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Biomedical subjects

J L Fischer

Publications and source records attributed to J L Fischer.

At least 19 recordsLinked to original sources
PubMed2001

Family, personality, and social risk factors impacting the retention rates of first-year Hispanic and Anglo college students.

This study investigated familial and behavioral differences between Hispanic and Anglo-American first-year college students. Analyses of variance and chi-square analyses were used to test for ethnic differences in (a) risk factors associated with family dysfunction, family addictions, personality factors, and social experiences, (b) student problem behaviors, namely alcohol use, drug use, and eating disorders, (c) a one-year follow-up of student retention, and (d) specific factors related to retention at the one-year follow-up. The Hispanic freshmen appeared to demonstrate resilience despite a lack of mentoring and greater paternal addiction. However, the one-year follow-up suggested that Hispanic females were at particular risk for leaving school. To improve college retention rates, social policy should focus on Hispanic students' vulnerabilities and strengths in making important developmental transitions.

Adult↗
PubMed1998

[Progressive cardiomyopathic lentiginosis].

We report on a 30-year-old man with progressive cardiomyopathic lentiginosis. This syndrome is first described by Polani and Moynahan 1972. They distinguish between the earlier described multiple lentigines syndrome, the LEOPARD syndrome (L-entiginosis, E-lectrocardiographic conduction defects, O-cular hypertelorism, P-ulmonary stenosis, A-bnormalities of genitalia, R-etardation of growth, D-eafness) and the progressive cardiomyopathic syndrome. The progressive cardiomyopathic syndrome is characterised by multiple symmetrical lentigines, hypertrophic obstructive cardiomyopathy and retardation of growth. All characteristics were present in our patient with only mild right ventricular hypertrophic cardiomyopathy.

Adult↗
PubMed1997

[High malignant B-cell non-Hodgkin lymphoma of the heart: intravital diagnosis by transesophageal echocardiography controlled biopsy].

We report about a 66-year old patient with Non-Q-wave infarction in coronary artery two-vessel disease. During an echo- and transesophageal multiplane echocardiography preoperatively before a coronary artery bypass surgery a right atrium septal tumor of unknown form was discovered. The computerized axial tomography (CAT) and nuclear magnetic resonance (NMR) scans did not demonstrate extracardiac pathologic findings. A transesophageal echocardiography-guided biopsy of the right atrial septum over the vena femoralis and the right atrium enabled intra vitam a very early diagnosis of high malignant B-cell Non-Hodgkin-lymphoma without the need for thoracotomy. The diagnosis was confirmed histopathologically and immunohistochemically and early treatment with cytostatic therapy could begin. To our knowledge the transesophageal echocardiography-guided biopsy has never been described in the worldwide literature.

Aged↗
PubMed1996

Isolation of Thermus strains from hot composts (60 to 80 degrees C).

High numbers (10(7) to 10(10) cells per g [dry weight]) of heterotrophic, gram-negative, rod-shaped, non-sporeforming, aerobic, thermophilic bacteria related to the genus Thermus were isolated from thermogenic composts at temperatures between 65 and 82 degrees C. These bacteria were present in different types of wastes (garden and kitchen wastes and sewage sludge) and in all the industrial composting systems studied (open-air windows, boxes with automated turning and aeration, and closed bioreactors with aeration). Isolates grew fast on a rich complex medium at temperatures between 40 and 80 degrees C, with optimum growth between 65 and 75 degrees C. Nutritional characteristics, total protein profiles, DNA-DNA hybridization (except strain JT4), and restriction fragment length polymorphism profiles of the DNAs coding for the 16S rRNAs (16S rDNAs) showed that Thermus strains isolated from hot composts were closely related to Thermus thermophilus HB8. These newly isolated T. thermophilus strains have probably adapted to the conditions in the hot-compost ecosystem. Heterotrophic, ovalspore-forming, thermophilic bacilli were also isolated from hot composts, but none of the isolates was able to grow at temperatures above 70 degrees C. This is the first report of hot composts as habitats for a high number of thermophilic bacteria related to the genus Thermus. Our study suggests that Thermus strains play an important role in organic-matter degradation during the thermogenic phase (65 to 80 degrees C) of the composting process.

