PubMed Health⌕ Search

Biomedical subjects

F Ebner

Publications and source records attributed to F Ebner.

At least 37 records · Page 2Linked to original sources
PubMed1996

INSIGHT: international nifedipine GITS study intervention as a goal in hypertension treatment.

The objective of the study is to compare fatal and nonfatal cardiovascular endpoints in hypertensive patients randomised to the calcium-channel blocker, nifedipine GITS or a thiazide diuretic, co-amilozide. A total of 6592 patients from nine countries (UK, France, Israel, Spain, Italy, The Netherlands, Sweden, Denmark and Norway) will be recruited, aged 55-80 and with a blood pressure (BP) > or = 150/95 or > or = 160 mm Hg (systolic). All patients will have at least one other major cardiovascular risk factor. Patients will be minimised by country and risk factors and randomised to double-blind treatment with either nifedipine GITS or diuretic. After a single dose titration, additional treatment will be atenolol or enalapril (where beta-blockade is contra-indicated). After achieving a target BP of 140/90 mm Hg patients will be followed for a total of 3 years. Primary endpoints are myocardial infarction, stroke, subarachnoid haemorrhage, heart failure and sudden cardiac death. The study has a power of 80% at 5% significance to detect a difference between 8% event rate over 3 years in diuretic-treated patients and 6% in those receiving nifedipine.

Aged↗
PubMed1995

Lack of pineal growth during childhood.

During childhood, serum melatonin concentrations drop by approximately 80%, but the 24-h melatonin excretion is stable. Arrest of pineal growth after the end of infancy has been proposed as one possible mechanism underlying that phenomenon. To test this hypothesis, we reviewed 332 magnetic resonance imaging brain studies, classified as normal, of endocrine-normal children, aged 1 day to 15 yr, and estimated the pineal and pituitary sizes. The pineal was identified in 277 of 332 magnetic resonance imaging studies (83%). The average size (mean +/- SEM) of the pineal gland (transaxial diameter, 5.6 +/- 2.1; midsagittal diameter, 5.0 +/- 2.4; planimetric area, 28.5 +/- 17.8) did not differ with age. A total of 74 of 277 pineals with cysts (26.7%) were found. The occurrence of pineal cysts was equally distributed among the different age groups (chi 2 = 11.6; df = 14; P = 0.7). Ten pineals showed more than 1 cyst (3.6%). The pituitary was identified in 325 of 332 brain images (97.9%). The average pituitary size increased by some 100% from 1 to 15 yr of age [transaxial diameter: F = 2.2; P = 0.005 (by two-way analysis of variance); midsagittal diameter: F = 3.7; P = 0.0001; planimetric area: F = 7.1; P = 0.0001]. The pituitary was slightly larger in females than in males [midsagittal diameter: F = 8.8; P = 0.003 (by two-way analysis of variance); planimetric area: F = 7.9, P = 0.005]. The data presented indicate a lack of a discernible pineal growth after age 1 yr, which contrasts with pituitary development in the same individuals. The data are in agreement with a hypothesis suggesting a growth arrest of the pineal after infancy.

Adolescent↗
PubMed1994

Follow-up and quality of survival of 67 consecutive children with CNS tumors.

We report the findings at follow-up in 67 consecutive children with central nervous system tumors treated over a 5-year-period at a single institution. The diagnoses were supratentorial astrocytoma (n = 12), cerebellar astrocytoma (n = 10), ependymoma (n = 9), medulloblastoma (n = 9), brain stem glioma (n = 6), optic pathway glioma (n = 5), and others (n = 16). The survival rates were 83% for supratentorial astrocytomas at a median of 46.5 months, 90% for cerebellar astrocytomas and 55% for ependymomas at 40 months, respectively, 55% for medulloblastomas at 22 months, 33% for brain stem gliomas at 23 months, and 80% for optic pathway gliomas at 49 months. With regard to neurological sequelae, 13 patients were treated for epilepsy, 13 patients had mild to moderate neurological deficits, and 4 patients were severely disabled. Seventeen of 37 tested patients performed below average on formal neuropsychometric testing, one-fourth attended special education courses, and at least one-fourth suffered from behavioral and adjustment problems.

Adolescent↗
PubMed1994

The sphenoid sinus during childhood: establishment of normal developmental standards by MRI.

