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Biomedical subjects

M Klein

Publications and source records attributed to M Klein.

At least 343 records · Page 19Linked to original sources
PubMed1994

[Current diagnosis and treatment of lead poisoning].

Lead may be an industrial and an environmental hazard which becomes of greater importance every year. Classical symptoms of plumbism are rare, whenever minor clinical signs increase in frequency. Erythrocyte zinc protoporphyrin and delta-aminolaevulinic acid dehydratase are reliable indicators of the importance of the lead poisoning in individuals. The concentration of lead in blood is also a suitable biological indicator as is EDTA mobilization test. The treatment is based on the use of chelating agents such as calcium EDTA or DMSA, but the only solution is reduction or removal of the sources of lead exposure.

Accidents↗
PubMed1994

A comparative analysis of management and prognosis in stage I and II fallopian tube carcinoma and epithelial ovarian cancer.

Staging and surgical as well as post-operative treatment of primary Fallopian tube carcinoma (FTC) followed the lines established for primary ovarian cancer (OC). In a nationwide retrospective analysis we were able to find a distinct difference between these two tumours. A total of 262 patients, 68 with FTC and 194 with OC, in stage I and II were included into this study. A univariate as well as a multivariate analysis for survival was performed, including factors such as age, histological type, grading and surgical and adjuvant treatment. A significantly poorer outcome (P = 0.0002) for FTC patients with a 5-year survival of 50.8% compared with 77.5% for OC patients was observed. This finding was persistent and independent of any investigated factor, in univariate as well as multivariate analyses. Therefore, we feel that a more aggressive therapeutic approach to the treatment of FTC even in early stages can be recommended. On the other hand, the retrospective character of our study has to be taken into account.

Age Factors↗
PubMed1994

Physical mapping of the mitochondrial genome of Arabidopsis thaliana by cosmid and YAC clones.

As part of the worldwide efforts at molecular analysis of Arabidopsis thaliana as a model plant the complete structure of the mitochondrial genome has been determined. The mitochondrial DNA molecules were mapped by restriction fragment analysis of more than 300 cosmid clones and purified mitochondrial DNA. The entire genome of 372 kb is contained in three different configurations of circular molecules and is split into two additional subgenomic molecules of 234 kb and 138 kb, respectively. These arrangements result from recombinations of the two sets of repeats present in combinations of inverted and/or direct orientation. Alignment of YAC clones confirms the in vivo presence of continuous DNA molecules of more than 300 kb in A. thaliana mitochondria. The presence of this comparatively large mitochondrial genome in a plant with one of the smallest nuclear genomes shows that different size constraints act upon the different genomes in plant cells.

Arabidopsis↗
PubMed1994

[Conisation in stage Ia cervix cancer].

Between 1975 and 1988, a total of 78 patients suffering from cervical cancer stage Ia were treated by conisation based on a positive smear. According to FIGO, these 78 patients consisted of 53 (67.9%) stage Ia1 and 25 (32.1%) stage Ia2 cases. Complete removal of the tumour by conisation was achieved in 51 patients. In 23 cases (29.5%) the margin of resection was reached by a carcinoma in situ, in 4 cases (5.1%) invasive carcinoma was found. Conisation was not followed by further surgery in 10/51 patients with complete tumour removal. One patient (1/23) with incomplete removal underwent surgery elsewhere. In the other 67/78 patients following hysterectomy, the pathologist diagnosed three cases of cervical cancer, 11 cases of carcinoma in situ and 53 cases (67.9%) without pathological findings. Carcinoma in situ after hysterectomy was found in only 2 cases (4.9%) with primarily free resection margins of the conus. Among the 27 patients with carcinoma in situ or invasive carcinoma reaching the conus margin, 9 cases of carcinoma in situ and 3 invasive carcinomas were diagnosed histologically after hysterectomy and one patient underwent surgery elsewhere. In this study, the value of conisation as single therapy of cervical cancer stage Ia1 and stage Ia2 with good prognosis (depth of infiltration of < 3 mm and no invasion of blood vessels) is discussed and the importance of thorough and exact histological examination is emphasised.

Adult↗
PubMed1994

[Surgical secondary measures in unsuccessful prostaglandin treatment of tubal pregnancy].

