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Biomedical subjects

B Vogel

Publications and source records attributed to B Vogel.

At least 19 recordsLinked to original sources
PubMed2001

Race and ethnicity and the identification of special needs children.

Increasingly, Medicaid and Title XXI Programs are using survey-based approaches to identify children with special health care needs (CSHCN) for quality assurance monitoring and program referrals. However, little work has been done examining how well instruments, like the Questionnaire for Identifying Children with Chronic Conditions and the CSHCN Screener, identify CSHCN among black and Hispanic families. Differences in item interpretation and in response styles could influence the identification of CSHCN from these groups. Our results suggest that children who are black or Hispanic with special health care needs may be underidentified relative to white or non-Hispanic children using currently available survey tools.

Adolescent↗
PubMed2000

Re-opened foramen ovale--a rare cause of postoperative dyspnea following pneumonectomy.

Dyspnea and hypoxemia are common postoperative problems following pneumonectomy. Platypnea, the increased dyspnea in the erect position relieved by assuming a prone position, has been reported as a result of right to left inter-atrial shunt. We report here on our experience with a patient who had severe platypnea with remarkable positional arterial desaturation following right pneumonectomy. After establishing the diagnosis with contrast-enhanced transesophageal echocardiography of the preoperatively undetected interatrial right-left shunt, cardiac surgery led to clinical improvement and resumption of platypnea. Given the rarity of the diagnosis, we think interatrial shunt, based on an open foramen ovale, should be taken into consideration when platypnea occurs in patients as a postoperative complication following lung surgery. Transesophageal echocardiography may be helpful in detecting patients with "anatomical closed but functional open" foramen ovale or genuine inter-atrial septal defect prior to lung surgery.

Dyspnea↗
PubMed1999

Endoscopic coronary artery bypass grafting on the beating heart using a computer enhanced telemanipulation system.

OBJECTIVE: To develop a technique for computer enhanced endoscopic arterial bypass grafting on the beating heart in an experimental canine model. METHODS: Mongrel dogs (30-35 kg) were used. After single lung ventilation of the right lung was initiated the dogs were placed to the right. The videoscope and the end-effectors of the da Vinci telemanipulation system (Intuitive Surgical, Mountain View, CA) were introduced through three ports. Surgery was performed remotely from the console (motion scaling 3:1). After harvesting of the internal thoracic artery (ITA) and preparation of its distal end, the Endostab, a newly developed endoscopic stabilizer, was introduced through an additional port. The anterior wall of the heart was stabilized and the collateral branch (RC) of the left anterior descending artery (LAD) was ligated proximally and distally. The arteriotomy was made and the ITA-graft anastomosed to the RC. The animals were sacrificed and the grafts were checked for patency using bench angiography. RESULTS: In two of five dogs total endoscopic beating heart bypass grafting, including ITA harvest, stabilization, arteriotomy and performance of the anastomosis, was successfully performed using computer enhanced technology and a new endoscopic stabilizer. In two dogs the procedure was completed with femoro-femoral cardiopulmonary bypass (CPB) support on the beating or fibrillating heart, respectively. One dog expired due to VT. Hemodynamically, endoscopic stabilization was well tolerated. All four grafts were patent despite a target vessel diameter of less than 1 mm. CONCLUSION: The endoscopic stabilizer can sufficiently immobilize the heart to enable endoscopic beating heart coronary artery bypass grafting by means of a computer controlled instrumentation system.

Animals↗
PubMed1998

Characterization of the CD55 (DAF)-binding site on the seven-span transmembrane receptor CD97.

CD97 is an activation-induced antigen on leukocytes which belongs to a new group of seven-span transmembrane (7-TM) molecules, designated EGF-TM7 family. Family members, including EMR1 and F4/80, are characterized by an extended extracellular region with several N-terminal epidermal growth factor-like (EGF) domains. Alternative splicing of CD97 results in isoforms possessing either three (EGF1, 2, 5), four (EGF1, 2, 3, 5) or five EGF domains (EGF1, 2, 3, 4, 5). We recently identified decay accelerating factor (DAF, CD55), a regulatory protein of the complement cascade, as a cellular ligand of the smallest isoform. Employing mutants of CD97(EGF1, 2, 5) in which the EGF domains have been systematically deleted, we here demonstrate the necessity of at least three tandemly linked EGF domains for the interaction with CD55. Consistent with the involvement of different EGF domains, monoclonal antibodies directed against the first EGF domain as well as the removal of Ca2+, for which binding sites exist in the second and fifth EGF domain, blocked binding to CD55. Compared to CD97(EGF1, 2 ,5) the larger isoforms CD97(EGF1, 2, 3, 5) and CD97(EGF1, 2, 3, 4, 5) have a significantly lower affinity for CD55. Thus, alternative splicing may regulate the ligand specificity of CD97 and probably other members of the EGF-TM7 family.

