Quality assessment of isolated pancreatic rat islets by high-resolution respirometry.
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Animals↗
Biomedical subjects
M Fischer
Publications and source records attributed to M Fischer.
A life care community from three perspectives.
Changing societal supports, family structures, and an increasing number of affluent elders have altered the caring giving and receiving patterns for many middle-aged and older adults in the United States. Life care communities have been available for several decades, but only in the last two decades have they begun to flourish. The following report exemplifies some of the benefits and the concerns encountered in a life care community.
Aged↗
Raspberry ketone from submerged cultured cells of the basidiomycete Nidula niveo-tomentosa.
The basidiomycete Nidula niveo-tomentosa produced 4-(4-hydroxyphenyl)-butan-2-one (raspberry ketone), one of the character impact components of raspberry flavor, and its corresponding alcohol. A systematic attempt was made to improve the productivity of this fungus. Variation of nutrient medium composition, precursor amount, time of supplementation, and cultivation period yielded a 50-fold increase in metabolite concentrations. Raspberry ketone and alcohol were easily isolated from the culture medium by solvent extraction. Glycosidically bound forms or accumulation of raspberry compounds in fungal cells were not detected. This microbial process offers an alternative for the production of natural raspberry flavor.
Basidiomycota↗
Mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) chemotherapy for gynecological sarcomas.
This report summarizes our experience with the combination of mesna, doxorubicin, ifosfamide, and dacarbazine (MAID) for patients with gynecological sarcomas. We reviewed the records of all patients who had received the MAID regimen for a gynecological sarcoma between 1993 and 2000. The MAID regimen was administered intravenously every 4 weeks in the hospital as follows: (1) mesna 1500 mg/m2/day x 4 days; (2) doxorubicin 15 mg/m2/day x 3 days; (3) ifosfamide 1500 mg/m2/day x 3 days; (4) dacarbazine 250 mg/m2/day x 3 days. The results of treatment with MAID were disappointing. Overall, the response rate was 9% with one complete response and one partial response (both in patients with uterine leiomyosarcoma). We did not observe any responses among the patients with carcinosarcomas of either ovarian or uterine origin. The median progression-free interval and survival were 11 months and 29 months, respectively. This regimen was associated with substantial toxicity (including a death from neutropenic sepsis) as well as high cost and inconvenience due to the requirement for inpatient administration. Although our study contains a limited number of patients with a variety of gynecological sarcomas, our review has led us to discontinue using MAID. It remains to be established if any combination chemotherapy regimen is better than single agent treatment.
Adult↗
Cutis marmorata telangiectatica congenita: laser doppler fluxmetry evidence for a functional nervous defect.
We report a 5-month-old infant with cutis marmorata telangiectatica congenita (CMTC) without associated abnormalities and unusual hemicorporal vascular markings. Laser Doppler fluxmetry of the involved skin, carried out for the first time, and the measurement of the transcutaneous partial pressure of oxygen indicate a functional disturbance, which may be the expression of an alpha-adrenergic innervation deficit of the cutaneous terminal blood vessels.
Female↗
[Severe drug-related skin reaction: toxic epidermal necrolysis caused by carbamazepine].
BACKGROUND: Drug-related skin reactions often present as macular, maculopapular or urticarial rashes. Severe drug eruptions are rare, with life-threatening events occurring in about 4 per one million persons a year. In pediatric patients the estimated incidence of Stevens-Johnsons-syndrome (SJS) and toxic epidermal necrolysis (TEN) is even lower. They are often caused by antiepileptic drugs like carbamazepine. CASE REPORT: A 10 (5)/ (12) year old boy of dark complexion suddenly developed a severe bullous skin disease six weeks after starting carbamazepine therapy due to focal epilepsy. Within few hours a life-threatening systemic inflammatory reaction occurred with subsequent respiratory failure. The clinical course was complicated by bacterial sepsis, bilateral thrombosis of the external iliacal veins and bilateral ocular symblephara. The skin healed with considerable pigmentary disturbance. We report the differential diagnostic and therapeutical features of toxic epidermal necrolysis and give a review of the literature.
