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Biomedical subjects

J Schmidli

Publications and source records attributed to J Schmidli.

53 records · Page 3Linked to original sources
PubMed1991

Quantitative nailfold capillary microscopy in cutaneous and systemic lupus erythematosus and localized and systemic scleroderma.

Quantitative television microscopy of nailfold capillaries of the fingers was performed in 12 patients with cutaneous lupus erythematosus (six with discoid type and six with disseminated type), in six patients with localized scleroderma (two with circumscribed type, two with linear types, and two with atrophic type), in 10 patients with systemic lupus erythematosus, and in eight patients with systemic scleroderma. The following features were analyzed and compared with a control group (n = 15) of similar age: venous plexus visibility; density of capillaries; avascular fields; hemorrhages; giant capillaries; diameters of the transitional segment, the arterial, and the venous limbs; loop width; and flow stop caused by local cooling test. The patient groups with cutaneous lesions only showed no essential differences as compared with the controls. Patients with systemic scleroderma differed in almost every finding from the controls and from patients with localized scleroderma. Patients with systemic lupus erythematosus exhibited significant differences in several findings as compared with the controls and the cutaneous lupus erythematosus group, but there was overlap.

Adolescent↗
PubMed1991

Lyme borreliosis.

Borrelia burgdorferi, the etiologic agent of Lyme disease, was the topic of an international conference in Stockholm which assembled 500 scientists from all over the world. About 300 oral and poster presentations revealed many new details on the complex life history of this bacterium, its molecular characteristics, the clinical consequences of human and animal infections, new diagnostic procedures and therapeutic regimens.

Animals↗
PubMed1989

[Extensive acrodermatitis chronica atrophicans involving the face].

We report on an 81-year-old woman suffering from extensive acrodermatitis chronica atrophicans with facial involvement. This unusual manifestation may be related to an immunodeficiency state in the course of multiple malignancies. The cutaneous lesions cleared significantly during an aminopenicillin therapy administered orally over 4 weeks.

Acrodermatitis↗
PubMed1988

Chemotactic monoclonal antibody conjugates: a comparison of four different f-Met-peptide-conjugates.

Intratumor macrophage numbers are enhanced by the administration of chemotactic f-MET-LEU-PHE - antitumor antibody - conjugates. The four f-MET-peptides f-MET-LEU-PHE, f-MET-LEU-PHE-o-methylester, formyl-norleucyl-phenylalanine and formyl-methionyl-phenylalanine, all chemotactic for human monocytes, where evaluated alone and conjugated to the melanoma directed monoclonal antibody ZME 018. f-MET-LEU-PHE-o-methyl-ester is the most active peptide, whereas f-MET-LEU-PHE - ZME 018 is the most active conjugate, not only inducing a response at the lowest concentration, but also the highest migrating cell numbers.

Animals↗
PubMed1987

["Aqua-SUP" in chronic palmoplantar dermatoses].

In 11 of 15 patients suffering from chronic dermatoses of the palms and soles (psoriasis inversa, palmoplantar pustulosis, palmoplantar hyperkeratotic eczema and idiopathic pompholyx), an improvement was achieved with "aqua-SUP" therapy. Trials using this therapeutic modality, which is a combination of balneotherapy and selective UV phototherapy (SUP), have only rarely been reported so far. In addition, five patients received internal medication (mainly aromatic retinoid) that had previously not been effective enough, three of them in combination with local corticosteroids. Four more patients were administered local corticosteroids in addition to "aqua-SUP". Four patients experienced local pain in the treated area, especially in the initial phase of phototherapy, and a mild erythematobullous reaction occurred in three of them. No other side-effects were observed. The efficacy of "aqua-SUP" for the treatment of the above-mentioned dermatoses lies in the same range as that of local PUVA, which has been used up to now. However, as "aqua-SUP" is easily manageable, it is more convenient for the patient and does not involve the problems of photosensitization.

