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Biomedical subjects

J Wagner

Publications and source records attributed to J Wagner.

At least 235 records · Page 13Linked to original sources
PubMed1993

Anticoagulant activity of Hirulog, a direct thrombin inhibitor, in humans.

Hirulog (BG8967) is a direct thrombin inhibitor built by rational design using the protein hirudin as a model (Maraganore et al. [1990]; Biochemistry 29: 7095-101). In order to evaluate the therapeutic potential for hirulog in the management of thrombotic disease, the tolerability and anticoagulant activity of the agent were examined in a study of human volunteers. In a randomized, placebo-controlled study (n = .54), the intravenous infusion of hirulog over 15 min showed a rapid, dose-dependent prolongation of activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT). There was a corresponding dose-dependent increase in plasma hirulog levels. The peptide was rapidly cleared with a half-life of 36 min and a total body clearance rate for the peptide of 0.43 l kg-1 h-1. Similar activity was observed following subcutaneous injection but with sustained pharmacodynamic and pharmacokinetic behavior. There was a significant correlation between pharmacokinetic and pharmacodynamic variables for both intravenous (r = 0.8, p < 0.001) and subcutaneous administration (r = 0.7, p = 0.002). To evaluate the possible interactions of aspirin on the tolerability and anticoagulant activity of intravenous hirulog, a cross-over design was employed in eight subjects. Aspirin administration did not modify the peptide's activity. At the administered dose of 0.6 mg kg-1 h-1 for 2 h, hirulog infusion prolonged APTT from 230 to 260% baseline. The infusion of hirulog in subjects who had received aspirin was not associated with any significant changes in the template bleeding time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

An abnormal pattern of blood vessels in the retroperitoneal space with a duplicated inferior vena cava in an adult: a case report.

During dissection a duplicated inferior vena cava (IVC) was found in an 82 year-old male. The IVCs were connected with each other by two anastomoses. The course of the other retroperitoneal veins also exhibited some alterations: Just below the diaphragm the azygos and the right ascending lumbar v. ran into the right IVC separately; the hemiazygos and the left ascending lumbar vv. joined before entering the left IVC. The testicular vv. ended normally on the right side in the right IVC, on the left side in the left renal vein. The embryologic basis of the pattern of these vessels is discussed and a short overview of the literature given. In the present case there were also some alterations in the course of the renal and testicular aa.

Aged↗
PubMed1993

Three-axes gyro system quantifying the specific balance of rowing.

Stabilizing the balance of the boat is a main task of the rowing motion. This leads to movements which are asymmetrical relative to the boat's plane of symmetry. The three-dimensional motion of the boat should be measured when investigating the elements of keeping the balance. This spatial motion must be described by the three components of the translational velocity and the three components of the angular velocity. The latter values can be measured using gyros. A system was developed which employs these sensors. The system is small and light enough to be used aboard a single scull. Measurements which were obtained using this system conclude the article. They illustrate some factors of importance for the stability of the boat and demonstrate the suitability of the system presented.

Biomechanical Phenomena↗
PubMed1993

[Bacterial pathogen colonization of the uterus in puerperium].

In a prospective study the spectrum of bacteriological organisms in the uterus was analysed within the first 3 days post partum. Smears were taken from the ectocervix and from the cavum uteri from 80 asymptomatic puerperae (70 had delivered spontaneously and 10 had had a vaginal-operative delivery). The smears were achieved using an endometrium catheter with a pilot cap. After the specialised sampling had been undertaken, in 47 of the 70 patients with spontaneous delivery and in 1 of the patients with operative delivery, no bacterial invasion was found in the cavum uteri. After prophylactic administration of antibiotics prenatally, bacterial organisms were found significantly less often (p < 0.05). On the other hand, intrauterine bacterial organisms were found significantly more frequently in patients who had had cervix priming with PGE2 and where foetal blood analysis had been performed sub partum (p < 0.05). Contrary to the smears from the cavum uteri, all ectocervical smears were positive. In 13 of 23 cases with positive proof of intrauterine bacterial organisms, a difference was found in the bacteriological spectrum compared with the parallel cervical smear taken. Further obstetrical factors play a role in influencing the bacterial invasion, however, there were no complications in any of the cases due to the smears being taken and no infections were observed during the rest of the lying-in period.

