Biomedical subjects
Publications and source records attributed to J Wagner.
Renal oncocytoma is an unusual benign tumor, occasionally suspected on preoperative clinicoradiological features. Its diagnosis is histopathological. We report such a case, in which gross appearance showed renal cell carcinoma signs, but oncocytoma was suspected prior to surgery, confirmed by histopathology including electron microscopy.
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Since 30 years, total hip and knee arthroplasties have improved the quality of life of those affected by osteoarthritis. Even so, mechanical complications increase with time: implant wear, bone resorption and especially loosening. Biomechanical research has led to major improvements through the study of the mechanical behaviour of both the implant and weightbearing bone. More performing total joint implants will, however, only be developed through an increased understanding of the mechanical characteristics of both normal and osteoarthritis tissue, as well as of the forces undergone by this implant, and especially of the biological response to different kinds of stresses.
Abdominal pregnancy is a serious obstetrical dilemma for mother and baby. Exceptional in the western world, it's often unsuspected or lately diagnosed. We report an autochtonous case, discovered at operation, with an alive, normal and full-term baby, and dramatic hemorrhagic consequences, threatening the mother's life.
In this paper an in vitro investigation of the biomechanical behavior of the tibiofibular frame in nonunion using electrical extensometry is presented. The intact and untreated nonunited frames are studied as well as three surgical treatments classically used in nonunion: the plating technique, the onlay graft technique and the external fixation according to Ilizarov. The monopodal position with extended knee is considered, and particular attention is paid to the different muscle insertions. The results for the plating and onlay grafting techniques resemble those for the intact frame, whereas the Ilizarov external fixator increases the overall rigidity of the frame. In the untreated nonunited tibiofibular frame, an inversion of the tension and compression areas at the level of the tibia was found. We hypothesize that this phenomenon could be one of the mechanical factors leading to nonunion. Indeed, cyclic stresses in the fracture callus might prevent bony fusion, for the areas healing under compression stresses must become tension areas once the tibia is healed and vice versa.
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B-scan was performed to examine the orbits of 54 patients with Graves' disease. The thickness of the medial and lateral rectus muscle was measured and the results were compared to a control of 24 persons. 21 of the 54 patients with Graves' disease showed different degrees of eye changes in Graves' disease (Class I to IV). In comparison to the control 31 of the 33 patients without clinical signs or symptoms of Graves' orbitopathy have enlarged extraocular muscles. This guides to the presumption of an obligatory orbital involvement in Graves' disease.
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The management of nine patients with pseudomyxoma peritonei was reviewed. Aggressive surgical resection of tumor is the standard of treatment, with many patients requiring multiple laparotomies. Chemotherapy, including the use of cisplatin is not effective. Long-term nutritional support provides a better quality of survival for select patients.
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To identify genes whose expression changes as a function of aging, we screened mouse cDNA libraries with cDNAs from mice of different ages. Specifically, whole-mouse cDNA libraries were constructed in lambda gt10 using poly(A) RNA from young (3 month) and old (27 month) C57BL/6J inbred mice and these lambda plaques were hybridized with radioactive cDNAs made from pooled poly(A) RNA from animals 3 or 33 months of age. Five clones were isolated that showed an aging-related pattern of expression and four of these were identified by computerized sequence matching to the GenBank database: MUP2 (a major urinary protein); Q10 of the MHC locus; a cytoskeletal actin gene; and creatine kinase. One gene whose expression increases with aging and is most abundant in spleen remains unidentified. All five cDNAs showed 4-fold to 17-fold changes with aging in their steady-state mRNA levels in at least one tissue.
A prospective scintigraphic study using Gallium 67 and granulocytes labelled with Indium 111 was carried out in 60 patients who were thought to have infection following orthopaedic operations. Both investigations gave positive results in 11 of the 16 infections observed. The Indium 111 labelled leucocyte scan was more accurate than the Gallium 67 studies in delineating patients who did not have an infection, and appears to be more reliable in the diagnosis of post-operative sepsis.
