PubMed Health⌕ Search

Biomedical subjects

A Adler

Publications and source records attributed to A Adler.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Subgingival plaque due to gingivitis and inactive periodontitis sites in the adult periodontitis patient].

There are several discrepancies with respect to the composition of subgingival plaque in gingivitis and in inactive adult periodontitis (AP). In this study we compared subgingival plaque samples taken from gingivitis sites to those from inactive periodontitis sites of the same patients. Of 44 patients plaque samples from 86 gingivitis sites and 92 periodontitis sites were analysed. Darkfield microscopy showed a higher proportion of spirochetes and mobile rods in the periodontitis sites. Analysis of cultures revealed a higher and statistically significant number of anaerobes in the periodontitis sites (1.7 x 10(7) vs 3 x 10(6), p = 0.006). The following bacterial species were isolated more frequently from periodontitis sites than from gingivitis sites: Actinobacillus actinomycetemcomitans (18% vs 10%), as well as the black-pigmented Prevotella intermedia (68% vs 48%) and Porphyromonas gingivalis (48% vs 28%). On the one hand, these small differences in the bacteriological parameters can be explained by the fact that both gingivitis and periodontitis plaque samples were taken from the same periodontitis patients. An infection of the gingivitis sites from the parodontitis sites within the same patient could not be excluded. On the other hand, the mean probing depth of the gingivitis sites was relatively high, 3.6 mm (measuring point interdental plus pseudo-pocket) which may favor the growth of anaerobic bacteria.

Adult↗
PubMed1995

[Digital image intensification radiography in endoscopic retrograde cholangiopancreatography].

The standard in ERCP is the use of the conventional radiography system. Digital radiography system are very seldom used in ERCP, and then mostly by digital luminescence radiography. In this study we report our experience with digital image amplification radiography (DIAR) in ERCP. We examined 53 patients of clinical routine aged from 21 to 90 years. During the ERCP we used the X-ray statues and the real-time exposures. At the end of an examination the image post-processing followed. Both conventional and digital image amplification radiography needed the same examination conditions. The special X-ray protection (special lead-shields) used at digital ERCP did not hinder the examination. The DIAR provided at least the same amount of information as conventional radiography. An advantage of DIAR is the possibility of image post-processing such as contrast change, zooming, etc., and the digital archiving and communication. The examination time was reduced by about 30% as compared conventional ERCP, resulting in a reduction of the X-ray exposure time for the patients. The disadvantages of DIAR can surely be compensated by a high ERCP-rate.

Adult↗
PubMed1994

[Tendon interposition arthroplasty vs Kessler silicone prosthesis for basal joint arthritis of the thumb].

Of 86 patients with osteoarthrosis of the trapeziometacarpal or pantrapezial joint operated on during 1978-1988, 52 cases (14 males, 38 females) were reviewed. 32 had undergone interposition of the flexor carpi radialis tendon and 18 Kessler's silicone prosthesis technique. 2 had silicone prosthesis replacement in 1 hand and tendon interposition in the other. The average age of all patients was 65.5 years (range 56-74). Average follow-up was 7.0 years for the 32 after the interposition procedure (range 8-14), and 10.5 years (range 8-14) after prosthesis implantation. A greater proportion of those after tendon interposition reported alleviation of pain. There was no statistically significant difference between the groups with regard to patient satisfaction, need for job change, range of abduction and opposition, grip and pinch power, thumb length and ability in activities of daily living. Tendon interposition arthroplasty is simple and relatively inexpensive compared to silicone prosthesis insertion, which has inherent complications, such as breakage of the prosthesis and synovitis. Tendon interposition has therefore been our standard procedure since 1988.

Aged↗
PubMed1994

Pulmonary fat embolism: a distinct cause of severe acute chest syndrome in sickle cell anemia.

