Computerized bioassays: two examples.
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Biological Assay↗
Biomedical subjects
C Schmidt
Publications and source records attributed to C Schmidt.
[Digital subtraction angiography and other non-invasive procedures for evaluating renal circulation and hypertension].
Nuclear medical techniques (such as isotope nephrograms, renal scintigrams) which are suitable as screening methods, have been unable to improve the diagnosis of reno-vascular hypertension. Amongst conventional procedures, the excretion urogram following a bolus injection was the most informative, particularly if performed together with nephro-tomography. Although ultrasound is of some use in evaluating the kidneys, the excretion urogram remains essential for the diagnosis of reno-vascular hypertension. Additional exposures and modifications (e.g. early phase urogram only add unnecessary radiation and cost without providing additional information. On the other hand, it would be useful to obtain digital subtraction angiograms of the renal arteries during the contrast injection. In this way, reliable information can be obtained on the cause of reno-vascular hypertension in more than 90% of patients. Similar results can be obtained by photographic subtraction (ISA). This should be used where DSA apparatus is not available. Angio-CT and sequential CT is not reliable for the diagnosis of renal artery stenosis. On the other hand, these methods provide density measurements or time-density curves of selected areas in the cortex or medulla of the kidney, which indicated abnormalities of the circulation and provide a comparison of the two sides.
Angiography↗
[Puncture biopsy of the lung. A retrospective evaluation of 127 observations].
On the grounds of a suspected localised tumorous lesion of the lung core biopsy (Tru-cut-needle) was performed in 127 patients to obtain a histologic diagnosis. This was successful on an average in 71.6% of the cases. The smaller lung lesions (less than 2.5 cm) showed a lower accuracy (65.2%) than the larger tumours (73.1%). Correct judgement of tumour status was effected in 88.2%. But in these cases also correct assessment of tumour status was less successful with the smaller tumours (69.6%) than with the larger ones (92.3%). In our case material core biopsy had a high complication rate: pneumothorax resulted in 54.3%, requiring special treatment in 9.4%. Haemoptisis was observed in 22.9% of which 2.4% had a severe and life-threatening clinical course. A correlation between these complications and the patient's age, the depth of the tumour in the lung and the frequency of the punctures was established. Pleural fluid was seen in 16.5% but in all cases it was negligible and no treatment was required. The pleural reaction showed no correlation to the age, to the tumorous lesion and to the frequency of puncture. The diagnostic advantage and the high accuracy of the core biopsy are evident. Nevertheless, we gave up this method in routine application in our lung tumour patients in favour of needle biopsy techniques. Core biopsy is still being used in examining special problems only.
Adult↗
Aggressive combination therapy in the successful management of life-threatening intracranial hemorrhage in a patient with idiopathic thrombocytopenic purpura.
We describe acute therapy for a 13-year-old female from Panama with chronic idiopathic thrombocytopenia purpura (ITP) refractory to steroids, splenectomy, vinca alkaloids, and azathioprine. She presented with neurologic deterioration from a posterior fossa intracranial hemorrhage (ICH). This followed a 3-month history of severe dysfunctional uterine bleeding, progressive from menarche, which had required multiple red cell transfusions. Steroid and vinblastine therapy and transfusion of 40 U of platelets failed to increase the platelet count above 10,000/microliter. Development of a second larger ICH (frontal) produced morbid increase in intracranial pressure that necessitated neurosurgical decompression. Plasma exchange and colloid repletion with intravenous gamma globulin (1 g/kg) and an infusion of 20 U of platelets resulted in a transient rise in platelet count to 160,000/microliter, permitting surgery without bleeding. Danazol (800 mg/day) and conjugated estrogen (Premarin 25 mg/day) were begun to control the uterine bleeding. Intensive plasma exchange and i.v. IgG infusions were continued daily for 24 days, then twice weekly for several weeks. Platelet-bound IgG decreased almost 500% over the first 10 days of therapy, and platelets increased dramatically to 600,000/microliter after 3 weeks of therapy. The patient has remained amenorrheic with a normal platelet count for more than 24 months on daily danazol therapy and monthly infusions of i.v. IgG (0.4 g/kg/dose).
Adolescent↗
[The solitary alveolar cell carcinoma].