Skin colonization with Staphylococcus aureus (S. aureus) was examined in 30 patients with atopic dermatitis (AD), in 25 patients with nonatopic eczema (NAE) and in 30 individuals as healthy controls (HC). Bacteria growth was examined in aerobic cultures and the population densities per dish were estimated; S. aureus colonization was found in the eczematous skin of 24 of 30 (80%) AD patients and in 13 of 25 (52%) NAE patients (NS, p greater than 0.1). In nonaffected skin S. aureus colonization was found in 19 of 30 (63%) of all AD patients compared with 6 of 25 (24%) in NAE patients and 1 of 30 (3%) in HC, respectively (p less than 0.05). In nonaffected skin, coagulase negative strains of staphylococcus were found in 25 of 30 (84%) controls and in 18 of 25 (72%) NAE patients compared with 12 of 30 (40%) patients with AD. It seems that colonization with S. aureus is not a characteristic feature for atopic dermatitis but is a frequent event in damaged skin; significantly elevated values were also observed in nonatopic eczema. The degree of colonization may depend on the severity and duration of the eczematous lesions.
To enhance the antimicrobial spectrum of the quinolones against anaerobic organisms and gram-positive bacteria, we investigated in two studies the parenteral combinations of ciprofloxacin (200 mg) and ofloxacin (200 mg) with metronidazole (500 mg) or clindamycin (600 mg) and the oral combinations of enoxacin (400 mg) and fleroxacin (400 mg) with metronidazole (400 mg), clindamycin (300 mg), or ornidazole (500 mg) (only with fleroxacin). The pharmacokinetics and serum bactericidal activities (SBAs) against 5 aerobic and 2 anaerobic species (total, 58 strains) were determined in two groups of 10 healthy volunteers by using a randomized crossover study design. The additions of metronidazole, clindamycin, and ornidazole did not affect the pharmacokinetics of the quinolones. The combination of clindamycin with ciprofloxacin, ofloxacin, and, to a lesser extent, fleroxacin resulted in an increase of the SBA against gram-positive strains (mean peak titers): Staphylococcus aureus, ciprofloxacin alone, 1:5.5; ciprofloxacin-clindamycin, 1:19.9; ofloxacin alone, 1:3.6; ofloxacin-clindamycin, 1:17.5; fleroxacin alone, 1:4.3; fleroxacin-clindamycin, 1:8.1; Streptococcus pneumoniae (fleroxacin and enoxacin were not tested), ciprofloxacin alone, 1:2.0; ciprofloxacin-clindamycin, 1:53; ofloxacin alone, 1:2.6; and ofloxacin-clindamycin, 1:49.2. The high SBA of quinolones against gram-negative bacteria was not affected by the combinations; however, relatively low activities against Pseudomonas aeruginosa were detected. In general, against anaerobic bacteria, low bactericidal activities were determined in both studies (mean peak titers ranged from 1:2.1 to 1:3.1; mean trough titers range from 1:2.0 to 1:2.9). In clinical settings with severe mixed infections, a parenteral therapy consisting of modern quinolones together with clindamycin or imidazole derivatives seems to be active and offers no obvious interactions.
Yeast kre mutants define a pathway of cell wall (1----6)-beta-D-glucan synthesis, and mutants in genes KRE5 and KRE6 appear to interact early in such a pathway. We have cloned KRE5, and the sequence predicts the product to be a large, hydrophilic, secretory glycoprotein which contains the COOH-terminal endoplasmic reticulum retention signal, HDEL. Deletion of the KRE5 gene resulted in cells with aberrant morphology and extremely compromised growth. Suppressors to the KRE5 deletions arose at a frequency of 1 in 10(7) to 1 in 10(8) and permitted an analysis of deletions which were found to contain no alkali-insoluble (1----6)-beta-D-glucan. These results indicate a role for (1----6)-beta-D-glucan in normal cell growth and suggest a model for sequential assembly of (1----6)-beta-D-glucan in the yeast secretory pathway.
The authors describe suicide rates in Toronto and Ontario and methods used for suicide in Toronto for 5 years before and after enactment of Canadian gun control legislation in 1978. They also present data from San Diego, Calif., where state laws attempt to limit access to guns by certain psychiatric patients. Both sets of data indicate that gun control legislation may have led to decreased use of guns by suicidal men, but the difference was apparently offset by an increase in suicide by leaping. In the case of men using guns for suicide, these data support a hypothesis of substitution of suicide method.