The etiology of most cases of acute chest syndrome (ACS) in sickle cell disease (SCD) is unknown. Although pulmonary fat embolism (PFE) is frequently found on autopsy, it is rarely considered in the differential diagnosis in pediatric patients. We conducted a study to determine if we could identify PFE in SCD patients with ACS, define the clinical and laboratory course of PFE, and determine if bronchoalveolar lavage is safe and useful in diagnosis of PFE. Twenty-seven SCD patients with ACS were evaluated and compared with 43 control patients. Serial tests (complete blood count, platelet count, nucleated red blood cells [NRBCs], chest x-ray, and oxygen saturations) were compared with steady-state results. Diagnosis of PFE was made by quantitative evaluation of pulmonary macrophages for intracellular fat. No serious complications from bronchoscopy were observed. In the SCD patients with ACS, 12 were PFE+ and 15 were PFE-. The clinical course of the two groups was quite different. All PFE+ patients experienced bone pain and 11 of 12 had chest pain. In contrast, only 6 of 15 of PFE- patients had bone or chest pain. Neurologic symptoms developed in 6 of 12 of the PFE+ group and in none of the PFE- group. Mean hospital days for PFE+ was 13 compared with 7 for PFE-. Laboratory studies in PFE+ showed a significant decrease in hemoglobin (-2 g, P < .05), platelet count (-293,000, P < .001), and an increase in NRBCs/100 white blood cells (+8.3, P < .001) compared with PFE-. These results indicate that when PFE is associated with ACS, it is characterized by a distinct clinical course, and that bronchial lavage is a safe and useful test in diagnosing PFE in patients with ACS.

Acute Disease↗
PubMed1994

Prognostic significance of cell DNA content in early-stage ovarian cancer (FIGO stages I and II/A) by means of automatic image cytometry.

Paraffin-embedded material from 69 patients with epithelial ovarian cancer FIGO stages I and II/A (including 21 patients with borderline carcinoma) was studied with automatic DNA image cytometry. Univariate analysis indicated a significant difference in survival based on the presence of nuclei with high DNA content (higher than 5 C). A group of patients with less than 0.2% cells with high DNA content had a 6-year survival of 87%, whereas in a group of patients with more than 0.2% of such cells, 6-year survival was 49%. This parameter remained significant when used in a group of stage I/a and I/b patients. Statistical analysis of diploid vs. non-diploid tumors also showed significant difference in survival. Separate analysis of 48 invasive ovarian cancers indicated that ploidy, the percentage of cells with high DNA content and tumor stage (stage I/a + b vs. stages I/c + II/a) reached significance for survival, whereas grading did not. In addition, comparison of clinical stage, grading, ploidy and the percentage of cells exceeding 5 C with a threshold at 0.2% by means of a multivariate analysis (Cox regression model) showed that only the percentage of cells exceeding 5 C remained statistically significant.

Adult↗
PubMed1994

Epididymal micropuncture with in vitro fertilization and oocyte micromanipulation for the treatment of unreconstructable obstructive azoospermia.

OBJECTIVE: To provide fertility to couples in whom the man has surgically unreconstructable obstructive azoospermia. DESIGN: Prospective. SETTING: Hospital-based IVF unit, including associated division of urologic microsurgery. PATIENTS: Couples referred to our fertility unit for treatment of men with surgically unreconstructable reproductive tract obstruction, including congenital absence of the vas deferens. MAIN OUTCOME MEASURES: Fertilization, pregnancies, and live births. RESULTS: Of 51 cycles in which sperm and eggs were retrieved, 67% (34/51) resulted in fertilization and 27.5% (14/51) developed clinical pregnancy. Clinical pregnancy rate per couple was 33% (14/43). A total of 15 live births have been obtained in 11 couples with one ongoing pregnancy. Epididymal length was the best predictor of sperm quality and pregnancy results. For couples with at least the corpus epididymis present, 41% (9/22) of cycles resulted in clinical pregnancies. CONCLUSIONS: Pregnancy rates are optimized using sperm retrieved from the epididymis by micropuncture and when micromanipulation is available for use during IVF.

Cell Survival↗
PubMed1994

Improved endoscopic management of severe upper gastrointestinal hemorrhage using a new wide-channel endoscope.

Problems in emergency endoscopy for upper gastrointestinal bleeding may arise due to blood and food debris preventing proper endoscopic vision and orientation. We present here a new big channel endoscope with a 6 mm suction and drainage channel that achieved complete evacuation of stomach contents in 122 of 123 patients with upper gastrointestinal bleeding, in whom complete gastric cleaning and identification of the bleeding source had proved impossible using standard endoscopes. Gastric emptying using the big-channel endoscope was possible within five minutes in all successful cases. Optimal conditions for therapeutic procedures were therefore provided. The size of the instrumentation channel may open up new indications also for non-emergency endoscopic diagnosis and treatment.

