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Biomedical subjects

J Weber

Publications and source records attributed to J Weber.

At least 379 records · Page 21Linked to original sources
PubMed1992

Incompletely resected advanced squamous cell carcinoma of the head and neck: the effectiveness of adjuvant vs. salvage radiotherapy.

Between 1982 and 1988, 441 patients were treated at the Medical College of Virginia for AJC Stage III and IV squamous cell carcinoma of the head and neck. We report here on 84 patients whose tumors were incompletely resected based on histopathological margins of 1 mm or less. Of these 84 patients, 49 were treated with surgery alone and 35 received immediate postoperative irradiation to doses of 50-70 Gy. The two patient groups are comparable with respect to stage of disease, age, male/female and racial ratios. This retrospective analysis, based on follow-up of 24-110 months, gives actuarial locoregional tumor control and survival data. The local control and disease-free survival rates in the combined modality group are significantly superior at the p = 0.0006 and p = 0.0003 levels, respectively, relative to the group treated with surgery alone. Patients in the combined modality group also experienced a significantly improved adjusted and overall survival, p = 0.005 and p = 0.01, respectively. The administration of postoperative irradiation was not associated with an increased rate of complications. The benefit of radiotherapy on survival was only seen when given as postoperative treatment but was lost in patients treated for salvage after tumor recurrence.

Adult↗
PubMed1992

Mapping the human liver/islet glucose transporter (GLUT2) gene within a genetic linkage map of chromosome 3q using a (CA)n dinucleotide repeat polymorphism and characterization of the polymorphism in three racial groups.

The human liver/islet glucose transporter (GLUT2), a candidate gene for diabetes, has been incorporated into a genetic linkage map for chromosome 3q using a (CA)n dinucleotide repeat polymorphism adjacent to the 3'-end of exon 4a. We have found a total of nine alleles ranging in length from 153 to 169 nucleotides in three racial groups and have determined the precise structure of the variable region for four of the alleles by DNA sequencing. Five alleles were found to be common to the American Black, Caucasian, and Pima Indian racial groups studied. One allele (169 bp) was unique to American Blacks, and another rare allele (153 bp) was found only in the Caucasian population studied. Observed heterozygosity of the polymorphism in the Caucasian (CEPH) reference pedigree collection is 60%, for American Blacks 71%, and for Pima Indians 53%. An independent study recently identified the same dinucleotide repeat and found six alleles in a Caucasian population (Froguel et al., 1991), a result that we confirm; however, our sequencing data indicate a different molecular structure for the polymorphism for some of the alleles. We have constructed a new genetic linkage map of chromosome 3q uniquely placing the GLUT2 gene between flanking markers D3S26 and D3S43. The genetic map consists of 23 loci (25 RFLPs and 2 (CA)n dinucleotide repeat markers) with 14 markers uniquely localized with odds of at least 1000:1. Three genes (FTHL4, TF, GLUT2) are integrated into the map, which spans a sex-average distance of 147.3 cM, 103.8 cM in males and 227.0 cM in females.(ABSTRACT TRUNCATED AT 250 WORDS)

Alleles↗
PubMed1992

Extracorporeal piezoelectric lithotripsy for retained bile duct stones.

Extracorporeal piezoelectric shock wave lithotripsy (EPL) was performed in 35 patients with endoscopically non-extractable stones. With this lithotripter, stones are visualized by ultrasound and shock waves are produced by a piezoelectric acoustic generator. The stones could be localized in 32 out of 35 patients. Fragmentation was achieved in 91.4% and complete stone removal in 77.1%. These results show that piezoelectric lithotripsy is also a useful method for the treatment of complicated bile duct stones, as already demonstrated for the electrohydraulically and electromagnetically generated shock waves systems. The piezoelectric system is especially useful in elderly and frail patients because no general anesthesia is needed and only 14% of cases require analgesia or sedation.

Aged↗
PubMed1992

[Automated percutaneous lumbar diskectomy (APLD): the early and late changes in the CT with a clinical correlation].

