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Biomedical subjects

J Berger

Publications and source records attributed to J Berger.

At least 235 records · Page 13Linked to original sources
PubMed1995

[Extracorporeal membrane oxygenation in newborn infants and children].

The purpose of this report is to describe our experience with veno-arterial (VA) and veno-venous extracorporeal membrane oxygenation (VV-ECMO) for neonates and children with severe acute respiratory or cardiocirculatory failure. From 1990 to 1994 20 neonates and 12 children were treated at the ECMO center in Graz. Indications for ECMO were acute respiratory failure in 27 patients and cardiocirculatory failure in 5 patients. Mean duration of ECMO was 228 +/- 30 hours. Fifteen neonates were weaned from ECMO and were subsequently extubated. Of the 12 children 7 had severe acute respiratory failure and underwent VV-ECMO. Five of these 7 children were weaned from ECMO and subsequently extubated. Only two of 5 patients with cardiac ECMO support could be weaned from bypass; one patient subsequently died, but the other patient is a long-term survivor. All patients with cardiac ECMO support after open heart surgery had severe mediastinal bleeding. The survival rate in neonates and pediatric patients with respiratory failure treated by ECMO was 75% and 71%, respectively, whereas it was only 20% in children with cardiocirculatory failure. Major complications on ECMO were local and intracerebral bleeding. ECMO is an effective therapy for neonates and children with acute respiratory failure. It is less effective for cardiac support in children after open heart surgery, but the use of heparin-layered ECMO systems might increase the safety of the procedure.

Carbon Dioxide↗
PubMed1995

[Evaluation of the impact of iron treatment. Interference of malaria].

In Togo, where malaria occurs all the year, 151 children, from 6 months to 3 years old, were distributed in 2 groups, one of which received an iron supplementation during three months, and the other a placebo during the same time. At the end of the trial, no significant difference was observed between the two groups. However, taking into account malaria infection at the end of the trial, children who received iron supplementation and who were free of malaria infection showed improvement of their haematological status when compared to children receiving placebo and also free of malaria infection. Authors presumed that iron supplementation was masked by malaria when they evaluated effect of iron supplementation on anaemia.

Anemia↗
PubMed1994

X-linked adrenoleukodystrophy (ALD): a novel mutation of the ALD gene in 6 members of a family presenting with 5 different phenotypes.

Fragments of the adrenoleukodystrophy (ALD) cDNA from a patient with adolescent ALD were amplified by polymerase chain reaction and subcloned. Bidirectional sequencing of the entire coding ALD gene disclosed a cytosine to guanine transversion at nucleotide 1451 in exon five, resulting in substitution of proline 484 by arginine. Five of nine siblings of the patient, comprising two cerebral ALD, one adrenomyeloneuropathy, one Addison only as well as the symptomatic mother (all accumulating very long chain fatty acids) carried this mutation, which was not found in the unaffected persons, in five unrelated ALD patients, and in twenty controls. We propose that this missense mutation generated the disease per se as well as the metabolic defect; the different phenotypes, however, must have originated by means of additional pathogenetic factors.

Adolescent↗
PubMed1994

PI 3-kinase activation is required for insulin stimulation of glucose transport into L6 myotubes.

Phosphatidylinositol 3-kinase (PI 3-kinase) is acutely stimulated by insulin but its role in regulating glucose metabolism is still not fully understood. Insulin acutely stimulates glucose transport into L6 myotubes approximately 2-fold, and activates PI 3-kinase activity 2 to 3-fold. Wortmannin, an inhibitor of PI 3-kinase, blocked insulin stimulation of 2-deoxyglucose transport into the myotubes in a time and dose-dependent manner. Inhibition was observed within 5 minutes and was complete by 30 minutes. The IC50 for this inhibition was approximately 10 nM; almost complete inhibition was observed at 100 nM. Similarly, insulin stimulation of PI 3-kinase activity was inhibited by wortmannin in a dose-dependent manner. The insulinmimetic vanadate activated hexose transport into the myotubes to more than 50% of the maximal level attained with insulin. Only approximately 60% of vanadate-activated glucose transport was inhibited by maximal wortmannin concentrations. It is concluded that insulin activation of PI 3-kinase is necessary for stimulation of glucose transport into L6 muscle cells. In contrast, vanadate appears to augment transport by acting upon PI 3-kinase-dependent and independent pathways.