Anti-Bacterial Agents↗
[Initial experiences in the treatment of children with metastatic and recurrent neuroblastoma using meta-iodobenzylguanidine].
At four involved hospitals 16 children were treated with Metaiodobenzylguanidine (131J-MIBG). These children had a relapse of neuroblastoma stage III or IV or did not respond sufficiently to chemotherapy. In 10 children extreme bone pain disappeared and they became free of fever during the MIBG-treatment. 10 children responded to the therapy demonstrated either by decrease of the solid tumor part or by decrease of catecholamines in urine or plasma or by decrease of bone-marrow involvement. One patient reached a complete remission continuing up to present time (longer than 180 days). 9 patients died meanwhile of tumor progression. 131J-MIBG is an effective instrument, to get a decrease of the tumor up to a complete remission in extensively pretreated patients with tumor relapse, which are refractory to chemotherapy.
3-Iodobenzylguanidine↗
[131(I)-meta-iodobenzylguanidine treatment of 32 children with therapy-refractory neuroblastoma].
The selective uptake and accumulation of 131J-Metaiodobenzylguanidine in neuroblastoma cells in vivo may be utilized for targeted irradiation. The experience with 32 neuroblastoma patients refractory to conventional high dose chemotherapy is reported. At diagnosis 8 patients had Evans stage III and 22 stage IV. 11/32 experienced recurrences after complete tumor disappearance and before mIBG treatment, 16/32 progressed from residual or nonresponding tumor and in 3/32 insufficient tumor regression by chemotherapy was observed. 2 children received one mIBG course each with no evidence of disease. Mean applied activity was 128 mCi per course (35-300 mCi), 360 mCi per patient (80-1033 mCi) and 19.2 mCi/kg per patient (3.2-37.9 mCi/kg), respectively. A total of 84 courses was given (mean 2.6 per patient). Pain relief was noticed in 14/14 patients with bone pain. Complete or very good partial remission was achieved in 5/32, partial remission in 11/32 and stable disease in 6/32 patients. In 8 children progression occurred and 2 patients were not evoluable. 20 children died, 12 are still alive (6 patients with initial stage IV, 6 with stage III disease). Main side effect was transient thrombocytopenia, which became more severe with increasing number of courses. We conclude that mIBG treatment is effective in some patients with refractory neuroblastoma and may be utilized in the future as front line therapy for patients achieving only incomplete regressions after high dose chemotherapy.
3-Iodobenzylguanidine↗
Mental retardation in Turner's syndrome.
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Adult↗
Aquaporins in plants.
Although very often exposed to a rapid changing environment, plants are in general unable to evade from unfavourable conditions. Therefore, a fine tuned adaptation of physiology including the water balance appears to be of crucial importance. As a consequence a relatively large number of aquaporin genes are present in plant genomes. So far aquaporins in plants were shown to be involved in root water uptake, reproduction or photosynthesis. Accordingly, plant aquaporin classification as simple water pores has changed corresponding to their molecular function into channels permeable for water, small solutes and/or gases. An adjustment of the respective physiological process could be achieved by regulation mechanisms, which range from post-translational modification, molecular trafficking to heteromerization of aquaporin isoforms. Here the function of the four plant aquaporin family subclasses with regard to substrate specificity, regulation and physiological relevance is described.
Ammonia↗
Perforation of the posterior tracheal wall during percutaneous dilatational tracheotomy.
Dilatative percutaneous tracheotomy is more and more indicated in intensive-care medicine. We report on the perforation of the posterior tracheal wall observed in 3 patients after this procedure. In 2 patients the tracheo-oesophageal fistula was closed by the use of a pediculated flap from the infrahyoideal muscle. The third patient died due to the underlying disease. As demonstrated by the 3 cases reported here, this complication cannot be avoided in every case neither by the use of an endoscope nor by extensive personal experience of the physician. The possibility of this complication should be known, because it seems to be typical of this procedure. In the case of perforation of the posterior tracheal wall, active surgical treatment seems to be a successful method to deal with this complication.