In 52 out of 162 patients treated, CT changes were measured at early and late stages and correlated with clinical findings. Reduction in height of discs was measured by digital radiography. During early stages 9.6% showed gas collections peripherally and 3.8% centrally. Early and late examination showed uniform reaction in the area of the prolapse: no changes (type I), return to normal findings (type II), diffuse reduction of a broadly based lesion (type III), reduction in focal changes based on a broad lesion (type IV). Early results: 94.3% type I, 3.8% type III, 1.9% type IV. Late results: 55.7% type I, 3.8% type II, 21.2% type III, 19.3% type IV. Maximal reduction of the height of the disc of 10% occurred in 32.6% of cases. There was no meaningful correlation between CT appearances and clinical status.

Humans↗
PubMed1992

Nocardia infection in AIDS: a clinical and microbiological challenge.

A case of Nocardia asteroides pneumonia was diagnosed after death in a patient with AIDS. Six sputum cultures and one bronchoalveolar lavage fluid contained no pathogens, and no growth was obtained from one pleural fluid aspirate. None of these specimens was incubated for more than two days. Extended incubation for mycobacteria also failed to help in the diagnosis. N asteroides was isolated from pus taken from the lung cavity during the post mortem examination. It is suggested that if nocardiosis enters the differential diagnosis all specimens should be cultured for at least two weeks and the use of selective media be considered. This case highlights the need for clinicians to maintain a high index of suspicion for this pathogen.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Cost cutting using radio frequency inventory control.

Bar coding should be a staple in every hospital by now--but it's not. The author tells how bar coding and the use of radio frequency transmission of inventory data direct to their mainframe computer has saved them time and money.

Computer Communication Networks↗
PubMed1992

[Perimetry equivalents of glaucoma progression].

Loss of sensitivity in chronic open-angle glaucoma is generalized, but heterogeneous. Particular parts of the visual field deteriorate proportionally, which also applies to the spatial behaviour. The proportionality factor and the slope of decay are most pronounced at the nasal and superior border of the field. In single cases, the topography of the field is variable, but it follows the retinal nerve fiber lines. For follow-up, topography seems to be unimportant. A number of standard threshold programs are adequate for this task. For follow-up the same type of instrument and the same program should always be used. The optimal value for analysis in perimetric follow-up is so far unknown. Although progression is often not linear, linear regression seems to be the most suitable statistical procedure. Some new methods of visualization help to process the information like the double representation, GATT, time diagram or the gray-scale bar.

Glaucoma, Open-Angle↗
PubMed1992

[Prevalence of anal incontinence in adults].

Inquiries were conducted to determine the prevalence of anal incontinence in a) the general population over 45 by a gallup poll studying 1,100 persons (A); b) 3,914 patients seen by their general practitioner or their gastroenterologist during the same week (B); c) 500 patients consulting for urinary stress incontinence (C1); d) 1,136 neurological patients suffering from micturation disorders (C2); and e) 10,157 elderly persons living in retirement homes or in hospital (D). In the general community (A), the prevalence of anal incontinence, including gas and stool incontinence, was 11 percent, the prevalence of fecal incontinence, 6 percent, the prevalence of daily or weekly fecal incontinence, 2 percent; prevalences were respectively 15.5 percent, 7.9 percent, and 3.2 percent in group B, and 27 percent, 9 percent and 3.8 percent in group C1. The prevalence of fecal incontinence was 18 percent in group C2 and 33 percent in group D. Prevalence did not depend on age in group A and C1, but was twofold higher in group C1 than in group A. The prevalence increased with age in groups B and D.

Adult↗
PubMed1992

The properties of perimetric thresholds in normal and glaucomatous eyes.

