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Biomedical subjects

M Zuber

Publications and source records attributed to M Zuber.

At least 199 records · Page 11Linked to original sources
PubMed1989

[Emergency coronary dilatation in acute myocardial infarct with contraindications to thrombolytic therapy: salvage of the myocardium by early intervention].

In 1986/87, emergency-PTCA in acute myocardial infarction was performed in 13 patients in whom thrombolysis was contraindicated. All infarct-related arteries could be opened with PTCA. Patency rate after one week was 94%. Reopening of the vessel resulted in immediate cessation of ischemic chest pain and in stable cardiac rhythm and hemodynamics. Prior cardiopulmonary resuscitation and/or cardiogenic shock did not influence short- or longterm outcome. In nine of eleven patients an improvement of left ventricular function was found after four to six months as compared to one to four weeks after PTCA. The functional result proved to be better if PTCA was performed early; PTCA within 90 minutes was associated with normal left ventricular function. Thus, PTCA is feasible as an emergency procedure in patients with acute myocardial infarction and contraindications to thrombolysis. It can salvage myocardium and improve or prevent severe infarct complications when performed early after onset of pain. Rapid hospital admission through the primary care physician importantly influences the outcome for these patients.

Adult↗
PubMed1989

[Implantable catheter systems. Experience with 205 patients].

In a five-year period (1983-1988) catheters were implanted in 205 patients (118 venous, 31 peritoneal, 29 arterial, 25 epidural and 2 pleural), using the same system (Port-a-Cath). Total implant duration was 88,345 patient days (242 patient years). On average there was one catheter complication per 2000 patients days. The only catheter-system infections occurred with peritoneal catheters. This relatively low complication rate was probably due to the use of only one system, a uniform implantation technique practised by only three surgeons, and strict postoperative supervision by the oncology nursing team.

Adolescent↗
PubMed1989

Quantitation and subcellular localization of proliferating cell nuclear antigen (PCNA/cyclin) in oocytes and eggs of Xenopus laevis.

Proliferating cell nuclear antigen (PCNA/cyclin) is a 36-kDa polypeptide present in the nuclei of mitotically active cells. It is known to be involved in DNA replication through an association with DNA polymerase delta. We examined the total content as well as the subcellular distribution of PCNA in the oocyte and the egg of Xenopus laevis by employing immunocytological staining and immunoblot analysis. While oocytes are not capable of replicating chromosomes, PCNA is abundant in the nucleus (about 65 ng per nucleus). The oocyte cytoplasm, on the other hand, does not contain a significant quantity of this protein. The amount of total PCNA does not change appreciably during oocyte maturation and the subsequent stages of egg cleavage. Thus, PCNA belongs to a class of proteins which are stockpiled during oogenesis in order to be utilized later for early embryogenesis.

Animals↗
PubMed1989

Peripheral neuropathy, coagulopathy and nodular regenerative hyperplasia of the liver in a patient with multiple serologic auto-antibody activities and IgM B-cell lymphoma.

A patient with IgM-secreting B-cell lymphoma developed demyelinating peripheral neuropathy, nodular regenerative hyperplasia of the liver, coagulopathy, and terminal miliary lymphomatous spreading. Serologic auto-antibody activities directed against myelin associated glycoprotein, prothrombinase complex (i.e. lupus anticoagulant) and smooth muscle cells were detected. It is suggested that there is a link between the IgM gammopathy, the immunological abnormalities and the various clinico-pathological conditions.

Autoantibodies↗
PubMed1989

Involvement of proliferating cell nuclear antigen (cyclin) in DNA replication in living cells.

