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Biomedical subjects

A Moritz

Publications and source records attributed to A Moritz.

At least 91 records · Page 5Linked to original sources
PubMed1998

Neuropsychological changes after cardiopulmonary bypass for coronary artery bypass grafting.

BACKGROUND: An alarming incidence (1% to 83%) of neuropsychological dysfunction has been reported after operations using cardiopulmonary bypass (CPB). The present clinical study re-evaluates these complications with current CPB technology in a strictly selected low-risk group of coronary artery bypass (CABG) patients. METHODS: 76 CABG patients, without history of stroke or internal carotid artery stenosis, were examined before, 5 days after, and 2 months after surgery. A neuropsychological test battery was employed according to the "Statement of Consensus on Assessment of Neurobehavioral Outcomes after Cardiac Surgery". Tests include the Block Design Test (problem-solving strategies, recognition and analysis of forms), the Trail Making Test (cognitive achievement at speed), and the Digit Span Test (short-term memory and memory of figures). RESULTS: Both postoperative test scores were not significantly decreased as compared to preoperative values. In contrast, neuron specific enolase (NSE) and S100 b protein, biochemical markers of cerebral injury, increased markedly during and immediately after surgery (NSE preop.: 7.07 +/- 2.40 ng/ml, 1 h postop.: 13.64 +/- 4.50 ng/ml, p < 0.001; S100 b preop.: 0.04 +/- 0.07 ng/ml, after crossclamp: 0.90 +/- 0.69 ng/ml, p < 0.001). One patient displayed postoperative transitional syndrome, another patient suffered from transitory paresis and hypesthesia of the left arm, which disappeared during hospital stay. CONCLUSIONS: Biochemical markers demonstrate significant postoperative cerebral injury during and immediately after CPB. However, CPB for CABG does not lead to marked impairment of neuropsychological scores, and clinically relevant neurological findings were observed in one patient only.

Aged↗
PubMed1998

Long-term effects of CO2 laser irradiation on treatment of hypersensitive dental necks: results of an in Vivo study.

OBJECTIVE: The present in vivo study was performed to examine the long-term effects of combined CO2 laser treatment and fluoridation on hypersensitive dental necks. SUMMARY BACKGROUND DATA: Attempts have been made to treat dental hypersensitivity by sealing exposed dentinal tubules, primarily using fluoride preparations, strontium chloride, and hydroxyapatite. However, these treatment methods have the disadvantage that the preparation is effective only for a limited period of time and must be applied repeatedly, at short intervals. The CO2 laser has been shown to have an excellent sealing effect on hypersensitive dentinal surfaces. METHODS: Test subjects suffering from dentinal hypersensitivity were recruited from the patients of the Department of Conservative Dentistry, School of Dentistry of the University of Vienna, Austria and treated with combined laser irradiation and fluoridation with stannous fluoride gel. The patients were followed up for a period of 18 months. In vivo examinations were supplemented by atomic absorption spectroscopy (AAS) of tiny dentin samples obtained from the dental necks 6 weeks and 18 months after laser treatment and by scanning electron microscopy (SEM). RESULTS: Compared to conventional fluoridation, combined laser irradiation and fluoridation was shown to be effective in the treatment of hypersensitive dental necks. When success was defined as complete freedom from pain, the success rate in the laser group was 96.5%. Furthermore, examinations of irradiated teeth under the scanning electron microscope still revealed complete closure of the dentinal tubules four and six months after laser treatment. AAS showed that tin was present in the samples, which indicates that combined laser treatment and fluoridation result in permanent integration of fluoride in the dentin surface. CONCLUSIONS: Based on these results, the CO2 laser can be recommended as an ideal tool for desensitization of dental necks.

Adult↗
PubMed1998

Clinical follow-up examination after treatment of canine leishmaniasis.

