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Biomedical subjects

R Müller

Publications and source records attributed to R Müller.

At least 1,063 records · Page 59Linked to original sources
PubMedDate not supplied

Results of mandatory exploration for penetrating neck trauma.

Management of penetrating wounds to the neck remains controversial despite decades of discussion in the literature. We assessed 393 consecutive stab wounds penetrating the platysma operated at our trauma service between January 14, 1991 and September 30, 1992 to evaluate our policy of mandatory neck exploration (NE). Injury to the common (n = 19 cases), external (n = 7), internal carotid (n = 5), innominate (n = 2), subclavian (n = 20), vertebral (n = 12), facial (n = 2), and intercostal (n = 2) arteries; the external (n = 36), internal (n = 65), subclavian (n = 20), and innominate (n = 4) veins; the pharynx/esophagus (n = 21); and the trachea (n = 28) was considered a positive NE (n = 167). 226 NEs were negative. Except for hemiparesis and bruit, the presence of clinical signs (shock, active hemorrhage, hematoma, surgical emphysema, dysphagia, blowing wound) did not predict a positive NE. Clinical signs were absent in 30% of positive NEs and in 58% of negative NEs. Complications of positive NE included wound infection (n = 7 cases), chyle drainage (n = 6), cerebellar stroke (n = 1), pneumonitis (n = 8), reoperation for recurrent hemorrhage (n = 1), subclavian artery graft occlusion (n = 1), bronchopleural fistula (n = 1), and cerebrospinal fluid leak (n = 1). Negative NEs were complicated by a wound infection in four cases and pneumonitis in one case. The mean hospital stay was 4.3 days for those with a positive NE and 1.5 days for those with a negative NE.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
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[Gastrin].

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Gastric Juice↗
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50 years of insulin.

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History, 20th Century↗
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Pharmacokinetics.

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Abnormalities, Drug-Induced↗
PubMedDate not supplied

Age-related hemodynamic changes during diastole: a combined M-mode and Doppler echo study.

To determine the effect of aging on the diastolic function of the left ventricle (LV) echo examination was performed in 115 subjects (47 women, 68 men) without any evidence of organic heart disease (2D and Doppler echo; exercise electrocardiography) aged 21 to 72 (mean +/- SD: 41 +/- 14) years. Transmitral flow with the characteristic early and late diastolic E-wave (E) and A-wave (A) was derived by pulsed Doppler ultrasound, whereas isovolumetric relaxation period (IVRP) was assessed by simultaneous M-mode registration of the aortic and mitral valve. Significantly increased values in older individuals (41 to 72 years; n = 57) as compared to younger subjects (21 to 40 years; n = 58) were found for the A/E ratio of the peak velocities (PAV/PEV) (90 versus 64%; p less than 0.001) and the velocity-time integrals (VTI-A/E) (79 versus 36%; p less than 0.001), atrial contribution to LV filling (AFF) (45 versus 26%; p less than 0.001) and isovolumic relaxation period (IVRP) (81 versus 72 ms; p less than 0.001). Age significantly correlated with PAV/PEV (r = 0.74; p less than 0.001), VTI-A/E (r = 0.83; p less than 0.001), AFF (r = 0.81; p less than 0.001) and IVRP (r = 0.74; p less than 0.001). Thus, age-related hemodynamic changes during diastole are characterized by a prolongation of IVRP and an increase of atrial contribution to LV filling.

Adult↗
PubMedDate not supplied

Function and energy metabolism of isolated rats hearts as influenced by Sr++.

