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Biomedical subjects

J Kramer

Publications and source records attributed to J Kramer.

At least 73 records · Page 4Linked to original sources

[Gadolinium-DTPA in magnetic resonance tomography. Clinical use--indications].

Magnetic resonance tomography was performed on 158 patients with different indications before and after the administration of contrast medium. The MR examination included various plain T1 and T2 weighted spin echo sequences as well as T1 weighted examinations after intravenous application of Gadolinium-DTPA ("Magnevist", Schering AG) in a dosage of 0.1 mmol/kg body weight. The following conclusions were drawn: The sensitivity of MR in detecting brain tumors, acoustic neuromas and pituitary adenomas was improved considerably after the administration of "Magnevist". To diagnose the type of tumor, the criteria which apply to Gd-DTPA are similar to those used for iodine-containing contrast medium in CT. In about 2/3rds of the cases, delineation of pathological tissues from surrounding edema and normal structures was better than in plain films. Hence, accurate, pretherapeutic staging of bronchial carcinomas and an exact definition of the expansion of the malignancies in the muscle-skeleton system were possible. In respect of tumors in the region of the base of the skull, we could omit T2-weighted sequences without noticeable loss of diagnostically relevant information; the examination time could thus be shortened by about 12 minutes.

Adolescent

Internal carotid artery aneurysm: a vascular manifestation of type IV Ehlers-Danlos syndrome.

Aneurysms of the distal internal carotid artery (ICA) can be difficult to manage. When seen in a patient with Ehlers-Danlos Syndrome, type IV (EDS-Type IV), the complexity of the problem is greatly increased. Proximal ICA ligation in the presence of an intact circle of Willis and adequate collateral circulation is a reasonable and safe approach. We recommend the liberal use of duplex scanning and intravenous digital angiography in patients with EDS, and plan to use these techniques to follow the small, asymptomatic, right ICA aneurysm in our patient. If the aneurysm rapidly grows or becomes symptomatic, treatment may require proximal ligation with extracranial-intracranial bypass. Understanding of the basic defects associated with EDS-Type IV will make the management of patients with vascular complications more safe.

Adult

Rapid determination of the human complement factor B phenotypes.

A rapid phenotyping method for human complement factor B (Bf) was worked out using high voltage acetate electrophoresis. The results were compared with those obtained by conventional agarose gel electrophoresis. Separation of the bands was performed in the same way, but only 2.5 hours were required for the evaluation of 24 samples. Furthermore, at least ten times less specific antibody was needed than for the conventional technique.

Complement Factor B

[Intratemporal course of the facial nerve in magnetic resonance imaging].

MR images of the intratemporal portion of the facial nerve were obtained with a 1.5 Tesla permanent magnet whole-body imaging system. The facial nerve was followed from the internal auditory through the temporal bone to the styloid foramen. MR promises to be a sensitive method for the evaluation of intratemporal facial nerve diseases.

Facial Nerve

Pediatric AIDS. Neuroradiologic and neurodevelopmental findings.

A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that contrast enhancing inflammatory mass lesions are uncommon.

AIDS-Related Complex

Enzyme activity and behavior in hyperactive children grown up.

Thirty-one men, originally seen as children for problems with overactivity, distractibility, and impulsiveness, were reevaluated at ages 21-23 years. Subjects were interviewed and tested and provided a blood sample for analyses of dopamine-beta-hydroxylase (DBH), monoamine oxidase (MAO), and catechol-O-methyl-transferase (COMT). A series of Pearson correlations between the biological variables and psychological measures revealed that MAO levels were negatively associated with measures of drug involvement, cigarette use, fire-setting, and sensation seeking; DBH levels were positively associated with measures of sensation-seeking; and COMT levels were negatively associated with a measure of hostility and positively correlated with a measure of impulsiveness.

Adult

Serum Lp(a) level as a predictor of vein graft stenosis after coronary artery bypass surgery in patients.

Although the serum lipoprotein fraction Lp(a) has been associated with coronary artery atherosclerosis, its relationship to narrowing of saphenous vein grafts has not previously been elucidated. We therefore measured serum Lp(a) levels in 167 symptomatic patients undergoing cardiac catheterization who had had coronary artery bypass surgery 0.7 to 14.3 years earlier. Lp(a), total cholesterol, and total triglyceride levels were compared with the degree of saphenous vein graft stenosis to test for any association. Serum Lp(a) levels were significantly associated with the degree of stenosis of saphenous vein grafts (r = .24, p = .002). Mean Lp(a) levels (mg/dl) in the 135 patients with stenosis were almost double (32.0 +/- 32.7, mean +/- SD) those in the 32 patients with no graft stenosis (16.7 +/- 22.6; p = .002). Graft stenosis was not associated with previous myocardial infarction, hypertension, obesity, diabetes, or smoking. Serum cholesterol levels (mg/dl) were slightly higher in the stenosis group (251.3 +/- 69) than in the no-stenosis group (231.8 +/- 48.8), but the difference was of borderline significance (p = .06). A stepwise increase in mean Lp(a) was found in groups of patients with increasing vein graft stenosis. At a serum Lp(a) level of 31.6 mg/dl or above, 92% of the patients demonstrated vein graft stenosis. Thus, patients with elevated Lp(a) levels have an increased risk of developing saphenous vein graft stenosis after coronary bypass surgery.

