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Biomedical subjects

M Berger

Publications and source records attributed to M Berger.

At least 433 records · Page 24Linked to original sources
PubMed1993

Disappearance of a left ventricular aneurysm on radionuclide ventriculography due to formation of a mural thrombus.

Radionuclide ventriculography is an accepted method for diagnosing left ventricular aneurysms, but false-negative studies have been associated with a mural thrombus filling the left ventricular cavity. We describe a patient with a left ventricular aneurysm due to myocardial infarction whose aneurysm scintigraphically "disappeared" from serial radionuclide ventriculograms. This was documented echocardiographically and pathologically to be due to the formation of a large mural thrombus. Review of the literature suggests that radionuclide ventriculography and echocardiography may be complementary techniques in the diagnosis of left ventricular aneurysm. Echocardiography may remain diagnostic when a mural thrombus has caused the loss of the characteristic scintigraphic findings on radionuclide ventriculography.

Adult↗
PubMed1993

Radioimmunoassay of mouse vas deferens protein: developmental profile and hormonal regulation.

This study investigated the hormonal regulation of the developmental pattern of a major protein of the mouse vas deferens (MVDP) which represents 10% of the vas deferens protein content. Using a specific radioimmunoassay, MVDP was first detected in 10-day-old males and its concentration increased sharply between 10 and 30 days, reaching adult levels at 40 days. In adult males, MVDP disappeared after castration, and testosterone treatment for 15 days was necessary to reverse the effect of castration completely. In 10-day-old mice castrated at birth, MVDP levels were similar to those measured in controls of the same age. Testosterone administration from 1 to 10 days of age did not induce precocious accumulation of MVDP. These results suggested that the neonatal expression of MVDP is independent of androgens. From 10 to 30 days, the increase in MVDP levels was androgen-dependent as shown by the castration and injection experiments. In males castrated at birth, the androgen-induced accumulation of MVDP was greatly reduced in adulthood. This suggested that neonatal androgens are necessary to obtain full expression of the MVDP gene in adults.

Aging↗
PubMed1993

Effectiveness, safety, and acceptability of a copper intrauterine device (CU Safe 300) in type I diabetic women.

OBJECTIVE: To evaluate the long-term effectiveness and safety of a copper intrauterine device fulfilling modern standards in type I diabetic women compared with nondiabetic women. RESEARCH DESIGN AND METHODS: Type I diabetic women (n = 59, age 27 +/- 5 yr, duration of diabetes 12 +/- 8 yr, HbA1c 7.0 +/- 1.2%, 78% nulliparous women) were prospectively evaluated at 3, 6, 12, 24, and 36 mo by a gynecological exam and a standardized questionnaire after insertion of the intrauterine device (CU Safe 300, 300 mm2 of copper). A group of nondiabetic women (n = 1150) of comparable age and parity evaluated according to the same study protocol served as a control group. RESULTS: In the diabetic women (1754 cumulative months of use), events leading to termination of the intrauterine device during the 1st yr (691 women-mo) were one accidental pregnancy, one expulsion, one removal for pain, two removals for bleeding, and one removal for planned pregnancy. Events during the 2nd (593 women-mo) and 3rd yr (470 women-mo) were zero and one accidental pregnancy., one and two removals for bleeding, one and one removal for pain, one and one removal for other medical reasons, and two and two removals for planned pregnancy, respectively. No case of pelvic inflammatory disease was diagnosed in the diabetic group, and one case was diagnosed in the nondiabetic group (28,369 mo of cumulative use). Events leading to termination of the intrauterine device per women observed per year and continuation with the intrauterine device after each year of use were comparable in the diabetic and nondiabetic groups for the 1st, 2nd, and 3rd yr. CONCLUSIONS: These results, although preliminary because < 100 diabetic women were studied, indicate that the intrauterine device CU Safe 300 is as effective, safe, and well-tolerated in diabetic as in nondiabetic women. Specific objections to the use of intrauterine devices in type I diabetic women do not seem to be justified for modern, copper-mediated models.

Adolescent↗
PubMed1993

Evaluation of a structured treatment and teaching programme on hypertension in general practice.

