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Biomedical subjects

M Hauser

Publications and source records attributed to M Hauser.

At least 91 records · Page 5Linked to original sources
PubMed1997

Diabetic nephropathy. Comparison of conventional and duplex Doppler ultrasonographic findings.

BACKGROUND: The purposes of this study were: to compare conventional and duplex Doppler ultrasonography in the detection of renal changes in diabetes mellitus; to investigate whether a correlation was found with various clinical stages; and to assess whether increased renal vascular resistance in asymptomatic patients correlated with mild renal functional impairment. MATERIAL AND METHODS: In 190 diabetic patients and 85 controls, conventional ultrasonography was used to assess renal length, parenchymal thickness, and cortical echogenicity. Renal vascular resistance was estimated by duplex Doppler measurements of intrarenal arterial resistive indices. According to clinical stage, the patients were classified into 3 groups. Resistive indices were compared between controls and patient groups and correlated with age and renal function. RESULTS: In asymptomatic diabetic nephropathy, renal length and parenchymal thickness were significantly increased compared to that of controls, reflecting hyperfiltration-induced nephromegaly. Differences between controls and patients with clinically manifest nephropathy were insignificant; only in advanced renal disease were both values significantly decreased. Cortical hyperechogenicity was noted only in very advanced disease. Resistive indices correlated well with renal function, and pathologic values (i.e. > or = 0.70) were observed in 15% in the asymptomatic group and in 87% in the group with advanced nephropathy. CONCLUSION: Renal changes in diabetic patients are detectable by conventional ultrasound only in very advanced stages of the disease. Pathologic resistive indices, however, may be detected in the earlier stages. Resistive indices correlate with serum creatinine levels and creatinine clearance rates. However, it remains unclear as to whether a diagnostic or prognostic benefit can be expected as compared to standard laboratory examinations.

Adolescent↗
PubMed1997

Renal vascular resistance in autosomal dominant polycystic kidney disease. Evaluation with color Doppler ultrasound.

PURPOSE: The purpose of this study was to evaluate the performance of color duplex Doppler ultrasonography in the assessment of renal vascular resistance (RVR) by measuring resistive indices (RIs) and pulsatility indices (PIs) in patients with autosomal dominant polycystic kidney disease (ADPKD), and to correlate the measured values with renal function and the presence of arterial hypertension. MATERIAL AND METHODS: In 42 patients with ADPKD and 65 control subjects, RIs and PIs were measured by means of color duplex Doppler sonography and correlated with clinical and laboratory findings and with morphological abnormalities at B-mode ultrasonography. RESULTS: Mean RI in the control subjects was 0.59 +/- 0.03 (+/-SD) and in the patients 0.71 +/- 0.11, (p < 0.01). Mean PI in the controls was 1.00 +/- 0.11 and in the patients 1.69 +/- 0.21, (p < 0.01). Elevated RIs and PIs heralded a progression of ADPKD. Doppler indices correlated significantly with renal function tests and morphological changes in the affected kidneys at ultrasound. Significantly higher RIs (p < 0.01) and PIs (p < 0.04) were measured in hypertensive ADPKD patients as compared to normotensive patients. Correlation of patient age and Doppler indices did not reach statistical significance. CONCLUSION: Doppler indices do reflect the increased RVR in patients with ADPKD and they correlate with renal function disturbance, with the development of systemic arterial hypertension, and with ultrasonographic abnormality of the kidney in these subjects.

Adult↗
PubMed1997

Gynecological complaints and war traumas. A study from Zenica, Bosnia-Herzegovina during the war.

BACKGROUND: During the war in former Yugoslavia people endured great suffering. Although many had sought refuge in other countries, the majority remained within Bosnia-Herzegovina. Special service for women within the war zone was urgently needed. A Women's Therapy Center was established in Zenica, Bosnia-Herzegovina offering reproductive health services and psychosocial assistance. The aim of the study was to establish the most commonly occurring gynecological problems during different periods in the war and relate these to war traumas. METHODS: Information from 486 records of consecutive gynecological consultations in four different periods during in 1993/94 were retrospectively recorded. RESULTS: Vaginal discharge, pelvic pain, and amenorrhea were the most commonly occurring problems. A higher proportion of pregnant women requested legal abortion in the first period compared to later periods when the situation was improved. In 14 (3%) of the consultations a history of rape during the war was recorded. Additionally 42 (9%) had suffered from other types of war traumas. The reporting of war traumas was significantly related to suffering from pelvic pain (p < 0.05). CONCLUSIONS: The focus on the need of victims of rape during war has highlighted the need for reproductive services as part of emergency situations. The suffering of war traumas has to be taken into account in the handling of gynecological problems in this situation.

Abortion, Legal↗
PubMed1997

Non-small cell lung cancer: nodal staging with FDG PET versus CT with correlative lymph node mapping and sampling.

