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Biomedical subjects

F Kraus

Publications and source records attributed to F Kraus.

At least 19 recordsLinked to original sources
PubMed2001

[Annual incidence and risk factors for nosocomial bacterial infections in an acute care geriatric unit].

PURPOSE: Elderly inpatients are particularly exposed to the risk of nosocomial infections, thus the study of their risk factors and consequences is of interest. METHODS: Among 1,565 subjects referred to a short-term geriatric unit, patients hospitalised for a year for an acute event and unable to move themselves were followed up for the occurrence of nosocomial infections. RESULTS: Among these 402 immobilised patients (age: 86.3 +/- 7.6 years), 102 nosocomial infections occurred in 91 patients (22.6%), whereas the estimation of the incidence in the total hospitalised population (1,565 subjects, age: 85.1 +/- 6.2 years) was 9.4% (95% confidence interval [CI] 8.3-11.2). Forty-seven point seven percent of nosocomial infections were urinary tract nosocomial infections, 27.5% were lower respiratory nosocomial infections, 9.2% were cutaneous nosocomial infections, 7.3% were septicaemia and 8.2% were of unknown origin. The relative risk (RR) of NI linked to functional dependency for mobility was 5.5 (95% CI: 3.93-7.7, P < 0.001). Other risk factors were: for all nosocomial infections: cancer diagnosis (RR 1.1, 95% CI: 1.1-1.2, P = 0.01); and respectively for urinary tract NI: bladder indwelling (RR 4.8, 95% CI: 2.9-7.7, P < 0.001), pulmonary NI: swallowing disorders (RR 5.4, 95% CI: 2.8-10.5, P < 0.001); and septicaemia: venous catheter (RR 5.4, 95% CI: 1.3-23.3, P = 0.002). NI were associated with an increased length of stay (22.1 +/- 11.7 days in infected patients vs 16.3 +/- 9.5 days in immobilised non-infected subjects, P < 0.001). The mean length of stay for the 1,565 subjects was 10.3 +/- 7.6 days. Death was attributed to nosocomial infections in 13 subjects. In conclusion, functional dependency for mobility, bladder indwelling, venous catheter, swallowing disorders and diagnosis of cancer were risk factors for nosocomial infections in hospitalised elderly subjects in an acutecare setting.

Aged↗
PubMed2001

Cloning and expression analysis of the mouse T-box gene Tbx18.

T-box genes encode transcription factors that regulate a variety of developmental processes. In this report, we describe the cloning and expression analysis of the novel mouse T-box gene Tbx18. During development expression is most prominent in the proepicardial organ and in the epicardium of the heart. Other sites of expression include the cranial paraxial mesoderm, the presomitic mesoderm, the anterior somite half, the genital ridge, and the developing limb buds.

Amino Acid Sequence↗
PubMed2001

Cloning and expression analysis of the mouse T-box gene tbx20.

T-box genes constitute a conserved multi-gene family with important roles in many developmental processes. In this report, we describe the cloning and expression analysis of a novel mouse T-box gene, Tbx20. Expression is prominent in the extraembryonic mesoderm, in the developing heart, the eye anlage and motor neurons of hindbrain and spinal cord.

Alternative Splicing↗
PubMed1997

Placental histology and clinical characteristics of patients with preterm premature rupture of membranes.

OBJECTIVE: To analyze the placental histology in cases of preterm premature rupture of membranes (PROM), classify the cases according to the results of the histologic examination, and determine if these histologic groups have different clinical characteristics and outcomes. METHODS: During a 3-year period, a cohort of 235 women with preterm PROM was studied prospectively. The women were classified according to placental histologic findings, and their prenatal and intrapartum courses and perinatal mortality and morbidity were analyzed and compared. RESULTS: One hundred two placentas (43.4%) exhibited acute inflammatory lesions, 48 (20.4%) had vascular lesions, 48 (20.4%) had both inflammatory and vascular lesions, 31 (13.2%) had no abnormal findings, four (1.7%) had villous edema, and two (0.8%) had chronic villitis. The four largest histologic groups had distinctive characteristics with respect to gestational age at the time of PROM and at delivery, duration of the latency period, and perinatal mortality and morbidity. CONCLUSION: Cases of preterm PROM may be classified according to placental histologic findings, and these groups have different clinical manifestations, prognoses, and outcomes.