OBJECTIVE: Evaluation of a structured hypertension treatment and teaching programme in general practice. DESIGN: Prospective controlled trial; follow-up period 18 months. SETTING: 10 primary health care practices. PRACTICES AND PATIENTS: From each practice 20 patients (30 to 60 years old, mean of the last two blood pressure measurements at or above 160 and/or 95 mmHg) were randomly selected; in 5 practices these patients were to participate in the treatment and teaching programme; in the remaining 5 practices hypertension care was continued without the availability of such a programme (controls). INTERVENTION: Structured treatment and teaching programme based upon four group sessions for patients mainly conducted by paramedical personnel. MAIN OUTCOME MEASURES: Blood pressure, body weight, prescription of antihypertensive drugs - as documented in the patient's records. MAIN RESULTS: Of the 100 control patients 26 and of the 100 intervention patients 14 were lost to observation; 46 patients had agreed to participate in the programme. The mean number of prescribed antihypertensive agents per patient decreased in the intervention group (1.8 +/- 1.3 at baseline, vs 1.2 +/- 1.2 at follow-up) compared to the control group (1.6 +/- 1.3 vs 1.8 +/- 1.6); difference 0.8 (95% CI 0.4 to 1.1), p < 0.0001. In the control group 9% and in the intervention group 33% of patients had documented reductions of body weight (p < 0.0001). Blood pressure decreased in the intervention group (162 +/- 14/100 +/- 7 mmHg at baseline, vs 154 +/- 16/95 +/- 9 mmHg at follow-up) compared to the control group (161 +/- 13/98 +/- 7 mmHg vs 158 +/- 18/96 +/- 11 mmHg); differences for systolic blood pressure 5 (95% CI 0 to 10) mmHg, p = 0.071; for diastolic blood pressure 4 (1 to 7) mmHg, p = 0.018. CONCLUSIONS: The introduction of a structured hypertension treatment and teaching programme in general practice may lead to significant improvements of hypertension care.

Adult↗
PubMed1993

Cost-effectiveness of a structured treatment and teaching programme on asthma.

The purpose of this study was to perform a cost-effectiveness analysis of the structured treatment and teaching programme for patients with asthma (ATTP) at Düsseldorf University. We investigated whether the monetary benefits outweighed the costs of the intervention. Adult patients with moderate to severe asthma participated in a 5 day in-patient programme. Follow-up was 3 yrs. The incremental costs and benefits of the intervention, compared with standard treatment, were calculated. Costs were incurred by the hospitalization and by lost productivity. Compared to the year before the programme, (average reduction) days spent in hospital (5.2 days per patient per year), days of absence from work (18.4 days per patient per year), acute severe asthma attacks (3.8 attacks per patient per year), and physician consultations (2.3 visits per patient per month), decreased in the 3 yrs after the intervention. The programme produced net benefits of DM 12,850 (in 1991 German marks) per patient within 3 yrs. Within the health care sector, the net benefits were DM 5,900. Within 3 yrs, the paying bodies saved DM 2.70, and society as a whole saved DM 5 on each DM spent for the programme. We conclude that the intervention produced net monetary benefits. This result was stable over a wide range of variation of the outcome measures. Therefore, programme deserves implementation, not only for its demonstrated medical benefits but also for its economic savings.

Absenteeism↗
PubMed1993

Improvement of hypertension care by a structured treatment and teaching programme.

Despite the availability of multiple nonpharmacological and pharmacological antihypertensive regimens large scale control of BP on a population basis is still unsatisfactory. To achieve a better quality in hypertension care we have developed and evaluated a structured outpatient hypertension treatment and teaching programme. This programme aims at improving of patients' compliance to antihypertensive therapy and is based on four groups sessions mainly conducted by paramedical personnel. This programme was evaluated in three different settings: in patients with hypertension, diabetes mellitus and poor compliance to antihypertensive drug therapy; in blind patients with diabetic nephropathy and severe hypertension; and in patients with essential hypertension as treated by primary healthcare physicians in general practice. In all three studies a significant improvement in compliance to antihypertensive therapy and, hence, in BP control was demonstrated leading to preservation of renal function in diabetic nephropathy and fewer drug prescriptions in essential hypertension. In conclusion, studies evaluating the effect of large scale implementation of such structured treatment and teaching programmes on the quality of hypertension care in the community should be carried out.

