Biomedical subjects
Publications and source records attributed to J Wagner.
The role of the pharmacist in helping to guide the patient and his family through the grief and bereavement process of death is described. The somatic and psychological components of grief and the five psychological stages of dying--denial and isolation, anger, bargaining, depression, and acceptance--are discussed. The pharmacist's role is one of understanding, tolerance and empathy for the dying patient and his family.
The presentation focuses on the structural rearrangements of the subunits and the processing of the various protein constituents which accompany the maturation events of the head of bacteriophage T4. The major features of the maturation steps of the head are the following: (a) the viral DNA is pulled into an empty head in a series of events; (b) cleavage of two core proteins, P22 (mol. mass = 31000), to small fragments and the internal protein IPIII (mol. mass = 23000) to IPIII (mol. mass = 21000) appears to be intimately linked to the DNA packaging event, whereas the cleavage of the major head protein of the viral coat, P23 (mol. mass = 55000), to P23 (mol. mass = 45000) precedes the DNA packaging event. Recently, we have obtained information about the mechanism by which the viral DNA is pulled into a preformed empty head. Our evidence suggests that the DNA becomes attached to the inside of the empty head and is subsequently collapsed in the interior by the so-called internal peptides. These are highly acidic and derived from a large precursor protein by cleavage.
Chimpanzees chronically infected with hepatitis-B virus showed transient changes in several markers of infection when treated with the interferon inducer polyriboinosinic-polyribocytidylic acid-poly-l-lysine carboxymethyl cellulose. Serum Dane-particle-associated D.N.A. polymerase, e antigen and hepatitis-B surface antigen, and intrahepatic hepatitis-B surface and core antigens diminished during treatment. Defective (D.N.A.-polymerase-negative) Dane particles increased in titre transiently during treatment; these may play a role in the modulation of hepatitis-B virus infection. Humoral immune responses in chronic hepatitis-B carrier chimps were unaffected. Interferon inducers (or exogenous interferon) may be useful for the treatment of chronic hepatitis-B virus infection.
13 of 30 patients suffering from pseudo-LE-syndrome showed a usually reversible enlargement of the heart during the acute stage of the disease. In two patients carditis occurring in pseudo-LE-syndrome lead to congestive heart failure and an additional patient died in the acute stage of carditis. As opposed to Systemic Lupus Erythematosus hypertension did not occur in a higher frequency than normal. In five cases cardiac catheter examinations showed slight elevation of the end-diastolic pressure in the right ventricle, in two cases an abnormal high mean pressure in the right atrium and a systolic gradient at the pulmonic valve was found. -Scintigrams showed definite enlargement of the spleen and to a lesser degree enlargement of the liver was seen. Laparascopy showed multiple concretions after peritonitis. Lymphographic changes in the retroperitoneal lymph nodes and lymphatic ducts were not observed in contrast to rheumatic diseases. Drug histories in most cases discovered intake of Venopyronum dragees prior to onset of the disease. But recurrent attacks of the disease also occurred without further intake of the drug.
In patients aged 24 to 45 years with angina pectoris, pathological changes in the exercise electrocardiogram and a normal coronary angiogram, a disturbance of the pattern of myocardial perfusion could be demonstrated in addition by scintigraphy. The cause of this disturbance of myocardial perfusion is unknown. Myocardial scintigraphy is indicated (1) to demonstrate an otherwise undetectable disturbance in the blood flow of the myocardium with a morphologically normal coronary system, (2) in subtotal coronary stenosis before the decision to perform a coronary bypass operation is made, (3) in cases of anginal syndrome with normal coronary angiograms.
The punctate of the pleural cavity of a patient was examined which very much increased the permeability of the membrane in the animal experiment. Proteases is ascribed the effect increasing permeability, which are adsorbed to macromolecules. The increase of permeability could be inhibited by contrycal. An increase of permeability by proteolytic enzymes is discussed as one of the possible pathomechanisms for the development of exudations.
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Fasting plasma triglycerides and cholesterol, as well as cholesterol in very low density, low density and high density lipoproteins, were measured in 250 MZ and 264 DZ adult male twin pairs. A new method was used to choose an estimate of genetic variance. This includes an estimate of genetic variance for use when the total variances of MZ and DZ twins are unequal. DZ twins had greater total variance for cholesterol. When genetic variance was estimated by subtracting the within-MZ-sets mean square from the within-DZ-sets mean square, all of the lipids had significant estimates of genetic variance; however, when genetic variance was estimated by a method designed to correct bias due to unequal total variances of MZ and DZ twins, only triglycerides had significant genetic variance. The heritability of plasma triglycerides was calculated to be 0.68.
