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R Brunner

Publications and source records attributed to R Brunner.

At least 91 records · Page 5Linked to original sources
PubMed1994

P-glycoprotein expression as unfavorable prognostic factor in acute myeloid leukemia.

In order to further define the role of the MDR1 gene in acute myeloid leukemia (AML), we determined the association between the presence of P-glycoprotein on leukemic cells and the efficacy of therapy in patients with AML. Immunocytochemistry with monoclonal antibody C219 was performed to demonstrate the presence of P-glycoprotein. Positive staining ranged from 0 to 60% of the leukemic cells. For further analysis, patients were assigned into groups with 0-5% staining cells (group 1, n = 33) and with > 5% staining cells (group 2, n = 19). The complete remission rate of induction chemotherapy was 76% for group 1 but only 32% for group 2 (p = 0.002). The median duration of overall survival was 19 months for patients in group 1 as compared to 3 months for patients in group 2 (p = 0.007). The data indicate that P-glycoprotein expression is associated with an unfavorable prognosis in patients with AML.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1994

Reproducibility and intraindividual variability of the pattern electroretinogram.

The human pattern electroretinogram (PERG) is a contrast-specific potential presumedly reflecting the functional integrity of ganglion cells. Many studies have devised criteria that enable PERG measurements to distinguish established glaucomatous (hypertonic) eyes from normal controls. As there are relatively few reports concerning the reproducibility and reliability of the PERG, we studied the intraindividual variability of the PERG in 20 healthy subjects. Both transient and steady-state responses were recorded using a high-contrast (98%), black-and-white, counterphasing checkerboard pattern (average luminance, 80 cd/m2) generated by a television monitor (subtending angle, 13.8 degrees x 10.8 degrees) using three different check sizes (15', 30', and 60'). Recordings were performed in both eyes simultaneously at a 7-day interval under test-retest conditions. Responses of 30' spatial frequency were most consistent and resulted in a mean amplitude (+/- SD) of 2.18 +/- 0.95 microV (P50) and 4.00 +/- 1.69 microV (N95) for transient patterns and 1.84 +/- 1.25 microV for steady-state patterns. No statistically significant difference was observed between either right and left eyes, test and retest conditions or 1st- and 7th-day recording sessions for PERG parameters. In linear correlation analysis there was an adequate, positive correlation between the right and left eyes (r = 0.78); a weak correlation between test and retest conditions (r = 0.58); and no correlation between measurements made at a 7-day interval. As a consequence, we conclude that the follow-up of patients (e.g., glaucoma, ocular hypertension) by means of PERG is critical, especially when therapeutic consequences may be based on the physiological variability of a weak retinal signal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Is general anaesthesia necessary to record reproducible electroretinograms in rabbits?

In toxicity testing of intraocularly applied substances the flash electroretinogram (ERG) serves as an indicator of intact or reduced retinal function in the animal. Insufficiently monitored narcosis may be a source of puzzling ERG results. We performed electroretinography in 25 dark-adapted rabbits without general anaesthesia to evaluate the reproducibility of that method. Two recordings obtained at a mean interval of 26.87 days were compared. The scotopic a- and b-waves showed the same characteristics concerning shape, amplitude and implicit time known from other publications dealing with ERG recordings in narcotised rabbits. No statistically significant difference could be found between the test and retest recordings. It could be demonstrated that narcosis is not necessary for recording of stable and reproducible scotopic ERGs in rabbits.

Anesthesia, General↗
PubMed1994

Atypical presentations of Best's vitelliform macular degeneration: clinical findings in seven cases.

The clinical findings obtained in seven patients from four families with atypical vitelliform macular degeneration are described. Five patients had an onset of the disease in childhood and two patients, at the age of 45 years. Their visual acuity was mildly reduced (0.52 +/- 0.27). The fundus showed variable changes with single or multiple central or paracentral yellowish subretinal exudates and deposits, sometimes surrounded by scars. Both eyes were affected in all patients. The scotopic and photopic electroretinograms were normal in all cases. The electrooculogram (EOG) showed a significant reduction of the light rise in all affected eyes, and in five eyes a reduction in the dark trough could be observed. In three clinically unaffected first-order relatives with normal fundus appearance, the light rise of the EOG was reduced, thus identifying them as gene carriers. The clinical features of atypical vitelliform macular degeneration are discussed with respect to similar diseases that must be excluded and may give reason for misdiagnosis.

Child↗
PubMed1993

[Sinus tarsi syndrome. Results of surgical treatment].

Following exclusion of other causes of pain debridement of the sinus tarsi was carried out in 47 hindfeet with persisting pain despite local infiltration with steroids. In 41 patients with a total of 42 feet treated this way, evaluation by a research questionnaire was possible: 15 patients had some persistent problems or had inadequate results after surgery, and in 13 of these a clinical follow-up examination was carried out. Our retrospective study confirms that surgery is successful in treating chronic pain syndromes in the region of the sinus tarsi, as is known from the literature. It is especially successful if the pain is not due to an earlier fracture. In 60% of the hindfeet an instability required a ligamentous reconstruction is found on surgery. This high percentage suggests that the development of the sinus tarsi syndrome may quite often be due to an instability in the hindfoot.

