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Biomedical subjects

J Cramer

Publications and source records attributed to J Cramer.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Ultrasonographic monitoring of conservative-functional treatment of rupture of the Achilles tendon].

Rupture of the Achilles tendon has become more common in recent years. Operative repair is the treatment generally used but non-surgical therapy is being accepted by an increasing number of surgeons because of the reports of good results with conservative treatment. Ultrasonographic examination not only allows an exact diagnosis to be made in muscle and tendon injuries, but also observation of the healing processes. Therefore, conservative functional treatment of rupture of the Achilles tendon can be used with more success, which is a very comfortable concept for these patients. We present a series of 22 subcutaneous ruptures of the Achilles tendon treated non-operatively to emphasize the value of conservative functional therapy with ultrasonographic monitoring. After immobilization of the lower leg by a walking cast in the equinus position for 3-6 weeks, the functional treatment follows using a decreasing heel lift and physiotherapy. Ultrasound examinations were performed frequently to recognize new diastasis early. We observed complete healing in all patients, absence of complications and excellent functional results. The morbidity of the patients was lower than with operative treatment and no hospital stay was needed. In conclusion, in our opinion ultrasound-controlled conservative functional treatment of rupture of the Achilles tendon should be used more frequently in future.

Achilles Tendon↗
PubMed1988

Kinetics of the inhibition by plasminogen activator inhibitor 2 of urokinase isolated from human urine and recombinant microorganisms. Further evidence for correct tertiary structure of recombinant urokinase.

The specific plasminogen activator inhibitor 2 (PAI-2) from human placenta was used to compare the kinetics of inactivation of recombinant urokinase and urokinase from human urine. The inactivation of the enzymes proceeded with identical second order rate constants. The result is considered a further indication of corresponding 3-dimensional structures of urokinases from human urine and of recombinant origin.

Glycoproteins↗
PubMed1987

[Foreign body in the tricuspid valve with valvular insufficiency and right-left shunt].

We present the case of a 50-year old man who progressively developed tricuspid valve insufficiency with opening of a patent foramen ovale responsible for right-to-left shunt with polycythaemia. The tricuspid valve insufficiency was due to a foreign body, probably of surgical origin as suggested by its radiological image and by the patient's previous history. It would have been introduced, far away from the tricuspid valve (compound fracture of the wrist), several years previously. At surgery, we found the foreign body embedded in the valve system. As a possible mechanism for the mutilation, an undiagnosed endocarditis was suspected but could not be confirmed. Three cases tricuspid endocarditis (with foreign bodies in the right ventricle) and 3 cases of asymptomatic tricuspid valve foreign bodies have been published. Fifty-five cases of foreign bodies introduced peripherally and migrated into the heart, the pericardium and the pulmonary artery are reviewed.

Coronary Circulation↗
PubMed1987

Ethics in focus.

Explore the source record for details and available documents.

Community Health Nursing↗
PubMed1986

[Spontaneous incomplete rupture of the supra-sigmoidal aorta presenting as aortic insufficiency. Apropos of an emergency surgical case].

We report a case of spontaneous incomplete rupture of the first segment of the ascending aorta presenting as aortic incompetence and acute tamponade confirmed by preoperative angiography in a 57 year old hypertensive woman. This patient underwent emergency conservative surgery with good results at 8 months' follow-up. This rare pathology occurs in the same terrain as dissection of the aorta. The diagnosis should be suspected not only when chest pain and/or aortic incompetence are associated or not with acute tamponade, contrasting with a normal electrocardiogram, but also in atypical presentations which necessitate angiography in multiple incidences in order not to miss the diagnostic signs which are often invisible in the standard projections. When there are no complications, this condition may pass undiagnosed. However, in most cases, it leads to acute tamponade due to intrapericardial rupture or to an aortic aneurysm or aortic incompetence. The latter complications are usually associated with severe regurgitation requiring surgical correction, which in some cases may be conservative.

Aorta↗
PubMed1985

Chemical, enzymological and pharmacological equivalence of urokinases isolated from genetically transformed bacteria and human urine.

Low molecular weight urokinase (LUK), which was prepared from E. coli containing a plasmid coding for human pro-urokinase, has an amino acid sequence identical to that of LUK isolated from human urine (uLUK) but lacks the carbohydrate side chain at Asn 144 of the B chain. This chemical difference results in an altered mobility in SDS polyacrylamide gel electrophoresis and an apparently increased specific activity of the E. coli-derived product (cLUK) in diffusion-limited test systems (fibrin agar plate tests). Comparative enzymological investigations in homogeneous phases reveal that the active centers and the substrate recognition sites of cLUK and uLUK are congruent. No significant difference between the enzymes was detectable in the following parameters: Michaelis constants and maximum velocities with the synthetic substrate S-2444; activation rates of human and porcine plasminogen; specificity for ten chromogenic substrates; inhibition constants for the competitive inhibitor benzamidine; inhibition by placental urokinase inhibitor and polyclonal antibodies. Further, cLUK and uLUK dissolved fibrin clots prepared from human plasma in vitro with essentially identical velocities. Both, cLUK and uLUK efficiently lysed injected emboli in rabbits and prevented renal fibrin deposition and death due to endotoxin infusion in rats. It is concluded that cLUK, despite the lack of the carbohydrate side chain, is functionally identical and pharmacologically equivalent to uLUK.

Amino Acid Sequence↗
PubMed1983

The role of alcohol in new-onset atrial fibrillation.

