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Biomedical subjects

J Meyer

Publications and source records attributed to J Meyer.

At least 487 records · Page 27Linked to original sources
PubMed1994

Modulation of cortical neuronal activity by a serotonergic agent: a PET study in humans.

This study investigates the effect of a serotonergic agent, fenfluramine, on neuronal activity, as measured using [18F]fluorodeoxyglucose (FDG) uptake with positron emission tomography (PET) in humans. Eleven subjects each received oral fenfluramine and placebo, on two different occasions, followed by FDG PET scans. Our study shows that fenfluramine modulates ongoing neuronal activity in a regionally specific fashion with a relative increase in metabolism in the prefrontal cortex and a relative decrease in the occipital-temporal regions.

Adult↗
PubMed1994

Extent of atherosclerosis and remodeling of the left main coronary artery determined by intravascular ultrasound.

This study used intravascular ultrasound (IU) to assess the incidence and extent of left main coronary artery (LMCA) disease and the effects of arterial remodeling. Sixty-nine patients undergoing cardiac catheterization were imaged with a 20 MHz rotational-tip IU device. Nine of the 69 studies (13%) could not be analyzed because of technical (n = 2) or anatomic (n = 7) reasons. Of the remaining 60 patients, 38 (63%) had at least 1 lesion in the left coronary artery perfusion territory by angiography; significant LMCA stenosis was present in 2 patients (3%). Intravascular ultrasonography demonstrated plaques in 27 of 60 LMCAs (45%), 6 of them in patients with normal angiograms. Twenty-four plaques (89%) were eccentric and calcium was present in 4 (15%). The mean minimal lumen diameter was 4.9 +/- 0.8 mm, the maximal lumen diameter was 5.6 +/- 0.8 mm, the planimetered lumen area was 22.6 +/- 6.0 mm2, the plaque area was 3.9 +/- 5.8 mm2, the vessel area was 26.5 +/- 5.9 mm2, and the area stenosis was 13 +/- 19%. In the 27 patients with plaque, plaque area was 8.7 +/- 5.7 mm2 and the area stenosis was 30 +/- 17%. The vessel area was significantly larger in diseased LMCAs (p < 0.001) and correlated with plaque area (r = 0.46). IU examination of the LMCA was feasible in 87% of patients and was more reliable for delineating plaques than angiography.

Aged↗
PubMed1994

Efficient encapsulation of proteins within liposomes for slow release in vivo.

A highly efficient method for the liposome encapsulation of granulocyte colony stimulating factor (rhG-CSF) was developed. The method was found to be gentle and led to no protein aggregation, denaturation or loss of protein activity. The liposomes obtained were judged to be oligolamellar based on a comparison of the actual with the theoretical trapped volumes. Slow release of encapsulated material from the liposomes was demonstrated both in vitro (90% serum, 37 degrees C) and in vivo after subcutaneous injection.

Animals↗
PubMed1994

Aortic intramural hemorrhage visualized by transesophageal echocardiography: findings and prognostic implications.

OBJECTIVES: This study describes the transesophageal echocardiographic and follow-up findings in patients with aortic intramural hemorrhage. BACKGROUND: Localized aortic intramural hemorrhage resulting in layered thickening of the aortic wall seems to represent a variant of acute aortic dissection without communication or a typical moving intimal flap. In autopsy studies this variant, attributed to a rupture of the vasa vasorum, has been described in 5% to 10% of patients with dissection. METHODS: In a prospective transesophageal echocardiographic study in patients with aortic dissection performed between 1986 and 1991, the diagnosis of intramural hemorrhage was established in 15 of 114 patients and either confirmed anatomically (7 patients) with an additional diagnostic imaging technique or on the basis of clear follow-up changes (8 patients). RESULTS: Elderly patients (mean age 70 years) with a history of hypertension were affected by this variant of dissection. The ascending aorta was involved in 3 patients and the descending aorta in 12. The longitudinal extent varied between 3 and 20 cm, and wall thickness varied between 0.7 and 3 cm. Classic aortic dissection developed in five patients (33%) and rupture in four (27%). Regression of aortic wall thickening was noted in two patients, whereas three patients became asymptomatic without apparent wall changes (33%). Surgery was performed in 5 patients, whereas medical therapy was continued in 10. During a mean follow-up period of 11 months, eight patients (53%) died because of complications of the aortic disease. CONCLUSIONS: Intramural hemorrhage represents a variant of aortic dissection and may be an early finding in patients who develop classic aortic dissection or rupture. Transesophageal echocardiography is an excellent method for the detection of intramural hemorrhage and for monitoring these patients.

