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C Fischer

Publications and source records attributed to C Fischer.

371 records · Page 21Linked to original sources
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Population-based clinical projects: bridging community-based and public health concepts.

Changes in the healthcare delivery system have shifted nursing curricula to a community-based focus. For public health nursing faculty, this shift requires that population-based clinical projects bridge community-based nursing concepts with those of public health. The authors describe four innovative examples of population-based clinical projects that incorporate core public health functions and public health interventions into the learning process.

Clinical Competence↗
PubMedDate not supplied

High signal intensity on T2-weighted MRI correlates with hypoperfusion in temporal lobe epilepsy.

Single-photon emission computed tomography (SPECT) and [99mTc]HMPAO were used to assess the functional significance of nonspecific magnetic resonance imaging (MRI) abnormalities observed in patients with temporal lobe epilepsy and no focal lesion on CT scan. We studied 18 patients whose MRI was normal or showed high signal intensity on T2-weighted images (T2WIs) at the site of the EEG focus in 11 and 7 cases, respectively. EEG was monitored during regional cerebral blood flow (rCBF) study. Lateralized hypoperfusion was present in 7 of 17 interictal (41%) and in one postictal cases; it was located in the temporal lobe on the side of the EEG focus in all, and was significantly more frequent in patients with high signal intensity on T2WI (86%) than in patients with a normal MRI (18%). The degree of temporal perfusion asymmetry measured in each individual was higher in patients whose MRI was abnormal.

Adolescent↗
PubMedDate not supplied

Mismatch negativity and N100 in comatose patients.

Mismatch negativity (MMN) and N100 auditory evoked potential were recorded in 52 healthy subjects and in 128 severely comatose patients. The MMN was present in 33/128 patients and N100 in 84/128. A ratio of 30/33 patients with MMN and 70/84 with N100 regained consciousness in a mean time of 6.3 +/- 4 days after the recording session. Thus, in terms of predicting return to consciousness, the MMN was more specific (90.9%) than the N100 (57.6%), but its sensitivity was lower (31.6% for MMN and 73.7% for N100, respectively). The amplitudes of MMN and N100 in comatose patients were smaller than those of healthy subjects. It is concluded that MMN and N100 can be very useful in predicting whether or not a comatose patient will regain consciousness.

Adolescent↗
PubMedDate not supplied

Mismatch negativity and N100 monitoring: potential clinical value and methodological advances.

Continuous long-term recording of brainstem (BAEPs), middle-latency (MLAEPs) and long-latency auditory evoked potentials, including the mismatch negativity (MMN), brings additional information on the immediate functional state and the outcome of patients in coma or recovering after surgery, in relation with clinical observations and therapeutics. A recently designed monitoring system is introduced, aimed at the continuous recording of late auditory potentials (N100 and MMN) as well as BAEPs and MLAEPs. Specific methodological aspects are emphasized. Long-term monitoring data from one patient recorded in the recovery room after surgery are displayed, allowing an illustration of the techniques used and of the problems raised.

Adult↗
PubMedDate not supplied

CD44s, E-cadherin and PCNA as markers for progression in renal cell carcinoma.

CD44s, E-cadherin and PCNA play an important role in the tumorigenesis of renal cell carcinoma (RCC), although their significance in the clinical progression of RCC is still not clear. In n = 137 cases of operatively resected RCC the expression of CD44s, E-cadherin and PCNA was semiquantitatively analyzed by the APAAP immunohistochemical method. The mean observation period of the n = 74 (54%) of patients with no evidence of disease was 52.6 months and for the n = 63 (46%) patients with progressive disease was 18.7 months. The mean progression free period occurring with absent or low levels of CD44s and PCNA expression was 79 and 118+ months, and with strong expression was 12 and 18 months (p < 0.001), respectively. With strong E-cadherin expression the progression free period was 110+ months, and with low expression 61 months (p = 0.01). A high CD44s/E-cadherin ratio and an above average PCNA expression were identified as independent prognostic parameters for the progression tendency of RCC.