Adult↗
PubMed1993

Laparoscopic management of ectopic pregnancy in a resident training program.

The range of procedures now routinely done through the laparoscope has continued to expand due to improved equipment for insufflation, hemostasis, and tissue manipulation, and to imaginative approaches to otherwise "routine" gynecologic problems traditionally treated by laparotomy. As with all new technologies, advocates predict that the methodology will prove to have an almost unlimited potential, while established skeptics predict that it will have a narrow applicability. With time and further clinical application, a consensus somewhere between the two positions will be reached. But while this technology develops and experience begins to accumulate, it is necessary to train residents in the technique. We discuss our experience with introducing laparoscopic management of ectopic pregnancy into a residency training program. Our results indicate a rapid learning curve, with minimal patient morbidity, brief hospitalization, and rapid convalescence.

Adult↗
PubMed1993

Gene expression of the renin-angiotensin system in human tissues. Quantitative analysis by the polymerase chain reaction.

Activation of tissue-specific gene expression of the components of the renin-angiotensin system (RAS) in humans may play an important role in cardiovascular regulation and pathophysiology. Studies of human tissue RAS expression, however, have been limited by the lack of availability of sufficient amounts of fresh human tissues and a sensitive method for detecting specific mRNAs. To demonstrate the presence of components of local RASs in humans we used the polymerase chain reaction (PCR) after reverse transcription to detect renin- angiotensinogen-, and angiotensin-converting enzyme-mRNA in small quantities of human tissues. Results indicated that all components of the RAS were widely expressed in human organ samples. In order to study changes of gene expression in small tissue samples (e.g., renal biopsies) obtained from patients, we established a competitive PCR assay for quantification of renin, using a 155-basepair deletion mutant of the human renin cDNA as an internal standard. Renin-mRNA concentration was quantitated in the kidney (1.74 +/- 0.2 pg renin/micrograms total RNA), adrenal gland (1.15 +/- 0.15 pg renin/micrograms total RNA), placenta (0.7 +/- 0.1 pg renin/micrograms total RNA), and saphenous vein (0.02 +/- 0.01 pg renin/micrograms total RNA). The method described here may serve as a highly sensitive tool to quantify alterations in gene expression in man under various pathophysiologic conditions. This study should provide the methodological basis for future studies of tissue RAS in human physiology and disease.

Adrenal Glands↗
PubMed1993

Cord blood banking for hematopoietic stem cell transplantation: an international cord blood transplant registry.

Human umbilical cord blood contains enough hematopoietic stem cells for transplantation instead of marrow cells to cure children and adults with leukemia and other potentially fatal marrow disorders. An international cord blood transplantation registry is currently collecting information about the results of these transplants. As a result of relative immune deficiency at birth, it is likely that partially matched unrelated transplants can be successful; for this purpose an international cord blood banking project is described.

Adult↗
PubMed1992

The clinical significance of resolving polyhydramnios.

Polyhydramnios is associated with multiple maternal and fetal abnormalities. Although the risks of persistent polyhydramnios are well described, the clinical implications of polyhydramnios that resolves prior to delivery are not. Thirty-four non-diabetic patients with resolving polyhydramnios were studied. An amniotic acid index of >or= 20 was used to define polyhydramnios. Antepartum and postpartum outcomes were compared with those patients with persistent polyhydramnios, and a control group of 102 singleton term deliveries. Patients with resolving polyhydramnios did not have a significant increase in congenital anomalies. An 8% incidence of congenital anomalies was noted in patients with persistent polyhydramnios; this was significant compared with controls (p < 0.05). Idiopathic resolving polyhydramnios was associated with a higher mean birth weight (p < 0.05) than controls, with significantly more babies weighing more than 4200 g. An increase in placental thrombus formation was noted in patients with idiopathic resolving and persistent polyhydramnios compared to the control group (p < 0.01). The etiology of this is unclear. Obstetricians should be aware of the risk of macrosomia and the possibility of placental disease in these fetuses.

Journal Article↗