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Biomedical subjects

M Berger

Publications and source records attributed to M Berger.

At least 469 records · Page 26Linked to original sources
PubMed1992

Hypertrophic obstructive cardiomyopathy presenting with profound hypotension. Role of two-dimensional and Doppler echocardiography in diagnosis and management.

Five patients, all women, age ranges 59 to 84 years, with underlying hypertrophic obstructive cardiomyopathy (HOCM) presented with profound hypotension. Initial clinical and hemodynamic evaluation suggested cardiogenic shock in two cases, acute myocardial ischemia in two cases, and hypovolemia in one case. The two patients thought to be in cardiogenic shock were given inotropes without improvement. One patient in whom myocardial ischemia was suspected received nitroglycerin, followed by a marked fall in blood pressure. All five patients remained hypotensive until two-dimensional and Doppler echocardiography were performed, identifying HOCM as the cause of the hypotension, thereby allowing for corrective therapeutic measures.

Aged↗
PubMed1992

Large pericardial effusions in the acquired immunodeficiency syndrome.

The increasing importance of the acquired immunodeficiency syndrome (AIDS) as a cause of large, clinically significant pericardial effusions has not been well documented. To determine the frequency and characteristics of large AIDS-associated pericardial effusions, we reviewed the records of 50 consecutive patients undergoing pericardiocentesis between 1985 and 1990; AIDS was the most common underlying illness and was present in 14 patients (28 percent). The pericardial fluid was diagnostic in three (21 percent) of the 14 cases (one bacterial, one positive for acid-fast bacilli, and one lymphoma). Of the 11 patients with nondiagnostic fluid, one underwent a pericardial biopsy which revealed granuloma consistent with mycobacterial disease, four had active pulmonary tuberculosis (TB), and two responded clinically to anti-TB therapy. Thus, in 8 (57 percent) of the 14 patients with AIDS, there was either definitive or suggestive evidence of mycobacterial disease. We conclude that AIDS is now a common underlying illness associated with large pericardial effusions and that mycobacterial disease may frequently be the etiology.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Movement analysis with microgravitation: theory and practical aspects for the calculation of target movements with the MONIMIR helmet lamp].

A new optoelectronic system for movement analysis is introduced. This equipment was employed with success during an Austrian-Soviet space flight. The method for the determination of position and orientation is described with the aid of an example, namely the determination of the location of the intersection of a beam of light generated by a helmet-mounted lamp with a screen.

Electrooculography↗
PubMed1992

Normal blood pressure in patients with insulinoma despite hyperinsulinemia and insulin resistance.

This article examines the relationship between blood pressure and serum insulin patients with endogenous hyperinsulinemia due to insulinomas. The hypothesis that hyperinsulinemia is an independent causal factor in the development of essential hypertension in this patient population was investigated. Inappropriately high plasma concentrations of insulin and proinsulin were found in these patients; however, their blood pressure levels did not differ from those of normal control subjects. Moreover, the surgical removal of the insulinomas did not reduce their blood pressure. Therefore, these findings argue against the hypothesis that hyperinsulinemia is an independent causal factor in the development of essential hypertension in humans.

Blood Pressure↗
PubMed1992

Severe hypoglycemia incidence and predisposing factors in 85 pregnancies of type I diabetic women.

OBJECTIVE: To evaluate the incidence and predisposing factors of severe hypoglycemia (SH) in pregnant women with insulin-dependent (type I) diabetes mellitus. RESEARCH DESIGN AND METHODS: SH (impairment of consciousness due to hypoglycemia subsequently treated with glucagon or i.v. glucose) was recorded in all pregnant type I diabetic women (n = 77) who attended our pregnancy clinic during 85 pregnancies from 1986 to 1990. RESULTS: Ninety-four SHs were reported during 35 pregnancies. Of 94 SHs, 84% occurred before the 20th gestational wk (median 12th wk) and 77% during sleep. In the group with SH, there was no permanent maternal sequelae, and there was a favorable fetal outcome (no perinatal death and no congenital malformation). Mean HbA1c values were not different between the group with and without SH for the first half (6.4 +/- 1.1 vs. 6.3 +/- 0.9%) and 2nd half (5.4 +/- 0.6 vs. 5.5 +/- 0.7%) of pregnancy. The percentage of women with SH before pregnancy (51 vs. 28%, P less than 0.05) and the incidence of SH patients before pregnancy (0.49 vs. 0.08 SH/patient/yr) was different between the group with and without SH. CONCLUSIONS: SH is frequent during pregnancies of type I diabetic women with near normoglycemia. The risk for SH is particularly pronounced during the first half of pregnancy and in women with a history of SH.

