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G Fischer

Publications and source records attributed to G Fischer.

At least 739 records · Page 41Linked to original sources
PubMedDate not supplied

A school-based strategy to assess children's environmental exposures and related health effects in economically disadvantaged urban neighborhoods.

The School Health Initiative: Environment, Learning, Disease (SHIELD) study is a novel school-based investigation of children's environmental health in economically disadvantaged urban neighborhoods of Minneapolis. This article describes the study design and summarizes lessons learned about recruiting and monitoring this historically understudied population. The SHIELD study focused on measuring children's exposures to multiple environmental stressors [volatile organic chemicals (VOCs), environmental tobacco smoke, allergens, bioaerosols, metals, pesticides, polychlorinated biphenyls (PCB), phthalates] and exploring related effects on respiratory health (e.g., lung function) and learning outcomes (e.g., standardized test scores, academic achievement). It involved intensive exposure monitoring, including environmental measurements inside and outside the children's schools and inside their homes, personal measurements with passive dosimeters worn by the children, and biological marker measurements in blood and urine. The SHIELD participants comprised a stratified random sample of 153 "index" children and 51 of their siblings enrolled in grades 2-5 at two adjacent elementary schools. The Minneapolis Public Schools (MPS) assisted with identifying, contacting, recruiting, and monitoring this population, which traditionally is difficult to study because families/children are highly mobile, speak a diversity of languages, frequently do not have a telephone, endure economic hardships, often do not trust researchers, and have a spectrum of unconventional lifestyles and living arrangements. Using a school-based approach, the overall SHIELD enrollment (response) rate was 56.7%, with a wide disparity between English-speaking (41.7%) and non-English-speaking (71.0%) families/children. Most children remained involved in the study through both monitoring sessions and exhibited an acceptable degree of compliance with study protocols, including providing blood and urine samples. Results indicate that it is both practical and affordable to conduct probability-based exposure studies in this population, but that it is also important to improve our understanding of factors (e.g., cultural, economic, psychological, social) affecting the willingness of families/children to participate in such studies, with special emphasis on developing cost-effective recruitment methods.

Air Pollution, Indoor↗
PubMedDate not supplied

Vulvar disease in children: a clinical audit of 130 cases.

We evaluated 130 prepubertal girls presenting with a vulvar complaint to determine the spectrum and frequency of conditions seen in this age group. Of the patients, 41 (33%) had atopic or irritant dermatitis, 23 (18%) had lichen sclerosus, 21 (17%) had psoriasis, 15 (12%) had vulvar lesions, most often hemangiomas and nevi, and 13 (10%) had streptococcal vulvovaginitis. Diagnoses less frequently seen were staphylococcal folliculitis (four patients), labial fusion (three patients), genital warts (two patients), molluscum contagiosum of the vulva only (one patient), vulvar bullous pemphigoid (two patients), scabies nodules (one patient), erythema annulare centrifugum (one patient), tinea (two patients), and vitiligo (one patient). We also encountered vulvar presentations of systemic diseases (varicella, staphylococcal scalded skin syndrome, and Henoch-Schönlein purpura, all one patient each). We did not see candidal vulvovaginitis in this age group nor did we encounter bacterial infection with pathogens other than Staphylococcus aureus and S. pyogenes.

Child↗
PubMedDate not supplied

Childhood psoriasis: a clinical review of 1262 cases.

