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Biomedical subjects

J Bauer

Publications and source records attributed to J Bauer.

At least 253 records · Page 14Linked to original sources
PubMed1997

[Systemic immunologic diseases as differential diagnosis in psychiatry].

Psychiatric symptoms may be caused by systemic autoimmune diseases. Quite often, mental disorders are an early symptom during the course of an autoimmune disease and sometimes they may even be the presenting symptom. This article reviews psychiatric and neurologic symptoms in systemic lupus erythematodes, Sjögren syndrome, primary vasculitides and other immunopathies such as the primary antiphospholipid syndrome and Sneddon's syndrome. The article also discusses diagnostic aspects and therapeutic options if an autoimmune disease as cause of a psychiatric or neurologic symptom is suspected. An increased awareness of psychiatrists and neurologists will make it possible that systemic autoimmune diseases are early identified as a possible cause of psychiatric symptoms and may then be treated adequately.

Autoantibodies↗
PubMed1997

Potent inhibition of interleukin-6 expression in a human astrocytoma cell line by tenidap.

Tenidap is a structurally novel antirheumatic agent with anti-inflammatory and analgesic properties. Previous studies have shown that tenidap is able to inhibit the production and action of cytokines such as interleukin-1, interleukin-6 (IL-6) and tumour necrosis factor alpha. However, the mechanisms by which tenidap inhibits cytokine synthesis are not yet known. We investigated in the human astrocytoma cell line U373 whether tenidap inhibits IL-6 synthesis by inhibition of certain signal transduction processes leading to IL-6 synthesis. Cells were stimulated with different substances which have previously been shown to activate protein kinase A or C, reactive oxygen intermediates as well as transcription factors such as nuclear factor kappa B and AP-1 and which all result in IL-6 synthesis. Tenidap was a very potent inhibitor of IL-6 synthesis independent of the stimuli used, suggesting an inhibitory mechanism other than inhibition of a certain signal transduction pathway. Since IL-6 has been shown to be involved in the etiopathology of Alzheimer's disease and since the use of nonsteroidal anti-inflammatory drugs appears to be of therapeutical benefit, it is concluded that tenidap should be tested in clinical trials in order to determine whether it may be useful for the treatment of Alzheimer's disease.

Alzheimer Disease↗
PubMed1997

Novel uses of the aromagram in infection control and epidemiology.

BACKGROUND: To facilitate the interpretation of data used in infection control and epidemiology, a novel data presentation format (the aromagram) has been developed and modified. METHODS: Aromagrams were developed with a personal computer-based graphics application. Aromagrams were based on antimicrobial susceptibility data from all specimen submitted to the University of California San Diego Medical Center's clinical microbiology laboratory between July 1992 and December 1994. RESULTS: The aromagrams created displayed both bacterial species-specific and antimicrobial agent-specific susceptibilities. Additional modified aromagrams incorporated costs of antimicrobial agents and temporal trends in susceptibility of individual species to selected antibiotics. CONCLUSIONS: The aromagram is a unique format for data presentation that can be used to illustrate antimicrobial susceptibilities (specific to both organisms and antimicrobial agents), temporal trends in susceptibility data, and antimicrobial costs. Aromagrams may be used to display data useful to infection control and epidemiology professionals and to clinicians.

California↗
PubMed1997

Nonconvulsive status epilepticus with generalized 'fast activity'.

We report the case of a 55-year-old patient with infrequent generalized tonic-clonic seizures since the age of 40 years and additional frequent episodes of disturbed behaviour and impaired cognition. The latter last from several hours up to one day with sudden onset and end of electroencephalographic (EEG) changes and clinical manifestations. They occurred about once a week before they were successfully treated with valproate and lamotrigine. From clinical, therapeutic and EEG findings we conclude that the patient suffers from nonconvulsive status epileptici, although the ictal EEG showed an untypical pattern of monomorphic generalized alpha rhythm. Many EEG characteristics point towards a primary generalized seizure disorder but a focal origin with secondary bilateral synchrony has to be considered as well. However, this is obviously a rare type which has not been described previously.

Alpha Rhythm↗
PubMed1997

Comparison of toremifene and tamoxifen in post-menopausal patients with advanced breast cancer: a randomized double-blind, the 'nordic' phase III study.