Adult↗
PubMed1994

[Vaginal sonography of the cervix in twin pregnancies].

In a prospective study of 97 uncomplicated twin pregnancies, vaginosonographic cervix measurements of length, thickness and width of the internal os were performed. Furthermore, a group of 113 uncomplicated primipara was measured by vaginosonography. The twin pregnancies were examined sonographically at 4-5 week intervals between the 14th and 34th week of gestation. The results of the measurements were correlated between these two groups in accordance with duration of pregnancy and the number of deliveries. The results showed in general, that the cervical length of multipara-multiple pregnancy is longer than in the primipara-multiple pregnancy. Between the 13th and 17th week of gestation the cervix of primipara showed a length of 48.1 +/- 2.1 mm, the multipara twins showed a length of 52.3 +/- 3.4 mm. Between the 18th and 22nd gestational week, the primipara showed a cervical length of 49.4 +/- 3.6 mm and the multipara a length of 49.6 +/- 2.6 mm. In the 23rd to 27th week, the primipara had a cervical length of 39.4 +/- 2.4 mm, the multipara of 49.3 +/- 3.7 mm. From the 28th to 33rd week, cervical length was reduced in primipara to 31.2 +/- 2.9 mm, and in multipara to 42.7 +/- 5.1 mm. In the normal group of multipara, the cervical length was slightly longer. The assessment of cervical thickness showed the widest cervices in multipara gemini followed by the primipara gemini, the smallest cervices were found in primipara-single pregnancies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Rapid discrimination of early CD34+ myeloid progenitors using CD45-RA analysis.

Mononuclear cells (MNC) isolated by density centrifugation of cord blood and healthy bone marrow, and of peripheral blood (PB) from patients treated with granulocyte-macrophage colony-stimulating factor (GM-CSF) or G-CSF after chemotherapy, were double-stained with anti CD34 monoclonal antibody (MoAb) (8G12) versus anti CD45, CD45-RB, CD45-RO, and CD45-RA, respectively, and analyzed by flow cytometry. In all specimens, CD34+ MNC co-expressed CD45 at a low level and the expression of CD45-RB was similar or slightly higher. Most CD34+ MNC were negative for CD45-RO, a weak coexpression was only seen in some bone marrow (BM) and blood samples. In contrast, CD45-RA could subdivide the CD34+ population into fractions negative, dim (+), and normal positive (++) for these subgroups, and typical staining patterns were observed for the different sources of hematopoietic cells: in BM, most CD34+ MNC were RA++. In PB, their majority was RA++ after G-CSF but RA+ or RA- after GM-CSF. In cord blood, the hematopoietic progenitors were mainly RA-/RO-. Semisolid culture of sorted CD34+ MNC showed that clusters and dispersed (late) colony-forming unit-GM (CFU-GM) originated from 34+/RA++ cells, while the 34+/RA- MNC formed compact and multicentric, both white and red colonies derived from early progenitors. Addition of 20 ng stem cell factor per milliliter of medium containing 34+/RA- cord blood MNC led to a change of many burst-forming unit-erythrocyte (BFU-E) to CFU-mix which was not, at least to this extent, seen in blood and BM. We conclude that early myeloid CD34+ cells are 45+/RA-. Because this population excludes 34+/19+ B cells and 33+ myeloid cells, both of which are RA++, two-color flow cytometric analysis using CD34 and CD45-RA facilitates the characterization and quantification of early myeloid progenitor cells.

Antibodies, Monoclonal↗
PubMed1993

Plasmanate as a medium supplement for in vitro fertilization.

PURPOSE: The purpose of this study was to evaluate the use of Plasmanate, a protein preparation containing human serum albumin and mixed globulins to autologous preovulatory maternal serum, as an in vitro fertilization (IVF) medium supplement. Plasmanate was used most often in cases involving unexplained infertility, sperm antibodies, and endometriosis or when serum was unavailable. RESULTS: In a retrospective analysis of 1019 consecutive IVF cycles, Plasmanate was used as the protein supplement to the fertilization medium in 28.6% and maternal serum was used in 71.4% of the attempts. Attempting to eliminate the effects of different medium lots and laboratory conditions, 450 matched patient cycles were compared using the two protein supplements. Finally, the effects of Plasmanate versus maternal serum were compared in prospective randomized trial on patients diagnosed with tubal infertility who were attempting IVF for the first time. The clinical pregnancy rate was 34% for the Plasmanate group versus 24% for those using maternal serum in the retrospective investigation. However, this trend was reversed in the prospective trial. CONCLUSION: Although further investigation is necessary, it appears that Plasmanate is an appropriate protein substitute in patient cases where serum is absent or unsuitable.

