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H Gerber

Publications and source records attributed to H Gerber.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Electronic expert system in medicine. For example ILIAD].

Expert systems are knowledge data bases founded on patient data, literature searches and opinions of experts. With these systems it is for instance possible to test or to take clinical decisions. ILIAD, USA version 4.2, an adaptable software using probabilistic strategies, was investigated. This system is, among other uses, employed for quality assurance and documentation, as a teaching instrument as well as a knowledge base. It comprises the ICD-9 index of diagnoses and a selected and commented up-to-date review of the literature from 'Mosby's Year Book of Medicine'. The features of ILIAD are presented, and the possibilities and limitations of its use as well as that of expert systems in general are discussed.

Diagnosis, Computer-Assisted↗
PubMed1996

[Latex allergy--not only a threatening danger to patients. A case report from an anesthesiological department].

A 31-old male nurse of anesthesiology was exposed to rubber gloves over a period of ten years. An atopic diathesis was known. From time to time he had episodes of pollinosis. Since nine months he had suffered from conjunctivitis, rhinitis and shortness of breath while wearing latex gloves. During a night shift ten minutes after consumption of tropical fruit (bananas, kiwi) he had to care for a patient in the emergency room. He wore rubber gloves and had to clean the emergency room. Initially, his palms and feet itched. Then he experienced angor and increased perspiration 90 seconds later he suffered severe dyspnea and dysesthesia in the lower extremities. Treatment with theophylline and beta sympathomimetics, steroids and antihistaminics was successful. This male nurse had a positive history for contact urticaria after exposition to rubber. He suffered a dramatic exacerbation when wearing latex gloves and inhaling latex-contaminated air after eating tropical fruits. Fruit could have been a potent booster. Hospital employees with a history of atopic disease should be screened for potential latex allergy before occupational exposure.

Adult↗
PubMed1996

[Tumor embolism with fatal cerebral infarct in pneumonectomy. Case report and review of the literature].

Carcinomas of the bronchi often infiltrate veins, particularly in advanced stages. Tumor propagation in pulmonary veins with intra-atrial extension has been reported. Systemic arterial tumor embolism is a potentially fatal hazard that is caused by surgery or it can be the initial manifestation of a bronchogenic carcinoma. The importance of early pulmonary venous ligation in lung cancer surgery, first stressed by Aylwin in 1951, is evident, particularly when intravenous tumor progression has been diagnosed preoperatively by echocardiography or CT scan. We report a case of lethal hemispheric brain infarction following tumor embolism during lobectomy for bronchus carcinoma. A review of the literature on this subject is presented; there were 38 cases of arterial tumor embolism because of primary lung neoplasms.

Aged↗
PubMed1996

Model of the athymic nude mouse for the study of benign goiter disease.

Since Shimosato et al., in the mid 70s transplanted for the first time thyroid carcinoma tissue onto nude mice, other research groups have made use of the nude mouse model for the investigation of xenotransplanted thyroid tissue. The use of this model for the investigation of benign goiters is briefly discussed in this article. Normal human thyroid tissue has been transplanted either as a control in experiments with benign and malignant goiter tissue, or for the study of thyroid tissue response to stimulators such as TSH or thyroid stimulating antibodies (TSAb). Thyroid glands from 8- to 10-week old human fetuses obtained at the time of legal abortion were cryopreserved in liquid nitrogen and successfully transplanted into nude mice. Moreover, all the variants of human benign goiter tissue have been xenotransplanted: tissue from nodular and diffuse goiters, hot and cold nodules or goiter areas, rapidly growing nodules, etc. Two examples of animal thyroid tissue xenotransplantation onto nude mice are briefly discussed: Nude mice bearing normal thyroid tissue transplants from 4 different species (man, rat, pig, guinea-pig) have been used for the study of the species specific effect of bovine TSH and TSAb. In studies aiming at elucidating the pathogenesis of hyperthyroidism, toxic goiter tissue from hyperthyroid cats has been transplanted. In methodological terms, these experiments have shown that surgically removed goiter tissue can be shipped by air in cell culture medium at 4 degrees C over long distances and then successfully transplanted.-Finally, cell lines such as the rat cell line FRTL-5 can be transplanted onto nude mice either as cell suspension or embedded in collagen, for example for the study of proliferation and folliculogenesis. Using the xenotransplantation model, function and proliferation, morphogenesis and differentiation, as well as thyroid autonomy and response to stimulators have all been studied in xenotransplanted human and animal thyroid thyroid tissue and cell lines under various experimental conditions. Although new research tools, for example transgenic animals, are now increasingly and successfully used, xenotransplantation still offers the possibility of addressing some specific questions which cannot be answered so easily with other experimental models. For example, studies with human tissue, involving drugs or radioactive tracers which cannot be applied to the intact human being, can relatively easily be performed with xenotransplanted human tissue and application of the drug or tracer to the host mouse. Or embryological development can be followed and studied using fetal thyroid (and other) tissue transplanted onto nude mice; here, of course, difficult ethical issues have to be considered. Finally, it should be mentioned that, although many scientific questions can be studied nowadays by cell culture or other in vitro systems, animal models are still needed. Extrapolation to the human being, however, should always be done with caution and we should always keep in mind that for the understanding of a human disease indeed human experimental models remain the goldstandard.