Our aim was to describe the types of psoriasis seen in a large series of patients presenting to a tertiary referral pediatric dermatology department using a classification system combining conventional terminology and additional categories based on the site and characteristics of the rash. A total of 1262 patients seen consecutively in the dermatology department of the Royal Alexandra Hospital for Children, Sydney, Australia, between 1981 and 1995 are described and classified according to the pattern of psoriasis at the time of presentation. Additional information recorded included family history, facial involvement, and history of a psoriatic type of diaper rash in infancy. The ages of the children ranged from 1 month to 15 years. There was an equal gender distribution and a high rate of positive family history at 71%. Twenty-six percent of children had a history of a psoriatic diaper rash and facial involvement occurred in 38% of children. Plaque psoriasis was the most common type overall, affecting 430 patients (34%). Three hundred forty-five children were less than 2 years of age, and this is the largest series of children with psoriasis in this age group presented to date. An entity defined by us as psoriatic diaper rash with dissemination was the most common type of psoriasis in the less than 2-year age group, affecting 155 (45%) patients. This large series offers information on the manifestations of psoriasis in childhood, but is particularly useful in examining the previously less well-described infant age group. The classification used is proposed as a practical way to describe psoriasis in children, particularly with respect to future descriptive studies.

Adolescent↗
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[Opiate addiction in gravidity - consequences for the newborn. Results of an interdisciplinary treatment concept].

AIMS: To evaluate the outcome of infants of drug dependent mothers (IDM) after establishing an interdisciplinary attention concept at the University Hospital in Vienna. To compare the influence of different maintenance agents on neonatal morbidity. PATIENTS AND METHODS: All newborns of opiate dependent mothers were prospectively included from III 1995 to IX 1999. The following data were collected: maintenance agent (methadone, slow release morphine, buprenorphine), infectious status, demographic data, congenital malformations, perinatal complications, as well as incidence and duration of the neonatal abstinence syndrome (NAS). Medical treatment with phenobarbital (1995 - 96) or morphine hydrochloride (MoHCl) (1997 - 99), respectively, was indicated when Finnegan score exceeded 10. RESULTS: 88 neonates (38 females/50 males) with a median gestational age of 39 weeks were included, 18 (20.5 %) were born prematurely. The median birthweight was 2905 g, 24 (27.3 %) infants were small for date (< 10th percentile), 15 (17 %) microcephalic. The malformation incidence was 7.4 %. 63 (72 %) of all newborns had to be treated due to abstinence syndrome: in the methadone group 76 %, in the morphine group 93 %, but in the buprenorphine group 19 % only (p < 0.01). Median duration of withdrawal was 15.1 days (d) with significant difference after antenatal buprenorphine exposure compared to methadone and morphine exposure (8.3 d versus 15 d and 16.5 d respectively). In neonates treated with phenobarbital duration of NAS was 17.6 d, whereas NAS in infants with MoHCl therapy lasted 12.8 d (p < 0.05). CONCLUSION: Incidence and duration of NAS after buprenorphine exposure was significantly lower than after methadone and morphine exposure. Withdrawal time under morphin-hydrochloride therapy was reduced by one third compared to treatment with phenobarbital.

Buprenorphine↗
PubMedDate not supplied

[Adjuvant treatment of knee osteoarthritis with weak pulsing magnetic fields. Results of a placebo-controlled trial prospective clinical trial].

PURPOSE: The aim of this study was the objective control of the therapeutic effect of weak pulsing magnetic fields (series of periodically repeating square pulses increasing according to an e-function, frequencies of 10, 20, 30, and 200-300 Hz) by means of a double-blind study on osteoarthritis of the knee. Measured parameters were the Knee Society score, pain sensation, blood count and cardiocirculatory values. METHODS: 36 placebo and 35 verum test persons (all with a knee gap smaller than 3 mm) were exposed daily for 16 minutes over 6 weeks to a low frequency magnetic field (flux densities increasing gradually from 3.4 up to 13.6 microT) encompassing the whole body. The last data collection was made 4 weeks after the end of treatment. RESULTS: Principally, the statistically ensured results exclusively favour the used magnetic field therapy; by far the greatest number of at least significant differences was found at the end of the whole treatment, lasting 6 weeks. In particular, it is striking that all 4 questioned pain scales showed at least significant improvements in favour of the verum collective; also the walking distance was increased. As another confirmed fact, even after 4 weeks without therapy the persistence of several functional and analgesic effects could be documented. CONCLUSIONS: Predominantly, on the one hand, pain relief in osteoarthritis patients was confirmed by a double-blind trial, on the other hand, increases in mobility could be proven. Furthermore, we describe mainly the modes of action of low frequency magnetic energy and 3 physical concepts that are seen as the connecting link between electromagnetic fields coupled into connective tissue and biochemical repair and growth processes in bones and cartilage. Proceeding from the results of this and preceding studies, one has to consider seriously whether this kind of magnetic field application should not be employed as cost-effective and side effect-free alternative or adjuvant form of therapy in the field of orthopaedic disorders.