PURPOSE: To prospectively compare the accuracy of positron emission tomography (PET) with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) with that of computed tomography (CT) in the nodal staging of non-small cell lung cancer. MATERIALS AND METHODS: PET and contrast material-enhanced CT were performed in 47 patients suspected of having or with newly diagnosed non-small cell lung cancer. Each imaging study was evaluated separately, and nodal stations were localized according to the American Thoracic Society mapping system. Extensive lymph node sampling (599 nodes from 191 nodal stations) of the ipsi- and contralateral tracheobronchial and mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Imaging findings were correlated with histopathologic staging results. RESULTS: The sensitivity of PET and CT was 89% and 57%, respectively, for the staging of N2 or N3 disease in mediastinal nodes; specificity was 99% and 94%, respectively; positive predictive value was 96% and 76%, respectively; negative predictive value was 97% and 87%, respectively; and accuracy was 96% and 85%, respectively. In assigning the correct N stage, PET was correct in 96% and CT in 79% of cases. CONCLUSION: PET with FDG appears to be superior to CT for nodal staging of non-small cell lung cancer.

Adult↗
PubMed1997

Catamenial hemoptysis. Diagnosis with MRI.

Thoracic endometriosis is a rare disorder. We report a case of a 26-year-old woman with a 4-year history of catamenial hemoptysis due to thoracic endometriosis which was diagnosed by MRI and treated successfully by means of video-assisted thoracoscopic wedge-resection of the solitary pulmonary lesion. Medical therapy with hormones was not necessary. There is no evidence of recurrence 10 months after the operation. This case demonstrates that MRI of the chest may be considered for the diagnostic work-up of patients with catamenial hemoptysis. It also shows that wedge-resection of pulmonary endometriosis foci by means of video-assisted thoracoscopy-an approach that has not been described in the literature thus far-is an effective therapy in localized peripheral pulmonary parenchymal endometriosis.

Adult↗
PubMed1997

Lung herniation through a postthoracoscopy chest wall defect: demonstration with spiral CT.

The incidence of complications following thoracoscopy is approximately 10%, the most prevalent being prolonged air leak and chest pain. We report two cases of lung herniation through the chest wall defect created by thoracoscopy. Use of the Valsalva maneuver during CT scanning is recommended as a diagnostic imaging method in cases with suspected lung herniation.

Endoscopy↗
PubMed1997

Interactions between dystrophin and the sarcolemma membrane.

Dystrophin serves as a link between the subsarcolemmal cytoskeleton and the extracellular matrix. The NH2 terminus attaches to the cytoskeleton, while the COOH terminus attaches to the dystrophin associated protein (DAP) complex, which can be separated into the dystroglycan, sarcoglycan, and syntrophin subcomplexes. While the function of each DAP is not known, the dystroglycan complex binds laminin in the extracellular matrix, and binds the dystrophin COOH terminus in vitro. The syntrophins also bind the dystrophin COOH terminus in vitro, but no evidence has been reported for an interaction between dystrophin and the sarcoglycans. Human mutations have been found in dystrophin, the sarcoglycans and laminin, all of which lead to various types of muscular dystrophy. We have been studying the dystrophin domains necessary for formation of a functional complex by generating transgenic mdx (dystrophin minus) mice expressing internally truncated dystrophins. These mice provide in vivo models to study the localization of truncated dystrophin isoforms, the association of the truncated proteins with the DAP complex, and the functional capacity of the assembled DAP complexes. Expression of a dystrophin deleted for most of the NH2-terminal domain in mdx mice leads to only a mild dystrophy, indicating that dystrophin can attach to the cytoskeleton by multiple mechanisms. Truncation of the central rod domain leads to normal DAP complex formation and almost fully prevents development of dystrophy. Deletion analysis of the COOH-terminal regions indicates that a broad cysteine-rich domain is indispensable for dystrophin function. This region coincides with the in vitro identified beta-dystroglycan binding domain. Mice lacking this latter domain express very low levels of the sarcoglycans, indicating that the sarcoglycan complex binds dystrophin via dystroglycan. All deletion constructs tested lead to normal expression of the syntrophins, indicating that syntrophin associates with the DAP complex via multiple binding partners.

Actins↗
PubMed1997

Ortho-vanadate affects both the tyrosination/detyrosination state of spindle microtubules and the organization of XTH-2 spindles.

