[Summation-diastolic murmur in mitral stenosis].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
T Fischer
Publications and source records attributed to T Fischer.
[Air pollution due to cigarette smoke: physiological and irritating effects].
We assessed the effects on the judgement of air quality, eye blinking rate,and lung functions of air pollution due to cigarette smoke. At the same time, subjective irritations were recorded. The measured effects were brought into relationship with the concentration of some pollutants in the air.
Air Pollutants↗
Outcome of peripheral blood stem cell mobilization in advanced phases of CML is dependent on the type of chemotherapy applied.
High-dose chemotherapy with autologous transplantation of in vivo purged PBSC is a novel investigational approach to treating chronic myelogenous leukemia (CML) patients not responsive to conventional therapy with interferon-alpha (IFN-alpha) and not eligible for allogeneic transplantation. PBSC mobilization using either '5+2/7+3'-type chemotherapy or 'mini-ICE/ ICE' chemotherapy was investigated in 43 patients with advanced phases of Philadelphia (Ph)-positive CML. Thirty patients were in late chronic phase (>12 months post diagnosis) and 13 patients in accelerated phase (AP) or blast crisis (BC). Contamination with Ph-positive cells was evaluated in harvests from 37/43 patients. The outcome of PBSC mobilization was dependent on the type of chemotherapy administered: a complete or major cytogenetic response (<35% Ph-positive metaphases) in leukapheresis collections was obtained in ten of 15 patients treated with 'mini-ICE/ICE' but in only three of 28 patients treated with '5 + 2/7 + 3' chemotherapy. One patient (1/43) in blast crisis died during mobilization therapy (2%). Twenty-five patients underwent PBSC transplantation and all of them engrafted successfully. Transplantation-related mortality was 0%. The data show that in advanced phases of CML the chance of harvesting Ph-negative peripheral blood stem cells depends on the type of chemotherapy used for mobilization.
Adult↗
Monilethrix--improvement by hormonal influences?
Monilethrix is a hereditary hair disorder that occurs monosymptomatically or as a monilethrix syndrome combined with other ectodermal anomalies. We report two siblings with the triple combination of monilethrix, keratosis pilaris, and koilonychia. In one of our patients, the hair disorder improved, with maximum hair growth up to 8 cm in length after her first menstrual period occurred, suggesting that hormonal influences may improve the hair disorders in monilethrix.
Child↗
[Inhibition of meconium induced activation of granulocytes from neonates and adults by pentoxyphylline].
BACKGROUND: Neutrophil activation plays a crucial role in the pathogenesis of the meconium aspiration syndrome. Therefore antiinflammatory strategies may offer therapeutic options. The methylxanthinderivative pentoxyphylline (PTX) is known to inhibit the tumor necrosis factor alpha-synthesis and neutrophil degranulation and thus may have beneficial effects on meconium-induced pulmonary inflammation. Effects of PTX on PMN-degranulation in neonatal whole blood have not yet been studied. PATIENTS AND METHODS: Heparin-anticoagulated (3 IE/ml) whole blood of healthy neonates (n = 6) and adult volunteers (n = 6) was incubated for 45 min. Spontaneous PMN-degranulation was compared with meconium-induced (3 mg/ml) and PTX-inhibited (0,025 - 0,4 mg/ml) degranulation by means of elastase (EL) and lactoferrin (LF) release from azurophilic and specific granules. EL- and LF plasma concentration was measured by immunoluminometric methods. RESULTS: Spontaneous degranulation of neonatal PMN was found to be significantly increased after 15 minutes compared with cells from adults (EL and LF concentration: 674 and 660 ng/10 6 PMN vs. 284 and 261 ng/10 6 PMN). At 45 minutes adult PMN showed an acceleration of degranulation in contrast to neonatal cells (EL and LF: 1827 and 1232 ng/10 6 PMN vs. 1400 and 860 ng/10 6 PMN). In presence of PTX (0,4 mg/ml) spontaneous release of EL and LF from neonatal PMN was inhibited by nearly 70 % at 45 min. while degranulation from adult PMN was found to be completely inhibited at 15 min. and reduced by 82 % and 78 % at 45 min. In presence of meconium (3 mg/ml) an increased degranulation of EL from PMN of both neonates and adults (317 % and 170 %) could be observed while LF release was found to be increased from neonatal cells only (267 % and 113 % respectively). PTX inhibited meconium-induced EL release in blood of bath neonates and adults by 63 % and 66 %, while LF release was inhibited by 72 % and 57 % respectively. CONCLUSION: Neonatal PMN exhibit an increased degranulation from azurophilic and specific granules compared with cells from adults. PTX was found to be an effective inhibitor of spontaneous and meconium induced PMN degranulation and may offer new therapeutic options.
