Prognostic index: prediction of operative mortality in geriatric patients by use of stepwise logistic regression analysis.
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Aged↗
Biomedical subjects
C Fuchs
Publications and source records attributed to C Fuchs.
Improved in vitro diagnosis of allergy to Alternaria tenius and Cladosporium herbarum.
To improve the in vitro diagnosis of mould allergy 22 children suffering from allergic asthma caused by Alternaria tenius and/or Cladosporium herbarum as proven by bronchial provocation test were investigated. Partially purified, standardized mould preparations were used in radioallergosorbent test (RAST) with conventional and new update mould discs, mould-induced histamine release and immunoblotting. Updated RAST discs were found to be superior to the old-type discs for the detection of Alternaria but not Cladosporium sensitivity. In all patients except one, specific IgE-antibodies to the respective mould were demonstrated by immunoblotting. Mould-induced histamine release failed to prove sensitization in only two patients. No differences were found comparing histamine release from whole blood with release from isolated cells. The results demonstrate a high sensitivity of in vitro tests when purified and standardized extracts are used.
Allergens↗
Tolerance intervals for standards in ultrasound measurements: determination of BPD standards.
Standards for the relationship between BPD and gestational age are used for the assessment of fetal size. We measured the BPD in 310 women with exact gestational age in a cross-sectional study. Two types of BPD charts were constructed based on tolerance intervals: directly from measurements and after model fitting. We found that the tolerance intervals based on the model are smoother and narrower than those achieved by direct determinations. The fit, advantages, and prospects of the model are discussed.
Body Constitution↗
TI-59 programmable calculator program for calculating predicted operative mortality in general surgery.
A program for the TI-59 programmable calculator for calculating predicted postoperative mortality is presented. Input data are based on handy, clinical, non-invasive pre-operative and operative parameters retrieved mostly significant in this respect by former multivariate logistic regression analysis of a broad data-base; their relative weights are incorporated into the program data base as basic coefficients. Considerations employed in its usage are discussed, as well as possible future technical and/or environmental modifications.
Humans↗
Results of preservation of the posterior canal wall in cholesteatoma surgery as related to middle-ear aeration.
The last otological generation witnesses a fierce discussion concerning the treatment of choice of cholesteatomatous ears--closed versus open technique being the issue. The reports of the success and failure of these two opposed techniques varied greatly (McCabe, 1977; Sadé, 1982a). It is the purpose of this study to clarify this issue further by reviewing the fate of 100 cholesteatomatous ears treated by the closed technique and followed up for as long as 13 years--a length of follow-up which has not hitherto been reported. We will also try and attempt to correlate the success and failure of this method with the ability of these ears to aerate--a clinical status which may be regarded as indicating the 'Eustachian function' of any particular middle ear in question.
Cholesteatoma↗
Growth inhibition and eicosanoid metabolism in the R3230AC mammary adenocarcinoma by interferon.
The mode of action of rat interferon (IFN) on growth of the R3230AC mammary adenocarcinoma was studied in vivo in Fischer female rats. A dose of 1 X 10(4) units of rat IFN given thrice weekly inhibited the growth of the transplanted mammary tumors. Of the five eicosanoids measured in the tumor, the content of four arachidonate products, prostaglandin (PG) E2, PGF2 alpha, 6-keto-PGF1 alpha, and thromboxane (TX) B2, was higher in mammary tumors from IFN-treated rats than the control rats. PGE2 was the major eicosanoid. In vitro PG synthesis (PGE1, PGE2, and PGF2 alpha) was lower in tumor microsomes prepared from IFN-treated tumors. These data suggest that the tumor content of four arachidonate products in the IFN-treated tumors was related to the in vivo effects of rat IFN. Indomethacin, a cyclooxygenase inhibitor, also inhibited tumor growth. Furthermore, when indomethacin was administered daily in combination with rat IFN, the tumor-inhibiting effect of rat IFN was reduced. These observations suggest that the effects of eicosanoids appear to be biphasic in this tumor model. Inhibition of arachidonic acid metabolism resulted in tumor growth inhibition, a finding consistent with the view that eicosanoid production is required for tumor enhancement. Conversely, in the experiments with rat IFN, retardation of tumor growth is associated with a greater amount of arachidonic acid metabolism, and indomethacin prevents this effect. Eicosanoids appear to be required for tumor-inhibiting effects of rat IFN, and yet inhibition in vivo of eicosanoid synthesis also resulted in retardation of tumor growth. Although the precise mechanism of action in each situation is unclear, these apparently contradicting results are consistent with the biphasic actions of eicosanoids reported in some normal tissues and transformed tumor cell lines.
Adenocarcinoma↗
Determination of complement activating circulating immune complexes and an example for antigen specific immune complex assays.
