Search PubMed⌕ Search

Biomedical subjects

M Fischer

Publications and source records attributed to M Fischer.

At least 487 records · Page 27Linked to original sources
PubMed1991

Regulation of thymocyte proliferation by alpha beta TcR+ CD3+ CD4- CD8- cloned natural suppressor (NS) cells.

Cloned alpha beta TcR+ CD3+ CD4- CD8- T cells, with natural suppressor (NS) activity, were cocultured with thymocytes in the presence or absence of mitogen or cytokines. Whereas thymocytes show a minimal response to phytohemagglutinin (PHA), IL-2, or IL-4 alone, they proliferate vigorously when cocultured with irradiated cloned NS cells in the presence of PHA or IL-2 or IL-4, but not with IL-1, IL-3, IL-6, IL-7, IFN-gamma, or GM-CSF. Among a total of 11 NS cell clones, derived from the spleen or thymus, only one clone (NR-1) did not induce thymocyte activation in synergy with PHA. This costimulation is most likely mediated by soluble factor(s), since supernatants, obtained from NS cells activated with phorbol ester (PMA) and calcymicin (A23187) or with solid phase anti-CD3 mAb, enhance thymocyte DNA synthesis in the presence of a mixture of PHA, IL-2, and IL-4. The latter factor does not appear to be a previously described lymphokine, since PMA- and A23187-activated NS cells secrete IL-3, TGF-beta, IFN-gamma, GM-CSF, and TNF-alpha, but not IL-1, IL-2, IL-4, IL-5, IL-6, IL-7, nor IL-10. None of the factors, identified in the NS cell supernatants, was able to stimulate thymocyte DNA synthesis. This study shows that, in addition to their previously reported suppressor function, cloned NS cells can exert immunostimulatory activities by virtue of a soluble mediator.

Animals↗
PubMed1991

A randomised controlled trial to evaluate the effects of flumazenil after midazolam premedication in outpatients undergoing colonoscopy.

The degree of sedation and amnesia, subjective assessment of awakening and side effects after intravenous injection of 3-4 mg midazolam and 1 mg flumazenil or placebo were studied directly after colonoscopy, and on the first and the eight day. A total of 91 patients were studied; 45 patients were given flumazenil and 46 patients a placebo. Five minutes after injection of the test drugs all 45 patients given flumazenil but only 38 patients given the placebo were alert (p = 0.006). All three response criteria (for sedation, amnesia and subjective assessment of awakening) were fulfilled by 84.4% of the patients given flumazenil and 45.7% of the patients given the placebo (p = 0.0002). Thirty minutes after injection of the test drugs dizziness, nausea, and fatigue were found in 3 patients given flumazenil and in 10 patients given placebo. One day after colonoscopy 9 of 45 patients (20%) given midazolam and flumazenil complained of fatigue and 9 of 46 patients (19.5%) given midazolam and placebo. Eight days (+/- 1 day) later two patients in each group complained of headache, nausea and fatigue. No patient developed phlebitis at the injection site. Flumazenil seems to be a safe and efficient drug for reversing the sedative effect of midazolam, premedication after colonoscopy. However, resedation due to the effects of midazolam may occur. Flumazenil thus permits administration of a higher dose of midazolam without prolongation of the surveillance time. Improved exploitation of time, space and nursing resources is thus possible without jeopardizing patient safety, although caution is necessary since patients may not be fit to resume all normal activities.

Adolescent↗
PubMed1991

Naftifine treatment of resistant dermatophytosis.

Despite an array of topical and systemic antifungal agents, cases of resistant dermatophytosis still exist. Use of naftifine, the first commercially available allylamine derivative, proved successful in the management of four such cases.

Administration, Cutaneous↗
PubMed1991

The adolescent outcome of hyperactive children diagnosed by research criteria--III. Mother-child interactions, family conflicts and maternal psychopathology.

