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Biomedical subjects

M Roth

Publications and source records attributed to M Roth.

At least 577 records · Page 32Linked to original sources
PubMedDate not supplied

Embolization of renal vascular lesions: clinical experience with microcoils and tracker catheters.

After biopsy (n = 6) and nephrostomy (n = 1) of three native and four transplanted kidneys, gross hematuria, hypertension, and deterioration of function necessitated performance of transarterial embolization. Angiography revealed five arteriovenous fistulas (AVFs), one pseudoaneurysm, and one arteriocaliceal fistula. Superselective catheterization was accomplished using 5 Fr standard diagnostic catheters and 3 Fr coaxial Tracker catheters. Four of five AVFs were embolized successfully by inserting unfibered (2 patients) and fibered (2 patients) platinum coils (diameters 2 mm and 4 mm, respectively). For one AVF, additional injection of butylcyanoacrylate was necessary. The pseudoaneurysm was embolized successfully by such injection, and the arteriocaliceal fistula was occluded using one unfibered 2-mm coil. Embolization stopped the bleeding in all patients. One week after treatment, renal function was improved in 5 patients and remained unaffected in 2. Superselective embolization using Tracker catheters and fibered microcoils is an effective, safe treatment of renal vascular lesions.

Adult↗
PubMedDate not supplied

The assay of exocrinous peptidases in clinical chemistry.

The various peptidases secreted by such exocrine tissues as gastric mucosa, pancreas and prostate are usually determined by catalytic methods. Another approach utilizes immunoassay. Endopeptidases were formerly assayed with protein substrates such as hemoglobin and albumin. These techniques are increasingly replaced by more specific ones using artificial peptide derivatives as substrates, some of which allow an increase in absorbance or fluorescence to be continuously recorded. The presently available methods of assaying pepsin, pancreatic trypsin, trypsinogen and carboxypeptidase A, enterokinase and several peptidases of human sperm are reviewed.

Carboxypeptidases↗
PubMedDate not supplied

Derealization and panic attacks: a clinical evaluation on 150 patients with panic disorder/agoraphobia.

One hundred fifty patients with Panic Disorder (PD) with or without Phobic Avoidance were subdivided into two groups on the basis of presence/absence of derealization and/or depersonalization (D-D) during panic attacks. D-D was found in 34.7% of the sample. By comparing the two groups, the patients with D-D were found to be younger and had an earlier onset of the disorder; they had a higher prevalence of avoidance behavior and a higher severity of the agoraphobic spectrum phobias. They were also more frequently subject to concomitant disorders such as Generalized Anxiety, Obsessive-Compulsive, and depressive symptomatology. The authors have hypothesized a correlation between the presence of D-D during panic attacks and a more frequent clinical evolution toward agoraphobia. This view is supported by finding that D-D in panic attacks corresponds to severer forms of PD, both in terms of the earlier onset of PD, and because PD shows higher levels of anxiety, depression, and disability.

Adolescent↗
PubMedDate not supplied

The dexamethasone suppression test in schizo-affective depression.

The dexamethasone suppression test (DST) was performed on 30 patients fulfilling RDC or Kendell criteria for schizo-affective depression. Symptoms characteristic of depression or schizophrenia were noted, and the severity of psychosis and the severity and endogenicity of depression were assessed. Ratings of severity were repeated at 2-month follow-up. Ten of the 30 subjects were DST non-suppressors, but no clear differences in symptoms, severity of illness or outcome between suppressors and non-suppressors emerged. Thus, although schizo-affective depression is associated with an increased frequency of HPA axis abnormality as assessed by the DST, this test does not clarify the status of schizo-affective depression in the classification of psychiatric illness.

Adolescent↗
PubMedDate not supplied

A correlative study on hippocampal cation shifts and amino acids and clinico-pathological data in Alzheimer's disease.

Amino acid transmitters and cations were assessed in the frontal cortex and hippocampus of 12 Alzheimer's disease (AD), 4 multi-infarct dementia (MID) patients, and 12 age-matched controls. In the hippocampus, but not in the frontal cortex of AD patients we observed an increase of sodium (Na) and a decrease of potassium (K) and magnesium (Mg) content as compared to controls. Calcium (Ca) was not changed. These cation shifts were highly correlated with glutamate, which was significantly decreased in AD hippocampus. Hippocampal Na and K levels correlated also highly with gamma-aminobutyrate, cholineacetyltransferase and noradrenaline levels in the hippocampus and dementia scores. These results show that Na and K changes are sensitive markers for neurodegenerative processes in AD and suggest a loss of glutamatergic neurons in AD hippocampus.

Aged↗
PubMedDate not supplied

Neurofibrillary degeneration and neuronal loss in Alzheimer's disease.

