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Biomedical subjects

L Reiter

Publications and source records attributed to L Reiter.

At least 19 recordsLinked to original sources
PubMed2005

Degenerative spondylolysis: a concise report of scintigraphic observations.

OBJECTIVES: Spondylolysis is traditionally thought to be a diagnosis of adolescence and childhood, and is ascribed to mechanical stress through the immature pars interarticularis. Over the last 4 yr we have noted a presentation of spondylolysis in association with hypertrophic zygapophyseal joint disease in the lumbar spine in an older age group. METHODS: Records of 94 patients presenting with low back pain were examined. A pattern of intense zygapophyseal joint uptake in association with extended uptake in the pars interarticularis was ascribed as degenerative spondylolysis. RESULTS: The ages of the 94 cases ranged from 33 to 80 yr (mean 64 yr). There were 53 males and 41 females. In the group with degenerative spondylolysis the mean age was 72 yr, with four females and two males. None of these six patients gave a history of childhood spinal disease or back pain and all were relatively inactive in terms of current participation in sport. All cases of spondylolysis were confirmed by computed tomography scanning. CONCLUSION: The finding of hypertrophic zygapophyseal joint disease in association with spondylolysis is easily recognized by scintigraphic tomographic imaging.

Adult↗
PubMed1996

Cogan's syndrome.

Explore the source record for details and available documents.

Cyclophosphamide↗
PubMed1995

Familial hyperuricemic nephropathy.

This report describes a Polynesian family that had the rare combination of hyperuricemia, precocious gout, hypertension, and renal failure at an early age, with an autosomal dominant inheritance. One family member had renal biopsy evidence of interstitial urate crystal deposition, a surprisingly uncommon observation in such families, and most had decreased fractional excretion of urate, reflecting either decreased secretion or enhanced postsecretory renal reabsorption of uric acid. One patient has had a successful renal transplant. On the basis of these observations, family members of any such index case should be screened for this disorder. Treatment of affected members might include a uricosuric agent and/or allopurinol early in the course of the disorder.

Adolescent↗
PubMed1994

Measuring blood pressure in pregnant women: a comparison of direct and indirect methods.

OBJECTIVES: Our goals were to determine (1) whether Korotkoff phase IV or V sound was a more accurate measure of diastolic blood pressure in pregnancy and (2) interobserver variability of mercury sphygmomanometry of pregnant women. STUDY DESIGN: Direct (intraarterial) and indirect (mercury sphygmomanometry) blood pressures were compared in 28 pregnant women. Interobserver variability was assessed in a separate study of 86 pregnant women using four highly trained observers. RESULTS: (1) Routine sphygmomanometry underestimated direct systolic pressure by 11 (3, 18) mm Hg, p < 0.001 (median, interquartile range of differences). Phase IV Korotkoff sound overestimated direct diastolic pressure by 9 (2, 12) mm Hg (p < 0.001) and phase V by 4 (2, 7) mm Hg (p = 0.04). Phase V-recorded diastolic pressure was closer to direct diastolic pressure significantly more often (75%) than was phase IV-recorded diastolic pressure (21%) (p = 0.003). Mean arterial pressures did not differ significantly according to the method used. (2) Median blood pressures did not differ among the four observers for systolic, diastolic phase IV, or phase V recordings. Maximum difference for blood pressure recording among observers was 4 (2, 6) mm Hg. CONCLUSIONS: Auscultatory sphygmomanometry in pregnant women underestimates systolic and overestimates diastolic blood pressure, but the phase V Korotkoff sound is more likely to represent the true diastolic pressure than is the phase IV sound.

Auscultation↗
PubMed1994

Hypertension in pregnancy: the incidence of underlying renal disease and essential hypertension.

