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Biomedical subjects

W Vogel

Publications and source records attributed to W Vogel.

At least 361 records · Page 20Linked to original sources
PubMed1989

Neopterin excretion after liver transplantation and its value in differential diagnosis of complications.

The aim of this study was to investigate patterns and clinical utility of a neopterin marker in liver allograft recipients. Urinary neopterin levels were studied in 59 transplant patients daily until discharge. During the early postoperative period (days +1 to +20) neopterin excretion exhibited a liver-specific pattern that clearly differed from that seen in renal and bone marrow transplant recipients. Neopterin concentrations increased and reached peak values on day +7. The height of this early peak varied in context with complications such as infection or rejection, and was correlated with an unfavorable prognosis. In contrast to the early phase, no liver-specific pattern was observed after day 20. As seen in all other transplant patient populations, values normalized in patients with an uncomplicated course but again increased during infection or rejection episodes. Neopterin levels were particularly high during CMV infection, and their increments were directly related to the severity of CMV disease. The neopterin marker, although not specific, enables discrimination between patients with a complicated and uncomplicated clinical course. High neopterin values early after transplantation are associated with unfavorable prognosis and correlate with an increased risk of developing CMV disease.

Biopterins↗
PubMed1989

[Is percutaneous liver biopsy using the Trucut (Travenol) needle superior to Menghini puncture?].

The aim of this study was to compare the quality of biopsy cylinders obtained by the Menghini or Trucut liver biopsy-method as well as the frequency of complications observed with both these methods. For this purpose, 74 Menghini and 62 Trucut biopsies were analyzed. Both groups were comparable with respect to histologic diagnosis, but no final diagnosis could be made in eight cases of Menghini biopsy because of insufficiency of the material obtained. Fragmentation of the sample occurred significantly more often in the Menghini group (p less than 0.05; chi 2 test). Trucut biopsies were significantly longer (12 mm versus 8 mm mean value; p less than 0.001; Wilcoxon rank sum test) and contained significantly more portal tracts (16 versus 6 mean value; p less than 0.001). None of the total 136 biopsies led to serious complications. We conclude that Trucut liver biopsy is superior to the Menghini method since tissue yield is better and both methods are equally safe.

Adolescent↗
PubMed1988

Chromosome 9 of Ellobius lutescens is the X chromosome.

Ellobius lutescens carries an apparently identical karyotype (2n = 17) in both sexes. On the basis of indirect evidence the unpaired chromosome 9 has been considered to represent the X chromosome of this species. We have obtained data to substantiate this view by four different techniques. After fusion of HPRT- RAG cells with E. lutescens fibroblasts we demonstrated that the enzymes HPRT and G6PD are localized on the presumptive X chromosome. By analysis of pachytene figures after silver staining we showed by electron microscopy that the single chromosome exhibits the typical features of an X chromosome in male meiosis. Hybridization of (GATA)4 and (GACA)4 oligonucleotide probes to E. lutescens DNA revealed several distinct bands in the high molecular weight range some of which appeared to be specific for the individual but not for the sex of the animal. Hybridization in situ of the (GATA)4 probe on metaphase spreads of E. lutescens did not highlight any particular chromosome segment but showed a significant deficit of these sequences in chromosome 9. These observations are discussed with respect to their bearing on X chromosome determination. Finally it is concluded that E. lutescens should be an ideal tool for testing candidate genes assumed to be involved in primary sex determination.

Animals↗
PubMed1988

The clinical vs. research paradox in psychopharmacological research.

Research to date suggests a general equivalence of efficacy of the various types of antidepressant drugs across the patient population. However, clinicians deal daily with the fact that there is little or no drug equivalence for any given patient, who may respond positively to one antidepressant but not to others. The paradox may result from the paucity of studies that focus on individual variation in drug response.

Antidepressive Agents↗
PubMed1988

Antianginal efficacy of gallopamil in comparison to nifedipine.

In a randomized double-blind crossover trial 30 patients with chronic stable angina were studied to compare the antianginal actions of gallopamil (150 mg/day) and nifedipine. With the initial nifedipine dose of 60 mg/day, the trial had to be stopped because of severe exacerbation of angina in 3 patients of the nifedipine group. Twenty-one patients were entered into a second protocol with the nifedipine dose reduced to 30 mg/day. Compared to the preceding placebo period, the exercise time to onset of angina (+ 30%, P less than 0.01) and the total exercise time (+ 18%, P less than 0.01) were prolonged by gallopamil but not by nifedipine (+ 20 and 13%, respectively, not significant) with no significant difference between the test drugs. Four patients became free of angina during exercise testing with gallopamil therapy and one patient with nifedipine. Both agents significantly reduced ST depression at maximal comparable workload by 77% (gallopamil) and 52% (nifedipine) compared with placebo; the difference between the drugs reached borderline significance (P = 0.055). The increase in heart rate and the rate-pressure product at maximal comparable workload was less with gallopamil than with nifedipine (P less than 0.01). In contrast to nifedipine, very few side effects were reported with gallopamil. Thus, gallopamil is an effective antianginal agent whose therapeutic to toxic ratio appears to be superior to that of nifedipine.

Adult↗
PubMed1988

[Sonography of the liver in Wilson's disease. Sonographic studies of the liver in Wilson's disease--significance for assessing prognosis?].

