Theories of sexual orientation: a reappraisal.
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Animals↗
Biomedical subjects
D Berger
Publications and source records attributed to D Berger.
Histological behavior of glutaraldehyde cross-linked bovine collagen injected into the human bladder for the treatment of vesicoureteral reflux.
Endoscopic subureteral collagen injection has become an accepted means for the treatment of vesicoureteral reflux in children. The aim of this study was to evaluate the histological behavior of glutaraldehyde cross-linked bovine collagen implants. The specimens were harvested from 29 patients who underwent reimplant surgery 2 to 30 months (mean 9.5) after unsuccessful subureteral injection therapy. In addition to routine hematoxylin and eosin staining, a new staining method (solophenyl red 3BL) able to demonstrate selectively neoformation of types I and III human collagen, was applied. Invasion of host fibroblasts into the bovine implant and the formation of endogenous types I and III collagen were demonstrated in all 29 cases. Adverse histological reactions were rare and, if present, they were predominantly of an inflammatory nature.
Biocompatible Materials↗
Immune responses elicited by recombinant vaccinia-human immunodeficiency virus (HIV) envelope and HIV envelope protein: analysis of the durability of responses and effect of repeated boosting.
Previous studies indicate that immunization with recombinant (r) vaccinia-human immunodeficiency virus type 1 (HIV-1) gp160 and boosting with baculovirus-derived HIV-1 rgp160 results in stronger cellular and antibody responses than those following either vaccine alone. The durability of immunity over 1 year was evaluated in 12 recipients. Both cellular and binding antibody responses remained detectable but diminished, and neutralizing antibodies were absent. To boost immunity, rgp160 was given again 1 year after the initial boost. Reboosting elicited strong HIV-specific lymphoproliferative responses. Binding antibody levels also rose dramatically, and the magnitude of the peak responses was significantly greater following the 2-year than following the 1-year boost. However, neutralizing antibody titers were low (1:10-1:20) and detected in only 4 of 12 persons. Moreover, persistent CD8+ cytolytic responses were not induced. Thus, although repeated rgp160 boosting after vaccinia-envelope priming can augment selected immune components, an altered regimen may be necessary to achieve protective long-term immunity to HIV-1.
AIDS Vaccines↗
Dissociation and child abuse histories in an eating disorder cohort in Japan.
Dissociation and childhood abuse were studied in female eating disorder outpatients in Japan. A self-report version of the Dissociative Disorders Interview Schedule (DDIS), which includes data on physical and sexual abuse, and the Dissociative Experience Scale (DES) were used. Nine of 41 subjects who completed the DDIS reported symptoms suggesting DSM-III-R multiple personality, and 6 of the 39 subjects who completed the DES scored over 30 (reflecting a high likelihood of posttraumatic stress or multiple personality). Subjects' sexual abuse history rates were considerably greater then those in the Japanese general population. Though physical abuse history was associated with high dissociation, no difference was seen between the high and low dissociators in sexual abuse histories.
Adolescent↗
Is the elimination of endotoxin and cytokines with continuous lavage an alternative procedure in necrotizing enterocolitis?
Ascites fluid was obtained intraoperatively in 12 consecutively treated neonates (6M, 6F, mean weight 940 g, mean gestational age 27th week, lethality 3/12) suffering from necrotizing enterocolitis (NEC). The concentrations of endotoxin and cytokines (IL-1, IL-6, TNF) were determined. Endotoxin and interleukins were excessively elevated in all patients, TNF only in those who survived. Postoperative treatment included the use of a continuous abdominal lavage system. This therapeutical procedure allows the elimination of endotoxin and cytokines out of the abdominal cavity in order to reduce their adverse biological effect.
Ascites↗
Diagnosis and treatment of necrotizing enterocolitis. A retrospective evaluation of abdominal paracentesis and continuous postoperative lavage.
