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Biomedical subjects

C Fuchs

Publications and source records attributed to C Fuchs.

At least 55 records · Page 3Linked to original sources

[High malignant B-cell non-Hodgkin lymphoma of the heart: intravital diagnosis by transesophageal echocardiography controlled biopsy].

We report about a 66-year old patient with Non-Q-wave infarction in coronary artery two-vessel disease. During an echo- and transesophageal multiplane echocardiography preoperatively before a coronary artery bypass surgery a right atrium septal tumor of unknown form was discovered. The computerized axial tomography (CAT) and nuclear magnetic resonance (NMR) scans did not demonstrate extracardiac pathologic findings. A transesophageal echocardiography-guided biopsy of the right atrial septum over the vena femoralis and the right atrium enabled intra vitam a very early diagnosis of high malignant B-cell Non-Hodgkin-lymphoma without the need for thoracotomy. The diagnosis was confirmed histopathologically and immunohistochemically and early treatment with cytostatic therapy could begin. To our knowledge the transesophageal echocardiography-guided biopsy has never been described in the worldwide literature.

Aged↗

Intramuscular ceftriaxone compared with oral amoxicillin-clavulanate for treatment of acute otitis media in children.

UNLABELLED: Two hundred and fifteen children aged 4 months 6 years with acute otitis media (AOM) were randomized to be treated either by a single i.m. injection of ceftriaxone, 50 mg/kg, with a second dose in the event of unsatisfactory response after 48 h or a history of recurrent AOM (109 patients) or amoxicillin clavulanate 12.5 mg tid (106 patients). The failure rate was similar in children treated by ceftriaxone and amoxicillin clavulanate, 4.6% and 4.7%, respectively (standard error for intergroup difference -2.87%, 95% confidence interval -5.62% to 5.87%). No significant differences between the groups were found in the dynamics of the resolution of the acute symptomatology, otoscopy findings, relapse rate at 30 days or tympanographic evidence of middle ear effusion at the scheduled visits on days 30, 60 and 90. Recurrence of AOM between days 31 and 90 was observed significantly in more children treated with amoxicillin clavulanate than with ceftriaxone--25 out of 84 (29.4%) versus 11 out of 81 (13.6%) (P = 0.012). CONCLUSION: Ceftriaxone injection(s) is as efficient at least as 10-day oral amoxicillin clavulanate for treatment of acute otitis media in children. Although not recommended as routine, ceftriaxone can be considered in the management of acute otitis media under special circumstances, particularly in cases when the ability to tolerate or absorb oral drugs is compromised, in children refusing or unable to take oral therapy or when the compliance is questionable.

Acute Disease↗

H-dependent formation of 5-aminolaevulinic acid-induced protoporphyrin IX in fibrosarcoma cells.

pH-Dependent variations in the fluorescence intensity of 5-aminolaevulinic acid-induced 5-aminolaevulinic acid protoporphyrin IX (PP IX) were compared with the cell viability following light irradiation. The fluorescence intensity was determined by flow cytometry and the cell activity was investigated by a colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay 24 h after photodynamic treatment. The results obtained by fluorescence measurements clearly showed that pH values of the incubation medium containing (5-ALA) below and above pH 7.4 led to a significant decrease in the fluorescence intensity. The viability of cells incubated with 0.6 mM 5-ALA in a medium at pH 6.0 was unaffected on exposure to light at lambda = 635 nm up to 15 J cm-2. However, cells incubated at pH 7.4 (with the other treatment parameters the same) were nearly completely destroyed. In addition, depletion of intracellular PPIX was faster in physiological medium than in acid medium.

Aminolevulinic Acid↗

Biomodulative effects induced by 805 nm laser light irradiation of normal and tumor cells.

