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Biomedical subjects

H Gerber

Publications and source records attributed to H Gerber.

At least 109 records · Page 6Linked to original sources
PubMed1993

Calcific periarthritis of the finger verified by X-ray diffraction of apatite.

The authors describe a 24-year-old woman presenting with swelling and pain of several finger joints. Roentgenograms showed periarticular, calcific deposits at all locations of swelling. One such deposit revealed the presence of hydroxyapatite crystals on X-ray diffraction. After two injections of corticosteroids in and around one deposit its size and density diminished rapidly, whereas the uninjected corresponding site of the other hand showed no initial improvement; after two years no difference was discernible. Under systemic and topic NSAIDs, pain and swelling improved similarly in all joints. In conclusion, periarthritis of the fingers associated with radiopaque deposits responded favourably to NSAID therapy, while local corticosteroid injections showed no additional benefit.

Adult↗
PubMed1993

Limitations to VO2max in humans after blood retransfusion.

Seven young, healthy male subjects performed maximal exercise on a cycloergometer with central venous and arterial catheters, before and after autologous retransfusion of red blood cells. Maximal oxygen consumption (VO2max), blood gas composition and haemodynamic variables were measured, in order to test the hypothesis of monofactorial vs. polyfactorial VO2max limitation. Autologous blood retransfusion led to significant increases in haemoglobin concentration and consequently arterial oxygen concentration during maximal exercise, while maximal cardiac output, heart rate and stroke volume were not significantly changed. The relationship between maximal oxygen delivery (cardiac output.arterial oxygen concentration; (Q.CaO2)max and maximal oxygen consumption in this study was VO2max (L.min-1) = 0.02 + 0.64.(Q.CaO2)max (L.min-1), the slope being significantly less than unity. These results suggest that (Q.CaO2)max plays but a fractional role in limiting VO2max, in agreement with recent models concerning the resistance to oxygen flow in the respiratory system (di Prampero and Ferretti, Respir. Physiol. 80: 113-128, 1990). The relative increase in VO2max after blood retransfusion matched the relative increase in 'aerobic performance', measured as the maximal power output that could be maintained aerobically for 30 min. Furthermore, the increase in maximal power output (15 +/- 3 watts) could account for almost all of the extra oxygen consumption. This match suggests that there is an inability to fully utilize muscle oxidative capacity in the normocythaemic state.

Adult↗
PubMed1993

Postoperative vomiting in children. A persisting unsolved problem.

Nausea and vomiting after anaesthesia and surgery in children remains a major problem. The following survey studies the frequency of postoperative vomiting and relates it to the anaesthetic technique, the surgical procedure, and postoperative analgesia. During one year, September 1989 until September 1990, 2370 surgical patients requiring anaesthesia were studied prospectively with the following protocol: 1) patient data, surgery and anaesthesia technique; and 2) postoperative follow-up were registered. Outpatients were followed up by telephone. The overall incidence of vomiting was 19.5%, which was lower than in other studies. An increased incidence of vomiting was found in children over 2 years of age, after certain operative procedures, and after general anaesthesia. Furthermore, postoperative opioid administration on the ward increased the risk of vomiting. Despite the low overall incidence of vomiting in our study, we still found a high frequency after certain surgical procedures. The use of regional anaesthesia, prophylactic antiemetic medication, and the introduction of new anaesthetics, may help to reduce the sometimes high incidence of postoperative nausea and vomiting in paediatric patients.

Adolescent↗
PubMed1993

Insufficiency fractures of the sacrum. Twenty cases and review of the literature.

Over the past 10 years, 231 insufficiency fractures of the sacrum have been reported in the literature. These fractures, which are due to osteopenia, form a distinct subgroup of pathologic fractures. In 1.8% (n = 20) of the older-than-55-years female patients (total = 1,015) admitted to the authors' Rheumatology department between 1989 and 1991, a fracture of the sacrum was diagnosed. In all cases the diagnosis was confirmed with computed tomography. Frequency, age, sex, diagnosis, underlying diseases, and associated fractures of the 20 cases of insufficiency fractures of the sacrum are described and compared with those previously reported. Insufficiency sacral fracture as a cause of low-back pain in women older than 55 years of age is concluded to be a clinical entity.

Aged↗
PubMed1993

DNA sequence analysis of serologically detected ELA class II haplotypes at the equine DQ beta locus.

The genetic diversity at the ELA DQ beta locus was investigated using polymerase chain reaction and DNA sequencing. Based upon serological methods 16 class II homozygous animals were selected and their genomic DNA was used. A DQ beta gene from an equine cDNA library was also sequenced. Our methodology and the similarity between the genomic and the cDNA sequences suggest that the studied locus is expressed on equine lymphocytes. In the predicted amino acid sequence the most extensive variation is located at residues 56-60. The pattern of these five amino acids is strongly correlated to the serological ELA class II specificities (W13, W22, W23, Be200). The alleles corresponding to the W23 specificity are the most divergent among the equine DQ beta alleles and also from other mammalian DQ beta sequences.