From 1980 to 1991, 70 preterm and 20 term infants suffering from necrotizing enterocolitis (NEC) were treated at the University of Ulm hospitals. NEC was primarily suspected from clinical signs. The diagnosis was established by plain abdominal X-rays, infection markers and abdominal paracentesis. Indication for surgery resulted from paracentesis, from radiologically proven perforation, from ileus symptoms and from rapid clinical deterioration; 44 preterm and 7 term infants underwent surgery. Bowel resections were performed in 5 of the term and in 16 of the preterm infants. An enterostomy was fashioned in 33 cases. Total necrosis of the gut was apparent in 8 infants. A continuous peritoneal lavage was performed in 34 babies. One term and 18 preterm babies, all with a birth weight less than 1000 g, died. This results in a NEC-related overall mortality of 19%.
Decision Support Techniques↗
[Juvenile ovarian granulosa tumor associated with pregnancy. A case report. Review of the literature].
A case of juvenile tumour of the granulosa occurred in a pregnant woman. Outcome was rapidly fatal. These tumours are classed as mesenchyma tumours of the sexual cords of the ovaries. The juvenile form occurs before the age of 30 years in 97% of the cases and has characteristic endocrine and anatomic features. The tumour remains localized in the ovary for a long period and may be treated with conservative surgery to preserve fertility in these young patients. Follow-up is aimed at detecting relapse which may occur early. Prognosis in such cases is very poor. Pregnancy does not modify the prognosis which is generally good.
Adult↗
Suicide evaluation in medical patients. A pilot study.
General hospital psychiatrists were given a pilot questionnaire aimed at characterizing patients evaluated for suicidality. Twenty-seven patients evaluated for suicidality in a 4-month period were studied for demographic, medical, psychiatric, and suicidal variables. Comparison with medical patients who had attempted/completed suicide in prior studies and recommendations to reduce suicidal impulses and improve the database were discussed.
Female↗
Pre- and postoperative urodynamic and anorectal manometric findings in children operated upon for a primary tethered cord.
The aim of the study was to assess the sensitivity of both urodynamics and anorectal manometry in detecting neurological signs in children with a primary tethered cord. Between 1989 and 1991, 9 children were operated upon for untethering of primary tethered cord in Lausanne. Both manometric studies were performed by the same team preoperatively and 6 months after surgery. Gaeltec catheters with micro-tip transducers were used with a standardized method. Preoperative manometric findings were pathological in 4 children without clinical signs of bladder dysfunction and in 3 without clinical fecal disorders. Postoperatively, bladder dysfunction regressed in one child and fecal disorders in another. Manometric findings remained nevertheless pathological. The authors held both urodynamics and anorectal manometry as mandatory for preoperative evaluation as well as for the postoperative monitoring of children with primary tethered cord.
Adolescent↗
Scintigraphic evaluation of multifocal hemangioendothelioma of bone.
Multifocal bone involvement was seen on bone scintigraphy in a young woman being examined for a suspected bone lesion noted on pelvic radiographs. Biopsy of the third lumbar vertebral body demonstrated a vascular lesion. The tumor was resected and a bone graft was performed. The patient was followed with serial scans to assess the viability of the bone graft and course of the disease. This report analyzes the scintigraphic characteristics of this rare tumor and emphasizes the importance of bone scintigraphy in the diagnosis, treatment, and follow up of this condition.
Adult↗
[Surgical procedures for the elimination of endotoxins].
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Endotoxins↗
[Endotoxin in blood plasma of patients after trauma].
Depending on the severity of the injury, high endotoxin levels may be found in patients with lung contusion but only slightly increased levels in patients with skull and brain trauma. This difference is highly significant. Patients with multiple injuries and fractures of the extremities as the main diagnosis and with a combination of injuries show a moderate increase in endoxin level on the day of admission. There is no relationship between the injury severity and endotoxemia.
Adolescent↗
Genetic instability of industrial strains of Penicillium chrysogenum.
It has shown that several characteristics of high-producing industrial strains of Penicillium chrysogenum tend to segregate in the course of cultivation (slant-to-slant transfer). Segregation includes a decrease in the yield of penicillin, mean conidial size, mean size of the nuclei, and an increase in the proportion of morphologically wild-type colonies. These lower-producing segregants also have a higher sensitivity against ultraviolet radiation and, as shown by cytofluorometric methods, a lower DNA content in the conidia, a decrease in phosphate uptake and in the activity of extracellular alkaline phosphatases compared to high-producing strains. Obviously, during mutagenesis/selection programmes ploidy mutants have been selected, which entails an increase in the number of genes coding enzymes responsible for penicillin biosynthesis. In the absence of selection pressure these high-producing strains segregate to lower-producing strains by chromosome losses in the course of slant-to-slant transfers.