To obtain baseline standards of normal age-related development of the sphenoid sinus during childhood magnetic resonance images of the sphenoid sinus in 401 patients less than 15 years old were reviewed. T1-weighted sagittal and T2-weighted axial scans were evaluated for bone marrow conversion, development of pneumatization, spatial enlargement and septation of the sphenoid sinus. The sphenoid sinus had a uniformly low signal intensity (red bone marrow) on T1-weighted images in all children less than 4 months old. Signal intensity changes from hypo- to hyperintense (bone marrow conversion) started at age of 4 months. Onset of pneumatization was observed in 12% of the patients at age 13-15 months. By age 43-48 months, 85% of the patients showed pneumatization of the anterior part of the sphenoid bone. Pneumatization was complete in all patients older than 10 years. Enlargement of the sinus showed a characteristic profile in each dimension. Median septation was observed irregularly with age, with a maximum of 77%. Septum variants were noticed between 4.5% and 20%. The recognition of this phenomenon may serve as a reference for evaluating normal and abnormal development of the sphenoid sinus and may be of great value for diagnostic and therapeutic management of pathologic conditions of the child's sphenoid sinus and its surrounds.

Adolescent↗
PubMed1994

Symmetric hypoplasia of the temporal cerebral lobes in an infant with glutaric aciduria type II (multiple acyl-coenzyme A dehydrogenase deficiency).

Symmetric hypoplasia of the temporal cerebral lobes was demonstrated by magnetic resonance imaging of the brain in a macrocephalic male patient with glutaric aciduria type II within the first week of life. Psychomotor development was normal until the age of 11 months, when the patient died of sudden cardiac arrest. Autopsy revealed symmetric hypoplasia of the temporal cerebral lobes with loss of axons and hypomyelination in the temporal medullary layers.

Fatal Outcome↗
PubMed1994

Magnetic resonance assessment of age-related development of the sphenoid sinus.

Magnetic resonance images of the sphenoid sinus in 401 patients under 15 years old were reviewed to establish normal age-related standards. T1-weighted sagittal and T2-weighted axial scans were evaluated for bone marrow conversion, development of pneumatization, spatial enlargement and septation of the sphenoid sinus. The sphenoid sinus had a uniformly low signal intensity (red bone marrow) on T1-weighted images in all children less than 4 months old. Signal intensity changes from hypointense to hyperintense (bone marrow conversion) started at the age of 4 months. Onset of pneumatization was observed in 12% of the patients at age 13-15 months. By age 43-48 months, 85% of the patients showed pneumatization of the anterior part of the sphenoid bone. Pneumatization was complete in all patients older than 10 years. Enlargement of the sinus showed a characteristic profile in each dimension. Median septation was observed irregularly with age, with a maximum of 77%. Septum variants were noticed between 4.5% and 20%. Because paediatric sinus disease is a challenging problem in children, these results may be useful as baseline standards of normal age-related development of the sphenoid sinus during childhood.

Adolescent↗
PubMed1994

[Distinguishing of scar tissue from recurrent tumor after therapy of tumors of the female pelvis].

Patients treated for gynecological malignancies are followed up at short intervals during the first 3 years after treatment. Locoregional recurrence in the pelvis is often not detectable by palpation. Thus, efficient and sensitive follow-up of patients treated for gynecologic malignancies requires the use of imaging techniques. Computed tomography is well suited for the primary diagnoses of locoregional recurrences and lymph-node metastases after radical surgery. In addition to detailed anatomical information, magnetic resonance imaging (MRI) permits tissue characterization on the basis of signal intensity and thus differentiation between fibrosis and recurrence. After primary radiotherapy for cervical cancer, MRI follow-up can assess tumor response to treatment. Prognostic evaluation of the success or failure of treatment requires knowledge of the signal characteristics and volume of the primary tumor and of the interval since primary treatment. In our experience, conventional spin-echo sequences with heavy T2-weighting are best for distinguishing between fibrosis and recurrence.

Cicatrix↗
PubMed1994

[Radiologic diagnosis of Perthes disease].

