Search PubMed⌕ Search

Biomedical subjects

J Fischer

Publications and source records attributed to J Fischer.

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

[Traumatic injury of the internal carotid artery in the extracranial segment. Description of a severe late complication].

Blunt traumatic injury to the extracranial internal carotid artery may lead to a dissection with resultant stenosis, occlusion, or a dissecting aneurysm. Delayed clinical presentation weeks, months, and even years after the injury is rare, but has important diagnostic, therapeutic and forensic implications. In the current era, where computed tomography is replacing angiography as the main diagnostic procedure, it is extremely important to keep this diagnosis in mind. We report the case of a 31-years-old male patient, who did well after a motorcycle accident with head and neck injury for six years. Since then he only showed left-side Horner's syndrome, which unfortunately was ignored. In 1993 the patient developed occlusion of central retinal artery, and after a therapy with streptokinase he presented with right-side palsy and complete aphasia. CT-scan revealed a large edematous infarction in the middle cerebral artery territory. Transfemoral digital subtraction angiography however demonstrated a dissecting aneurysm of the left extracranial internal carotid artery as the source of intracranial embolization. Severe sequelae of this kind can only be warded of by early diagnosis and proper surgical therapy of vascular injury. Therefore even minimal symptoms suggesting the possibility of a traumatic injury to the carotid artery are recommending timely angiographic investigation.

Adult↗
PubMed1995

[Paradoxical respiratory response, changes in heart rate and skin circulation in progressive isocapnic hypoxia in sleep apnea patients].

In 73 patients with sleep apnea syndrome, lung function tests, night-time polysomnography for determining the apnea index (AI), hyperoxic progressive hypercapnia tests under rebreathing conditions, and, after a short pause, isocapnic progressive hypoxia tests were carried out. The objective of these examinations was to study peripheral and central chemosensitivity, changes in heart rate and capillary cutaneous circulation under isocapnic hypoxia in patients with sleep apnea syndrome (SAS). The following linear relationships were presupposed for the evaluation: for peripheral chemosensitivity between SaO2 decrease and the increase in respiratory minute volume (VE) and for central chemosensitivity between PETCO2 rise and VE increase. Of the SAS patients with an AI > or = 10, 22.5% did not react to the hypoxia test with and increase in VE but rather with a decrease in the respiratory minute volume. This patient group exhibited a positive correlation between an increase in capillary cutaneous circulation and an increase in heart rate during the hypoxia test. The hypoxic respiratory response behavior is independent of the hypercapnic respiratory response, age, Broca index, initial heart rate, blood pressure, pulmonary function values, and the size of the apnea index. The results are discussed in the context of a reduced peripheral chemosensitivity and an associated reduced sympathetic activation.

Arousal↗
PubMed1995

[Glucose tolerance, insulin resistance and arterial hypertension in patients with obstructive sleep apnea syndrome].

Each of 51 patients (42 male, 9 female) examined by polysomnography for suspected obstructive sleep apnea syndrome (OSAS) was subjected to a glucose load test with 75 g glucose and determination of blood sugar and blood insulin levels (at 0, 30, 60, 120 and 180 min). The patients were divided into 4 groups; with and without excess weight (Broca index < or = > 110%), and with and without pathological apnea index (< or = > 10). There was no significant difference between the groups with respect to age. The corresponding groups did not show any significant differences with regard to Broca index or apnea index. However, the patient group with a Broca index > or = 110% and a pathological apnea index > or = 10 was significantly different to all other groups with regard to glucose and insulin level after 60 min. This group was also significantly different to all other groups with regard to systolic and diastolic blood pressure. The reduced glucose tolerance and increased insulin resistance in combination with arterial hypertension in this patient group is indicative that a combination of adiposity and OSAS represents a particularly high risk factor for the development of arterial hypertension even though the pathological mechanism responsible for the development of arterial hypertension is also present in members of both the normal weight OSAS group and the overweight group without OSAS who exhibit a metabolic predisposition for the development of hypertension. A synergetic interaction of both pathomechanisms favors the development of arterial hypertension. Overweight patients with OSAS thus constitute a high-risk group for the development of cardiovascular diseases.

Adult↗
PubMed1995

[Prevalence of sleep apnea syndrome with primary arterial hypertension in a cardiologic rehabilitation clinic].