Neuronal loss in Alzheimer's disease, especially in cerebral cortex and hippocampus, appears closely associated with the process of neurofibrillary degeneration. In certain noncortical nuclei neuronal loss appears not to depend upon the formation of neurofibrillary tangles. Neurofibrillary tangles and neurons were counted in the same populations of neurons in five brain regions. In the locus ceruleus and nucleus basalis, where tangles have a loose or globose structure, correlations with neuronal counts were not significant. In cerebral cortex and hippocampus, tangles have a more dense and often a flame-like appearance and their correlations with neuronal counts were significant. The relationships between tangles and noncortical neurons reported here suggest that the appearance of tangles does not necessarily herald the demise of a neuron in Alzheimer's disease. It can be reasonably anticipated that these relationships depend upon the clinical heterogeneity of Alzheimer's disease, regional differences in the brain and/or the macromolecular composition of neurofibrillary tangles.

Aged↗
PubMedDate not supplied

The interplay between X-ray crystallography, neutron diffraction, image reconstruction, organo-metallic chemistry and biochemistry in structural studies of ribosomes.

Crystals of ribosomes, their complexes with components of protein biosynthesis, their natural, mutated and modified subunits, have been subjected to X-ray and neutron crystallographic analyses. Electron microscopy and 3-dimensional image reconstruction, supported by biochemistry, genetic, functional and organo-metallic studies were employed for facilitating phasing of the crystallographic data. For example, a monofunctional multi heavy-atom cluster (undecagold) was designed for covalent and quantitative binding to ribosomes. The modified particles were crystallized isomorphously with the native ones. Their difference-Patterson maps contain indications for the usefulness of these derivatives for subsequent phasing. Models of the ribosome and its large subunit were reconstructed from tilt series of 2-dimensional sheets. The comparison of the various reconstructed images enabled an initial assessment of the reliability of these models and led to tentative assignments of several functional features. These include the presumed sites for binding mRNA and for codon-anticodon interactions, the path taken by the nascent protein chain and the mode for tRNA binding to ribosomes. These assignments assisted in the design of biologically meaningful crystal systems. The reconstructed models are being used to identify structural features in initial density maps derived from X-ray and neutron diffraction data.

Crystallography↗
PubMedDate not supplied

Evaluation of prenatal diagnosis of cleft lip/palate by foetal ultrasonographic examination.

Ultrasound scans in the midtrimester of pregnancy are now a routine part of antenatal care in many countries. This type of screening procedure can detect serious foetal anomalies. Thanks to our registry of congenital anomalies a study was undertaken. The objective of the study was to evaluate prenatal detection of cleft lip (palate)(CL/P) by routine ultrasonographic examination of the foetus in 265679 consecutive pregnancies from 1979 to 1998. The percentage of prenatal detection of CL/P was low. For isolated malformation (foetuses with only CL/P) the detection rate was low: 17.8%; however, this detection rate increased from 5.3% during the period 1979-1988 to 26.5% during the period 1989-1998, for foetuses with associated malformations (foetuses with CL/P and one or more additional major malformations) these detection rates were 34.6, 13. 3 and 50.0%, respectively. In foetuses with associated malformations with CL/P this detection rate was higher for chromosomal abnormalities with CL/P and for non-syndromic, non-chromosomal multiply malformed children with CL/P than for non-chromosomal recognized syndromes with CL/P.

Abnormalities, Multiple↗
PubMedDate not supplied

["Fitness for public service" - results of standardised acceptance examinations].

From Nov. 1 1990 to Dec. 31 2001 4928 applicants (61 % female, 39 % male) were examined, totalling 6580 pre-employment examinations, to decide whether they fulfilled the health requirement criteria for civil servants. Standardised aptitude criteria were used, career-specific requirements taken into account. To exclude with a high probability were any risks of premature disability for service or frequent disorders. In 394 cases (= 5.99 %) the results were negative. This assessment was final in 298 cases (= 4.53 % of all examinations) or was confirmed negative in repeated examinations even after special conditions had been imposed. Main reasons for disqualification were second- and third-degree adipositas with additional risk factors or a metabolic syndrome, chronic cardio-vascular and metabolic diseases requiring permanent treatment, malignant neoplasms or non-fulfilment of the criteria for special careers. The comparatively high rate of disqualification is mainly due to the high average age of the applicants examined (40 % of all applicants were over 40, 13 % were older than 50). Purpose, sensitivity and specifics of such examinations are discussed. Taking into consideration the high rate of civil servants prematurely unfit for work, such pre-employment examinations are regarded as highly justified. Moreover, it is necessary to have clear guidelines, aptitude criteria and examination procedures for individual careers. It is also important to adhere strictly to local responsibility for pre-employment examinations.

Adult↗
PubMedDate not supplied

[Short-term-interval stress following corrective operations in tetralogy of Fallot].

