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Biomedical subjects

J Schauer

Publications and source records attributed to J Schauer.

At least 37 records · Page 2Linked to original sources
PubMed1999

[The solitary echinococcal cyst--a rare cause of a round pulmonary focus].

HISTORY AND ADMISSION FINDINGS: A 29-year-old man from Kazakhstan presented with right-sided chest pain, cough, whitish sputum and a temperature up to 38.5 degrees C. He had been working in an animal farm for the previous two years. INVESTIGATIONS: Laboratory tests showed increased inflammatory parameters (WBC 15.9 gpt/l with an increased proportion of band and segmented granulocytes, C-reactive protein (242.3 mg/dl). Chest radiogram showed an infiltration and effusion in the right base judged to be due to pneumonia. In addition there was a round homogeneous mass, 2.5 cm in diameter, at the lateral thoracic wall in the 8th lower lobe segment. Computed tomography (CT) of the lung and mediastinum confirmed these findings. Bronchoscopy, echocardiography, upper abdominal sonography and CT of the skull revealed no other space-occupying lesion. DIAGNOSIS, TREATMENT AND COURSE: The right-sided pneumonia was successfully treated, at first with ceftriaxone (i.v.), later with ofloxacin (by mouth). An echinococcal cyst was considered especially because of the patient's profession in Kazakhstan in the differential diagnosis of the right-sided round mass and confirmed by an indirect haemagglutination test giving an antibody titre of 1:1024. In response a thoracotomy was performed and the mass, histologically an echinococcal cyst (E. granulosa), resected. There were no other cysts. There was no explanation for the right-sided pneumonia. CONCLUSIONS: Even though Echinococcosis is rare in Central Europe, it should be included in the differential diagnosis of a round pulmonary mass. A detailed history, especially with regard to occupation and country of origin, is essential. Serological tests for specific Echinococcus antibodies, together with usual imaging procedures, will usually and quickly provide the diagnosis.

Adult↗
PubMed1999

Prolonged oral L-carnitine substitution increases bicycle ergometer performance in patients with severe, ischemically induced cardiac insufficiency.

Acute and chronic L-carnitine application exerts protective effects in a number of cardiac diseases. These favourable effects are attributed to improvements of the energy metabolism and have been found both in animal experiments and in man. In order to investigate the effect of long-time oral L-carnitine substitution on physical performance, 41 patients suffering from class NYHA II or III cardiac insufficiency were recruited for a clinical study. Following the double-blind, randomized, placebo-controlled design of the study, 20 patients were given 3 x 1 g L-carnitine daily for 120 days whereas the control group (21 patients) received placebo. Bicycle ergometer tests were used to determine maximum performance, systolic and diastolic blood pressure, heart rate, and ST changes. Four series of tests were carried out: on day 0 (before the first substrate application), on the 60th and the 120th day (during L-carnitine or placebo application), and on the 180th day (60 days after the end of substitution). A significant improvement in performance (significantly higher maximum performance during bicycle ergometry) could be found within the carnitine group on the 60th and 120th day of L-carnitine application; and haemodynamical parameters showed a tendency to improve, too. These effects, which were attributed to L-carnitine, could be detected even 60 days after the end of substitution. No corresponding changes were found in the placebo group. The findings presented in this paper support suggestions of other authors that L-carnitine in combination with the usual medication (digitalis, beta-blockers, calcium antagonists, nitrates) improves performance and effort tolerance in patients with cardiac insufficiency. Moreover, the findings suggest a favourable long-term effect, which lasts beyond the actual L-carnitine application, on the performance of patients with advanced cardiac insufficiency.

Adult↗
PubMed1998

Compartmentalization of pro-inflammatory cytokines in tuberculous pleurisy.

Increased levels of interleukin-6 (IL-6) and IL-8 are found in various immunologically mediated inflammatory disorders. Concentrations of IL-6, IL-8 and the soluble form of the IL-6 receptor (sIL-6R) were determined in serum and effusion fluid of 25 patients with tuberculous pleurisy utilizing enzyme linked immunosorbent assays (EIA). Serum IL-6 levels were only slightly increased in patients with tuberculous pleurisy in comparison to controls (11.1 +/- 2.1 vs 7.3 +/- 1.0 pg ml-1). IL-8 could not be detected in the serum of tuberculosis patients, but it was detected in the serum of healthy controls (8.0 +/- 1.5 pg ml-1). In comparison to serum, IL-6 and IL-8 were found in high concentrations in pleural effusions (IL-6: 932 +/- 70 vs 11.1 +/- 2.1 pg ml-1, P < 0.0001; IL-8: 450 +/- 85 vs 0 +/- 0 pg ml-1). In contrast, sIL-6R concentrations were much higher in serum compared to pleural effusion levels [30,477 +/- 1905 vs 9881 +/- 1177 pg ml-1, P < 0.0001 (mean +/- SEM)]. The authors conclude that elevated levels of IL-6 and IL-8 in pleural effusions are compartmentalized at the site of active disease. The low levels of sIL-6R in the presence of high levels of IL-6 in pleural effusions, and the high levels of sIL-6R in the presence of low levels of IL-6 in serum suggest that the expression or shedding of sIL-6R may be downregulated in the presence of excessive amounts of IL-6.

