Search PubMed⌕ Search

Biomedical subjects

E Haller

Publications and source records attributed to E Haller.

At least 19 recordsLinked to original sources
PubMed1999

Comparison of different biomaterials for glaucoma drainage devices.

OBJECTIVES: To compare the inflammatory reaction associated with the insertion of silicone and polypropylene endplates and endplates made of a new biocompatible polymer, Vivathane, in the rabbit subconjunctival space. METHODS: Similar-sized endplates made of 3 different biomaterials were sutured to the sclera in the superotemporal quadrant of the rabbit eye. Thirty eyes of 15 albino New Zealand rabbits were randomly assigned to the 3 groups. Conjunctival vascular hyperemia was graded in a masked fashion among groups. At the end of 3 weeks, the enucleated eyes were examined histologically and using scanning electron microscopy. RESULTS: Polypropylene and Vivathane were associated with significantly more inflammation in clinical observations and based on histological grading. Silicone was associated with the least amount of inflammation. Three polypropylene and 1 Vivathane plate were extruded between the second and third week. CONCLUSIONS: Silicone is the most inert of the 3 materials tested. Inflammation associated with biomaterials may contribute to the failure of the glaucoma drainage devices. CLINICAL RELEVANCE: Bleb inflammation may be related to the biomaterial being used as the endplate. Endplates should be handled carefully during surgery to avoid creating rough spots.

Animals↗
PubMed1997

Purification and characterization of a phytase from Klebsiella terrigena.

A cytoplasmatic phytase was purified about 410-fold to apparent homogeneity with a recovery of 28%. The enzyme is induceable under carbon limitation in the presence of phytate. It behaves as a monomeric protein of a molecular mass of about 40 kDa. The phytase is rather specific for phytate and exhibits optimal conditions for phytate degradation at pH 5.0 and 58 degrees C. Kinetic parameters for the hydrolysis of Na phytate are KM 300 microM and kcat 180 s-1 at 35 degrees C and pH 5.0. Phytate is hydrolyzed in a stepwise manner; the penta- and tetrakisphosphate were identified as I(1,2,4,5,6)P5 and I(1,2,5,6)P4. Consequently, this enzyme is a 3-phytase (EC 3.1.3.8).

6-Phytase↗
PubMed1997

Propranolol as an adjunct therapy for hyperthyroid tremor.

We evaluated the use of propranolol as an adjunct to carbimazole in the treatment of hyperthyroid tremor and tachycardia in a double-blind, cross-over and placebo-controlled study. Seven patients were given carbimazole plus either placebo or propranolol (40 mg) for 1 month and then switched to the alternative adjunct treatment for a further month. All patients showed significant improvements (p < 0.001) of heart rate and tremor amplitude after 1 or 2 months from baseline. One month after the baseline, the mean improvements of heart rate were 23% for the carbimazole + placebo group and 38% for carbimazole + propranolol group. Tremor also improved during the 1st month of the study by 31% in the carbimazole + placebo group versus 59% in the carbimazole + propranolol group. Whereas further improvements were observed in both variables in those receiving propranolol as the second adjunct treatment, this was not the case in those who received placebo during the same period. These findings confirm that the beta-blocker propranolol is a useful adjunct in the early treatment of both the tremor and tachycardia of hyperthyroidism.

Adrenergic beta-Antagonists↗
PubMed1996

Botulinum toxin A in non-dystonic tremors.

The present pilot study evaluated the effect of botulinum toxin A on primarily non-dystonic tremors using accelerometry in a single-blind, placebo-controlled design. Resting, postural, intention, or head tremor were assessed before and approximately 1 month after intramuscular saline and botulinum toxin A (25-50 U) respectively. Half of the patients showed > or = 30% placebo effect. Tremor in 10 of 17 patients (60%) studied improved further after botulinum toxin A (range 30-95%), exceeding the placebo effect by > or = 30%. Nine patients demonstrated clinically significant focal weakness in the extensor muscles after botulinum toxin A which interfered with fine movements. Patients were subdivided into PD-like and ET-like tremor(s). Both groups experienced large placebo effects for resting tremor, with little or no further improvement after botulinum toxin A. The improvement in postural tremor after botulinum toxin A, of 40% in the PD-like and 57% in the ET-like groups, however, was approximately twice that of placebo. In conclusion, botulinum toxin A exerts a modest tremorlytic effect, however the dose, and its distribution over the sites injected, need to be optimised to minimise focal weakness.

