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Biomedical subjects

M Kraemer

Publications and source records attributed to M Kraemer.

15 recordsLinked to original sources
PubMed1992

[Acute abdominal pain--standardized findings as diagnostic support. Results of a prospective multicenter intervention study and testing of a computer-assisted diagnosis system].

Despite powerful diagnostic tools (e.g. ultrasound, special laboratory investigations), the diagnosis of acute abdominal pain is still a considerable problem. Several studies in the UK have shown that the diagnostic accuracy can be improved by structured and standardized history taking and clinical examination and by computer-aided diagnosis. In the framework of a concerted action of the European Community we have conducted a prospective multicenter interventional trial comparing two consecutive phases: a) a baseline phase in clinical routine without additional intervention, b) a test phase with structured and standardized history and clinical examination (questionnaire, documentation programme). In addition, a computer-aided diagnostic system developed in the UK was applied to the cases in the test phase. Outcome criteria were the diagnostic accuracy of the initial and the final examiner, the perforated appendix rate, the negative appendectomy rate, the negative laparotomy rate and the rates of diagnostic errors with missing indication to operation and of delayed urgent operations. No differences could be found between the phases with respect to the outcome criteria. In the baseline phase (test phase) diagnostic accuracy was 59% (59%), diagnostic accuracy after investigation (senior examiner) was 77% (78%), perforated appendix rate was 11% (16%), negative appendectomy rate was 13% (15%), negative laparotomy rate was 7% (8%), the rate of missed urgent indications to operation was 1.1% (1.9%) and the rate of delayed urgent operations was 3.4% (2.4%). Major differences between the centers were recorded. Computer-aided diagnosis resulted in a diagnostic accuracy of 51%. The introduction of structured and standardized history taking and clinical examination has not brought any improvement of the good results in clinical routine. It is doubtful, whether existing systems of computer-aided diagnosis are able to significantly decrease the still remaining error rate of 20%.

Abdomen, Acute↗
PubMed1991

The ventilatory threshold: method, protocol, and evaluator agreement.

To evaluate the effects of different methods of detection, exercise modes, protocols, and reviewers on oxygen uptake (VO2) at the ventilatory threshold (ATge), 17 men with heart disease (mean age 59 +/- 6 years) and six healthy men (mean age 60 +/- 11 years) underwent six exercise tests on different days. Each subject performed three treadmill tests (Bruce, Balke, and ramp) and three bicycle ergometer tests (50 W/stage, 25 W/stage, and ramp) in random order. The ventilatory threshold was determined for each of the six exercise tests by three independent, blinded reviewers by means of graphic plots of three commonly used methods of determination: (1) changes in the ventilatory equivalents for VO2 and VCO2, (2) changes in end-tidal oxygen and carbon dioxide pressures, and (3) the intersection of the slope of VCO2 and VO2 (V slope). The largest variability in the ATge was observed with changes in the exercise protocol. The greatest absolute (ml/min) and percentage differences in oxygen uptake at the ATge as a result of changes in protocol, method of determination, and observers were 336 (36%), 125 (12%), and 70 (7%), respectively. The overall intraclass correlation coefficient for VO2 at the ATge among the three reviewers was 0.60 and among the three protocols was 0.85 (p less than 0.01). The V slope method of detection had consistently good agreement among reviewers and was least affected by the protocol. The variance in the ATge (excluding intersubject and error variance) accounted for by differences in protocol, method, and reviewer was 82%, 14%, and 4%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Anaerobic Threshold↗
PubMed1991

Comparison of the ramp versus standard exercise protocols.