Adult↗
PubMed1986

Conjugation behaviour of different monoclonal antibodies to f-methionyl-leucyl-phenylalanine.

Monoclonal antibodies (moab) are potentially useful carriers for the targeting of effector substances into tumors. Conjugation of the chemotactic peptide f-Met-Leu-Phe (fMLP) to tumor-directed antibodies yields compounds active in vitro and in vivo. The present experiments examine the conjugation of fMLP to four different moab iso- and idiotypes. Molar coupling rations and chemotactic activity are not dependent on the moab species used for conjugation.

Antibodies, Monoclonal↗
PubMed1985

[Remote results of mitral valve surgery in mitral valve insufficiency, 1972-1982].

Between 1972 and 1982 315 patients were operated on for isolated or predominant mitral insufficiency at Surgical Clinic A, University of Zurich. The etiology was rheumatic in 51 patients and degenerative in 133. Of these 164 patients, 42 underwent a reconstructive procedure and 122 mitral valve replacement. Patients who underwent mitral valve reconstruction were younger and had a longer average postoperative observation time than patients who had mitral valve replacement. Operative mortality of the total series was 2.4%. Late postoperative survival was very similar in the patients with rheumatic and degenerative mitral incompetence. Seven-year survival after mitral valve reconstruction was 87 +/- 5%, compared to 76 +/- 6% after mitral valve replacement. Mitral valve reconstruction patients required more reoperations than those with mitral valve replacement. On the other hand, the incidence of late embolism and endocarditis was lower after mitral valve reconstruction. Age of patients at operation and a preoperative reduction of ejection fraction and cardiac index were predictors of a less favourable postoperative course. From these observations we conclude that surgery should be carried out before irreversible impairment of left ventricular function, even where symptoms are less than severe. If possible, reconstructive surgery for mitral incompetence is justified in view of the lower postoperative risk of embolism and endocarditis and in spite of the higher incidence of recurrences requiring reoperation.

Adolescent↗
PubMedDate not supplied

Perfused rabbit heart: endothelium-derived relaxing factor in coronary arteries.

The study was performed to demonstrate the presence of the endothelium-derived relaxing factor (EDRF), previously found to be active in isolated artery preparations in vitro, in the coronary arteries of rabbits remaining in contact with the beating perfused heart. This was accomplished by following the response of the preconstricted obtuse marginal coronary artery to topically administered acetylcholine (ACH). Both intact arteries and arteries in which the endothelium had been removed were studied. Preconstriction of the obtuse marginal coronary artery was accomplished by topical application (spray) of histamine (10 microM), in 2 ml Krebs-Henseleit (KH) solution. This resulted in a decrease in internal diameter of the coronary artery, a decline in coronary flow, and an increase in total coronary vascular resistance. The principal difference between intact coronary arteries and those in which the endothelium had been removed was in the response to ACH. In arteries with intact endothelium preconstricted with histamine, topical administration (spray) of ACH (0.6 mM in 2 ml KH solution) caused, as compared with histamine, an increase in coronary flow, a significant decrease in total coronary vascular resistance, and a rise in internal vascular diameter. Arteries in which the vascular endothelium had been removed, as compared to those pretreated with histamine, responded to topical administration of ACH (0.6 mM in 2 ml KH solution) with a decrease in coronary flow, coronary vascular resistance, and internal vascular diameter. No change in the dose-response curve to histamine between the two preparations was noted. The results demonstrate that coronary vascular endothelium exerts a protective effect in coronary arteries remaining in contact with the perfused beating heart.

Acetylcholine↗
PubMedDate not supplied

Less invasive surgical treatment of renal cell carcinomas extending into the right heart and pulmonary arteries: surgery for renal cell carcinoma.