Adult↗
PubMed1996

Impact of a smoking ban on a locked psychiatric unit.

BACKGROUND: This study prospectively evaluated the impact of a complete smoking ban on a locked psychiatric unit. METHOD: The setting was a 16-bed inpatient unit with 83% (134/162) involuntary patients, no off-unit smoking area, no possibility of granting smoking passes, and a mean length of stay of 2 weeks. The effect of a complete smoking ban was measured by surveys of both staff and patients before and after the ban. In addition, objective indicators of ward disruption were measured, including rates of aggression, use of p.r.n. medications, need for seclusion and restraints, elopement, and discharges against medical advice. RESULTS: Although staff initially expressed concern about the ban's potential negative impact, after it began, t tests revealed that staff were significantly (p < .05) less concerned about patients' needing more medication, becoming restless, being too fragile to cope with withdrawal, leaving the unit against medical advice, or trying to elope. Staff were significantly (p < .02) more positive about the ban than were patients. Although patients, overall, had negative views toward the new policy, their opinions were somewhat less negative after its implementation. Rates of assaultive behavior, use of seclusion and restraints, use of p.r.n. medication, and against-medical-advice or elopement discharges did not change after the ban was in effect. When polled, 78% (40/51) of the staff voted to keep the ban. CONCLUSION: This study found that staff anticipated negative consequences to a total smoking ban; however, their attitudes changed after it began. The ban had no significant impact on the ward milieu, and although patients were not in favor of it, they felt less negative over time.

Adult↗
PubMed1995

Prediction of 18-month survival in patients with primary myelodysplastic syndrome. A regression model and scoring system based on the combination of chromosome findings and the Bournemouth score.

The predictive potential of six selected factors was assessed in 72 patients with primary myelodysplastic syndrome using univariate and multivariate logistic regression analysis of survival at 18 months. Factors were age (above median of 69 years), dysplastic features in the three myeloid bone marrow cell lineages, presence of chromosome defects, all metaphases abnormal, double or complex chromosome defects (C23), and a Bournemouth score of 2, 3, or 4 (B234). In the multivariate approach, B234 and C23 proved to be significantly associated with a reduction in the survival probability. The similarity of the regression coefficients associated with these two factors means that they have about the same weight. Consequently, the model was simplified by counting the number of factors (0, 1, or 2) present in each patient, thus generating a scoring system called the Lausanne-Bournemouth score (LB score). The LB score combines the well-recognized and easy-to-use Bournemouth score (B score) with the chromosome defect complexity, C23 constituting an additional indicator of patient outcome. The predicted risk of death within 18 months calculated from the model is as follows: 7.1% (confidence interval: 1.7-24.8) for patients with an LB score of 0, 60.1% (44.7-73.8) for an LB score of 1, and 96.8% (84.5-99.4) for an LB score of 2. The scoring system presented here has several interesting features. The LB score may improve the predictive value of the B score, as it is able to recognize two prognostic groups in the intermediate risk category of patients with B scores of 2 or 3. It has also the ability to identify two distinct prognostic subclasses among RAEB and possibly CMML patients. In addition to its above-described usefulness in the prognostic evaluation, the LB score may bring new insights into the understanding of evolution patterns in MDS. We used the combination of the B score and chromosome complexity to define four classes which may be considered four possible states of myelodysplasia and which describe two distinct evolutional pathways.