To compare the hemodynamic and gas exchange responses of ramp treadmill and cycle ergometer tests with standard exercise protocols used clinically, 10 patients with chronic heart failure, 10 with coronary artery disease who were asymptomatic during exercise, 11 with coronary artery disease who were limited by angina during exercise and 10 age-matched normal subjects performed maximal exercise using six different exercise protocols. Gas exchange data were collected continuously during each of the following protocols, performed on separate days in randomized order: Bruce, Balke and an individualized ramp treadmill; 25 W/stage, 50 W/stage and an individualized ramp cycle ergometer test. Maximal oxygen uptake was 16% greater on the treadmill protocols combined (21.4 +/- 8 ml/kg per min) versus the cycle ergometer protocols combined (18.1 +/- 7 ml/kg per min) (p less than 0.01), although no differences were observed in maximal heart rate (131 +/- 24 versus 126 +/- 24 beats/min for the treadmill and cycle ergometer protocols, respectively). No major differences were observed in maximal heart rate or maximal oxygen uptake among the various treadmill protocols or among the various cycle ergometer protocols. The ratio of oxygen uptake to work rate, expressed as a slope, was highest for the ramp tests (slope +/- SEE ml/kg per min = 0.80 +/- 2.5 and 0.78 +/- 1.7 for ramp treadmill and ramp cycle ergometer, respectively). The slopes were poorest for the tests with the largest increments in work (0.62 +/- 4.0 and 0.59 +/- 2.8 for the Bruce treadmill and 50 W/stage cycle ergometer, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Radio-functional analysis of the cervical spine using the Arlen method. Part Three: Post-traumatic syndromes. A statistical analysis of 480 subjects.

The purpose of this study was to determine the differences in patterns of cervical mobility diagrams obtained by the Arlen method in a control population of 240 subjects and in a group of 240 patients who had previously sustained an indirect cervical trauma. The characteristics of antero-posterior mobility of the cervical spine in the control population and their variations due to age and sex are summarized. A statistical study is devoted to the amplitudes of the different vertebral segments during flexion and extension. The authors have tried to elucidate the functional features of the injured spine in its totality and at different levels in both flexion and extension. The two groups were compared in an analysis of spinal dysfunctions (hypomobility, loss of mobility, paradoxical mobility).

Adolescent↗
PubMed1989

Engraftment of T-depleted major histocompatibility complex-mismatched bone marrow in T-deficient versus natural killer-deficient recipients.

When bone marrow transplantation recipients undergo standard pre-transplant immunosuppressive therapy, engraftment failures are significantly more frequent with the use of T-depleted allogeneic donor bone marrow cells than with T cell-containing allogeneic donor bone marrow cells. The relative importance of T versus natural killer (NK) cells in the rejection process of T-depleted donor bone marrow cells remains debatable. Here, NK- and T-deficient mouse mutants were transplanted across the same major histocompatibility complex (MHC) differences with homozygous or heterozygous T-depleted bone marrow cells. Results show that under the experimental conditions described, residual host NK cells are almost exclusively responsible for the increased rejection rate.

Animals↗
PubMed1989

Radio-functional analysis of the cervical spine using the Arlen method. A study of 699 subjects. Part One: Methodology.

The authors describe successively the radiological technique and measurement method of Arlen's radio-functional analysis of the cervical spine, the characteristics of antero-posterior cervical spine mobility in a control population and the variations observed in these characteristics according to age and sex. A few typical diagrams of radio-functional analysis obtained in various types of pathology are offered as examples. The ease with the Arlen method can be used in routine practice; its diagnostic and prognostic value and its role in the follow-up of patients with cervical diseases or injuries are emphasized.

Adolescent↗
PubMed1989

Radio-functional analysis of the cervical spine using the Arlen method. A study of 699 subjects. Part Two: Paradoxical tilting of the atlas.

The authors describe a peculiar movement of the first cervical vertebra: the so-called paradoxical tilting of the atlas, which consists of extension in relation to McGregor's line during flexion of the cervical spine. This physiological phenomenon has already been reported by several authors. The purpose of this study was to determine the mean amplitude and frequency of paradoxical tilting of the atlas in subjects with no known cervical pathology and to evaluate some of the factors that may influence it. The younger the subject the more frequent and more ample this paradoxical tilting: it occurs very often before the age of 40 years and is present in more than 93% of subjects under 20. Its amplitude diminishes with age, until it is replaced by mobility in flexion.

Adolescent↗
PubMed1988

Development of the fetal rat liver: ultrastructural and stereological study of hepatocytes.

Qualitative and quantitative changes in the liver tissue composition have been studied during prenatal development of the Wistar rat by electron microscopy and stereologic methods. The absolute volume of the fetal liver is multiplied by 84 between days 13 and 20 of gestation. In the meantime, the average hepatocyte volume is multiplied by 1.5 between days 12 and 20. The volumetric fraction of hepatocytes increases from 35% of the volumetric fraction of the liver on day 12 to 66% on day 20 of gestation. The non-hepatocyte cells decrease from 49% on day 12 to 25% on day 20. By days 12 and 13, the rough endoplasmic reticulum and the Golgi apparatus are well differentiated, indicating that young fetal hepatocytes are able to synthesize and export plasma proteins. The volumetric fraction of free ribosomes decreases from 38% of the hepatocytic cytoplasm on days 12 and 13 to 6% on day 20. The mitochondrial compartment occupies about 10% of the hepatocyte cytoplasm. The mitochondria, small and round on days 12, 13 and 14, become oblong from day 18 of gestation. The shape of hepatocytes changes during the prenatal development, from potato-like on days 12, 13, 14 to cubic on day 20, with an intermediate, more spheric, stage on day 18.