The influence of light emitted from a diode laser centred at lambda = 805 nm was investigated on murine skeletal myotubes (C2), normal urothelial cells (HCV29), human squamous carcinoma cells of the gingival mucosa (ZMK) and urothelial carcinoma cells (J82) in a computer-controlled irradiation chamber. Cells were treated with varying fluences between 0 and 20 J cm-2. The response was tested by analysis of the mitotic index using single cell counting after Orcein staining and proliferation index based on BrdU incorporation during DNA synthesis. While the mitotic index of C2, HCV29 and J82 cells increased at a fluence of 4 J cm-2, irradiation with fluences of 20 J cm-2 resulted in a slight decrease. ZMK tumor cells showed a decrease of the mitotic index with both fluences. No significant differences could be determined when using irradiances between 10 mW cm-2 and 150 mW cm-2. The BrdU test after irradiation showed no significant effects compared to the controls in each cell line.

Animals↗

Correlation between retractions of the pars flaccida and the pars tensa.

Retractions of the pars flaccida (PF) and the pars tensa (PT) were assessed in 250 atelectatic ears in an attempt to find out the way in which the differences in mechanical properties of the two parts of the tympanic membrane are reflected clinically. Retraction of PF was found in 217 ears (86.8 per cent) and retraction of PF in 150 (60 per cent). The concomitant presence of both types of retraction was observed in 117 ears (46.8 per cent) while 133 (53.2 per cent) had only one type, 100 of them (75.1 per cent) PF retraction and 33 (24.9 per cent) PT retraction. When only one type of retraction was present, the empirical probability of having a PF retraction was 75.1 per cent, while the probability of having a PT retraction was only 24.9 per cent. Clinically, the more frequent occurrence of PF retraction in the absence of PT retraction than vice versa reflects the greater collapsibility of the PF. When both types of retractions were present, we found a positive correlation between their severity.

Ear Diseases↗

In swine myocardium, the infarct size reduction induced by U-89232 is glibenclamide sensitive: evidence that U-89232 is a cardioselective opener of ATP-sensitive potassium channels.

We determined whether U-89232, a derivative of the ATP-sensitive potassium (KATP) channel opener cromakalim, is cardioselective and whether its action on the myocardium is still sensitive to glibenclamide. Experiments were performed in open-chest pigs subjected to a 60-min occlusion of the left anterior descending coronary artery (LADCA) and to 2 h of reperfusion. Four groups of animals were studied (n = 6 each). Animals received either U-89232, 3 mg/kg i.v. over a 15-min period (U), or glibenclamide, a selective KATP channel blocker, 1 mg/kg i.v. over a 15-min period (GLI) before the LADCA occlusion. In the GLI + U group, first glibenclamide (1 mg/kg/15 min) and then U-89232 (3 mg/kg/15 min) were infused before the 60 min of ischemia. Saline-treated animals served as controls (CON). Hemodynamic parameters were continuously monitored. Regional contractile wall function was quantified with ultrasonic crystals aligned to measure wall thickening. At the end of the protocol, infarct size (IS, as percentage of risk region) was determined by incubating the myocardium with p-nitrobluetetrazolium. With comparable myocardium at risk, infusion of U-89232 before 60 min of LADCA occlusion significantly reduced infarct size (IS, 18.5 +/- 3.7%; p < 0.001 vs. 63.2 +/- 3.3% for the controls), whereas glibenclamide had no effect on infarct size (IS, 69.5 +/- 4.4%). The administration of glibenclamide before U-89232 infusion blocked the infarct size-reducing effect of U-89232 [IS, 61.2 +/- 9.1 (NS) vs. controls and p < 0.001 vs. U]. Infusion of U-89232 had no effect on hemodynamic parameters or on regional wall function. At least in a pig model, U-89232 appears to be a cardioselective KATP channel opener, because in the absence of hemodynamic alterations, it exhibits a profound cardioprotective effect, which is fully reversible by blocking KATP channels.

Animals↗

Secretory otitis media in adults: II. The role of mastoid pneumatization as a prognostic factor.