Adult↗
PubMed1998

Proinflammatory cytokine levels in patients with lung cancer and carcinomatous pleurisy.

Increased levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) have been reported in various diseases, including lung cancer. The role of the soluble form of the IL-6 receptor (sIL-6R) remains to be explored. We therefore measured IL-6, IL-8 and sIL-6R in effusion fluid and blood serum of 10 lung cancer patients with carcinomatous pleurisy (5 men, 5 women, age 64.3 +/- 4.4 years) by enzyme-linked immunosorbent assays. Serum levels of healthy individuals served as control. Concentrations of sIL-6R were much higher in serum compared to pleural effusion fluids of tumor patients (25,698 +/- 1,993 vs. 9,438 +/- 1,407 pg/ml: p < 0.0001). In contrast, IL-6 and IL-8 were found at high concentrations in carcinomatous pleural effusions in comparison to serum (IL-6: 964 +/- 176 vs. 10.2 +/- 1.3 pg/ml, p < 0.0001; IL-8: 319 +/- 85 vs. 9.6 +/- 9.6 pg/ml, p < 0.0001). The serum concentrations of IL-6 were not significantly increased in lung cancer patients (10.2 +/- 1.3 pg/ml) in comparison to controls (7.3 +/- 1.0 pg/ml). IL-8 was detected in the serum of only 1 patient and in low levels in the serum of controls (8.0 +/- 1.5 pg/ml; all values are mean +/- SEM). We conclude from this study that decreased levels of sIL-6R, but increased levels of IL-6 and IL-8, are found in pleural effusion fluid of patients with lung cancer and carcinomatous pleurisy. The low sIL-6R levels in the presence of high IL-6 levels in pleural effusions and the high sIL-6R levels in the presence of low IL-6 levels in serum may suggest a downregulation of sIL-6R expression of sIL-6R shedding in the presence of excessive amounts of IL-6.

Aged↗
PubMed1998

The effect of corticotropin-releasing hormone (CRH) on the adrenal medulla in hypophysectomized rats.

CRH occurs in the adrenal medulla of rats. We were interested to know whether CRH affects meduallary chromaffin cells in the absence of ACTH. We investigated the morphological changes of the adrenal medulla in Sprague Dawley rats with light and electron microscopy in normal rats, hypophysectomized rats, and hypophysectomized rats following injections of CRH (10 micrograms = 3 nmol for three days). Chromaffin cells were characterized by immunohistochemistry (anti-tyrosine hydroxylase). At light microscopy level chromaffin cells of hypophysectomized rats were reduced in number. On electron microscopy the number of granules and cell organelles were decreased. Following injections of CRH the medulla regained a more compact texture with cell organelles homogenously distributed, but with chromaffin granules still being reduced in number. Immunohistochemistry allowed the identification of chromaffin cells located within the adrenal cortex. In hypophysectomized rats these cells showed fewer signs of alterations compared to cells located within the medulla itself and had recovered better after treatment with CRH. In conclusion, CRH seems to exert a trophic effect on chromaffin cells in the absence of pituitary ACTH. This observation may provide further evidence for a close interaction of the two neuroendocrine stress systems.

Adrenal Medulla↗
PubMed1997

[Right ventricular function and pulmonary hypertension].

BACKGROUND: Hypothetically the right ventricular function measured by Equilibrium Radionuclide Ventriculography (RNV) is determined by the right ventricular ejection fraction and depends on the afterload. We investigated the possibility to evaluate the increased pulmonary artery pressure (PAP) by using this method. PATIENTS AND METHOD: We examined 109 patients (54.6 +/- 11 years) with chronic obstructive pulmonary disease (COPD). Lung function test, analysis of blood gases, pulmonary artery catheterisation and RNV were done within one week. RESULTS: There are 52 patients with non. 37 with labile and 20 with fixed pulmonary hypertension. Patients with normal PAP and nearly normal RVEF (49.2 +/- 8) were used as control group. Patients with pulmonary hypertension have had a lower mean RVEF, but there was no significant difference to the control group. Furthermore there was no significant correlation between mean PAP and RVEF detectable. By using RNV we diagnosed fixed pulmonary hypertension with a sensitivity of 95% and a specificity of 33% reduced RVEF and partial respiratory failure as a second noninvasive parameter achieved a more precise but not sufficient prediction of pulmonary hypertension, tested in Chi Square-Test. Obviously the RVEF depends not only on the afterload but also on the preload and contractility. However, influences on contractility are multidimensional and difficult to assess and to determine. CONCLUSION: Eventually it is not possible to use the RNV for measuring RVEF to diagnose pulmonary hypertension in COPD.

Adult↗
PubMed1997

Corticotropin-releasing hormone-binding protein and its possible role in neuroendocrinological research.