In 16 dogs, the diagnosis of canine leishmaniasis could be detected by direct microscopic identification, by determination of the antibody titre or by PCR method (peripheral blood/bone marrow). On the basis of the clinical and laboratory diagnostic results 9 cases of the cutaneous type and 7 dogs of the combined cutaneous-visceral type (+ mono- or polyarthritis, hepatopathy and/or renal insufficiency as well as occular manifestation) have been classified. Therapy was: GLUCANTIME in 6 dogs, allopurinol in 3 dogs as single agent, combination-therapy GLUCANTIME and allopurinol in 7 dogs. During GLUCANTIME-treatment the following adverse reactions could be observed: general weakness, reduced food intake up to anorexia, vomiting and diarrhoea. Laboratory parameters showed sporadically leucopenia or pancreatitis. Adverse reactions during allopurinol therapy were: vomitus/diarrhoea or urine concrements. One dog with GLUCANTIME therapy, 2 dogs with allopurinol as well as 2 dogs with combination therapy are clinically symptom-free at the moment (peripheral blood and bone marrow: PCR negative). The remaining 11 patients showed a good to very good improvement of the clinical symptoms. However, since the peripheral blood respectively the bone marrow continue to be PCR positive, relapses have to be expected in these dogs.

Allopurinol↗
PubMed1998

PCR follow-up examination after treatment of canine leishmaniosis (CaL).

A study has been performed to investigate the usefulness of the polymerase chain reaction (PCR) for both the diagnosis and the follow-up after treatment of canine leishmaniosis (CaL). Blood samples (PBL) and/or bone marrow aspirates (BM) could be examined in a total of 18 confirmed cases of primary CaL. PBL was PCR-positive in 87%, whereas the BM was found to be positive in all cases (n=14) tested. PBL and BM from a total of 13 patients were submitted to PCR examinations after meglumine antimoniate (Glucantime) treatment. Only one dog showed a negative PCR after 2 treatment cycles (days 1-2: 50 mg/kg bw; days 3-10: 100 mg/kg bw). Examination of the PBL and BM after 15 months remained further PCR negative. All other dogs, from which four were pretreated with allopurinol up to 5 weeks, continued to be positive (92%) at least in the BM. Ten dogs could be monitored by means of the PCR after allopurinol treatment (2 x 10 mg/kg/bw/day/) either as a monodrug therapy in seven or as a successive combination with Glucantime in three cases. Two out of three dogs which showed good clinical improvement after daily administration for five weeks were likewise PCR negative in both the PBL and the BM. The four other dogs remained positive after the single therapy with allopurinol up to 5 weeks. A further three dogs were treated with allopurinol for 5 weeks, 6 and 20 month, respectively, after being clinically cured with Glucantime. Two of them were PCR negative in the PBL and BM after 5 weeks and 20 month, respectively. The results presented suggest that longterm treatment with allopurinol has some therapeutic benefit in CaL especially when administered following treatment with the pentavalent antimonial Glucantime.

Allopurinol↗
PubMed1998

[Equine Cushing syndrome (ECS). Case report, review of its diagnosis and therapy and substantial differences from Cushing syndrome in dogs].

Equine and canine Cushing's syndrome, both of which are the result of elevated cortisol levels, show some different pathogenetical and clinical features and require different therapeutical approaches. In older horses the equine Cushing's syndrome (ECS) is not uncommon. Nearly all cases result from excessive hormone production in cells of the pars intermedia of the pituitary. Besides elevated levels of adrenocorticotrope hormone (ACTH), high peripheral levels of pro-opiomelanocortin, beta-endorphines and alpha-melanocyte-stimulating hormone can be measured. In middle-aged and geriatric dogs, Cushing's syndrome is the most frequently diagnosed endocrinologic abnormality. 80-85% of cases are pituitary-dependent and 15-20% are caused by cortisol producing tumors of the adrenals. 90% of pituitary lesions can be identified as adenomas, which are localised in most cases in the pars distalis of the gland, but may occur rarely in the pars intermedia, too. Clinical symptoms in both species are characterised by wasting despite good appetite or polyphagia, reduction of muscle mass with altered fat deposition and lethargy. Whereas polydipsia/polyuria is a very common feature in dogs with Cushing's syndrome, in horses it is almost invariably a sign of concurrent secondary diabetes mellitus. A typical symptom in ECS is a continuously growing haircoat (hirsutism), whereas in canine Cushing's syndrome generalised alopecia may bring the owner to consult a veterinarian. The symptoms and diagnostic procedures in a 33-year-old mare are described. Useful diagnostic tests are reviewed with special attention to species differences in reacting to them. The therapeutic approach with dopamine-agonists such as bromocriptine and pergolide as well as cyproheptadine to ECS is reviewed.