In perimetry, threshold is defined as the stimulus intensity at which the frequency of perception is 50%. Around the threshold, there is a transition zone in which the frequency of perception turns from 0% to 100%. We examined the frequency-of-seeing-function in 21 persons with and without pathological damage at various locations in the visual field. We used the classic method of constant stimuli: 12 different stimulus intensities were presented 25-50 times each. The results were: (1) The frequency-of-seeing curve showed the typical S-shaped transition zone as is known from other psychophysical thresholds. The slope of the curve and thereby the size of the transition zone varied by a factor of 17. The 'threshold coefficient,' which is the difference between the intensities that provoke a 50% and a 84% frequency-of-seeing, ranged from 1.13 to 19.83 dB. (2) The threshold coefficient was strongly correlated with the threshold level itself (r2 = 0.596). (3) Other influencing factors such as pathological damage or peripheral location appeared to be covariant, because they influenced the threshold level. A substantial influence of these factors on the threshold coefficient could not be found. Different fluctuations of the threshold are therefore mainly an effect of the threshold level. This may serve as a anticipatory knowledge that allows the optimization of staircase measurement procedures and enables the improvement of the statistical analysis of visual fields.

Adult↗
PubMed1992

Perimetric follow-up in glaucoma with a reduced set of test points.

The global mean defect (GM) is probably the most useful visual field index for glaucoma follow-up. We compared 50 regional subsets of test locations to estimate the GM. Using the data on 424 automated fields of 257 patients with either primary open-angle glaucoma or ocular hypertension, we calculated the partial sample error of the regional mean defect as compared with the GM. In many regions, the measured sample error was greater than expected for a representative sample of points. Some sample errors were up to 5 times larger (regions "upper hemifield" and "lower hemifield"). Only a few subsets proved to be representative of the whole field, namely, regions "ring 3" (10 degrees-15 degrees), "ring 4" (15 degrees-20 degrees) and "ring 5" (20 degrees-25 degrees). The use of such programs for follow-up is very accurate for staging. Moreover, theoretical calculations reveal that trend analysis is even more significant if the reduction in examination time is combined with a proportional increase in examination frequency.

Adolescent↗
PubMed1992

Effect of an effervescent citrate-cimetidine combination on intragastric pH in healthy subjects. A randomized, placebo-controlled three-period cross-over design.

Twelve healthy male volunteers participated in a randomized placebo-controlled, three-period cross-over study to assess the effect of a new effervescent citrate-cimetidine combination (200 mg cimetidine/tablet) (C) on intragastric pH in comparison with a liquid aluminium-magnesium hydroxide antacid (A) and placebo (P). The intragastric pH values were determined by an Ingold combined glass electrode and recorded by a "pH 60" portable unit. Each pH-metry lasted 5 hours and was performed on three separate occasions at one-week intervals. Each treatment was orally administrated at 09.00 h, following a 1-hour baseline intragastric pH recording. The effect of C was measurable almost immediately after drug intake with a median pH between 5-6.5 within 3 minutes, lasting for a mean of 110 minutes and median pH greater than 4 for at least 4 hours. The rise of gastric pH with C was higher (P less than 0.01) and longer (P less than 0.01) than that of A: median pH between 3.5 and 4.5 for 10 to 35 minutes, pH above the placebo curve for 140 minutes and above pH 3 for 50 minutes. In terms of percentage of time at or above each pH level, the differences between the three treatment groups were significantly in favor of C compared to A and A compared to P.

Adult↗
PubMed1991

[Acute kidney failure caused by hantavirus infection].

A 37-year-old man suddenly fell ill with high fever (up to 39.6 degrees C), headache and lumbar pain. There was marked thrombocytopenia (minimal level of 48,000/microliters), moderate anaemia and a slow rise in serum lipase concentration to maximally 1352 U/l. Marked sinus bradycardia (to as low as 34 beats/min) occurred in the further course of the disease, as well as upper abdominal pain (endoscopically diagnosed as antral gastritis), subileus and splenomegaly. Two haemodialysis treatments were needed because of acute renal failure. An IgG antibody titre of 1:512 and an IgM titre of 1:80 against hantavirus antigen confirmed that this virus was responsible for the haemorrhagic fever with renal syndrome. This infection, transmitted by wild rodents and frequently observed in Asian countries, has a rising incidence in Central Europe. It should be included in the differential diagnosis of acute renal failure of uncertain cause.

Acute Disease↗