Aged↗
PubMed1994

Depressive symptomatology in women and residential proximity to high-voltage transmission lines.

A number of epidemiologic studies indicate an association between depression and proximity to high-voltage transmission lines. These studies have been criticized, however, for using surrogate measures of electromagnetic fields and unstandardized measures of depression. In an effort to overcome these limitations, the authors administered the Center for Epidemiological Studies Depression scale (CES-D) in 1992 to 152 women in Orange County, California, who lived either adjacent to a transmission line or one block away. The results indicated that the average magnetic field level is 4.86 mG at the front door of homes adjacent to transmission lines and 0.68 mG at the front door of homes one block away. There was no significant difference in CES-D scores between the groups when demographic variables were controlled for. The homogeneity of the study population may limit the generalizability of findings.

Adult↗
PubMed1994

High-frequency rotational ablation following failed percutaneous transluminal coronary angioplasty.

Percutaneous transluminal coronary angioplasty (PTCA) failed in 29 of 1,150 patients (2.5%) after successful passage of the guide wire. The reasons for failure were inability to pass the lesion with a balloon in 28 patients and inability to dilate the lesion in 1 patient. In these patients (15 stenoses and 14 chronic occlusions) rotational ablation was performed. We were able to pass the burr through the lesion in all of them, resulting in a reduction of diameter stenosis from 87 +/- 15 to 51 +/- 18%. Rotational ablation alone was initially successful (stenoses reduction > 20% and residual stenoses < 50%) in 15 of 29 (52%) patients. Additional PTCA was performed in 21 of 29 (72%) patients, in 8 to optimize the initially successful result and in 13 because the outcome was unsatisfactory. After dilatation the diameter stenosis was reduced to 41 +/- 14% immediately after the procedure and to 36 +/- 13% at 24 hr control. Overall success was achieved in 21 of 29 (72%) patients immediately after the procedure and in 26 of 29 (90%) patients at 24 hr control. No acute major complications occurred. We conclude that rotational ablation can be used as a safe and effective alternative when PTCA is not successful.

Angioplasty, Balloon, Coronary↗
PubMed1994

Assessment of spontaneous coronary artery dissection by intravascular ultrasound in a patient with unstable angina.

We describe a case of spontaneous coronary artery dissection that gave rise to post infarction unstable angina. An ambiguous angiographic appearance was shown by intracoronary ultrasound to arise from an extensive coronary dissection. The dissection membrane separating true and false lumina and features to suggest sluggish flow and early thrombosis in the false lumen were observed. No increase in lumen calibre was evident on ultrasound after PTCA (probably a consequence of the relatively large ultrasound catheter blank), but coronary flow reserve measured with intracoronary Doppler did improve and the patient remained stable and free of angina following the procedure.

Angina, Unstable↗
PubMed1994

Left atrial thrombi despite anticoagulant and antiplatelet therapy.

To investigate risk factors for embolization in patients with echocardiographically detected left atrial thrombi and to evaluate thrombus development, we examined 29 patients with transesophageal and transthoracic echocardiography at two points during a follow-up of 18 months. We compared patients with a history of possible arterial embolization (n = 13) with those without (n = 16) in regard to age, gender, left atrial dilatation, localization of the thrombus in the left atrial cavity, spontaneous echo contrast, and atrial fibrillation. Eight patients were treated with aspirin, 20 with phenprocoumon. Only left atrial spontaneous contrast was associated with thromboembolism (10/15 patients with spontaneous contrast experienced arterial embolism; p = 0.038). In six patients arterial embolism occurred after thrombus detection (14% per patient per year). Four of these patients were treated with phenprocoumon, two with aspirin. At reexamination, one thrombus was detected in the patient without anticoagulant treatment and one thrombus was detected in the 8 patients treated with aspirin (13%), compared with ten thrombi detected in the 20 patients (50%) treated with phenprocoumon (p = NS). In 17 patients no thrombus was seen at reexamination. Since only 2 patients had undergone thrombectomy and 3 experienced arterial embolism during follow-up, thrombi disappeared under medical therapy in 12 patients. Patients with left atrial thrombi have a high risk of arterial embolization despite proper anticoagulative or antiplatelet treatment. Embolization occurs significantly more often if spontaneous echo contrast can be visualized. Left atrial thrombi can be reduced in size by the administration of antiplatelet and anticoagulative agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Survival models for developmental genetic data: age of onset of puberty and antisocial behavior in twins.