Eighteen patients were investigated by laevocardiography, perfusion scintigraphy and with a 201thallium scan. In four patients with normal contractility of the left ventricle, normal uptake of 202thalium was found in every patient. Hypokinesia of the anterior wall or apex of the ventricle showed normal uptake on the 201thallium scintigram in four out of five patients. It follows that it is not usually possible to diagnose hypokinetic mural portions on 201thallium scintigrams without quantitative analysis. Our experience up to date with areas of akinesia has shown that it is possible to demonstrate areas of scarring (as negative contrast) in seven out of nine cases.
Hepatitis A antigen (HA Ag) was purified from feces collected during acute illness from patients with naturally occurring viral hepatitis, type A. Positive fecal specimens were identified by immune electron microscopy, but for detection of HA Agduring purification immune adherence hemagglutination (IAHA) and microtiter solid-phase radioimmunoassay were used. Isopycnic banding in cesium chloride, rate-zonal separation in sucrose, and preparative zonal electrophoresis were used in various combinations for successive purification, and the purified antigen was successfully used in a test for antibody by IAHA. Seronconversions to HA Ag were demonstrated by IAHA in 20 instances of hepatitis A virus infection, but in none of six cases of type B hepatitis or three cases of post-transfusion hepatitis unrelated to heaptitis A or B viruses, nor in two individuals without hepatitis. In addition, the temporal pattern of antibody development during type A hepatitis was studied in serial sera from an experimentally infected chimpanzee. Antibody titers by IAHA correlated well with antibody ratings determined by immune electron microscopy.
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A methodical introduction of the measurement of regional myocardial microperfusion is given. Based on the results of selective coronary perfusion scintigraphy in this technique two isotopes are injected into the same coronary artery with a characteristic time interval between the two injections. The influence of the coronary active drug on regional myocardial microperfusion can be measured, when the second isotope is injected after a time interval corresponding to the maximum drug effect. The second isotope then marks the actual regional microperfusion under the influence of the drug. The two isotopes can be discriminated by their characteristic energy spectra and then quantitatively be compared. The scans are taken in different positions and then compared with the corresponding coronarograms and left ventriculograms.
The influence of Dipyridamol and Oxyfedrin on regional myocardial precapillary microperfusion patterns was investigated in groups of 15 and 13 patients by means of selective double lable perfusion scintigraphy. Automatic impulse rate integration allows the comparison of different perfusion areas in the same scintigram as well as the comparison of different identical regions in different scintigrams. The scans were taken in two positions (frontal and l.a.o.). Microperfusion patterns were measured before and after the intravenous application of the drug. We found a typical shift of the microperfusion patterns with both medicaments. Under the influence of Oxyfedrin and Dipyridamol there was an increase of the relative microperfusion intensity in the vicinity of the major arteries but there were great differences as to the degree of their reaction maximum. Besides the results of the groups some typical cases are demonstrated. The method allows a satisfactory measurement of differences in the regional precapillary myocardial perfusion under the influence of coronary active drugs. We believe that statements on physiologic and pathologic functions are possible.
Coronary insufficiency is defined. Some specialities of coronary circulation and aspects of their regulation are discussed. Physical mechanisms such as arteriovenous pressure gradient, vascular and extravascular components of the coronary resistance, the influence of rhythm change on the contraction-conditions of the myocardium, as well as the pulse-rate are differentiated from biological regulation mechanism, such as metabolic, nervous and hormone influences. The typical distrubance of this regulation in the coronary insufficiency is emphasized including impaired left ventricular function. In the second part, the clinic or coronary insufficiency deducted from the anatomical-pathological lesions as well as their pathophysical relations is dealt with, for instance manifestation of angina pectoris and myocardial infarct. The indications and contra-indications for selective coronary angiography are described.
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On isolated guinea-pig papillary muscles as well as on electrically driven atria digoxin was infused into the bath fluid until cardiac arrest occurred. The concentration of digoxin which caused standstill is defined as the toxic one. The toxicity was determined under various Ca2+-concentrations. On the papillary muscle the increase of extracellular Ca2+ from 0.9 to 7.2 mM increased the toxicity of digoxin, i.e. significantly diminished its toxic concentrations. Likewise, on electrically driven atria an increase of Ca2+ from 0.45 to 7.2 mM increased the toxicity of digoxin. These results demonstrate that with regard to the toxicity Ca2+ and digoxin act synergistically.