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Biomedical subjects

M Werner

Publications and source records attributed to M Werner.

At least 307 records · Page 17Linked to original sources
PubMed1990

Chronic myeloproliferative disorders in bone marrow biopsies.

This Diagnostic Seminar intends to announce that CMPDs can be classified from BMB histologically by a rather simple system, which can be applied by interested histopathologists successfully. The rationale of this classification is to stay within the groups of diseases which are outlined by clinical findings including the peripheral blood and bone marrow smears. The concept of traditional classification as given by the WHO and textbooks, however, has to be revised as follows (1) Primary diseases of CMPDs must be distinguished from advanced disorders. Primary diseases are CML, P. vera, Thrombocythemia, CMGM, and unclassifiable CMPD. (2) Idiopathic, primary myelosclerosis of the bone marrow is a reactive feature consecutive to neoplastic transformation of hematopoiesis, i.e. myeloproliferation. (3) Advanced disorders comprise (3.1.) excess of blasts and blast crisis, and (3.2.) early myelosclerosis, myelosclerosis and myelofibrosis, advanced myelofibrosis. Advanced disorders are designated by a composed term classifying them among the groups of primary disease and specifying the advanced stage by a suffix, so that the underlying disease remains coining the term, even in unclassifiable cases in which only CMPDs can be applied. (4) The CML group must be subtyped into CML of common type versus that with increase or predominance of megakaryocytes. By this system of classification, it seems possible to classify and type the spectrum of variations occurring among CMPDs to a satisfying result.

Biopsy↗
PubMed1990

[Cytogenetic examination of bone marrow cells in stem cell diseases of myelodysplastic syndromes].

Cytogenetic examination of bone marrow cells was performed in 43 patients with myelodysplastic syndrome (MDS). MDS was diagnosed from bone marrow biopsies and smears according to the FAB classification. Of all 43 patients 24 (56%) had clonal karyotype changes including frequently monosomies of chromosomes #5 and #7 as well as interstitial deletions of the long arm of #5, 5 q-. Chromosome aberrations were observed in patients belonging to all FAB-subgroups, e.g. 11/15 patients with RA, 6/10 with RAEB, 5/9 with RAEB/T, and 1/9 with CMMoL. Complex chromosome aberrations involving more than 2 chromosomes occurred predominantly in patients with RAEB/T (4/9) but also in patients with RA (2/15) and RAEB (2/10), and correlated significantly (p less than 0.002) with a shorter survival. No correlation was found between chromosome aberrations and the development of ANLL in 9/43 patients (21%).

Aged↗
PubMed1990

[Myelosclerosis in myelodysplastic syndromes (MDS). Retrospective analysis of 232 patients with MDS].

In a retrospective study, 45 (19.4%) out of 232 patients with MDS revealed myelosclerosis (MS) in bone marrow biopsy (BMB). Histological classification according to FAB criteria showed the following distribution: RA 21 (47%), RARS 1 (2%), RAEB 9 (20%), RAEB-T 3 (7%), and CMMol 11 (24%). Sclerosis occurred in all subtypes of MDS, but with a higher incidence in CMMol. Clinical data showed lower values of hemoglobin and lower platelet counts in MDS.MS. Life expectancy was reduced to 7.8 months, compared with 15.0 months in MDS without MS (p = 0.0026). In RA, the survival times were 9.7 months in MDS.MS, compared to 27.9 months in MDS without MS (p = 0.0035). 21 (47%) of the patients with MDS.MS experienced a transformation into ANLL. Myelosclerosis therefore seems to herald a bad prognosis.

Biopsy↗
PubMed1990

[Multilocular, ependymal cyst of the cerebellum].

The present pathomorphologic report presents a case of an ependymal cyst of the cerebellum recurring 13 years after the first operative removal. The lesion is interpreted as ependymal cyst with growth-tendency. Pathogenesis and histogenesis of cysts of the present localisation are discussed.