As local drug treatment grew more common, the risk of persisting trophoblast remnants increased in tubal pregnancies treated in this way. We studied the secondary surgical measures in 52 patients, who had to undergo surgery for a second time after tubal pregnancy treated with prostaglandins. The indication for revision was arrived at 30 times on the basis of laboratory parameters (increasing or constant beta-HCG) (Group I). Reoperation had to be performed 22 times because of acute clinical symptoms (Group II). Laparotomy was performed 40 times, repelviscopy 12 times. In patients of Group I, the rate of rupture, that, had already occurred at the time of secondary surgery, was significantly smaller (p < 0.0001); in that case secondary surgery was significantly more often successful (p < 0.06) in preserving the tubes. In case of constant beta-HCG values 11 patients (50% of Group II) developed acute symptoms; another 7 patients (31.8%) also had to be reoperated on due to acute complaints, although the values were already clearly reduced. The study proves, that tubal pregnancies can be reoperated with preservation of the tubes even after unsuccessful prostaglandin therapy. The starting position for secondary surgery with preservation of the tubes is much better before acute clinical symptoms occur.

Adult↗
PubMed1994

[Energy and nitrogen metabolism of pregnant and lactating sows in addition to the suckling piglets. 4. Chemical composition and energy content of the conception products, reproductive organs and the live weight gain or loss in pregnant or lactating sows].

The chemical composition and the energy content of the conception products, the reproductive organs and the live weight gains or losses of pregnant and lactating sows were determined in dependence on the litter number (1, 2 and 4) and the energy supply (120, 100 and 80% of requirement recommendation) of sows as well as on the course of gestation and lactation. The results will be used as a basis for factorial derivation of requirement recommendation. The deposition of protein and energy in the conception products in dependence on the time is characterized by an exponential function. The deposition of nutrients and energy in the conception products is increased with rising litter size. The deposition of nutrients and energy per fetus is lower in the litter number 1 than in the litter number 2 and 4. The energy supply in the selected limits has no significant influence on the litter size as well as on the intrauterine deposition of nutrients and energy. The litter number, the energy supply as well as the course of gestation and lactation influence considerably the weight, the chemical composition and the energy content in the mammary gland. The chemical composition and the energy content of the live weight gains or losses of pregnant and lactating sows are strong affected by the energy supply. The increased energy supply of the pregnant sows is connected with increased live weight gains and with increased contents of dry matter, fat and energy however decreased contents of protein in the live weight gains. The live weight losses of the lactating sows are connected with mobilisation of body fat and body protein. The proportion of body fat to body protein degradation is increased with increased losses of body weight. Regression equations are calculated for the relationships between course of gestation and lactation respectively and deposition of protein and energy in the conception products, reproductive organs and maternal live weight gains or losses of sows.

Animals↗
PubMed1994

Gallium-67 scintigraphy as an aid in the detection of spinal epidural abscess.

Gadolinium-enhanced MRI is considered the study of choice for diagnosing spinal epidural abscess (SEA). Most of such cases, however, are not suspected initially, and thus do not benefit from the procedure. A case of SEA is described in which positive Ga-67 scintigraphy shortly before onset of lower extremity dysfunction was instrumental in obtaining an emergency gadolinium-enhanced MRI and establishing the diagnosis.

Abscess↗
PubMed1994

Muscle bioenergetics in obese Zucker rats.

The purpose of this study was to investigate the energetic metabolism in obese Zucker rats, using phosphorus nuclear magnetic resonance spectroscopy at rest and during a 2-Hz muscle stimulation and subsequent recovery. Animals were anesthetized with ketamine (150 mg/kg ip). Fed obese rats and 2-day-fasted obese rats were compared with their normally fed and 2-day-fasted lean litter mates. No differences were found between the two groups for ATP, total creatine, phosphocreatine (PCr), and intracellular pH. Starvation in lean rats resulted in a significant fall in inorganic phosphate (Pi), increased resting ADP level, and decreased PCr and ADP recovery after stimulation. The obese rats exhibited a decreased PCr/Pi and increased ADP at rest and a decreased PCr resynthesis and ADP metabolization rate after stimulation. Muscle stimulation in fasted obese rats induced higher PCr depletion and more pronounced acidosis. These results suggest an in vivo mitochondrial metabolism dysfunction in fasted lean as well as in fed and fasted obese rats.

Adenosine Diphosphate↗
PubMed1994

Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. The protective effects of captopril.