Forty cases of new-onset atrial fibrillation (AF) were reviewed to establish the frequency of various causes. Alcohol intoxication caused or contributed to 14 cases (35%). Coronary artery disease (22.5%) and pulmonary disease (22.5%) were also common causes of acute AF. Among patients less than 65 years old, alcohol caused or contributed to approximately two thirds (63%) of the cases of AF. Thyrotoxicosis was uncommon (one case in 40); no patient had a diagnosis of mitral stenosis, pulmonary embolism, or pericarditis. There were no complications of AF in alcoholic patients; the majority (88.9%) converted spontaneously to a normal sinus rhythm within 24 hours. Alcohol intoxication should be considered early in the differential diagnosis of new-onset AF in young patients. Many patients may not require admission to an intensive care unit or a costly battery of diagnostic tests.

Aged↗
PubMed1981

Determination of catecholamine permeability coefficients for passive diffusion across phospholipid vesicle membranes.

A convenient catecholamine transport assay has been developed which permits continuous, instantaneous monitoring of transmembrane flux. Epinephrine transport has been examined by spectrophotometrically monitoring adrenochrome formation resulting from the passive diffusion of catecholamine into unilamellar phospholipid vesicles containing entrapped potassium ferricyanide. Ferricyanide oxidation of epinephrine under the conditions employed is fast compared to membrane transport, which obviates the need for intravesicular concentration or volume determinations. Epinephrine transport data over a pH 6 to 7 range have been fitted to an integrated rate equation from which a permeability coefficient for neutral epinephrine of 2.7 1.5 X 10-6 cm/sec has been obtained.

Epinephrine↗
PubMed1980

[Mid-systolic click syndrome, coronary spasm and sudden death. General review apropos of a tracing from terminal Prinzmetal's angina, recorded by the Holter method].

The authors review the literature on arrhythmias and ST changes, the principal causes of sudden death in the mid systolic click-late systolic murmur (SC-SM) syndrome, having recorded the ECG during sudden death of a patient with this syndrome by Holter monitoring. This would also appear to be the first reported case of sudden death recorded by this technique. It showed that death was caused by ventricular fibrillation which was preceded by a clinical and electrical episode of Prinzmetal angina. Hypotheses explaining the abnormalities of ventricular repolarisation and rhythm in so-called "idiopathic" SC-SM syndrome are reviewed. Special attention is paid to studies suggesting the participation of coronary spasm and autonomic nervous system disturbances. In conclusion, the authors underline: - the value of ambulatory electrocardiography in patients with the SC-SM syndrome and especially in a defined high risk group; - the value of testing for coronary spasm when coronary angiography is envisaged; - the need for better management with antiarrhythmic therapy. The indications of betablockade are discussed as these drugs are thought to favourise coronary spasm.

Angina Pectoris↗
PubMed1979

[Isoenzyme distribution of creatine kinase in various human organs. Interest in human pathology (author's transl)].

The isoenzyme content of creatine kinase was determined in various human organs after autopsy. The results found were on the whole in agreement with the literature. Their analysis dictates the choice of a method of separation of the MB fraction: chromatography or electrophoresis. It permits better interpretation of the results of estimation of the MB fraction in the serum.

Brain↗
PubMed1978

[The MB Iso-enzyme of creatine phosphokinase in myocardial infarction (author's transl)].

CPK and its MB iso-enzymatic fraction were measured in 240 patients, 180 of whom suffered from myocardial infarction. MB iso-enzyme was expressed as a percentage of total CPK and a minimum figure of 4 per cent of MB isoenzyme was taken as indicative of a diagnosis of myocardial infarction. In the 180 patients with an infarction, the average MB level as a percentage of total CPK was 12.1 +/- 5.4 per cent. Five patients with a proven infarct had an MB iso-enzyme level of less than 4 per cent. Amongst the 60 patients without a myocardial infarction who were included in view of a pathological level of CPK, the average maximum level of MB was 1 +/- 2.5 per cent. Five of these 60 patients (false positives: 8.3%) had an MB iso-enzyme level of greater than 4 per cent. It is concluded that the estimation of MB iso-enzyme of CPK using a chromatographic technic is a highly valuable laboratory method for confirming or eliminating a diagnosis of myocardial infarction in the numerous clinical circumstances when such a diagnosis is difficult or even impossible on the basis of standard data.

Adult↗
PubMed1975

[Separation and assay of the MB isoenzyme of serum creatine phosphokinase. Results apropos of 152 cases].

MB iso-enzyme of creatine phosphokinase (CPK) was estimated after chromatography. The technique used, Mercer's technique, was simple and rapid. It required 1 ml of serum. The study carried out in 152 subjects showed that CPK was increased (N less than 90 mU/ml). In the group of 104 patients with myocardial infarction (average CPK levels = 829 mU/ml +/- 516), the MB iso-enzyme was found in the serum in significant levels (average level of the MB fraction = 10.9% +/- 5.4). On the other hand, in the control group of 44 patients with various diseases, (CPK = 672 mU/ml +/- 531) the MB iso-enzyme remained low (0.35% +/- 0.44). In two subjects with myocardial infarction, no MB fraction was found. On the other hand, in two patients who died, one from necrotic, prostatic adenocarcinoma, the other from necrotic epidermoid lung cancer, the MB iso-enzyme was significantly increased. The test proposed here, which is applicable in a routine laboratory, seems the most specific of all laboratory examinations available to the clinician for the diagnosis of myocardial infarction.

Chromatography↗