Animals↗
PubMed1998

Procedures for enamel and dentin conditioning: a comparison of conventional and innovative methods.

Composite materials have become an integral part of the wide range of filling materials currently available. Conditioning is necessary to achieve adequate bonding of the composite material to enamel and dentin. Normally, this is done by applying acid preparations to the dental surfaces. These acids have an etching effect that causes surface roughening. The increasing application of lasers in dentistry has introduced another possibility. Laser irradiation can cause roughening of enamel and dentin surfaces. Another interesting alternative is the so-called kinetic cavity preparation technique. This method also results in distinct surface roughening. The purpose of the present study, was to compare the described methods. Tensile bond strength tests and shear bond tests were carried out to examine the adhesion of a composite material to surfaces treated with these methods. Laser irradiation with certain devices and the air-abrasive technique yielded results similar to those with acid etching.

Acid Etching, Dental↗
PubMed1997

Irradiation of infected root canals with a diode laser in vivo: results of microbiological examinations.

BACKGROUND AND OBJECTIVE: It was shown in previous studies [1] that the Nd:YAG laser can be used as an excellent tool for killing bacteria in root canals. The present examinations were carried out with a high power diode laser in comparison with a conventionally treated control group. STUDY DESIGN/MATERIALS AND METHODS: In this in vivo study, 40 patients with infected root canals underwent diode laser treatment. To verify the findings, microbiological tests were performed and the results compared to those obtained with conventional antibacterial treatment. RESULTS: The microbiological examination revealed streptococci at relevant concentrations in 20 cases and staphylococci in 5 cases. Extensive bacterial reduction was achieved in all cases by repeating laser treatment only once. Following the first irradiation, minimal streptococcal growth was observed in 7 root canals and minimal staphylococcal growth in 2 root canals. The maximum log kill was 4.22 for streptococci and 3.33 for staphylococci. In the control group, a maximum reduction by only one log step could be achieved in 6 of 10 patients. CONCLUSIONS: Compared with the results achieved with the conventional bactericidal technique in the control group, the high power diode laser seems to be highly suitable for killing bacteria in infected root canals.

Bacterial Infections↗
PubMed1997

Five-year follow-up after heart valve replacement with the CarboMedics bileaflet prosthesis.

BACKGROUND: The CarboMedics valve is a relatively new, low-profile, bileaflet, mechanical prosthesis. The results of a prospective follow-up study after valve replacement with this prosthesis in a university hospital are presented. METHODS: We implanted 640 CarboMedics prostheses in 583 patients in the aortic (n = 359), mitral (n = 167), or aortic and mitral positions (double valve replacement; n = 57). Patient ages ranged from 11 to 81 years (mean age, 58 +/- 12.3 years). RESULTS: Overall hospital mortality was 9.0%; however, when high-risk urgent cases were removed from the calculation, the operative mortality fell to 4.5%. Follow-up was 98% complete, comprising 2,027 patient-years for a mean follow-up of 44 months (range, 6 to 72 months). Actuarial freedom from complications (linearized rates in parentheses) was as follows: late mortality, 85% +/- 2.0% (2.3%/patient-year); thromboembolism, 92% +/- 1.1% (1.6%/patient-year); anticoagulation-related hemorrhage, 87% +/- 1.2% (2.8%/patient-year); prosthetic valve endocarditis, 98% +/- 0.5% (0.1%/patient-year); and overall valve-related morbidity and mortality, 76% +/- 2.1% (4.3%/ patient-year). CONCLUSIONS: The CarboMedics valve shows a low rate of valve-related complications comparable with other new mechanical heart valve prostheses.