In a group of 132 randomly selected male patients with the admission diagnosis arterial hypertension in a cardiological rehabilitation clinic, nightly monitoring was performed with Mesam 4 with records of the metabolism laboratory values and sleep disturbances longitudinally. Desaturation indexes of > or = 10/h after manual correction for plausibility revealed a total prevalence of 27.3% in the case of breathing disturbances. The prevalence increased to 52% in the over 55 year-old patients with a Broca index of > or = 120% in comparison to merely 15.4% in standard weighted, comparable age group. No differences were found in the laboratory values. These results again show the frequent occurrence of the combination adiposity, hypertension, and sleep apnea syndrome which has often been missed previously in specialist rehabilitation clinics.

Adult↗
PubMed1995

[Comparison of CPAP and BiPAP equipment with reference to work of breathing, pressure and flow constancy].

We have investigated mask pressure curves and nasal flow during nasal C- and BiPAP ventilation in the recumbent position. Nasal spontaneous breathing, C- and BiPAP-applications of 10 and 10/7 cmH2O have been investigated in 7 patients and 4 controls. With aid of an automatic computerised analysis each in- and expiratory phase has been normalized by time and plotted as pressure-volume-loop from pooled data. The ventilators showed significant intra- and inter-machine differences. The investigations are considered as approach to real assessment of patient's work of breathing on home ventilators. They clearly show that ventilators have individual patterns, which should be considered carefully, long term machine-according effects are not yet known.

Adult↗
PubMed1995

[Factors affecting bone regeneration in Ilizarov callus distraction].

We evaluated the X-rays of 36 patients who underwent 50 callus distractions. With the aid of a computerized digitalisation system for analogue films, the relative X-ray density of the distraction area was calculated for each X-ray. These relative X-ray densities were figured graphically for the duration of treatment for each patient. In the consolidation phase, the graph of each patient had a logarithmic relationship. The gradients of the logarithmic density curves were considered an indicator of the quantity of new bone formation. These gradients were correlated to the following clinical parameters: age of the patient, beginning of distraction after corticotomy, average speed of distraction, average weight bearing during the distraction and consolidation phase, location of corticotomy (distal femur versus proximal tibia) and diclofenac medication. Except for the location of the corticotomy and diclofenac, all parameters had an influence on osteoneogenesis by callus distraction. The parameters affecting new bone formation the most were the age of the patient and weight bearing. Patients aged under 18 years (p = 0.005), beginning of distraction later than 8 days (p = 0.109), an average distraction speed below 1 mm/day (p = 0.079), and average weight bearing of more than 30 kg (p = 0.068 for the distraction phase and p = 0.089 for the consolidation phase) showed a quantitatively higher rate of new bone formation by callus distraction than the patients in the other groups. Patients with a shorter leg due to poliomyelitis and one patient with an amniotic leg tie showed a slower increase in X-ray density graphs than the other patients.

Absorptiometry, Photon↗
PubMed1995

A plant lectin derived from Viscum album induces cytokine gene expression and protein production in cultures of human peripheral blood mononuclear cells.

A plant lectin from Viscum album (ML-I) has been shown to increase the number and cytotoxic activity of natural killer cells and to induce antitumor activity in animal models. However, the mechanisms underlying the effects of ML-I on natural host defenses are unknown. After 24 h incubation of peripheral blood mononuclear cells in the presence of 10 and 1 ng/ml of ML-I, mRNA expression and secretion of a panel of cytokines were evaluated by reverse polymerase chain reaction and by ELISA, respectively. The lectin induced expression of interleukin (IL)-1 alpha, IL-1 beta, IL-6, tumor necrosis factor-alpha, interferon-gamma, granulocyte-monocyte colony-stimulating factor and IL-10 genes but no expression of IL-2 and IL-5 genes could be detected. Regarding cytokine secretion, IL-6 and TNF-alpha production was induced by 10 ng/ml ML-I. On the other hand, IL-10 secretion was only stimulated by 1 ng/ml lectin. No production of IFN-gamma or, as expectable, IL-2 could be detected. In addition, ML-I increased the percentage of HLA-DR+ T lymphocytes in vitro. In tests performed on whole blood, monocytes and granulocytes bound the fluorescence-conjugated ML-I molecules to a higher degree than lymphocytes. Expression of IL-1 beta and IFN-gamma genes could also be observed upon ML-I stimulation of nonadherent cells. These results suggest that lectin-sugar interactions on the cell surface of immunocompetent cells can induce cytokine gene expression and protein synthesis.

