PubMed Health⌕ Search

Biomedical subjects

E M Jacobs

Publications and source records attributed to E M Jacobs.

At least 19 recordsLinked to original sources
PubMed2000

[Clinical thinking and decision-making in practice. A pregnant Turkish woman with a liver tumor].

A 30-year-old Turkish woman suffered from pain in the right upper abdomen during the 32nd week of her third pregnancy. On ultrasound a liver tumour was diagnosed. The patient was followed without treatment during pregnancy. The outcome of the pregnancy was uncomplicated. The diagnosis of focal nodular hyperplasia was made post partum using MRI with contrast and a liver biopsy. The born son suffered the syndrome of Klippel-Trenaunay-Weber, also a vascular malformation. A liver tumour during pregnancy can influence the outcome of the pregnancy, but the pregnancy may also affect the progression of tumour growth. Considerations regarding the diagnostic evaluation and treatment should be made with caution. Ultrasound and MRI are well established methods to diagnose a liver tumour during pregnancy. The duration of the pregnancy is important in the diagnostic and therapeutic approach to the tumour.

Adult↗
PubMed2000

[Acute renal insufficiency due to vomiting or diarrhea: the Achilles heel of medical support for heart failure].

Morbidity and mortality of heartfailure are decreasing because of improved medical treatment. The recompensation balance can however be very fragile, which is illustrated by three patients. A woman aged 73 and a man aged 62, both known with heart failure, became seriously ill after diarrhoea; examination revealed uraemia, hyperpotassaemia and raised digitalis levels. A man aged 72, also with heart failure and diarrhoea, developed sensory disorders in both feet. He, also, was found to suffer from renal insufficiency. All patients used an angiotensin converting enzyme inhibitor or an angiotensin-II-antagonist and an aldosterone receptor blocker as well. During the (innocent) intercurrent disease by which their intravascular volume diminished they developed a severe renal insufficiency which needed clinical, intensive treatment. After haemodialysis, all three recovered well. Renal function plays an essential role in the fragile treatment balance that exists in recompensated cardiac patients. The medication that is beneficial for the cardiac functioning may at the same time compromise the renal perfusion. Good monitoring and good instructions about what to do in case of intercurrent diseases are of vital importance in these patients.

Acute Kidney Injury↗
PubMed1999

Atrial natriuretic peptide increases albuminuria in type I diabetic patients: evidence for blockade of tubular protein reabsorption.

BACKGROUND: It has been suggested that atrial natriuretic peptide (ANP) contributes to the glomerular hyperfiltration of diabetes mellitus. Infusion of ANP increases the urinary excretion of albumin in patients with type I diabetes mellitus (IDDM). Although the increased albuminuria is attributed to a rise in glomerular pressure, alterations in tubular protein handling might be involved. PATIENTS AND METHODS: We have studied the effects of ANP in nine microalbuminuric IDDM patients. After obtaining baseline parameters, ANP was infused over a 1-h period (bolus 0.05 microgram kg-1, infusion rate 0.01 microgram kg-1 min-1). Renal haemodynamics, sodium and water clearance and tubular protein handling were studied. RESULTS: The glomerular filtration rate (GFR) increased from 116.4 +/- 8.9 to 128.3 +/- 8.8 mL min-1 1.73 m-2, whereas the effective renal plasma flow (ERPF) decreased from 534.3 +/- 44.3 to 484.9 +/- 33.3 mL min-1 1.73 m-2 (P < 0.05). As a result, the filtration fraction was significantly higher during infusion of ANP. ANP attenuated proximal tubular sodium reabsorption. Urinary albumin excretion rose from 87.57 +/- 21.03 to 291.40 +/- 67.86 micrograms min-1 (P < 0.01). Changes in the urinary excretion of beta 2-microglobulin and free kappa light chains were more marked, the excretion of beta 2-microglobulin increasing from 0.28 +/- 0.21 to 51.87 +/- 10.51 micrograms min-1 (P < 0.01), and of free kappa-light chains from 4.73 +/- 1.74 to 46.14 +/- 6.19 micrograms min-1 (P < 0.01). CONCLUSIONS: The observed rise in albuminuria during infusion of ANP does not simply reflect a change in glomerular pressure, but might at least partly result from an attenuation of tubular protein reabsorption.

Adult↗
PubMed1994

Fast scan conversion algorithms for displaying ultrasound sector images.

Two fast algorithms for interpolation of ultrasonic sector-scans were developed. Both algorithms are based on line-drawing algorithms and are free from multiplications in the innermost loops. The algorithms were compared to the following conventional interpolators: 2-D windowed sinc, bicubic spline, 4 x 4 point bicubic spline, bilinear, and nearest neighbor. The most accurate of the two new algorithms is about eight times faster than nearest neighbor interpolation. The quantitative errors are of the same order as the errors of the nearest neighbor interpolator. The subjective image quality is between nearest neighbor and bilinear interpolation.

Algorithms↗
PubMed1991

A simulation study of echographic imaging of diffuse and structurally scattering media.