The present study reports the results of a prospective, 8-year follow-up study of 100 hyperactive and 60 normal children followed from childhood into adolescence. Ratings of child behavior problems and family conflicts as well as direct observations of mother-child interactions were taken in childhood and again at adolescent follow-up. At outcome, hyperactives continued to have more conduct and learning problems and to be more hyperactive, inattentive, and impulsive than controls. Hyperactives were also rated by their mothers as having more numerous and intense family conflicts than the normal controls, although the adolescents in both groups did not differ in their own ratings of these conflicts. Observations of mother-adolescent interactions at outcome found the hyperactive dyads displaying more negative and controlling behaviors and less positive and facilitating behaviors towards each other than in the normal dyads. These interaction patterns were significantly related to similar patterns in mother-child interactions observed 8 years earlier. Mothers of hyperactives also reported more personal psychological distress than normal mothers at outcome. Further analyses of subgroups of hyperactives at outcome, formed on the presence or absence of ADHD and oppositional defiant disorder (ODD), indicated that the presence of ODD accounted for most of the differences between hyperactives and normals on the interaction measures, ratings of home conflicts, and ratings of maternal psychological distress. Results suggest that the development and maintenance of ODD into adolescence in hyperactive children is strongly associated with aggression and negative parent-child interactions in childhood.

Achievement↗
PubMed1991

Complete androgen deprivation prior to radical prostatectomy in patients with stage T3 cancer of the prostate.

Twenty-one patients with stage T3 cancer of the prostate underwent complete androgen deprivation (LH-RH agonist and flutamide) for 3 months prior to radical prostatectomy. Two problems were to be dealt with: the decrease in the volume of the prostate, and the possibility of downstaging (= pT less than pT3 according to the UICC 1987 classification) of the prostatic cancer. A decrease in the volume was noted in each case. A downstaging effect (pT in comparison to T stage) was noted in 33% of the patients. The downstaging effect was noted in 75% of grade 1 tumor, in 31% of grade 2 tumors, but not in grade 3 tumors.

Aged↗
PubMed1991

Recombinant human superoxide dismutases: production and potential therapeutical uses.

In many pathological situations, tissue damage is caused by cellular generation of superoxide free radicals (O2-). These active species are generated during post-ischemic reperfusion of organs, in hyperoxic tissue, during acute and chronic inflammation and during exposure to ionizing radiation. Exogenous superoxide dismutase (SOD) was shown to significantly prevent such damage. The genes for human cytosolic Cu/ZnSOD and mitochondrial MnSOD were cloned and introduced into an E. coli expression system. The proteins were expressed in high yields and purified to homogeneity, yielding pharmaceutical-grade materials. These enzymes were used in a variety of in vivo animal models for the demonstration of their protective effects against oxidative damage. Comparative pharmacokinetic studies in rats have revealed that the half-life of Cu/ZnSOD was 6-10 min., while that of MnSOD was 5-6 hours, thus indicating that MnSOD may be superior to Cu/ZnSOD for the treatment of chronic diseases. Indeed, MnSOD was found to be effective as an anti-inflammatory agent in the rat carrageenan induced paw edema acute inflammation model. Both enzymes were also effective in ameliorating post-irradiation damage in mice exposed to whole-body or localized chest X-ray radiation.

Animals↗
PubMed1991

[Ruptured aneurysm of the lienalis artery as a cause of acute abdomen. Case report and review of the literature].

The case of a 82-year-old lady with acute abdominal pain is reported. Intraoperatively we find a ruptured aneurysm of the splenic artery. Splenectomy with resection of the aneurysm is performed. An overview of the newer literature is presented. Epidemiology, etiology, clinical findings, diagnosis, prognosis and treatment of splenic artery aneurysms are discussed.

Abdomen, Acute↗
PubMed1991

[Statistical meta-analysis of multicenter clinical studies of ibuprofen with regard to cohort size].

