[The viewpoint of the European College of Orthodontics].
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Europe↗
Biomedical subjects
A Horn
Publications and source records attributed to A Horn.
Horner's syndrome after long-term epidural block.
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Adult↗
[The therapy of the metritis, mastitis, agalactia (MMA) complex of swine].
In a pig breeding unit that during years had been infected with MMA Complex the sick sows were divided into three groups: Group 1 The sows received 50 mg per kg bodyweight Ampicillin Trihydrate in one dose per day for three days i.m. Group 2 The sows received 50 mg per kg bodyweight Ampicillin Trihydrate in one dose per day for three days in form of intrauterine infusion with 200 ml of sterile saline solution. Group 3 The sows received 300 mg per kg bodyweight Ampicillin Trihydrate in one dose per day for three days in form of intrauterine infusion with 200 ml of sterile saline solution. The number of dead piglets until the tenth day of life was recorded. Group 2 and 3 showed significantly lower death rates of piglets as compared to group 1. Group 3 showed better results as compared to group 2.
Ampicillin↗
Evidence for glycosylphosphatidylinositol anchoring of intralumenal alkaline phosphatase of the calf intestine.
1. Considerable amounts of intestinal alkaline phosphatase (AP) were found intralumenally in all animal species investigated, i.e. calf, pig, goat, rat, mouse, guinea pig, hen and carp. The ratios between the total activity of AP found intralumenally and the total intestinal activity vary considerably. Calves and pigs show the highest, i.e. 0.77 and 0.44, respectively, while rodents have much lower ratios. Only 20-34% of the intralumenal alkaline phosphatase (IAP) of the calf and pig is soluble and not within the sediment after centrifugation at 135,000 x g for 60 min. whereas the IAP of rodents is soluble in the range of 60-72% of the total IAP. 2. For the IAP of the mucosa and chyme of calf, all criteria were found which are generally used, indicating a glycosylphosphatidylinositol (GlcPtdIns) anchor as proved by strong hydrophobicity using Triton X-114 phase partitioning, phenyl-Sepharose binding and enzyme aggregation, and the susceptibility to phosphatidylinositol-specific phospholipase C (PtdIns-PLC) and papain digestion. 3. More than 80% of the mucosa alkaline phosphatase (MAP) of the proximal part of the intestine and of the particulate fraction of IAP exhibit these criteria indicating the presence of the GlcPtdIns-anchor structure, whereas the anchor content of the soluble intralumenal enzyme decreases from the pylorus to the ileocecal junction. 4. MAP partially purified to a specific activity of 1747 IU/mg retains the anchor structure. 5. The results presented indicate that the release of large amounts of AP into the chyme is realized without splitting the GlcPtdIns anchor. The possible intralumenal function of this form of AP is discussed.
Alkaline Phosphatase↗
Venous and neural invasion as predictors of recurrence in rectal adenocarcinoma.
After radical surgery for rectal adenocarcinoma, the presence of venous and neural invasion of tumor cells was correlated with the pattern of treatment failure, local in the pelvis or distant. Of 128 operation specimens, venous and neural invasion was demonstrated in 22 percent and 32 percent, respectively. A significant decrease of the distant recurrence-free 5-year survival (Kaplan-Meier method) was seen when venous invasion was demonstrated (32.9 percent vs. 84.3 percent; P less than 0.0001), whereas more local failures were registered in patients with neural invasion. The local recurrence-free 5-year survival in patients with neural invasion was 64.3 percent, compared with 81.1 percent when neural invasion was not demonstrated (P = 0.03). Their prognostic value was then studied in a Cox regression model including stage and grade. Neural invasion had the strongest association with local recurrences, whereas venous invasion was found to be the third strongest independent predictor of metastasis, after lymph node status and extent of local tumor infiltration. We conclude that examining for the presence of venous and neural invasion gives reliable prediction of recurrences after radical resection of rectal cancer. Recording of tumor recurrence pattern may lead to a better selection of patients for adjuvant therapy after surgery.
Adenocarcinoma↗
Fibrinolytic therapy of deep vein thrombosis with continuous intravenous infusion of a recombinant tissue plasminogen activator.