Cardiac Catheterization

Facial skeletal dimensions in patients with nasal septal deviation.

The anatomy and the concomitant function of the face seem to be reciprocal issues. Previous studies have shown that stenosis in the posterior part of the nose, hampering nasal air flow, is associated with a retrognathic face and a posterior rotation of the lower jaw, i.e. components of the adenoid syndrome. The present study examines facial cephalometric morphology in adults with a deviated nasal septal cartilage, i.e. an anteriorly positioned nasal stenosis. Compared to a group of unafflicted individuals, also with regard to rhinomanometric resistance, a significantly smaller posterior facial height, smaller height of the anterior nasal aperture, a posterior rotation of the lower jaw and a shorter nasal floor and ceiling were found. This may mean that growth of the nasal septal cartilage and growth of the surrounding skeletal areas are out of step. A relatively undersized skeletal frame, in the sagittal plane, may have led to the buckled non-fitting septal cartilage, with increased air flow resistance as a secondary effect. If this interpretation is correct, an early cautious surgical correction of the septal deviation, also balancing this growth incongruence, might be worth serious consideration.

Adult

Screening of IgA deficiency by ELISA: population frequency in Hungary.

The probability of the development of an anaphylactic shock in IgA deficient patients following repeated blood transfusion or the administration of any other IgA containing preparation is high. Since these individuals usually show mild, if any, clinical symptoms, the detection of deficiency and/or sensitisation is very important. We have developed an ELISA system suitable for both the rapid mass screening of IgA deficiency and for the detection of anti-IgA already present in the serum. Applying these methods for screening of serum IgA deficiency in healthy Hungarian population resulted in a similar pattern to that reported for other countries. Interestingly, the prevalence of IgA deficiency among Gipsies living in Hungary was significantly higher. We could detect anti-IgA only in one of our IgA deficient patients.

Antibodies, Anti-Idiotypic

[Intracavernous injection of vasoactive substances in the treatment of erectile dysfunction].

Herein we report our experience with a clinical trial of intracavernous injection of vasoactive substances (Papaverin, Dibenzyran, Regitin) in 41 patients suffering from erectile dysfunction for longer than 1 year. In 14 out of 33 patients the application of papaverin alone was already sufficient to produce an excellent erection (T/E-grade 4) under clinical conditions. The simultaneous injection of two agents (Papaverin + Dibenzyran or Papaverin + Regitin) in patients with no or insufficient response to papaverin improved the results additionally. Besides a positively effect of delay from the injection to the erection could be observed in comparison with an injection of only papaverin. In conclusion, this method combined with an autoinjection therapy is an alternative approach to treat certain patients with erectile dysfunction.

Dose-Response Relationship, Drug

[Value and indications for high-resolution real-time sonography in nontumor salivary gland diseases].

308 patients with salivary gland diseases were investigated using real-time sonography. In 142 patients we suspected neoplasms of the salivary glands on the sonograms. In the remaining 166 patients we investigated the following entities: sialolithiasis (74 patients), acute sialadenitis (54 patients), abscess formation (16 patients), chronic sialadenitis or autoimmune disease (53 patients) and cysts of salivary gland (5 patients). The changes in the sonographic morphology of the different diseases will be described. The role of ultrasound in the diagnosis of the different diseases will be discussed and the indications for sonographic investigations are summarised.

Abscess

SSC1, a member of the 70-kDa heat shock protein multigene family of Saccharomyces cerevisiae, is essential for growth.

The genome of the yeast Saccharomyces cerevisiae contains a family of genes related to the HSP70 genes (encoding the 70-kDa heat shock protein) of other eukaryotes. Mutations in two of these yeast genes (SSC1 and SSD1), whose expression is increased a few fold after temperature upshift, were constructed in vitro and substituted into the yeast genome in place of the wild-type alleles. No phenotypic effects of the mutation in SSD1 were detected. However, a functional SSC1 gene is essential for vegetative growth. This result, in conjunction with experiments involving mutations in other members of this multigene family, indicates that at least three distinct functions are carried out by genes of the HSP70 family.

Chromosome Mapping

Cortical atrophy in young adults with a history of hyperactivity in childhood.

A computed tomographic (CT) brain scan study was conducted in 24 young males treated and followed up for hyperactivity since childhood. Compared to 27 matched controls, adults with a history of hyperactivity had a significantly greater frequency of cerebral atrophy. No differences in cerebellar atrophy frequency or in lateral cerebral ventricle-to-brain ratio (VBR) were found. The possible associations of hyperactivity or perhaps stimulant drug treatment to atrophic brain changes are discussed.

Adult