The use of survival analysis for developmental genetic data is discussed. The main requirements for models based on the decomposition of frailty distributions into shared and unshared components are outlined for the simple case of twins. Extending the earlier work of Clayton, Oakes, and Hougaard, among others, three forms of hazard model are presented, all of which can be applied to pedigree data with flexible baseline hazards without the use of numerical integration. The first two models use an additive decomposition of frailty, with either gamma or positive stable law distributed (PSL) components. The third model previously described by Hougaard involves a multiplicative PSL decomposition. The models are applied to data on the onset of puberty in male twins and illustrate the importance of correct specification of the baseline hazard for correct inference about genetic effects. The difficulty of assessing model specification using information only on the margins is also noted. Overall, the new model with additive PSL components appeared to fit these data best. A second application illustrates the use of a time-varying covariate in examining the impact of puberty on the onset of conduct disorder symptomotology.

Adolescent↗
PubMed1994

Locating human quantitative trait loci: guidelines for the selection of sibling pairs for genotyping.

Simulation studies were conducted to assess the relative merits of different nonrandom sampling strategies for the selection of sibling pairs for genotyping in the attempt to locate individual loci (QTLs) contributing to variation in human quantitative traits. For a constant amount of variation contributed by a QTL (25% of the total) the frequencies and dominance relationships of a trait increasing allele were varied. Three strategies for selection of pairs for genotyping were based on the phenotypic values of the siblings: "Concordant sib pairs" (CSP) are pairs in which both individuals exceed a given threshold value; "discordant sib pairs" (DSP) are pairs in which one member exceeds a given upper threshold and the other is below a specified lower threshold; and "most similar pairs" (MSP) are pairs selected for falling below a specified percentile ranking of the within-pair mean square for the quantitative trait. Tests for linkage with markers at 1, 2, 5, 10, and 20 cM from each of the QTLs were conducted for each of the selected samples and compared with tests based on the regression, in the entire sample, of within pair variation on the proportion of alleles identical by descent (IBD) at each marker locus. Tests for the effect of the increasing allele at the QTL ("candidate gene") were also conducted for the DSP pairs. No single nonrandom selection procedure yields as much as half the information realized in the total sample. However, a combined strategy which involves genotyping the 5% of MSP and DSP for the upper and lower quintiles of values of the quantitative trait (a further 3% of the sample approximately) yields lod scores which are usually more than 65% of the values realized for the entire sample. Tests comparing the proportion of increasing alleles in high- and low-scoring siblings from DSP samples are uniformly very powerful for detecting candidate loci. Even when it is not possible to measure the entire range of the phenotype with uniform precision, some attempt to differentiate among individuals in a common "unaffected" class of individuals can lead to considerable increase in power.

Alleles↗
PubMed1994

A simple method for censored age-of-onset data subject to recall bias: mothers' reports of age of puberty in male twins.

Genetic analysis of variation in age of onset of development milestones or psychopathological behaviors has been little researched, owing largely to the computational difficulty of dealing with "censored" observations. Censored observations arise when the only information on individuals is that they have reached a particular age but without onset having occurred. This paper shows how models can be simply fitted to such data using programs that can perform genetic analysis of categorical data by maximum likelihood. The method is illustrated using the program Mx with data on maternal report of the onset of puberty in twin sons from the Virginia Twin Study of Adolescent Behavioral Development. Frequently, data on age of onset is collected by retrospective recall. This can pose a variety of measurement problems. Suggestions are made for models that account for some of these problems or are robust to their presence. Substantial evidence for "telescoping" of onset dates is found for the puberty data. If left unaccounted for, these effects can artifactually inflate estimates of common environment effects.

Adolescent↗
PubMed1994

Contrast echocardiography of the left ventricle an independent predictor of pulmonary artery pressure?

