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Biomedical subjects

F Nagel

Publications and source records attributed to F Nagel.

At least 19 recordsLinked to original sources
PubMed2006

[Cheilitis granulomatosa Melkersson-Rosenthal syndrome].

Melkersson-Rosenthal syndrome is a rare disorder characterized by a triad of recurrent orofacial swelling, recurrent paralysis of the facial nerve and lingua plicata. The complete triad only occurs in 25% of MRS cases. Monosymptomatic or oligosymptomatic variants are more frequent; other findings include granulomas in other facial sites, regional lymphadenopathy, fever, psychotic disorders and hyperplastic gingivitis are associated with MRS. This can be a diagnostic challenge. The etiology and pathogenesis of MRS are unknown. Corticosteroids or clofazimine appear the best therapeutic options.

Adrenal Cortex Hormones↗
PubMed2006

Efficacy of crisis intervention treatment with topical corticosteroid prednicarbat with and without partial wet-wrap dressing in atopic dermatitis.

BACKGROUND: The wet-wrap treatment has been reported to be beneficial in acute episodes of atopic dermatitis (AD) skin lesions. OBJECTIVE: The efficacy of topical corticosteroid prednicarbat with and without additional wet-wrap dressing was investigated in a prospective, randomized and controlled study. METHODS: In the left-right comparison study, 24 adults and children with an acute episode of AD were included. One arm or leg was randomly treated with the topical corticosteroid prednicarbat plus wet-wrap dressing; only prednicarbat was applied on the leg or arm of the other side. RESULTS: After 48-72 h of treatment, in both groups an improvement of the local SCORAD was observed. In comparison to the side of the body treated with corticosteroid alone, the decrease of the local SCORAD in the corticosteroid plus wet-wrap dressing group was significantly better. The severity of AD improved in the wet-wrap group at an average of 4.4 points, in the corticosteroid group 3.0 (p<0.011). CONCLUSIONS: Wet-wrap therapy with a topical corticosteroid is an effective treatment option in patients with exacerbated AD. The treatment is helpful in improving skin conditions, shortening the time of corticosteroid application.

Adolescent↗
PubMed2004

[Thrombosis of the iliac artery in a premature neonate: thrombolytic therapy using rt-PA].

Thromboembolic events in neonates are very rare. They are often associated with severe disease affecting the newborn or are secondary to central venous lines or arterial catheters. Most of the described cases of thromboses of the iliac or femoral arteries are associated with cardiac catheterisation or femoral invasive blood pressure monitoring. The relationship between single umbilical arteries and an increased incidence of structural and chromosomal anomalies is well known, but a higher rate of thromboembolic disease in infants with single umbilical arteries has not been described. Rt-PA (recombinant tissue plasminogen activator) has been successfully used in small studies and numerous case reports. To date controlled clinical trials giving guidelines for antithrombotic therapy using rt-PA are still lacking. We report the clinical course of a 700 g premature male, who was born by Caesarean section at 29 + 6 gestational weeks. On the fifth day the baby suffered from arterial thrombosis of the right pelvis axis. Antenatally a single umbilical artery was identified. Iliac arteries on the involved site appeared hypoplastic. Additionally, the prothrombin G20210A mutation was found. The patient was treated successfully using recombinant tissue plasminogen activator. In the case of a high risk of limb or organ loss due to arterial thrombosis, thrombolysis using rt-PA is justified. Appropriate rt-PA treatment has been studied for the adult but not the paediatric population. Hence, well-designed clinical trials are necessary to determine the pharmacokinetics and dynamics of thrombolytic agents in children.

Dandy-Walker Syndrome↗
PubMed1999

Effects of heat shock on the functional morphology of cell organelles observed by video-enhanced microscopy.

In living astrocytes and MDCK cells we observed morphological phenomena during and after heat shock (HS) utilizing our new perfusable microchamber system, which monitors pH, pO(2), pCO(2), and temperature. By means of electronic light microscopy and confocal laser scanning microscopy, mitochondria were demonstrated to swell and to reduce their motility. The specific fluorescent probe MitoTracker Green revealed that the mitochondrial morphology changed from a rodlike into an annular shape with a central vacuole-findings which were corroborated by transmission electron microscopy. After HS (shift from 37 degrees C to 45 degrees C for 15 min) the mitochondrial membrane potential (DeltaPsi(m)) was depressed in most but not all mitochondria as monitored with the fluorescent probe JC-1. The dual emission images of JC-1 illustrated a heterogeneous red staining of distinct areas of single mitochondria. The shape changes as well as the drop of the membrane potential of the mitochondria indicated severe cellular stress and a direct intervention on the mitochondrial permeability transition.