The objective of this study was to ascertain the likelihood of underlying renal disease or essential hypertension in women diagnosed antepartum as having pre-eclampsia. One hundred eighty-six women (antepartum diagnosis of pre-eclampsia in 87 women and gestational hypertension, also known as "mild pre-eclampsia" by other definitions, in 99 women) in whom no underlying disorder was apparent during pregnancy or the early puerperium were entered into the study. Women were reviewed between 3 and 60 months postpartum. All patients were assessed by measurement of blood pressure, urinalysis, and phase-contrast urine microscopy, and those with pre-eclampsia also had plasma urea, electrolyte, and creatinine concentrations determined and underwent renal imaging with either intravenous pyelography or ultrasound. The kidneys were also imaged in the gestational hypertension group if there was any clinical suspicion of underlying renal disease on review. Essential hypertension was diagnosed if systolic blood pressure was higher than 140 mm Hg and/or diastolic blood pressure was higher than 90 mm Hg after 3 months postpartum and the results of other investigations were normal. Renal disease was diagnosed in the presence of abnormal findings on urinalysis, urine microscopy, or renal imaging, or by elevated plasma creatinine concentration. Seven (8%) of the 87 women with pre-eclampsia had underlying disease (essential hypertension, five patients; renal disease, two patients [one with reflux nephropathy and one with medullary sponge kidney]), as did 16 (16%) of the 99 women with gestational hypertension (essential hypertension, 14 patients (14%); renal disease, two patients (2%) [one with medullary sponge kidney and one with thin basement membrane disease]).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Impaired renin stimulation in pre-eclampsia.

1. Pre-eclampsia is characterized by reduced plasma active renin concentration and renal prostacyclin production. The aim of this study was to determine whether the plasma active renin concentration could be stimulated in women with pre-eclampsia by intravenous frusemide, which stimulates renin acutely through a prostacyclin-mediated mechanism. 2. Plasma active renin concentration, plasma aldosterone concentration, haematocrit and urinary sodium, creatinine and 6-keto-prostaglandin F1 alpha were measured before (0) and 15, 30 and 60 min after intravenous frusemide in 10 non-pregnant women, 10 normal pregnant women and nine women with pre-eclampsia. Six normal pregnant and six non-pregnant women underwent the same measurements after injection of 2ml of saline to control for effects of time and posture. 3. Baseline plasma active renin concentration (but not plasma aldosterone concentration) was lower in pre-eclamptic women [4.0 (1.7-6.2) pmol of angiotensin I h-1 ml-1; median (interquartile range)] than in normal pregnant women [6.7 (5.3-12.2) pmol of angiotensin I h-1 ml-1] (P < 0.05). Baseline urinary 6-keto-prostaglandin F1 alpha/creatinine ratio, urinary sodium excretion and fractional sodium excretion did not differ between normal pregnant and pre-eclamptic women. 4. After frusemide, plasma active renin concentration rose significantly in non-pregnant (P = 0.002) and normal pregnant (P = 0.008) women, but not in women with pre-eclampsia. Individual results showed stimulation in all non-pregnant and normal pregnant women but in only six out of nine pre-eclamptic women, significantly fewer than in normal pregnancy (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1993

[The ethical status of the child in family and child psychotherapy].

The implications of the United Nations' Convention on the Rights of the Child for psychotherapy and family therapy with the children are elaborated. Referring to the ethical discourse about patient information and informed consent, the authors suggest to integrate minors into decisions about participation in and goals of therapy. Shortcomings of common ways in dealing with minors in therapy are analyzed and discussed in the light of ethical principles. Empirical data concerning adequate judgments about competences of children are evaluated and suggestions for practical work in therapy and counseling are presented.

Child↗
PubMed1990

Modulation of the malignant phenotype with the urokinase-type plasminogen activator and the type I plasminogen activator inhibitor.

Gene transfer techniques were utilized to evaluate the role of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor type 1 (PAI-1) in enhancing or preventing the expression of the invasive malignant phenotype, respectively. Mouse L-cell transfectants expressing human uPA or human PAI-1 as well as mouse B16 transfectants expressing mouse uPA or human PAI-1 were generated. These transfectants were tested using a variety of experimental methods including smooth muscle cell matrix solubilization in vitro, lung colony formation in vivo and co-cultures of antagonist-expressing cells in vitro. Results from these studies provide direct evidence for an enhancing role of uPA in malignant invasion and experimental metastasis and for a modulatory role of PAI-1 in tumor cell-mediated breakdown of extracellular matrices.

Animals↗
PubMed1990

Pre-operative ultrasound measurement of bile duct diameter: basis for selective cholangiography.