Recombinant human rt-PA was administered to 22 patients with deep vein thrombosis at a dosage of 30 to 120 mg/day (0.5 to 1.76 mg/kg body weight/24 hr) over 2 to 10 days. rt-PA induced phlebographically documented substantial recanalization in 18 of 21 patients. The lowest dose of 0.5 mg/kg/24 hr tested here was thrombolytically effective, whereas a dose of 0.95 mg/kg/24 hours and more led to hemorrhagic complications and premature discontinuation of therapy in four of six patients. Blood clotting analysis did not reveal any substantial decrease in fibrinogen concentrations, whereas the euglobulin clot lysis time and thromboelastography demonstrated a systemic fibrinolytic effect. Therapy with rt-PA can thus be considered as an alternative and effective method of therapy in treatment of deep vein thrombosis. The results of this study show that even a dosage of lower than 0.5 mg/kg/24 hr might prove to be effective. Further studies would be required to show whether the fibrin specificity of rt-PA leads to a superiority of this fibrinolytic substance over the conventional thrombolytic agents, streptokinase and urokinase.
Blood Coagulation Tests↗
Ischaemic necrosis of lesser curve of stomach after proximal gastric vagotomy.
Of 483 patients treated by proximal gastric vagotomy (PGV) between 1972 and 1986 four (0.8%) developed lesser curve necrosis with perforation and one died of diffuse peritonitis. Gastroscopy 3-6 days after PGV in 26 patients between November 1985 and May 1987 showed that five had developed ischemic ulcers on the lesser curve (19%). One further patient developed lesser curve necrosis with perforation before endoscopy, giving a total of six lesser curve lesions after 26 vagotomies (23%). Endoscopy also showed that most patients had some gastric retention. Ulcers with maximal diameters of 0.4-2 cm were asymptomatic. One patient with a large ischaemic ulcer (3 cm) had an abrupt fall in haemoglobin concentration (from 148 to 73 g/l) as did two patients who developed lesser curve necrosis with perforation and peritonitis (143 to 93, and 159 to 71, respectively). We conclude that ischemic ulcers are relatively common after PGV, that small ulcers are asymptomatic and do not perforate, and that an upper GI bleeding after PGV strongly suggests that lesser curve necrosis has developed.
Aged↗
Low-dose preoperative radiation postpones recurrences in operable rectal cancer. Results of a randomized multicenter trial in western Norway.
A randomized, multicenter clinical trial was conducted in Western Norway to study the effectiveness of preoperative radiation therapy in operable rectal cancer, given at a dosage of 3150 cGy in 18 fractions, 2 to 3 weeks before radical surgery. Three hundred nine patients were entered into the trial between May 1976 and December 1985. After radiation no tumor was seen in 4.5% of the patients. There was no increased morbidity or mortality at surgery. The 5-year survival for evaluable patients was 57.5% in the control group and 56.7% in the radiotherapy group. For patients operated on for cure the 5-year survival was 60.9% and 64.2% in the control group and radiotherapy group, respectively. Radiation significantly delayed both local and distant recurrences in patients in the radiation group who had curative resection from 13.3 months in controls to 27.1 months. The local recurrence rate in the corresponding groups was 21.1% and 13.7%, respectively. We conclude that higher preoperative radiation doses should be used in new trials as a higher dosage may transform the observed positive effects into a survival benefit.
Adult↗
[Thrombocyte function and thrombocyte-associated immunoglobulins in patients with systemic lupus erythematosus and chronic polyarthritis].
The investigation of in vitro platelet functions from patients with SLE and rheumatoid arthritis (RA) revealed a distinctly reduced aggregation mass after both collagen und ADP induction. The platelet serotonin contents were significantly decreased in both groups. An "aspirin-like" platelet defect could be excluded by finding a normal malonyldialdehyde release of patients' platelets upon thrombin stimulation. Significantly increased platelet associated IgG was also detected, whereas platelet associated IgM remained within normal limits. These results are interpreted as indicating an ongoing platelet release reaction induced by IgG platelet antibodies, which induce the observed impairment of platelet functions and may also lead to the release of proinflammatory platelet mediators.
