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Biomedical subjects

G Kaiser

Publications and source records attributed to G Kaiser.

At least 91 records · Page 5Linked to original sources
PubMed1988

Sagittal synostosis--its clinical significance and the results of three different methods of craniectomy.

From 1973 to 1986, 50 infants with sagittal synostosis have been operated by three different methods of craniectomy (linear craniectomy and extended craniectomies, as proposed by Schut and Epstein et al.). Preoperatively, the mean cephalic index was 67 +/- 4, 35.5% had clinical findings as cerebral palsy, psychomotor retardation and/or neurological signs, and intraoperatively the epidural pressure was more than 200 mm H2O in 60% (recorded in the last 20 patients). The mean follow-up time was 4.7 (1-10.6) years. Postoperatively, only 14.5% had minor clinical signs, which were mostly not in relation to the former scaphocephaly. Half of the patients with increased ICP had clinical signs preoperatively, and none of the 20 patients had distinct findings postoperatively. Out of the 20 children operated on by linear craniectomy or by Schut's method up to 1980, two-thirds had no school problems and one-third some school problems; one-third had occasionally headaches and one-quarter ametropia. Concerning the aesthetic results, Epstein's method and, somewhat less Schut's method, were superior to linear craniectomy, as verified by craniometry and by the tracings of the outlines of the neurocranium 0.4-0.7 and 1.6-2.0 years postoperatively: mean cephalic indices 73 +/- 5 (normal in one-fourth), 74 +/- 7 (normal in half) and 79 +/- 4 (normal in nearly all patients). Epstein's method is superior to the other two methods because it renders it possible to increase the breadth the greatest during the period of greatest postnatal brain growth. In addition to the effect on the neurocranium, the extended craniectomies add to normalization of the base of the skull (in contrast to the natural history of scaphocephaly). In the long run, the results obtained remain the same. The disadvantage of residual skull defects (approximately 11% of the patients with extended craniectomies) can be avoided by performing surgery prior to 4-6 months of age or by preserving the removed bone in a deep-freeze for a limited time.

Cerebral Palsy↗
PubMed1988

Interaction between furosemide and the converting enzyme inhibitor benazepril in healthy volunteers.

Single oral doses of 10 mg converting enzyme inhibitor benazepril (CGS 14824A) and 40 mg furosemide were administered to 12 healthy male volunteers either separately or concomitantly. The pharmacokinetic parameters of benazepril were not influenced by coadministration of furosemide. Urinary excretion of total furosemide was significantly reduced by 10 to 20% in the presence of benazepril. This effect was considered clinically insignificant. Erect blood pressure decreased and pulse rate increased only during concomitant treatment.

Adult↗
PubMed1988

Comparative study of alloimmune reactions induced by leukocyte and platelet transfusions in humans: characteristic changes of activation markers, gamma interferon, and FcR blocking antibody production.

This study was undertaken to define immune responses induced by leukocyte and platelet transfusions. We offer evidence that activation by alloimmunization with intravenously administered "buffy coat" cells results in immune alterations similar to the early rejection episodes following kidney transplantation. Thus, IL-2 and HLA-DR expression increased on PBL 2 and 3 days after antigen exposure and paralleled elevations of IFN-gamma, neopterin, and beta 2 microglobulin levels. No significant changes were detected in the number of T-cell subpopulations. Alloimmunization by purified platelets alone that express only class I MHC antigens failed to induce the above alteration, even after repeated exposure. Repeated alloimmunization with "buffy coat" cells or isolated platelets stimulated a progressive increase up to 100% blocking activity on EA rosette formation. We conclude that the expression of activation markers on PBL and the production of IFN gamma and neopterin reflect the early phase of alloimmune response induced by leukocytes. This type of alloactivation is not a prerequisite for the development of FcR-blocking antibody, which is produced after pure platelet transfusion as well.

Binding, Competitive↗
PubMed1988

[Congenital hydrocephalus--initial status (prognosis) of congenital hydrocephalus].

Only 1/4-1/3 of the surviving patients have severe neurological findings, are continuously treated with anticonvulsives and/or have a severe mental retardation; the same number of school children is totally dependent on nursing and ineducable. All patients remain shunt-dependent. A few prognostic pointers can be obtained from the aetiology of hydrocephalus, from the occurrence of perinatal pathology and from the head circumference at birth. In cases with a head circumference of more than 45 cm shunting should be performed beyond the neonatal period only for nursing reasons.

Cephalometry↗
PubMed1988

[Congenital hydrocephalus. A multicenter retrospective longitudinal study of newborn infants treated with shunts 1976-1985].

A multicentric retrospective evaluation of 54 children was performed who were born between 1976 and 1985 with a clinically recognisable hydrocephalus and thereafter shunted. The 4 topics of the study included: 1) Analysis of pregnancy, antenatal diagnostic procedures and parturition, 2) Preoperative evaluation and intraoperative findings, 3) Long-term follow-up and 4) Prognosis (actual status) of the 45 surviving patients at the end of the study (May 1987). Patients with neonatal hydrocephalus were observed in 11% of all children shunted during the same time in the hospitals included in this study. During this period the incidence of new cases did not decrease.