Adolescent↗
Combined physical therapy for lymphedema evaluated by fluorescence microlymphography and lymph capillary pressure measurements.
The treatment of patients with lymphedema is still controversial. Combined physical therapy with manual lymph drainage and compression therapy is most frequently used to reduce lymphatic leg swelling. However, objective evidence is rare that this empirical form of treatment has a scientific basis. In a prospective study fluorescence microlymphography and pressure measurements in cutaneous lymph capillaries were used to assess objectively the effect of combined decongestive physical therapy on abnormal microlymphatic dynamics in lymphedema. 12 patients with primary and secondary lymphedema were studied before treatment, after 2 weeks of intensive physical therapy and 3 months of continuing compression and ergotherapy. After 2 weeks of intensive manual lymph drainage and compression bandaging (phase 1) microlymphatic hypertension (12.8 +/- 5.7 mm Hg) was significantly (p = 0.01) reduced to a mean lymph capillary pressure of 5.9 +/- 4.5 mm Hg. More than 3 months later after continuing compression lymph capillary pressure (3.2 +/- 5.2 mm Hg) was still significantly (p = 0.03) reduced. Simultaneously the maximum spread of the fluorescent contrast medium in the superficial lymph capillary network decreased significantly (p = 0.01) from 21.3 +/- 14.3 to 11.3 +/- 4.8 mm. Accordingly the clinical condition improved, and the mean circumferences of the forefoot and ankle were significantly (p < 0.05) reduced. Combined decongestive physical therapy is an effective treatment for lymphedema which results in a normalization of microlymphatic hypertension and an improvement of the clinical appearance.
Adult↗
Simultaneous assessment of muscle and skin blood fluxes with the laser-Doppler technique.
The laser-Doppler technique was used to assess local muscle and skin blood fluxes at the lower limb in 20 healthy volunteers. After puncturing the anterior tibial muscle with a steel cannula, a single-fibre probe with a diameter of 0.5 mm was inserted into the muscle. Simultaneously, the skin blood flux was measured at calf and foot. The muscle blood flux at rest was 3.5 to 4 times higher than the skin blood flux at calf or foot. The spatial variability of the muscle blood flux at three different sites of measurement was considerable and tended to be higher than in the skin of the calf. After an arterial occlusion lasting 3 min, peak flux was reached in the muscle after 18.7 +/- 9.8 s, in the skin of the calf after 16.8 +/- 9.3 s, and in the skin of the foot after 22.9 +/- 14.6 s (NS). The relative flux increase during reactive hyperaemia was significantly lower in the muscle (2.7 +/- 1.3) than in the skin of the calf (3.9 +/- 1.9; p<0.05) or the foot (5.1 +/- 3.5; p<0.005). The reproducibility of reactive hyperaemia response in muscle was excellent with unchanged probe position, but exhibited a marked variability on different days. The laser-Doppler technique provides the possibility for simultaneous measurement of flow dynamics in muscle and skin with a high temporal resolution. Methodological problems include differences in probe geometry of the single-fibre compared to standard probes and differences in optical properties of the tissues. Direct comparison of flux values may, therefore, be subject to criticism, but not the comparative analysis of relative flux changes. The influence of tissue trauma on muscle blood flux has to be considered for the analysis of flux data.
Adult↗
Flow velocity of cutaneous lymphatic capillaries in patients with primary lymphedema.
For the first time measurements of lymph flow velocities in cutaneous microlymphatics of patients with lymphedema were performed and compared with healthy subjects. Flow velocity in single lymphatic skin capillaries was measured using fluorescence video microscopy after subepidermal microinjection of FITC-dextran 150,000 in 15 healthy volunteers and 16 patients with primary lymphedema. Initial filling of the lymphatic capillary network was fast with significantly higher mean velocities in patients with primary lymphedema than in healthy controls (890 +/- 43 vs. 550 +/- 390 microns/s, p < 0.05). The resting velocities were not significantly different between controls and patients (10.3 +/- 4.1 vs. 16.6 +/- 13.9 microns). In 12 out of the 16 lymphedema patients cutaneous backflow of the fluorescent contrast medium from deeper invisible lymphatics was observed. In 4 of these patients rhythmic reflux with a mean frequency of 1.4 +/- 0.5 cycles/min was measured by video densitometry in microlymphatics with a significantly (p < 0.01) enhanced diameter. Mean flow velocity (Vp) in these precollectors was significantly increased compared to the resting velocities (p < 0.01). On the basis of these results the hypothesis is advanced that rhythmic cutaneous backflow originates from intrinsic contractions of deeper lymph collector segments and is transmitted to the superficial microlymphatics through incompetent connecting channels. This newly recognized mechanism appears to be an important factor for the pathophysiology of lymphedema.