21 clinically asymptomatic children aged 5.5 to 15.5 years were examined by bicycle exercise 1 to 9 years after surgical repair for tetralogy of Fallot. The results were compared to normal values gained from 169 healthy children (10 age groups of girls and boys). Submaximal exercise testing was performed in three stages of 1, 2 and 3 Watts per kg body weight, followed by 2 minutes of recovery. The following results were gained: 7 of the 21 patients showed rhythm disturbances during the exercise testing. Only three of them had documented arrhythmias before this date. Another 3 children with normal exercise test had arrhythmias in their former history. Thus total incidence of documented arrhythmias is 48 percent in contrast to only 1.2 percent in the control group. Using this weight related exercise test the heart rates of the patients were significantly lower during exercise than those of the control group. The differences are most evident during the maximal exercise period. The ability of LVET-shortening with increasing heart rates was significantly reduced in the patients. PEP was significantly prolonged. Both phenomena lead to a relatively shorter diastole than in normal subjects. This must result in a hemodynamical disturbance under the conditions of high frequencies. Blood pressure monitoring is not very valuable for the interpretation of hemodynamic changes. There are signs of alterations of hemodynamics as well as of the heart rhythm in the patients after surgical repair for the tetralogy of Fallot, even if the patients feel very well. By short time submaximal exercise testing it is possible to detect these alterations.

Adolescent↗
PubMedDate not supplied

[Traumatic spondylolysis in the hedgehog. A contribution to the problem of isthmus dysplasia].

Traumatic spondylolysis in a hedgehog is reported. On the basis of that rare observation the "dysplastic" thinning of the vertebral isthmus frequently associated with spondylolysis in man is claimed to be related to the "neuroenveloping" function of the spine shared with that of the neurocranium. Dysplasia of the isthmus results from abnormal ganglio-foraminal interrelation in the embryo rather than from any primary derangement of the vertebral bone growth proper.

Animals↗
PubMedDate not supplied

Correlations between vascular calcification and atherosclerosis: a comparative electron beam CT study of the coronary and carotid arteries.

PURPOSE: Electron beam CT (EBCT)-derived coronary artery calcium scores correlate with the extent of atherosclerosis, but there is a substantial variance about the general relationship between coronary calcification and coronary atherosclerosis. The relationship between calcification and atherosclerosis may also differ in various arteries. This study was designed to evaluate whether the relation between carotid artery intima-media thickness (IMT) and carotid artery calcium could be used as a correction factor to improve the correlation between coronary calcification and coronary atherosclerosis. METHOD: We measured atherosclerosis in the coronary and carotid arteries by angiography and ultrasonography, respectively, and quantified coronary and carotid calcium deposition with EBCT in 50 subjects. The correlation between the findings in the carotid and coronary arteries was investigated. RESULTS: Coronary artery calcium score correlated with coronary angiography and with carotid calcium score. Coronary stenosis correlated with carotid IMT. There was no meaningful correlation of carotid IMT and carotid calcium. CONCLUSION: There is an intraindividual variation in the relationship of plaque mass to calcification among different vessels. The relation between carotid artery calcification and carotid IMT is not predictive of the relation between coronary artery calcification and coronary obstruction.

Aged↗
PubMedDate not supplied

Improved cholesterol management in coronary heart disease patients enrolled in an HMO.

The purpose of the study was to describe the effect of physician reminders on the measurement of low-density lipoprotein cholesterol (LDL-C) levels and treatment to achieve an LDL-C goal of < or = 100 mg/dL in coronary heart disease (CHD) patients. After reminders were initiated, the number of CHD patients without a documented LDL-C was reduced from 30% to 18%, between January 1997 and July 1998, and the percentage of CHD patients achieving the LDL-C goal improved from 10% to 27%. Thus, reminders can be an effective tool in improving cholesterol management of CHD patients. In contrast, a cholesterol-lowering clinic made available to some physicians, in addition to the reminders, was rarely used.

Cholesterol, LDL↗
PubMedDate not supplied

The validity of informant reports in assessing the severity of dementia: evidence from the CAMDEX interview.

The evaluation of a patient's mental state, overall clinical profile and behavioural disturbance in the process of diagnosing dementia requires at least two sources of information: the patient and the informant. Since the severity of the dementia may interfere with the subjective perception of these disorders, it is important to evaluate the consistency between these two sources of information and the clinical and psychometric evaluation made by the physician. Accordingly, in this study five behavioural areas, derived from the semi-structured interview schedule provided by the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX, i.e., Sleep, Depressed Mood, Everyday Activity, Memory and Global Mental Functioning) have been tested on the patient and his/her informant. Eighty dementia patients (mean age = 74 years) and their informants participated in the study. The dementia group was subdivided into two levels of severity according to DSM-IIIR criteria: 41 with mild dementia and 39 with moderate dementia, respectively, matched for age and schooling. The rating of impairment was found to increase along with the severity of dementia in all the above-mentioned areas, except for sleep. However, the source of information per se significantly influenced the evaluation of memory functioning. Moreover, the significant interaction between the two factors considered indicates that memory functioning is evaluated quite differently by the patients and the informants, as only in the assessment made by the latter group did the impairment increase in parallel with severity of dementia. Finally, whereas none of the subjective measures recorded in the patients were significantly correlated with their test scores, the correlations between the informant memory appraisals and patient test results proved to be significant. The present findings confirm the validity of informant reports in assessing cognitive and memory disorders in early-stage dementia, as well as in distinguishing patients with mild from those with moderate dementia.

Aged↗