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Biomedical subjects

K Jäger

Publications and source records attributed to K Jäger.

At least 19 recordsLinked to original sources
PubMed1992

[Aneurysma spurium following arterial catheterization: diagnosis and follow-up].

Pseudoaneurysm (PA) formation is one possible complication after intra-arterial catheterisation. Due to danger of rupture PA must be clearly differentiated from haematoma. PA is an arterially perfused cavity near the puncture site with direct communication with the femoral artery. Its clinical diagnosis is unreliable. We systematically reviewed 628 patients who had undergone femoral catheterisation (for angiography, PTA, local thrombolysis or aspiration) over a period of 1 year. Duplex scanning was performed within 1 to 3 days after puncture in the cases with the slightest suspicion of PA. In 7 patients (1.1%) PA could be confirmed (2 after angiography, 3 after PTA and 2 after local lysis). On the ultrasound B-mode image PA appears as a low or anechoic structure which can be precisely measured. With pulsed (colour) Doppler, flow can be detected within a PA, allowing easy differentiation from thrombosed PA or from haematoma. The velocity of the systolic inflow-jet as well as of the diastolic outflow can be determined. The velocity of the inflow-jet will usually be much higher than the blood flow velocity in the femoral artery. Duplex-scanning allows repeated non-invasive follow-up examinations for better determination of indications for surgery. Of the 7 diagnosed PA, 2 needed prompt operation (1 because of rupture, 1 because of intense local pain). One patient required operation during follow-up because of increase in size of PA. In the remaining 4 patients, spontaneous thrombosis was observed with repeated duplex examinations.

Aged↗
PubMed1992

Intestinal phase of superior mesenteric artery blood flow in man.

Duplex ultrasound was used to investigate superior mesenteric artery haemodynamics in humans in order to study the contribution of the small intestine to the postprandial splanchnic hyperaemia, and to determine the relative potencies of the major food components in the postprandial mesenteric flow response. Duplex parameters of vessel diameter, mean velocity, and volume flow were determined serially in the basal state and after stimulation. Flow parameters were significantly (p less than 0.05) increased after liquid and solid oral meals. Modified sham feeding did not alter mesenteric blood flow. Intestinal perfusion of an isocaloric liquid test meal induced flow increases comparable with oral intake. Superior mesenteric artery blood flow also significantly (p less than 0.05) increased after isocaloric and iso-osmolar loads of intraduodenal carbohydrate, fat, and protein meals. Responses were similar after the test meal, fat, and protein, but were significantly (p less than 0.05) less for carbohydrates. Different osmolar loads of saline did not affect flow responses. We conclude that the intestinal phase is the major regulator of the postprandial mesenteric blood flow response in healthy humans and that the chemical nature of food determines the mesenteric response pattern.

Adult↗
PubMed1992

[Prevention of thromboembolism in hip traumatology: low molecular weight heparin versus dextran].

A prospective, randomized trial has been undertaken to evaluate the prophylactic effects of low molecular weight heparin (LMWH) and dextran-70 in 216 patients with hip fracture during a postoperative period of ten days. Deep vein thrombosis (DVT) was diagnosed using the 125Iodine fibrinogen uptake test, confirmed by ascending venography. 113 patients received LMWH and 103 dextran-70. The frequency of DTV of 14.2% in the LMWH group was significantly lower compared with the 30.1% in the dextran group (p less than 0.003). During the first 10 days postoperative there were no fatal pulmonary embolism (PE). After this period PE occurred in 2 patients (1.8%) in the LMWH group and 1 patient (1.0%) in the dextran group. In each group one patient died from PE. There was no major bleeding in either group. The frequency of local complications was slightly higher in the dextran group (10.7%) compared with the LMWH group (3.5%). The postoperative hemoglobin level was significantly lower in dextran treated patients than in patients receiving LMWH (p less than 0.0001).

Adult↗
PubMed1992

Differences in DNA fingerprints of continuous leukemia-lymphoma cell lines from different sources.

The genetic stability of human cell lines in long-term culture has been tested by DNA fingerprinting a panel of 31 different continuous cell lines from patients with leukemias or lymphomas. Duplicates of the same cell line obtained from different sources, subclones of cell lines, and samples of cell lines at different passage levels were studied. In most cases the fingerprints of duplicates of the same cell line remained perfectly preserved even after long-time passaging. However, in five cases there were notable differences between individual fragments of corresponding fingerprints. We have found four cases of mislabeled and/or cross-contaminated cell lines so far. Taken together, our results indicate that DNA fingerprinting qualifies as a very reliable means of cell line identification which allows the detection of mislabelling or contamination and of genetic variation among subclones.

Base Sequence↗
PubMed1992

[How do occlusion disorder and stress influence cybernetic masticatory control?].

Chewing forces were registered and compared in three subjects under normal conditions as well as in presence of occlusal interferences, and under stress. Biting force, blood pressure, and concentration of blood catecholamines were measured. Psychic stress was induced by demanding reactions on a test machine. In the presence of occlusal interferences, no significant increase in biting force was recorded. However, the biochemical analysis documented that biting forces appeared to be no longer under local control, but, increased up to 600% when the level of stress was raised. This study confirms the importance of stress as an etiologic factor in masticatory dysfunction.

Adult↗
PubMed1991

Cholinesterase solubilizing factor from Cytophaga sp. is a phosphatidylinositol-specific phospholipase C.