Adult↗
PubMed1990

[Initial experiences in diagnosis of graft rejection following clinical heart transplantation. Detection of graft-directed activated T-cells].

The binding of antigen-loaded carrier to mononuclear cells of heart transplant recipients has been investigated by means of an antigen-specific rosette technique. The increase of rosette forming cells and the inhibition of this reaction with monoclonal antibodies against activated T-cells is a sign of a beginning rejection. 3-6 days later infiltrating immunological competent cells are seen in biopsy.

Adult↗
PubMed1989

Human monoclonal antibodies directed against ovarian carcinoma.

In order to obtain human monoclonal antibodies for immunodetection or treatment of ovarian carcinoma, we generated hybridomas by fusing peripheral blood lymphocytes of patients with ovarian carcinoma and the mouse myeloma cell line X63.Ag8.653. The patients were immunized prior to collection of peripheral blood lymphocytes with autologous tumor cells admixed with New Castle Disease Virus. Immunocytologic studies of hybridoma supernatant with tumor cells fixed with methanol and air-dried tumor cells indicated that all 14 antibodies reactive with tumor cells were directed against cytoplasmic or nuclear antigens. One hybridoma designated as 1B3 was very stable and secreted a specific IgM antibody. This cell line expanded in nude mice and the monoclonal antibody 1B3 was effectively purified from ascites or supernatant fluid. In experiments with tissue sections partly derived from the patient whose peripheral blood lymphocytes were used for fusion, biotinylated 1B3 recognized ovarian tumor cells. There was no significant cross-reaction against normal tissue from stomach, small intestine, colon, lung, kidney, endometrium, placenta, or lymph node. Mammary carcinoma preparations were also stained by 1B3 while normal breast tissue was negative.

Animals↗
PubMed1989

Strategic use of individual and combined enzyme indicators for acute pancreatitis analyzed by receiver-operator characteristics.

The optimal strategy for the diagnosis of acute pancreatitis with enzyme assay results as indicators was evaluated in 67 emergency cases in whom this condition was suspected. We measured urine amylase expressed as activity concentration (U/L), timed excretion (U/h), and amylase/creatinine clearance ratio, and also serum amylase, elastase, lipase, and trypsinogen, at admission and repeatedly during hospitalization. The receiver-operator characteristic function was used to evaluate the diagnostic discrimination of each variable among initial findings and among the highest individual findings established retrospectively. We applied the same treatment to multiple univariate discrimination, using the six possible pairs and the four possible triplets of serum indicators. The results suggest that such urine assays should be abandoned, that all individual serum assays combine about 0.9 sensitivity with 0.9 specificity, that pairing of two assays does not clearly enhance discrimination, and that triplets of tests may degrade discrimination. The trade-off between sensitivity and specificity is a function not only of the chosen decision threshold but also of the sampling strategy (initial vs highest values) and of the interpretation rule (Boolean "and" vs "or" strategy).

Acute Disease↗
PubMed1989

A randomized comparison between midazolam and thiopental for elective cesarean section anesthesia. I. Mothers.

In a randomized blind trial midazolam (0.3 mg kg-1) was compared with thiopental (4 mg kg-1), both combined with meperidine-nitrous oxide, for elective cesarean section anesthesia in 40 women. We found no statistically significant differences between thiopental and midazolam at induction, during operation or recovery with regard to maintenance doses, change in maternal neurologic status based on a modified Glasgow Coma Scale, systolic blood pressure, and heart rate. Induction time was 120 seconds with midazolam and 111 seconds with thiopental. There were significant differences with regard to diastolic blood pressure. Side effects occurred with approximately equal frequencies, but vomiting was significantly more frequent after thiopental. Perivenous tenderness and erythema occurred in four patients, all after thiopental. Midazolam appears to be a suitable alternative to thiopental for the induction and maintenance of anesthesia for elective cesarean section.