Mitotic spindles of a cultured endothelial cell line from Xenopus tadpole heart (XTH-2) contain distinct subsets of differentially stabilized microtubules (MTs) enriched in tyrosinated (Tyr) and in nontyrosinated (Glu) tubulin. Generally, the distribution of the more labile Tyr-MTs and of the Glu-MTs indicative for the more stable MT-subclass was remarkably different. During all mitotic stages the Tyr-staining of spindle fibers predominates, whereas the Glu-species was mainly restricted to the peripheral regions of half spindles where the MTs have to sustain a bending stress. Moreover, Glu-tubulin is enriched in prophase centrosomal areas, and, from metaphase on, exclusively also in the centrioles. Glu-positivity does not remain constant, instead, the intensity weakens from metaphase to telophase reflecting the decreasing MT nucleating capacity of the centrosomes. During the spindle cycle, the interzonal spindle at the anaphase-telophase transition exceeds all other stages in Glu-stainability and retains the high amount of detyrosinated MTs during telophase. External application of millimolar vanadate has different effects upon spindle components organization: First, additional assembly of Tyr-MTs together with a Glu-negative reaction of the centrioles was registered and, secondly, a drastic disarrangement of the Tyr-staining spindle fiber component became evident. At the onset of anaphase, an extreme spindle lengthening presumably due to the separation of the Tyr- and Glu-MTs occurred. Obviously, the Glu-spindle fibers were less affected and remained largely in their original spindle position. Redistribution of anti-dynein staining following vanadate incubation suggests a causal relationship between inhibition of dynein motor proteins and disarrangement of different microtubular spindle components. These results suggest that the changes in the spindle framework are at least partly due to malregulation of centrosomal phosphorylation events, respectively to inactivation of special cross-bridging proteins interacting between distinct MT-subsets by a phosphate mimicking effect of vanadate and finally, by a vanadate-induced displacement of polar asters.

Animals↗
PubMed1997

[Hemodynamic assessment of venous aneurysm of the lower leg and therapeutic consequences].

Based on the hemodynamic findings in patients with fusiform and saccular aneurysms, one can conclude that only cases with a saccular aneurysm will subsequently form parietal thrombi in the aneurysm that will bear the danger of pulmonary embolism. In fusiform aneurysms no disturbance of flow was noted. We have been comparing two patients from our institution with the current literature. As far as the treatment plan is concerned, it can be said that aneurysms with a history of thromboembolic complications and/or mural thrombi will undoubtedly be a strict indication for operative correction. The remainder of patients can be followed by means of color Doppler and duplex sonography.

Aneurysm↗
PubMed1996

[High-resolution computerized tomography of the lungs: bases, findings, indications].

High resolution computed tomography (HRCT) of the lungs uses thin-section CT (1- to 2-mm collimation scans) combined with a targeted reconstruction with a high-spatial frequency algorithm. HRCT is currently the most sensitive non-invasive imaging method for parenchymal and bronchoscopically inaccessible bronchial abnormalities of the lung. The following indications for HRCT of the pulmonary parenchyma are established: (1.) complementary examination in symptomatic patients with normal chest radiographs and/or normal pulmonary function testing; (2.) morphologic characterization of a nonspecific radiographic pattern; (3.) assessment of the activity and follow-up of a parenchymal disease; (4.) localization of a lung biopsy; (5.) localization of bronchiectasis.

Adult↗
PubMed1996

Bilateral volume reduction surgery for diffuse pulmonary emphysema by video-assisted thoracoscopy.

UNLABELLED: We prospectively studied the surgical aspects, functional results, and complications of video-assisted bilateral thoracoscopic volume reduction surgery in patients with severe diffuse pulmonary emphysema. METHODS: Fifteen men and five women with a mean age of 64 years (range 42 to 78 years) whose daily activity was substantially impaired by severe airflow obstruction and hyperinflation underwent thoracoscopic volume reduction surgery. The prospective preoperative assessment and postoperative assessment at 3 months included (1) pulmonary function studies, (2) grading of dyspnea, and (3) exercise performance; pulmonary function tests were also performed immediately before discharge from the hospital. RESULTS: There was no perioperative mortality. All patients left the hospital after a median stay of 15 days (6 to 27 days). Only seven patients had a prolonged chest tube drainage time (>7 days). At 3 months the mean (+/- standard deviation) forced expiratory volume in 1 second had improved by 42% (+/-3.8%), from 0.80 L (+/-0.23) to 1.09 L (+/-0.28) (p < 0.001); residual volume had decreased from 5.8 L (+/-1.5) to 4.4 L (+/-1.0) (p < 0.001). Shortly before discharge the forced expiratory volume in 1 second was already 1.10 L (+/-0.26). The median 12-minute walking distance increased from 495 m (35 to 790 m) to 688 m (175 to 1035 m) (p < 0.001) and the mean maximal oxygen consumption from 10 ml/kg per minute (+/-2.5) to 13 ml/kg per minute (+/-2.3) (p < 0.0005). The patients reported a substantial relief of dyspnea with a mean decrease in the Medical Research Council score from 3.4 to 1.8.

Adult↗
PubMed1996

Hernia of the lung repaired by VATS: a case report.

Hernia of the lung is an uncommon clinical entity. The majority of reported hernias are acquired traumatic thoracic hernias. A case of an acquired spontaneous hernia occurring through an old anterior thoracotomy scar is presented. We believe pathogenesis of this hernia was the result of increased intrathoracic pressure secondary to tracheobronchomegaly and anterior-posterior collapse of the trachea during expiration. The hernia was successfully repaired by a video-assisted thoracic surgical (VATS) technique using prolene mesh and a hernia stapler similar to the technique used in repair of an inguinal hernia.

Aged↗