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Biomedical subjects

B Frey

Publications and source records attributed to B Frey.

At least 91 records · Page 5Linked to original sources
PubMed1996

[Invasive Pseudomonas aeruginosa and Ecthyma gangrenosum infection in a child without risk factors].

BACKGROUND: Pseudomonas aeruginosa sepsis, well known in immunocompromised patients, is rare in previously healthy children. CASE REPORT: A previously healthy 4 month-old boy was admitted with the suspicion of meningococcal septicemia. Three days prior to admission, he had developed high fever and two 4 cm-diameter skin lesions on his right leg, with dark red colour and a central haemorrhagic blister. He subsequently developed generalized seizures; meningitis and urinary tract infection were excluded. Despite topical therapy with an antistaphylococcal drug skin lesions extended, particularly at the level of the head. The patient was given oral amoxicillin-clavulanate, but his condition worsened; he was transferred to our intensive care unit with septic shock and a diagnosis of meningococcemia. Blood cultures grew Pseudomonas aeruginosa. Despite intensive therapy and appropriate antibiotic therapy, the patient died. CONCLUSION: To allow early diagnosis and adequate treatment, it is mandatory to diagnose Ecthyma gangrenosum as the most frequent manifestation of invasive infection with Pseudomonas aeruginosa.

Bacteremia↗
PubMed1996

Effects of two different enalapril dosages on clinical, haemodynamic and neurohumoral response of patients with severe congestive heart failure.

Angiotensin converting enzyme inhibitors improve symptoms and prolong life in congestive heart failure, but the dose in the individual patient is uncertain. A randomized, 48-week, double-blind study was performed to investigate the safety and efficacy of 'high' in comparison to continued 'low' angiotensin converting enzyme inhibitor therapy in severe heart failure. Eighty-three patients (56 +/- 1.1 years; 69 men, 14 women) in New York Heart Association functional class III/IV on digoxin, furosemide and 'low' angiotensin converting enzyme inhibitors (captopril < or = 50 mg.day-1 or enalapril < or = 10 mg.day-1) were included. After a > or = 14 day run-in on 10 mg.day-1 enalapril, digitalis and furosemide, right heart catheterization at rest and exercise was performed. All patients presented with atrial pressure > 10 mmHg and/or pulmonary artery pressure > 35 mmHg, and/or cardiac index < 2.5 l.min-1.m-2 at rest. Patients then received enalapril 5 mg twice daily (n = 42), or 20 mg twice daily (n = 41) in random order. Thus, patients randomized to low doses of enalapril actually had no change in therapy from baseline to 48 weeks. Forty-three patients (52%) completed the study, 19 patients on the low dose and 24 patients on the high dose. Both dosages equally influenced survival with 15 (18%) deaths, eight on low dose and seven on high dose. After 48 weeks, functional capacity by New York Heart Association class improved more on the high dose than on the low dose (P = 0.04). In contrast, alterations in invasive haemodynamic variables at rest and exercise as well as maximal exercise capacity were comparable in both groups. Diastolic blood pressure decreased and the change between both groups was statistically significant (P = 0.01). Changes in plasma creatinine levels did not differ between high and low dose treatment and no patients had to be withdrawn because of deterioration in kidney function. With regard to neurohumoral activity, a tendency to a discrepant response to both treatments was observed with a blunted increase in noradrenaline on high versus low enalapril dose. Thus, high-dose enalapril treatment proved superior to low dose as regards symptomatology in severe heart failure after long-term treatment, despite similar effects on haemodynamics and on maximal exercise capacity.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

Influence of ectomycorrhization and cesium/potassium ratio on uptake and localization of cesium in Norway spruce seedlings.

Norway spruce (Picea abies (L.) Karst.) seedlings growing in a growth pouch system were used to investigate the effects of the ectomycorrhizal fungus Hebeloma crustuliniforme (Bull. ex St. Amans) Quél. and various Cs/K ratios on the uptake of (134)Cs, expressed as a percentage of the total amount of (134)Cs supplied. The amount of (134)Cs taken up by seedlings increased with increasing Cs/K ratio. At a Cs/K ratio of 0.1, uptake of (134)Cs ranged between 7.2 and 7.3% and was independent of ectomycorrhizal status, whereas at Cs/K ratios >/= 1 uptake of (134)Cs varied from 8.1 to 11.1% for ectomycorrhizal and from 10.4 to 14.4% for non-inoculated plants. Ectomycorrhizal seedlings contained a lower concentration of (134)Cs than non-inoculated seedlings. Among plant parts, the amount of (134)Cs was significantly lower in needles and lateral roots of ectomycorrhizal seedlings compared with non-inoculated seedlings. Among fungal and seedling tissues, highest X-ray net counts of (133)Cs were measured in fungal hyphae of ectomycorrhizal mantles. X-Ray net counts of (133)Cs in lateral roots of ectomycorrhizal and non-inoculated plants were similar, but 5 to 10 times higher than in main roots and needles, suggesting an accumulation of (133)Cs in lateral roots and slow translocation to other plant parts. In contrast, X-ray net counts of K indicated that K was readily mobilized from lateral roots to main roots and needles. Elemental mapping showed a relatively homogeneous distribution of (133)Cs within the root.

