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Biomedical subjects

S Walter

Publications and source records attributed to S Walter.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Myocardial abscess complicating myocardial infarction.

Myocardial abscess may occur rarely as a complication of myocardial infarction. This case report is the first demonstration of a myocardial abscess at the site of acute myocardial infarction in a 38-year-old man diagnosed by transesophageal echocardiography and color-flow imaging. Transesophageal echocardiography was crucial in the timing of surgery. Three months later the patient was well. Our patient is the first reported survivor of this uncommon complication of myocardial infarction.

Abscess↗
PubMedDate not supplied

[Direct genotype analysis in congenital myotonic dystrophy with an unusual family anamnesis].

We report a case of congenital myotonic dystrophy (CMD) in which not only the mother but also the paternal family is affected by myotonic dystrophy (DM). Clinical symptoms consisted of poor spontaneous movements, typical facial appearance, respiratory insufficiency attributable to diaphragmatic weakness, feeding difficulties due to impaired gastrointestinal tract motility and poor sucking, joint contractures and thin ribs. She died at 7 month of age, still ventilated, from aspiration pneumonia. By employing molecular genetic methods we were able to show that the affected child was not homozygous for the DM gene.

Electromyography↗
PubMedDate not supplied

[BCG-vaccination in neonates as a cause of osteomyelitis--an argument against BCG-vaccination?].

BCG-osteomyelitis is a rare complication of BCG-vaccination. By means of a case report clinical and immunological findings are discussed. Contrary to the undramatic clinical symptoms the x-ray showed pronounced osteolytic lesions in the sternum. The bacteriological examination demonstrated mycobacteria of BCG-type. Immunological investigations presented normal humoral and cellular immunity. The therapy (curettage, antituberculous drugs) was effective. In spite of this complication the BCG-vaccination is furthermore recommended.

BCG Vaccine↗
PubMedDate not supplied

Expression of monocyte chemotactic protein and interleukin-8 by cytokine-activated human vascular smooth muscle cells.

The present study was designed to investigate the capacity of human vascular smooth muscle cells (SMCs) to produce a cytokine chemotactic for monocytes (monocyte chemotactic protein [MCP]) and by way of comparison, a related polypeptide activator of neutrophils (known as interleukin-8 [IL-8] or neutrophil activating protein-1 [NAP-1]. On exposure to IL-1, SMCs released high levels of chemotactic activity for monocytes, which could be removed by absorption with anti-MCP antibodies. MCP production by activated SMCs was comparable to that of IL-1-stimulated umbilical vein endothelial cells. Activated SMCs released appreciable levels of IL-8, as determined by a specific enzyme-linked immunosorbent assay, but little chemotactic activity for neutrophils. IL-1-treated SMCs expressed high levels of both MCP and IL-8 mRNA transcripts, as assessed by Northern blot analysis. Tumor necrosis factor and bacterial lipopolysaccharide but not IL-6 also induced MCP and IL-8 gene expression in SMCs. Nuclear runoff analysis revealed that IL-1 augmented transcription of the MCP and IL-8 genes. The capacity of SMCs to produce a cytokine (MCP) that recruits and activates circulating mononuclear phagocytes may be of considerable importance in the pathogenesis of vascular diseases (e.g., vasculitis and atherosclerosis) that are characterized by monocyte infiltration of the vessel wall.

Blotting, Northern↗
PubMedDate not supplied

Evaluation of the protected brush catheter and bronchoalveolar lavage in the diagnosis of nosocomial pneumonia.

We assess the sensitivity and specificity of the protected brush catheter (PBC) and bronchoalveolar lavage (BAL) in diagnosing nosocomial pneumonia in nonimmunocompromised critically ill patients. Computerized bibliographic literature searches of MEDLINE were performed, and the reference list of each article selected was reviewed. Of 496 citations, there were 19 articles (describing 18 studies) that proved relevant. Study quality was assessed, and descriptive information concerning study populations, interventions, and clinically relevant outcome measurements was extracted. The sensitivity and specificity of PBC were high (pooled estimates, 89.9 and 94.5%, respectively). Criteria for a positive BAL have varied between studies, and sensitivity ranged from 53.3 to 100%, whereas specificity was 98.6%. Most studies did not report whether antibiotics were withheld on the basis of negative test results. In those that did, the incidence of adverse outcomes consequent on withholding antibiotics was low. BAL and PBC, combined with the use of quantitative cultures, appear to increase accuracy in diagnosing pneumonia. The strength of inference is hampered, however, by the absence of a "gold standard" for the diagnosis of pneumonia. Moreover, the generalizability of these findings is limited by the fact that there are so few methodologically sound studies from so few centers. A randomized trial of PBC is needed.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Gemcitabine and protracted 5-FU for advanced pancreatic cancer. A phase II study.