Cerebrospinal Fluid Shunts↗
PubMed1987

Determination of a new angiotensin converting enzyme inhibitor and its active metabolite in plasma and urine by gas chromatography-mass spectrometry.

A specific and sensitive gas chromatographic-mass spectrometric method for the simultaneous quantification of unchanged 3-[( 1-ethoxycarbonyl-3-phenyl-(1S)-propyl]amino)-2,3,4,5-tetrahydro-2-oxo-1- 1-(3S)-benzazepine-1-acetic acid (I) and its active metabolite, the dicarboxylic acid (II), in plasma and urine has been developed and validated. 2H5-labelled analogues of I and II were used as internal standards. The compounds were isolated from plasma and urine under acidic conditions using XAD-2 resin or Extrelut 1 columns. Following derivatization with diazomethane, the samples were analysed by packed-column gas chromatography-electron-impact mass spectrometry with selected-ion monitoring. The analysis of spiked plasma and urine samples demonstrated the good accuracy and precision of the method, which is suitable for use in pharmacokinetic and bioavailability studies with the new angiotensin converting enzyme inhibitor prodrug I.HCl in humans.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1987

[The importance of thermography in the diagnosis of lumbar radicular pain syndromes].

This study proved the existence of lateral differences in thermographic recordings of the legs of 83 out of a total of 84 patients with the clinical diagnosis "lumbar disk herniation". In 68.5 per cent only of 71 patients with unilateral symptoms, however, the hypothermic areas occurred in the symptomatic leg. These areas could not be matched with corresponding dermatomas. As regards determination of the level of the herniation, thermography is an unreliable method for differentiation between the different segments, because the site of the dermatoma cannot be identified in relation to the site of the herniation. The mechanism of difference in temperature distribution probably depends on sympathetic reflexes with increased activity in the vasoconstrictor system due to pain. These reflexes are not limited to one dermatoma. This has been confirmed by means of diagnostic nerve blocks of the appropriate root.

Adult↗
PubMed1987

HLA investigations in cardiomyopathies.

Typization of HLA A, B and C antigens of peripheral lymphocytes was performed in 14 patients suffering from cardiomyopathy and in 10 family members from 10 families. Among the antigens of locus A, the most frequent were the subgroups of HLA A9 (A23 and A24) in 7/14, and those of HLA A10 (A25 and A26) in 3/14; frequent antigens of locus B were the types B5, B7, B12 and B35. In 2 of 10 families the cardiomyopathy was transmitted by autosomal dominant genes, while the other cardiomyopathy cases were sporadic. The HLA B8 antigen was not observed in any case of cardiomyopathy.

Adolescent↗
PubMed1986

The value of multiple shunt systems in the treatment of nontumoral infantile hydrocephalus.

A multiple shunt system has been employed in nine children with hydrocephalus combined with absent or insufficient communication with intracranial-filled spaces. The common feature of the different lesions to such a shunt system is a pressure difference, which can be adjusted by this procedure. There arise four general indications: the uniform drainage of CSF spaces which do not communicate with each other; the uniform drainage of CSF and other separate liquid filled intracranial spaces; to obtain gradual and steady diminution of enormously dilated CSF or other fluid-filled spaces; the use of both sides for shunting in cases with recurrent failures of a unilateral drainage. The postoperative efficacy of a multiple shunt can be proved by demonstrating evenly decreasing CSF and other fluid-filled cavities, and by equilibrium between their different pressures. Evaluation of possible shunt failure in a multiple system requires CT and ICP recordings.

Cerebrospinal Fluid Shunts↗
PubMed1986

Chemical structure and mutagenic activity of aminoimidazoquinolines and aminonaphthimidazoles related to 2-amino-3-methylimidazo[4,5-f]quinoline.

We have synthesized 11 heterocyclic aromatic amines with chemical structures related to that of 2-amino-3-methylimidazo [4,5-f] quinoline (IQ), a potent mutagen occurring in broiled sardines, fried beef and beef extract. The mutagenic activity of these IQ analogs was studied and compared with that of IQ using the Ames test with strain TA98 of Salmonella typhimurium in presence of a metabolic activation system (S9 mix) derived from rat liver. The mutagenic activities of the IQ analogs vary over a million-fold; structure-activity comparisons indicate major contributions of the methyl substitution in the imidazole ring and of the quinoline-N, and significant contributions of methylation of the exocyclic amino group and of the geometry of the entire ring system.

Animals↗
PubMed1986

Suggestions for the construction of a flow-reducing device in the treatment of hydrocephalic children, based on clinical and experimental results.