Chromosomes, Human↗
PubMed1995

[Motility disorders in brachytherapy of choroid melanomas with Ru106 applicators].

Accurate visualization of the tumor base by diaphanoscopy is essential for optimal placement of a ruthenium plaque. Depending on the localization of the tumor, dissection of one or more of the rectus muscles is necessary during placement of the plaque or during the course of protracted irradiation. Orthoptic investigations were performed to evaluate the cause of motility disorders and to follow up the functional outcome. In 13 patients (out of 30) who underwent ruthenium-106 therapy for uveal melanomas, one or more muscles had to be dissected during placement of the plaque and were reinserted in the same operation or after removal of the applicator. In 4 cases rectus muscles had to be shifted and were replaced after the irradiation. There were 5 patients who developed motility disorders with double vision. All of them were orthophoric within 6 months without surgery.

Adult↗
PubMed1995

In situ effects of interferon on human glioma protein kinase C-alpha and -beta ultrastructural localization.

Transmission electron microscopy was used to determine how immunogold labeling of PKC-alpha or -beta is modulated by the antitumor drug IFN (HuIFN alpha-2b) in the cytoplasm, membrane structures, and nucleus of rapidly dividing and confluent human glioma U-373 cells. Results showed that except for nuclear localization, there were no specific cytoplasmic organelles that PKC-alpha or -beta translocated to following HuIFN alpha-2b treatment. Electron micrographs of PKC-beta in proliferating cells depicted 1.34-fold more PKC-beta in the nucleus than in the cytoplasm and a 1-min HuIFN alpha-2b (500 units/ml) treatment transiently increased PKC-beta immunoreactivity in the cytoplasm (1.95-fold) and nucleus (1.97-fold). In confluent cells, incubation with HuIFN alpha-2b for 2 min significantly decreased cytoplasmic PKC-beta immunoreactivity by 37%, and no change was observed in nuclear PKC-beta labeling. PKC-alpha labeling in proliferating cells showed similar immunoreactivity in both control cytoplasm and nucleus. Treatment of proliferating cells with HuIFN alpha-2b for 2 min decreased PKC-alpha in the cytoplasm (59%) and nucleus (44%). In confluent cells, cytoplasmic PKC-alpha labeling decreased 59% at 1 min, 61% at 2 min, and 76% at 10 min of HuIFN alpha-2b treatment. Nuclear PKC-alpha decreased by 65% at 1 min, 80% at 2 min, and 62% at 10 min after HuIFN alpha-2b treatment. Western blots of total PKC-alpha in proliferating and confluent cells and PKC-beta in confluent cells showed similar results. However, Western blots of total PKC-alpha and -beta in proliferating cells did not demonstrate any significant changes in either PKC-alpha or -beta immunoreactivity following 1-min HuIFN alpha-2b treatment. These results suggest that treatment of proliferating U-373 cells with HuIFN alpha-2b for 1 min unfolds and exposes PKC-beta antigenic sites (hinge region) and increases in situ PKC-beta immunogold labeling.

Amino Acid Sequence↗
PubMed1994

Hematologic, clinical, and cytogenetic analysis in 109 patients with primary myelodysplastic syndrome. Prognostic significance of morphology and chromosome findings.

