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Biomedical subjects

S Wagner

Publications and source records attributed to S Wagner.

At least 343 records · Page 19Linked to original sources
PubMed1991

Circadian pattern of intragastric acidity in duodenal ulcer patients: a study of variations in relation to ulcer activity.

The relation between intragastric acidity and duodenal ulcer activity was studied prospectively in 21 patients with endoscopically proved duodenal ulcers. The 24 hour intragastric acidity was measured on four separate occasions by continuous recording using combined glass electrodes: (a) in the presence of an ulcer crater without treatment; (b) during active ulceration being treated with ranitidine; (c) during early healing after a six week course of ranitidine; (d) during late healing six months after acute ulceration. Intragastric acidity was also monitored in 20 healthy subjects. At all stages of ulcer activity and during all predefined time periods, duodenal ulcer patients had significantly higher gastric acidity than healthy control subjects. Duodenal ulcer patients showed a similar circadian pattern of intragastric acidity during exacerbation of ulcer disease and in remission during the early and late ulcer healing periods. These results argue against a direct relation between the activity of duodenal ulcer disease and gastric acidity. It is concluded that the chronic recurrent course of duodenal ulcer disease does not result from a fluctuation in intragastric acidity.

Acute Disease↗
PubMed1991

Dysmegakaryopoiesis in myelodysplastic syndromes (MDS): an immunomorphometric study of bone marrow trephine biopsy specimens.

An immunohistochemical and morphometric analysis was performed on trephine biopsy specimens of the bone marrow in 40 patients (23 men and 17 women, mean age 62 years) with different subtypes of myelodysplastic syndromes (MDS) to determine dysmegakaryopoiesis, but particularly precursor cells--that is, pro- and megakaryoblasts. In 31 of the 40 patients the numbers of megakaryocytes were increased which was associated with a predominance of smaller cell forms (micromegakaryocytes). Compared with periodic acid Schiff, immunostaining with a formalin resistant monoclonal antibody against glycoprotein IIIa (Y2/51(CD61) showed a clinically important proportion of immature elements. These could be designated pro- and megakaryoblasts by taking morphometric measurements on smears and bone marrow sections. There was a relevant increase in the number of promegakaryoblasts in 32 patients, consistent with uncontrolled expansion of the precursor pool. Seventeen repeated bone marrow biopsy specimens taken after chemotherapy largely showed a decrease in the numbers of megakaryocytes including the precursor cell population. Moreover, morphometric evaluation disclosed that micromegakaryocytes in MDS differ significantly from those in chronic myeloid leukaemia (CML) due to distinctive nuclear features and a disturbed nuclear:cytoplasmic ratio. These changes generate a more pleomorphic or atypical appearance of this cell population in MDS, compared with micromegakaryocytes in CML. It is concluded that the disproportionate increase in megakaryocyte precursors and the grossly abnormal aspects of micromegakaryocytes in MDS are characteristics of the severe defect involving haematopoiesis in this disorder.

Adult↗
PubMed1991

Functional description of the left ventricle in patients with volume overload, pressure overload, and myocardial disease using cine magnetic resonance imaging.

Cine magnetic resonance imaging (MRI) is a three-dimensional imaging technique with sufficient temporal resolution to provide quantitation of left ventricular (LV) dimensions and function. It can be used to describe the three-dimensional geometrical and functional characteristics of various cardiac disease states. Accordingly, the purpose of the study was to noninvasively characterize LV function with cine MRI using LV mass, systolic wall stress, ejection fraction, and fractional wall thickening, and to compare these functional determinants among three major cardiac disease states. Patients were selected from echocardiographic criteria and specific history of disease and divided into the following groups: compensated moderate to severe aortic regurgitation; compensated LV hypertrophy caused by systemic hypertension; and dilated congestive cardiomyopathy. Normal subjects without evidence of heart disease were studied for comparison. Cine MRI was performed at 1.5 Tesla in the short-axis plane. Wall stress was calculated from MRI, along with blood pressure recordings and carotid pulse tracings, according to the Laplacian expression. The end-diastolic volume to LV mass ratio distinguished between concentric and eccentric LV hypertrophy. Peak-systolic wall stress was increased in volume overload lesions and myocardial disease and significantly different (P less than .01) compared with pressure overload lesions and normal subjects. Ejection fraction was significantly decreased (P less than .01) in myocardial disease compared with volume and pressure overload lesions and normal subjects. Among these disease states, LV mass was not different but was significantly higher in all (P less than .01) compared with normal subjects. Fractional wall thickening was increased in pressure overload lesions. Thus, the increase in LV mass in volume overload lesions and primary myocardial disease is not adequate to prevent an increase in wall stress, whereas LV mass increased sufficiently in pressure overload lesions to normalize systolic wall stress. Cine MRI can be used to noninvasively describe the three-dimensional geometry and functional state of the heart in various pathological conditions and might be used to monitor therapeutic effects.

