupted in 8 (10%). The mean (+/- SD) number of radiofrequency applications was 12 +/- 8. After a mean (+/- SD) follow-up of 20 +/- 8 months, recurrences occurred in 14 patients (17%). The location of the final successful site in the first group of 50 patients was in area 1 in 39%, area 2 in 36% and area 3 in 25%. In the next 30 patients, when lines of radiofrequency lesions were placed at several sites, they produced success rates of 70%, 40% and 10% at areas 1, 2 and 3, respectively. CONCLUSIONS: Radiofrequency catheter ablation of atrial flutter can be performed with a high success rate and is safe. The highest success rate is achieved with radiofrequency energy applied in the isthmus between the inferior vena cava orifice and tricuspid valve.
Actuarial Analysis↗
Pentylenetetrazole-induced seizure up-regulates levels of microtubule-associated protein 1B mRNA and protein in the hippocampus of the rat.
Stimuli that evoke seizure are capable of inducing structural changes in the hippocampus. However, late-acting genes related to these changes have not been described. Administration of pentylenetetrazole (PTZ; 50 mg/kg) to rats of various ages evoked tonic-clonic seizures. Using RNA gel blot analysis we found that the level of the mRNA for microtubule-associated protein 1B (MAP1B) was robustly increased in the hippocampus of 3-month-old rats. The levels of MAP1B mRNA in hippocampus peaked at 40 h and began to decline by 72 h following PTZ treatment. Immunoblotting with anti-MAP1B antibody demonstrates the increase in content of immunoreactive proteins 40-72 h after seizure onset in the hippocampus of PTZ-treated rats. These results indicate that MAP1B is a sensitive indicator of hippocampal structural changes occurring in response to PTZ-induced seizure activity.
Animals↗
[Pulmonary manifestations in HIV patients: role of thoracic radiography, CT and HRCT].
AIM: To determine the prevalence of pulmonary changes on chest radiographs and computed tomography (CT/HRCT) in HIV patients and their relation to pulmonary symptoms. MATERIAL AND METHOD: 64 HIV patients were examined prospectively. 15 had no respiratory symptoms (group I), 30 had non-specific respiratory symptoms (group II), 19 complained of dyspnoea (group III). Chest radiographs and CT were performed within a week. In patients with positive findings, bronchoscopy was carried out with bacteriological and histological examinations. RESULTS: In group 1, 13% of chest radiographs and 40% of CTs showed infiltrative changes. In group II, the figures were 27% and 57% respectively. In group III, abnormalities were found in all cases by both examinations. CONCLUSIONS: In the absence of pulmonary symptoms, imaging is not indicated since it has no clinical consequences. In the presence of pulmonary symptoms, CT/HRCT should be performed whether the chest radiograph is normal or not, since it may reveal additional information.
Adult↗
Fibronectin mRNA (FN-V95+) is increased in the liver of old Sprague-Dawley rats: effect of food restriction.
Because fibronectin (FN) mRNA has been shown to be increased in the brain of old rats and during in vivo and in vitro aging of both endothelial cells and fibroblasts, it was of interest to determine what effect age and caloric restriction have on the ability of liver cells to express FN mRNA. The prevalence of fibronectin mRNA containing the alternatively spliced variant V95 (FN-V95) was examined by RNA gel blot hybridization in the liver of 10-mo, 18-mo, 30-mo ad lib-fed (AL) and 30-mo food-restricted (FR) rats. The transcripts coding for FN-V95 mRNA were well expressed in the liver of 10-mo and 18-mo-old rats. The hybridization signal then increased (1.3-fold, p < .05) in the liver of 30-mo AL rats vs 10-mo-old rats. However, the prevalence of FN-V95 mRNA was dramatically decreased (approximately 4.5-fold, p < .01) in the liver of 30-mo food-restricted rats as compared to 30-mo-old AL rats. The distribution of FN-V95 mRNA was also investigated by non-radioactive in situ hybridization (ISH) on liver frozen sections. The hybridization signal for FN-V95 mRNA was evenly distributed among liver cells of 10-mo and 18-mo-old rats, while weak hybridization signals were sparsely scattered on liver sections derived from 30-mo-old FR rats. In contrast, strong hybridization signals showing a localized distribution were detected on liver sections obtained from 30-mo-old AL rats. Histologic examination of cryostat sections also revealed a massive accumulation of lipid droplets in the liver of 30-mo-old AL rats.(ABSTRACT TRUNCATED AT 250 WORDS)
Aging↗
Potent agonist action of 2-thioether derivatives of adenine nucleotides at adenylyl cyclase-linked P2Y-purinoceptors.
1. Analogues of adenine nucleotides inhibited beta-adrenoceptor-stimulated cyclic AMP accumulation in C6 rat glioma cells with a pharmacological selectivity consistent with that for involvement of a P2Y-purinoceptor. 2. The inhibitory effect of adenine nucleotides was completely prevented by pretreatment of cells with pertussis toxin. 3. The capacity of a series of recently synthesized 2-thioether analogues of adenine nucleotides to inhibit cyclic AMP accumulation was examined. Several ATP analogues, e.g. 2-cyclohexylthio and 2-hexylthio ATP, inhibited cyclic AMP accumulation with EC50 values of approximately 30 pM. These values represent 100,000 fold increases in potency over ATP. 4. Analogues of ADP exhibited the same remarkable increase in potency relative to their natural congener and diphosphates were at least as potent as the corresponding triphosphates at the C6 cell P2Y-purinoceptor. 5. The relative potencies of a broad series of agonists at the C6 cell receptor did not correspond to the relative potencies of the same compounds for activation of P2Y-purinoceptors on turkey erythrocyte membranes. Some agonists, particularly 2-thioether derivatives were more potent for stimulation of the C6 cell receptor, whereas other agonists were more potent in the turkey erythrocyte system. 6. These results add further support to the view that the adenylyl cyclase-linked P2Y-purinoceptor of C6 rat glioma cells is a different subtype from the phospholipase C-linked P2Y-purinoceptor of turkey erythrocyte membranes and several mammalian tissues.
Adenine Nucleotides↗
Multiple choice vocabulary test MWT as a valid and short test to estimate premorbid intelligence.
The discrepancy between current and premorbid ability is a relevant indicator of acquired mental impairment, which itself is closely related to general cerebral dysfunction. The use of tests sensitive to cerebral dysfunction, raises relatively few problems compared with tests being resistant that are used to estimate premorbid mental ability. For premorbid ability, verbal tests assessing knowledge, especially vocabulary, have been shown to be valid. A test, possibly more insensitive to brain dysfunction than the ones usually administered, is the multiple choice vocabulary test (MWT = Mehrfachwahl-Wortschatz-Test). At present only German versions are available. They are presented in some detail because of their advantages. Construction of the MWT is simple, and it can be easily administered in about five minutes. The results correlate fairly well with global IQ in healthy adults (median of r = 0.72 in 22 samples) and are more insensitive to current disturbances than such tests as the WAIS vocabulary test. The limitations of premorbid tests with respect to diagnostic validity are discussed. It is concluded, that studies which do not control premorbid intelligence have to be considered as a "malpractice" and should not be accepted by scientists.
Adolescent↗