Aged↗
PubMedDate not supplied

[Pseudomembranous colitis in Hirschsprung disease].

Pseudomembranous colitis (PMC) is a potentially fatal complication in Hirschsprung's disease. The pathogenesis of PMC which usually takes a fulminant course, is obscure. The disease generally is associated with antibiotic therapy. We describe the clinical course and the pathological findings in a 7 1/2 months old infant with Hirschsprung's disease after surgical treatment. The pseudomembranous colitis of the patient with letal consequence is considered to be connected with antibiotic therapy.

Abscess↗
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[Development of complete liver cirrhosis in hyperphagia-induced fatty liver].

The progression of alimentary fatty liver to liver cirrhosis is a very rare observation. During the year after surgical extirpation of a suprasellar craniopharyngioma in a seven years old boy developed severe obesity and again six years later at autopsy a complete liver cirrhosis with fatty liver was established. Injury of the ventromedial hypothalamic nuclei and resulting hyperphagia is the reason for the obesity following suprasellar tumours. The pathogenesis of liver cirrhosis following alimentary fatty liver is not completely evident up to now, such a progression is possible--as shown in this case--also in children and within a short period.

Adolescent↗
PubMedDate not supplied

Treatment of childhood vulvar lichen sclerosus with potent topical corticosteroid.

Potent topical corticosteroid is recognized as the treatment of choice for vulvar lichen sclerosus in adults. A series of 11 children with vulvar lichen sclerosus were treated with the potent topical corticosteroid betamethasone dipropionate 0.05%, seven using an optimized vehicle preparation. There was an excellent response to therapy in all cases. No serious adverse effects or unwanted sequelae occurred. Eight of the 11 children experienced complete remission after 3 months of therapy. In these children no maintenance therapy has been necessary during follow-up periods ranging from 3 to 18 months. Three children required maintenance therapy with a mild topical corticosteroid. We conclude that in children, as in adults, potent topical corticosteroid is a safe and effective treatment for vulvar lichen sclerosus.

Administration, Topical↗
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Attenuation of anaphylactic shock and related mortality in guinea-pigs after administration of a potent protein kinase inhibitor, K252a.

We examined whether protein kinases have a role in the expression of anaphylactic shock (AS). Guinea-pigs sensitized to ovalbumin were administered i.p. saline (control) or 10 micrograms/kg K252a, a potent protein kinase inhibitor, 30 min before challenge. The development of AS and mortality was observed for the next 2 h. In the K252a-treated group the incidence of AS fell to 53% from 100%, the maximum intensity was 62% less than the control, and mortality dropped to 16% from 50% of the animals. We suggest that protein kinases are involved in the expression of AS, and that inhibitors of these enzymes may protect against the symptoms of AS and allergy.

Anaphylaxis↗
PubMedDate not supplied

On the mechanism of sphingomyelin interaction with solubilized membrane proteins.