BACKGROUND: Left ventricular enlargement after myocardial infarction increases the likelihood of an adverse outcome. In an echocardiographic substudy of the Survival and Ventricular Enlargement (SAVE) Trial, we assessed whether captopril would attenuate progressive left ventricular enlargement in patients with left ventricular dysfunction after acute myocardial infarction and, if so, whether this would be associated with improved clinical outcome. METHODS AND RESULTS: Two-dimensional transthoracic echocardiograms were obtained in 512 patients at a mean of 11.1 +/- 3.2 days after infarction and were repeated at 1 year in 420 survivors. Left ventricular size was assessed as left ventricular cavity areas at end diastole and end systole and left ventricular function as percent change in cavity area from end diastole to end systole. Patients were randomly assigned to placebo or captopril, and the incidence of adverse cardiovascular events consisting of cardiovascular death, heart failure requiring either hospitalization or open-label angiotensin-converting enzyme inhibitor therapy, and recurrent infarction were determined over a follow-up period averaging 3.0 +/- 0.6 years. Irrespective of treatment assignment, baseline left ventricular systolic area and percent change in area were strong predictors of cardiovascular mortality and adverse cardiovascular events. At 1 year, left ventricular end-diastolic and end-systolic areas were larger in the placebo than in the captopril group (P = .038, P = .015, respectively), and percent change in cavity area was greater in the captopril group (P = .005). One hundred eleven of the 420 1-year survivors with 1-year echo measurements (26.4%) experienced a major adverse cardiovascular event, and these patients had more than a threefold greater increase in left ventricular cavity areas than those with an uncomplicated course. Sixty-nine patients with adverse cardiovascular events were in the placebo group compared with 42 patients in the captopril-treated group (a risk reduction of 35%, P = .010). CONCLUSIONS: Two-dimensional echocardiography provides important and independent prognostic information in patients after infarction. Left ventricular enlargement and function after infarction are associated with the development of adverse cardiac events. Attenuation of ventricular enlargement with captopril in these patients was associated with a reduction in adverse events. This study demonstrates the linkage between attenuation of left ventricular enlargement by captopril after infarction and improved clinical outcome.

Captopril↗
PubMed1994

N-terminal proatrial natriuretic factor. An independent predictor of long-term prognosis after myocardial infarction.

BACKGROUND: Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly. METHODS AND RESULTS: To test the prognostic value of N-terminal proANF after myocardial infarction, its plasma concentration was measured a mean of 12 days after infarction in 246 patients in the Survival and Ventricular Enlargement (SAVE) Study. N-terminal proANF was a much stronger predictor of survival than ANF itself. Furthermore, in multivariate analysis of cardiovascular mortality and development of heart failure, N-terminal proANF in contrast to ANF and other neurohormones was still a powerful and independent predictor when the model included age, gender, prior myocardial infarction, hypertension, diabetes, use of thrombolysis, Killip class, infarct location, and LVEF. CONCLUSIONS: The measurement of N-terminal proANF supplements presently used clinical and objective assessments and provides an important independent predictor of prognosis with respect to cardiovascular mortality and development of heart failure.

Atrial Natriuretic Factor↗
PubMed1994

Sarcoid reactions in cystic duct carcinoma.

A diagnosis of sarcoidosis was evoked in a 61-year-old man on clinical and histologic bases. Nevertheless, a bile duct carcinoma was disclosed in association with the discovery of generalized sarcoid-like granulomas. This is only the third time that such an association has been described. HLA-B8, DR3, and DRw52 antigens were found, suggesting that altered immunologic mechanisms could play a role in the pathogenesis of this sarcoid-like reaction.

Bile Duct Neoplasms↗
PubMed1994

Early detection of antibodies to human immunodeficiency virus 1 by a third-generation enzyme immunoassay. A comparative study with the results of second-generation immunoassays and western blot.

The aim of the study was to examine the sensitivity and the specificity of a HIV-1/HIV-2 third-generation enzyme immunoassay, the Abbott recombinant HIV-1/HIV-2 third-generation enzyme immunoassay, which is reported to detect simultaneously IgG and IgM. Sensitivity was evaluated with sera from seropositive subjects and a series of samples from eight HIV-1 seroconverting subjects. Results were compared with Western blot, second-generation immunoassays (including Vidas HIV-1 + 2) and an HIV-1 antigen assay. Specificity was studied with sera collected from a low-risk population and sera with false-reactive enzyme immunoassays results. In seven cases, the third-generation immunoassay detected HIV-antibodies several days earlier (range 4 to > or = 9 days) than the Western blot test according to the criteria proposed by the Association of State and Territorial Public Health Laboratory Directors, ie, positive with two of the three bands-gp160 or gp120, gp41, and p24. In the last case detection occurred at the same time as Western blot. The second-generation tests generally detected HIV-antibodies at the same time as Western blot. Antigaenemia was positive in the first samples tested in most cases, prior to or simultaneously with the Abbott third-generation test first reactivity, before the second generation tests and the Western blot test. In most cases, the disappearance of detectable HIV antigen was observed, and was concurrent with the development of the antibodies immune response. For our low-risk population, the current third-generation EIA test obtained a false-reactive rate of 0.26%. Our data indicate that the Abbott third-generation immunoassay is more sensitive than the Western blot test and the second-generation tests. The addition of a third-generation assay to the strategy for HIV-antibody screening may indeed be of interest and could make it possible to decrease the number of false-negative results.