Androstadienes↗
PubMed1994

A randomized study of coronary angioplasty compared with bypass surgery in patients with symptomatic multivessel coronary disease. German Angioplasty Bypass Surgery Investigation (GABI)

BACKGROUND: The standard treatment for patients with symptomatic multivessel coronary artery disease is coronary-artery bypass grafting (CABG). Percutaneous transluminal coronary angioplasty (PTCA) is widely used as an alternative approach to revascularization, but a systematic comparison of the two procedures is needed. We compared the outcomes in patients one year after complete revascularization with CABG or PTCA. METHODS: A total of 8981 patients with multivessel coronary disease were screened at eight clinical sites, and 359 patients were randomly assigned to undergo CABG (177 patients) or PTCA (182 patients). Enrollment required that complete revascularization of at least two major vessels supplying different myocardial regions be deemed clinically necessary and technically feasible. RESULTS: Among the patients in the CABG group, an average of 2.2 +/- 0.6 vessels were grafted, and among those in the PTCA group, 1.9 +/- 0.5 vessels were dilated. After CABG, hospitalization was longer (median, 19, as compared with 5 days for PTCA), and Q-wave myocardial infarction in relation to the procedure was more frequent (8.1 percent, as compared with 2.3 percent after PTCA; P = 0.022), whereas in-hospital mortality did not differ significantly between the two groups (2.5 percent in the CABG group and 1.1 percent in the PTCA group). At discharge 93 percent of the patients in the CABG group were free of angina, as compared with 82 percent of those in the PTCA group (P = 0.005). During the first year of follow-up, further interventions were necessary in 44 percent of the patients in the PTCA group (repeated PTCA in 23 percent, CABG in 18 percent, and both in 3 percent) but in only 6 percent of the patients in the CABG group (repeated CABG in 1 percent and PTCA in 5 percent; P < 0.001). Seventy-four percent of the patients in the CABG group and 71 percent of those in the PTCA group were free of angina one year after treatment. Exercise capacity improved similarly in both groups. However, 22 percent of the CABG group, as compared with only 12 percent of the PTCA group, did not require antianginal medication (P = 0.041). CONCLUSIONS: In selected patients with multivessel coronary disease, PTCA and CABG as initial treatments resulted in equivalent improvement in angina after one year. However, in order to achieve similar clinical outcomes, the patients treated with PTCA were more likely to require further interventions and antianginal drugs, whereas the patients treated with CABG were more likely to sustain an acute myocardial infarction at the time of the procedure.

Aged↗
PubMed1994

Potentiation of insulin stimulation of phosphatidylinositol 3-kinase by thiazolidinedione-derived antidiabetic agents in Chinese hamster ovary cells expressing human insulin receptors and L6 myotubes.

Thiazolidinedione derivatives are insulin-sensitizing agents with proven antidiabetic activities in vivo. To explore the mechanism of action of this class of compounds, the effects of pioglitazone, CP-86,325, and AD-5075 on elements of the insulin signal transduction pathways were studied in Chinese hamster ovary cells overexpressing human insulin receptor (CHO.T) and L6 myotubes. In CHO.T cells, the binding of insulin to its receptor and the insulin-stimulated tyrosine kinase activity of the receptor were not altered by pioglitazone or CP-86,325. In contrast, treatment of CHO.T cells with the compounds resulted in significant increases in insulin-stimulated phosphatidylinositol (PI) 3-kinase activity. This insulin-enhancing effect was also observed in L6 myotubes treated with CP-86,325. The augmentations in kinase activity observed in CHO.T cells correlated with increases in the amount of PI 3-kinase (p85 subunit) in anti-phosphotyrosine immunoprecipitates of cell lysates. No gross changes in the tyrosine phosphorylation state of the insulin receptor substrate-1 were detected in insulin-stimulated CHO.T cells following treatment with the compounds. Furthermore, the compounds did not enhance insulin stimulation of mitogen-activated protein kinase or DNA synthesis in CHO.T cells. Thus, thiazolidinedione-derived antidiabetic agents may act as insulin sensitizers by augmenting insulin stimulation of PI 3-kinase activity in a rather specific manner.