Studies on the high-affinity receptor for IgE from rat basophilic leukemia cells (RBL-2H3) have shown that the phospholipid sphingomyelin remains attached to the protein complex during washing of the affinity immobilized complex under solubilizing conditions. Here we extended these findings and compared the species distribution patterns in sphingomyelin and phosphatidylcholine of the receptor-bound lipids to those of the plasma membrane lipids. FC epsilon-receptor-bound sphingomyelin but not phosphatidylcholine was enriched in long-chain fatty acids. We then examined other membrane proteins with respect to sphingomyelin enrichment. RBL-2H3 cell surface proteins, immobilized on concanavalin A-Sepharose and washed under solubilizing conditions, also showed a two- to six-fold enrichment in the associated sphingomyelin. Similar observations were also derived from other cell types, such as the mouse fibroblast cell line A-9 and the pig kidney epithelial cell line PK-1. Since this has been observed in all the three cell sources, it was suggested that sphingomyelin enrichment in FC epsilon-receptor preparations, although reproducible, was not specific for this protein. That this phenomenon was not specific for a particular protein might also be concluded from experiments that have shown nonhomogenous distribution of sphingomyelin in protein-free lipid-detergent mixtures. These results are compatible with a model whereby the interaction between sphingomyelin and soluble membrane proteins results from preference to nonmicellar phases or to structures with extended hydrophobic domains, probably due to the imperfect fitness of the detergent micelles to properly accomodate these lipids. This feature makes long-chain sphingomyelin a plausible candidate for the lipid responsible for the stabilizing effect that crude lipid preparations exert on the structural and functional properties of some membrane protein, e.g., FC epsilon R.

Animals↗
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Quantitative detection of tumor M2-PK in serum and plasma.

The majority of tumors express an isoform of the glycolytic enzyme pyruvate kinase, the type tumor M2. The isoenzyme exists in an active tetrameric and a less active dimeric form. The dimeric form is strongly overexpressed in tumor cells and this new tumor marker is thus called tumor M2-PK. This isoenzyme is released from tumor cells and is quantitatively detectable in body fluids by a sensitive enzyme-linked immunosorbent assay (ELISA). To establish the ELISA for the routine diagnostic in a clinical laboratory, the sample stability was evaluated. Therefore, blood samples were collected in different ways from healthy donors. Reproducibility of tumor M2-PK detection in EDTA-plasma was not affected by the day to day 'stress' in a clinical routine (e.g. shaking, leaving the samples at room temperature for several hours without prior centrifugation). Similar results were obtained with citrate-plasma, whereas detection in serum and heparin-plasma was only reproducible when the blood samples were centrifuged within 2 hrs after collection. It appears that lymphocytes contain small amounts of the tumor M2-PK isoenzyme. They might release tumor M2-PK in heparin-plasma and serum samples, but not in EDTA-plasma samples. The results indicated that EDTA-plasma appears to be most appropriate for the routine diagnostic of tumor M2-PK as a tumor marker.

Antibodies, Monoclonal↗
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Image cytophotometric DNA analysis of cystadenolymphomas.

Warthin's tumour of the parotid gland is generally a benign lesion, consisting of an epithelial and a lymphoid component with unclear histogenetic relationship, 17 cases of Warthin's tumour were investigated for ploidy related parameters by the image analysis system CAS200. All cases investigated were euploid. A diploid DNA pattern (Auer type I) was detected in 7/17 (41%) cases both in the epithelial and lymphoid component of the same tumour. In addition to a diploid cell fraction a tetraploid cell component was found in 7/17 (41%) cases, coincidentally, in the epithelial and lymphoid component (Auer type II). Euploidy in all investigated cases is in agreement with the generally benign nature of Warthin's tumours. The similarity of the DNA pattern (Auer type) in the genetically unrelated epithelial and lymphoid components in most cases (84%) is suggested to be related to a similar functional state of these two components and is discussed in relation to the histogenesis of cystadenolymphomas.

Adenolymphoma↗
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Reduced levels of coagulation factor XIII in patients with advanced tumor disease.