Antihypertensive Agents↗
PubMed1993

[Development of children after reproduction-medical treatment of their parents].

The issue of child development after infertility treatment of the parents deals with the impact of technology on the sublime psychic process of establishing the pre- and postnatal triad of father, mother and child. The reasons that, in a development psychologic and child psychiatric view, lead to the necessity of qualitative analysis of the subject are being discussed in this article. In addition, the results and findings of existing publications are presented. Last not least, the investigation and evaluation of prognostic factors is discussed with regard to their importance for the development of parent and child after infertility treatment and also for the decision making process when the parents are counselled by doctors on the issue of infertility treatment.

Adaptation, Psychological↗
PubMed1993

[Psychological and pediatric psychiatry aspects of development of children resulting from medical reproduction treatment of their parents].

Subject matter are actual case reports dealing with somatic symptoms in child development. Related thoughts on child psychiatry and development psychology are being discussed with due respect to the understandable reluctance of the parents in revealing and reflecting details of the development of child and parents. A future goal should be to keep child development under a closer surveillance for a longer period of time with special focus on the parent-child and the inter-parent relationship.

Adaptation, Psychological↗
PubMed1993

[Movement disorders in weightlessness].

The system MONIMIR has been developed to study the coordination of eye, head and arm movements as well as spinal reflexes in microgravity and was used during three spaceflights on board of the station MIR. The following investigations in the course of the experiment MONIMIR were performed: (1) slow head movements in three planes, (2.3) fast pointing movements of eyes, head and arm to acoustic and visual targets, (4) tracking movements of eyes, head and arm to visual targets, (5) head and arm movements based on short term memory and (6) patellar-tendon-reflex. In microgravity different functions and effectors showed different nature and degree of disturbance and different courses in adaptation; in most of the tests exactness and velocity of head and arm movement was decreased; head movements were more disturbed than arm movements; fast pointing movements were more severely affected than slow tracking movements which partly improved; visual controlled movements showed better adaptation as only proprioceptive controlled movements; the patellar-tendon-reflex was highly increased. Disturbances were most pronounced in the early stage of the spaceflights; at later stages most of the performances improved. Methods and results can be used not only for improvement of election and health control of cosmonauts/astronauts for future longterm space missions but also for diagnostics and research of adaptational processes in course of diseases or extreme conditions on earth.

Extraterrestrial Environment↗
PubMed1993

[Applied psychoacoustics in space flight].

Simulation free field hearing by head phones by means of digital filter technics was used to investigate directional hearing and audiocinetic vection in microgravity. Our data showed basic informations for the understanding of the reciprocal influence of vestibular and auditory inputs for dynamic orientation. The technical equipment of free field hearing simulation by headphones and the performed experiments are described in detail. Furthermore the new established technology is discussed in terms of the value in psychoacoustic research as well as in clinical practice.

Auditory Perception↗
PubMed1993

[Cholesterol non-consensus in primary prevention of coronary heart disease. Methodologic problems in the interpretation of epidemiologic studies].

Evidence for a population intervention to lower mean serum cholesterol levels with the aim of a primary prevention of coronary artery disease and a reduction of cardiovascular mortality is critically reviewed. The arguments brought forward in favor of such interventions are frequently flawed by methodological shortcomings. Quite often, descriptive associations are taken as proofs of causal relationship--or results of prospective studies on selected cohorts are extrapolated to the general population without justification. For adolescents, women, and persons above 60 years of age (i.e., for the majority of the population) there is actually no evidence in favor of initiatives to screen for and generally lower serum cholesterol levels. Even for middle-aged men, lowering of hypercholesterolemia in an attempt of primary prevention of coronary heart disease was not followed by the expected decrease in overall mortality. A public discussion of the apparent cholesterol non-consensus is urgently needed in Germany in order to protect both the population, as well as the reputation of the medical profession against unjustified health campaigns.

Cause of Death↗
PubMed1993

[Significance of historical and current hallucinogenic research in psychiatry].