Adult↗
PubMed1991

[Immunohistochemistry and morphometry of bone marrow in acquired immunodeficiency syndrome with special emphasis on megakaryopoiesis and macrophages].

An immunomorphometric study was performed on formalin-fixed and paraffin-embedded bone marrow biopsies in 20 patients with AIDS (18 males, 2 females-stage IV A-D). In comparison with a control group megakaryocytes (CD61-Y2/51) revealed not only a significant hyperplasia, but remarkably irregular shapes of cells and nuclei, together with a disturbance of the nuclear-cytoplasmic ratio. No predominance of micromegakaryocytes as in myelodysplastic syndromes was observable. Contrasting idiopathic (immune)-thrombocytopenia, HIV-infected patients with a pronounced depression of the platelet count did not show a significant elevation of the number of promegakaryoblasts. This feature is in keeping with findings of a severe impairment of progenitor cell proliferation and differentiation in AIDS. There was a pronounced increase in the macrophage population (PG-M1). This alteration may be related to inflammatory lesions accompanying this disorder as well as to an enforced and premature destruction of hematopoietic cell elements in the myeloid stroma.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Protective effects of calcium antagonists on energy and substrate metabolism during ischemia and reperfusion in hypertensive myocardial hypertrophy.

The aim of the present study was to define the protective effects of verapamil and nifedipine on mechanical performance and energy and substrate metabolism of the postischemically reperfused myocardium in a chronic pressure overload cardiac hypertrophy model. The isolated beating rat heart preparation was used and left ventricular pressures and high-energy phosphates were continuously monitored during 30 min of global ischemia and reperfusion, respectively. Recovery of mechanical performance and high-energy phosphate and sugar monophosphate metabolism was significantly impaired in untreated hypertrophied hearts compared with normal control hearts and hypertrophied hearts treated with calcium antagonists. In hypertrophied hearts with chronic verapamil treatment, recovery was significantly improved compared to acute verapamil treatment, nifedipine treatment, and normal control hearts. Thus, verapamil and nifedipine exerted a protective effect on the postischemic recovery of the hypertrophied myocardium that was most prominent following long-term pretreatment with verapamil. Prolonged maintenance of adequate plasma levels and tissue distribution of calcium antagonists before an ischemic event may improve the postischemic prognosis in the presence of pressure-induced myocardial hypertrophy.

Adenosine Triphosphate↗
PubMed1991

[Multiple coagulation disorders following cesarean section].

We refer to a case report describing the diagnostic and therapeutic problems resulting in multiple intra- and postoperative coagulation disorders. Differential diagnostic indications respecting to the most important disorders within the coagulation system are described especially. Local hyperfibrinolysis is accounted in detail; besides we inform about our own therapeutic experiences.

Adult↗
PubMed1991

The role of omeprazole (40 mg) in the treatment of gastric Helicobacter pylori infection.

The efficacy of omeprazole in the elimination of Helicobacter pylori was investigated in a prospective randomized-controlled trial. 50 patients with upper gastrointestinal symptoms and chronic active H. pylori-associated gastritis were allocated to one of the following four therapeutic schedules: 1) omeprazole 40 mg/d for 4 weeks (n = 13); 2) bismuth subsalicylate (BSS) 3 x 600 mg for 4 weeks (n = 12); 3) omeprazole plus BSS for 4 weeks (n = 13); 4) triple therapy (BSS for 4 weeks, amoxicillin 3 x 750 mg and metronidazole 3 x 400 mg for 10 days) (n = 12). Clinical symptoms, endoscopic and histologic findings, and H. pylori status were reassessed immediately after therapy, and 1 and 6 months later. After cessation of therapy bacterial clearance rates were: 1) omeprazole 2/13 (15%); 2) BSS 6/12 (50%); 3) omeprazole plus BSS 5/13 (38%); 4) triple therapy 10/12 (83%). The degree of density of gastric mucosal infestation with H. pylori and the degree of activity of gastritis was reduced in all treatment groups but was most prominent after triple therapy. Clinical symptoms improved in all treatment groups. One and six months after completion of therapy H. pylori eradication rates were: 1) omeprazole 0/13 (0%); 2) BSS 1/12 (8%); 3) omeprazole plus BSS 1/13 (8%); 4) triple therapy 10/12 (83%). Our study shows that 40 mg/d omeprazole is ineffective in eradicating H. pylori. Dual therapy with omeprazole and bismuth subsalicylate does not improve bacterial elimination. Only triple therapy effectively eradicates H. pylori.

