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Biomedical subjects

D Jäger

Publications and source records attributed to D Jäger.

At least 91 records · Page 5Linked to original sources
PubMed1992

[The importance of 201-thallium myocardial scintigraphy in the hypertensive patient].

Thallium-201 exercise myocardial scintigraphy was performed in 57 patients (37 males, 20 females; mean age 55.4 [43-78] years) with angina and systemic hypertension after exclusion by coronary angiography of any coronary macroangiopathy. The exercise ECG of 32 patients could not be used in the diagnosis of ischaemia because of the presence of left ventricular hypertrophy with abnormal repolarization or left bundle branch block. Abnormal haemodynamics were demonstrated at cardiac catheterization in 23 patients (Swan-Ganz). Only 10 of the studied hypertensives with normal coronary angiograms had a myocardial scintigram within normal limits, while 12 had extensive ischaemic zones in the left ventricle. All patients with left bundle branch block had evidence of exercise-dependent apical "ischaemia". Thallium-201 myocardial scintigraphy should not be used as a screening method in hypertensives with angina, because the high proportion of "false-positive" findings, in the sense of a macroangiopathy, will nevertheless require early invasive diagnosis.

Adult↗
PubMed1992

[Latex proteins as the trigger of respiratory and systemic allergies].

56 patients (52 members of the hospital's staff, four with other employment) who had hypersensitivity reactions to latex articles and developed an immediate-type response to latex extract with the skin-prick test were studied. Specific IgE antibodies were present in the enzyme-allergo-sorbent test of 50 of the subjects. Latex-containing surgical and household gloves were the main cause of allergies. Patients with isolated contact urticaria (n = 8) had a tendency towards lower antibody concentrations than those with additional respiratory and/or systemic symptoms (n = 48). Occupation-related provocation tests triggered rhinitis in 19, conjunctivitis in ten, and bronchial obstruction in six. The main allergen was found to be a protein with a relative molecular mass of 58,000, originating from the latex milk and passing from the latex glove into the glove powder. In the course of usual activities considerable allergen inhalation can occur. Even small amounts (e.g. 400 ng/ml) can precipitate significant allergic reactions. The results show that the main latex allergen, a glycine-rich protein molecule, can cause cutaneous, inhalant and systemic hypersensitivity reactions.

Adult↗
PubMed1992

Efficacy and safety of APSAC in the treatment of acute myocardial infarction.

A prospective, open, multicentre post-marketing surveillance on the efficacy and safety of intravenous APSAC in the treatment of acute myocardial infarction was performed in 2436 patients. Reperfusion suggested by non-invasive parameters was achieved in 77.3% of patients. In-hospital mortality was low (7.1%). After exclusion from analysis of patients greater than 70 years of age and those reported to be in cardiogenic shock, mortality rate was 2.9%. More importantly, non-invasive evidence for successful thrombolysis resulted in a significantly lower mortality (3.3%) compared with patients without evidence of successful reperfusion (17.2%). The incidence of serious adverse events was low (132 in 2436 patients, 8/2436 = 0.3% fatal). The data from this post-marketing surveillance conducted under every-day clinical conditions confirm the efficacy and safety of APSAC as a thrombolytic agent in acute myocardial infarction, as demonstrated previously in controlled clinical trials.

Acute Disease↗
PubMed1992

Aerobic capacity in rate modulated pacing.

Whether heart rate or AV synchrony is the most important factor for an increase in aerobic capacity was evaluated in a comparative study between sinus bradycardia, VVIR, DDD, and DDDR stimulation. Sixteen patients (mean age 67 years) with chronotropic incompetence and implanted DDDR pacemaker (Telectronics META 1250) were randomly studied by cardiopulmonary exercise testing. All patients were exercised to their anaerobic threshold (AT) with the following heart rates: DDD 84 +/- 3, VVIR 110 +/- 5, and DDDR 116 +/- 6 beats/min. Mean oxygen uptake (VO2, mL/kg per min) at AT was 7.4 +/- 0.3 in DDD and VVIR modes. A 12% increase was measured in DDDR mode (8.3 +/- 0.4). Compared to VVIR work capacity in the DDDR mode was improved by 17% (41 vs 48 W/min). In patients with isolated sinus node disease (n = 9) the increase of VO2 and work capacity at AT during DDDR mode was more pronounced (16% and 20%, respectively, compared to VVIR). In patients with intermittent second or third degree AV block (n = 7) the differences between the pacing modes were not significant. This might partly be due to a lesser degree of chronotropic incompetence in this subgroup. In conclusion only the conjunction of heart rate increase and preservation of AV synchrony provides a significant improvement in aerobic capacity during exercise.

Aged↗
PubMed1991

[The effect of molsidomine on portal and cardiac hemodynamics in liver cirrhosis].