Journal Article↗
PubMed1996

Heart rate variability in isolated rabbit hearts.

The presence of heart rate variability (HRV) in patients with cardiac denervation after heart transplantation raised our interest in HRV of isolated, denervated hearts. Hearts from seven adult white ELCO rabbits were transferred to a perfusion apparatus. All hearts were perfused in the working mode and in the Langendorff mode for 20 minutes each. HRV was analyzed in the frequency domain. A computer simulated test ECG at a constant rate of 2 Hz was used for error estimation of the system. In the isolated, denervated heart, HRV was of random, broadband fluctuations, different from the well-characterized oscillations at specific frequencies in intact animals. Mean NN was 423 +/- 51 ms in the Langendorff mode, 406 +/- 33 ms in the working heart mode, and 500 ms in the test ECG. Total power was 663 +/- 207 ms2, 817 +/- 318 ms2, and 3.7 ms2, respectively. There was no significant difference in any measure of HRV between Langendorff and working heart modes. The data provide evidence for the presence of HRV in isolated, denervated rabbit hearts. Left atrial and ventricular filling, i.e., the working heart mode, did not alter HRV, indicating that left atrial or ventricular stretch did not influence the sinus nodal discharge rate.

Animals↗
PubMed1996

The importance of the kidney in primary hypertension: insights from cross-transplantation.

Experimental renal cross-transplantation studies with genetically hypertensive and normotensive rats have shown that hypertension travels with the kidney. The underlying mechanisms are currently not well understood. Genetically normotensive recipients of a kidney from spontaneously hypertensive rats show a decreased capacity to excrete sodium when challenged with a high-salt diet. Furthermore, they retain more sodium than recipients of a kidney from genetically normotensive donors immediately after transplantation and removal of the native kidneys. Sodium retention precedes hypertension and may contribute to its development. Most recently, it has been shown that bilateral nephrectomy and transplantation of a genetically normotensive kidney attenuates the development of hypertension in young transplanted spontaneously hypertensive rats. Thus, long-term blood pressure in renal transplanted rats is critically determined by the genetic background of the renal graft. Together, these data indicate that genetically determined renal mechanisms play a major role in primary hypertension.

Animals↗
PubMed1995

Diurnal variation of ventricular response to atrial fibrillation in patients with advanced heart failure.

Variability of ventricular rate was quantified by two measures of heart rate variability: the SD of the mean R-R interval (SDNN) and the SD of the 5-minute mean R-R interval (SDANN). In 35 patients with atrial fibrillation and advanced heart failure (left ventricular ejection fraction 20% +/- 9%, cardiac index 2.4 +/- 0.7 L/min/m2), SDNN and SDANN were compared to 13 preselected clinical and hemodynamic variables for prediction of outcome. During a 12-month follow-up period, 8 (23%) patients deteriorated clinically; 3 (9%) died, and 5 (14%) underwent heart transplantation. SDNN and SDANN correlated to the difference of the mean R-R interval between night (2 AM to 3 PM) and day (11 AM to noon) with r values of 0.62 and 0.77, respectively. From 15 preselected variables, only SDANN (chi 2 = 6.7, p = 0.01) was independently associated with survival on multivariate analysis. Dichotomized SDANN at 100 msec accurately predicted 12-month survival in 28 (80%) patients (relative risk = 9.77, p = 0.001). In conclusion, analysis of heart rate variability is useful in quantifying diurnal variation of ventricular rate in atrial fibrillation and might be useful in predicting survival in patients with advanced heart failure.

Aged↗
PubMed1995

Factitious hyperthyroidism causing acute myocardial infarction.

Myocardial ischemia is a rare but severe and possibly life threatening manifestation of hyperthyroidism, but does not usually result in persistent ischemia. We report on a 71-year-old woman who had undergone total thyroidectomy with subsequent irradiation because of follicular carcinoma 3 years ago. Since then, she had been maintained on oral levothyroxine replacement therapy at a dose of 0.15 mg alternating with 0.2 mg daily. When latent hypothyroidism became evident despite replacement therapy, the dose of levothyroxine was increased to 0.3 mg a day. Three weeks later, the patient suffered from an acute posterior myocardial infarction, although she had no previous history of coronary artery disease. Subsequent coronary arteriograms revealed no evidence of disease of the major vessels. Myocardial scintigraphy 3 weeks after infarction still revealed a persistent perfusion defect. Since it is known that thyroid hormones increase oxygen demand, the rapid elevation of oxygen utilization caused by thyrotoxicosis factitia is likely to be responsible for this patient's myocardial infarction. The case illustrates that a sudden increase in levothyroxine replacement dose should be avoided.