Adult↗
PubMed1993

Reversal of diastolic dysfunction by intravenous magnesium chloride.

OBJECTIVE: To treat diastolic dysfunction in patients with coronary artery disease (CAD). DESIGN: Open study of the intravenous injection of 5 mL of a solution containing 17% magnesium chloride (equal to 100 mg of elemental magnesium) during routine coronary angiography in patients with a raised left ventricular end-diastolic pressure (LVEDP). SETTING: A hospital department of cardiac hemodynamics. SUBJECTS: Ten patients with angiographically documented CAD. RESULTS: After magnesium chloride injection, the LVEDP was significantly reduced in all patients, from a mean of 24 +/- 3 to 16 +/- 3 mmHg (P < 0.001). CONCLUSIONS: Under the short term conditions of the study, the injection of magnesium chloride effectively improved left ventricular diastolic function. Further study of the long term effect is required.

Aged↗
PubMed1992

DNA systematics and evolution of the artiodactyl family Bovidae.

Nine additional sequences from representatives of different tribes of the family Bovidae were combined with six published artiodactyl sequences to provide orthologous mtDNA for investigation of bovid phylogeny and evolution. Each species was represented by a homologous 2.7-kilobase-pair stretch of mtDNA for the complete 12S and 16S rRNA genes and three adjacent tRNA genes. These data, when compared to other results, provided evidence for a monophyletic Bovidae and for two clades within the family: one including the tribes Boselaphini, Bovini, and Tragelaphini and another for an Antilopini/Neotragini grouping. All other intrafamilial relationships were only weakly supported. These sequence comparisons suggest that most bovid tribes originated early in the Miocene with all extant lineages present by approximately 16-17 million years ago. Thus, bovid tribes provide an example of rapid cladogenesis, following the origin of families in the infraorder Pecora.

Animals↗
PubMed1990

Phylogeny and evolution of antlered deer determined from mitochondrial DNA sequences.

Mitochondrial DNA sequences of both ribosomal RNA genes and three adjacent transfer RNA genes were obtained for the three extant subfamilies of antlered deer (Cervinae, Muntiacinae, and Odocoileinae) as well as for their antlerless sister group Hydropotinae (family Cervidae). Phylogenetic analysis of these sequences (each nearly 2.7 kilobase pairs in length) supports a cervine/muntiacine clade to the exclusion of odocoileines. These results are statistically significant, stable, and congruent with some independent data. Our mitochondrial DNA sequences, when coupled with other information, indicate that the earliest fossil antlered deer are not closely related to living muntiacines or any other contemporary subfamily. From this information, we hypothesize an Old World, Late Miocene origin of Odocoileinae.

Animals↗
PubMed1990

Mitochondrial genotype of a unisexual salamander of hybrid origin is unrelated to either of its nuclear haplotypes.

We examined mitochondrial DNA (mtDNA), enzyme, and morphological variation among 17 unisexual Ambystoma of hybrid origin. Electrophoretic comparison of diagnostic enzymes indicates that these unisexuals are triploid with two nuclear genomes from the bisexual species Ambystoma laterale and one from Ambystoma jeffersonianum; however, according to restriction analysis, the mtDNAs of these specimens derive from a third species, Ambystoma texanum. This unusual situation is apparently due to a partially independent segregation event in an ancestor of these unisexuals. This situation highlights the potential importance of molecules with different inheritance patterns in elucidating complex cases of reticulate evolution.

Ambystoma↗
PubMed1990

Nitrate therapy in patients with coronary artery disease--preparations and doses with and without development of tolerance.