Adolescent↗
PubMed1988

Measurement of acceleration: a new method of monitoring neuromuscular function.

A new method for monitoring neuromuscular function based on measurement of acceleration is presented. The rationale behind the method is Newton's second law, stating that the acceleration is directly proportional to the force. For measurement of acceleration, a piezo-electric ceramic wafer was used. When this piezo electrode was fixed to the thumb, an electrical signal proportional to the acceleration was produced whenever the thumb moved in response to nerve stimulation. The electrical signal was registered and analysed in a Myograph 2000 neuromuscular transmission monitor. In 35 patients anaesthetized with halothane, train-of-four ratios measured with the accelerometer (ACT-TOF) were compared with simultaneous mechanical train-of-four ratios (FDT-TOF). Control ACT-TOF ratios were significantly higher than control FDT-TOF ratios: 116 +/- 12 and 98 +/- 4 (mean +/- s.d.), respectively. In five patients not given any relaxant during the anaesthetic procedure (20-60 min), both responses were remarkably constant. In 30 patients given vecuronium, a close linear relationship was found during recovery between ACT-TOF and FDT-TOF ratios. It is concluded that the method fulfils the basic requirements for a simple and reliable clinical monitoring tool.

Acceleration↗
PubMed1988

Cerebral blood flow, vasoreactivity, and oxygen consumption during barbiturate therapy in severe traumatic brain lesions.

Mean hemispheric cerebral blood flow (CBF) and intracranial pressure (ICP) were measured in 19 severely head-injured patients treated with barbiturate coma. The CBF was calculated from the clearance of tracer substance monitored by extracranial scintillation detectors after intravenous administration of xenon-133. In 11 of the patients cerebral arteriovenous oxygen differences were measured simultaneously. In all patients the effects of pronounced hyperventilation were recorded prior to initiation of barbiturate treatment. A normal CBF response to hyperventilation (delta CBF/delta PaCO2 greater than or equal to 1) was obtained in eight patients. In these patients induction of barbiturate coma was accompanied by physiological decreases in CBF and in the calculated cerebral metabolic rate of oxygen (CMRO2); they also exhibited a rapid and lasting decrease in ICP. A decreased or an abolished CO2 reactivity was recorded (delta CBF/delta PaCO2 less than 1) in 11 patients. In 10 of these 11 patients the physiological decreases in CBF and CMRO2 were not obtained during barbiturate treatment and the decrease in ICP was transitory. This study demonstrates a correlation between cerebral vasoreactivity, physiological effects of barbiturate therapy, and clinical outcome.

Adolescent↗
PubMed1987

The leader peptide of yeast gene CPA1 is essential for the translational repression of its expression.

The expression of gene CPA1, encoding the glutaminase subunit of the arginine pathway carbamoyl-phosphate synthetase, is repressed by arginine at a posttranscriptional level. The 5' region of CPA1 mRNA contains a 25 codon upstream open reading frame. The importance of this feature for the repression of CPA1 expression has been analyzed by oligonucleotide-directed mutagenesis and by sequencing of constitutive cis-dominant mutations obtained in vivo. The results show that the leader peptide, the product of the upstream open reading frame, plays an essential, negative role in the specific repression of CPA1 by arginine. A model of translational regulation of CPA1 is proposed that takes into account the cis-dominance of the mutations affecting the leader peptide.

Arginine↗
PubMed1987

[The Berne Härz-As (Ace of Hearts) Project: goals, study plan and initial results].

The Berne Härz-As (Ace of Heart) project is a randomized trial in changing cardiovascular risk factors, morbidity and subjective health. It further investigates to what extent psychosocial and somatic factors account for these health indicators in the course of at least 4 years. A pilot study conducted in two companies (N = 620) indicates that the project is feasible and acceptable to both management and employees and that the intervention goals are justified.

Cardiovascular Diseases↗
PubMed1987

Asymptomatic blood methanol in emergency room patients.