Corticotropin-releasing hormone-binding protein (CRH-BP), predominately produced by the liver, is a glycoprotein with a molecular weight of 37 kDa. The mature protein consists of 7 exons and 6 introns, with 5 tandem disulfide bridges which are essential for the binding of corticotropin-releasing hormone (CRH). This binding protein is distributed and expressed differently from corticotropin-releasing hormone receptors (CRH-Rs), as is the ligand requirement. Most CRH in plasma is bound to its binding protein, is therefore inactive and unable to bind to its receptor. Other competitives can reverse the binding, liberating CRH. Together with the CRH neuropeptides and CRH receptors, CRH-binding protein plays a role in the hypothalamic-pituitary-adrenal axis, in immune/inflammatory reactions as an auto/paracrine proinflammatory regulator, in pregnancy, as well as in some pathological conditions.

Adrenocorticotropic Hormone↗
PubMed1997

A hospital-based domestic violence group.

OBJECTIVE: This study of a public-hospital-based drop-in group for women who were victims of domestic violence sought to determine whether the group attracted clients from the target population of patients in the medical system, to identify characteristics of the battered women attending the group, and to examine whether the group shared the same characteristics as battered women who were evaluated in other contexts within the medical system. METHODS: Fifty-nine clients attending a domestic violence group at an urban public hospital completed questionnaires on referral sources, demographic characteristics, needs, and satisfaction. Included for comparison were clinical data on referral sources and demographic characteristics for 224 battered women evaluated by clinical social workers at the hospital and affiliated clinics. RESULTS: Referral patterns differed for the two groups: the majority of the social work cases were referred from the emergency room, and the majority of the referrals to the domestic violence group were from outside agencies, informal sources, and the hospital's inpatient units. A greater proportion of women attending the group were white, divorced or separated, and no longer living with their partners. Among the social work cases, the women were more likely to be ethnic minorities, single, and still living with their partners. CONCLUSIONS: The domestic violence group intervention attracted a different subgroup of battered women than did the social work intervention, which was likely due to differences in readiness to initiate change and to cultural barriers to group participation.

Adult↗
PubMed1997

[Surfactant administration and laterally independent positive pressure ventilation in acute lung failure and atelectasis after septic abortion. Case report].

We report the case of a 35 years old female patient suffering from Staphylococcus aureus induced abortion in the 7th/8th week of gestation. Sepsis with acute respiratory failure (ARDS) developed, which could be treated successfully. Pneumonia, caused by Pseudomonas aeruginosa, induced a recurrence of ARDS, complicated by a persistent incomplete atelectasis of the left lung. Independent ventilation of both lungs with increased pressure on the left side combined with bronchoscopy guided instillation of 1 g of bovine surfactant (Alveofact), caused improvement of arterial oxygenation and radiological signs, signalling airation of collapsed lung areas.

Abortion, Septic↗
PubMed1993

[Noninvasive diagnosis of pulmonary hypertension in patients with COPD using regression and discriminant analysis].

The evidence of elevated non-invasive parameters in prediction of pulmonary hypertension was examined in 168 patients with chronic obstructive pulmonary disease (COPD). Forced vital capacity (FVC), Tiffeneau-test (FEV1), oxygen partial pressure, x-ray ascertained diameter of right descending branch of pulmonary artery (RDB), myocardial scintigraphy, and right ventricular ejection fraction showed significant differences between patients with and without pulmonary hypertension. Neither of them alone allows prediction of pulmonary pressure exactly, only in combination non-invasive parameters are usable. In non-invasive diagnosis of catheterisation we suggest to use a regression function including FEV1, FVC and RDB by an ascertained specificity of 80% and sensitivity of 75%. To classify the patients according to normal and increased pulmonary artery pressure, FEV1, RDB and myocardial scintigraphy by a discriminant function with specificity/sensitivity of 80%, are relevant parameters. Accurate diagnosis of latent pulmonary hypertension requires right heart catheterisation. The domain of non-invasive diagnosis is screening and therapy monitoring of pulmonary hypertension, or if right heart catheterisation is contraindicated.

Adult↗
PubMed1993

[Therapy of chronic cor pulmonale].

Treatment of chronic cor pulmonale consists in therapy of causing disease and early influence of pulmonary hypertension. Long-time oxygen therapy is proved to be an effective measure of live support. Drug effects on pulmonary hypertension up to now are unsatisfactory. In special cases vasodilators have to be checked on responder rate. Right heart decompensation requires an in-patient treatment; physical rest, oxygen insufflation and diuretics are reliable.

Combined Modality Therapy↗
PubMed1992

[Treatment with antibacterial chemotherapy].

The importance of a true indication of antimicrobiological chemotherapy is discussed on beginning of the paper. A correct choice of antibiotics and proper strategy of therapy will be demonstrated. Additionally essential antibiotics are presented.

Anti-Bacterial Agents↗
PubMed1992

[Antibiotic therapy of bacterial respiratory tract infections].

Infections of the airways are among the most frequent of inflammatory diseases appropriate for antibacterial therapy. One must differentiate between infections of the upper and lower airways, respectively infections obtained externally, and nosocomial infections. Since a relatively uniform spectrum of microbes can usually be expected, well-planned antibacterial therapy is possible. For nosocomial infections, on-target antibacterial therapy is required. For the various diseases of the airways, diagnostic and therapeutic strategies are outlined.

Anti-Bacterial Agents↗