Adult↗
Correlation and quantification of relative 2-dimensional projected vertebral endplate z-axis rotations with 3-dimensional y-axis vertebral rotations and focal spot elevations.
BACKGROUND: The use of lines erected on the vertebral endplates of the anterior-to-posterior radiograph to assess z-axis vertebral rotation is a common clinical practice. OBJECTIVE: To quantify the projection/distortion error of lateral flexion (z-axis rotation) measurement, which results from actual axial (y-axis) rotation and changes in focal spot elevation, on AP radiographs. STUDY DESIGN: A 3-dimensional model of a 4th and 5th lumbar vertebrae was constructed with a computer. The angle between the projected inferior vertebral endplate of the 4th lumbar vertebra, and the projected superior vertebral endplate of the 5th lumbar vertebra was measured. This was done for combinations of 0, 7, 14, and 21 degrees of axial (-y-axis) rotation with 0, 15, and 30 cm of elevation of a modeled focal spot. RESULTS: An angle was produced between the projected inferior 4th lumbar vertebral endplate and the projected superior 5th lumbar vertebral endplate as a result of y-axis rotation of the 3-dimensional model. Increasing magnitudes of y-axis rotation and increasing focal spot elevation produced a lack of confidence in this measurement. CONCLUSION: In a clinical setting, limited ranges of y-axis rotation have little significant effect on the accuracy of this measurement. Increases in y-axis rotation and focal spot elevation can affect measurement accuracy.
Computer-Aided Design↗
Mechanoreception at the cellular level: the detection, interpretation, and diversity of responses to mechanical signals.
Cells from diverse tissues detect mechanical load signals by similar mechanisms but respond differently. The diversity of responses reflects the genotype of the cell and the mechanical demands of the resident tissue. We hypothesize that cells maintain a basal equilibrium stress state that is a function of the number and quality of focal adhesions, the polymerization state of the cytoskeleton, and the amount of extrinsic, applied mechanical deformation. A load stimulus detected by a mechano-electrochemical sensory system, including mechanically sensitive ion channels, integrin-cytoskeleton machinery, and (or) a load-conformation sensitive receptor or nonreceptor tyrosine kinase, may activate G proteins, induce second messengers, and activate an RPTK or JAK/STAT kinase cascade to elicit a response. We propose the terms autobaric to describe a self-loading process, whereby a cell increases its stress state by contracting and applying a mechanical load to itself, and parabaric, whereby a cell applies a load to an adjacent cell by direct contact or through the matrix. We predict that the setpoint for maintaining this basal stress state is affected by continuity of incoming mechanical signals as deformations that activate signalling pathways. A displacement of the cytoskeletal machinery may result in a conformational change in a kinase that results in autophosphorylation and cascade initiation. pp60Src is such a kinase and is part of a mechanosensory protein complex linking integrins with the cytoskeleton. Cyclic mechanical load induces rapid Src phosphorylation. Regulation of the extent of kinase activation in the pathway(s) may be controlled by modulators such as G proteins, kinase phosphorylation and activation, and kinase inhibitors or phosphatases. Intervention at the point of ras-raf interaction may be particularly important as a restriction point.