Adolescent↗
PubMed1991

[Disordered alpha 2-adrenoreceptor function in hemodialysis patients with renal anemia--a possible cause of increased blood pressure in relation to recombinant human erythropoietin?].

Nine patients on maintenance hemodialysis and transfusion-demanding renal anemia (group A) were treated with rHuEPO 120 IU/kg i.v. three times per week. Hemoglobin-content was raised from 7.2 +/- 0.9 to 10.4 +/- 0.8 g/dl. In all patients blood pressure rose, three patients developed arterial hypertension. Mean diastoloic blood pressure was 66 +/- 12 and 78 +/- 16 mmHg (p less than 0.001) before and after rHuEPO. Rise in blood pressure was accompanied by a significant fall in plasma-noradrenaline-levels (from 498 +/- 100 to 383 +/- 75 pg/ml; p less than 0.05) and alpha 2-adrenoceptor-density (from 574 +/- 76 to 384 +/- 49; p less than 0.05). Compared to nine patients on maintenance hemodialysis and hematocrit over 30% (group B), patients with severe renal anemia (group A before treatment) had higher densities of alpha 2-adrenoceptors (574 +/- 76 vs. 218 +/- 32; p less than 0.001) despite higher plasma-noradrenaline-levels (498 +/- 100 vs. 399 +/- 63; n.s.). We suppose a anemia-related disturbance of alpha 2-receptor-function with the result of abolished receptor down-regulation and impaired vascular reagibility to vasoconstricting stimuli. With the correction of anemia receptor-function improves, receptor down-regulation as well as vascular reagibility is re-established resulting in augmented vascular resistance and higher blood pressure.

Adult↗
PubMed1991

Repair of fibular ligaments: comparison of reconstructive techniques using plantaris and peroneal tendons.

The results of treatment of chronic ligamentous insufficiency of the lateral hindfoot using plantaris tendon grafting (52 ankles) or peroneal tenodesis (128 ankles) were compared with an average followup of 66 months. In two-thirds of all cases an instability of the subtalar joint was present, isolated or combined with an instability of the talocrural joint. The overall outcome with both methods was good, but the results after plantaris repair were slightly more favorable. This fact is underlined by the frequency of reoperations: 1.9% after plantaris repair compared with 9.4% after peroneal tenodesis. We conclude that plantaris repair is the method of choice.

Adolescent↗
PubMed1991

Changes in the alpha adrenergic system and increase in blood pressure with recombinant human erythropoietin (rHuEpo) therapy for renal anemia.

Recombinant human erythropoietin (rHuEpo) is effective in correcting renal anemia with the development of hypertension as the most frequent side-effect. Compared to hemodialysis patients with normal hemoglobin concentration, nine examined patients with transfusion-dependent renal anemia had low blood pressure in the context of high alpha 2-receptor densities and high plasma levels of catecholamines. This constellation can be explained by a defective receptor-ligand-interaction. During treatment with rHuEpo all patients showed an increase in blood pressure due to increased peripheral resistance, accompanied by a significant fall in plasma noradrenaline and alpha 2-receptor-density. There was a significant negative correlation between hemoglobin concentration and alpha 2-receptor density. We conclude that correction of renal anemia abolishes anemia-mediated disturbance of alpha 2-receptor function with the consequence of receptor down-regulation and increased vasoconstriction, which contributes to the rise in arterial blood pressure.

Adult↗
PubMed1991

[Malunited supracondylar and condylar humeral fractures].

We present three important types of posttraumatic deformity of the distal humerus: varus deformity, valgus deformity and complex deformity. Their primary causes are discussed. Slight varus deformities are the result of purely lateral slip of supracondylar fractures or radial overgrowth after a lateral condylar fracture. Severe varus deformities occur after ulnar slip of the distal fragment following supracondylar fracture caused by a rotational deformity. The results after correlation of varus deformities with a rotational deformity are poor. The only way of obviating this problem is to recognize a rotational deformity as soon as possible before adaptation of the elbow occurs, and also to correct it early, if necessary. Valgus deformities occur mostly after radial malunion. Depending on the size of the fragment and the disability of the patient, the fragment should be stabilized-but the potential involvement of the malunion in the elbow function must be borne in mind. Complex deformities and their unknown origins are also discussed. The correction of such deformities depends exclusively on the elbow function. More aggressive primary regimens are urgently needed to prevent the necessity for such secondary corrections, which are very demanding and, depending on the type, have a high failure rate.

Adolescent↗
PubMed1991

Erythrocyte apheresis in combination with elimination of fibrinogen and plasma proteins of higher molecular weight in macular disease and in uveal effusion syndrome.