Alleles↗
PubMed1993

Incremental dosing versus single-dose spinal anesthesia and hemodynamic stability.

We compared the hemodynamic stability after spinal anesthesia with two different dosing regimens in the elderly. Fifty patients, all older than 60 yr and scheduled for elective knee or hip surgery were assigned to two groups. After administration of 10 mL/kg of lactated Ringer's solution (RL) intravenously (i.v.) in the first group, we performed a continuous spinal anesthesia (CSA) by means of a 28-gauge catheter through which repetitive injections of 2.5-5 mg of plain bupivacaine 0.5% were given. In the other group, a single-dose spinal anesthesia (SS) with 20 mg of the same local anesthetic (LA) was carried out. Noninvasive mean arterial pressure (MAP), heart rate, and levels of analgesia were measured. To maintain MAP within 25% of initial value, the patients received additional i.v. fluids (RL) as first measure. When MAP could not be maintained despite hydration, incremental doses of ephedrine were given i.v. Six patients in the CSA group and 17 in the SS group developed a level of anesthesia higher than T6 (P < 0.01). In the SS group more fluid was needed (792 vs 388 ml) than in the CSA group (P < 0.01). Moreover, more patients of the SS group (11 vs 4) required ephedrine (P < 0.05). We conclude that CSA produces reliable and predictable analgesia for lower limb surgery with less need for correction of hemodynamic changes compared to SS.

Aged↗
PubMed1992

Carcinosarcoma of the urinary bladder: a distinct variant characterized by small cell undifferentiated carcinoma with neuroendocrine features.

The clinicopathological features of two carcinosarcomas of the urinary bladder are reported. The tumours occurred in a 64- and a 66-year-old patient presenting with haematuria and both were polypoid. The epithelial component was consistent with small cell undifferentiated carcinoma with neuroendocrine differentiation, whereas the sarcomatous component did not display specific features. The carcinomatous component showed immunohistochemical reactivity for different epithelial markers as well as for chromogranin and neuron specific enolase. Conversely, the sarcomatous cells stained strongly for vimentin and in one case for muscle actin and smooth muscle actin. The differential diagnosis of biphasic tumours of the bladder is discussed and the literature reviewed.

Actins↗
PubMed1992

[The effect of static magnetic fields on osteoblast activity: an in-vitro study].

The aim of the present study was to investigate whether the influence of static magnetic fields can be demonstrated in an osteoblast cell culture. For this in-vitro study we used osteoblasts originating from the embryonal calvariae of rats. The total material (n = 41) was divided in four groups: a) cell cultures submitted to the fields of attracting magnets (n = 11), b) cell cultures in the fields of repelling magnets (n = 10), c) cell cultures under the influence of demagnetized magnets (sham group, n = 11), d) control cultures (n = 9). The cell cultures were subjected for 21 days to magnetic fields (intensity 178 ml) using Neodynium magnets. Osteoblast activity was histo-chemically determined by staining the alkaline phosphatase produced. The quantitative evaluation was performed by measuring the optical density of the cell cultures and the results were statistically analysed. The results of these in-vitro study are: 1. The optical density of the cell cultures was nearly the same in samples with or without the influence of magnetic fields. 2. No divergent reaction could be found between the application of homogeneous and heterogeneous magnetic fields. 3. The different orientation of homogeneous magnetic fields in vertical or horizontal direction did not effect the osteoblast cell culture. 4. The cellular distribution in the osteoblast cultures does not follow the orientation of the magnetic field lines. 5. The form of the osteoblasts was nearly the same among all four groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Effect of human thyroid stimulating autoantibodies on the radioiodine uptake of the mouse thyroid gland.

Administration of sera from patients with active Graves' disease to nude mice bearing human thyroid xenografts provides the opportunity to compare directly the effects of TSAb on thyroid tissue of different species. The results presented in this paper, namely the fact that only one of 8 Graves' sera increased the RAIU of the nu/nu mouse thyroids modestly while all sera increased the RAIU in the transplanted human tissue considerable, clearly show a species specific effect of TSAb.

Animals↗
PubMed1992

On the genetic basis of equine allergic diseases: II. Insect bite dermal hypersensitivity.