Animals↗
PubMed1999

A new perfusion cell chamber system for determination of heat shock effects by means of video-enhanced microscopy.

A user friendly microscope perfusion chamber which allows real-time observation of individual cells at high magnification has been designed. An integrated multisensor was used to monitor the cell culture conditions. To prove the potential of the system heat shock experiments were performed. By means of video-enhanced contrast microscopy (VECM) the mitochondria morphology of cultured astrocytes was demonstrated to change from a rod-like to an annular shape after heat shock. For further analyses mitochondria were stained on the microscope stage.

Animals↗
PubMed1999

Capillary zone electrophoresis determination of meropenem in biological media using a high sensitivity cell.

A capillary electrophoresis method with a high sensitivity cell (Z-cell) has been developed for the determination of meropenem in aqueous solution and in biological media (urine, plasma). Water samples were analysed using two calibration curves of meropenem with standard capillary and a capillary with a high sensitivity cell. In urine, the samples were only diluted in buffer and were injected without any further sample preparation. For the analysis of plasma samples, a calibration curve was utilized covering the meropenem concentration range of 0.5-200 microg/ml. The detection limit and the relative standard deviation of the migration times and of the peak areas were determined.

Electrophoresis, Capillary↗
PubMed1998

[Mendelson syndrome in infancy and childhood].

Acute pulmonary failure caused by gastric acid aspiration is designated as Mendelson's syndrome. It is characterized by a trias of symptoms comprising bronchial obstruction, pulmonary oedema, and right ventricular failure. The pathomorphological pulmonary alterations show the typical symptoms of ARDS and allow the differentiation of three phases. The initial phase of injury is characterized by cauterization of the bronchial and alveolar epithelium. It is followed by the exsudative second phase during which alveolar oedema are developing. They impair the pulmonary surfactant synthesis and the formation of hyaline membranes. Fibrosis processes are typical of the proliferative third phase. Every of the mentioned three phases may be classified by their corresponding clinical symptoms. The therapy is entirely symptomatic and follows the intensive medical standards of the ARDS-therapy.

Child↗
PubMed1996

Familial arhinia, choanal atresia, and microphthalmia.

We describe two females (aunt and niece) with variable manifestations of arhinia, choanal atresia, microphthalmia, and hypertelorism. In the literature there is only one report on this syndrome in sibs. We hypothesize autosomal dominant inheritance with reduced penetrance.

Adolescent↗
PubMed1994

Childhood asthma in four countries: a comparative survey.

BACKGROUND: Asthma mortality among young people varies widely between different countries. Geographical differences in asthma prevalence are also believed to exist, but evidence is sparse owing to the lack of multicentre surveys using common protocols. A survey was conducted of 12-year-old children living in defined areas of New Zealand, Wales, South Africa and Sweden, in order to see whether asthma prevalence and mortality rates in children show parallel differences. METHODS: Questionnaires enquiring about a history of asthma and respiratory symptoms were issued to the parent. The children performed a simple exercise challenge test. RESULTS: Information was obtained for 4353 children. A history of asthma at any time was reported for 16.8% of children in New Zealand, 12.0% in Wales, 11.5% in South Africa and 4.0% of Sweden, and a similar pattern was shown by several other indices of asthma (various relevant symptoms, inhaler use, response to exercise challenge, and asthma mortality at ages 5-19 years). In Sweden wheezing was negatively associated with pet ownership; elsewhere there was a positive (though non-significant) association. Cat ownership was highest in New Zealand and lowest in Sweden. CONCLUSIONS: The prevalence of asthma in children shows geographical variation which is parallel to that of asthma mortality, being high in New Zealand and low in Sweden. Differential exposure to animal allergens is a possible factor in this variation.

Adolescent↗
PubMed1994

[Therapy with ACE inhibitors in chronic heart failure and limited kidney function].

UNLABELLED: Renal function in 31 patients with mild to moderate heart failure (NYHA Classes II-III) was studied before and during treatment with ACE-inhibitors. Maximal treatment doses were based on randomization: captopril 3 x 12.5 mg or lisinopril or enalapril, both 1 x 10 mg. Before therapy and at the end of titration phase (after 6 days) glomerular filtration rate and renal blood flow were determined from inulin and PAH clearance (steady-state method). In the total study group the median arterial pressure significantly decreased from 94 mmHg to 84 mmHg (p < 0.01), whereas glomerular filtration rate was only moderately, however, significantly reduced from 103 ml/min to 97 ml/min (median values, p < 0.01). Renal blood flow, however, increased from 372 ml/min to 403 ml/min (p < 0.01). Changes in glomerular filtration rate (GFRd) were significantly dependent on those of renal blood flow (GFRd = 0.07 RPFd - 9.2; p < 0.05). All three ACE-inhibitors showed similar changes in glomerular filtration rate and renal blood flow. Ten of the patients had additionally received cyclooxygenase inhibitors. With respect to severity of heart failure and renal function these patients did not differ from the remaining 21 patients of the group. In both groups, a decrease of glomerular filtration rate was found, however, in those patients who had received acetylsalicylic acid there was no increase of renal blood flow. CONCLUSION: A small, however significant decrease of glomerular filtration rate is already seen in patients with mild to moderate heart failure treated with ACE-inhibitors. Increase of renal blood flow counteracts the decrease of glomerular filtration rate. During concomitant application of acetylsalicylic acid the increase of renal blood flow remains absent.