Proliferating cell nuclear antigen (PCNA) (also called cyclin) is known to stimulate the activity of DNA polymerase delta but not the other DNA polymerases in vitro. We injected a human autoimmune antibody against PCNA into unfertilized eggs of Xenopus laevis and examined the effects of this antibody on the replication of injected plasmid DNA as well as egg chromosomes. The anti-PCNA antibody inhibited plasmid replication by up to 67%, demonstrating that PCNA is involved in plasmid replication in living cells. This result further implies that DNA polymerase delta is necessary for plasmid replication in vivo. Anti-PCNA antibody alone did not block plasmid replication completely, but the residual replication was abolished by coinjection of a monoclonal antibody against DNA polymerase alpha. Anti-DNA polymerase alpha alone inhibited plasmid replication by 63%. Thus, DNA polymerase alpha is also required for plasmid replication in this system. In similar studies on the replication of egg chromosomes, the inhibition by anti-PCNA antibody was only 30%, while anti-DNA polymerase alpha antibody blocked 73% of replication. We concluded that the replication machineries of chromosomes and plasmid differ in their relative content of DNA polymerase delta. In addition, we obtained evidence through the use of phenylbutyl deoxyguanosine, an inhibitor of DNA polymerase alpha, that the structure of DNA polymerase alpha holoenzyme for chromosome replication is significantly different from that for plasmid replication.

Animals↗
PubMed1989

Incidence of arrhythmias and myocardial ischaemia during haemodialysis and haemofiltration.

Thirty-two patients (10 male, 22 female; age 37-82 years) undergoing maintenance haemodialysis or haemofiltration were studied by means of Holter device capable of simultaneously analysing rhythm and ST-changes in three leads. Twenty-five patients were on haemodialysis, seven on haemofiltration, mean duration of haemodialysis/haemofiltration being 3.4 +/- 3 years. Incidence of ventricular tachycardia was low, being detected only in 1 of 32 patients. Ventricular premature beats in excess of 10/h during a period of 2 h were found in 8 of 32 patients and 100 supraventricular premature beats for 2 h or more in 4 of 32 patients. Both ventricular premature beats and supraventricular premature beats were most frequently recorded during the last hour of haemodialysis/haemofiltration. ECG signs of ischaemia were detected in eight patients, four of whom were asymptomatic. Ischaemia also occurred predominantly during the last hour of haemodialysis/haemofiltration. Two symptomatic patients displayed neither arrhythmias nor ST-changes while being monitored. The study shows that silent ischaemia and arrhythmias in patients undergoing chronic haemodialysis/haemofiltration may not be infrequent. Recognition of these events could be of importance in the management of these patients.

Adult↗
PubMed1989

[Antibiotic prophylaxis in colon surgery: cefazolin (Kefzol- ornidazole (Tiberal) versus cephazolin-placebo].

A prospective, randomized, double-blind and controlled clinical trial of systemic antibiotic prophylaxis with Cefazolin and Ornidazol (CO) versus Cefazolin and Placebo (CP) was carried out consecutively in 100 patients undergoing elective, colorectal surgery. The incidence of wound infection in the CP-group was 20% (n = 10) and in the CO-group 8% (n = 4) (p less than 0.10 ns). The reduction of anaerobic bacterias from 20% (n = 10) in the CP-group to 0% (n = 0) (CO) was significant (a1 = 0.0139; a2 = 0.0277 s, Fischer's exact test). The time of hospitalization was reduced from 20.3 days (CP) to 16.7 days (CO) (p less than 0.05 s). The agent for antibiotic prophylaxis in elective colorectal surgery is to cover the spectrum of anaerobic bacterias.

Adolescent↗
PubMed1988

[Acute myocardial infarct in patients under 30 years old].

Between 1980 and 1985 nine patients under the age of 30 were admitted to our hospital with acute myocardial infarction. They represented 4% of all patients with acute myocardial infarction. Coronary angiography was performed in 8 patients and in a high proportion (5 patients) no stenotic lesion was found. In these patients, vasospasm seems to be the most likely pathogenesis. In one patient no angiography was performed; he had stopped anticoagulation therapy after aortic valve replacement and therefore coronary embolism was the obvious reason for the infarct. After a median of 5 years (2-7) no patient had died or had suffered a new coronary event. The 5 patients with angiographically normal coronary arteries had ceased taking medication and were all back to work full time. Psychological evaluation showed impaired ability to express aggression in all 9 patients.

