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Biomedical subjects

B Wagner

Publications and source records attributed to B Wagner.

357 records · Page 20Linked to original sources
PubMedDate not supplied

Spiral computed tomographic angiography of the renal arteries: a prospective comparison with intravenous and intraarterial digital subtraction angiography.

PURPOSE: To assess the accuracy of computed tomographic angiography (CTA) in the evaluation of the renal arteries in comparison with intravenous (IVDSA) and intraarterial digital subtraction angiography (IADSA). METHODS: In 18 patients, 35 CTAs and DSAs (27 IADSA, 8 IVDSA) of the renal arteries were performed. CTA was done with 2-3 mm collimation,2-4 mm/sec table speed, after intravenous injection of 80 ml of contrast medium at 4 ml/sec with a scanning delay time of 14-21 sec. No previous circulation time curve was performed. CTA data were reconstructed with maximum intensity projection (MIP) and shaded surface display (SSD). The presence of stenosis was assessed on a three-point rating scale (grade 1-3). The quality of the examinations; visualization of the ostium, the main artery, and its branches; vessel sharpness, linearity, and intraluminal contrast filling were evaluated. We compared CTA with DSA. RESULTS: CTA had 96% sensitivity, 77% specificity, and 89% accuracy in the detection of stenoses > 50%. Due to technical errors two stenoses were erroneously diagnosed as positive but there were no false negative diagnoses. The quality of CTA was good in 56% and moderate in 34% of cases. Visualization of the ostium and main artery was graded as 1.74 (out of 2) points and of the renal branches as 1.02 (out of 2) points and of the renal branches as 1.02 (out of 2) points. The quality of CTA images was worse than that of IADSA in 52%, equal in 41%, and better in 7% of cases. CTA was equal to IVDSA in 25% and better in 75% of the cases. CONCLUSION: CTA is an accurate noninvasive method for the evaluation of renal arteries. Examination quality is essential for the diagnosis. CTA is limited in its ability to visualize the branches of the renal artery and accessory arteries. CTA seems to be superior to IVDSA.

Adult↗
PubMedDate not supplied

Cytogenetic studies in a canine neurofibroma.

An 11-year-old German shepherd bitch developed a neurofibroma in the right shank. On cytogenetic analysis of the tumour cells 90% presented themselves with trisomy 2, a derivative chromosome 13 (der13) and centric fusions 10/35 and 24/31.

Animals↗
PubMedDate not supplied

[Bottom-up analysis of the case costs of stem cell transplantation and selected chemotherapies].

BACKGROUND: Up to now, reliable data has not been available on the actual costs of treating oncological patients. However, such data material is urgently required in view of the institution of the health service reform with the concomitant introduction of the G-DRG remuneration system. PATIENTS: The medical services and their costs for 66 patients comprising several stays in hospital, part-time hospitalization and outpatient visits to the clinic categorized "establishment of the diagnosis", "stem cell therapy (SCT)" and "chemotherapy" were recorded in parallel to treatment over a time period of three months. It was thus possible to relate a cost volume of 2.7 million euro to more than 2800 nursing days (full and partial hospitalization) and more than 500 outpatient visits. METHODS: All pertinent costs were collated with the various stays/movements of the patients over 100 calendar days. This was very largely possible thanks to a sophisticated costing and setting off of payments within the hospital on the part of the service providers in the hospital in direct allocation to patients and the third-party payers. Additionally, partial and full surveys as well as questionnaires enabling allocation to the individual case as far as possible, especially the staff requirement, were used. A breakdown of the costs in terms of the patient nursing days was only effected in marginal areas such as the "hotel function" or the general administrative costs. A further subdivision of the stays and movements as well as the phases of the stays applied to the service or the treatment progress above and beyond the areas of treatment. In the case of chemotherapy, a distinction was therefore made between "protocol blocks" and "stays due to complications" and in the case of SCT inter alia even individual phases such as "conditioning". RESULTS AND CONCLUSIONS: It is problematical to represent these patients within an DRG case flat rate system because of frequent and very divergent residence periods with regard to services and costs. The multiplicity of treatment sessions is manifested in the compact "establishment of the diagnosis" to determine a therapy protocol which entails very elaborate inpatient measures under hospitalization, in the expensive and individual "stays due to complications" which usually take place between the "chemotherapy blocks", and the expensive long-term care of the SCT patients after the end of the residence limit (GVD). Owing to the small and divergent numbers of cases in Germany (2000 new patients in 50 centers and 330 SCT per year) and per center, this problem cannot be dealt with by means of a quantity compensation argumentation, as is doubtless justified elsewhere. The actual individual case costs of oncological patients would be 166,72 euro; per outpatient contact and covered by 459,30 euro; per day of hospital care and 808,20 euro; per inpatient treatment day (admission plus discharge day calculated separately and comprised stem cell transplantation patients beyond the residence limit) is covered. The level of the currently applicable case flat rate payments for stem cell transplantations and heterologous donors, mismatched heterologous donors and family donors appear appropriate in relation to the GVD. (The true costs of all oncological patients would indeed be even higher if the GOA payment of the ILV did not only relate to a house-internal low pricing of the GOA scoring value, but would also relate to HLA typing, unpaid physician overtime and the costs of the study centers to the individual cases. From 2002, there will be changes consequent on the judgment of the European Court that stand-by is working time, so that more physicians must be employed and there are expensive changes in the infrastructure owing to the need for a GMP clean area laboratory to process stem cells according to the medical products law.) The indeterminate bound-aries between the three treatment categories place in question the dual financing by the Panel Doctor's Association and the health insurance funds and indicate that a total-sum remuneration appears appropriate.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Glutathione in Tetrahymena thermophila.