Adult↗
Comparison of a new automated kinetically determined fibrinogen assay with the 3 most used fibrinogen assays (functional, derived and nephelometric) in Austrian laboratories in several clinical populations and healthy controls.
A new automated kinetically determined fibrinogen assay was measured in plasmas of healthy subjects and three clinical cohorts (acute-phase reaction, liver cirrhosis and fibrinolytic therapy) that were expected to show normal, high and low levels of fibrinogen. The results were compared with the results of fibrinogen measurement using the derived method, the method according to Clauss and an immunological-nephelometric method. Altogether, the best correlation was achieved between the kinetic and the derived method. However, results from the derived method were generally higher than values obtained through the kinetic method. This was particularly true for high concentration levels above 400 mg/dl (patients with acute phase reaction) as well as for plasmas containing fibrin(ogen) degradation products and low concentrations of fibrinogen (below 150 mg/dl). Fibrinogen determinations in several commercial plasma pools with declared fibrinogen levels show remarkable heterogeneity when different methods were applied. To improve the discernment of fibrinogen determinations we suggest adjustment of standard preparations to international reference materials and the specification of the method used. Furthermore the attending physician is asked to cast a critical eye on fibrinogen values with regard to the used method of determination.
Acute-Phase Reaction↗
Comparison of a new automated kinetically determined fibrinogen assay.
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Blood Chemical Analysis↗
Influence of contralateral obstructions on Doppler-frequency spectral analysis of ipsilateral stenoses of the carotid arteries.
Contralateral obstructions have been suggested to be responsible for inaccuracy in Doppler sonographic diagnosis and estimation of severity of internal carotid artery stenoses. Therefore correlations of the systolic peak frequency of the internal carotid artery (Doppler-Frequency-Spectrum-Analysis) and severity of stenoses found by angiography have been compared in subgroups with (n = 36) and without (n = 48) additional contralateral obstructions. The linear regressions in both subgroups were found to be very similar (Y = 0.0098X - 12.4 and Y = 0.0099X - 14.0), the coefficients of correlation identical (r = 0.83). In 26 patients, the systolic peak frequency of the internal carotid artery did not demonstrate a significant change due to operation of the contralateral vascular lesion; thus indicating that contralateral obstructions do not influence CW-Doppler sonographic findings of an ipsilateral vessel wall lesion concerning diagnostic accuracy and non-invasive estimation of the severity of stenoses.
Arterial Occlusive Diseases↗
Reproducibility of carotid artery Doppler frequency measurements.
Doppler sonography of 29 extracranial carotid arteries was performed twice within three days or less. Angiography revealed stenoses with from 10 to 95% diameter reduction in 25 internal carotid arteries whereas four vessels were found to be normal. The systolic peak frequency of the internal carotid artery read from the Doppler spectrum (n = 29) could be reproduced very well. This was shown by a linear regression nearest the line of identical values with a coefficient of correlation r = 0.97 (p less than 0.001). Other values derived from the spectral analysis of the Doppler shift signal were not so well reproduced including the peak frequency ratio (systolic peak frequency of the internal carotid artery/systolic peak of the common carotid artery) (n = 22; r = 0.81; p less than 0.001). The mean frequencies read from the zero-crossing detector recordings (n = 20) could not be reproduced as demonstrated by a linear regression far away from the line of identical measurements with a coefficient of correlation r = 0.43 (p less than 0.05).
Arterial Occlusive Diseases↗