Over a four-month period, methanol was found in the blood of 18 patients among 687 sequential emergency room admissions screened for alcohols by gas chromatography. In the patients with positive results, blood ethanol ranged from 6 to 570 mg/dL (1.3-123.7 mmol/L), blood methanol from 2.3 to 4.0 mg/dL (0.72-1.25 mmol/L). Methanol exposure during preparation of the sampling site or in the course of specimen handling, ingestion of denatured alcohol, as well as methanol production from the metabolism of aspartame are ruled out as causes for these findings. The authors conclude that endogenous methanol production is the probable major cause, while methanol as a fermentation congener may be a contributory minor cause.

Alcoholism↗
PubMed1987

A comparison between two emergency cricothyroidotomy instruments.

As part of a training programme for younger doctors, two commercially available, emergency cricothyroidotomy sets were evaluated. Prior to the surgical procedure, half of the doctors in each group received an audiovisual lesson. In a simulated but realistic emergency situation, involving autopsy material, cricothyroidotomy was performed utilizing either the "Nutrake" or the "Gentofte" system. The audiovisual lesson increased the speed and the success rate of the doctors performing this procedure as well as strengthening their confidence. Both systems allowed positive pressure ventilation. The participating doctors achieved a higher success rate at a faster speed with the "Nutrake" set.

Catheterization↗
PubMed1987

The cholinergic system in aging.

A morphometric analysis of neuronal loss during normal aging was performed in the nucleus basalis Meynert complex of the basal forebrain (Nbm) (nucleus septi medialis, nucleus of Broca's diagonal band, nucleus basalis) and the ciliary ganglion, a peripheral cholinergic structure, in patients free of neurological and psychiatric illness. As a basis for morphometric evaluation of the Nbm complex, a three-dimensional reconstruction of this complex structure was made. Neuronal counts in the Nbm complex and the ciliary ganglion remained stable up to the age of 60 or 50 years, respectively. After this age the number of neurons declined moderately in ciliary ganglion in all cases studied as well as in the Nbm complex in some cases (-20 and -25%, respectively, at about 90 years of age). In 3 out of 8 cases older than 60 years, neuronal counts in the Nbm complex were not reduced, so that no significant decline in neuronal number is apparent from the mean values of the 17 cases studied. No age-related changes were found in the neuronal distribution amongst the different subgroups of Nbm neurons using the alternative nomenclature of Mesulam et al. [J. comp. Neurol. 214: 170-197, 1983]. Our results provide no evidence that the cortical cholinergic projection system and peripheral cholinergic neurons might be especially vulnerable during normal aging. The severe degeneration of the cholinergic cortical projection system in SDAT is probably caused by mechanisms different from those acting during normal aging.

Adult↗
PubMed1987

Transesophageal atrial pacing using a pill electrode for the termination of atrial flutter.

To determine the efficacy of transesophageal rapid atrial pacing with a "pill-electrode" for the termination of atrial flutter, we studied 14 consecutive unselected patients presenting with atrial flutter of various etiologies. The bipolar pill-electrode (interelectrode distance 13 mm) was introduced orally without sedation. Of 14 pacing attempts, atrial capture was obtained in 13 (93 percent), and sustained alteration in rhythm (atrial fibrillation, sinus rhythm or type 2 flutter) in 12 (86 percent). Normal sinus rhythm occurred in six (43 percent), in all of whom it was preceded by transient atrial fibrillation. There was no difference in baseline flutter rates, pacing rates for atrial capture, or duration of flutter between patients reverting to sinus rhythm and those remaining in flutter or converting to atrial fibrillation. Pacing was well tolerated in all but one subject. Thus, esophageal pacing with the pill-electrode was simple to perform, well-tolerated and highly successful for atrial capture in patients with atrial flutter. Although it had a lower success rate than DC cardioversion in producing sinus rhythm, the simplicity of application makes it a useful initial alternative, particularly in patients in whom cardioversion may be hazardous.

Adult↗