For the screening of complement activating circulating immune complexes a new fluorescence linked immunosorbent assay was developed. Anti-human C3 or anti-human C4 F(ab')2 fragments were coupled to a nitrocellulose matrix. Nitrocellulose pieces of definite size covered with anti-C3 and anti-C4 were incubated with serum samples or standards for 15 min followed by a reaction with a fluorescence labelled anti-human IgG or anti-human-IgM. The nitrocellulose disks were then washed and the remaining fluorescence was read by a solid-phase fluorometer. The method was standardized by a WHO Tetanus toxoid anti-Tetanus immune complex reference substandard. (This standard and further controls were used to prove the reproducibility of the system.) Patients suffering from chronic inflammatory diseases were compared to healthy controls. The best discrimination between patients and controls was demonstrated by the determination of C3-IgG aggregates, followed by C3-IgM, C4-IgG, and C4-IgM aggregates. The easy performance, the stability of necessary chemical substances, the reliable standardization by a reference standard, and the clear-cut differences between patients and healthy control groups proved this test to be suitable for routine purposes. Furthermore, it could be demonstrated by means of an artificial model immune complex that this system can be expanded--by slight modifications--to antigen-specific CIC-assays. A CEA-anti-CEA CIC test is described as an example of an antigen specific CIC test not limited to complement activating CIC, and the data of 127 patients with colorectal carcinoma are given.
Antigen-Antibody Complex↗
[Can x-ray computed tomography confirm brain death?].
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Brain Death↗
[Continuous ambulatory peritoneal dialysis. 5-year clinical experience].
Continuous ambulatory peritoneal dialysis (CAPD) is, next to conventional home dialysis, a world-wide method of treating chronic renal failure. This is the report of clinical experience of 34 CAPD patients who, from October 1978 to the end of 1983, had undergone 642 treatment months. The incidence of peritonitis after introduction of a new connector system in 1983 was reduced to 1 per 46 CAPD treatment months. In only 7 patients was it necessary to discontinue CAPD for reasons connected with the type of dialysis. No patient requested discontinuance of CAPD. Suitable bag and tube materials, adequate space, and well trained personnel are decisive for a successful CAPD programme, in addition to careful selection of patients. The latter aims at optimal patient motivation for the treatment method which, in principle, is more cost effective than home dialysis. In so far as patients fulfil the requirements for home dialysis they can be excellently rehabilitated.
Adolescent↗
The statistical properties of a stepwise procedure for testing the purity of fruit juice.
In many cases no fixed standards are available and a sample from a target population is used to provide the necessary quality-control norms. Furthermore, many products possess several correlated attributes that are relevant to the authenticity question. This article addresses some issues related to statistical tests used in such cases, focussing in particular on a procedure that has been lately proposed for differentiating between pure and adulterated fruit juice. The quality control of fruit juice is usually performed by comparing the values of several characteristics in the tested sample against some prespecified standards. In many cases those standards are based on the values found in a sample of a presumably pure juice, which is used as a "reference sample" or a "base sample". Several detection methods were recently proposed that use universal "base samples" and are supposed to be valid when applied to juices from different sources or different varieties. We compare the results yielded by the use of various "base samples" and show that the application of such a method to Israeli citrus juice leads to too many rejections of pure juices. We suggest that the main drawbacks of the method is the use of improper "base sample" that is not specific to the sample being tested.
Amino Acids↗
Mandibular dysfunction in 10-18 year old school children as related to morphological malocclusion.
An association was sought between certain morphologic characteristics of malocclusion--Angle classification, over-bite, over-jet, open-bite, cross-bite and crowding--and the presence or absence of three cardinal symptoms of mandibular dysfunction--joint sounds, joint sensitivity to palpation and muscle sensitivity--in a sample of 369 Israeli school children. In addition, two additional independent variables, 'occlusal wear' and 'previous orthodontic treatment' were introduced into the statistical analysis. Occlusal wear and abnormal overbite were the only factors found to increase significantly the presence of dysfunction symptoms.
Adolescent↗
Some properties of the plasma hGH activity in patients with Laron-type dwarfism determined by a radioreceptor assay using human liver tissue.
A radioreceptor assay for human growth hormone (hGH) using the 100,000-g pellet of human liver tissue homogenates obtained from a 13-year-old male donor of a kidney transplantation is described. The dilution curves of the plasma hGH of 6 patients with Laron-type dwarfism (LTD) as well as those of the plasma hGH from 1 normal child and 2 acromegalic patients were all found to be parallel to the standard curve, suggesting that in the LTD syndrome the circulating hGH is biologically active.
Acromegaly↗
Effect of dialysate glucose load on plasma glucose and glucoregulatory hormones in CAPD patients.