Realistic simulations of echographic image formation were performed. The simulations were based on a focussed single element transducer of 3.5 MHz and linear scanning. The tissue model scanned was composed of a homogeneous, nonattenuating, medium containing point-like scatterers. The scatterers were distributed in space in two different arrangements: randomly with a fixed number density of 7500 per cubic centimeter and regularly in a cubic matrix with a characteristic distance of 1 mm. These two populations of scatterers yielded the diffuse and the structural scattering component, respectively. The B-mode texture was assessed by first and second order statistical parameters. The effects of various modifications of the matrix, i.e., the relative scattering strength, the orientation and the position uncertainty of the scatterers, on the statistical parameters were systematically investigated. Increasing the relative scattering strength yields a monotonic increase of the mean grey level, the ratio of structural over diffuse scattering intensity and a decrease of the signal-to-noise ratio and the autocorrelation lengths. Increasing the position uncertainty to 20 percent reduces these effects practically to zero, except for the lateral ACF's. Rotation of the matrix with respect to the beam axis induces a periodicity in all statistical parameters, which is symmetric around 45 degrees. Again, the effects become statistically insignificant at a position uncertainty of 20 percent, with the exception of length of the lateral ACF. While assuming that in a single clinical B-mode echogram of the liver many orientations of the matrix will be simultaneously present, the B-mode lines of images obtained for a range of orientations were taken together and the overall statistical parameters calculated. The mean, the signal-to-noise ratio of the echo amplitude, SNRA, and the axial and lateral lengths of the ACF for the multirotation condition are significantly different from both the diffuse and the zero degree orientation. The structural backscattering intensity cannot be estimated any more with a reasonable precision. The structural separation distance, however, can still be assessed at a 10 percent level of the position uncertainty, even in the multirotation case and is therefore a robust clinical parameter.

Computer Simulation↗
PubMed1987

Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer.

Between 1979 and 1984, 195 evaluable patients were entered in an international multicenter study comparing two regimens for patients with completely resected pathological Stage II testicular cancer (that is, with positive retroperitoneal lymph nodes). All patients had undergone orchiectomy and dissection of the retroperitoneal lymph nodes. They were randomly assigned to be treated with two cycles of immediate adjuvant cisplatin-based chemotherapy or to be observed monthly with treatment at relapse. The median follow-up period was four years. Of the 97 patients assigned to adjuvant chemotherapy, 6 (6 percent) had a recurrence; however, only 1 had received adjuvant chemotherapy before the recurrence. Three died (one of testicular cancer), and 94 of the 97 survived. Of the 98 patients who were observed, 48 (49 percent) had a relapse. However, almost all patients with relapses were effectively treated, and 93 of the 98 are alive and disease-free; 3 have died of testicular cancer. No identifiable factors were strongly associated with the risk of relapse. We conclude that two courses of cisplatin-based adjuvant chemotherapy will almost always prevent relapse in pathological Stage II testicular cancer treated with orchiectomy and retroperitoneal-lymph-node dissection. However, when surgery, follow-up, and chemotherapy are optimal, observation with chemotherapy only for relapse will lead to equivalent cure rates.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1980

Adriamycin given as a weekly schedule without a loading course: clinically effective with reduced incidence of cardiotoxicity.

Three hundred and thirty-six patients with a variety of tumors were treated with Adriamycin given weekly as an iv bolus of 1 mg/kg with subsequent doses adjusted for hematologic toxicity. This weekly schedule, not utilizing a loading course, resulted in only a 20% incidence of stomatitis. The number of evaluable patients and the percent with objective responses (respectively) according to tumor type were: lung (57 patients, 14%); sarcoma (62, 24%); breast (31, 35%); transitional cell carcinoma (17, 29%); non-Hodgkin's lymphoma (17, 29%); head and neck (16, 13%); colorectal (13, 0); ovarian (eight, 25%); and other (53, 11%). These response frequencies are comparable to those reported for every-3-week regimens using 60-75 mg/m2 of Adriamycin. Sixteen patients were given 450-550 mg/m2 of Adriamycin, five were given 550-600 mg/m2, and ten were given greater than 600 mg/m2. None of the study patients developed definite evidence of drug-induced congestive heart failure. Therefore, Adriamycin given as a weekly schedule provides a clinically effective alternative to the every-3-week schedule of administration. The weekly schedule is associated with tolerable toxicity and a decreased risk of developing drug-induced congestive heart failure.

Doxorubicin↗
PubMed1976

Effect of trimethylcolchicinic acid methyl ether d-tartrate (TMCA) on Hodgkin's and non-Hodgkin's lymphoma.

Trimethylcolchicinic acid methyl ether d-tartrate (TMCA; NSC-36351) was administered daily by mouth to 71 patients with malignant lymphomas. Partical (greater than 50%) responses were observed in eleven of 37 patients with Hodgkin's disesse, two of 22 patients with lymphocytic lymphoma, and one of two patients with mixed cell lymphoma. One complete and three partial responses were noted in nine patients with histiocytic lymphoma. Responses lasted from one to 91+ months (median: four months) and occurred in patients whose disease was resistant to alkylating agents, vinblastine, vincristine, procarbazine, prednisone or BCNU. Toxic effects included leukopenia, thrombocytopenia, nausea, diarrhea, stomatitis, alopecia and dermatitis.

Antineoplastic Agents↗