Adult↗
PubMed1993

[Delayed stenosis after endoscopic sphincterotomy (EST)?].

To answer the question of restenosis following endoscopic sphincterotomy (EST) different and sophisticated methods were performed. Using the Erlangen type papillotome we developed a practicable and standardised method for measurement of the size of the EST that is able to define a restenosis. Depending on the indication for EST we found different percentages of restenosis: common bile-duct stones 14%, papillary stenosis 23.1%, duodenal diverticula without bile duct stones as cholestatic entity 40%. On one hand reduction of EST size is not corresponding to clinical symptoms, on the other hand the symptoms of patients after EST with sufficient EST size have to explained in other ways such as gall bladder still existing. Due to these experiences in patients with symptoms following EST we propose a control ERC combined with mechanical measurement of the sphincterotomy size.

Adult↗
PubMed1993

[S-phase fraction and proportion of cells with high DNA content as prognostic factors of lymph node negative breast cancer].

Breast cancer is the most frequent female cancer in Western Europe. Roughly half of the patients have no axillary lymph node involvement at time of operation. In this group of patients adjuvant treatment should only be undertaken in the subgroup with a high risk of recurrence. Suitable significant prognostic parameters are needed to identify patients at risk. S-phase fraction and the percentage of cells with a high DNA content are two prognostic factors that are determined by measuring total nuclear DNA and cell cycle analysis. Both were analyzed in large studies and have shown their impact on prognosis. However, divergent results underline the necessity for larger studies with a longer follow-up.

Aneuploidy↗
PubMed1992

Breast cancer and timing of surgery during menstrual cycle. A 5-year analysis of 385 pre-menopausal women.

It has been proposed that the timing of breast-cancer surgery in relation to menstrual phase has a prognostic impact on outcome. We carefully evaluated a combined 2-center series of 385 pre-menopausal women operated on for stage-I and stage-II breast cancer with a median follow-up of 5 years for a possible impact on outcome of the date of their last menstrual period (LMP) before surgery. The distribution of risk factors of the study cohort as well as prognostic indicators corresponded to previously published results. Nodal status, grading, and (in part) hormone-receptor status differentiate well between patient subgroups with high and low risk of relapse and death after breast-cancer surgery. In neither univariate nor multivariate analysis was any impact of the so-called "unopposed" estrogen secretion detected. We did not observe any effect of LMP on long-term survival in any of several prognostic subgroups, in particular in hormone-receptor-positive patients. From our results and from the literature, we conclude that LMP does not provide any prognostic information for outcome after breast-cancer surgery and therefore the proposed modification of scheduling of breast-cancer operations is not justified.

Age Factors↗
PubMed1992

Subzonal sperm insertion and the frequency of gamete fusion.

The subzonal sperm insertion technique was applied to assess the potential of motile human spermatozoa to form pronuclei. In 184 mature human oocytes, subzonal sperm insertion was used as the primary mode of insemination in cases with abnormal semen analyses. Oocytes (n = 131) that failed to fertilize in vitro in cases with normal semen profiles were also micromanipulated for secondary insemination. The frequency of sperm fusion, expressed as a percentage, was defined as the total number of male pronuclei formed divided by the total number of spermatozoa inserted subzonally. Our results indicate that 37% of spermatozoa from men with normal semen are able to fuse with the oolemma and decondense within the ooplasm, when placed in the perivitelline space of the oocyte. Excluding the oocytes that appeared morphologically abnormal (presence of cytoplasmic inclusions such as refractile bodies within the ooplasm), the frequency of sperm fusion increased to nearly 60%. Moreover, 14% of subzonally inserted spermatozoa from men with abnormal semen analyses demonstrated an ability to form a pronucleus. The incidence of polyspermy was high, ranging from 30 to 80% in the different groups studied. It is therefore concluded that the human oolemma provides little protection against multiple sperm fusion and that the frequency of gamete fusion is unexpectedly high, even when the spermatozoa are derived from infertile men.

Evaluation Studies as Topic↗