Effects of Sr++ and isoproterenol were studied in rat hearts perfused with red cell containing media. Sr++ in the presence of Ca++ causes a positive inotropic effect without corresponding metabolic changes. Without Ca++ 0.5 mM Sr++ causes an immediate arrest, 2 mM Sr++ a complete contracture (14 min) and 5 mM a contracture after about 44 min. At a level of 10 mM Sr++ phasic contractions are maintained (60 min). Occurring phasic contractions are prolonged 3 to 6fold. Administration of isoproterenol (ISO) at a level of 0.5 mM Sr++ causes a delayed occurrence of cardiac arrest and incomplete contracture. At a concentration of 2 and 5 mM Sr++ positive inotropic responses proceed to a contracture (7 min, 50 min resp.). VO2 is reduced by 0.5 mM Sr++ initially by 2 mM Sr++ with delay. 5 and 10 mM Sr++ induce an initial increase. Subsequent decrease is smallest at 10 mM Sr++ ISO at all Sr++ concentrations induces an increase in VO2 initially and strong reduction finally. During 10 min administration, high energy phosphate stores (HEP) are reduced at all Sr++ concentrations, but to the smallest extent at 10 mM Sr++, ISO at levels of 0.5 and 2 mM Sr++ induces a partial recovery of HEP, but at 5 and 10 mM a further reduction. Finally, under the influence of ISO the metabolic state is similar to that without ISO. Sr++ at high concentrations in absence of Ca++ seems to be capable of substituting in principle for Ca++ also concerning metabolism. Severe metabolic disturbances at low Sr++ concentrations indicate a failure of regulation of oxidative phosphorylation.

Adenosine Diphosphate↗
PubMedDate not supplied

24-h blood glucose pattern in type I and type II diabetics after oral treatment with pentoxifylline as assessed by artificial endocrine pancreas.

Based on the known action of xanthine derivatives on the insulin secretion, the effect of pentoxifylline on carbohydrate homeostasis of type I (IDDM) and type II (NIDDM) diabetics was investigated. Pentoxifylline is known to exert a favorable influence on hemorheological disturbances in such patients. Twenty-four hour blood glucose pattern and insulin requirements were evaluated in type I and type II diabetics by the use of the artificial pancreas before and after a 14-day treatment with pentoxifylline 400 mg p.o. (Trental 400) t.i.d. During the stabilization period before treatment with pentoxifylline, NIDDM patients required 10.1 +/- 3.8 U of insulin and the IDDM 35 +/- 13.7 U. After 2 weeks on pentoxifylline, NIDDM required only 6.3 +/- 2.8 U (p less than 0.05) and IDDM 28.5 +/- 9.7 U (n.s.). Average blood glucose during the 24h decreased by 15.8 +/- 3.5% in NIDDM and by 10.3 +/- 2.5% in IDDM. Moreover, a significant smoothing of glucose fluctuations during the 24h was noted in both groups. It is concluded that pentoxifylline administered concurrently to any antidiabetic type of treatment leads to better blood glucose control as well as to prevention or delay of vascular complications.

Adolescent↗
PubMedDate not supplied

Gastrin release and gastric secretion induced by dimethylxanthine in man.

Gastrin release and gastric secretion in response to i.v. dimethylxanthine (2 mg/kg for 5 min followed by a 55-min infusion of 2.5 mg/kg) were studied in 25 normal subjects. Gastrin release was significantly stimulated, whereas gastric acid and pepsin secretion was inhibited. The adenylcyclase activation may, therefore, play a role in the mechanism of gastrin release. Moreover, dimethylxanthine seems to be a useful aid in studies on G-cell function in man.

Gastric Juice↗
PubMedDate not supplied

Hepatic and pancreatic metabolism and biliary excretion of the protease inhibitor camostat mesilate.

The hepatic metabolism and biliary and pancreatic excretion of the serine protease inhibitor camostat mesilate and its metabolites FOY-251 and GBA were studied in rats in vivo and in in sutu liver-perfusion experiments. After oral feeding (100 mg/kg) and iv infusion (5 mg/kg.h) of camostat mesilate, the original compound and both metabolites appeared in bile, but could not be detected in pancreatic juice. In plasma, only FOY-251 and GBA were detected. In the perfused rat liver, camostat mesilate (10 microM) was eliminated by 33.8% and its molar rate of degradation to FOY-251 was 25.1%. During the study period about 0.1% of camostat mesilate and FOY-251 appeared in bile. The liver perfusion of FOY-251 or GBA revealed very low hepatic extraction rates of 10.3 and 2.4%, respectively. In conclusion, the low hepatic extraction rate of camostat mesilate and its metabolites leads to high concentrations of the active metabolite FOY-251 in plasma. Camostat mesilate and its metabolites are effectively excreted into bile, but not in rat pancreatic juice.