BACKGROUND: Radical resection using deep hypothermic circulatory arrest improves the survival of patients with transvenous intracardiac tumor extension of renal cell carcinomas. A less invasive surgical approach avoiding deep hypothermia, circulatory arrest, and cross-clamping of the aorta is presented. METHODS: Between 1987 and 1999, 12 patients (mean age 57+/-8 years) underwent resection of a renal cell carcinoma extending into the right atrium, right ventricle, or pulmonary arteries. After median sterno-laparotomy, normothermic cardiopulmonary bypass is used cannulating the ascending aorta, superior caval vein, and inferior caval vein below the renal veins. The tumor and the corresponding kidney are radically excised, including the renal vein. Tumor fragments from the inferior caval vein, the right heart, and pulmonary arteries are removed either on the fibrillating or beating heart. RESULTS: Operative mortality was 0%. Mean cardiopulmonary bypass time was 53+/-27 minutes (median 36; range 32-110 minutes). Mean blood loss per patient was 1200 mL. Mean duration of postoperative mechanical ventilation was 36+/-12 hours (median 36; range 30-77 hours), mean intensive care stay 5.5+/-5 days (median 3; range 1-48 days), and mean duration of hospitalization 22+/-12 days (median 21; range 10-58 days). All patients were discharged home. Patients with multiple tumor manifestations outside the cardiovascular systems died within 9 months after the operation. CONCLUSIONS: The use of normothermic cardiopulmonary bypass is a less invasive method for radical resection of renal cell carcinoma with intracardiac tumor extension. Radical resection does not improve survival in patients with multiple distant metastases.

Adult↗
PubMedDate not supplied

Low systemic vascular resistance after cardiopulmonary bypass: incidence, etiology, and clinical importance.

BACKGROUND: Low systemic vascular resistance during and immediately after cardiac surgery in which cardiopulmonary bypass is utilized is a well-known phenomenon, characterized as vasoplegia, which appears with an incidence ranging between 5% and 15%. The etiology is not completely elucidated and the clinical importance remains speculative. METHODS: In this prospective clinical trial, we assessed the incidence of postoperative low systemic vascular resistance in 800 consecutive patients undergoing elective coronary artery bypass grafting and/or valve replacement. We have attempted to identify the predictive factors responsible for the presence of low systemic vascular resistance and we have examined the subsequent postoperative outcome of those patients who developed early postoperative vasoplegia. The severity of vasoplegia was divided into three groups according either to the value of systemic resistance and/or the dose of vasoconstrictive agents necessary to correct the hemodynamic. RESULTS: Six hundred twenty-five patients (78.1%) did not develop vasoplegia, 115 patients (14.4%) developed a mild vasoplegia, and 60 patients (7.5%) suffered from severe vasoplegia. Low systemic vascular resistance did not affect hospital mortality but was the cause for delayed extubation and prolonged stay on the intensive care unit (ICU). Logistic regression analysis identified temperature and duration of cardiopulmonary bypass, total cardioplegic volume infused, reduced left ventricular function, and preoperative treatment with angiotensin-converting enzyme (ACE)-inhibitors, out of 25 parameters, as predictive factors for early postoperative vasoplegia. CONCLUSION: The occurrence of low systemic vascular resistance following cardiopulmonary bypass is as high as 21.8%. The etiology of this clinical condition is most probably multifactorial. Mortality is not affected by vasoplegia, but there is a trend to higher morbidity and prolonged stay in the ICU.

Aged↗
PubMedDate not supplied

Spontaneous dissection of common iliac artery. A case report.

Spontaneous dissection of the iliac artery is very rare but known as a complication of high-energy traumatic injuries and has been reported in connection with pregnancy, collagen diseases, and alpha-1-antitrypsin deficiency. The authors report a 42-year-old man with an acute dissection of the common iliac artery during exercise. Groin pain and claudication were the early symptoms. Computerized angiotomography was diagnostic. Operative iliac artery reconstruction was performed. A prerelease control computed tomography examination showed a dissection of the distal aorta and left iliac artery. To their knowledge, the combination of the 2 dissections has not been previously published.

Acute Disease↗