Reduction of hematocrit as well as elimination of fibrinogen and plasma proteins of higher molecular weight are effective approaches in hemorheology. A combination of these therapeutical concepts was applied in one patient with uveal effusion syndrome and in 16 patients with maculopathy. The hematocrit was reduced by erythrocyte apheresis. Fibrinogen and plasma proteins were eliminated by plasma exchange. In the case of uveal effusion syndrome the filling of the scleral veins as well as the uveal effusion were reduced. Furthermore visual function was improved significantly. In 9 of the 16 patients with maculopathy a significant increase in visual acuity occurred. The therapy described lowers significantly the following parameters: hematocrit, fibrinogen, serum proteins, plasma viscosity, erythrocyte aggregation and apparent whole blood viscosity (native and standardized). In a multiple linear regression analysis we found correlations as follows: plasma viscosity correlates with fibrinogen and proteins of higher molecular weight (r = 0.82), erythrocyte aggregation with fibrinogen and proteins of higher molecular weight (r = 0.88), standardized apparent whole blood viscosity with fibrinogen and proteins of higher molecular weight (r = 0.88) and native apparent whole blood viscosity with hematocrit, fibrinogen and proteins of higher molecular weight (r = 0.91).

Blood Component Removal↗
PubMed1990

[Vascular risk factors in patients with ophthalmoplegia].

The occurrence of high-risk factors for vascular disorders was analysed in a group of 43 patients suffering from diplopia of unknown aetiology. The subjects (25 men and 18 women) were aged between 17 and 78 years. Previously excluded were patients with intracranial or orbital tumors, ocular myositis or myasthenia, multiple sclerosis, endocrine orbitopathy, head trauma, cerebral hemorrhage or aneurysms, leucaemic infiltrates or metastasising tumors. Compared to the control groups of extensive epidemiological studies, the patients showed a higher prevalence of arterial hypertension and diabetes mellitus. Adipositas, lipometabolic disturbance and cigarette smoking were also more frequent. The findings support the hypothesis of a vascular origin of eye-muscle paresis.

Adolescent↗
PubMed1990

[Early diagnostic criteria of ankylosing spondylitis in patients with acute anterior uveitis].

A group of 59 patients with acute anterior uveitis (AAU) were examined for ankylosing spondylitis (AS) according to the New York criteria und criteria for early diagnosis of AS: 17/59 (29%) presented AS according to the New York criteria: a further 13/59 (22%) were classified as having incipient AS according to the early diagnosis criteria. These findings indicate that in a group of AAU patients there are, in addition to patients with definite AS, patients with initial AS though X-rays of the sacroiliac joints are still negative or equivocal. Early diagnosis criteria seem to be useful for identification of these patients at an early stage and can be used as a major selection criterion for monitoring programs.

Acute Disease↗
PubMed1989

[Recording and analysis of the electrooculography using a personal computer. Initial experiences with normal probands and patients with diseases of the posterior eye segment and intraocular foreign bodies].

The electro-oculogram (EOG) is recorded by a personal computer and analyzed during the examination. If the results obtained with this method in normal subjects are compared with the conventional method (with which data recorded in analog form have to be measured manually), there is no significant difference. In patients with diseases of the posterior segment (e.g., posterior uveitis) or intraocular foreign bodies the results of computer and manual analysis are also practically identical. There are two computer analysis techniques: for subjects with almost normal EOGs the trigger-independent method is sufficiently accurate. In patients with pathologic EOGs, however, and in particular those with small potential differences, the trigger-related method is more likely to lead to correct results. The analysis path can be displayed on the computer monitor at any time, so that the examiner can always check whether it is correct. In contrast to manual analysis, the computer analysis cannot be influenced subjectively by the examiner. This considerably improves the comparability of examination results. A further advantage of computer analysis is its speed: the result is available immediately following the examination. It is a low-cost system which is easy to install and use, and thus suitable for routine clinical work.

Chorioretinitis↗
PubMed1989

Nd:YAG laser therapy of an oral verrucous leukoplakia.

A 75-year-old female patient afflicted with an extensive verrucous oral leukoplakia is reported. With treatment by the Nd:YAG laser under local anesthesia on an outpatient basis, the disease could be kept under control for 4 years.

Aged↗
PubMed1989

Peripheral hemodynamics, blood viscosity, and the renin-angiotensin system in hemodialysis patients under therapy with recombinant human erythropoietin.

Treatment of renal anemia with rhEPO (120 U/kg body weight/hemodialysis) in transfusion-dependent patients on maintenance hemodialysis led to an increase in blood pressure, regional peripheral resistance and whole blood viscosity. Our results are in agreement with earlier findings that partial correction of renal anemia results in hemodynamic changes characterized by a fall in cardiac output together with an increase in blood pressure due to increased vascular resistance. The increase in whole blood viscosity correlated with the increase in regional peripheral resistance but not with the increase in mean arterial blood pressure. Thus, other regulating factors of vascular resistance must be involved. Correction of renal anemia does not influence the reninangiotensin system. However, peripheral responsiveness of vascular smooth muscles may have changed due to improved tissue oxygenation and thus leading to an increase in vasoconstriction.

Adult↗