One hundred and nine patients with primary myelodysplastic syndrome (MDS) were classified according to the French-American-British (FAB) criteria: 27 refractory anemia (RA, 25%), 26 RA with ringed sideroblasts (RARS, 24%), 16 RA with excess of blasts (RAEB, 15%), 10 RAEB in transformation (RAEB-t, 9%), 25 chronic myelomonocytic leukemia (CMMoL, 23%), and five unclassifiable MDS (4%). Forty-three were women and 66 were men (sex ratio 2:3). Age ranged from 30-92 years (mean 69 years) with nine patients aged less than 50 years (8%). A cytogenetic result was obtained in all cases. At initial study, a chromosome defect was observed in 56% of patients. Rates of abnormality depended on FAB subtype: 52% in RA, 100% in RA 5q-, 50% in RARS, 56% in RAEB, 70% in RAEB-t and 44% in CMMoL. The most frequent single defects were del(5q), -7/del(7q), del(20q), Y loss, and +8. Except for the 5q- syndrome entity, specific chromosome defects were not associated with particular FAB subtypes. Bone marrow (BM) insufficiency (22%) and leukemic transformation (21%) were the most important causes of death. The rate of leukemic transformation increased with the number of dysplastic BM cell lineages and was also associated with karyotype complexity and the proportion of abnormal/normal metaphases. The longest median survivals were observed in RARS (142 months) and RA/RA5q- (91 months) types. Median survivals decreased with increasing Bournemouth score values. Patients with three abnormal cell lineages had a median survival shorter than those with one or two abnormal lineages. Similarly, patients with complex defects had shorter survival than those with single or double defects or a normal karyotype. There was no statistically significant difference between survival of NN (normal), AN (abnormal/normal), and AA patients or between survival of patients with del(5q), -7/del(7q), +8 or del(20q).

Adult↗
PubMed1994

IgE to food allergens are highly prevalent in patients allergic to pollens, with and without symptoms of food allergy.

Serum samples from 274 patients allergic to one or more of three pollens (birch, grass, mugwort), from 36 patients allergic to cat and/or Dermatophagoides pteronyssinus but not to pollen and from 55 non-allergic controls, as well as 20 cord blood samples, were examined for specific IgE to six 'pollen-associated' food allergens by using a new sensitive assay (CAP). A questionnaire asking for reactions to food was also sent to all patients. In the pollen group, 111 patients (47%) were positive (> or = 0.71 kU/l) for a food allergen (392 positive tests). Of these, 92 were sensitive to apple, 68 to potato, 64 to carrot, 63 to celery, 61 to peach and 44 to melon. In the non-allergic group, no IgE to any of the food allergens tested was found, whereas in the group allergic to non-pollen allergens, only one individual had such an IgE. The CAP assay was found to be more sensitive than RAST for the allergens studied. A history of clinical reactions (oral symptoms in 67, rhinoconjunctivitis in 65, asthma in 42 and urticaria in 39) to the corresponding food allergen was reported mainly by patients with positive CAP. In conclusion, we found a high prevalence of IgE to some food allergens in patients allergic to pollen and the absence of such antibodies in the control groups. The new in vitro assay, being more sensitive than previous ones, indicated a high prevalence of food specific IgE in pollen allergic patients, which in many cases did not correspond to clinical symptoms of food allergy.

Adolescent↗
PubMed1993

Successful management of patients with "multiple chemical sensitivities" on an inpatient psychiatric unit.

BACKGROUND: Much controversy exists over the diagnosis, etiology, and treatment of "multiple chemical sensitivities" also known as "environmental illness." The experience of multiple nonspecific reactions to numerous environmental agents leads to these diagnoses. Due to skepticism surrounding the validity of these patients' complaints, they are often referred for psychiatric evaluations, but successful management on a psychiatric inpatient unit can be complicated because of their unique presentations. METHOD: The approach taken by a university psychiatric inpatient unit to the evaluations of three such patients is presented along with a literature review of etiologic theories and treatment recommendations. RESULTS: Each of the three patients presented with severe disability from their "sensitivities," but each improved significantly over the course of a 17-day hospitalization. CONCLUSION: These patients benefited greatly from a serious, nonjudgmental, comprehensive approach to the evaluation of their multiple complaints. Despite the absence of any positive organic findings, each felt that her experiences had been validated, and each subsequently improved. When evaluating similar patients, clinicians should be aware of useful, effective management strategies and should avoid overt skepticism and confrontation.

Adult↗
PubMed1992

Eating disorders. A review and update.