The metaanalysis can be either understood as a confirmatory analysis, i.e., imposing a requirement for reproducibility, or it can be rated as a descriptive analysis. To derive confirmatory statements from the statistical metaanalysis of comparative studies, the same requirements prevail as for every individual clinical study: The statistical metaanalysis must be planned prospectively, operational target criteria must be specified ex ante, requirements for inclusion for the individual studies must be fulfilled (comparability of aim, design, inclusion and exclusion criteria, investigational methods of the individual studies). The statistical metaanalysis of comparative studies especially undergoes criticism then, when after inspection of the individual studies that show non-significant results, the summarization, i.e., the compilation of these individual studies leads to a significant overall result in the metaanalysis, which is possibly medically irrelevant. In addition to the metaanalysis, reviews or synopses of a preparation or a substance are also important, in which all available reports on a topic are taken into consideration for a summarizing medical assessment. The results of 28 comparative studies with ibuprofen in the treatment of osteoarthritis are classified in a synopsis. The results of these studies are classified as "ibuprofen better, ibuprofen worse, or ibuprofen equivalent to the respective reference substance". These results lead to the conclusion that ibuprofen at a daily dose of 1200 mg or more is superior to placebo, equivalent or superior to acetylsalicylic acid and, at an appropriate dosage, is comparable to other NSAIDs with regards to the efficacy. The tolerance of ibuprofen must be classified as excellent. The results of six non-comparative studies with ibuprofen carried out from 1985-1990, on a total of 45742 patients in 9115 study centers can be presented in a descriptive statistical metaanalysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Cohort Studies↗
PubMed1991

[Alternative vascular approaches in transluminal angioplasty of infra-inguinal arteries].

61 procedures using an alternative vascular access for PTA are reported. Puntures of mid and distal femoral arteries and popliteal arteries in antegrade as well as retrograde direction have been proven effective and sufficiently safe, when unfavourable anatomic situations did not allow the performance of a standard procedure. 14 cases necessitated puncture of and access via crural arteries.

Aged↗
PubMed1991

[Clinical and urodynamic results after various ileum neobladder procedures].

Urinary diversion after cystectomy in 15 male patients suffering from advanced transitional cell carcinoma of the bladder (pT-pT3b) was performed by ileal neobladder in different ways: S type n = 5, U type n = 3, J type n = 3 and W type n = 4. The perioperative mortality was nil, the overall complication rate 60%. The patients were followed up by means of regular urodynamic controls after 3, 6 and 12 months. After a median follow up period of 18 months (12-29) the J type and W type seem to be superior with regard to postoperative continence. All patients with W type neobladder are continent. The capacity of the neobladders varies from 200 to 800 ml; the W pouches have the highest capacity.

Aged↗
PubMed1991

Comparison of different types of cardioplegia and reperfusion on myocardial metabolism and free radical activity.

Current techniques of myocardial protection during global ischemia include hypothermia, cardioplegic arrest and controlled reperfusion. To compare different types of cardioplegia and reperfusion techniques we measured the levels of adenine nucleotides and malondialdehyde (MDA, as free radical activity) in 33 patients undergoing heart surgery. The patients were randomized in three groups according to the characteristics of cardioplegia and reperfusion: cold blood cardioplegia with unmodified blood reperfusion (control group, 11 patients), crystalloid cardioplegia and reperfusion (Hôpital Lariboisière protocol, 11 patients) and crystalloid cardioplegia with allopurinol enriched blood reperfusion (Hôpital Broussais protocol, 11 patients). Myocardial biopsy specimens were obtained before cardioplegic arrest (preischemic values), at the end of ischemia and after 30 minutes of reperfusion. Biopsy specimens were analyzed by high performance liquid chromatography for levels of adenine nucleotides and MDA. In the three groups, the preischemic values of adenine nucleotides and MDA were not significantly different. For AMP and ADP concentrations neither treatment nor biopsy-time effects appeared. ATP concentration decreased significantly with biopsy-time without specific treatment effect. For MDA concentration neither treatment nor biopsy-time effects were observed. This study suggests that there is no statistically significant difference between any of the three cardioplegia and reperfusion techniques for either ATP or MDA; the three reperfusion techniques limit the free radical activity but do not prevent the fall in high energy phosphates.

Adenine Nucleotides↗
PubMed1991

[Automation in the modern coagulation laboratory. Exemplified by the integration of the Microanalyser ACL 300].

We report on the organisation of our coagulation laboratory which had to meet the requirements of both, the large routine operations and those of a special laboratory for specific blood coagulation problems. A valuable support for the routine activities of our coagulation laboratory was the installation of 2 automated coagulation analysers, type ACL 300. Due to the selective (diagnosis/therapy) patient-related allotment of samples and the establishment of a final diagnosis according to a step-wise method it was possible to integrate the 2 ACL 300 analysers into our existing system and consequently to take full advantage of the savings in staff time. Moreover we report on the evaluation of the 1st ACL 300 (810) analyser and the specific characteristics of the ACL series.