BACKGROUND/AIMS: Coagulation factor XIII, which induces the stabilization of fibrin the final step in the coagulation cascade, has various physiological effects. Among these, its beneficial effect in gastrointestinal bleeding episodes is well known. With the exception of inflammatory bowel disease, however, few data are available about this effect, particularly with regard to its role in diffuse bleeding in tumor patients. The study was designed to carry out prospective follow-up investigations, gathering data concerning factor XIII levels in patients with advanced gastrointestinal tumors and evaluating the course of the disease as well as the incidence of bleeding. METHODOLOGY: Sixty patients (22 women, 38 men; median age: 60; range: 29-79) with advanced gastrointestinal tumors were followed-up prospectively. Factor XIII levels were measured using chromogenic substrate. The correlation between the FXIII level and the patients' survival was analyzed using the Cox model. RESULTS: Factor XIII deficiency (below 70%) was seen in only 7 patients (11.6%), 6 of whom died within a median of 1.5 months after the measurement. In all patients however, there was a significant correlation (P = 0.0133) between FXIII levels and the risk of death. Four bleeding episodes occurred in 3 patients, three times with FXIII levels being below the lower normal range. When substitution was attempted, it was only successful in 1 patient in whom the FXIII level was reduced. CONCLUSIONS: FXIII may have predictive value as a marker for the prognosis in these patients with advanced tumor disease. Bleeding episodes were rarely seen, but when they do occur they may be associated with reduced levels of FXIII, and substitution may be beneficial as an adjunct or even as the sole therapeutic intervention.

Adult↗
PubMedDate not supplied

[Spino-thalamic cordotomy in cancerous pain. Results of a series of 124 patients operated on by the direct posterior approach].

The authors -- about a series of 124 cancerous patients treated during the 12 last years with open spino-thalamic cordotomy for intractable pain -- have tried to evaluate effectiveness of the operation with regard to its levels in relation to the site of pain. Patients suffering median or bilateral perineo-pelvic pain, isolated or associated with algias in one or both legs (group I: 50%) underwent a bilateral C8-C6 cordotomy in one stage. Patients with the same perineo-pelvic cancers but suffering only unilateral pain (group II : 31,8%) and patients with painful cancers in the leg (group III : 3,2%), were operated on with a C7 controlateral cordotomy. Patients suffering widespread unilateral pain in the chest, isolated or associated with algias in the arm, for instance from lung or breast cancers (group IV : 15%) underwent a controlateral C2 cordotomy. There was 3,2% mortality and one paraplegia. A useful early effect(i.e. complete or partial relief) was obtained : in 85% cases (60% and 25%) for the 1st group, in only 51% (36% and 15%) for the 2nd, and in 87% (56% and 31%) for the 4th. Relief was complete in each of the 4 cases of the 3rd group. In the 2nd group 39% of patients were completely relieved of their initial unilateral pain, but complained of an early post-operative pain on the other side. This secondary pain was supposed existing prior to the operation, but masked because of its lesser intensity. The useful results at the time of death, after a 6 month mean survival (from 1 month to 4 years), were 63,75% in the 1st group, 33% in the 2nd, 100% in the 3rd and 72% in the 4th. The high rate of poor results with unilateral cervical cordotomy in the perineo-pelvic cancers with apparently unilateral pain, led us since then to systematically perform for them a bilateral cordotomy. Thus, our general management for pain of malignant origin is now as follows: C8-C6 bilateral cordotomy for all the perineo-pelvic cancers whatever uni- or bilateral the site of pain may be; C7 controlateral cordotomy for the painful cancers of the leg; and C2 controlateral cordotomy for hemithoracic and/or arm pain, when related to very extended lung or breast cancers. We prefer complete posterior rhizotomy for limited cancers of the thoracic wall, and selective posterior rhizotomy through the scope, from -- the brachial plexus roots down to T4 -- for pain as from the PANCOAST-TOBIAS syndromes, or in case of painful involvements of the upper limb roots. For cervico-facial cancers we generally use combined sections of the sensory cranial nerves in the posterior fossa and of the cervical posterior roots.

Cordotomy↗
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[Pan-spinal ependymoma. Apropos of 2 cases with complete exeresis].