Biomechanical Phenomena↗
Suppression of UV-induced erythema by topical treatment with melatonin. Influence of the application time point.
The UV-suppressive effect of topical melatonin was assessed at different application time points in a double-blind randomized clinical trial. The lower back of 20 healthy volunteers was treated with 0.6 mg/cm2 melatonin or vehicle either 15 min before or 1, 30 or 240 min after UV irradiation. The erythema was evaluated visually and measured by chromametry 24 h after irradiation. UV-absorbing effects of melatonin were measured at a concentration of 8 microg/ml with a spectrophotometer. Melatonin absorbs UV light at a wavelength of 225-275 nm which is clearly below the wavelength of UVA and UVB (290-390 nm). The visual score showed that application of melatonin 15 min before irradiation significantly suppressed erythema compared to treatment with vehicle alone (p < 0.001). Similar results were found by chromametry (p < 0.001). Treatment after irradiation showed no UV suppression. The erythema suppressive effect of melatonin might be explained by the radical-scavenging mechanism of quenching meanly hydroxyl radicals (.OH) which are known to be most present in sunburn reaction of the skin. The protective effect of the pre-irradiation treatment might be explained by penetration into the skin within 15 min and the presence in a local concentration at the irradiation time point.
Administration, Topical↗
Caries prevalence after cessation of water fluoridation in La Salud, Cuba.
In the past, caries has usually increased after cessation of water fluoridation. More recently an opposite trend could be observed: DMFT remaining stable or even decreasing further. The aim of the present study conducted in La Salud (Province of Habana) in March 1997 was to analyse the current caries trend under the special climatic and nutritional conditions of the subtropical sugar island Cuba, following the cessation, in 1990, of water fluoridation (0.8 ppm F). Diagnostic evaluations were carried out using the same methods as in 1973 and 1982. Boys and girls aged 6-13 years (N = 414), lifelong residents in La Salud, were examined. Between 1973 and 1982 the mean DMFT had decreased by 71.4%, the mean DMFS by 73. 3% and the percentage of caries-free children had increased from 26. 3 to 61.6%. In 1997, following the cessation of drinking water fluoridation, in contrast to an expected rise in caries prevalence, DMFT and DMFS values remained at a low level for the 6- to 9-year-olds and appeared to decrease for the 10/11-year-olds (from 1. 1 to 0.8) and DMFS (from 1.5 to 1.2). In the 12/13-year-olds, there was a significant decrease (DMFT from 2.1 to 1.1; DMFS from 3.1 to 1. 5), while the percentage of caries-free children of this age group had increased from 4.8 (1973) and 33.3 (1982) up to 55.2%. A possible explanation for this unexpected finding and for the good oral health status of the children in La Salud is the effect of the school mouthrinsing programme, which has involved fortnightly mouthrinses with 0.2% NaF solutions (i.e. 15 times/year) since 1990.
Adolescent↗
Sequence determination of low molecular weight salivary histidine-rich polypeptides from electroblots.
Saliva contains six major cationic antifungal histidine-rich polypeptides (HRP) which are degraded by salivary proteases to smaller minor peptides. The primary structures of the minor peptides from one of these major HRPs, HRP-5, were elucidated in this study. Digestion of the HRP-5 substrate by human parotid saliva was followed by cationic polyacrylamide gel electrophoresis, electroblotting onto Whatman GF/C paper and gas-phase sequencing of Coomassie blue stained blots. A total of eight minor peptides were structurally analyzed. The smallest molecule characterized contained seven amino acid residues, suggesting that the technique was applicable for sequence determination of cationic peptides in the low molecular weight range.
Amino Acid Sequence↗
Prevention of irritant dermatitis.
Irritant contact dermatitis is the most frequent cause of occupational hand eczema and results from undue environmental demands on the skin. Preventive measures to reduce the irritant stress to the skin is the best method of tackling this problem.