Animals↗
PubMed1996

The seven-span transmembrane receptor CD97 has a cellular ligand (CD55, DAF).

CD97 is an activation-induced antigen on leukocytes with a seven-span transmembrane (7-TM) region homologous to the secretin receptor superfamily. However, in contrast to this group of peptide hormone receptors, CD97 has an extended extracellular region with three EGF domains at the NH2 terminus, two of them with a calcium binding site. By demonstrating that lymphocytes and erythrocytes specifically adhere to CD97-transfected COS cells we here show that CD97 in parallel with its molecular evolution has acquired the ability to bind cellular ligands. A mAb selected on its capacity to block the adhesion between CD97 transfectants and red cells was found to be directed to the NH2-terminal short consensus repeat (SCR) of decay accelerating factor (DAF, CD55), a regulatory protein of the complement cascade. The specificity of the interaction of CD97 with CD55 was established by the observation that erythrocytes that lack CD55, obtained from patients with paroxysmal nocturnal hemoglobinuria (PNH) or the CD55, phenotype Inab, failed to adhere to CD97 transfectants. This is the first demonstration of a cellular ligand for a 7-TM receptor.

Animals↗
PubMed1994

Lupus erythematosus and Miller-Fisher syndrome.

OBJECTIVE: To compare the clinical course of an unusual case of Miller-Fisher syndrome in systemic lupus erythematosus with therapeutic interventions, in particular with plasma exchanges. DESIGN: The clinical state and laboratory and electrophysiologic parameters were controlled for over a year and related to therapeutic attempts with immunoglobulins, steroids, and plasma exchanges. SETTING: Medical intensive care unit of a university hospital. PATIENT: A 17-year-old black female student with known systemic lupus erythematosus who developed ataxia, are flexia, and ophthalmoplegia (Miller-Fisher syndrome) and later became tetraplegic and required full mechanical ventilatory support. RESULTS: High-dose immunoglobulin treatment combined with corticosteroid pulse therapy was not beneficial. However, plasma exchange (performed five times over a period of 4 months) was followed by a striking clinical improvement within hours after each plasma exchange. CONCLUSIONS: Plasma exchange appears to remove a yet unknown agent producing a distal motor nerve conduction block and is efficacious in severe neuropathy associated with Miller-Fisher syndrome in lupus erythematosus.

Adolescent↗
PubMed1994

Dihydroergotamine nasal spray for the acute treatment of migraine.

We conducted a multicenter, double-blind, parallel-group study to compare the efficacy and safety of dihydroergotamine (DHE) nasal spray and placebo over 4 hours in the treatment of migraine. Of the 112 patients enrolled, 100 were included in the "intent-to-treat" efficacy analysis. The patients self-administered either 2.0 mg DHE (0.5 mg per nostril, repeated after 15 minutes) or placebo at the onset of two separate headaches and rated hourly the drugs' effects on pain severity, pain relief, nausea, and vomiting. The physicians assessed the overall effectiveness of the drugs in relieving headache pain, nausea, and vomiting. Both the patients' and physicians' ratings indicated that DHE was significantly superior to placebo in improving headache and nausea; according to the patients' ratings, these between-group differences were already significant at the first (hour 1) evaluation. There were no significant differential treatment effects with respect to relief of vomiting. Most adverse events were mild or moderate, confined to the nasopharyngeal area, and probably related to the route of administration. We conclude that DHE nasal spray is a safe and effective treatment for the pain and nausea of migraine attacks.

Administration, Intranasal↗
PubMed1993

[Advantages of dehydration in dying patients. Nursing aspects].

Many caregivers still believe that the use of intravenous infusions or nasogastric tubes should be an automatic response to dehydration in patients who are close to death. The decision for doing so is more influenced by emotional factors than by a clear review of the problems and advantages artificial fluid therapy can cause in the individual. However dehydration can be advantageous for the dying by alleviating certain symptoms. The main problem--a dry mouth--can be treated by often and regular mouth-care, eventually done by the relatives of the patient. There can be an exchange of roles: By caring for "their" patient the relatives become more responsible for him and health-care professionals are acting more in the background supporting them.

Dehydration↗
PubMed1993

Ultrasonographic detection and guided biopsy of thoracic osteolysis.