The effect of a dialysate exchange with both 1.5 and 4.25% glucose solutions on plasma levels of glucose, insulin, gastric inhibitory polypeptide (GIP), and glucagon has been investigated in 5 continuous ambulatory peritoneal dialysis (CAPD) patients. Only in the case of the 4.25% solution did plasma glucose levels rise above 100 mg/dl. 4 of the 5 patients responded to this change with a marked insulin secretion. Employing the 1.5% solution, plasma glucose remained stable and only a slight insulin stimulation was observed in 2 patients. It is concluded that provided the 4.25% dialysates are used only occasionally, there will be no continuous stimulation of the pancreatic beta-cells due to absorption of glucose from the dialysate alone during CAPD treatment. GIP levels are highly elevated in CAPD patients. A dialysate exchange with either a 1.5 or a 4.25% glucose solution had no effect on this gastrointestinal hormone. Hyperglucagonemia was also observed in this collective. An initial suppression of glucagon levels occurred in 4 of the patients after a 4.25% dialysate exchange. The 5th patient demonstrated an initial rise followed by a later decrease in glucagon, a response similar to that reported in adult onset diabetes after an oral glucose tolerance test.
Adult↗
Missing stapes and stapes-replacing prosthesis.
Our study of 205 ears with missing stapes, secondary to some type of chronic ear disease, showed that only 40% of such ears are suitable for ossiculoplasty. The remaining 60% are unsuitable because of a fixed footplate, severe atelectasis, hearing better than 25 dB (these patients do not need the operation), or poor discrimination. A new stapes replacement prosthesis (SRP), which we term Tabor, is described for use where indicated. The prosthesis has two parts: The lower part (or base) is made of a broad inorganic, biocompatible material (Teflon). This part fits and covers most of the footplate, ensuring maximal stability. The upper part of the prosthesis is made of autograft or homograft bone--usually a malleus head--the contact of which with the drum prevents extrusion. In twelve out of fourteen ears insertion of this prosthesis was successful; the average postoperative air conduction went from 56 dB to 29 dB, leaving an average air-bone gap of 16 dB. The bone conduction also improved, from an average of 20 dB to 13 dB.
Bone Conduction↗
Functional aspects of the superoxide dismutative action of Cu-penicillamine.
The superoxide dismutative action of Cu-penicillamine was examined by pulse radiolysis. The second order rate constand of the reaction wpith superoxide was 0.4 +/- o.2.10(9) M-1.s-1, comparable to the action of Fe and Mn-superoxide dismutases. No marked pH-dependence was seen. Neither ethylene diamine tetraacetic acid nor cyanide affected the catalytic action of Cu-penicillamine. The cyanide resistant reactivity as well as further X-ray photoelectron spectrometric measurements supported the suggestion of a Cu(I) stabilized sulphur radical being the active species involved in the catalysis of superoxide dismutation.
Binding Sites↗
[Hyperparathyroidism and metabolic acidosis (author's transl)].
Severe secondary hyperparathyroidism and marked metabolic acidosis occurred in five patients in advanced renal failure due to chronic interstitial nephritis. In all instances there was an immediate and lasting rise in plasma standard bicarbonate concentration after subtotal parathyroidectomy. These observations suggest that the metabolic acidosis in some patients with advanced renal failure is, at least in part, due to hyperparathyroidism and, therefore, responsive to its appropriate treatment.
Acidosis↗
[Influence of dental caries prophylaxis using fluor-vigantoletten 1000 on plasma fluoride levels in infants (author's transl)].
A group of 57 newborns was divided into two: group I (27 subjects) received solely 1,000 I.U. vitamin D3 per day for 6 months, whereas group II (30 subjects) were given a combination of 1,000 I.U. vitamin D3 and 0.25 mg fluoride. At the end of the time of observation there was a significant difference between the plasma concentrations in the two groups. The median value was 13.06 microgram/l (range: 8:18-39.4 microgram/l) in group I and 16.54 microgram/l (range: 9.9--41.2 microgram/l) in group II. Fluoride is obviously available to infants when administered in combination with Vitamin D3. In addition, it could be proven, that after 6 month administration of fluoride there are no signs of cumulation, overdosage or even intoxication.
Cholecalciferol↗
[Comparison of ion-selective electrodes and flame photometry for the determination of serum Na+ and K+ for clinical purposes (author's transl)].
The ORION SPACE-STAT (SS-30) and the TECHNICON STAT/ION were used to investigate quality control of Na+- and K+-determinations in test sera (n=8) and in the plasma of 100 patients. The flame photometer IL 543 was used as a reference apparatus. The ion-selective electrode instruments, SS-30 and STAT/ION, gave results very similar to those of flame photometry. The values from the SS-30 were higher by an average of 3% to 5% compared with the values from the other instruments. An explanation for this bias may be the fact that the SS-30 (unlike the STAT/ION and the IL 543) measures electrolyte activities or concentrations in undiluted plasma water. On the basis of these results the routine use of ion-selective electrodes for Na+- and K+-determination can be recommended for clinical laboratories.
Electrodes↗