Administration, Oral↗
PubMedDate not supplied

Stigmatella aurantiaca Sg a15 carries genes encoding type I and type II 3-deoxy-D-arabino-heptulosonate-7-phosphate synthases: involvement of a type II synthase in aurachin biosynthesis.

3-Deoxy-D-arabino-heptulosonate-7-phosphate (DAHP) synthases catalyse the first step of the shikimate pathway. Two unrelated DAHP synthase types have been described in plants and bacteria. Two type II (aroA(A2) and aroA(A5)) and one type I DAHP synthase gene (aroA001) were identified from the myxobacterium Stigmatella aurantiaca Sg a15. Inactivation of aroA(A5) leads to a mutant that is impaired in the biosynthesis of aurachins, which are electron transport inhibitors and contain an anthranilate moiety. Feeding of anthranilic acid to the mutant culture restores production of aurachins. Inactivation of aroA(A2) and aroA001 does not impair production of aurachins or other known secondary metabolites of S. aurantiaca Sg a15.

3-Deoxy-7-Phosphoheptulonate Synthase↗
PubMedDate not supplied

Rapid, easy and economical dot EIA for detection of antibodies to HIV-1 using recombinant env- and gag-proteins.

A rapid and simple screening test for antibodies to HIV-1 was designed on the principle of dot-EIA. Recombinant HIV-1 env and gag polypeptides are fixed on nitrocellulose sheets. Peroxidase conjugated protein A is used for detection of bound antibodies. After addition of hydrogen peroxide and 2-bromo-1-naphtol antigen-antibody complexes are visualized as discrete blue coloured spots. The test is completed within 15 min. Out of 111 sera positive by commercial EIA and Western blot analysis 110 were recognized by dot-EIA (sensitivity: 99.1%). False positive results compared with commercial EIA were found in 2 of 423 healthy blood donors (specificity: 99.5%).

False Positive Reactions↗
PubMedDate not supplied

Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation.

OBJECTIVE: To compare needle acupuncture, medication (tenoxicam with ranitidine), and spinal manipulation for managing chronic (>13 weeks duration) spinal pain syndromes. DESIGN: Prospective, randomized, independently assessed preintervention and postintervention clinical pilot trial. SETTING: Specialized spinal pain syndrome out-patient unit at Townsville General Hospital, Queensland, Australia. SUBJECTS: Seventy-seven patients (without contraindication to manipulation or medication) were recruited. INTERVENTIONS: One of three separate, clearly defined intervention protocols: needle acupuncture, nonsteroidal anti-inflammatory medication, or chiropractic spinal manipulation. MAIN OUTCOME MEASURES: Main outcome measures were changes (4 weeks vs. initial visit) in the scores of the (1) Oswestry Back Pain Disability Index, (2) Neck Disability Index, and (3) three visual analogue scales of local pain intensity. RESULTS: Randomization was successful. After a median intervention period of 30 days, spinal manipulation was the only intervention that achieved statistically significant improvements (all expressed as percentages of the original scores) with (1) a reduction of 30.7% on the Oswestry scale, (2) an improvement of 25% on the neck disability index, and (3) reductions on the visual analogue scale of 50% for low back pain, 46% for upper back pain, and 33% for neck pain (all P<.001). Neither of the other interventions showed any significant improvement on any of the outcome measures. CONCLUSIONS: The consistency of the results provides, in spite of several discussed shortcomings of this pilot study, evidence that in patients with chronic spinal pain syndromes spinal manipulation, if not contraindicated, results in greater improvement than acupuncture and medicine.