Blotting, Western↗
PubMed1994

[Splenic arteriovenous fistula. Apropos of 2 cases and review of the literature].

Two cases of splenic arteriovenous fistula (SAVF) are reported and the literature pertaining to this disease is discussed. SAVF is a rare but curable cause of portal hypertension. Until recently, diagnosis was based and angiographic findings. However, it can now be reached with duplex-Doppler sonography, CT or MRI. Duplex-Doppler sonography highlights an enlarged splenic vein with a turbulent flow. CT scan detects the arterial aneurysms and shows the early opacification of the enlarged splenic vein. MRI depicts all the morphological abnormalities and flow-void due to time-of-flight losses may indicate the location of the fistula. Intra-arterial obliteration of the fistula is a good alternative to surgical procedure for treating SAVF in avoiding the potentially serious threat of gastrointestinal hemorrhage.

Adult↗
PubMed1994

Subperiosteal giant-cell reparative granuloma.

We present a case of subperiosteal giant-cell reparative granuloma followed over six years showing the complete evolution from the early phase of subperiosteal haematoma to the end stage of an ossified haematoma. Such lesions, although they are histologically similar to true giant-cell tumours, can be distinguished by the patients' age, their location on the diaphysis, and by their radiological and histological features.

Adult↗
PubMed1994

Gastroschisis: can antenatal ultrasound predict infant outcomes?

OBJECTIVE: To test previously proposed but unproven antenatal ultrasound prognostic criteria in fetal gastroschisis. METHODS: Thirty consecutive gastroschisis-affected pregnancies and their outcomes were reviewed retrospectively. Data were tabulated by review of antenatal ultrasound videotapes, with blinded comparison to indicators of short- and long-term infant outcomes obtained from the medical records. Criteria of previous reports were applied to these data, focusing on their ability to prognosticate effectively. RESULTS: Applying a criterion of 10 mm bowel dilatation proved minimally useful in prognosticating infant outcomes. However, a stricter 17-mm criterion for clinically important bowel dilatation provided prognostic information, with remarkable improvement in specificity (75 versus 37%) and positive predictive value (55 versus 37%) for infant morbidity, with comparatively little loss of sensitivity (71 versus 85%). CONCLUSIONS: Bowel dilated more than 17 mm on antenatal ultrasound appears to be associated with increased short- and long-term infant morbidity. Whether this finding warrants obstetric intervention in the preterm gastroschisis-affected pregnancy with substantial bowel dilatation remains to be determined.

Congenital Abnormalities↗
PubMed1993

Structure-function analysis of the C-terminal segment of human interleukin-6.

It has been hypothesized that interleukin-6 (IL-6) and granulocyte-colony-stimulating factor (G-CSF) may fold as four-alpha-helix bundle proteins. To probe the functional role of the putative fourth helical segment of IL-6 (D-helix), a chimeric IL-6/G-CSF analog containing the predicted D-helix of G-CSF as well as a panel of IL-6 D-helix point mutants were analyzed for their respective secondary structure, antigenicity, and receptor binding and biological activities. The putative D-helix of IL-6 could not be replaced by its G-CSF counterpart in spite of their high degree of similarity and thus is indispensable for the antigenic and functional integrity of the IL-6 receptor binding site. Conversely, the grafting of the G-CSF D-helix did not confer any G-CSF activity to IL-6. A synthetic helical peptide containing the IL-6 D-helix was inactive, even when mixed with or linked to a peptide from the A-helix known to be involved in the active site. However, the conserved residues F173, R179, and R182 found in the D-helices of both IL-6 and G-CSF critically contribute to the architecture of the IL-6 active site. Indeed, mutation of F173 or R179 markedly affected IL-6 receptor binding and biological activities, but not the conformation of a major neutralization epitope. Furthermore, substitution of R182 resulted in a significant unfolding of the D-helix accompanied by a drastic loss in IL-6 antigenicity and functional activities. Nevertheless, residues other than F173, R179, and R182 also contribute to IL-6 specificity.

Amino Acid Sequence↗