Adult↗
PubMed1991

Evaluation of valvular heart disease with cine gradient echo magnetic resonance imaging.

Electrocardiographic referenced repetitive gradient echo magnetic resonance imaging (cine GRE) has been used to detect and quantify valvular regurgitation. Regurgitation is recognized as a signal void in the high intensity blood pool on these images. Mitral regurgitation causes a signal void in the left atrium in systole, and aortic regurgitation produces one in the left ventricle in diastole. The specificity, sensitivity, and diagnostic accuracy of cine GRE for the detection of mitral and aortic regurgitation was greater than 0.93, 0.89, and 0.92, respectively. The severity of regurgitation has been quantified as the difference in the stroke volume between the two ventricles by measuring the volume of the blood pool, as shown in the stack of magnetic resonance tomograms. Severity has also been assessed by measuring the volume of the signal void. Finally, measurements of the volume of aortic regurgitation have recently been achieved by using velocity-encoded cine GRE. This technique provides a direct measurement of retrograde flow in the aorta during diastole. New cine GRE imaging techniques provide a noninvasive means for quantification of valvular as well as ventricular function.

Aortic Valve↗
PubMed1991

Megakaryocytopoiesis in idiopathic thrombocytopenic purpura: a morphometric and immunohistochemical study on bone marrow biopsies with special emphasis on precursor cells.

A morphometric and immunohistochemical study was performed on trephine biopsies of the bone marrow in patients showing idiopathic thrombocytopenic purpura (ITP) and reactive thrombocytosis (RTH). Features of megakaryocytopoiesis were determined not only by using the periodic acid Schiff reaction (PAS), but also by immunostaining with the monoclonal antibody Y2/51, detecting a formalin-resistant epitope of glycoprotein IIIa (CD61). An increased number of megakaryocytes was observed in both ITP and in RTH as compared with a control group. Immunostaining revealed a predominance of small immature elements of this cell lineage, particularly in cases of ITP. Following previous experimental cell culture studies on megakaryocyte precursors and features derived from corresponding smear preparations, we characterized promegakaryoblasts immunomorphometrically. According to these calculations, ITP, as opposed to RTH, features a disproportionate expansion of the megakaryocyte precursor pool.

Antibodies, Monoclonal↗
PubMed1991

Intragastric long-term pH-metry in hemodialysis patients. A study with famotidine.

The onset and duration of famotidine action were studied in 14 hemodialysis (HD) patients and 16 healthy controls (control group: CG) who were examined by ambulatory intragastric 24-hour pH-metry. 20 mg famotidine was administered i.v. 90 min after HD in the afternoon (AN; 2 p.m.; n = 8) or evening (E; 8 p.m.; n = 6), followed by a standard meal. Mean onset of action in the AN and E groups of the HD patients was 90.3 +/- 28.2 min and 98.8 +/- 29.8 min, and in CG patients 36.3 +/- 11.9 min and 53.6 +/- 22.3 min, respectively (p less than 0.05). Duration of action in the AN and E groups of the HD patients was 22.7 +/- 2.1 h and 21.6 +/- 2.6 h, and in CG patients 6.0 +/- 1.1 h and 11.4 +/- 1.6 h, respectively (p less than 0.05). Our study showed a retarded and prolonged action of famotidine in HD patients. The time of administration of famotidine had no effect on its action in HD patients. This is in contrast to normal subjects in whom evening administration delays the onset and prolongs the duration of famotidine action in comparison to afternoon administration.