The sequelae of secretory otitis media (SOM) were monitored in 72 adult patients with SOM who were followed up for an average of 33 months. It was found that SOM became chronic and retraction of the tympanic membrane appeared as a function of the pneumatization of the mastoid. Ears with poor pneumatization (less than 6 cm2) developed chronic SOM in 52.2% of cases, as compared with 20% in cases with well-pneumatized ears (6 cm2 and above). Atelectasis developed in 37.3% of poorly pneumatized ears, and in only 5.7% of well-pneumatized ears. These sequelae may therefore be linked pathogenetically to the extent of pneumatization, as both the SOM and the sequelae appeared many years after formation and maturation of the pneumatic system. This study supports other studies that view the mastoid pneumatic system as an organ, as a middle ear pressure buffer. Well-pneumatized ears rarely develop a negative pressure and are seldom associated with chronic sequelae. Ears with poorly pneumatized mastoids lack the physiological function of such a pressure buffer. Ears with a tendency to develop a negative gas balance, whether as a result of deficient ventilation or excessive diffusion, will therefore develop a negative pressure more readily when their pneumatic system is underdeveloped, and consequently will be more prone to develop chronic sequelae.

Adolescent↗

Variability in symptom expression among sexually abused girls: developing multivariate models.

Examined which of several apparent risk variables were predictors of internalizing and externalizing problems in 48 girls who were referred for therapy after disclosing sexual abuse. Specifically, the effects of abuse characteristics, support from nonoffending parents, victims' coping strategies, and victims' cognitive appraisals on symptomatology were assessed. As hypothesized, results indicated that internalizing and externalizing problems were associated with different sets of predictor variables. Victims' self-reports of depression and anxiety were related to lower perceived support from nonoffending parents, more use of cognitive avoidance coping, and more negative appraisals of the abuse. These results were partially replicated when using parent-report measures of depression, but were not replicated for parent reports of victim anxiety. Incest was the only variable that was significantly related to parent-reported anxiety. Parent-reported aggressive behaviors were predicted by level of abuse-related stress; and aggression, social problems, and sexual problems were all related to the tendency to cope by controlling others. Social problems were also related to coping by self-distraction. Regression analyses were done for each dependent variable to examine which predictors accounted for unique variance when controlling for other significant zero-order correlates. Implications of these results for understanding variability in symptom expression among sexual abuse victims are discussed.

Adaptation, Psychological↗

Stereoselectivity of lipases in supercritical carbon dioxide. I. Dependence of the regio- and enantioselectivity of porcine pancreas lipase on the water content during the hydrolysis of triolein and its partial glycerides.

The stereoselectivity of porcine pancreas lipase (PPL) was investigated during the enzymatic hydrolysis of triolein and its partial glycerides in the presence of supercritical carbon dioxide (SCCO2) as reaction medium. The water content of the immobilized lipases was varied. The partial glycerides were separated into mono- and diglycerides by TLC, converted to their 3,5-dinitrophenylurethane derivatives and subsequently resolved into sn-1,2 and sn-2,3 enantiomers (estimation of dioleins) or into sn-1 and sn-3 enantiomers (estimation of monooleins) by HPLC on a chiral stationary phase (Sumichiral OA-4100). In all reactions under the conditions employed, PPL revealed a distinct preference for the sn-3 position of the glycerol. However, the stereoselectivity depends on the reaction time, the substances initially used and the enzyme water content. It seems that the effect of the enzyme water content on the activity and selectivity of porcine pancreas lipase in SCCO2 is based on a modification of the "micro-environment' of the enzyme by the solution of CO2 in water, causing a decrease of the pH value.

Animals↗

Phase II trial of ZD1694 (Tomudex) in patients with advanced pancreatic cancer.