Environmental Microbiology↗
PubMed1995

Comparison of Doppler echocardiographic methods with heart catheterisation in assessing aortic valve area in 100 patients with aortic stenosis.

OBJECTIVE: To examine the practicability and accuracy of Doppler echocardiographic methods in determining aortic valve area. METHODS: Aortic valve areas determined by three methods using Doppler echocardiography (applying the continuity equation and the modified Gorlin formula using data from Doppler echocardiography and right heart catheterisation) were compared with values obtained by heart catheterisation. PATIENTS: 100 consecutive patients with aortic stenosis aged between 34 and 83 years (mean (SD) 66 (10)). RESULTS: Differences in individual patients' measurements of aortic valve area by the three Doppler techniques varied by up to 0.56 cm2 compared with values obtained by heart catheterisation. On average, values obtained from Doppler echocardiographic methods lay up to 51% below and 78% above those obtained by heart catheterisation. CONCLUSIONS: All three Doppler echocardiographic methods were practicable in routine clinical practice for patients of all ages, but they were of limited accuracy when compared with the aortic valve areas found invasively using the invasive Gorlin equation. However, these deviations may not always be due to inadequacies of the Doppler methods: they could also be caused by limitations in the Gorlin formula. Doppler methods can be repeated if required, they allow examination of the morphology of the valve, and they subject the patient to considerably fewer risks than the invasive procedure. An adequate strategy in determining the severity of aortic valve stenosis would be to calculate the valve area by Doppler echocardiography as well as considering the valvar aortic pressure gradient. The valve area alone should not be relied on exclusively, as has been the increasing practice in the past few years.

Adult↗
PubMed1994

[Not Available].

Explore the source record for details and available documents.

France↗
PubMed1993

Recipient selection and evaluation for vascularized pancreas transplantation.

Vascularized pancreas transplantation (PT) is becoming an accepted therapy for selected type I diabetic patients. However, selection and evaluation criteria remain uncertain. In the last 3.5 years, we have interviewed 205 and evaluated 151 diabetic patients for PT. The degree of renal dysfunction (creatinine clearance below 45 ml/min) was used to select patients for combined pancreas-kidney transplantation (PKT) or solitary pancreas transplantation (PTA) (clearance above 70 ml/min). The cardiovascular evaluation (stress thallium study with liberal use of coronary angiography) was used to determine operative risk and provided the other major selection criterion. A total of 104 patients were selected as candidates for PT; 70 have undergone PKT with 98.6% patient survival (1 cardiovascular death), 97.1% kidney graft survival, and 94.2% pancreas graft survival. Thirty-three evaluated patients (24.1%) were not accepted as candidates for PT; 13 have undergone cadaveric kidney transplantation, 5 were placed on the kidney waiting list, and 9 have died. Criteria for PTA include 2 or more diabetic complications or hyperlabile diabetes. Patient (n = 12) and pancreas graft survival after PTA is 83.3 and 50%, respectively. Our conclusion is that a multidisciplinary approach was used for recipient selection for PT based on degree of nephropathy, cardiovascular risk, and presence of diabetic complications. Nearly 75% of diabetic patients evaluated were acceptable candidates for PT. Only 4 (3.8%) of these selected patients died while awaiting or undergoing PT, thus optimizing the use of scarce allograft resources and providing evidence for appropriate patient selection.

Adult↗
PubMed1993

A comparative analysis of results and morbidity in type I diabetics undergoing preemptive versus postdialysis combined pancreas-kidney transplantation.