Arthritis, Rheumatoid↗
Determination of rate constants of monoclonal antibodies to enzymes.
A novel graphical method for determining rate constants of the immune reaction of enzyme-inhibiting or -activating antibodies has been evaluated. The experimental determination of kinetic constants does not require purification of antibody and enzyme nor any separation step of bound and free entities. The resultant enzyme activity is used as a measurement of the extent of enzyme-antibody complex formation. The plot ln magnitude of v - v infinity versus t (v = enzyme activity at time t, v infinity = enzyme activity at infinite time) yields straight lines in the case of antibody excess. Slope and vertical intercept of that primary plot can be used for secondary plots to obtain association (k1) and dissociation (k-1) rate constant, the dissociation constant KD of the complex and the residual enzyme activity of the complex (g/f). The suitability of the graphical method has been established experimentally using the mab IB 10B8 (2) which inhibits alkaline phosphatase activity. With the homogeneous assay in the presence of substrate as well as a microassay in the absence of substrate, k1 and g/f were found to be 4.68 x 10(7) M-1 min-1; 3.74 x 10(7) M-1 min-1 and 0.035; 0.107 respectively. For k-1 and KD, only crude estimates could be derived. The method has been tested for model discrimination using computer simulated data.
Alkaline Phosphatase↗
Preoperative radiotherapy in operable rectal cancer.
The effect of preoperative radiotherapy (31.5 Gy in 3.5 weeks) in operable rectal cancer was examined with respect to resectability and prognosis after two surgical procedures, abdominoperineal resection, or low anterior resection. Preoperative radiation did not influence the surgeon's selection of low anterior resection, which was similar (40 percent) in each group. Radiation improved five-year survival probability and decreased the incidence of local recurrence significantly after low anterior resection. In contrast, no improvement of treatment results was found in patients treated by abdominoperineal resection after radiotherapy.
Adenocarcinoma↗
The role of venous and neural invasion on survival in rectal adenocarcinoma.
A total of 254 rectal adenocarcinomas were examined for the presence of venous and neural invasion. Both the incidence of venous and neural invasion increased with Astler-Coller's stage, except for stage C1 related to neural invasion. Both prognostic factors predicted significantly reduced actuarial survival rates in patients with node-negative tumors. Thus, examination for the presence of venous and neural invasion can add information to conventional staging in node-negative tumors for assessing prognosis after radical surgery for rectal adenocarcinoma.
Actuarial Analysis↗
Tumour shrinkage and down staging after preoperative radiation of rectal adenocarcinomas.
In order to analyse the influence of low radiation doses on human rectal adenocarcinomas, gross and microscopical changes after preoperative radiation were compared to controls treated with immediate surgery in a randomised, prospective trial. The X-ray doses given were 31.5 Gy in 3.5 weeks, and the interval between radiation and operation was 2 to 3 weeks. A total of 138 patients having preoperative radiotherapy and 131 controls were analysed. The overall tumour size was reduced after radiation. Complete tumour regression was obtained in six (4.4%) patients. All of these tumours were exophytic and mobile at the initial examination and all were either well or moderately well differentiated. A significant downstaging was found after preoperative radiation. The incidence of positive lymph nodes was 27.5% in the resected specimens in controls and 18.4% after radiation (p less than 0.05). The total number of recurrences was reduced after radiation in stage C2 tumours, but not in the other stages. Preoperative radiation did not influence the histological grade of the tumours. There was no difference between the two randomised groups with respect to 5-year survival or disease-free survival in any histopathological stage.
Adenocarcinoma↗
Long-term effects of cerebellar pathology on cognitive functions.
Twelve patients with circumscribed chronic neocerebellar lesions but without CT-evidence of forebrain damage (other than the effects of shunting) were investigated for deficits of cognitive functions. Two different mechanisms were considered as possible causes of cognitive impairment: (1) Damage to the dentato-thalamo-cortical projection leading to impairments of cortical functions, and (2) prolonged intracranial pressure resulting in diffuse forebrain damage and subcortical dementia. Patients with lesions in the left neocerebellum showed deficits in cognitive operations in three dimensional space, consistent with the right forebrain dominance for spatial functions. Prolonged intracranial pressure, on the other hand, resulted in a mild overall cognitive impairment.