Adult↗
PubMed1991

Alcohol and pyruvate cardioplegia. Twenty-four-hour in situ preservation of hamster hearts.

Isolated hamster hearts were first perfused with a normal Krebs-Henseleit medium to demonstrate comparable viability of hearts before perfusing and storing them for 24 hours in one of three solutions. The three solutions were a physiologic saline with pyruvate as the substrate and 4% alcohol to arrest the heart (group 1), a standard cardioplegic solution (group 2), and an alcohol-free physiologic saline with pyruvate as the substrate (group 3). Recovery in terms of rate/pressure product and oxygen consumption after 30 minutes of reperfusion was 81% and 93%, respectively, for group 1, 13% and 32% for group 2, and 70% and 72% for group 3. Percent of physiologic recovery was not related to recovery of adenosine triphosphate. The adenosine triphosphate level returned to approximately 40% control level in all three groups, and in all three groups inorganic phosphate remained approximately 320% over control level after 30 minutes of reperfusion. Phosphocreatine level significantly higher in groups 1 and 3 than in group 2, as a result of improved oxygen consumption. Intracellular pH, determined by phosphorous 31 nuclear magnetic resonance spectroscopy, was physiologic in groups 1 and 3 but alkaline in group 2. This alkalinity may have been caused by leaky membranes. Pyruvate helped preserve mitochondrial function during depressed oxygen delivery, such as was seen during the 24-hour storage period. Four percent alcohol arrested the heart; combined with pyruvate plus alcohol solution were better than a standard cardioplegic solution for maintaining functional capability.

Animals↗
PubMed1990

[Pancreas transplantation in Type I diabetic patients].

Successful pancreas transplantation can result in the longterm normalization of glucose metabolism. Since most pancreas recipients already have severe diabetic complications, and the observation period after transplantation is rather short, an assessment of the effect of complete glucose normalization on these diabetic changes is problematic. It has, however, been shown that the development of diabetic nephropathy can be prevented, peripheral microcirculation improved, and autonomic and peripheral neuropathy and retinopathy stabilized. These positive effects are, possibly, in part due to the elimination of uremia, since most patients receive both a pancreas and a kidney. The aim must be to perform pancreas transplantation in an early stage of diabetes, even though remarkable improvements have also been reported in terminal stages of the disease, and the quality of life of these patients has been significantly improved.

Blood Glucose↗
PubMed1990

mRNA of bovine tissue inhibitor of metalloproteinase: sequence and expression in bovine ovarian tissue.

A cDNA library derived from poly(A+)RNA of bovine ovary was screened with a PCR fragment comprising the coding region of human tissue inhibitor of metalloproteinase inhibitor (TIMP). From a number of positive clones, pBGR19, containing a 747 bp insert, was identified and sequenced. The derived amino acid sequence represents that of the precursor of bovine TIMP. Northern analysis reveals a TIMP specific mRNA of 800 bp. Southern analysis indicates that one gene appears to specify bovine TIMP. TIMP mRNA is only weakly expressed in follicular granulosa- and theca cells, whereas luteinization of the follicle is associated with an increase of expression. Expression varies with the stage of the luteal phase; it was highest in stages I and III, but low in stages II and IV of the oestrous cycle.

Amino Acid Sequence↗
PubMed1990

Seminalplasmin, the major basic protein of bull seminal plasma, is a secretory protein of the seminal vesicles.

From the experimental results of three independent methods: (1) indirect immunofluorescence employing monospecific anti-seminalplasmin-IgGs, (2) cell-free translation of poly(A)+ RNA from seminal vesicle and testicular tissue, as well as (3) Northern analysis of poly(A)+ RNA of the latter tissues with a synthetic seminalplasmin-specific antisense DNA probe, it is concluded that the biosynthesis of seminalplasmin occurs in seminal vesicles but not in testis.

Amino Acid Sequence↗
PubMed1990

[Fasciitis in granulomatous myositis--an atypical manifestation of sarcoidosis?].

We report about two female patients with a histopathological proven granulomatous myositis associated with a fasciitis. One patient showed noncaseating granulomas in the muscle fascia. She suffered from symmetrical contractures of the digital flexors and ankles. The second patient showed uveitis and polyneuropathy, too. In addition, increased activities of the angiotensin-converting-enzyme and lysozyme in the sera suggested that both cases represent a new form of sarcoidosis.

Adipose Tissue↗