Adult↗
PubMed1992

Effects of antihypertensive treatment with beta-blockers on glucose metabolism.

The beneficial effects of beta-blockers on morbidity and mortality in both essential hypertension and diabetes mellitus have been demonstrated in several antihypertensive trial. Recently, negative side effects of beta-blockers on glucose metabolism have been suggested that could limit their wide-spread use. However, on detailed analysis, any side effects of beta 1-selective beta-blockers on glucose metabolism do not appear to be relevant for clinical practice and hence do not restrict the use of these agents as first-line antihypertensive drugs in diabetic and nondiabetic patients.

Adrenergic beta-Antagonists↗
PubMed1992

Photosensitized formation of 8-hydroxyguanine (7,8-dihydro-8-oxoguanine) in DNA by riboflavin.

Potosensitized formation of 8-hydroxyguanine in DNA by riboflavin was observed. A reaction mechanism involving guanine radical cation and hydration reaction was proposed. This hypothesis was confirmed by the incorporation of [18O]-atom within guanine moiety in isotopic experiments using [18O]-H2O. Photosensitized formation of oh8Gua by riboflavin was also observed in cellular DNA.

Animals↗
PubMed1992

[Epididymitis disclosing an idiopathic urethroseminal reflux in children].

Idiopathic urethroseminal reflux is exceptional in children. In both of our cases, it presented in the form of epididymitis and was confirmed by suprapubic cystography, which also eliminated an obstructive cause and any associated malformations. Long-term antiseptic treatment prevented recurrent infections.

Child↗
PubMed1992

Risk of obesity in type II diabetes mellitus.

The obvious syntropy of obesity and type II (non-insulin dependent) diabetes mellitus has always suggested a causal inter-relationship between the two diseases. However, the actual pathophysiological connection still remains to be elucidated. Recent findings have suggested that insulin resistance and hyperinsulinaemia might link glucose intolerance/type II diabetes mellitus, hypertension and hyperlipoproteinaemia in the context of a hypothetical 'syndrome X' characterized by an excessive risk constellation for the development of atherosclerosis. However, as to the practical consequences of the ('diabesity') syndrome of type II diabetes mellitus and structured programmes for effective therapy, very little new information has been gathered during the past 100 years.

Diabetes Mellitus↗
PubMed1992

Are CAT-scans necessary for preoperative localization of insulinomas?

OBJECTIVES: Do CAT-scans provide useful information in terms of preoperative localization of insulinomas after a biochemical diagnosis is established or may CAT-scan imaging be safely abandoned? PATIENTS AND METHODS: CAT-scan results from 30 consecutive patients between 1980-1990 with established insulinomas were retrospectively evaluated with regard to actual tumour size (volume) and identification and localization as verified during surgery. RESULTS: In all patients, the tumours were easily detected by manual palpation during surgery, although the size of 67% of the tumours (n = 20) was less than 2.5 cm3. In only 7 patients (23%) the tumour had been correctly localized by computer tomography. Detected tumours were significantly larger than undetected tumours (median size 5.3 vs 1.3 cm3; p < 0.005). CONCLUSION: Despite the low sensitivity of computer tomography as documented in this study, all patients with an insulinoma were definitely cured after surgical intervention. Thus, CAT-scans are neither necessary nor helpful for preoperative localization of insulinomas.

Adult↗
PubMed1992

Clinical application of two computerized diabetes management systems: comparison with the log-book method.