Brain Damage, Chronic↗
Immunoaffinity chromatography of enzymes.
Immunoaffinity chromatography of enzymes represents an attractive purification technique suitable for one-step and large-scale purification of enzymes to homogeneity. Monoclonal and polyclonal antibodies can be used equally well. The broad use of the technique is restricted by the harsh elution conditions which are often required. The efforts to overcome these limitations and to optimize the method are reviewed, viz. proenzyme purification, purification of enzymes as part of multienzyme complexes carried out by a mild dissociation step, specific elution by substrates and effectors, enzyme stabilization, electrophoretical desorption and negative elution by adsorbing impurities from the crude extract, and hypotonic elution. The current practice is discussed considering antibody and enzyme selection, optimization of elution conditions, and washing steps using different media. Representative examples are given for various approaches.
Animals↗
Thromboprophylactic effect of low molecular weight heparin started in the evening before elective general abdominal surgery: a comparison with low-dose heparin.
A prospective randomized double-blind trial was performed comparing conventional low-dose heparin with a LMWH fragment (Kabi 2165, Fragmin) for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the fragment was given in the evening before surgery, and thereafter every evening. There were 1002 analyzable patients, 826 having received correct prophylaxis. Sixty three percent of the patients were operated on for malignant diseases. The frequency of DVT was significantly reduced among patients with correct prophylaxis with the heparin fragment (9.2 to 5.0%, p = 0.02). In patients with malignancies the reduction was from 11.2 to 6.4% (p = 0.06). The frequency of bleeding was 6.7% among the heparin fragment patients and 2.7% among the patients given conventional heparin (p = 0.01). The corresponding frequencies for patients with malignancies were 3.2 and 2.8%, respectively (p = 0.28). All bleedings were minor and of no clinical significance. Local pain at the injection site was reported significantly less often among patients with the fragment. Twenty patients died, 13 with malignant disease, mortality being the same in the two groups. It is concluded that heparin fragment administered in the evening before surgery and then every evening is a practically acceptable alternative to prevent postoperative DVT in patients undergoing elective abdominal surgery, also when the histology shows malignancy. Thus, the advantages of using LMWH compared with conventional low-dose heparin are simplified administration routines, better thromboprophylactic effect, and less local pain at injection sites. A disadvantage is the slight increase in hemorrhagic side effects, all of minor clinical importance and not seen in patients undergoing surgery for malignancy.
Abdomen↗
A new graphical method for determining the affinity constants of monoclonal antibodies to enzymes.
A new graphical method is presented for determining the affinity constants of antibodies to enzymes. The method does not require purification of reactants or separation steps at equilibrium. The plot 1/v versus [AT]/V - v) ([AT] = total concentration of antibody binding sites, V = enzyme activity measured in the absence, and v = activity measured in the presence, of antibodies) yields straight lines in the case of simple antibody-enzyme interactions. More complex interaction models show different curve shapes, which can be used for model discrimination as shown by computer simulation studies. The applicability of the method was demonstrated by the determination of the affinity constant of the monoclonal antibody IB 10B8 to alkaline phosphatase of calf intestine. This antibody inhibits enzymic activity completely.
Alkaline Phosphatase↗
Transanal extirpation for early rectal cancer.
Transanal extirpation was performed in 38 patients with adenocarcinoma of the rectum. In 17 patients (group I) the tumor extended into the submucosa only, and in 14 patients (group II) tumors extended into, but not through, the muscularis propria. There was a significant difference in local recurrence between groups I and II. None of the patients in group I and six of the patients (42.6 percent) in group II developed local recurrences (P = 0.02). The 5-year actuarial survival probability was 100 and 82.6 percent, respectively. Transanal extirpation is an alternative to transsphincteric and abdominoperineal resection in the treatment of early well or moderately well-differentiated cancer of the rectum. The surgical procedure is simple and has few complications; however, only tumors extending no deeper than the submucosa are suitable for this treatment. The operation should be followed by frequent sigmoidoscopies and rectal palpation. The procedure should be defined as an excisional biopsy until results from the histologic examination are presented.
Adenocarcinoma↗