BACKGROUND/AIMS: Although chemotherapy in advanced pancreatic cancer procures dismal results, both 5-fluorouracil and gemcitabine have shown a modest activity. We report a phase II study of gemcitabine combined with protracted 5-fluorouracil. METHODOLOGY: Gemcitabine was given at 1000 mg/m2/week intravenously, in combination with concomitant 5-fluorouracil 200 mg/m2/day as a protracted venous infusion, both 3 out of 4 weeks in patients with locally advanced or metastatic pancreatic adenocarcinoma. Twenty-nine patients were enrolled, among whom 27 were metastatic. Response rate, overall and progression-free survival were endpoints, as well as tolerance and clinical benefit. RESULTS: We observed 3 (10%) partial responses, and 12 (42%) stabilizations within which the median disease control was 5.6 months. The median progression-free and overall survivals were 2.8 and 4 months, respectively. A clinical benefit was observed in 39% of patients. Myelosuppression was the main toxicity, but no grade 4 was observed. Other toxicities were mild. CONCLUSIONS: This combination chemotherapy was well tolerated in advanced pancreatic cancer patients.

Adenocarcinoma↗
PubMedDate not supplied

Impact of cigarette smoking on pulmonary function in non-allergic subjects.

BACKGROUND: Cigarette smokers have been shown to have a greater tendency to develop respiratory allergies than non-smokers. Since the early obstructive airway changes seen in respiratory allergy and smoking are similar, the early airway changes seen in populations of young smokers might be attributed to the fact that a proportion of smokers are allergic. We therefore studied the effects of smoking on non-allergic individuals. METHODS: Forced expiratory spirograms and peak expiratory flows were measured in a population of asymptomatic non-allergic male medical students, 59 smokers and 110 non-smokers. They had between 2 and 5 examinations performed serially over a period of 4 years. RESULTS: Smoking had a negative impact on pulmonary function. Analysis of covariance and multiple regression analysis using age, height gain and weight change as covariables showed that smokers, when compared to non-smokers, had a significantly greater percentage decline in the forced expiratory volume in one second expressed as a fraction of the forced vital capacity (4.01 +/- 4.6 v. 1.52 +/- 5.84), the forced expiratory flow in the middle half of the forced vital capacity (FEF25%-75%; 11.36 +/- 15.09 v. 5.3 +/- 17.58) and the ratio of the FEF25%-75% to the forced vital capacity (FEF/FVC; 14.06 +/- 14.45 v. 6.95 +/- 17.94). CONCLUSIONS: Our results suggest that young smokers, within a few years of starting to smoke, develop changes in pulmonary function indicating early peripheral airway narrowing, and that these effects worsen progressively with continued smoking.

Adult↗
PubMedDate not supplied

AIDS seminars for senior grades in secondary schools.

AIDS seminars lasting 70 minutes, consisting of an oral presentation, a videotape and time for discussion, were offered to students in grades 11, 12 and 13 in secondary schools in the Hamilton Board of Education. Specially chosen teacher and public health nurse facilitators were assigned to sessions. 19 secondary school principals and 1,898 students in 10 schools completed questionnaires about the usefulness of the seminars. Students and principals viewed the seminars. Students and principals viewed the seminar as highly valuable for obtaining new information in sessions with either public health nurse or teacher facilitators. The oral presentation was rated most valuable but students rated the videotape and the discussion components highly as well. The students strongly agreed that the seminar assisted in understanding how STDs could be prevented, and made them aware of the community groups or agencies they could go to for help. A substantially greater number of females than males indicated they wished to attend other seminars.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Effects of upper respiratory infections on the forced expiratory volumes and flow rates.

The effects of an upper respiratory infection on some commonly measured spirometric indices have been determined in this study. The forcod vital capacity, forced expiratory volume in one second, forced expiratory flow in the middle half of the vital capacity and the peak expiratory flow were significantly lower during the infection. This stresses the need in cross sectional and longitudinal pulmonary function evaluation, to avoid testing a subject while he has an upper respiratory infection.

Adult↗
PubMedDate not supplied

How useful is the FEV1%?

The ability of the forced expiratory volume for 1 second expressed as a percentage of the forced vital capacity (FEV1%) in identifying early airway narrowing was compared with that of the forced expiratory flow in the middle half of the forced vital capacity (FEF 25-75%), in two populations, young smokers and subjects with allergic rhinitis who are known to have early airway narrowing. FEV1% appears to be more sensitive, in differentiating these groups and in identifying abnormality. Among smokers, FEV1% detected abnormality in 19% while FEF 25-75% only in 7% and among the allergic subjects the former detected abnormality in 25% while the latter only in 19%. In longitudinal studies, the decline in pulmonary function in smokers is identified almost equally well by both parameters. Critical ratios (t) were 2.85 and 3.86 after 1 to 2 years and 7.32 and 3.97 after 3 to 4 years for FEV1% and FEF 25-75% respectively. A high degree of correlation exists between these two measurements in all the subjects. These findings indicate the usefulness of FEV1% in the detection of early airway narrowing and are of special interest to those engaged in a busy clinical practice, as the FEV1% is a quicker measurement to make, than the FEF 25-75%.

Adult↗