Five patients with Wilson's disease with prognostically different hepatic manifestation were studied via ultrasound. Three of them presented histologically with fatty changes, fibrosis and interspersed areas of normal parenchyma. In these three patients, a peculiar ultrasound picture of the liver was observed which was quite different from the findings in the two others and which has not yet been recognized in the context of Wilson's disease. The parenchymal echo pattern was of increased echogenicity with numerous roundish foci of decreased echogenicity resembling metastatic liver disease. In contrast, the echo texture of the two patients with chronic active hepatitis leading to hepatic failure, was coarse, diffusely enhanced and without focal lesions. These findings indicate that ultrasound may help to define Wilson patients with good prognosis for the predominance of fatty changes and fibrosis in the liver.

Adolescent↗
PubMed1988

Stress ulcer prophylaxis and ventilation pneumonia: prevention by antibacterial cytoprotective agents?

The gastric and tracheal flora of 142 consecutive patients receiving stress ulcer prophylaxis were investigated, identifying identical isolates by typing. Furthermore, the growth pattern of normal respiratory bacteria and organisms causing ventilation pneumonia at different pH values and the in vitro effect of sucralfate and bismuth subsalicylate on these bacteria in simulated gastric fluid were studied. The results obtained were as follows: (1) with rising gastric pH bacterial counts in gastric aspirates, especially gram-negatives, increased significantly; (2) in 45 (31.7%) of the patients identical organisms were first isolated in gastric samples and one to two days later in tracheal secretions; (3) ventilation pneumonia was significantly more frequent in patients with high gastric pH; (4) pathogens causing ventilation pneumonia grew well in simulated gastric fluid at higher pH values, unlike normal respiratory organisms; and (5) sucralfate and bismuth subsalicylate showed antibacterial activity against frequent causative organisms of ventilation pneumonia.

Anti-Bacterial Agents↗
PubMed1988

Enhanced serum levels of beta-2-microglobulin, neopterin, and interferon-gamma in patients treated with recombinant tumor necrosis factor-alpha.

The effect of different doses of recombinant human tumor necrosis factor-alpha (rTNF-alpha) on serum levels of neopterin, beta-2-microglobulin and interferon-gamma (IFN-gamma) was investigated in tumor patients. Twelve patients with advanced malignant disease were treated and received single doses of either 1, 10, or 100 micrograms/m2 rTNF-alpha on days 0 and 7. Neopterin, beta-2-microglobulin and IFN-gamma serum levels were measured from day -2 to day 12 of the study. Application of rTNF-alpha leads to a marked and dose-dependent increase of neopterin and beta-2-microglobulin levels; no rTNF-alpha-dependent changes were observed after 1 microgram/m2, and maximum increments were seen in patients receiving 100 micrograms/m2. Serum levels of both parameters peaked after 2 days and returned to baseline values within 1 week. IFN-gamma levels were also elevated after application of rTNF-alpha. We failed, however, to demonstrate a clear correlation between the serum levels of IFN-gamma, beta-2-microglobulin, and neopterin because of the wide range of pre- and posttreatment levels of IFN-gamma. We conclude that neopterin and beta-2-microglobulin represent useful markers for monitoring biological response to treatment with rTNF-alpha.

Adult↗
PubMed1988

Longitudinal study of major histocompatibility complex antigen expression on hepatocytes in fine-needle aspiration biopsies from human liver grafts.

Expression of MHC class II antigens on hepatocytes is part of the natural history of liver grafts. The expression appears to be enhanced by rejection episodes but not during infection and seems to persist on higher levels in chronic rejection and multigraft recipients. Intense expression of class I antigens is a nonspecific feature of the posttransplant situation.

Biopsy, Needle↗
PubMed1988

[Isovolemic hemodilution in patients with coronary heart disease].

In the age of cellsavers patients suffering from coronary heart disease are diluted to a hematocrit of 20% or even less during a surgical intervention in the coronaries and they leave the operating room with a hematocrit of 30%. On the other hand, a hemodilution to a level of 30% in patients with coronary heart disease represents a contraindication due to the limited coronary reserve. On the occasion of the collection of autologue blood, before vascular surgery or for therapeutical hemodilution, the hematocrit was reduced from 45 to 35% by means of an isovolemic hemodilution with 500 ml of Haes 200/0.5 10% in 50 patients. In the load-ECG the pressure X frequency-product and the dyspnoe decreased significantly. The microcirculation in the nailfold and the systemical blood fluidity increased significantly. As in 22% of the patients a deterioration was stated, we propose to dilute all the patients who have to undergo a coronary vessel operation without exclusion criteria once isovolemically and to stress them before and afterwards. The patients having a clinical defict should be diluted intraoperatively only to 30% and postoperatively not under 35%.

Angina Pectoris↗
PubMed1987

Potential of urinary neopterin excretion in differentiating chronic non-A, non-B hepatitis from fatty liver.

Urinary neopterin excretion was measured in 26 patients with histologically proven chronic non-A, non-B hepatitis (16 chronic persistent hepatitis, 10 chronic active hepatitis) and in 16 patients with steatosis. The potential of neopterin levels to discriminate between the two patient groups was compared with that of standard laboratory variables. Neopterin levels and triglycerides were shown to be the best variables for discriminating between the hepatitis and fatty liver patients, neopterin being the more specific of the two. Neopterin excretion in chronic persistent hepatitis was not statistically different from that in chronic active hepatitis. In the absence of specific tests, increased neopterin excretion seems to be a useful marker for diagnosing chronic non-A, non-B hepatitis and particularly in differentiating it from fatty liver.

Adult↗