The study was planned to compare, in a prospective double-blind randomized trial, the efficacy and safety of toremifene (TOR) and tamoxifen (TAM) in post-menopausal patients with advanced breast cancer who have not had prior systemic therapy for advanced disease. Four hundred and fifteen post-menopausal patients with oestrogen receptor (ER)-positive or ER-unknown advanced breast cancer were randomly assigned to receive daily either 60 mg TOR or 40 mg TAM. The patients were stratified to measurable and non-measurable but evaluable groups. They were assessed for response to therapy, time to progression (TTP), time to treatment failure (TTF), response duration, overall survival and drug toxicity. Two hundred and fourteen patients were randomized into TOR and 201 into TAM treatment. The response rate (complete + partial) was 31.3% for TOR and 37.3% for TAM (P = 0.215). The 95% confidence interval (CI) for the 6% difference was -15.1% to 3.1%. The median TTP was 7.3 months for TOR and 10.2 months for TAM (P = 0.047). The 95% CI for the hazard ratio of 0.80 was 0.64-1.00. A percentage of the TOR patients (9.8%) and the TAM patients (18.9%) discontinued the treatment prematurely (P = 0.011) for various reasons. Consequently, the median TTF of 6.3 vs 8.5 months did not differ significantly (P = 0.271). The hazard ratio was 0.89 and the subsequent 95% CI 0.73-1.09. The median overall survival was 33.0 months for TOR and 38.7 months for TAM (P = 0.645). The hazard ratio was 0.94 with 95% CI of 0.73-1.22. The transient difference in TTP may be related to an imbalance in ER content of the tumours. When only patients with ER-positive tumours were considered (n = 238), no difference between two treatments was seen (P = 0.578). TAM was associated with an overall slightly higher frequency of adverse drug reactions than TOR (44.3 vs 39.3%) and a higher discontinuation rate due to these events (3.5% vs 0.9%). Treatment-emerged moderate dizziness (P = 0.026) and cataracts (P = 0.026) were more frequent among TAM than among TOR patients. In conclusion, TOR (60 mg day(-1)) and TAM (40 mg day(-1)) are equally effective and safe in the treatment of advanced post-menopausal ER-positive or ER-unknown breast cancer.

Adult↗
PubMed1997

Prostaglandin E2 induces interleukin-6 synthesis in human astrocytoma cells.

Prostaglandins (PGs) and cytokines, such as interleukin-1 (IL-1) and interleukin-6 (IL-6), have been implicated in the etiopathology of various inflammatory and degenerative disorders, including Alzheimer's disease (AD) and prion diseases. Nonsteroidal antiinflammatory drugs (NSAIDs), potent inhibitors of PG synthesis, appear to be beneficial in the treatment of AD. To assess whether PGs are able to induce IL-6 synthesis in cells of the CNS, IL-6 mRNA and protein syntheses were measured in a human astrocytoma cell line after stimulation with different PGs. PGE1 and PGE2, but not PGD2 and PGF2 alpha, led to a rapid and transient induction of IL-6 mRNA, followed by IL-6 protein synthesis. Furthermore, PGE2 potentiated IL-1 beta-induced IL-6 mRNA synthesis. These results are discussed with respect to the participation of PGs in neurodegenerative diseases (and its inhibition by NSAIDs) by affecting cytokine expression.

Alprostadil↗
PubMed1997

[Epilepsy in the very old].

Epilepsy ist the third most common neurological disease of the elderly. In the elderly the incidence is higher than in childhood and adolescence. Cerebrovascular diseases are in 50% of the cases the most common cause for a seizure beyond the age of sixty. The importance of neoplasias is often overestimated. The risk for a renewed seizure after a first seizure is higher in the senium than in youth. Furthermore, the incidence of seizure-related injuries is increased in the elderly and therefore, anticonvulsive therapy must be started early with guaranteed compliance. With regard to therapy, the altered pharmacokinetics in senium must be considered. The drug of first choice is carbamazepine. If a monotherapy with carbamazepine, phenytoin or valproate does not control the seizures a combination with one of the new antiepileptic drugs must be initiated. Due to their pharmacokinetic characteristics, the new drugs-such as vigabatrin, gabapentin and lamotrigine-are specially suitable in the therapy of elderly patients. In case of undesirable side effects, monotherapy with one of the new anti-convulsants ought to be considered.