Research in experimental psychosis has a long tradition extending through several stages. With the world wide abuse of psychoactive substances it came to an abrupt end. Systematic questions within this framework of research are still unresolved, and research on newly developed compounds is almost completely lacking. A review of the pharmacological and psychological effects of various psychoactive agents is provided, and results of recent experimental studies on arylalkylamines are discussed. It is argued that from a systematic as well as from a methodological viewpoint the traditional approach of experimental psychosis represents a valuable tool in psychiatric research.

3,4-Methylenedioxyamphetamine↗
PubMed1992

Right-sided endocarditis in intravenous drug users. Prognostic features in 102 episodes.

OBJECTIVE: To describe the clinical, laboratory, and echocardiographic findings in a large group of patients with right-sided endocarditis and to determine whether any of these findings is predictive of prognosis. DESIGN: Retrospective survey of medical records to evaluate the course of hospitalization with follow-up on 6-month survival. Review of two-dimensional echocardiograms by an observer blinded to clinical information. SETTING: Large, metropolitan, voluntary hospital. PATIENTS: One hundred twenty-one intravenous drug users with clinical and bacteriologic evidence of 132 episodes of endocarditis. The presence of a right-sided valvular vegetation detected by two-dimensional echocardiography was required for entry into the study. MEASUREMENTS AND RESULTS: Staphylococcus aureus was the most common infecting organism (82%, 108 of 132). Vegetations involved the tricuspid valve in 127 episodes, the pulmonic in 4, and both in 1; they ranged in size from 0.4 to 4.3 cm (mean, 1.5 +/- 0.7 cm). Vegetations greater than 1.0 cm were present in 106 cases (80%). Among patients with isolated native right-sided endocarditis who reached a definite end point in treatment, mortality was 7% (7 of 98). Vegetations greater than 2.0 cm were associated with a significantly higher mortality compared with vegetations of 2.0 cm or less (33% compared with 1.3%, P less than 0.001). CONCLUSIONS: Overall, right-sided endocarditis has a favorable prognosis. Although complications and prolonged fever are common, most cases respond to medical therapy. Our findings suggest that vegetation size may be an important predictor of outcome and that vegetations greater than 2.0 cm are associated with increased mortality.

Adolescent↗
PubMed1992

Photooxidation of d(TpG) by phthalocyanines and riboflavin. Isolation and characterization of dinucleoside monophosphates containing the 4R* and 4S* diastereoisomers of 4,8-dihydro-4-hydroxy-8-oxo-2'-deoxy-guanosine.

Phthalocyanine mediated photosensitization of 2'-deoxyguanosine (dG) in oxygen saturated aqueous solution has previously been shown to result in the addition of molecular oxygen to the guanine base generating the 4R* and 4S* diastereoisomers of 4,8-dihydro-4-hydroxy-8-oxo-2'-deoxyguanosine (dO) (the asterisk denotes unambiguous assignment of the 4R and 4S diastereoisomers). The data presented here show that the same guanine modified bases are generated in a 1:1 ratio when thymidylyl-(3',5')-2'-deoxyguanosine (d(TpG)) is similarly photo-oxidized. These modified dinucleoside monophosphates, labelled d(TpO)-A and -B, have been isolated by high performance liquid chromatography and characterized by proton NMR spectrometry, fast atom bombardment mass spectrometry, and enzymatic digestions. Photosensitization in D2O instead of H2O leads to an increase in the rate of d(TpO) formation that is consistent with a type II (singlet oxygen) reaction mechanism. Three interesting properties of these modified dinucleoside monophosphates are: i) the rate of their digestion with spleen phosphodiesterase is greatly reduced relative to d(TpG), ii) they are not digested by snake venom phosphodiesterase, and iii) they are stable to 1.0 M piperidine at 90 degrees C for 30 min. The latter observation indicates that 4,8-dihydro-4-hydroxy-8-oxoguanine is not a base lesion responsible for the strand breaks observed following hot piperidine treatment of DNA exposed to type II photosensitizers or chemically generated singlet oxygen.

Chromatography, High Pressure Liquid↗