In Legg-Calvé-Perthes disease (LCPD), magnetic resonance imaging (MRI) and conventional radiography in two planes are considered the most important methods of investigation for early diagnosis and for assessment of the course of the disease. MRI can reveal the early marrow oedema, thus allowing early differential diagnosis against diseases that are similar in clinical appearance (coxitis fugax, epiphyseal dysplasia). The extent of the necrotic area within the epiphysis, the most important indicator of the prognosis of the disease and thus for the therapeutic management, can be assessed earlier and more reliably with MRI than with other techniques. The loss of containment can be visualized by MRI, because depiction of the cartilaginous structures is possible earlier than with conventional radiography. Staging of LCPD is also possible with MRI, especially in stages I and II. Radiography shows the reossification and the osseous remodelling of the epiphysis better. A disadvantage of MRI seems to be the occasional need for sedation or anaesthesia of the child to avoid motion artefacts.

Diagnosis, Differential↗
PubMed1994

Magnetic resonance imaging in cervical carcinoma: diagnosis, staging, and follow-up.

Clinicians have long looked for an imaging modality that can provide accurate and useful information on cervical carcinoma. In the past 10 years, magnetic resonance imaging (MRI) has come to play an important role in evaluating patients with this disease before treatment and in monitoring them afterward. Before treatment, MRI can accurately depict tumor size (volume) and extension. MRI thus has the potential to supplant the traditional clinical International Federation of Gynecology and Obstetrics (FIGO) staging system for this disease, which is based on clinical findings and is inherently subjective. Promising areas of research include endorectal, endovaginal, and phased-array coils.

Female↗
PubMed1993

Giant dissecting aortic aneurysm with concealed perforation in an 81-year-old female.

This paper describes the history of an 81-year-old female suffering from a giant dissecting aortic aneurysm with concealed perforation within the thorax. The patient had suffered from arterial hypertension for about 10 years and had been treated with thiazide. Nine months prior to admission the patient was in a state of collapse, and ultrasound examination revealed an intra-abdominal aortic aneurysm. At this time thoracic x-ray showed aortic sclerosis and elongation of the aorta but no signs of aneurysm formation. After this episode the patient was symptom-free for the next 9 months. Following a further syncopal attack with severe thoracic pain, the patient was hospitalized at the intensive care unit. Both in thoracic x-ray and computed tomography of the thorax, a pronounced dissecting aortic aneurysm with perforation of the thoracic aorta into the mediastinum could be established. Because of the patient's poor general condition and advanced age, as well as far-reaching pathological findings, surgery was not advised by either the heart and vascular surgeon or the anesthetist. Following 1 week's intensive therapy, the patient's general condition improved greatly, with stabilization of thoracic pain, blood pressure, and respiratory action. On the other hand, thoracic x-ray, computed tomography, and magnetic resonance imaging produced a distinct progression of the aneurysm with consequent mild displacement of mediastinum and left lung. Laboratory examinations for syphilis showed no evidence of that disease. After further improvement the patient was discharged 4 weeks after admission and has been symptom-free for 6 months in spite of the extensive pathological findings described herein.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Mucopolysaccharidosis I and intracranial tumor in a patient with high-pressure hydrocephalus.

In a 19-month-old patient with mucopolysaccharidosis I (Pfaundler-Hurler, MPS I/H) high-pressure hydrocephalus required the implantation of a ventriculo-peritoneal shunt. Despite a reduction in both ventricular volume and intracranial pressure, clinical symptoms suggesting compression of the brain stem persisted. Brain MRI revealed a tumor within the posterior cranial fossa. Cytologic examination of the cerebrospinal fluid was suggestive of a poorly differentiated ependymoma. High-pressure hydrocephalus is a common complication in MPS I/H. As changes in mucopolysaccharide metabolism may be associated with an increased risk of developing neoplasms, the possibility of an intracranial tumor should be considered in patients with MPS I/H and high-pressure hydrocephalus.

Brain Neoplasms↗
PubMed1993

Intracellular sodium activity and its regulation in guinea-pig atrial myocardium.