Antigens, CD↗
PubMedDate not supplied

Angiomyolipoma of the kidney. Comparison between magnetic resonance imaging, computed tomography, and ultrasonography for diagnosis.

In six patients with angiomyolipoma of the kidney, five showed a typical pattern in T1, proton and T2 weighted images, with magnetic resonance imaging (MRI). Angiomyolipoma is recognized by its characteristic fatty tissue components, which result in high signal intensity in T1 and proton weighted images and a low signal in T2 weighted images. Five of the patients were also examined with ultrasonography (US); in four of these, the tumor could be recognized by its echodense pattern. Computed tomography (CT) was slightly less sensitive; three out of six examinations failed to produce a definite diagnosis. Instead of the typical low attenuation values of fat, Hounsfield units similar to either muscle or kidney tissue were observed in these 3 cases. In conclusion, the specific diagnosis of angiomyolipoma depends on the amount of fatty tissue present at MRI, CT, and sonography.

Adult↗
PubMedDate not supplied

In vitro and in vivo evaluation of a new Opaque system for metal ceramic restorations.

This study made an in vitro comparison of the shear strength in a corrosive solution, the scanning electron microscopy of the processing steps, and the x-ray powder diffraction analyses of a newly developed opaque system (Biopaque) with a traditional opaque-system (Opaque P). Clinically, two traditional opaque systems (Opaque P and Vita-VMK-Paint-On 88 opaque) were compared to Biopaque over a 4-year period. A total of 218 metal ceramic units were placed for 29 patients. One hundred ten were veneered with Biopaque, 50 with Opaque P, and 58 with Vita-VMK-Paint-On 88. The technical failure rate of the metal ceramic restorations was 9.6%, and the biological failure rate 5.5%. There was no significant difference of the shear strength in a corrosive solution between Biopaque and the traditional opaque system (Opaque). The x-ray powder diffraction analyses revealed that only the base paste of Biopaque was a newly developed material. In this study, the new opaque system (Biopaque) showed the same in vitro and in vivo results as the other conventional opaque systems. However, at least 5 years of clinical evaluation are necessary before this new opaque system can be completely recommended.

Adult↗
PubMedDate not supplied

Flow-cytometric analysis of the DNA content in paraffin-embedded tissue and in fresh tumour samples obtained from renal cell carcinoma: comparison of DNA ploidy using ethidium bromide and mithramycin.

With the help of the deparaffination technique described by Heldly, it has become possible to conduct large-scale flow-cytometric (FCM) studies, including retrospective DNA analysis of renal cell carcinoma (RCC). The quality of these histograms, however, has to be comparable to the quality of the analyses from fresh tumour tissue. The present study compares the application of FCM on fresh tumour tissue from RCC with paraffin-embedded archive material, thus for the first time, the same combination of stains (ethidium bromide/mithramycin) was used for both materials. From a total of 44 tumours, 125 histograms were obtained from fresh tumour tissue. Aneuploidy was found in 78 (62.4%) of the DNA analyses (coefficient of variation, CV = 5.5%). These 78 aneuploid histograms were compared with 228 sections from the archive material which had been deparaffined and stained. This involved, a deparaffinising period of twelve hours as well the application of pepsin and protease, which was necessary to obtain high-quality histograms (CV = 6.0%). Retrospectively, a total of 58 histograms from 36 cases were available for comparison. Of the archive material, 23/36 tumours were classified as aneuploid; thus new stem cell lines could be detected retrospectively in 63.8% of the cases. The comparison of DNA indices (DI) in the two series produced no significant differences, and the comparison of the mean values for the CV-5.5% for native material histograms and 6.0% for archive material histograms-was not statistically significant. The detritus part in the archive histograms revealed a mean value of 6.3% for native histograms the mean value was 13.4%. These differences were also not significant. These results show that, using the staining combination ethidium bromide/mithramycin, the quality of the histograms obtained with archive material is equal to the quality of the histograms obtained from fresh tumour material. Furthermore, when taking into consideration the clonal heterogeneity of RCC, it is possible to use retrospective analysis to detect aneuploidy with a high degree of certainty and accuracy.

Carcinoma, Renal Cell↗