BACKGROUND: Currently available therapies for advanced pancreatic cancer offer only palliative benefits, and patients with this disease have a poor prognosis. We undertook a phase II trial of ZD1694 (Tomudex), a quinazoline folate analogue that is a potent and selective thymidylate synthase inhibitor, to determine this analogue's efficacy and safety in patients with advanced pancreatic adenocarcinoma. PATIENTS AND METHODS: ZD1694, 3.0 mg/m2, was administered to 42 adult patients with pancreatic adenocarcinoma as a 15-minute intravenous infusion every 3 weeks for up to 6 doses. Objective tumor response was assessed every 6 weeks; clinical examinations, adverse event assessments, and clinical laboratory tests were performed every 3 weeks. RESULTS: ZD1694 produced an overall response rate of 5% (95% confidence limits [CI], 1% to 16%) in the study group. Of 42 patients, 2 (5%) had a partial response, 12 (29%) had stable disease, 21 (50%) had disease progression, and 5 (11%) could not be evaluated for response. Grade 3 vomiting, grades 3 and 4 fever, grade 3 leukopenia, grade 4 thrombocytopenia, and grades 3 and 4 liver function elevations were reported. Toxic effects with ZD1694 were reversible and manageable. CONCLUSIONS: ZD1694 has an acceptable safety profile but limited activity in patients with advanced pancreatic cancer.

Adult↗

Photodynamic effects of 5-aminolevulinic acid-induced porphyrin on human bladder carcinoma cells in vitro.

The efficiency of 5-aminolevulinic acid (ALA) in photodynamic therapy (PDT) was investigated in vitro using urothelial carcinoma cells of various differentiation. HCV29, RT4 and J82 cells were cultured in 96-well plates, incubated with 25-100 micrograms/ml ALA in serum-containing medium for 4 h, and irradiated at 630, 635 and 640 nm wavelength with light doses of 15-100 J/cm2. The degree of reduced tetrazolium bromide corresponding to cell viability was determined with a colorimetric MTT assay 0, 24 and 48 h after PDT. A remarkable reduction of mitochondrial activity occurred in poorly (J82) and well differentiated (RT4) malignant urothelial cells. Twenty-four hours after photodynamic treatment with 100 micrograms/ml ALA and 50 J/cm2, the metabolic activity of malignant cells was nearly extinguished, while HCV29 cells, derived from normal urothelium, behaved similarly to non-irradiated control cells. The photosensitivity of cells depended on presence or absence of fetal bovine serum (FBS) in the ALA-incubation medium. A wavelength of 635 nm was up to 60% more effective compared with 630 nm, which is more frequently applied in PDT. From the results of our in vitro studies, we can define a "therapeutic window" for malignant cells without damaging benign cells. The time delayed effects and the strong wavelength dependence are important factors for a clinical application.

Aminolevulinic Acid↗

Studies and comparison of pterin patterns in the plasma of dogs and cats and their alteration in various neoplasias and virus infections.

Physiological pterin levels were evaluated in plasma samples of healthy dogs and cats. Biopterin and 7-xanthopterin were determined quantitatively by HPLC after partial purification by ion exchange chromatography. Neopterin, pterin and 6-hydroxymethylpterin were not detectable in plasma samples. Pterin levels in plasma of dogs with neoplasias and cats with neoplasias or viral infections (FeLV, FIV, FIP) were determined. Dogs with various tumours did not show qualitative but distinct quantitative alterations in the pterin concentration in plasma. Biopterin concentrations in plasma of dogs after tumour exstirpation significantly decreased compared to the levels before surgery. There was only a moderate increase of the biopterin levels in plasma of cats with neoplasias in comparison to healthy animals of this species. Cats suffering from viral infections, however, showed a significant rise in biopterin concentrations. The results underscore the importance of pterins as sensitive indicators for the presence of activation of cell mediated immune response. With emphasis on biopterin the role of pterins as helpful parameters for the preventation and the monitoring of diseases is pointed out.

Animals↗

Secretory otitis media in adults: I. The role of mastoid pneumatizationas a risk factor.