Anorexia nervosa and bulimia nervosa are prevalent illnesses affecting between 1% and 10% of adolescent and college age women. Developmental, family dynamic, and biologic factors are all important in the cause of this disorder. Anorexia nervosa is diagnosed when a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea. A diagnosis of bulimia nervosa is made when a person has recurrent episodes of binge eating, a feeling of lack of control over behavior during binges, regular use of self-induced vomiting, laxatives, diuretics, strict dieting, or vigorous exercise to prevent weight gain, a minimum of 2 binge episodes a week for at least 3 months, and persistent overconcern with body shape and weight. Patients with eating disorders are usually secretive and often come to the attention of physicians only at the insistence of others. Practitioners also should be alert for medical complications including hypothermia, edema, hypotension, bradycardia, infertility, and osteoporosis in patients with anorexia nervosa and fluid or electrolyte imbalance, hyperamylasemia, gastritis, esophagitis, gastric dilation, edema, dental erosion, swollen parotid glands, and gingivitis in patients with bulimia nervosa. Treatment involves combining individual, behavioral, group, and family therapy with, possibly, psychopharmaceuticals. Primary care professionals are frequently the first to evaluate these patients, and their encouragement and support may help patients accept treatment. The treatment proceeds most smoothly if the primary care physician and psychiatrist work collaboratively with clear and frequent communication.

Adolescent↗
PubMed1991

[Ozone, ventilatory function and bronchial reactivity].

Forty adult hospital workers were followed prospectively in 1989 by monthly assessment of the lung function and bronchial responsiveness to methacholine in a rural region in Switzerland. No correlation was demonstrated between these values and the concentrations of tropospheric ozone. Nevertheless, this is not incompatible with previous studies showing impairment of ventilatory function in subjects exposed to ozone, for several reasons: ozone levels in 1989 were low, the indoor concentrations were lower than outdoors and the volunteers performed little or no physical activity.

Adult↗
PubMed1991

Obstetric complications in a patient with Bernard-Soulier syndrome.

We describe the obstetric complications and management of a patient with Bernard-Soulier syndrome. Severe bleeding at the time of delivery and delayed postpartum hemorrhage were prominent features of her pregnancies. Further complicating this woman's pregnancies was the development of antibodies to platelet glycoprotein IB/IX, leading to neonatal alloimmune thrombocytopenia.

Adult↗
PubMed1990

Right arm involvement and pain extension can help to differentiate coronary diseases from chest pain of other origin: a prospective emergency ward study of 278 consecutive patients admitted for chest pain.

In a prospective study of 278 consecutive patients admitted to an emergency ward for chest pain, the 115 clinical and paraclinical parameters available at the time of admission were evaluated by computer comparison with the final diagnoses. The most valuable items for making the diagnosis were classified according to their sensitivity, specificity and predictive value. Among the 278 patients, 100 individuals had myocardial infarctions (MI), 47 had unstable angina, 25 had stable angina and 106 patients had a non-coronary disease. The twelve most sensitive items for distinguishing MI from other conditions were the following: sudden onset of pain (70%); duration of more than 60 min (88%); constriction and squeezing (79%); oppression (75%); prior anginal attacks (61%); sex male (72%); age over 60 years (74%); abnormal heart auscultation (62%); abnormal electrocardiogram (ECG) (98%); segment (ST) disturbances (86%); increased glucose level (77%); CKMB fraction greater than 6% of total creatine kinase (CK) level (63%). Among the twelve most specific items, also with the best positive predictive value, irradiation in the right arm is of most importance; among the 51 patients with right arm involvement, 48 suffered from a coronary disease and 41 from a myocardial infarction. The largest extension of pain was reported in the latter group. It is concluded that chest pain with a wide irradiation involving the right arm strongly suggests that a myocardial infarction is ongoing.

Arm↗
PubMed1990

Clozapine and seizures.

Clozapine is a newly released antipsychotic that is associated with a higher prevalence of seizures than traditional neuroleptics. The authors describe four patients who developed seizure activity during clozapine treatment and provide recommendations for clinical management of this problem.

Adult↗