Alveolar-cell carcinoma was first described by Malassez in 1876. It contributes 5 per cent to all malignant tumors of the lung. In a retrospective study 75 patients with alveolar-cell carcinoma were analyzed. Clinical symptoms are non-specific and the tumor will often be discovered on the occasion of a routine chest X-ray as a small peripheral and infiltrative lesion. The most frequent form is a nodule which generally shows a regular and well defined outline, but may sometimes be irregular and have spiky margins too. Very often an air bronchogram and the tail sign can be seen so the combination seems typical of solitary alveolar-cell carcinoma. In the case material investigated the authors found it in 36 per cent. The early stage of localized alveolar-cell carcinoma has a good prognosis when treated by surgery. Multilocular and advanced cases, however, have a very poor prognosis. Therefore, early radiological diagnosis is most important. The value of needle aspiration biopsy in the diagnosis of alveolar-cell carcinoma is emphasized.
Adenocarcinoma, Bronchiolo-Alveolar↗
Naftifine solution (1%) in the treatment of pityriasis versicolor in Zambia.
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Adolescent↗
[Sudden infant death. An analysis of psychosocial conditions].
The Sudden Infant Death Syndrome (SIDS) has been studied mainly in a medical-biological view. In this paper emphasis is put on the fact that SIDS is also a psychosocial phenomenon: As the infant exists in a continuous exchange with his environment, his death can be considered a reaction to extreme stress load including psychosocial factors. In proceeding from that concept, the social and psychological conditions of 94 mothers of SIDS cases have been analyzed and compared with 68 mothers of healthy infants of similar age, urban/rural relation, and social class distribution. Both groups differed considerably. The SIDS group was more "jeopardized" in any aspect. Probability to die seems to increase with the number of accumulated risk factors. The conclusions drawn can be utilized for prevention.
Family↗
[Arteriography of the hand in Raynaud's phenomenon].
Analysis of 356 angiographic images of hand from 216 patients with Raynaud's phenomenon confirmed the higher prevalence of occlusive arterial lesions (75% of cases) when compared with idiopathic Raynaud's syndrome. The ulnar artery (30% of cases) and digital collateral arteries of free borders of hand (45 to 62% of cases) were the most frequently affected. This preferential localization of the arterial thromboses can be explained by repeated microtrauma from manual occupations (markedly increased in cases of digital arteriopathy). Correlation between the occlusive lesions and a thoracic outlet syndrome is lacking.
Adolescent↗
Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion.
Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.
Analysis of Variance↗
[Cystic lymphangioma of the greater omentum].
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Adult↗
[Stimulation-induced changes in the ultrastructure of the synapses in the hippocampus by post-tetanic potentiation].
Within the frame of experimental brain research at present the phenomenon of potentiation (posttetanic potentiation, long-term potentiation) is considered to provide a possible mechanism of learning processes and memory formation on the synaptic level. Tetanic stimulation of the Nucleus septalis fimbrialis produces the posttetanic potentiation in synapses of the hippocampal CA 3-region, whereafter a long-lasting increase in the amplitude of evoked potentials can be recorded. By quantitative electron microscopical morphometry we investigated the morphological changes in synapses of the Stratum radiatum of the hippocampal CA 3-region of rabbits (1 hour following posttetanic stimulation). Tetanic stimulation of the Nucleus septalis fimbrialis induces an enlargement of the postsynaptic spine area significantly by 28% and a decrease of the mean area of presynaptic terminals by 24%. No changed number of synapses were found in comparison to the controls. Furthermore stimulation of the Nucleus septalis fimbrialis induces a transient decrease of synaptic vesicles in various zones of the presynaptic area, especially near the presynaptic membrane. These results demonstrate morphologically detectable changes as a consequence of synaptic activation. Therefore posttetanic potentiation is characterized by various morphologic changes reflecting probably an early phase of the learning process with transient effects on the ultrastructure of the synapses.
Animals↗
[Effect of obstetrical manipulations on the prostaglandin content of the uterus].
It is reported about the concentration of PG F2 alpha, PG E2, TxB2 and 6-keto-PG F1 alpha in amniotic fluid after obstetrical manipulations without rupture of amniotic membranes. Only digital distension of the cervix was followed by a rise of PG F2 alpha values. On the other side there was no increase in PG-concentration after application of a transabdominal catheter or after amniotomy.
6-Ketoprostaglandin F1 alpha↗
[Pulsatility index and circulatory resistance factor in arteriopathies of the lower extremities].