Cells, Cultured↗
PubMed1994

Types of trauma in cases of homicide.

A group of 251 victims of homicide in the years 1978-1988 were examined to determine the causes of their injuries. It was found that 51.4% of homicide victims exhibited evidence of injuries due to blunt trauma, 31.9% were victims of sharp trauma and 29.5% suffered from strangulation. Less common were shootings (18.7%) and other traumata (4.0%). Males were most commonly victims of injuries caused by blunt (51.9%) and sharp (33.6%) trauma, possibly due to more frequent physical confrontations among men. Females also demonstrated injuries due to blunt trauma (50.8%), but strangulation was nearly equal (47.5%). Women were commonly murdered by the aggressor's bare hands within the setting of conflicts in relationships. In 36.7% of all cases, injuries were caused by a combination of aggressive traumas. Combined injuries were common in cases of strangulation (77.3%), blunt trauma (64.3%) and sharp trauma (46.9%), whereas shooting injuries were seldom combined (12.8%) because they were usually fatal alone. Female victims demonstrated combined fatal injuries more frequently than males, probably because conflicts in relationships can cause extreme emotional outbursts and thus lead to the use of multiple aggressive traumatisations.

Adolescent↗
PubMed1994

PCR cloning and expression analysis of cDNAs encoding cysteine proteinases from germinating seeds of Vicia sativa L.

cDNA clones encoding cysteine proteinases from cotyledons of germinated seeds of Vicia sativa L. have been obtained by means of PCR. Degenerate oligonucleotide primers were designed according to conserved amino acid regions of known cysteine proteinases. The deduced amino acid sequences of the cDNA clones encoding VSCYSPR1 and VSCYSPR2 display strong homology to cysteine proteinases of the so called papain superfamily. Northern analyses revealed developmentally regulated expression of both the mRNAs in germinating seeds. The transcripts were shown to be products of two distinct single genes, each exhibiting structural polymorphisms as exposed in few nucleotide substitutions.

Amino Acid Sequence↗
PubMed1994

Composite cerebral metastasis and oligodendroglioma: an exceptional form of mixed neoplasia.

Our report describes the uncommon case of a 61 year old female patient who underwent a left parietooccipital craniotomy and extirpation of a malignant tumor. Histological examination revealed a metastatic carcinoma of mammary origin intimately intermingled with a calcified oligodendroglioma WHO II. The preexisting oligodendroglial part had been detected four years before, but since then had been misinterpreted as a glious scar resulting from a previous brain trauma. Three years before neurosurgical intervention, the patient had undergone a left side mastectomy. The histological finding at that time was a solid breast tumor WHO T1N0. The occurrence of cerebral mixed neoplasias and possible causal factors are discussed.

Brain Neoplasms↗
PubMed1994

[Metrical studies of the pharynx in patients with cheilognathopalatoschisis and their significance for nasal breathing].

This study compares the topography of the pharyngeal structures of 115 patients with isolated and combined cleft palates with the topography of the pharyngeal structures of 115 patients without cleft palates. The study revealed that the sagittal dimensions in the cleft palate patients are significantly reduced. The maximum closeness can be observed at the lower margin of the velum. In order to clarify growth dependent change of the sagittal pharynx dimensions the growth of the pharynx of 61 cleft palate patients was documented at 4 different points in time between age 7 and age 18. Over this period of growth only a slight increase in the sagittal plane of the pharyngeal area was observed. Especially conspicuous was the stagnation of the distance of the lower margin of the velum to the posterior pharyngeal wall. An increase in air passage resistance, which is the cause of incompetent breathing with all its consequences for growth and dentition development, is derived from these topographical relationships. The study concludes that the postoperative functional competence of the velum is a conditio sine qua non not only in relation to speech but also in relation healthy breathing.

Adolescent↗
PubMed1994

Ultrastructural study of delta-opioid receptors in the dorsal horn of the rat spinal cord using monoclonal anti-idiotypic antibodies.