Industrial Microbiology↗
Subureteral collagen injection for the endoscopic treatment of vesicoureteral reflux in children. Followup study of 97 treated ureters and histological analysis of collagen implants.
Endoscopic subureteral injection has become an established alternative means for treating vesicoureteral reflux in select children. However, which injection material to use remains a controversy. Polytetrafluoroethylene (Teflon) has been injected in more than a thousand patients with few complications, although experimental and clinical studies have demonstrated migration of the injected particles into distant organs, such as the lungs and the brain, as well as local and metastatic granuloma formation. Therefore, we introduced, following experimental studies in the mini-pig model, glutaraldehyde cross-linked, highly purified bovine collagen for injection. Between June 1988 and October 1991, 97 refluxing ureters in 66 children were treated by endoscopic subureteral collagen injection. In 58.8% of the ureters reflux was cured after 1 and in 77.3% after 2 injections. Considering improvement to grades I and II reflux without further treatment as success, the success rate increased to 68.0% after 1 and to 89.7% after 2 injections. Mean followup was 18.5 months (range 3 to 39 months). After 2 failed injections the patients either returned to antibiotic long-term prophylaxis or the reflux was operatively corrected. The operative procedure was never compromised by the preceding injection. A direct correlation between deficient length of the submucosal tunnel of the intravesical ureter and the iatrogenic malposition of the collagen deposits, and the failures could be demonstrated. Granuloma formation at the site of injection was not found. The results of the histological investigation of the collagen deposits removed at open ureteral reimplantation for failures are reported. It could be demonstrated that endogenous fibroblasts invade the bovine collagen implant and that these cells show active production of new human collagen, types I and III, replacing the implant.
Adolescent↗
Drinkers and their driving: compliance with drinking-driving legislation in four Australian states.
This study replicates work in Norway and the United States in investigating the extent to which Australian drivers attempt to comply with drinking-driving legislation. In a four-state survey of 1,133 drinkers, it was found that people were aware of the need to control their alcohol input before driving, and derived estimates of blood alcohol after a recent away-from-home drinking occasion demonstrated that the amount people drank was influenced by whether or not they were driving. Drivers reported drinking less than nondrivers and were also those who usually consumed less alcohol. These findings were also true of people with different levels of normal consumption. Although these results are encouraging, it is suggested that there is need for further modification of sanctions, and that the community needs more information about the alcohol content of drinks and drink sizes if people are to moderate effectively their drinking before driving.
Accidents, Traffic↗
[Surgical therapy of acute pancreatitis].
In patients with proven acute pancreatitis which is not necrotizing conservative therapy leads to a rapid pain release; after sanitation of the basic disease, complete healing is achieved. In case of a biliary pancreatitis with incarcerated gallstones in the papilla an EPT with removal of the choledochal stones is carried out within the first 12 hours after onset of incarceration symptoms; after disappearance of the symptoms of acute pancreatitis an endoscopic or minilap.-cholecystectomy is performed. Conservative therapy leads to a complete cure in patients with minor necroses without any bacterial contamination and without extensive retroperitoneal fatty tissue necroses. Surgery is indicated if a surgical acute abdomen or a sepsis develops, if patients do not respond to maximum intensive care treatment over at least 72 hours, or if organ complications, such as pulmonary/renal insufficiency, cardiocirculatory dysfunction/shock and metabolic disorders grow worse under ICU treatment. The choice procedure against bacterially contaminated necrosis is their careful removal by necrosectomy or débridement. Resectional techniques should be avoided. A third of patients needs reoperation because of extensive inflammatory processes in the retroperitoneum and around the pancreas. Treatment centres report a hospital mortality rate of clearly below 20%.
Acute Disease↗
[The pathophysiological bases of peritonitis therapy].
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Combined Modality Therapy↗