Animals↗
PubMed1995

[Clinical aspects, diagnosis and drug therapy of hyperthyroidism].

Graves' disease and toxic uni- or multinodular goiter are the most frequent causes of hyperthyroidism. Graves' disease is caused by thyroid stimulating immunoglobulins which are directed against the TSH receptor of thyroid follicular cells. Graves' disease affects more females than males and is associated with diffuse goiter and a rapid appearance of symptoms and signs of hyperthyroidism. Patients with Graves' disease are on average younger than patients with toxic nodular goiter. The diagnosis of Graves' disease is usually easy, particularly if signs of endocrine opthalmopathy are present. Toxic nodular goiter is seen more often in older patients with pre-existing goiters. Symptoms and signs of hyperthyroidism often appear only slowly. Hyperthyroidism in these older patients can be oligosymptomatic. Older patients should therefore be investigated for the presence of hyperthyroidism, even if they present only a few symptoms or signs which could suggest this diagnosis. The development of ultrasensitive TSH assays has simplified the diagnosis of hyperthyroidism and made the TRH-test, often used in the past, almost superfluous. At the present time, it is practically always possible to differentiate between Graves' disease and toxic nodular goiter as the cause of hyperthyroidism on the basis of clinical and laboratory findings alone, and in many cases thyroid scintiscans are therefore no longer necessary. A patient with newly diagnosed Graves' disease is treated with antithyroid drugs (carbimazole or PTU) for one year. If hyperthyroidism persists after this one year of antithyroid drug treatment, or if it recurs, another year of therapy with carbimazole or PTU is indicated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[A high serum creatine kinase picture due to too much or too little exercise].

In case I, a 31-year-old man who had undergone unusual high-performance training, painful swellings occurred in the left arm and creatine kinase activity was raised (28,644 U/l), as well as that of the transaminases. A rapid urine test for blood was positive, but the sediment was free of red blood cells. There were no other pathological findings. Fluid intake was increased to 31 daily and on the third day he was symptom-free and creatine kinase activity had fallen to 6475 U/l, reaching normal values on the 15th day. Case 2 concerned a 28-year-old woman with paranoid schizophrenia who had taken several tablets of clozapine and then remained in bed for 3 days. She complained of pain in the region of the gluteus maximus muscles, exacerbated on pressure but otherwise unremarkable. Creatine kinase was raised to 21,492 U/l, creatine to 186 mumol/l, and the transaminases were likewise increased. The urine strip-test for blood was twice positive. She was treated with frusemide (80 mg daily) and infusions of electrolyte solution (21 daily). She became pain-free on the second day and the various enzyme activities rapidly fell to normal.

Adult↗
PubMed1995

Long-term follow up to patients with frozen shoulder after mobilization under anesthesia, with special reference to the rotator cuff.

UNLABELLED: In order to evaluate the efficacy of mobilization under anesthesia as a therapy for frozen shoulder, 43 patients with a mean age of 52.8 years were examined after an average time of 4.7 years. Since some authors have been concerned about rotator cuff tears, special attention--using sonography--was paid to rotator cuff lesions. RESULTS: Clinical and sonographic examinations were very similar and showed a perfect recovery in 27 of 37 patients (73.0%). The average time off work after mobilization was 6.2 weeks compared with expected spontaneous recovery of about 30 months. Outcome was worse in patients with previous trauma to their shoulder. In 2 patients (5.4%) the sonography revealed a slight rotator cuff tear, which is not uncommon in 60-year-old persons. Two additional patients (5.4%) underwent shoulder surgery two years after mobilization due to a persistent impingement syndrome and to a supraspinatus-tear. We conclude, that mobilization under anesthesia for frozen shoulder is an effective treatment modality causing little harm.

Adult↗
PubMed1995

Laptop meralgia.

Explore the source record for details and available documents.

Adult↗
PubMed1995

Partial sequence of the equine immunoglobulin epsilon heavy chain cDNA.

In order to isolate a part of the immunoglobulin E (IgE) heavy chain cDNA of the horse, primers have been designed based upon well conserved sequences in humans, sheep and rats. The PCR resulted in a 500 bp fragment which hybridised with a human IgE constant region probe. The fragment was cloned and sequenced and its derived protein sequence compared with the corresponding sequences in humans, sheep and mice. Most amino acids common to these three species are also shared by the horse.

Amino Acid Sequence↗
PubMed1995

Vasculitides in hairy cell leukemia.