Pulsatility index (P.I.) and Resistance factor (Gosling) are computed on Doppler arterial recordings in 43 healthy subjects and 95 arteriopathies (184 lower limbs). The statistical analysis points out the high significance of tibial P.I. for early diagnosis of arterial disease, of femoral P.I. for assessment of aorto-iliac stenosis or obstruction and of the ratio tibial P.I./femoral P.I. in the evaluation of leg arteries patency. The popliteal P.I. discriminates proximal and distal lesions.
Adult↗
Peri-operative infection prophylaxis with ornidazole and gentamicin in elective colonic surgery.
In a study of 60 patients undergoing elective colonic surgery peri-operative infection prophylaxis by the "one-shot' method was compared with that of 48-hour duration. The antibacterial agents used were ornidazole and gentamicin. Considering the patient population as a whole, no significant differences were found in the results. All the infectious complications which occurred post-operatively were due to bacterial contamination by aerobic pathogens. No anaerobic pathogens were detected in any of the cases.
Aged↗
[The occult fracture in the roentgen picture and its detection using bone scintigraphy].
A retrospective study was made of patients with initially negative radiographs and positive radionuclide bone images. Comparison of conventional radiography and bone scanning in traumatology shows that the masked bone fracture can be seen in the bone scan but a focal accumulation of the radioactive material may not correspond to a bone fracture in every case. The ligamentous avulsion of a bone chip and/or the periosteum can yield the same image. Usually bones respond to trauma with an abnormal focal tracer accumulation because of irregular metabolic processes and the disturbance of the local blood circulation. By using a highly sophisticated technique (3-phases bone scanning) the focal disturbances can be seen. The greatest problem in scanning is the nonspecificity of abnormal tracer accumulation. Although bone scanning is very important in the diagnosis of any traumatic lesion of the bone it cannot replace the conventional radiograph.
Adult↗
[Pulsatility, flow and metabolic diseases].
Metabolic diseases, and particularly diabetes mellitus have a well-established vascular determinism. Diabetic arteriopathy is associated from its onset with elevated tissue blood flow at rest and blood and plasma hyperviscosity. These anomalies are corrected by the perfect equilibration of the glycemia with the artificial pancreas. In 8 to 28% of cases, according to the author, there is an original hemodynamic picture; the enhanced flow hyperpulsatile diabetic arteriopathy observed in a caricatural manner in ulcerated mutilating acropathies. The vasomotor inertia of the diabetic artery and the metabolic neuropathy suggest that surgery to increase blood flow might be of interest in diabetic patients, as a function of results of previous function tests.
Diabetes Mellitus, Type 1↗
[Determination of free L-triiodothyronine (FT3) in serum. Comparative tests of 2 FT3 radioimmunoassays].
A trial of the routine use of two test procedures for the evaluation of free L-triiodothyronine (FT3) was carried out (1070 patients). The normal values given by the manufacturers are not correct with respect to our patient group. In order to avoid false hyperthyroid (FT3-Amerlex) or false hypothyroid (FT3-DPC) values, the normal spectrum was redetermined for each. Under these conditions, both tests could show a definite difference between normal and overfunctioning of the thyroid. In substitution therapy with L-thyroxine, the quality of adjustment may be assessed according to the FT3 value. An extension of the normal spectrum, as for FT4, is not necessary. Since any additional assessment of the carrier protein concentration becomes irrelevant, the FT3 test is advisable also for economic reasons.
Humans↗
Selective transduction of recombinant plasmids with cloned pac sites by Salmonella phage P22.
Recombinant plasmids having PstI fragments of P22 DNA inserted in the vector pBR322 can be transduced efficiently by Salmonella phage P22, irrespective of the cloned phage sequences. When the rec function of the donor cells and the corresponding recombination system erf of the infecting phage are simultaneously inactivated, only plasmids containing the P22 pac site can be transduced. By this selective, generalized transduction an EcoRV DNA fragment of the P22 related phage L has been identified that carries a base sequence recognized by phage P22 as a packaging signal. Experiments in which only one of the two recombination systems was inactivated, showed that the bacterial rec system obviously promotes cointegrate formation between plasmid and phage DNA much more efficiently than the phage-coded erf system, allowing the specialized plasmid transduction observed by Orbach and Jackson (1982).
Cloning, Molecular↗