An investigation was conducted on 21 patients (16 men and five women; mean age 48.2 [34-67] years) with cirrhosis of the liver of various aetiologies to determine whether molsidomine, which selectively reduces pre-load with-out the development of tolerance, effects portal and cardiac haemodynamics in liver cirrhosis and portal hypertension. Intravenous injection of 2 mg molsidomine reduced the hepatic vein closing pressure after 30 min by 8% (P less than 0.05) and the hepatic vein closing pressure gradient by 13.4% (P less than 0.002). The cardiac output fell by 5.8% (P less than 0.02) and the mean systemic arterial pressure by 4.2% (P less than 0.003). The reduction in hepatic venous closing pressure gradient did not correlate with the fall in cardiac output and mean arterial pressure. In 15 of 21 patients the hepatic venous pressure fell, but in six patients (28.6%) the pressure was not reduced (non-responders). The latter failure of response was associated with marked ascites, significant functional liver decompensation and alcoholic liver cirrhosis. Preliminary long-term observations with molsidomine point to a reduction in portal pressure by as much as 40%. This suggests that the drug is suitable for preventing bleeding from oesophageal varices.

Adult↗
PubMed1991

[Intolerance reactions to ionic and nonionic contrast media in cardiac diagnosis. A randomized double-blind study].

Reactions to an ionic and a nonionic contrast medium were compared in a randomized double-blind trial involving 1153 patients (897 men, 256 women; mean age 56 [18-84] years) who underwent left-heart catheterization with coronary angiography. 584 patients (group 1) received the ionic contrast medium meglumine diatrizoate (Urografin 76%), while 569 (group 2) received the nonionic iopromide (Ultravist -370). Reactions of skin and mucosae, heart and circulation, lungs and respiratory tract, as well as of the central nervous system were noted. There was no significant difference between the two groups with respect to age, weight, height, allergic predisposition, left-ventricular ejection fraction, or serum electrolyte concentrations. Mild reactions, not requiring any treatment, occurred in 108 of the 1153 patients (9.4%), 85 (14.6%) in group 1 and 23 (4%) in group 2 (P less than 0.001). Severe reaction requiring treatment occurred in eight patients of group 1 (1.4%) and 14 of group 2 (2.5%)--difference not significant. Ventricular fibrillation was more frequent among group 2 patients (four compared with one in group 1), while two of three asystoles requiring treatment occurred in group 1 patients. The results show that, while mild reactions not requiring treatment were clearly less frequent after nonionic contrast medium injection, the risk of severe reactions was not reduced by their use.

Adolescent↗
PubMed1990

[Systemic fibrinolysis following resuscitation or temporary electrostimulation].

Short-term systemic thrombolytic treatment with 1.5 million I.U. streptokinase or 1.8 million I.U. urokinase or APSAC was carried out in 13 patients with acute myocardial infarction (11 men, 2 women, mean age 61 [44-73] years) after cardiopulmonary resuscitation (n = 11) or transvenous electrostimulation (n = 2). In seven of the patients the infarct vessel was found to be patent after the course of thrombolytic therapy. No haemorrhagic complications occurred. Two patients died: one of a reinfarct at 3 months and the other suddenly at home at 6 months. These results show that short-term high dosage systemic thrombolytic treatment can be successfully performed in individual cases even after resuscitation or central venous catheterization, provided that any serious traumatic lesions or inadvertent arterial punctures have been avoided.

Aged↗
PubMed1989

Stabilization of dicentric chromosomes in Saccharomyces cerevisiae by telomere addition to broken ends or by centromere deletion.

We introduced CEN6 DNA via integrative transformation into the right arm of chromosome II in a haploid Saccharomyces cerevisiae strain thus creating a dicentric chromosome. The majority of the transformed cells did not grow into colonies as concluded from control transformations with mutated CEN6 DNA. Five percent of the initial transformants with the wild-type centromere gave rise to well growing cells. We analysed the probable fate of the dicentric chromosome in two transformants by electrophoretic separation of chromosome sized DNA and by hybridizations with chromosome II DNA probes. We found two different mechanisms which generated cells lacking dicentric chromosomes. The first mechanism is breakage of the chromatid between the two-centromeres and healing of the new ends to functional telomeres thus creating progeny cells with the chromosome II information split into two genetically stable new chromosomes one carrying CEN2 and the other CEN6. The second mechanism is loss of the resident CEN2 by a 30-50 kb deletion event which resulted in a genetically stable but shortened chromosome II. Both mechanisms operated in the two transformants studied.

Aneuploidy↗
PubMed1989

Many yeast chromosomes lack the telomere-specific Y' sequence.

Chromosomal DNAs of 26 different strains representing Saccharomyces species were analyzed by pulsed-field gel electrophoresis and subsequent hybridization to Y' telomere DNA. Hybridization to Y' was found exclusively in Saccharomyces cerevisiae strains, and among these strains, Y' sequences were found to be lacking in small, middle-sized, and large chromosomes.

Chromosome Mapping↗