In two consecutive studies the clinical application and suitability of two computer-assisted data management systems (Camit and Cadmo) were evaluated in a prospective manner. In each study nineteen long-standing, stable insulin-dependent patients were randomly assigned to one of two groups. In study I assessment of metabolic control and insulin dose adjustments were based either on the Camit S1 data analysis or on the conventional log-book method, whereas in study II the Camit S2 and the Cadmo simulation programs were evaluated. HbA1c values decreased significantly in both studies (p < 0.05). A clear decline in hypoglycemic events as well as a significant reduction of the percentage of glucose values below 4.0 mmol/l (p < 0.005) and a marked increase (p < 0.05) in the percentage of glucose levels in the target range (4.0-10.0 mmol/l) were observed. We found both computerized assessment systems to be reliable and suitable for the assessment of blood glucose control and for insulin dose finding. The graphical and statistical presentation of the numerous glucose and insulin data allowed a better summary of blood glucose control and metabolic trends. More time could be spent for problem solving, which proved to be much less exhausting with the computer for the attending physician. Further studies should address the educational potential of computerized systems for the patient as well as for the physician.

Adult↗
PubMed1992

Detection of interleukin-6 and alpha 2-macroglobulin immunoreactivity in cortex and hippocampus of Alzheimer's disease patients.

We examined brains from Alzheimer's disease (AD) patients by immunohistochemistry for the presence of protease inhibitors. Immunoreactivity for alpha 2-macroglobulin (alpha 2-M), the most potent of the known human protease inhibitors, was found in a subgroup of cortical and hippocampal AD senile plaques. In addition, large hippocampal neurons in AD brains displayed intracellular alpha 2-M immunoreactivity which was consistently stronger than in normal aged brains. In cultured human cells of neurogenic origin (SH-SY5Y neuroblastoma cells), alpha 2-M synthesis could be strongly induced by the inflammatory cytokine interleukin-6 (IL-6) indicating that human alpha 2-M behaves as an acute-phase protein in the nervous system. Therefore, we also examined AD brains for the presence of IL-6 and found strong immunostaining in and around a subgroup of senile plaques as well as around large cortical neurons. Only very few senile plaques also stained for C-reactive protein, an acute phase protein known to be inducible by IL-6. We propose that the presence of IL-6 and alpha 2-M immunoreactivity in AD brains is functionally linked and that a sequence of immunological events is part of the pathology of AD.

Aged↗
PubMed1992

Timing between the subcutaneous administration of insulin and consumption of a carbohydrate rich meal.

There is considerable uncertainty as to the appropriate timing of preprandial injections of short acting insulin before consumption of a meal. 8 healthy male volunteers were subjected to a glucose clamp (glucose 4.2 mmol/l) by means of a continuous insulin infusion on two occasions. On each occasion the subjects ingested a standardized meal. Twelve units of short acting insulin were injected subcutaneously either immediately before (A) or 30 min prior to the meal (B). In a control study (C) only the meal was consumed. The maximal increment of insulin concentrations after sc injection was 53.1 (6.9) mU/l in A and 58.6 (5.1) mU/l in B and thus comparable to C (52.8 (4.7) mU/l), however it was reached 30 to 60 min later as compared to endogenous stimulation. Injection 30 min prior to meal resulted in higher insulin concentrations early after the meal, but the glucose infusion rate doubled to 5.3 (0.3) mg/kg/min before the meal in order to prevent hypoglycaemia. Omission of this time interval is less hazardous, but bears the risk of late postprandial hyperinsulinaemia.

Adult↗
PubMed1992

The effects of biperiden on nap sleep after sleep deprivation in depressed patients.

Sixteen patients with a major depressive disorder were allowed to take a nap at 5 A.M. after a period of total sleep deprivation. The patients were randomly assigned to biperiden or placebo treatment prior to the nap to test the hypothesis that anticholinergic medication is capable of preventing a nap-related worsening of mood. Total sleep deprivation positively influenced mood for the whole group. Contrary to expectations, the rate of nap-related relapses of mood did not differ between placebo- and biperiden-treated individuals, and biperiden did not significantly suppress rapid eye movement (REM) sleep. There was only a tendency for lower REM time after administration of biperiden compared to placebo. This unexpected result may be due to a high cholinergic tone in the patient group investigated and a high REM propensity in the early morning hours. Studies with more selective M1/M2 receptor antagonists are necessary to clarify whether nap-related changes of mood can be prevented by anticholinergic blockade.

Affect↗
PubMed1992

A modest proposal.

Explore the source record for details and available documents.

Economics, Medical↗