Acute Disease↗
PubMed1995

Sudden death and staged therapy for hemodynamic stabilization in patients enrolled in a heart transplantation program.

To investigate the impact of staged therapy for advanced heart failure on therapeutic endpoints, 236 consecutive patients (coronary artery disease/dilated cardiomyopathy in 61/175 patients, left ventricular ejection fraction 14% +/- 5%, New York Heart Association Class II/III/IV in 102/79/55 patients, respectively) with advanced heart failure were prospectively followed. One hundred thirty-seven patients enrolled from January 1989 to December 1991 were treated conventionally with digoxin, furosemide, and low dose angiotension converting enzyme (ACE) inhibition. Patients refractory to this therapy underwent urgent heart transplantation. Ninety-nine patients enrolled from January 1992 to August 1993 underwent staged therapy: stage 1: maximal tolerated ACE inhibition; stage 2: therapy with PGE1 for pre- and afterload reduction to achieve hemodynamic stabilization; or stage 3: refractory patients bridged to heart transplantation with continuous outpatient dobutamine. Sudden death was defined as death within 1 hour of symptoms if heart failure symptoms remained stable over the previous 7 days. Conventionally treated patients were followed for 10 +/- 9 months; patients who underwent staged therapy for 9 +/- 5 months. In the group of patients that underwent standard therapy, 39 of 137 (28%) patients died: 5 (13%) deaths occurred suddenly, and death due to progressive pump failure occurred in the remaining 34 (87%) patients. In the group of patients that underwent staged therapy, 25 of 99 (25%) patients died: 13 (52%) deaths occurred suddenly, and 12 (48%) deaths occurred due to progressive pump failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Alprostadil↗
PubMed1995

Comparison of body composition between German and American adults with mental retardation.

Several studies have confirmed that there is a high incidence of obesity among adults with mental retardation (MR) living in the United States. However, there has never been a systematic comparison of the anthropometric characteristics between adults with MR from different countries. The purpose of this study was to compare the body composition levels of 210 adults with MR residing in two different residential settings in the United States and in Germany. Subjects' mean age was 31.7 yr. Skinfold measurements were used to estimate percent body fat (PBF), and height and weight were used to compute body mass index (BMI). Results indicated that PBF was significantly higher among females (P < 0.001); subjects in the institutional setting had significantly lower PBF and BMI levels than subjects in the family setting (P < 0.001); and PBF and BMI levels were significantly higher in subjects from the United States compared with the German subjects (P < 0.001). These findings indicate a need for further investigation into the caloric intake, energy expenditure, lifestyle, and metabolic characteristics of adults with MR living in the United States and Germany.

Adipose Tissue↗
PubMed1994

Tn 5Map, a transposon for the rapid mapping of restriction sites in plasmids.

A transposon was constructed allowing the rapid restriction mapping of plasmids. This transposon, Tn 5Map, contains a cleavage site for the I-SceI endonuclease which recognizes an 18-mer. After in vivo transposition of Tn5Map into the plasmid of interest, the plasmid is isolated and linearized with I-SceI. Splinkers labelled with digoxygenin and complementary to the left and right end of the linearized molecule are added and ligated. After partial digestion of the splinkered molecules with the restriction enzyme of interest, separation of the cleavage products in an agarose gel, and Southern transfer, the labelled fragments are visualized by the addition of the chemiluminescent substrate AMPPD and alkaline phosphatase. The restriction map can be directly read from the bottom to the top of the gel.

Bacteriocin Plasmids↗
PubMed1994

The differential diagnosis on the electrocardiogram between ventricular tachycardia and preexcited tachycardia.