Aged↗
PubMed1997

Characteristics of multicellular spheroids formed by primary cultures of human thyroid tumor cells.

Features of multicellular tumor spheroids (MCTS) differed depending on their types of cells. MCTS formed by 4000 human thyroid primary culture epithelial tumor cells displayed diameters between 0.31 and 0.33 mm within 2 days regardless of the stage of malignancy of the originating tumors. Their cellular composition reflected that of the originating tumor in regard to DNA content and the expression of cytokeratin, vimentin, as well as thyroglobulin. During the following 3 weeks, their sizes increased up to diameters of 0.42 mm when their cells had been derived from carcinomas, and MCTS originating from adenomas stopped growing within the next 2 days. After 8 days of incubation, proliferating cells were only found in carcinoma MCTS. The cells were randomly distributed over the total volume of the spheroids, which displayed irregular cell arrangements but not concentric cell layers and did not form necrotic centers.

Antigens, Neoplasm↗
PubMed1997

Extracorporeal circulation increases nitric oxide-induced methemoglobinemia in vivo and in vitro.

OBJECTIVES: Methemoglobinemia is a well-known side effect of nitric oxide inhalation. We tested the hypothesis whether cardiopulmonary bypass increases methemoglobin formation by nitric oxide. DESIGN: A two-phase study: a) a controlled, prospective in vivo study of inhaled nitric oxide treatment followed by b) a second, prospective and controlled in vitro study. SETTING: Pediatric intensive care unit and research laboratory in a university hospital. PATIENTS: The in vivo study consisted of 25 patients following open-heart surgery and 19 children with acute respiratory distress syndrome (ARDS) or persistent pulmonary hypertension of the newborn. The in vitro study consisted of 20 patients with and 20 patients without cardiopulmonary bypass. INTERVENTIONS: For the in vivo study, methemoglobin measurements were taken before and after application of 20 parts per million (ppm) of nitric oxide. For the in vitro study, red blood cells of patients were incubated with 32 ppm nitric oxide before and after surgery. Methemoglobin, glutathione, adenosine triphosphate (ATP), and nicotinamide adenine dinucleotide/nicotinamide adenine dinucleotide phosphate (NADH/NADHP) concentrations were compared. MEASUREMENTS AND MAIN RESULTS: For the in vivo study, nitric oxide inhalation increased methemoglobin from 0.2 +/- 0.1% to 1.2 +/- 0.7% in patients receiving nitric oxide after open-heart surgery and from 0.2 +/- 0.1% to 0.5 +/- 0.4% in ARDS/persistent pulmonary hypertension of the newborn patients (p < .01). For the in vitro study, nitric oxide incubation of red blood cells increased methemoglobin concentration from 3.7 +/- 1.9% preoperatively to 7.4 +/- 2.4% after open-heart surgery. This increase was not observed in patients who did not undergo cardiopulmonary bypass (3.6 +/- 1.6% vs. 3.6 +/- 1.9%; p < .001). In erythrocytes of patients undergoing extracorporeal circulation, there was no difference between pre- and postoperative glutathione, ATP, and NADH/NADPH concentrations. CONCLUSIONS: Cardiopulmonary bypass is an important risk factor for methemoglobinemia when inhaled nitric oxide is applied. This risk is not secondary to diminished concentrations of energetic substrates.

Administration, Inhalation↗
PubMed1997

Development of spatial contrast sensitivity from infancy to adulthood: psychophysical data.

PURPOSE: This study examined changes in contrast sensitivity, the location of the peak of the contrast sensitivity function (CSF), and the shape of the function from infancy to adulthood. METHODS: Contrast thresholds were obtained using behavioral methods, preferential looking for infants, and operant techniques for older children and adults, with the same stimuli for all ages. RESULTS: Contrast sensitivity at the peak improved almost two log units from infancy to adulthood. Much of the shift in the peak to higher spatial frequencies occurred in infancy. Sensitivity was not yet at adult levels at 8 years of age. CONCLUSIONS: The reduction in contrast sensitivity at the lowest frequency between 2 and 4 months of age suggests an increase in lateral inhibition during early infancy. Contrast sensitivity at the peak increased by two log units from then until adulthood.