Eighty-six osteolytic lesions of the rib cage were examined by means of conventional radiography and ultrasonography. The ultrasonographic criteria of osteolysis are described. Only 1 rib metastasis was missed by ultrasonography while 13 lesions were not detected by x-ray film. Of 63 ultrasonographically guided biopsies, 62 resulted in the final diagnosis; complications were not observed. The results recommend ultrasonographic examination combined with guided biopsy as the first diagnostic step, if a metastasis of the rib cage is suspected after physical examination or after a pathologic bone scan.

Biopsy↗
PubMed1992

Detection of glycyrrhetinic acid-like factors (GALFs) in human urine.

Patients with the syndrome of apparent mineralocorticoid excess and those who ingest licorice show markedly decreased 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) and 5 beta-reductase activity; both are important for the deactivation of glucocorticoids and other steroid hormones. Glycyrrhetinic acid (GA), present as its glycoside in licorice, is a potent inhibitor of both 11 beta-OHSD and 5 beta-reductase and, as we have also shown, confers Na(+)-retaining properties on glucocorticoids and amplifies those of aldosterone and deoxycorticosterone. We report the results of our initial studies demonstrating the presence of naturally occurring substances, which inhibit both 5 beta-reductase and 11 beta-OHSD as does GA, in partially purified extracts of urine from normotensive men and nonpregnant and pregnant women. Since these substances exhibit GA-like activity, we have termed them GA-like factors (GALFs). This "inhibitory" material is heat stable and does not react with ninhydrin; the majority is not extractable with ethyl acetate and thus is not a "free" steroid. When further purified by high-performance liquid chromatography with a methanol/water gradient, the majority of these GALFs appeared in two regions of inhibitory activity. The chemical nature of this material is currently being investigated. These experiments indicate that normal human urine contains GALFs that may play a role in Na+ homeostasis and regulation of blood pressure.

11-beta-Hydroxysteroid Dehydrogenases↗
PubMed1990

[Autochthonous pulmonary dirofilariasis in Europe].

The chest X-ray of a 39-year-old woman who had an acute onset of fever, cough, dyspnoea and thoracic pain revealed two peripheral round opacities (about 1.5 cm in diameter) in the right lower lobe. Extensive further studies having failed to discover the cause, a diagnostic thoracotomy was performed and the two pleura-adjacent tumours were removed. Histological examination revealed granulomatous encapsulated filariae, species Dirofilaria immitis. This was confirmed by a positive ELISA test with Dirofilaria immitis antigen. As the patient had been on holiday in Corsica three months before onset of symptoms, it is most likely that the pulmonary dirofilariasis was acquired autochthonously in Europe.

Adult↗
PubMed1990

Poly- and monoclonal antibodies against recombinant rat brain calbindin D-28K were produced to map its selective distribution in the central nervous system.

Many processes in the CNS depend on calcium. The calcium signal is transduced into an intracellular response via Ca2(+)-binding proteins, including calbindin D-28K. In many laboratories, polyclonal antibodies against chicken intestinal calbindin D-28K have been used to study its localization in the brain (normal and degenerated) of various species, including humans, but some of these antisera cross-reacted with other proteins, including calretinin. We purified recombinant rat brain calbindin D-28K to raise antisera in rabbits and purified a recombinant rat-chicken calbindin D-28K hybrid protein to immunize mice for the generation of monoclonal antibodies. These antisera were highly specific for calbindin D-28K, as demonstrated by two-dimensional Western blotting analysis. Immunohistochemical analyses combined with in situ hybridization studies demonstrated that calbindin D-28K in the Purkinje cells of the cerebellum is independent of vitamin D. The antibodies described here will be important tools for studying the regulation of expression of calbindin D-28K and its biological function in the brain and in the PNS.

Animals↗
PubMed1990

[Thoracoscopic pericardial fenestration--diagnostic and therapeutic aspects].

This article reports on four tumour patients with extensive, but cytologically innocuous pericardial effusion. In three cases, a tumour-cell-negative pleural effusion, on the left, was also present. Thoracoscopy showed that the pleura were unremarkable, whereupon, with the aid of the biopsy forceps--in one case the Nd:YAG laser--the pericardium was opened. The procedure provided diagnostically high-yielding material; in addition, pericardial tamponade was "permanently" eliminated (period of observation up to 4 years). This shows that, in addition to its diagnostic value, thoracoscopic pericardial fenestration also can be therapeutic. It represents an alternative to the surgical approach.

Humans↗