Animals↗
PubMed1988

[Diagnostic chorionic biopsies in the first trimester. Report of experiences over a 2 year period].

We report about 58 ultrasonographically guided transcervical chorionic villus biopsies from January 1985 to November 1987. Maternal age greater than 35 years (n = 28), followed by trisomy 21 or 18 (n = 10) were the mean indications. Biochemically evaluation of storage diseases (n = 6) and genomically DNA-analysis because of phenylketonuria (n = 2) were combined in each case with cytogenetic diagnosis. In the other cases certain indications were the reasons for biopsy. In 52 of 58 cases we were successful in biopsies and diagnoses. In the other 6 biopsy specimen we didn't found chorionic villi. 3 abortions we observed up to day 3 after operation (n = 3) and after 6 weeks (n = 1). Pathological findings were 1 trisomy 16, 1,47,XYY-karyotype and 1 embryo with phenylketonuria. Another reason for termination of pregnancy was male karyotype in a Morbus Duchenne-risk and 1 risk for Rett-syndrome. Meanwhile 30 healthy babies were born.

Adult↗
PubMed1986

The effect of dexamethasone on transferrin secretion by cultured fetal rat hepatocytes.

Cultured fetal rat hepatocytes derived from 12, 15 and 19-day gestation rats are capable of secreting transferrin. When dexamethasone is added to the medium an increased secretion rate is observed. The changes in secretion rates in control as well as dexamethasone-treated cells during culture have been shown to correlate with the level of mRNA coding for transferrin. Immunocytochemical experiments show that initially all hepatocytes contain transferrin which is localized in the lumina of the perinuclear space, rough endoplasmic reticulum and in the saccules and vesicles of the Golgi apparatus. During culture, particularly in control cells, the intensity of labelling varies from cell to cell. In addition, adjacent cells are observed to label more intensely in different intracellular organelles.

Animals↗
PubMed1979

[Ultrastructural demonstration of transferrin synthesis in the adult rat liver].

An ultrastructural immunoenzymatic study allowed us to demonstrate in Rat adult hepatocytes the presence of transferrin on the rough endoplasmic reticulum and in the Golgi apparatus. Such localizations suggest that the different steps of transferrin synthesis could possibly be related topographically to them. These results further an approach to the problems of maturation and secretion of transferrin.

Animals↗
PubMed1979

Demonstration of the simultaneous presence of transferrin, hemopexin and albumin in the same adult rat hepatocyte.

The location of three plasma proteins (transferrin, hemopexin, and albumin) in hepatocytes was investigated in adult rats. The synthesis of transferrin anf hemopexin has been established by ultrastructural studies showing a labeling of the rough endoplasmic reticulum (RER). By using an indirect immunoenzymatic method with monospecific antibody solutions, the three proteins were detected in the same hepatocyte. The simultaneous presence of different plasma proteins in hepatocytes seems to point to the fact that the synthesis in these cells could be a non-specialized type.

Animals↗
PubMedDate not supplied

The dual nature of lateral eye movements.

This study investigated the validity of lateral eye movements (LEM) as a measure of the individual differences and task demands aspects of LEM by comparing eye movements to information questions that had no clear hemispheric locus with eye movements to rhyme questions that demanded specific left hemisphere involvement. Fifty subjects were asked to respond to the two types of questions and the initial direction of their eye movement was recorded. The results indicated that LEM are a reliable measure of individual differences because both test-retest and split half reliabilities were high (.78 to .85). LEM were also shown to be responsive to task demands. The number of leftward LEM did not differ from rhyme and information questions, but there were more rightward LEM and fewer stares to the rhyme question. These results suggest that LEM are a reliable individual difference measure and are sensitive to task differences. There is clear evidence that LEM have neuropsychological implications, but every task demands the integrated functioning of the whole brain and these implications should not be overgeneralized.

Adolescent↗