Biomedical subjects

Robert Fischer

Publications and source records attributed to Robert Fischer.

9 recordsLinked to original sources

PubMed2007

p38 mitogen-activated protein kinase inhibition ameliorates angiotensin II-induced target organ damage.

We investigated whether or not p38 mitogen-activated protein kinase inhibition ameliorates angiotensin II-induced target organ damage. We used double transgenic rats harboring both human renin and angiotensinogen genes (dTGRs). dTGR, with or without p38 inhibitor (BIRB796; 30 mg/kg per day in the diet), and nontransgenic Sprague-Dawley rats were studied in 2 protocols. In protocol 1 (week 7), systolic blood pressure of untreated dTGRs was 204+/-4 mm Hg, but partially reduced after BIRB796 treatment (166+/-7 mm Hg), whereas Sprague-Dawley rats were normotensive. The cardiac hypertrophy index was unchanged in untreated and BIRB796-treated dTGRs. The beta-myosin heavy chain expression of BIRB796-treated hearts was significantly lower in BIRB796 compared with dTGRs, indicating a delayed switch to the fetal isoform. BIRB796 treatment significantly reduced cardiac fibrosis, connective tissue growth factor, tumor necrosis factor-alpha, interleukin-6, and macrophage infiltration. Albuminuria was not reduced in BIRB796-treated dTGRs. Tubular and glomerular damage with tumor necrosis factor-alpha expression was unaltered, although serum creatinine and cystatin C were normalized. Renal macrophage infiltration, fibrosis, and vessel damage were reduced. In protocol 2 (week 8), we focused on mortality and arrhythmogenic electrical remodeling. Mortality of untreated dTGRs was 100% but was reduced to 10% in the BIRB796 group. Cardiac magnetic field mapping showed prolongation of depolarization and repolarization in untreated dTGRs compared with Sprague-Dawley rats with a partial reduction by BIRB796. Programmed electrical stimulation elicited ventricular tachycardias in 81% of untreated dTGRs but only in 48% of BIRB796-treated dTGRs. In conclusion, BIRB796 improved survival, target organ damage, and arrhythmogenic potential in angiotensin II-induced target organ damage.

Angiotensin II↗

PubMed2006

Oblique interaction of spatial dark-soliton stripes in nonlocal media.

We report what we believe to be the first experimental observation of a large spatial lateral shift in the interaction of obliquely oriented spatial dark-soliton stripes. We demonstrate by numerical simulations that this new effect can be attributed to the specific features of optical media with a nonlocal nonlinear response.

Journal Article↗

PubMed2006

Reduced-symmetry two-dimensional solitons in photonic lattices.

We demonstrate theoretically and experimentally a novel type of localized beam supported by the combined effects of total internal and Bragg reflection in nonlinear two-dimensional square periodic structures. Such localized states exhibit strong anisotropy in their mobility properties, being highly mobile in one direction and trapped in the other, making them promising candidates for optical routing in nonlinear lattices.

Journal Article↗

PubMed2006

Cardiac magnetic resonance and cardiac magnetic field mapping in a patient with stress-induced cardiomyopathy (tako-tsubo).

We encountered a 65-year-old woman with typical electrocardiogram (ECG) changes and new-onset left ventricular dysfunction with apical ballooning that exhibited typical changes of tako-tsubo-like cardiomyopathy. We used cardiac magnetic resonance (CMR) and cardiac magnetic field mapping (CMFM) to detect changes in structural, mechanical, and electrophysiological myocardial properties during follow-up. CMR displayed an acute myocardial injury, but neither fibrosis nor necrosis. CMFM exhibited severely disturbed repolarization with an inhomogeneous magnetic field. These pathological findings persisted much longer than the abnormalities detected by CMR and the ECG.

Aged↗

PubMed2005

Staff management in the in vitro fertilization laboratory.

Although many IVF centers have implemented a Quality Management System, staff management in the IVF laboratory is still highly neglected. This article describes methods for staff development and monitoring of staff performance in the IVF laboratory.

Clinical Competence↗

PubMed2004

[Interdisciplinary quality management in preventive medicine institutions].

Like all health care institutions, preventive medicine institutions, too, need a quality assurance structure. An integrated system consisting of "balanced score card", "finite-elements-model" and "interdisciplinary quality circles" is presented. This organisational structure allows the implementation of quality assurance in complex institutions as well, such as health care organisations. In addition, this concept guarantees broad acceptance by all team members, not least due to complexity reduction.

Austria↗

PubMed2004

[Short version of the guideline "Early Detection of Breast Cancer in Germany"].

The aim of this evidence-, consensus- and outcome-based good clinical practice guideline is to help physicians, and women in making appropriate healthcare decisions about the early detection of breast cancer. The principle of early detection of breast cancer comprises the detection and diagnosis of pre-malignant breast tumours (UICC stage 0, carcinoma in situ) with a possible cancer risk reduction and the detection and diagnosis of breast cancer at an early stage (UICC stage 1) with a scientifically proven 90% chance of cure. By establishing a nation-wide comprehensive quality assurance program for the early detection of breast cancer this guideline lays the foundation for a timely reduction of breast cancer mortality and achievement of cure with less impairment of patient's quality of life. It would appear that this guideline makes major improvements in women's healthcare feasible.

Algorithms↗

PubMed2003

Nodular sclerosing Hodgkin disease: new grading predicts prognosis in intermediate and advanced stages.

The prognostic value of histologic classification and single histomorphologic parameters in Hodgkin disease has been widely debated in the literature. Whereas several former studies identified single parameters to be of clinical relevance, some recent reports have doubted the prognostic value of histology using modern treatment. Grading of the largest histologic category of Hodgkin disease, nodular sclerosis (NS), has been controversially discussed concerning clinical relevance. In this study, 965 cases of NS were reviewed to assess 9 histomorphologic parameters. The histologic results were correlated with laboratory and clinical findings and with overall survival and disease-free survival. Based on these results, a new grading of the NS category was established. The new grading, based on the 3 criteria eosinophilia, lymphocyte depletion, and atypia of the Hodgkin/Reed-Sternberg cells, was a significant indicator of prognosis in intermediate and advanced stages. Patients investigated in this study represent an outstanding collection because all of them were enrolled in the prospective multicenter clinical trial of the German Hodgkin Lymphoma Study Group. All of them had been staged uniformly according to the Ann Arbor system and had received stage-adapted modern treatment according to multimodality protocols. A subtle analysis of histology could represent a possible way to identify patients with a significantly better or worse prognosis. This new grading should help to avoid overtreatment to reduce severe therapy-related side effects such as acute toxicity and chronic sequelae such as cardiopulmonary complications and secondary neoplasias.

Adolescent↗

PubMed2002

Is your IVF programme good?

Few standards exist today to assess the quality of an IVF centre. Although much focus is placed upon pregnancy rates, emphasis on this outcome alone is inadequate. The purpose of this report is to examine those factors that should be considered in assessing the overall quality of an IVF centre. Current methods to assess quality are reviewed. Many governing bodies throughout the world currently focus solely on pregnancy rates, which can be misguided if factors such as multiple pregnancies, ovarian hyperstimulation, patient satisfaction, and the proper evaluation of laboratory and clinical protocols are not taken into account. Measurements of quality and methods to improve it are critical in all business models, including IVF. We propose an international standard such as the ISO 9001 for IVF centres to properly evaluate and improve the delivery of their care.

Female↗