Rapid tolerance development with respect to hemodynamic, anti-anginal and anti-ischemic effects is a relevant clinical problem associated with any longterm treatment with nitroglycerin, isosorbide dinitrate or isosorbide 5-mononitrate. Tolerance occurs with any dosing regimen that results in nitrate accumulation in the plasma or nearly-constant plasma concentrations, as is the case with multiple daily doses of oral nitrates or continuous application of transdermal patch systems. Nitrate tolerance can be prevented by the interval treatment. This encompasses incorporation of an application-free interval which prevents meaningful nitrate accumulation such that, from a low baseline level, renewed drug administration leads to an increase in the nitrate plasma concentration greater than 2.5-fold. From controlled studies, dosing regimens for interval treatment proven to be effective have been designated for isosorbide dinitrate and isosorbide 5-mononitrate, as well as for transdermal nitroglycerin patch systems. The early attenuation of nitroglycerin, seen within the first 12 h of its use, according to the results of a recently completed study, can be counteracted through continuously increasing plasma concentrations during this period. Interval treatment does not enable 24-h therapeutic protection. Studies with ST-Holter monitoring, however, have shown that adequate coverage can be provided for the period during which the vast majority of ischemic episodes occur. Clinically-relevant rebound phenomena do not occur during interval treatment. Pharmacological approaches to prevent nitrate tolerance, on the basis of the limited and, in part, conflicting data available, do not provide an alternative to interval treatment.

Administration, Cutaneous↗
PubMed1990

[Treatment of heart failure with calcium antagonists].

Vasodilators have a well-established role in the treatment of congestive heart failure. By virtue of their vasodilating properties, the calcium channel blockers have been advocated for use in the treatment of heart failure, in particular, in consideration of the fact that the left ventricular dysfunction in 60 to 70% of the patients with this condition is due to ischemic heart disease, the primary disorder for which the calcium channel blockers are intended to treat. The net hemodynamic effect of calcium channel blockade is the result of two opposing actions: negative inotropy and systemic vasodilation with reflex-induced sympathetic stimulation. The balance is dependent on the prevailing cardiovascular status prior to administration of the drug. In the presence of no or only mild-to-moderate left ventricular dysfunction and intact adrenergic reflexes, a small amount of negative inotropy is readily offset by afterload reduction and adrenergic stimulation. In the presence of severe left ventricular dysfunction sufficiently extensive to lead to heart failure, a condition in which homeostatic reflexes are already attenuated, even a slight amount of negative inotropy can lead to unequivocal deterioration of hemodynamics. Of the three conventional calcium channel blockers, verapamil exerts the most marked negative inotropic effects. Even verapamil, however, has been shown to lead to hemodynamic improvement in some patients, at least after acute administration. Apparently, the cut-off point between beneficial and adverse actions lies at an ejection fraction between 30 and 40% and a pulmonary capillary pressure of about 20 mm Hg. In patients beyond these limits, if treated with verapamil, worsening of heart failure is not uncommon.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcium Channel Blockers↗
PubMed1990

[Echocardiographic and Doppler echocardiographic characterization of left ventricular diastolic function].

For noninvasive assessment of diastolic ventricular function, in addition to echocardiography, more recently, in particular, Doppler echocardiography has been employed. M-mode echocardiogram velocity curves for diameter changes as well as Doppler-echocardiographically registered velocity curves of mitral flow characterize the temporal changes of diastolic flow into the left ventricle. They represent the overall result of factors which influence diastolic filling and are functions of the temporal course of the pressure difference between left atrium and left ventricle. Registration of M-mode and Doppler echocardiograms: For determination of M-mode parameters which should describe left ventricular diastolic function, in addition to the motion of the mitral valve, the left ventricular contours of septum and posterior wall between mitral leaflets and papillary muscles are recorded together with the ECG. For evaluation of the index of atrial emptying, an M-mode registration is obtained from the region of the aortic root. Determination of the Doppler echocardiographic parameters is based on analysis of the blood flow velocity in the region of the mitral valve in the apical four-chamber view with the pulsed Doppler method. Additionally, simultaneous to the Doppler curve, a phonocardiogram is registered or, alternatively, a continuous-wave Doppler registration is obtained which delineates the left ventricular outflow signal and the artefact of mitral valve opening. Parameters for characterization of left ventricular diastolic filling: The first peak of the velocity curve of the diameter change in the M-mode echocardiogram corresponds with the maximal diameter change resulting from early-diastolic filling and the second peak with the maximal diameter change of the left ventricle associated with atrial filling. From this curve as well as the diameter curve relative to time and the mitral valve motion, the times for isovolumetric relaxation as well as the rapid, slow and atrial filling phase which characterize the ventricular filling and the diameter changes of the left ventricle during these time intervals can be derived. The maximal velocity of the diastolic diameter change (PFR) is used to characterize the maximal early diastolic flow. The atrial emptying index characterizes the fraction of filling volume in the first third of diastole with respect to total filling volume of the left ventricle. As an indirect parameter for description of the early-diastolic filling, the steepness of the early-diastolic closure of the anterior mitral leaflet is used. From Doppler velocity profiles of the mitral inflow, early and late diastolic maximal velocities and their velocity time integrals as well as the relationships of these parameters to each other are determined.(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Flow Velocity↗
PubMed1988

[Balloon valvuloplasty in mitral stenosis. Hemodynamic results, influencing factors and comparison with surgical procedures].