Autoanalysis↗
PubMed1991

[Value of coronary reperfusion in cases of very low cardiac output following coronary artery bypass grafts].

From January 1986 to December 1988, 244 patients had a coronary artery revascularization at St Joseph Hospital. Four patients (1.8%) died in post operative time (less than 30 days). None died directly from cardiogenic shock. Five patients had a severe low cardiac output (2 h to 48 h post-op) and needed cardiac resuscitation. These patients were immediately taken to the operating room. The coronary bypasses were explored (2 technical errors corrected), the metabolic disorders were treated and a coronary reperfusion was done with the Buckberg's technique. All the patients could be weaned from cardiopulmonary bypass, two with intra aortic balloon pumping. One patient died of digestive complication the 10th postoperative day. The four other patients survived and are in good clinical condition. The severe low cardiac output after coronary revascularization can be reversible with resuscitation in operating room, short assistance, and coronary reperfusion.

Aged↗
PubMed1991

[Improvement in the prognosis of severe mediastinitis by the use of muscle flaps].

Between 1984 and 1988, 12 mediastinitis were observed in a series of 1.724 cases of cardiac surgical procedures by sternotomy (0.7%). These 12 patients were retrospectively separated in 2 groups in terms of surgical management. In group I (5 patients in 1984 and 1985) the treatment was mediastinal irrigation and in case of failure, an omental transposition. In group II (7 patients in 1986, 86 and 88) the treatment was mediastinal irrigation and in case of failure, a mobilization of muscle flaps. Four patients died in group I of poly-visceral failure with a persistent severe sepsis. In group II, there was no death and the cicatrization was quickly obtained with an average length of stay in intensive care unit of 62 days. The mediastinal irrigation is the treatment of choice for benign mediastinitis, but the prognosis of severe mediastinitis was in our series greatly improved by muscle flap procedures realized with plastic and reconstructive surgical techniques.

Cardiac Surgical Procedures↗
PubMed1991

[Terminology of ultrasound vascular diagnosis].

There is at present no accepted nomenclature regarding diagnostic vascular ultrasound. At two scientific meetings, the Study Group for Vascular Diagnosis of the German Society of Ultrasound in Medicine (DEGUM) developed a terminology for Doppler and duplex sonography of the arteries and veins supplying the brain and of peripheral vessels. The most important of these sonographic terms and their synonyms are presented. Recommendations as to which of the presently employed terms should be avoided, are given.

Blood Flow Velocity↗
PubMed1990

[Efficacy of Pygeum africanum extract in the medical therapy of urination disorders due to benign prostatic hyperplasia: evaluation of objective and subjective parameters. A placebo-controlled double-blind multicenter study].

The efficacy of an extract of Pygeum africanum in the treatment of micturitional disorders due to benign prostatic hyperplasia was tested in a multicentre double-blind trial versus placebo. Capsules containing 50 mg of Pygeum africanum extract or placebo were administered at a dosage of 1 capsule in the morning and 1 capsule in the evening over a period of 60 days. 263 patients were included in this study, which was carried out in 8 centres in Germany, France, and Austria. Evaluation was mainly based on quantitative parameters such as residual urine, uroflowmetry and the precise monitoring of diurnal and nocturnal pollakiuria. Treatment with the Pygeum africanum extract led to a marked clinical improvement: a comparison of the quantitative parameters showed a significant difference between the Pygeum africanum group and the placebo group with respect to therapeutic response. The characteristic subjective symptoms of micturitional disorders, which were evaluated by the patients in a qualitative manner, were also significantly improved by administration of Pygeum africanum extract. Overall assessment at the end of therapy, showed that micturition improved in 66% of the patients treated with Pygeum africanum extract, as compared with an improvement of 31% in the placebo group. The difference was significant at the statistical level of p less than 0.001. During therapy with Pygeum africanum extract, gastrointestinal side effects occurred in 5 patients. Treatment was discontinued in three of those cases.

Double-Blind Method↗