The horses studied were of the Swiss Warmblood breed and most were ELA-typed to assess a possible association of dermal hypersensitivity to insect bites with the major histocompatibility complex. Firstly, the occurrence of the condition was examined in 304 half-siblings sired by six stallions (A to F). Fourteen cases of dermal hypersensitivity were recognized and all were in the 153 offspring of Stallions C, E and F. Most animals of this group were also investigated for chronic hypersensitivity bronchitis: none of the sires displayed clinical signs of dermal hypersensitivity, but Stallions D, E and F were affected by chronic bronchitis. Among the animals investigated for both conditions only one horse showed coincidence of the two diseases as can be expected when the diseases are not correlated. The frequency of manifest dermal hypersensitivity and/or chronic hypersensitivity bronchitis varied in the half-sibling groups of individual sires. These findings suggest that the allergic conditions are independent entities. Secondly, the occurrence of dermal hypersensitivity was studied in three generations of horses at a stud at which Stallion C had exerted a particularly strong influence. A total of 302 animals, all born and raised at this stud, were surveyed over a period of 12 years. The descendants of Stallion C showed a significantly higher incidence (P less than 0.01) of dermal hypersensitivity (two daughters out of 19; eight second generation offspring out of 103; one third generation offspring out of 85) than did the controls of the same age classes but unrelated to Stallion C at the same stud (0 out of 95).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Clonal analysis of human tumors with M27 beta, a highly informative polymorphic X chromosomal probe.

The clonality of human tumors can be studied by X inactivation/methylation analysis in female patients heterozygous for X-linked DNA polymorphisms. We present a detailed study on clonal tumor analysis with M27 beta, a highly informative probe detecting a polymorphic X chromosomal locus, DXS255. The polymorphism detected at this locus is due to variable numbers of tandem repeats. The rate of constitutional heterozygosity detected by M27 beta was 88%. Normal tissue from gastrointestinal mucosa and thyroid showed random, hence polyclonal, patterns. Nonrandom clonal X inactivation was detected in all 22 malignant neoplasms that had been shown to be clonal by other DNA markers, such as antigen receptor gene rearrangements or clonal loss of heterozygosity at 17p and other loci. 16/48 normal blood leukocyte samples (33%) showed considerably skewed X inactivation patterns. Comparison of blood leukocytes and normal tissue indicated that in a given individual, X inactivation patterns may be tissue specific. M27 beta was used to study the clonal composition of 13 benign thyroid nodules from 12 multinodular goiters with rapid recent growth, traditionally termed "adenomas." Nine of them were clonal, whereas four nodules and tissue from a case of Graves' goiter were not, indicating that some, but not all, such thyroid nodules may represent true clonal neoplasms. The M27 beta probe permits one to study the clonal composition by the X inactivation approach of a wide variety of solid tumors from most female patients. As a control, normal tissue homologous to the tumor type of interest is preferable to DNA from blood leukocytes, since the latter may show nonrandom X inactivation patterns in a fairly high proportion of cases. M27 beta may, therefore, be of limited use for the clonal analysis of neoplasms derived from hematopoietic cells.

Clone Cells↗
PubMed1992

Histomorphological and immunohistochemical evidence that human nodular goiters grow by episodic replication of multiple clusters of thyroid follicular cells.

This study was aimed at dissecting the cellular mechanisms that underly the growth of actively expanding human goiter nodules. Thirty-two nodules from different patients, all removed because of steady recent growth, were serially sectioned and screened for 1) histomorphological signs of cell proliferation and 2) in situ expression of the immunohistochemically stained p21ras protooncogene product. Bovine, porcine, and rat thyroid glands (the latter from both T4- and perchlorate-treated animals) were used as controls. In normal glands, only a few follicular cells contain substantial amounts of stainable p21ras. Some of these cells are unusually large, but do not proliferate. In contrast, all goiter nodules contain areas where the epithelial cells are morphologically grossly altered and heavily loaded with p21ras. Cells of this type are mostly clustered in large cohorts coating whole follicles or entire groups of follicles. Only a small fraction of these activated cells actually proliferates at any one point in time. Actively replicating cells are scattered in tiny foci all over the nodules. The earliest proliferating buds are solid, but soon begin to generate microfollicles that enlarge by adding new cells to the follicular epithelium. Regionally heterogeneous p21ras content in morphologically identical cells suggests that growth occurs in bursts and waves. We conclude that goiter nodules grow by episodic proliferation of heterogeneous cohorts of epithelial cells from which new follicles are generated. Only a tiny fraction of all goiter cells proliferate at any one point in time. The molecular mechanisms governing these growth processes are unknown.

Adolescent↗
PubMed1992

[Struma, hyper- and hypothyroidism].

Careful history and physical examination form the basis of thyroid diagnostics. They are important for the choice of the appropriate laboratory and imaging tests such as sonography and scintigraphy. Estimation of FT4 and TSH (measured with a 'sensitive' assay) are nowadays considered to be the principal laboratory tests for thyroid disease. Euthyroidism and hypothyroidism are confirmed by measuring FT4 and TSH (not FT3 or TT3), hyperthyroidism by measuring FT3, FT4 and TSH. If a goitre is observed, the primary tests are TSH and sonography.

Diagnosis, Differential↗