Percutaneous transluminal valvuloplasty for mitral stenosis represents an alternative to surgical treatment. The reported increases in valve orifice area vary with values from 0.6 to 2.03 cm2 over a wide range. This study was undertaken to evaluate our own results and to determine if factors could be identified which may exert an influence on the outcome of the procedure. Additionally, to evaluate this new method of treatment, the pressure-flow relationship at rest and during exercise after valvuloplasty was compared with that observed after mitral valve commissurotomy or mitral valve replacement. In 25 patients with moderately-severe to severe mitral stenosis, mean age 56 +/- 11 years, mean valve orifice area 1.1 +/- 0.37 cm2, 52% with preexistent regurgitation, antegrade percutaneous, transvalvular valvuloplasty was carried out. Diagnostic catheterization was performed immediately prior to and after the procedure. Two concurrent groups of patients were analyzed for the purpose of comparison: 26 consecutive patients who underwent mitral valve commissurotomy with a comparable valve orifice area of 1.13 +/- 0.39 cm2 of whom 31% had a regurgitant component; and 37 consecutive patients who had valve replacement mostly with a Björk-Shiley prosthesis (M 29, 31, 33), mean age 52 +/- 8 years, comparable valve orifice area of 1.1 +/- 0.37 cm2 and a regurgitant component in 65%. Dilatation of the valve was carried out after transseptal catheterization with the use of an 8F Mullins sheath introducing a 7F balloon-tipped catheter (Critikon) via the left atrium, the left ventricle and into the descending aorta through which a 300 cm long 0.035" guidewire was advanced. By means of a retrieval catheter introduced via the femoral artery into the descending aorta, the guidewire was exteriorated via the femoral artery. After dilatation of the septum with a 9F dilatation catheter with a balloon of 8 mm diameter, a 10F or 12F dilatation catheter (Trefoil 3 X 12 mm or Bifoil 2 X 19 mm) (Schneider-Shiley) was advanced transseptally and the balloons positioned at the level of the mitral valve. The balloons were inflated with a pressure averaging 3.6 + 0.65 atmospheres (2-4.7 atm) and a mean duration of 27 +/- 8 s (16 to 45 s) on the average 3.9 +/- 1.6 times (1 to 9X) until disappearance or widening of the hour-glass waist of the balloon.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

[Interval therapy in effective treatment of angina pectoris using nitroglycerin patch systems. A controlled study with determination of nitroglycerin plasma levels].

In ten patients with angiographically-documented coronary artery disease, stable angina pectoris and reproducible exercise-induced ST-segment depression, the extent and duration of antiischemic and antianginal effects of transdermal nitroglycerin patches delivering 10 mg/24 hours were investigated according to a double-blind, crossover, placebo-controlled protocol. Exercise testing and blood sampling for determination of nitroglycerin plasma concentrations were carried out at 2.5 and twelve hours after initial application, at 2.5, twelve and 24 hours after renewed application subsequent to a twelve-hour treatment pause as well as at 2.5 hours after application of a third patch (Figure 1). At 2.5 hours after initial application there was a reduction in exercise-induced ST-segment depression from 2.7 mm +/- 0.19 (SEM) to 0.75 +/- 0.2 (-72%; p less than 0.001) (Figure 2). The exercise capacity to onset of 1 mm ST-segment depression increased from 117 Watt X min +/- 34 (SEM) to 361 Watt X min +/- 84 (+210%; p less than 0.001) (Figure 3). At twelve hours, exercise-induced ST-segment depression was reduced only from 2.5 mm +/- 13 to 1.77 +/- 0.2 (-32%; p less than 0.01) and the increase in exercise capacity to onset of 1 mm ST-segment depression was narrowed from 136 Watt X min +/- 28.5 to 215 Watt X min +/- 43 (+59%; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