Authors performed in two patients a macroscopically complete exeresis of a panspinal ependymoma. The first case concerns a 27 years old woman, submitted to surgery in 1971, soon after a delivery, who exhibited a tumor in all points identical to the one described by G. Horrax an D. Henderson (1939). The second case concerns a male subject submitted to surgery in May 1973 because of a lesion extending from C2 to L2 and corresponding to a dorsal fleshy ependymoma, surrounded by two voluminous pseudosyringomyelic cysts, with respectively cervical and dorsal-lumbar localization. Such cases rare, with sometimes difficult clinical and roentgenologic diagnosis, raise before all problems of surgical tactics. We are dealing here with benign ependymomas, few favourable to roentgentherapy. Their management is surgical, i.e. complete exeresis. The few common extent of some of these tumors to the totality of the spinal cord does not modify in any manner such a principle. The same may be said of some etiologic circumstances, such as pregnancy, that often enough constitute a postponing of diagnosis and mangement detrimental for the patient. Only, the march of the surgical procedure may be object of discussion. The here reported experience lets appear that, when necessary, complete exeresis may be performed in one session under the same conditions and with the same spinal risks than for a less extensive analogous tumor. At long term the problem of spasticity of lower extremities has to be considered. However, in spite of extensive laminectomy, no major deformity of the vertebral column is to be noted.

Adult↗
PubMedDate not supplied

[Experimental intracranial venous microsurgery. Bypass of the sagittal sinus for arterial or venous repair and preoperative measurement of the cerebral impedance in the dog].

By-passes of the sagittal sinus-which is 2,5 mm in diameter-were carried out with autogenous arterial or venous grafts, in 34 dogs, using the classical microtechniques (operative microscope, micro-instruments, micro-sutures...). Controls were done both 1 degree by angiography (direct sinography was the only convenient procedure to visualize the sinus and the by-pass) during survival, and 2 degrees by anatomical and histological examination after sacrifying the animals, on an average the 40th post-operative day (from the 10th to the 75th day). The early patency rate (within the first post-operative month) was 76 p. 100. All cases of early thromboses, which affected especially venous autografts, were related to technical insufficiencies. The late patency rate (after a one month follow-up) was only 64 p. 100, because of the secondary occlusion of some arterial autografts. All these late thromboses were related to an extensive fibrosis of the arterial wall.

Animals↗
PubMedDate not supplied

Effects of niguldipine, a new dihydropyridine calcium antagonist, on regional blood flow, cardiac performance and myocardial metabolism in anaesthetized open-chest dogs.

The haemodynamic and metabolic effects of niguldipine (0.01, 0.025 and 0.5 mumol/kg i.v.), a novel dihydropyridine calcium antagonist, were evaluated in 18 anaesthetized open-chest dogs. The following parameters were continuously measured: heart rate, arterial and pulmonary arterial blood pressure, left and right atrial pressure, left ventricular dp/dtmax, cardiac output, regional blood flow in the circumflex branch of the left coronary artery, and in 1 renal and 1 femoral artery. At predetermined intervals, contents of O2, CO2, H+ ions, glucose, lactate and free fatty acids were determined in blood drawn from the left atrium and a regional cardiac vein. Niguldipine induced a dose-dependent decrease in both systolic and diastolic arterial blood pressure, which led to an increase in heart rate and cardiac output. Mean left atrial pressure was markedly reduced by all doses. Coronary blood flow increased dose-dependently and persistently. Perfusion in the renal and femoral vascular beds also increased, but only transiently and to a lesser extent. Calculation of vascular conductances revealed a preferred vasodilating drug effect on the coronary vascular bed. Right atrial and systolic and diastolic pulmonary artery pressures were not noteworthy altered. Balances of metabolic substrates, O2, CO2 and H+ ions did not indicate any major drug effect of niguldipine on myocardial metabolism.

Anesthesia↗