We analyzed clinically 102 ears with secretory otitis media (SOM) belonging to 72 adult patients who during their adult life had not suffered previously from ear disease. As in children, most of the cases (63%) could be traced directly to an upper respiratory tract infection. The most striking finding was the preponderance of poorly pneumatized mastoids-which were measured planimetrically-among our SOM cohort. This was found in adult SOM ears compared to contralateral healthy ears (4.59 versus 7.88 cm2), as well as when all 102 SOM ears were compared with values of the normal population (5.41 versus 12.9 cm2). This study showed that poorly pneumatized mastoids are a significant risk factor as far as adult SOM is concerned.

Adolescent↗

The pars flaccida middle ear pressure and mastoid pneumatization index.

The degree of pars flaccida retraction and the levels of mastoid pneumatization were assessed and correlated in 388 adults with intact pars tensa. Poorly pneumatized mastoids were found to be associated with retraction of pars flaccida; the poorer the pneumatization, the deeper the retraction. Well pneumatized mastoids were usually associated with normal position of the pars flaccida. The pars flaccida was previously also shown to retract in face of ME negative pressure--and its degree can be seen to be an index of ME negative pressure. Thus, the correlation of deeper degrees of pars flaccida retractions with mastoid hypopneumatization (and vice versa) lends strength to the studies which show the mastoid pneumatic system to have a function of a passive ME pressure buffer. This observation lends further evidence as to why ears with poorly pneumatized mastoids are a priori at risk to develop complications such as SOM in adults, tympanic membrane retractions and perforations, incus necrosis or retraction pocket cholesteatoma. Ears with a large pneumatic system are hardly at such risk.

Ear Diseases↗

[Impairment of myocardial perfusion reserve in microvascular angina (syndrome X): assessment by 99mTc-MIBI-SPECT].

AIM: In 22 patients with typical chest pain and normal coronary arteries (microvascular angina, syndrome X) 99mTc-MIBI-SPECT was examined in regard to assess impairment of myocardial perfusion reserve. METHOD: The study was performed with 99mTc-MIBI-SPECT at rest and under vasodilation with dipyridamole. The findings were compared with a normal database. A normal perfusion reserve was said to be an increase > 20% of the 99mTc-MIBI-activity. RESULTS: In 2/22 (9%) of the patients the perfusion reserve lay > 20% i.e. 37%. In 91% of the patients a diminution or even decrease of the perfusion was to be seen. From these 9/22 (41%) of the patients showed a diminution of the 99mTc-MIBI-uptake by 6%. 1/22 patients had a decrease of the perfusion under vasodilation with dipyridamole i.e. a lower activity of 99mTc-MIBI by 13% CONCLUSION: Vasodilation 99mTc-MIBI-SPECT offers good imaging quality and enables semi-quantitative assessment of myocardial perfusion reserve in patients with microvascular angina.

Blood Pressure↗

[Pseudodefects in myocardial SPECT after implantation of defibrillator patches: phantom measurement with SPECT and PET].

AIM AND METHODS: In order to estimate the effect of an epicardial or subcutan defibrillator patch electrode on the imaging of myocardium with SPET and PET we performed measurements with a body phantom and two different patch electrodes. RESULTS: We found that in 201TI-SPET with epicardial placing one electrode causes significant pseudodefects, which might lead to the impression of an infarction ("pseudoinfarction"), particularly in the case of reduced myocardial wall thickness. Measurements with 99nTc show the same pseudodefects. In case of subcutaneous placing the electrodes are much less likely to cause relevant absorption effects. With PET even epicardially placed both patch electrodes do not produce pseudodefects. Therefore the risk of false-positive findings is very small with PET. CONCLUSION: In order to avoid false positive findings in cardiovascular nuclear medicine caused by defibrillator patch electrodes, patients with patch electrodes should be referred to PET, if available.

Artifacts↗