Acupuncture Therapy↗
PubMedDate not supplied

Similarities and dissimilarities between pattern VEPs and motion VEPs.

The contrast response functions (CRF) of pattern-appearance and motion-onset VEPs for periodic stimuli (gratings) were compared. The CRF for pattern-appearance is accelerative for the P100 component and compressive for the N200 component. Contrary to these results, the CRF for motion-onset shows an almost negligible slope for both components within the contrast range tested (0.5-64%). To better isolate the neural contributions to these different VEP components, we studied the effects of prior adaptation to stationary and moving gratings. Adaptation to stationary gratings has no effect on both VEP components for motion-onset and the P100 component for pattern-appearance, but did reduce the amplitude of the N200 for pattern-appearance. Adaptation to slow (1 deg/s) and fast (4 deg/s) gratings left the P100 amplitudes unaltered, while it significantly reduced the N200 amplitudes for both pattern-appearance and motion-onset. These results suggest that the N200 component of the motion-onset VEP is generated by motion-dependent neurons, whereas the same component for pattern-appearance arises from contrast-dependent neurons. The observed differences between P100 and N200 components appear to reflect the activity of both transient and sustained neural mechanisms.

Adaptation, Ocular↗
PubMedDate not supplied

Motion VEPs with simultaneous measurement of perceived velocity.

The dependency of the N200 amplitude of the motion-onset VEP evoked by a parafoveal grating of variable speed (0.25-13.5 deg/s, corresponding to 0.5-27 Hz) and constant contrast (4%) was studied. Additional measurements were made with parafoveally presented gratings of constant speed (2 deg/s, corresponding to 4 Hz) and a variable contrast (0.5-64%) before and after adaptation to a stationary or drifting grating. In this latter experiment, simultaneous psychophysical measurements were made of the perceived speed. The amplitude of the N200 wave increased with increasing stimulus speed within the slow speed range up to 1.5 deg/s (corresponding to 3 Hz). Adaptation to a stationary grating had no significant effect on the relationship between the N200 amplitude and stimulus contrast. Contrary to this, adaptation to a slowly drifting grating (1 deg/s, corresponding to 2 Hz) or to a rapidly drifting grating (4 deg/s, corresponding to 8 Hz) reduced the N200 amplitude significantly. Adaptation to a stationary grating slightly reduced the perceived speed of subsequently viewed gratings. Adaptation to a slowly drifting grating increased the perceived speed of the subsequently viewed gratings, whereas adaptation to a rapidly drifting grating decreased the perceived speed. The findings can be best explained by a two-channel model of speed perception. While the motion VEP reflects the sum of both channel activities, the psychophysical measures point to the antagonistic encoding of low and high velocities.

Adaptation, Ocular↗
PubMedDate not supplied

Tissue and cell type-specific expression of two human c-onc genes.

Cellular genes containing nucleotide sequences homologous to retroviral oncogenes (v-onc) have been identified in the genomes of a variety of species of both the vertebrate and invertebrate phyla. Expression of such genes, termed c-onc genes, has been shown to be tissue-specific in chickens and mice and to be modulated during murine development and differentiation of human haematopoietic cells. We report here that the level of the c-fos gene transcripts is 100-fold greater in human term fetal membranes than in other normal human tissues and cells. These levels of c-fos expression in human amniotic and chorionic cells are close to the level of v-fos expression that results in the induction of osteosarcomas in mice and transformation of fibroblasts in vitro. This observation suggests that the induction of neoplastic transformation by the FBJ murine osteosarcoma virus may require the expression of the fos gene product at high levels in an inappropriate cell type. In contrast, the human c-fms gene is expressed at high levels specifically in term placenta and trophoblastic cells. The tissue and cell type-specific patterns of c-fos and c-fms expression suggest that the physiological function of the c-fos and c-fms encoded proteins may be associated with those embryo-derived cells whose primary functions are protection and nourishment of the human fetus.

Adult↗