In the culture supernatant of Cytophaga sp. we detected an enzyme that converted glycosylphosphatidyl-inositol-anchored acetylcholinesterase to the hydrophilic form. This enzyme had a cleavage specificity of a phospholipase C. It hydrolyzed phosphatidylinositol but did not act on phosphatidylcholine. On gel filtration the enzyme migrated with an apparent molecular mass of about 17 kDa. It displayed maximal activity between pH 6-6.5 and did not require cofactors for the expression of catalytic activity. Mercurials and zinc ions inhibited the enzyme and its activity also decreased with increasing ionic strength in the assay. With acetylcholinesterase as substrate optimal activity was obtained in pure micelles of Triton X-100, whereas in mixed micelles containing Triton X-100 and phosphatidylcholine the activity was reduced. The enzyme from Cytophaga sp. showed little activity towards acetylcholinesterase embedded in intact membranes where more than 1000-times higher concentrations of phosphatidylinositol-specific phospholipase C was necessary to solubilize acetylcholinesterase as compared to acetylcholinesterase in detergent micelles.

Acetylcholinesterase↗
PubMed1991

[Assessment of the leg veins using duplex ultrasonography].

Duplex scanning, first used for the investigation of arterial diseases, is characterized by the combination of B-Mode ultrasound and spectral analysis or color imaging of PW-Doppler signals. This provides information on both the morphology of the vessel and the corresponding hemodynamics. Compared to the conventional noninvasive techniques in phlebology such as plethysmography and CW-Doppler its major advantage is the additional morphologic information. Until now this anatomical information was only available by invasive phlebography. This technique, however, gives only limited informations on hemodynamics. Using an appropriate technique of duplex scanning, the deep veins from the calf to V. cava as well as the superficial veins and the perforators can be examined. In the hand of a skilled investigator deep vein thrombosis can be diagnosed with accuracy. Compared to the gold standard phlebography sensitivity and specificity are high: 96% and 99% resp. The duplex technique is also very reliable in differentiating the diagnosis of deep vein thrombosis: Baker's cysts, hematomas and tumors usually are easily detected by B-scan. Investigation of chronic venous insufficiency is also possible by duplex-scanning. Imaging of the veins and pulsed Doppler analysis allows to determine whether the reflux is in the deep or superficial system. On a more scientific field duplex allows the precise noninvasive determination of hemodynamic parameters. Thus it is possible to measure physiologic venous hemodynamics and to quantify drug effectiveness. Duplex sonography holds a key position in the phlebological diagnostic procedure. This new technique causes no harm to the patient and important information is obtained at relative low costs.

Blood Flow Velocity↗
PubMed1991

[Changes in the ultrasound power spectrum due to concentric stenoses of the femoral artery of the dog].

An artificial stenosis model consisting of a revolving centric cylinder with six boreholes (10-60% diameter reduction) was implanted in the superficial femoral artery of anaesthezised beagles (n = 10). Range gated pulsed Doppler signals were recorded at 7 sites between three diameters upstream to ten diameters downstream the Angle corrected parameters derived from the contour of spectral lines between 3 and 21dB on both sides of mode frequency were calculated for different time windows. Two groups of dogs could be distinguished. Group A showed marked downstream power spectrum changes which did not correlate to the degree of stenosis. In Group B, in contrast, the degree of power spectral disturbances correlated to the degree of stenosis. It was suggested that partial thrombosis of the stenoses during measurement provides an acceptable explanation for the missing correlation in Group A.

Animals↗
PubMed1991

[The concept of integrated internal medicine-psychosomatic patient management--experiences and results with its application in a general hospital].

Psychosomatic therapy has been realized by integration into general ward's therapeutic program in a general hospital. Within 3 1/2 years of development the medical staff has been qualified to perform basic elements of psychosomatic therapy, whilst the structure of the medical department has been changed in different aspects. During a period of 28 days the real extend of psychosomatic therapy now has been evaluated by questionnaire: 438 psychosomatic and psychosocial interventions were documented in this time, concerning 149 patients (= 53% of all patients treated in the department). Causes, trigger mechanic, settings, frequency, median duration, and different kinds of all these interventions are described. According to the clientèle of our medical department, with a lot of elderly and multi-handicapped persons, the main topics of interventions concerned--besides of specific psychosomatic treatment--addiction and problems of alcoholism, coping strategies and compliance, as well as further support of handicapped singles after discharge.

Aged↗
PubMed1991

[New therapeutic approach in the celiac trunk compression syndrome].

Etiology and treatment of the coeliac compression syndrome remains controversial. The external compression, near the origin of the truncus coeliacus and the poststenotic dilatation is well demonstrated by angiography on a lateral projection. The development of collaterals like the pancreaticoduodenal and gastroduodenal artery can be assessed on a frontal view. The grading of the stenosis as well as the direction of the flow in these artery can be measured with the duplex sonography. These investigations show a steal syndrome: blood coming from the mesenteric artery irrigate the common hepatic artery through the collaterals. The flow in the common hepatic artery is therefore retrograde. We used an original technique to correct this flow pattern in the case of a 52-year-old patient: after dividing the arcuate ligament, we reduced the vascular territory of the truncus coeliacus with the proximal ligation of the splenic artery. The duplex sonography shows postoperatively the suppression of the steal syndrome with a normal flow pattern in the hepatic artery despite minimal change in the stenosis of the truncus coeliacus. The patient remained asymptomatic since the operation. We concluded that an angioplasty or reimplantation of the truncus coeliacus is unnecessary to correct the steal syndrome. A normal flow can be provided by a stenotic truncus coeliacus once the splenic artery has been ligated.

Blood Flow Velocity↗