Dermatitis, Contact↗
Antigen preparation for the patch test.
At this time patch testing is the most important tool in the evaluation of patients with dermatoses. From 70 to 80% of all cases of contact allergy are estimated to be discovered by using the standard trays with just 20 to 30 different substances and mixes.
Allergens↗
[Puerperal inhibition of lactation with metergoline or bromocriptine].
In a controlled, randomised, prospective, clinical study, the effect of prolactin suppression and clinical course of the lactation suppressors Bromocriptine and Metergoline were investigated. During 7 months 150 patients were studied. 81 of those patients, who did not nurse, were treated by Bromocriptine (primary lactation suppression: n = 62, secondary suppression: n = 19) and 69 of the patients were treated by Metergoline (primary suppression: n = 54, secondary suppression: n = 15). The drugs were administrated orally to all subjects, dosed 2 x 2.5 mg/d of Bromocriptine for 14 days and 3 x 4 mg/d of Metergoline for 10 days, starting in average after 13 hours. Puerperal suppression of prolactine were compared with randomised breast feeding subjects (n = 30). In Bromocriptine treated women the average plasma prolactin level decreased from 78.4 +/- 22 ng/ml to 17.0 +/- 3.3 ng/ml during five days of treatment. In Metergoline treated women the plasma prolactin level decreased from 129.7 +/- 15.1 ng/ml to 56.9 +/- 10.0 ng/ml during the first days of treatment. Prolactin level of breast feeding subjects decreased from 233.6 +/- 21.4 ng/ml to 185.8 +/- 23.7 ng/ml during the same period (p < 0.05). There is no statistical significancy of clinical difference of both drugs, but a statistical trend was seen. With Bromocriptine treated women were suppressed efficiently in 71 of 81 cases, 10 refused. Refusals were divided in two quality levels, level I with subjects with moderate complaints and little puerperal lactation, level II with subjects with considerable complaints including strong puerperal lactation. With Metergoline suppressed women, treatment was efficiently in 51 of 69 cases, but refusals of level I were observed in 11 cases and refusals of level II were observed in 7 cases. The results show that Bromocriptine and Metergoline are effective on suppression of lactation. Under the current drug dose of Metergoline an advantage of Bromocriptine were observed. Only further studies could investigate, whether an adaptation of drug dose would improve the clinical efficiency of Metergoline.
Administration, Oral↗
[Prenatal diagnosis of hypoplastic left heart syndrome--indications for abortion or transplantation?].
Early diagnosis of fetal cardiac malformations in center of Perinatal Medicine is now possible with the use of modern high frequency ultrasound technics in combination with the 3-step-program of the DEGUM. The diagnosis of most cardiac malformations can early already be obtained in the 2nd trimester as for example the lethal hypoplastic left ventricle syndrome. We want to discuss the problem of prenatal diagnosis of the hypoplastic left heart syndrome and the possibilities of therapeutic procedures.
Abortion, Eugenic↗
[Vaginal delivery in breech presentation does not increase early newborn morbidity. Results of 423 infants with breech presentation 1988-1992].
423 deliveries by breech presentation (1988-1992), delivered by vaginally or abdominally management, were analysed. 72 preterm (32nd to 36th gestational week) and 351 term labours were studied. In 239/423 (56.5%) cases neonates were delivered vaginally, in 54/423 (12.8%) and 130/423 (30.7%) cases primary or secondary cesarean section was necessary. In 120/423 (51.9%) cases of all primaparous spontaneously delivery were realized. There was no difference in early morbidity of vaginal und abdominal delivered neonates (pHNA, APGAR-Score, intracranially bleeding). Three intracranially bleedings (I degrees, II degrees, III degrees) observed in the vaginally delivery group (n = 239), were not the result of breech presentation or vaginally management. No correlation between vaginally management, acidosis and intracranially bleeding were observed. In patients presented with preterm labour (32nd to 36th gestational week) and/or fetal intrauterin growth retardation, cesarean section could be indicated. In postnatal sonographic screening of all neonates hip joint disorders were twice more frequently in female neonates (n = 51 vs. n = 26) without correlation to delivery mode. In conclusion, if certain personally and equipmently conditions are considered, vaginally delivery mode does not correlate to an increase of early neonatal morbidity.