A few hydrocephalic children originally shunted for progressive hydrocephalus become shunt-independent later on (5). The most important mechanisms resulting in shunt independence are, on the one hand, induced by growth, and, on the other hand, the gradually diminishing function and, finally, occlusion of the vascular catheter. With a flow-reducing device it should be possible to imitate this mechanism, resulting in appropriate cases in shunt independence within a predictable time. Instead of by growth, the reduction of flow and finally, the occlusion, could be achieved in such a device by the normal CSF contents. In preliminary examinations we studied retrospectively the behaviour of soft tissue in 9 proximal and distal obstructions of different derivation systems, as well as the influence of the shunt parts on the CSF content of cells and proteins. Soft tissues always lead to an obstruction by the ependyma or by a fibrinous plug; however, an intraluminar invasion of cells was never found. Incubation of different parts of the shunt system with mononuclear leucocytes did not lead to a decreased survival of cells, and the amount of cells in shunted children compared to unaffected ones did not show any difference. CSF proteins in 54 hydrocephalic children are on the average similar to a normal population of the same age distribution (3, 4). Experimental work on 22 different membrane types is presented in respect of their technical aspects and laboratory findings. Membranes with a pore diameter from 0.05 to 10 micron were perfused in a sterile unit at constant temperature with artificial CSF of 20 times augmented concentration in proteins (8).(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebrospinal Fluid Proteins↗
PubMed1986

Comments on the management of newborn with spina bifida cystica--active treatment or no treatment.

From 1977-1984 46 children with myelomeningocele (MMC) have been admitted immediately following birth. According to Lorber's adverse criteria, 8 received no active treatment (17%) (rejected group). The other 38 were operated on within the first 24 hours (83%) (selected group). The first group had a mean of 3 criteria per patient. The decision not to treat was taken in consultation with the parents, social factors playing an important rôle, too. 5 children died within a few days to 2 months subsequent to an infection. 3 survived and were shunted at 2-4 months at the request of the parents. With the exception of 2, all mothers agreed with the former decision 1-8 years later. Among the 38 patients with active treatment 12 should not have been operated on (26% of all MMC cases), because they had adverse criteria too though less than the rejected group. Among these 12 patients, there are more shunt patients, and their walking capacity is inferior to that of the remaining 26, but there is no difference in respect of their intellectual capacity. Without additional measures Lorber's criteria refer rather to come than to spontaneous mortality. They predict subsequent walking capacity and bladder function correctly, but not the intelligence, and patients with good intellectual capacity may thus be excluded from treatment. To avoid this, at least 3 adverse criteria and/or the three last ones (hydrocephalus, birth injury, major congenital defects) as well as social factors, should be taken into account. Following selection the paediatric surgeon should remain available for the parents' support and reevaluation of the child.

Cerebrospinal Fluid Shunts↗
PubMed1986

Transport of anions in isolated barley vacuoles : I. Permeability to anions and evidence for a cl-uptake system.

The anion contents of young barley leaves and of mesophyll protoplasts from the leaves was compared. Anion loss from the protoplasts during isolation was small. Although only about 60% of the leaf cells were mesophyll cells, phosphate and sulfate contents of the mesophyll cells accounted for almost 90% of the leaf contents. Chloride accumulated in the leaf epidermis. The rapid isolation of vacuoles from mesophyll protoplasts permitted the determination of vacuolar ion concentrations. Sodium and nitrate levels were very low in the cytoplasm, and much higher in the vacuole. When barley plants were grown in the presence of low NaCl levels, chloride concentrations were comparable in cytoplasm and vacuole, and similar observations were made with sulfate. Cytoplasmic phosphate concentrations were close to 30 millimolar and potassium concentrations 100 millimolar. During a 30 minute incubation period at room temperature, anion contents of isolated vacuoles decreased considerably. Efflux of NO(3) (-) was faster than that of Cl(-). Phosphate and sulfate crossed the tonoplast only slowly. 4,4'-Diisothiocyano-2,2'-stilbenedisulfonic acid partially inhibited the efflux of nitrate and, to a lesser extent, that of chloride. Decreased efflux was also observed in the presence of MgATP. In remarkable contrast, p-chloromercuribenzene sulfonate and HgCl(2) stimulated the efflux of nitrate and chloride, but not of phosphate. Labeled chloride was taken up by isolated vacuoles. The apparent K(m) for chloride uptake at low chloride concentrations was 2.3 millimolar. At elevated chloride concentrations, chloride did not display saturation characteristics but, rather, characteristics of a diffusional process. Uptake was stimulated by ATP.

Journal Article↗
PubMed1986

Treatment of progressive posthemorrhagic hydrocephalus with temporary external ventricular drainage. Preliminary results.

Peri-intraventricular hemorrhage (PIVH) is a major problem of preterm neonates: over 40% of infants with birth weight less than 1500 g have been found to experience this disorder. The posthemorrhagic hydrocephalus (PHH) is generally believed to occur secondary to obliterative posterior fossa arachnoiditis. Its management in critically ill premature infants with multiple medical problems has thus become quite significant. This paper reports the results of the placement of a temporary external ventricular drainage in three patients in whom progressive ventricular dilatation began within two weeks after severe neonatal PIVH. In all patients the hydrocephalus and increased intracranial pressure were controlled within three weeks of treatment. One infant died from other problems associated with his prematurity. Early demonstration of progressive ventricular dilatation by ultrasound and prompt external drainage has been found to be a safe initial method to treat PHH in preterm infants.

Cerebral Hemorrhage↗