Animals↗
PubMed1994

Increased expression of basic fibroblast growth factor in hyperoxic-injured mouse lung.

Basic fibroblast growth factor (bFGF) is a mitogenic polypeptide for a wide variety of cell types and has been immunolocalized in the rodent and human lung. We investigated the mRNA and protein expression of bFGF in hyperoxic-injured adult mouse lungs using northern blot analysis and immunohistochemistry. Mice (6-8 weeks) were continuously exposed to 80% oxygen up to 4 days. Levels of bFGF mRNA were increased from room air control on days 3 and 4 of hyperoxia. mRNA levels of acidic fibroblast growth factor (aFGF), fibronectin, and transin/stromelysin were also examined in this injury model. Similar to bFGF, the fibronectin and transin/stromelysin mRNA levels were increased after 3 days of hyperoxia. In contrast, the aFGF mRNA levels were gradually reduced on each day of hyperoxia. A rabbit polyclonal anti-bFGF antibody was used to determine the distribution and levels of expression in the hyperoxic-injured lungs. The room air control and day 1 hyperoxic-exposed lungs exhibited staining for bFGF in the basement membranes of the blood vessels, airways, and alveoli. Patchy but intense alveolar staining was prominent on day 4 of hyperoxia. The bFGF immunoreactivity of blood vessels and airways was unaffected by the hyperoxia exposure. These results suggest that bFGF may play a role in the alveolar response to hyperoxic-induced injury by virtue of the altered mRNA levels and protein distribution in this injury model.

Animals↗
PubMed1994

Source localization using event-related desynchronization (ERD) within the alpha band.

Voluntary finger movements result in a maximal ERD in the 10-12 Hz band close to electrodes C3 and C4, overlying the sensorimotor hand areas. This ERD focus is not very pronounced with EEG data recorded against a common reference electrode (monopolar recording). After transformation of the raw data using common average, local average and weighted average reference and the Hjorth method, respectively, the ERD becomes enhanced over electrodes C3 or C4. Movement-related EEG data were studied with 17, 19, 30 and 56 electrode montages using large and small interelectrode distances. The best focused ERD was obtained with a 56 electrode montage with small interelectrode distances and local average reference data.

Alpha Rhythm↗
PubMed1994

Prolonged extracorporeal organ support in a 2-year-old boy after cardiac surgery.

A case report of a 2-year-old boy who developed severe post-operative low cardiac output, sudden cardiac arrest and consecutive multiple organ system failure after open heart surgery is described. Initially the hemodynamic situation was stabilized by extracorporeal membrane oxygenation (ECMO) combined with continuous hemofiltration (CHF) carried out for 7 days. Continuous veno-venous hemofiltration (CVVH) was necessary for further 17 days. One episode of plasmapheresis restored transiently a severe post-operative coagulopathy and enabled the removal of the pulmonary artery catheter and the chest tubes.

Cardiac Output, Low↗
PubMed1994

Cardiopulmonary resuscitation after thoracic surgery: echocardiographic observations.

We report echocardiographic observations during external chest compression in a patient with marked abnormalities in thoracic anatomy following emergency surgery of aortic arch aneurysm. Transesophageal echocardiography demonstrated direct right ventricular, aortic and left atrial compression, only minimal left ventricular compression and an open mitral valve during closed chest heart massage. Colour flow doppler demonstrated forward blood flow across the mitral valve and along the left ventricular outflow tract during the compression phase. Echocardiographic findings indicate that factors apart from simple cardiac pump mechanism contributed to blood flow during cardiopulmonary resuscitation (CPR) in this postoperative patient after a major thoracic surgical intervention.