Acidosis↗
[Breech presentation--information, anxiety and pattern of expectations of established obstetricians and pregnant patients. 2: Results of a survey of women with breech presentation].
The frequency of caesarean section is increasing. A corresponding reason for this development is the increasing quota of primary caesarean section in patients with breech presentation. The aim of this study was to extend the expectation- fear- and information-profile in these patients and therefore the influence on the caesarean section rate. 100 patients with breech presentation were randomized and prospectively questionnaired. In summary, the study shows that women with breech presentation prefer primary caesarean section as the favourite delivery mode. Fears experienced before the delivery were focused accordingly on the condition of the child were in conflict to the higher incidence of maternal risk factors. Only an objective clearing of the obstetrical conditions and risk factors of the delivery modes (vaginal delivery mode, caesarean section) can induce patient's compliance which is the presupposition for a vaginal delivery mode of breech presentation.
Adult↗
[What effect does leg position in breech presentation have on mode of delivery and early neonatal morbidity?].
The objective of the present study is to establish whether the position of the legs in breech presentation deliveries affects the vaginal or abdominal mode of surgical delivery and the early neonatal morbidity. The patient population investigated (n = 266) comprised 163 primiparae (61.3%) and 103 multiparae (38.7%). Of the 266 term infants (more than 37 complete WOP) with breech presentation, 71.3% (127/178) could be delivered vaginally from a simple pelvic presentation and 55.3% (42/76) from an incomplete or complete footling presentation. The average duration of labor was 460 minutes in a pelvic presentation delivery, and 400 minutes in a footling presentation delivery. The rate of acidosis (pHNA < 7.20) was 26% in the neonates delivered from the pelvic presentation as compared to 11.9% in the footling presentation deliveries. The number of neonates with a 5/10 minute APGAR score of seven points was 0/0% in pelvic and 4.8/2.4% in footling presentation. Of the neonates delivered from pelvic presentation, 10.2% (13/127) were moved to the neonatology department as compared to 14.3% (6/42) babies delivered from footling presentation. A secondary Cesarean section was indicated in 28.7% of pelvic presentation deliveries commenced vaginally (51/178) and in 44.7% of the footling deliveries (34/76). The rate of acidosis was 49% (25/51) in the babies with pelvic presentation and 21% (7/34) in the babies with footling presentation. The percentage of neonates with respiratory depression (5/10 minute APGAR score < 7 points) was 3.9/2.9% in the babies delivered from pelvic presentation and 2/0% in the babies delivered from footling presentation. Correspondingly, the rate of transfer to the neonatology ward was extremely high: 33.3% (17/51) of the pelvic presentation babies and 8.8% (3/34) of footling babies. In 11 pregnant women (5.8%) with a fetus in pelvic presentation, a primary Cesarean section was indicated, in half of these cases (n = 5) because of "suspicion of a discrepancy", three times at request of the patients and three based on fetal and on maternal indication. Because she had rejected vaginal delivery, primary Cesarean section was performed in one pregnant mother (1.3%) with a fetus in footling presentation. Fetuses with simple pelvic presentation at term were more frequently delivered vaginally than fetuses in footling presentation (71.3% compared to 55.3%). The rate of respiratory acidosis was higher in the neonates with pelvic presentation than those with footling presentation (26% as compared to 11.9%). They compensated this acidotic metabolism within a short time, so that the transfer to the neonatology ward was only temporary. The same applied to the babies delivered by secondary Cesarean section.
Adult↗