The ultrastructural localization of delta-opioid receptors was studied using monoclonal anti-idiotypic antibody prepared with an anti-D-Ala2-D-Leu5-enkephalin. Immunocytochemical techniques were used on vibratome sections from rats perfused with paraformaldehyde. A high density of immunoreactivity was observed in the dorsal horn of the spinal cord, particularly the two superficial layers, the dorsolateral funiculus and the area surrounding the central canal. The labelling was absent when the antibody was preincubated with the immunogen. Competition between the anti-idiotypic antibody and different ligands, delta or mu, was controlled by preincubation of tissue sections with the ligand in the presence of peptidase inhibitors for 3-4 h before addition of the anti-idiotypic antibody. Enkephalin, dermenkephalin and naltrindole induced disappearance of the labelling at 10(-9) M while dermorphin or dermorphin Lys7 were ineffective at the same concentration. Lamina II of the dorsal horn was studied by electron microscopy. The immunolabelling was mainly localized on cell membranes at appositions between the two neurons. About one third were localized between an axon terminal and a dendrite, the same proportion of labellings were between two axon terminals. Labelling was occasionally observed at appositions between a glomerular terminal and a dendrite or a terminal or at axoglial appositions. Axosomatic localizations were rare. The presynaptic localization of the labelling is in favor of a presynaptic mechanism of action for delta-opioids in the spinal cord, providing that these receptors are functional. delta-Opioid peptides probably act non-synaptically since receptors were never localized on synaptic differentiations.

Animals↗
PubMed1994

[Acceptance of electronic data processing supported documentation of ultrasound findings in routine clinical practice. A survey].

We carried out a survey to determine the acceptance of the ultrasound documentation software, CUBUS, in clinical practice. Since August 1, 1988, CUBUS, versions V1.01 to V2.02 has been employed in clinical routine. By October 1991 10,850 reports had been stored in version 2.02. The software is installed on a personal computer (Siemens PCD-2, 40MB, 640 KB RAM) to which a laserprinter is connected. The work of operating the system is shared between the nursing and medical staff. In order to investigate the acceptance of the printed reports produced with this system, we carried out a poll among the physicians working at the hospital. Among the 86 physicians who receive 95% of the US reports, 58% (n = 50) responded. On the basis of the categories good, satisfactory, adequate and poor, we requested an assessment of layout, presentation, comprehension, completeness and overall impression. The overall impression was assessed as good or satisfactory in 34% and 42%, respectively. In the case of the individual criteria (see above), the categories good and satisfactory scored 62% and 34%, 58% and 32%, 68% and 18% and 72% and 24%, respectively. The terminology used was accepted by 84%. Addition of, for example, image documentation, and endosonography, will expand the advantages of the input of findings and further improve the good overall impression made by the report printout in our survey, so that the relatively long input time requirement accounting for some 30% of the total examination time, is accordingly justified.

Attitude of Health Personnel↗
PubMed1994

The cardiocirculatory reaction to isokinetic exercises in dependence on the form of exercise and age.

Although isokinetic training is gaining in importance in prevention and rehabilitation, even for older patients, there is hardly any information available on the extent of cardiocirculatory stress. This study was aimed, therefore, at examining the cardiocirculatory reaction to various isokinetic forms of exercise in dependence on age. Sixty-four subjects between 22 and 60 years of age were assigned to four age groups and the maximum torque measured in concentric and eccentric exercises with various angle accelerations. Moreover, all subjects underwent 1-min concentric and eccentric endurance stress and an isometric test. The cardiocirculatory reaction as reflected in heart rate and blood pressure patterns was determined, as well as the plasma catecholamines adrenaline and noradrenaline measured. The eccentric maximum torque was significantly above the concentric maximum torque; there was a significant inverse relationship to age only in the concentric mode of exercise (r = -0.48; p < 0.01). The cardiocirculatory reaction in endurance stress and isometry, like the behavior of heart rate, blood pressure, and plasma catecholamines, was greatest in concentric exercise, although the maximum strength values were lower, followed by eccentric exercise and isometry. Exercise values such as those attained in maximum ergometric forms of exercise were not reached. It is concluded that no special precautionary measures are required in isokinetic forms of exercise.

Adult↗