Adolescent↗
PubMed1997

The oblique effect in Chinese infants and adults.

PURPOSE: Lessened acuity for oblique contours as compared with horizontal and vertical contours, the oblique effect, is characteristic of humans and animals. The magnitude of the oblique effect in humans varies with ethnic origin. Three experiments were performed to determine the source and extent of this variation in Chinese and Caucasian subjects. METHODS AND RESULTS: Experiment I. Acuity for vertical and oblique gratings was measured in Chinese infants with a preferential looking technique. The development of visual acuity for Chinese infants was found to be strikingly similar to that reported for Caucasian infants. For infants of both races at about 1 year of age, the magnitude of the oblique effect was about 1 octave. Experiment II. Acuity for main-axis (horizontal and vertical) and oblique gratings was measured in Chinese and Caucasian adults. The oblique effect in Chinese subjects was significantly smaller than in Caucasian subjects. The Chinese also had significantly better acuity for oblique gratings, but not for main-axis gratings. Experiment III. To determine whether differential sensitivity to main-axis and oblique-axis gratings extends to suprathreshold spatial frequencies, contrast sensitivity for four orientations at each of five spatial frequencies was assessed in Chinese and Caucasian adults. There were no significant differences in contrast sensitivity between Chinese and Caucasian subjects at any spatial frequency. The differential sensitivity increased with increasing spatial frequency for both ethnic groups. CONCLUSION: The difference in the magnitudes of the oblique effect in Chinese and Caucasian subjects appears in acuity thresholds in adults, and may result solely from the Chinese having better acuity for obliquely oriented gratings.

Adolescent↗
PubMed1997

False-positive results from cultures of Mycobacterium tuberculosis due to laboratory cross-contamination confirmed by restriction fragment length polymorphism.

During 1994, a cross-contamination problem leading to false-positive cultures of Mycobacterium tuberculosis was revealed in a mycobacteriology laboratory processing 30,000 to 35,000 samples per year. Molecular strain typing based on restriction fragment length polymorphism confirmed the contaminations. Out of 1,439 positive cultures of Mycobacterium tuberculosis, 49 samples from 48 patients were suspected to be cross-contaminated. In 37 cases, growth was observed both in BACTEC vials and on solid media, indicating that the contamination took place during the processing of the samples. The majority of the contaminated samples had been handled by the same technician.

Bacterial Typing Techniques↗
PubMed1997

Treatment of ocular melanoma metastatic to the liver by hepatic arterial chemotherapy.

PURPOSE: Ocular melanoma is characterized by a high rate of liver metastases and is associated with a median survival time less than 5 months. There is no standard treatment available. Treatment strategies have, without success, relied on the experience with metastatic cutaneous melanoma. The only effective treatment is chemoembolization using cisplatin and polyvinyl sponge, which has never become accepted on a large scale. The objective of the study was to establish prospectively the efficacy and toxicity of hepatic intraarterial fotemustine, a third-generation nitrosourea, in patients with liver metastases from ocular melanoma. PATIENTS AND METHODS: Thirty-one patients were subjected to laparotomy to place a totally implantable catheter into the hepatic artery and received fotemustine 100 mg/m2 as a 4-hour infusion, first once a week for four times and then, after a 5-week rest period, every 3 weeks until progression or toxicity. Cox regression models were used to assess the prognostic role of patient survival characteristics. RESULTS: Objective responses were observed in 12 of 30 assessable patients (40%; 95% confidence interval, 22% to 59%). The median duration of response was 11 months and the median overall survival time, 14 months. Lactate dehydrogenase (LDH) appeared to be the strongest prognostic factor for survival. Toxicity was minimal and treatment could be administered on an outpatient basis. CONCLUSION: The results of hepatic arterial chemotherapy with fotemustine produced a high response rate and survival similar to chemoembolization therapy. It involves no major toxicity and preserves the quality of life. To assess further its effectiveness, a randomized study to compare hepatic intraarterial versus intravenous chemotherapy is being planned.

Adult↗