In Tetrahymena, glutathione is synthesized from the same precursors as it is in higher animals and is present in similar intracellular concentrations. The intracellular thiol-disulfide ratio is also identical to that of mammalian tissues, due to the activity of glutathione reductase. The intracellular GSH-level was found to be dependent on the sulfur-containing amino acids in the chemically defined medium.

Animals↗
PubMedDate not supplied

Rapid production of recombinant allergens in Nicotiana benthamiana and their impact on diagnosis and therapy.

BACKGROUND: Type I allergies are immunological disorders that afflict a quarter of the world's population. Recombinant allergens have improved the diagnosis of allergic diseases and allow the formulation of new therapeutic approaches. Over 50% of all allergens are of plant origin. OBJECTIVE: We have applied a novel method of overexpressing plant allergens in the tobacco-related species Nicotiana benthamiana. METHOD: This method is based on the use of a chimeric tobacco mosaic virus that harbors a foreign gene sequence and directs its transcription after the infection of the host plant. RESULTS: We have expressed the model allergen Bet v 1, the major birch pollen allergen, and two Hevea brasiliensis latex allergens, the spina-bifida-associated allergens Hev b 1 and Hev b 3, in N. benthamiana using such a viral vector. Bet v 1, Hev b 1 and Hev b 3 produced by this method were recognized by patients' IgE suggesting that the plant-produced allergens were properly folded. Nonpurified Bet v 1 expressed in N. benthamiana leaves had the same immunogenicity as purified Bet v 1 expressed in Escherichia coli or natural Bet v 1 when tested in a murine model of type I allergy. CONCLUSION: We conclude that this plant expression system offers a viable alternative to fermentation-based production of allergens in bacteria or yeasts.

Allergens↗
PubMedDate not supplied

Effects in animals of chronic administration of spironolactone--a review.

Spironolactone, an aldosterone antagonist, has been found effective in the treatment of certain forms of hypertension, ascites, and edematous conditions. Since patients may receive daily doses of spironolactone for many years, it is important to determine the chronic effects on tissues. This study reviews the tissue changes in rats, dogs, and monkeys receiving spironolactone daily for up to two years. Dose levels were frequently in excess of 100 times the recommended human dose. The pituitary, adrenals, and kidneys of all animals showed no significant changes. Histologic changes were noted in rat livers, thyroid, and male internal genitalia. There were alterations in monkey testes and male mammary glands. This study found no evidence to suggest that spironolactone is tumorigenic or carcinogenic. Species differences in metabolism may account for the diversity of tissue observations.

Animals↗