Adolescent↗
PubMed1997

Expression of transcription factor genes after influenza A virus infection.

Infection of human monocytes with influenza A virus induces a broad range of proinflammatory cytokines and mononuclear cell attracting chemokines before the infected cells undergo apoptosis. The underlying mechanisms by which the corresponding genes are transcriptionally initiated after virus infection are still poorly understood. Activation of NF-kappa B seems to play an important role in the regulation of many proinflammatory cytokine genes, but cannot be the only mechanism, since several cytokine genes lack respective binding sites in their promoter regions. Therefore, we additionally investigated other transcription factors of possible importance such as CREB, CTF, OTF-1, and OTF-2. To explore long-term regulatory mechanisms, we investigated the induction of transcription factors on the gene expression level which may be important to substitute for metabolized transcription factor proteins after their activation. We identified a cell-type-specific differential response: CREB, CTF, OTF-1, OFT-2, and NF-kappa B genes were strongly induced 1 to 4 hours after influenza A virus infection in the monocytic cell line Mono Mac 6, while in freshly prepared human monocytes no significant changes were detected. In infected monocytes, which die by apoptosis, the expression of CREB, CTF, and OTF-2 was rather suppressed 8 hours after infection. In conclusion, the long-term regulation of transcription factor gene expression in non-proliferating cells seems to be of minor importance after influenza infection since in apoptosisprone cells an immediate availability of transcription factor proteins is required.

Animals↗
PubMed1997

B-50/growth-associated protein-43, a marker of neural development in Xenopus laevis.

To study the regulation and function of the growth-associated protein B-50/growth-associated protein-43 (mol. wt 43,000) in Xenopus laevis, B-50/growth-associated protein-43 complementary DNAs were isolated and characterized. The deduced amino acid sequence revealed potential functional domains of Xenopus B-50/growth-associated protein-43 that may be involved in G-protein interaction, membrane-binding, calmodulin-binding and protein kinase C phosphorylation. The expression of B-50/growth-associated protein-43 at the RNA and protein level during development was investigated using the Xenopus complementary DNA and the monoclonal B-50/growth-associated protein-43 antibody NM2. The antibody NM2 recognized the gene product on western blot and in whole-mount immunocytochemistry of Xenopus embryos. Moreover, visualization of the developmentally regulated appearance of B-50/growth-associated protein-43 immunoreactivity showed that this mode of detection may be used to monitor axonogenesis under various experimental conditions. In the adult Xenopus, XB-50/growth-associated protein-43 messenger RNA was shown to be expressed at high levels in brain, spinal cord and eye using northern blotting. The earliest expression detected on northern blot was at developmental stage 13 with poly(A) RNA. By whole-mount immunofluorescence, applying the confocal laser scanning microscope, the protein was first detected in embryos from stage 20, where it was expressed in the developing trigeminal ganglion. Also later in development the expression of the B-50/growth-associated protein-43 gene was restricted to the nervous system in Xenopus, as was previously found for the mouse. In conclusion, we find that XB-50/growth-associated protein-43 is a good marker to study the development of the nervous system in Xenopus laevis.

Amino Acid Sequence↗
PubMed1997

Myocardial revascularization without cardiopulmonary bypass in pigs: a comparison between beta-blockers and Ca2+-channel blockers.