In this prospective study, prior to cholecystectomy, the diameter of the common hepatic duct was measured; duct size was then compared with probability of finding stones at operation. Of 115 patients entering the study, 36 had stones removed from the common duct at the time of cholecystectomy but only three (8%) were demonstrated by ultrasonography. No stones were found in ducts less than or equal to 3 mm in size (31% patients). Only two of 26 patients with ducts measuring 4 mm had stones. As duct size increased, so did the probability of stones and all patients with ducts greater than or equal to 9 mm in diameter had stones. It is concluded that pre-operative ultrasound provides a reliable basis for a policy of selective cholangiography.

Cholangiography↗
PubMed1984

Developmental changes in slow cortical potentials of young children with elevated body lead burden. Neurophysiological considerations.

The effects of age and blood lead level (PbB) on slow cortical potentials elicited during classical conditioning were studied in children aged 13 to 75 months. At normal PbB levels (less than 30 micrograms/dl), SW voltage tended to be positive in children under five years old and negative in children over five years. A reverse age-related polarity shift was observed in children with elevated PbB levels (Otto et al., 1981). Evidence indicative of excitatory (or disinhibitory) effects of Pb exposure in immature animals (associated with hyperactivity in animals and children) was reviewed. Reversals in locomotor activity (hypoactivity) and electroconvulsive activity have also been noted in adult animals exposed to Pb as pups. Neurophysiological evidence suggests that slow surface-positive potentials in very young children may reflect axodendritic inhibitory processes. As the cortex matures, the locus of inhibitory activity shifts deeper to axosomatic connections. Negative slow potentials observed in older children, therefore, are presumed to reflect the surface negative (dendritic depolarization), depth positive (somatic hyperpolarization) dipole hypothesized by McSherry (1973) as the neurophysiological substrate of the CNV. Although the developmental model of the CNV proposed here is based on preliminary data and is clearly speculative, the implications of the model and data merit consideration. Positive shifts observed in very young children during the CS-UCS interval suggest why previous investigators have had great difficulty in eliciting contingent negative variation in subjects younger than five years. The data also suggest that body Pb burden at any level produces an observable effect on CNS function. Further study is needed to replicate and clarify these findings.

Cerebral Cortex↗
PubMed1983

[Problems of diagnostic typology of married couples in therapy].

Over the past years there has been great interest in developing diagnostic typologies of married couples undergoing therapy. 92 couples admitted to therapy were asked to fill out the Giessen test, a test widely used for diagnosis in marital therapy. The method of cluster analysis was used to find a classification. The decision for an 8-cluster solution was based on statistical and clinical data. The 8 diagnostic types are briefly described.

Adult↗
PubMed1981

Behavioral toxicity of acute and subacute exposure to triethyltin in the rat.

The behavioral effects of both acute and subacute triethyltin (TET) exposure were examined in the rat. Animals acutely exposed to TET at doses of 0, 1.5 and 3.0 mg/kg showed a dose-related decrease in motor activity when tested between 2 and 4 hr following exposure. Subacute (3 week) exposure to TET in the drinking water (5 or 10 ppm) resulted in performance decrements in the following: maze activity, open field behavior, acoustic startle response and landing foot-spread. Early signs of behavioral deficits were observed 2 weeks after 10 ppm TET. These effects were reversible within one month after termination of exposure.

Animals↗
PubMed1979

Modulation of the acoustic startle reflex in humans in the absence of anticipatory changes in the middle ear reflex.

If a weak tone precedes an intense tone, then the acoustic startle eyeblink reflex elicited by the stronger stimulus is inhibited. It has been suggested that the leading stimulus gives rise to a protective middle ear reflex that attenuates the effective intensity of the second. This hypothesis was tested and disproved. In seven subjects intense tone bursts sufficient to elicit both intratympanic and eyeblink responses were presented sometimes alone and sometimes preceded at various lead times (25 to 400 msec) by a weak tone. The weak tone inhibited the amplitude of the eye blink to the strong tone, maximally at intervals of 100 to 200 msec, but was never seen to produce any of the anticipatory impedance changes that would be characteristic of middle ear reflex activity during the interval between the two stimuli.

Adolescent↗