The 12-lead surface electrocardiogram is a simple and useful tool for the differential diagnosis of regular wide QRS complex tachycardia. However, criteria do not as yet exist to discriminate between ventricular tachycardia and supraventricular tachycardia with anterograde conduction over an accessory pathway (preexcited tachycardia). Therefore, we designed a new stepwise approach with three criteria for the electrocardiographic differential diagnosis between ventricular tachycardia and preexcited tachycardia and prospectively studied 267 regular tachycardias with electrophysiologically proven mechanism and a wide QRS complex (> or = 0.12 s): 149 consecutive ventricular tachycardias and 118 consecutive preexcited regular tachycardias. Underlying heart disease was old myocardial infarction in 133 of 149 (89%) ventricular tachycardias. The patients presenting with preexcited tachycardia had no additional structural heart disease. Atrial fibrillation with preexcited QRS complex was not included. The criteria favoring ventricular tachycardia were: (1) presence of predominantly negative QRS complexes in the precordial leads V4 to V6, (2) presence of a QR complex in one or more of the precordial leads V2 to V6, and (3) AV relation different from 1:1 (more QRS complexes than P waves). The final sensitivity and specificity of these three consecutive steps to diagnose ventricular tachycardia were 0.75 and 1.00, respectively. This new stepwise approach is sensitive and highly specific for the differential diagnosis between ventricular tachycardia in coronary artery disease and preexcited regular tachycardia.

Coronary Disease↗
PubMed1994

Neuropeptides are potent modulators of human in vitro immunoglobulin E synthesis.

We determined the effect of adrenocorticotropin hormone (ACTH) on the regulation of IgE synthesis. Depending on the concentration, ACTH enhanced or inhibited IgE synthesis in a culture system where IgE synthesis was induced with interleukin-4 (IL-4) and anti-CD40 monoclonal antibody in peripheral blood mononuclear cells. Similar effects on IgE synthesis were observed by adding ACTH-related peptides, e.g. corticotropin-releasing factor (CRF), the inducer of ACTH, or alpha-melanocyte stimulating hormone (alpha-MSH), a cleavage product of ACTH. However, ACTH had no effect on IgG or IgM synthesis in this culture system. ACTH did not act directly on either B or T cells as there was no influence on IgE synthesis in a system using purified B cells alone or co-cultured with T cells. The effect of ACTH on IgE synthesis was mediated by accessory cells. This was shown by priming purified CD14-positive monocytes with ACTH and reconstitution experiments. Therefore, these findings suggest that ACTH and the related peptides CRF and alpha-MSH can influence the microenvironment modulating an IL-4 and anti-CD40 monoclonal antibody driven class switching to IgE via accessory cells.

Adrenocorticotropic Hormone↗
PubMed1994

Familial isolated pulmonary hypoplasia: a case report, suggesting autosomal recessive inheritance.

The exceptional observation of a healthy couple with two girls and a boy suffering from pulmonary hypoplasia and two normal children is reported. The affected infants died 1, 2 and 20 h after birth respectively. No other malformations were found. Histological findings suggest that the underdevelopment of the lungs has its origin at a more proximal level than the terminal bronchioles. Autosomal recessive inheritance is suggested.

Congenital Abnormalities↗
PubMed1994

Cardiac depolarization and repolarization in Wolff-Parkinson-White syndrome.

Delta wave and QRS complex polarities have been extensively studied in preexcitation syndromes. However, only limited data exist about ventricular depolarization and repolarization in the setting of maximal preexcitation in relation to the site of insertion of the accessory pathway. Therefore this study was designed to systematically analyze cardiac depolarization and repolarization in patients with maximal preexcitation. We analyzed the polarity of the QRS complex and T wave on the frontal plane on the conventional 12-lead electrocardiogram in 118 patients with maximal preexcitation. Fast atrial pacing was used to provoke maximal ventricular preexcitation. The 32 patients with a left lateral accessory pathway showed right-axis deviation of the QRS complex (110 +/- 20 degrees) with a left-axis deviation of the T-wave axis (-40 +/- 25 degrees). The 54 patients with a posteroseptal accessory pathway had a left axis of the QRS complex (-50 +/- 20 degrees) with a right-axis deviation of the T-wave axis (95 +/- 15 degrees). The 11 patients with a right lateral accessory pathway had a left axis of the QRS complex (-40 +/- 20 degrees) and a right axis of the T wave (110 +/- 10 degrees). In 7 patients with a left anterolateral accessory pathway and 14 patients with a right anteroseptal accessory pathway, the axis of the QRS complex was 50 +/- 25 degrees and 45 +/- 20 degrees, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Purification and characterisation of the restriction endonuclease ItaI from Ilyobacter tartaricus recognizing 5'-GC decreases NGC-3'.

ItaI, an isoschizomer of the subclass IIW [Kessler and Manta, Gene 92 (1990) 1-248] restriction endonuclease (ENase), Fnu4HI [Leung et al., Nucleic Acids Res. 6 (1979) 17-25], has been isolated from Ilyobacter tartaricus. The ENase has the five-base palindromic recognition sequence, 5'GC decreases NGC-3'. It cleaves behind the second nucleotide and produces a one-nt 5' overhang.

Deoxyribonucleases, Type II Site-Specific↗