The purpose of this study was to develop the surgical technique for internal mammary artery grafting on the beating heart. In 10 pigs, heart rate was reduced with esmolol (n = 5) or verapamil (n = 5). In addition, the anti-ischaemic and anti-arrhythmic potencies of these drugs were investigated. Haemodynamics, mechanical function and ischaemia-sensitive laboratory measurements were assessed perioperatively. There were no differences in pre-ischaemic data including ischaemic clamping time of the left anterior descending artery. At the end of ischaemia haemodynamic parameters were significantly lower in the esmolol-group (P < 0.05). In the verapamil-group, one pig died from ventricular fibrillation during ischaemia, and one showed fibrillation during reperfusion (P < 0.01). There were no differences in cardiac function or enzymes between the groups. Reduction of heart rate was provided by both drugs, but no conclusive evidence was provided with regard to additional anti-ischaemic and anti-arrhythmic protection.

Adrenergic beta-Antagonists↗
PubMed1997

Increased pulmonary flow velocities in oversized homografts in patients after the Ross procedure.

OBJECTIVE: Between September 1991 and July 1996, 60 patients (mean age 29.8 +/- 9 years; range 5-57) underwent aortic root replacement with pulmonary autograft, a viable biologic and nondegenerating substitute. The pulmonary root was replaced with cryopreserved homografts from cardiac transplant recipients. The aim of this study was to evaluate differences in early valve function of viable and cryopreserved allografts. METHODS: All patients had Doppler echocardiographic examinations preoperatively, at discharge from hospital and 54 patients at 1 year follow-up. We measured aortic and pulmonary peak flow velocities with continuous and pulsed-wave Doppler, and graded aortic and pulmonary insufficiency (AI, PI) with color Doppler flow (grade 0-IV). Intraoperatively, the diameters of the pulmonary root and the pulmonary homograft were measured with standard valve probes and matched to body surface area. RESULTS: Pulmonary peak flow velocity (PVmax) increased significantly from preoperative 0.87 +/- 0.11 m/s to 1.30 +/- 0.34 m/s postoperatively (P < 0.001). The implanted homografts (mean 25.9 +/- 2.4 mm) were larger than their native pulmonary diameter (mean 23.3 +/- 1.8 mm) in all patients. Homograft size matched for body surface area (BSA) did not correlate with increased PVmax. There was a significant increase of PVmax at follow-up (FU) since discharge, also (1.83 +/- 0.53 m/s; P < 0.001). Pulsed-wave Doppler demonstrates that increase of PVmax is located directly at the homograft leaflets and not at the anastomoses. Aortic peak flow velocities (AVmax) were normal postoperatively and at FU (post = 1.35 +/- 0.35 m/s; FU = 1.17 +/- 0.27 m/s). There was no significant change in AI or PI since discharge (AI FU = 0.8 +/- 0.4; PI FU = 0.7 +/- 0.5). Eight patients with fever and symptoms diagnosed as post-pericardiotomy syndrome had significantly higher PVmax at FU (PVmax = 2.41 +/- 0.40 m/s; P < 0.02). CONCLUSIONS: The Ross procedure leads to normal AVmax but significant increase of PVmax even in oversized cryopreserved homografts immediately after surgery. Further increase of PVmax without changes in AVmax in the first year demonstrates that changes in flow velocities are valve related and not due to increase in cardiac output. Further investigations will be necessary to determine whether this observation is due to valve rejection or early leaflet degeneration and treatment with immunosuppressive therapy is warranted.

Adult↗
PubMed1997

Treatment of hypersensitive teeth using neodymium:yttrium-aluminum-garnet lasers: a comparison of the use of various settings in an in vivo study.

The spectrum of the methods available to treat hypersensitive teeth is very great. The chances for success in the use of these different therapies are equally variable. Faced with the already successful effort of the Nd:YAG laser in the treatment of exposed tooth necks, the effectiveness of the use of different settings of the Nd:YAG laser on exposed dentine was examined in this clinical study. In the case of comparison of the therapy success of the laser settings amongst one another, no significant difference could be found. This leads us to a conclusion, that laser irradiation is therapeutically effective at very low settings.

Adult↗
PubMed1997

The carbon dioxide laser as an aid in apicoectomy: an in vitro study.