Forty-two cases of vasculitis coincident with hairy cell leukemia (HCL) have been reported, of which 17 had panarteritis nodosa (PAN), 21 had cutaneous leukocytoclastic vasculitis (LCV), and 4 had vessel wall infiltration by hairy cells. PAN generally occurred after the diagnosis of HCL, splenectomy, and infection. HBs antigen was detected in 3 of 12 patients tested, whereas immune complexes were positive in 3 of 4 patients tested. LCV was often preceded by infection and was frequently detected before HCL. Serum immunoglobulin levels were generally elevated when measured. Cryoglobulins, complement, rheumatoid factor, and antinuclear antibodies showed no clear association with vasculitis in HCL. These reports suggest a role for infection and splenectomy as contributing factors to vasculitis.

Adult↗
PubMed1995

Epidermal growth factor stimulates cell proliferation and inhibits iodide uptake of FRTL-5 cells in vitro.

In accordance with the available data most authors conclude that epidermal growth factor (EGF) has very little or no effect on FRTL-5 cells. This has been viewed as a serious handicap of this cell line. In the present study we cultivated three strains of FRTL-5 cells from different sources and assessed their response to EGF with regard to proliferation, function and differentiation. Cell proliferation was assessed by counting in a Coulter cell counter after culturing cells at suboptimal conditions in well plates. Cell function was studied by measuring iodide uptake. Cell differentiation was examined immunocytochemically by staining monolayer cultures for thyroglobulin (Tg) and EGF receptor (EGFr) as well as morphologically by microscopical evaluation of monolayer cultures. All three FRTL-5 cell lines investigated express EGFr. In two wild type FRTL-5 cell lines EGF stimulates growth, an effect that is enhanced by the presence of TSH, and partially inhibits iodide uptake. A third mutated strain of FRTL-5 cells does not respond to EGF. Tg expression can be demonstrated immunocytochemically in EGF-treated cells as well as in controls. Morphologically, in monolayer culture EGF-treated cells cannot be distinguished from controls. Contrary to previous reports, these studies demonstrate EGF effects on FRTL-5 cells that are consistent with EGF effects established in other thyroid follicular cells.

Animals↗
PubMed1994

[Osteoporosis screening--indications for bone densitometry].

Osteoporosis is a major public health problem because of increasing prevalence and the cost of related morbidity, especially fractures of the spine and hip. The perimenopausal evaluation of risk patients by assessment of clinical risk factors and bone-mass measurements are used to select patients for prevention of postmenopausal and age-associated bone loss. The value of bone-mass for prediction of fracture-risk and the clinical significance of bone-densitometry for patient management is reviewed. Four essential clinical indications for bone mass assessment are discussed.

Absorptiometry, Photon↗
PubMed1994

[Gonorrheal arthritis].

A 43-year-old female patient presented with migratory arthralgias, generalized exanthema and arthritis of the left elbow. She had a history of fever and chills three days earlier. Beside to a maculopapular and pustular rash and a joint involvement we found a swelling of the dorsal surface of her right hand without wrist effusion or synovitis. The clinical presentation was typical for the diagnosis of disseminated gonococcal infection (arthritis-dermatitis syndrome). Arthrocentesis was performed, and the cultures of the synovial fluid on chocolate agar were positive for Neisseria gonorrhoeae. The serologic examination for gonococcus was negative, it became positive some weeks later. The therapy with intravenous penicillin G 6 x 10(6) units/day for ten days was successful; unfortunately, we could not treat the partner. The present case report is illustrated with colour prints and describes the typical clinical picture of a diagnosis which is nowadays rare or even forgotten.

Adult↗
PubMed1994

Etiopathology of feline toxic nodular goiter.

We have discussed the etiopathology of feline toxic nodular goiter in the context of human nodular goiter pathogenesis. We have reviewed thyroid heterogeneity, growth regulation, functional and growth autonomy, nodule and tumor formation, and the evolution of toxic nodular goiter in the human being. By addressing toxic nodular goiter of the cat, the history, morphologic findings, xenotransplantation and cell culture studies, evidence for and against circulating thyroid stimulators and epizootiological studies of the feline disease have been summarized. Due to its structure, the thyroid gland offers some unique possibilities to study the mechanisms that are responsible for cellular heterogeneity, the emergence of autonomous nodular growth and function, and, ultimately, the development of tumors. The demonstration of naturally occurring clones of cells with high intrinsic proliferation potential within the follicular epithelium of the thyroid has fostered promising new concepts on the genesis of nodular growth of benign and possibly malignant endocrine tumors. Hyperthyroid cat goiters contain single or multiple, autonomously (i.e., TSH-independently) functioning and growing nodules. Neither hyperfunction nor growth of these nodules depends on extrathyroidal circulating stimulators. The basic lesion appears to be an excessive intrinsic growth capacity of some thyroid cells. The factors enhancing the transformation of a normal thyroid into a nodular hyperfunctioning goiter over many years are still unknown. Immunological, environmental, and nutritional factors are the focus of ongoing studies, but an infectious agent can not yet be excluded.

Animals↗