1. Intracellular Na+ activity (aNai) and membrane resting potential were studied in quiescent guinea-pig atrial and papillary muscles by means of Na(+)-sensitive and conventional microelectrodes. The effects of the cardioactive steroid dihydroouabain (DHO) on aiNa, force of contraction and sarcolemmal Na+, K(+)-ATPase activity were also investigated. 2. In thirty atria and twenty-two papillary muscles, aNai amounted to 8.0 +/- 0.2 and 4.7 +/- 0.3 mM, respectively (mean +/- S.E.M.). When both tissues were from the same animal, with the same ion-sensitive microelectrode mean aNai values of 7.9 +/- 0.2 and 5.1 +/- 0.5 mM (P < 0.01) were obtained from eight atrial and eight papillary muscles, respectively. 3. Membrane resting potentials (Em) were significantly (P < 0.001) more negative in the papillary muscles (-83.5 +/- 0.7 mV; n = 8) than in the atrium (-78.1 +/- 0.5 mV; n = 8). Deviation of Em from EK (determined by K(+)-sensitive microelectrodes) was 3.0 +/- 0.2 mV in ventricular (P < 0.05) and 6.1 +/- 0.3 mV in atrial preparations (P < 0.05). 4. Inhibition of the Na+ pump by DHO increased aNai of the atrium within 10 min by 0.6 +/- 0.1 (n = 7), 1.3 +/- 0.1 (n = 5) and 3.2 +/- 0.2 mM (n = 5) at 5, 10 and 30 microM, respectively. In the papillary muscle, 10 microM DHO was without effect while aNai rose by 1.0 +/- 0.1 (n = 5) and 2.9 +/- 0.2 mM (n = 6) at 30 and 120 microM DHO. 5. Consistent with the aNai measurements, the potency of DHO to increase force of the isometric contraction was three times higher in atrium than in papillary muscle (stimulation frequency 0.2 Hz). 6. Hydrolytic activity of sarcolemmal Na+,K(+)-ATPase isolated from atria amounted to only one third of that detected in ventricles (0.07 +/- 0.01, n = 6, versus 0.2 +/- 0.01 mumol phosphate released min-1 (g tissue)-1, n = 5). The inhibitory potencies of DHO on sarcolemmal Na+,K(+)-ATPase preparations were found to be identical in the enzymes from either tissue. 7. It is concluded that a lower Na+ pump density is responsible for the higher aNai and for the lower resting membrane potential in atrial as compared to ventricular cells. The regulation of cellular Na+ homeostasis in atrial muscle appears to be closer to the limits of its capacity than in ventricle, explaining the higher sensitivity of the atrium to interventions which impede Na+ pump activity.

Animals↗
PubMed1993

Multiple sclerosis-like syndrome in a woman heterozygous for adrenoleukodystrophy.

A 28-year-old asymptomatic woman was diagnosed to be heterozygous for adrenoleukodystrophy (ALD) by elevated very long-chain fatty acids in serum and fibroblasts after ADL had been diagnosed in her son. A year later she had transient unilateral blurred vision. Evoked potentials and brain magnetic resonance imaging showed further separate cerebral white matter lesions suggesting multiple sclerosis (MS). MS-like syndromes in women heterozygous for ALD may be more frequent than previously recognized.

Adrenoleukodystrophy↗
PubMed1993

Clinical manifestations of late onset cerebral storage disease: a case of metachromatic leukodystrophy.

Clinical symptoms, MRI of the brain and neuro pathological findings of a case with adult metochromatic leukodystrophy are presented. Clinically it is important to consider a possible late-onset manifestation of an inborn cerebral storage disease, when uncertain psychopathological symptoms are difficult to assign to well-known diseases. These cerebral storage diseases may appear as "juvenile behaviour disturbance" or "schizophrenia". The clinical suspicion may further be confirmed by simultaneous or subsequent neurological or ophthalmological symptoms. The definitive diagnosis is possible by biochemical or histopathological methods. MRI of brain and neuro pathological findings correspond well with regard to white matter lesions.

Adult↗
PubMed1992

[Gemfibrozil in the differential therapy of disorders of fat metabolism].

In addition to high concentrations of LDL cholesterol, high levels of triglycerides and low concentrations of HDL cholesterol are now known to be independent risk factors in the development of atherosclerosis. The use of Gemfibrozil, with its LDL cholesterol-reducing, HDL cholesterol-raising, and triglyceride-lowering effects, would thus appear to make good sense for the treatment of lipid metabolism anomalies with no selective elevation of LDL cholesterol; it would thus also appear to be superior to HMG-CoA-reductase inhibitors.

Cholesterol, HDL↗