Aortic Aneurysm, Thoracic↗
PubMed1994

The correlation of epidemiological variables.

Data from a sizable hospital-based, case-control study from 1985 to 1990 permitted us to examine the correlation of variables by degree of interrelationship. The variables examined relative to their confounding interrelationships include smoking; consumption of alcohol, coffee, meat, vegetables, and fruits; body mass index; education, and age. The variables with the broadest impact on others are age and education. While the association among these variables is generally known, the degree of association made possible by our large database is generally not fully appreciated and is of obvious significance when data are adjusted for one other variable. In some instances, the intercorrelation among different variables is relatively complicated. For instance, cigarette smoking correlates positively with meat consumption and negatively with intake of fruits and vegetables, which, in turn, correlates with alcohol intake. These interrelationships need to be clearly understood before interpreting epidemiologic data for causation. In general, the correlations are similar for men and women. This study of correlation of variables, some expected and some unexpected, should be of value as a source to epidemiologists and provide a useful base.

Adult↗
PubMed1994

A comparative study of conventional ligation and self-ligation bracket systems.

The increased use of self-ligating bracket systems frequently raises the question of how they compare with conventional ligation systems. An in vitro and clinical investigation was undertaken to evaluate and compare these distinctly different groups, by using five different brackets. The Activa ("A" Company, Johnson & Johnson, San Diego, Calif.), Edgelok (Ormco, Glendora, Calif.), and SPEED (Strite Industries Ltd., Cambridge, Ontario) self-ligating bracket systems displayed a significantly lower level of frictional resistance, dramatically less chairtime for arch wire removal and insertion, and promoted improved infection control, when compared with polyurethane elastomeric and stainless steel tie wire ligation for ceramic and metal twin brackets.

Ceramics↗
PubMed1994

Vitiligo and other diseases: coexistence or true association? Hamburg study on 321 patients.

In the past, several authors described an association of vitiligo with autoimmune disorders and the presence of different tissue autoantibodies. A review of the literature showed large differences in the results. Therefore, 321 patients with vitiligo (male/female ratio 114/207) were examined to see whether the frequencies of associated diseases and phenomena (i.e. Koebner phenomenon, canities praecox, halo nevi, poliosis circumscripta), the number of pigmented lesions and the presence of autoantibodies are of significance in order to support (a) a subentity of childhood vitiligo and (b) whether there is a true predisposition or association of autoimmune or other diseases in this group of patients. The data confirm earlier results of a prevalence of thyroid disease and the presence of thyroid antibodies, whereas other diseases are a random event. 6.2% of the patients had congenital nevi compared with 2.8% in a normal healthy population. Based on the results of this study and the significant higher risk for development of melanomas in this patient group, an annual checkup is recommended.

Adolescent↗
PubMed1994

The psychotherapeutic treatment of male homosexuality.

This paper discusses aspects of the aetiology and treatment of male homosexuality, a topic that has become quite controversial in recent years. The paper is based on material from the author's patients, and also notes the contributions of others. In spite of many reports of successful treatment outcomes, some people continue to deny such results. This paper confirms that such patients can indeed be understood and treated successfully. A possible aetiological factor that has not been mentioned before in the literature is discussed, namely, the abortion of a pregnancy caused by the male patient that may have led to his "coming out" or declaring his homosexuality. Three main conclusions are reached. First, that some people who have had homosexual fantasies, behaviors, or identified themselves as homosexual, can become comfortably and fulfillingly heterosexual with psychotherapeutic treatment. Second, that human sexuality is not rigidly compartmentalized into either hetero- or homosexuality but varies on a continuous spectrum, and is affected in any individual by psychodynamic influences. Third, that before "coming out," young people, especially teenagers, should have the opportunity to explore their sexual identity with a psychodynamically oriented psychotherapist.

Adult↗