OBJECTIVE: To achieve the required goal of optimally sealing the apical section and the root-canal when performing an apicoectomy, the authors decided to use the CO2 laser as an additional aid. SUMMARY BACKGROUND DATA: The CO2 laser has previously shown to have an excellent sealing effect on dentin surfaces. METHODS: In this in vitro study, the authors examined the effects of CO2 laser application in apicoectomies with the help of color penetration tests and scanning electron microscopic (SEM) examinations. Sections and root canals were irradiated with low power (0.5 W) in continuous wave mode for totally 20 sec. The thermal stress for the adjacent tissues attaching thereto is moderate as shown by infrared-spectroscopy. RESULTS: A comparison with nonirradiated samples revealed that CO2 laser irradiation reduced color penetration at the section to a minimum. Also, irradiation of the root-canal wall resulted in satisfactory sealing of the surface. These findings were supported by the results of the SEM examinations. CONCLUSIONS: CO2 laser treatment optimally prepares the tooth for final intraoperative filling because of sealing of the dentinal tubules, the resultant elimination of niches for bacteria and the sterilizing effect of the laser.

Apicoectomy↗
PubMed1997

Bacterial reduction in periodontal pockets through irradiation with a diode laser: a pilot study.

This study examines the application of a diode laser with a wavelength of 805 nm for periodontal treatment. While the use of the diode laser in this field has not been investigated so far, several authors have reported on the use of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for such applications. The aim of this study was to examine the immediate effect of the diode laser in reducing the bacterial concentration in periodontal pockets. Important periodontal indices (PBI, CPITN) were assessed in 50 patients to obtain initial values for a planned long-term study and to select appropriate periodontal pockets for this study. The periodontal pockets were required to have a minimum depth of 4 mm. Only proximal pockets were included in this study. The patients were subdivided into two groups. After microbiological samples had been collected with sterile paper tips, the group selected for laser treatment was subjected to scaling. One week after scaling, the patients underwent laser treatment. One week later, a second series of microbiological samples were obtained and the patients were subjected again to scaling; this time, however, they did not undergo laser treatment after 1 week. Two weeks after scaling, another series of microbiological samples was collected. The microbiological samples were evaluated to verify bacterial elimination from the periodontal pockets. A comparison between the initial and the final bacterial counts revealed that irradiation with the diode laser facilitates considerable bacterial elimination, especially of Actinobacillus actinomycetemcomitans, from periodontal pockets.

Aggregatibacter actinomycetemcomitans↗
PubMed1997

Nd:YAG laser irradiation of infected root canals in combination with microbiological examinations.

In this in vivo study, 30 subjects with infected root canals were treated with the neodymium: yttrium-aluminum-garnet, or Nd:YAG, laser using standard laser settings and procedures. In microbiological examinations conducted before irradiation, the authors found streptococci in 30 cases and staphylococci in 15 cases. After the first irradiation, the authors found that 19 root canals showed minimal streptococcal growth and 10 root canals showed minimal staphylococcal growth.

Aluminum Silicates↗
PubMed1997

In vitro irradiation of infected root canals with a diode laser: results of microbiologic, infrared spectrometric, and stain penetration examinations.

This study aimed to examine the suitability of the diode laser with a wavelength of 810 nm for reducing bacteria in root canals. Forty-four extracted, endodontically prepared teeth were inoculated with Escherichia coli and Streptococcus faecalis. No bacterial growth was observed when the teeth were irradiated at an output power of 4 W and a pulse rate of 10 milliseconds, with breaks of 10 milliseconds between the irradiations. Exposure time was five times 5 seconds. Infrared spectroscopic examinations revealed that irradiation at 4 W under even circling movements resulted in a maximum rise in temperature of 6 degrees C on the root surface. Stain penetration tests and scanning electron microscopic examinations revealed complete closure of the dentinal tubules on the irradiated root canal walls.

Dental Pulp Cavity↗