To test the hypothesis that left heart opacification is dependent on pulmonary artery pressure, we analyzed consecutively 12 patients with normal and 8 patients with abnormal pulmonary artery pressure with a new lung capillary stable echo contrast agent. Patients underwent contrast echocardiographic examination within 6 hours before right and left heart catheterization with 200 mg/ml and 400 mg/ml SHU 508A intravenously. The mean pulmonary artery pressure was 15.4 mmHg in the patients with normal pulmonary artery pressures and 46.4 mmHg in the patients with pulmonary hypertension (p < 0.000). Echocardiograms were video-intensitometrically analyzed for intensity maximum (MAX), half-time of video-intensity decay (T1/2), area under the intensity curve (AUC) in the right and left ventricle and transit time from left to right heart (TT). Patients with normal pulmonary artery pressure showed sufficient left heart opacification, in the left ventricle MAX was 37 +/- 15 IU, AUC measured 653 +/- 463 IUxs and T1/2 was 4.4 +/- 2.6 s, while patients with elevated pulmonary artery pressure showed no significant left heart opacification. In the left ventricle MAX was 8 +/- 10 IU (p = 0.006), AUC measured 66 +/- 108 (p = 0.003) and T1/2 was 2.0 +/- 2.0 s (p = 0.041). TT was significantly increased in patients with elevated pulmonary artery pressure (11.8 +/- 4.6 s versus 6.5 +/- 2.8 s in patients with normal pulmonary artery pressure, p = 0.005). Thus, elevated pulmonary pressure has a significant impact on left heart opacification, which may be used for diagnostic purposes.

Adult↗
PubMed1994

Echocardiographic visualization of anomalous left main coronary arteries originating from the right sinus of Valsalva.

We report on two patients in whom the anomalous left main coronary artery arising from the right sinus of Valsalva with a septal course could be visualized by transthoracic echocardiography. It appeared as a small echo-free space, anterior to the aorta in the short parasternal axis. If the left main coronary artery arises anomalously from the right sinus of Valsalva, it can take four different courses until it branches into the left anterior descending and the circumflex coronary artery. The course between aorta and pulmonary trunk can be differentiated into an interarterial and a septal course using angiographic criteria. The interarterial course is a potentially life-threatening anomaly due to a high rate of myocardial infarction and sudden cardiac death. Echocardiography alone seems not to be able to distinguish between the potentially life-threatening interarterial and the benign septal course, as in our patients.

Coronary Angiography↗
PubMed1994

Intravascular ultrasound imaging in acute aortic dissection.

OBJECTIVES: This study was performed to determine the potential of intravascular ultrasound in the detection and delineation of aortic dissection. BACKGROUND: Intravascular ultrasound is a new technique capable of displaying real-time cross-sectional images of arterial vasculature. Its clinical use has been explored mostly in coronary and peripheral arterial circulation. METHODS: Intravascular ultrasound imaging of the aorta was performed using a 20-MHz ultrasound catheter in 28 patients with suspected aortic dissection. All patients underwent contrast angiography; 7 had computed tomography; and 22 had transesophageal echocardiography. RESULTS: Imaging of the aorta from the root level to its bifurcation was performed in all patients in an average of 10 min. No complications occurred. Dissection was present in 23 patients and absent in 5. In the patients without dissection, intravascular ultrasound revealed normal aortic anatomy. In all 23 patients with dissection, intravascular ultrasound demonstrated the intimal flap and true and false lumena. The longitudinal and circumferential extent of aortic dissection, contents of the false lumen, involvement of branch vessels and the presence of intramural hematoma in the aortic wall could also be identified. In cases where aortography could not define the distal extent of the dissection, intravascular ultrasound did. CONCLUSIONS: Our experience in this series of patients with aortic dissection indicates that intravascular ultrasound could be valuable in the identification and categorization of aortic dissection and in the description of associated pathologic changes that may be clinically important. It can be performed rapidly and safely and could serve as an alternative or adjunct diagnostic procedure in patients with aortic dissection.

Acute Disease↗
PubMed1994

An animal model for the assessment of gingival lesions.

A model of gingival inflammation was performed in Sprague-Dawley rats weighing 180-200 g. Mechanical bamboo stick-induced injury was inflammatory when bacteria contaminated the sticks. Bacteria were first obtained from gingival fluid collected from a patient with adult periodontitis. Another strain from Institut Pasteur (IP 6444) induced similar inflammation. Inflammation was then quantified 10 days later by means of elastase assays performed in gingival extracts. In parallel, elastic structures were observed and elastic fibers were quantified by automated image analysis. This technique of "impaction" was able to induce a gingival inflammatory reaction characterized by a significant increase of gingival elastase content, infiltration of gingival tissues by elicited cells, and gingival elastic fiber breakdown. These parameters were correlated, and measurement of one of them might be useful for pharmacological studies applied to the treatment of periodontal lesions. An example of results obtained from animals treated by heparine was shown.

Animals↗
PubMed1994

Tracheal rupture after tracheal intubation.

Tracheal rupture is a rare complication of tracheal intubation. We present a case of tracheal rupture which was diagnosed 20 h after a smooth intubation sequence and uncomplicated anaesthesia. Possible causes are discussed with reference to cases described previously.

Anesthesia, General↗