Aged↗
PubMed1994

[Comparison of public health systems within the European Community].

Only two out of three ideal types of health care systems can be observed in the European Community (EC): Centrally planned systems (countries with a national health service) and systems managed mainly by associations of health insurance funds and also of providers (countries with a social insurance system). We find no country with a market-type health care system in Europe. Both types of systems occurring in the EC are compared with each other, both with regard to their ideal types and also to their actual operations when judged on grounds of financing and production of health care. When seen as ideal types, we note considerable differences. Real types however exhibit only gradual differences. The shares of major subcategories of health spending differ widely between EC countries. These differences, however, cannot be attributed to the different health care systems. Similar observations can be made regarding different forms of payment for hospital care and for physician services and also regarding the share of total health expenditure in GDP.

Cost-Benefit Analysis↗
PubMed1992

Angiotensin-converting enzyme inhibitors and renal function in heart failure.

Patients with severe heart failure often exhibit signs of an impaired renal function. As judged from serum urea and creatinine concentrations, renal function may deteriorate further after the addition of angiotensin-converting enzyme (ACE) inhibitors to therapy. The beneficial effect of unloading the failing heart by reducing the systemic outflow resistance is opposed by a potentially harmful effect of unloading the kidney by preferentially reducing the outflow resistance of the glomerulus. However, development of functional renal insufficiency is unlikely and is a rare cause for withdrawing ACE inhibitors when certain precautions are considered: (1) The initial dose of the ACE inhibitor has to be reduced with increasing severity of heart failure (the titration period thereafter should be monitored carefully); (2) an increase in serum creatinine not exceeding 30% of the basal value may be taken as evidence for a beneficial action of the drug, which in addition to altering cardiac function alters kidney function (when the increase in serum creatinine is considered to be of clinical significance, it seems wise to reduce the dose of diuretics first--thereby neuroendocrine stimulation can be attenuated and the dependency of renal filtration from angiotensin II-induced efferent vasoconstriction can be reduced); and (3) the coadministration of inhibitors of prostaglandin synthesis (e.g., acetylsalicylic acid) appears to be associated with a higher risk of impairing renal function: the decrease in glomerular filtration rate is more marked and the compensatory increase in renal plasma flow following ACE inhibition is no longer observed.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1992

[Modification of cerebral hemodynamics by invasive routine diagnostic procedures].

By means of cw-Doppler-ultrasonics pulsation curves of anterior cerebral arteries were recorded before, during and after a necessary capillary blood sampling in 12 premature newborns. Patients were stable and needed no oxygenation. Blood pressure and transcutaneous oxygen saturation have been recorded simultaneously. The most important hemorheological parameters were within normal range. Immediately following irritation pulsatility indices increased, partly diastolic reflux phenomena could be observed. Finishing irritation values went back to starting position very fast. It is supposed such strong changes of cerebral vascular resistance could be the reason of cerebrovascular damages in non sedated premature newborn babies.

Arousal↗
PubMed1991

[Acute cor pulmonale as a sequela of tumor embolism].

It is reported on a 22-year-old female patient with a chondroplastic osteosarcoma in the sacrum in whom in the course of her disease a massive embolism due to a tumour developed under the clinical picture of an acute pulmonary embolism. The clinical tentative diagnosis of a massive pulmonary embolism was confirmed by means of lung perfusion scintigram and pulmonary angiography. All efforts for a rapid recanalisation of the left pulmonary trunk by means of mechanical alteration, use of balloon catheter and subsequent thrombolysis were without success. Pathologo-anatomically a recurred tumorous thrombus embolism with an extensive pulmonary infarction in the left inferior lobe of the lung was found. The incidence as well as diagnostic viewpoints of embolisms due to tumour are discussed.

Adult↗
PubMed1987

[Reconstruction of function and esthetics in facial defects].

The article describes the modern trends in cosmetic surgery as well as new techniques. Details, however, are not discussed. In the section on reconstructive surgery, the eye lids and the lips are dealt with and well-established methods are mentioned.

Esthetics↗