Although combined pancreas-kidney transplantation (PKT) has become a valid treatment option for selected type I diabetics, the timing of PKT relative to the degree of nephropathy remains controversial. We analyzed results and morbidity in 30 type I diabetics undergoing PKT after starting dialysis (PKT:D) versus 31 type I diabetics undergoing PKT prior to dialysis (PKT:ND). The two groups were similar with the respect to age, duration and severity of diabetes, gender, race, preservation time, retransplants, sensitization, HLA-matching, and CMV status. The mean preoperative serum creatinine was higher in the PKT:D group (9.9 +/- 3.4 vs. 3.9 +/- 1.9 mg/dl PKT:ND, P < 0.01). All patients were managed with quadruple immunosuppression with OKT3 induction. Actuarial patient survival is 100% (PKT:D) and 96.8% (PKT:ND). Renal and pancreas allograft survival are 97% and 93%, respectively, in both groups. The incidence of rejection, infection, operative complications, reflux pancreatitis, and total hospital days was similar in both groups. Long-term renal and pancreas allograft function and quality of life were like-wise comparable. No adverse coagulation or immunologic effects were noted in the PKT:ND group. Rehabilitation potential favored the PKT:ND group. PKT can be performed safely and effectively in the absence of uremia. In selected type I diabetics with significant nephropathy, we believe that PKT is the best treatment option and need not be considered as preemptive, especially in view of increasing waiting times and the variable progressive nature of diabetic complications.

Adult↗
PubMed1990

Hyperammonemic encephalopathy in urinary diversion with urea-splitting urinary tract infection.

We present two cases of hyperammonemic encephalopathy secondary to urea-splitting urinary tract infection with urinary diversion. One patient had a ureterosigmoidostomy, the other an ileal loop diversion. Neither patient had significant underlying liver disease, but both had considerable muscle atrophy that may have predisposed them to develop hyperammonemia. Medical therapy did not provide long-term control of symptoms. In both cases, hyperammonemic encephalopathy resolved after revision of their urinary diversions. The probable mechanism of the metabolic derangements produced by urea-splitting urinary tract infections is reviewed. We suggest that patients with urinary diversion who develop hyperammonemic encephalopathy secondary to a urea-splitting urinary tract infection be treated with surgical revision of the urinary system to improve drainage and decrease bowel contact time.

Acidosis↗
PubMed1988

[Rupture of the ventricular septum following posterior wall infarction: echo- and Doppler echocardiography diagnosis with pressure determination].

In the postinfarct ventricular septal rupture, an early surgical intervention improves prognosis. A rapid and accurate diagnosis is necessary. A 56-year-old patient was admitted to the hospital with a Q-wave posterior myocardial infarction. Auscultation suggested a ventricular septal defect. Neither M-mode nor the two-dimensional echocardiography with apical four- chamber view could confirm the ventricular septal defect. Only the subcostal view showed a basal ventricular septal defect, which was sometimes covered by the septal leaflet of the tricuspid valve. With the continuous wave Doppler, a left-to-right shunt on the ventricular septum could be registered and the pressure in the right ventricle could be measured. Catheterization confirmed the diagnosis of a basal ventricular septal defect with the associated pressure characteristic. The basal ventricular septal defect was successfully closed with a patch. The high accuracy of the continuous-wave Doppler, which is superior to M-mode and two-dimensional echocardiography, was confirmed by this report. Pressure measurement in the right ventricle by continuous wave Doppler also provides a non-invasive diagnostic method that can be used at the bedside.

Blood Flow Velocity↗
PubMed1987

Selectivity of basolateral anion exchange in the acidification pathway of turtle bladder.

The turtle urinary bladder in vitro acidifies the solution bathing its luminal surface. Protons are actively extruded across the apical membrane by an H+-ATPase. Bicarbonate ion exits the cell across the basolateral membrane via a stilbene-sensitive, anion exchange for chloride. Chloride then exits the cell via a conductive pathway. The present studies were undertaken to define the specificity of the basolateral anion exchange mechanism for chloride. Turtle bladders were mounted on chambers in vitro, short-circuited, and treated with ouabain. The current remaining after inhibition of sodium transport was used to measure the acidification rate. Ion replacement studies with bromide, isethionate, sulfate, and nitrate indicated that only bromide supported acidification at rates comparable to chloride. In separate experiments, kinetic analysis of anion interaction with the exchanger indicates that maximal acidification rates decrease in the order: Cl greater than Br greater than SO4 greater than methyl sulfate = gluconate. The affinity of the exchanger decreases in the order: Cl greater than SO4 greater than Br greater than HCO3 greater than methylsulfate greater than gluconate. These selectivity sequences indicate "strong" interaction of the anions with the selectivity site. The differences in position of the polyatomic anions in the two sequences indicates that the "binding" site is accessible but that transport is limited by steric factors.

Animals↗