Acute Disease↗
PubMed1988

[MTBE litholysis and extracorporeal shock wave lithotripsy of gallstones].

Two new therapies for cholesterol gallstones, MTBE litholysis and extracorporeal shock-wave lithotripsy, have been developed and clinically tested in the last five years. In principle MTBE litholysis is applicable in 50-80% of gallstone patients and shock-wave lithotripsy in 25-30%. In MTBE litholysis a pigtail catheter is placed in the gallbladder by the percutaneous-transhepatic route using ultrasound-guidance. The gallstones can than be dissolved with the cholesterol contact solvent MTBE (methyl tert-butyl ether). With appropriate selection criteria the successful dissolution rate is 80-90%. Over 99% of radiolucent gallstones (1-3 stones per gallbladder) can be fragmented by extracorporeal shockwaves. Bile acids must be administered as adjuvant litholytic therapy, and thus the remaining fragments can be dissolved in 91% of cases within 2-18 months. In view of the limited experience with these procedures at the present time they are mainly indicated for symptomatic surgical high-risk patients and for those who strongly wish to avoid surgery. With careful evaluation of study data a broader indication policy may be possible in the future. The new methods and the essential study data are presented.

Cholelithiasis↗
PubMed1988

Pharmacokinetics of cyclosporine G in patients with renal failure.

The pharmacokinetics of the cyclosporine A (CsA, Sandimmune) analogue Nva2-cyclosporine, or cyclosporine G (CsG) was investigated in 6 patients with terminal renal failure after a 4-hr intravenous infusion (3.5 mg/kg) and after oral administration (600 mg) of the drug. Blood samples were collected up to 38 hr and CsG concentrations were measured by radioimmunoassay and high-performance liquid chromatography. The resulting pharmacokinetic parameters of CsG were similar to those described for CsA in the same patient population. Based on HPLC determinations, a mean terminal elimination half-life of 18.9 hr was calculated. The total body clearance was 0.55 L/hr/kg, the volume of the central compartment was 0.32 L/kg, and the steady-state volume of distribution was 5.97 L/kg. After oral administration maximum CsG concentrations in blood were reached between 2.5 and 3 hr, and the bioavailability was in the range of 24-55% (mean 36%). The ratios between the polyvalent RIA and HPLC determinations were considerably larger after oral dosing than after i.v. infusion. The blood-to-plasma ratio was 1.23, which is smaller than that observed for CsA. These results suggest that in patients undergoing renal transplantation the same dosing strategies can be applied for CsG as have been established for CsA.

Adult↗
PubMed1988

[Dysglobulinemic neuropathies].

Monoclonal gammopathies are frequently associated with peripheral neuropathies of which clinical, electrophysiological, pathological and possibly pathogenetical aspects are heterogeneous. Nevertheless some clinico-biological entities, which account for the majority of cases, have been recently recognized: 1) The IgM neuropathy is a chronic demyelinating sensori-motor polyneuropathy with tremor and ataxia as prominent features. It can be either associated with MGUS or Waldenstrom macroglobulinemia. The light chain of the gammopathy is kappa in a majority of cases. Numerous reports have demonstrated specific antibody activities supported by the M-protein and directed against various peripheral nerve antigens, usually myelin components such as the myelin associated glycoprotein (MAG). The ultrastructural evidence of widely spaced myelin is suggestive of the diagnosis but is not consistent. Treatment directed towards the gammopathy is occasionally associated with improvement of the symptoms. 2) The neuropathy of the osteosclerotic myelomas and solitary plasmacytomas present as a chronic sensori-motor polyradiculoneuropathy with conspicuous demyelination and may be associated with one or more of the systemic clinical features of the Crow-Fukase or POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin changes). The POEMS syndrome may also be associated with "benign" monoclonal or even polyclonal dysproteinemias. The M-proteins are almost all IgG or IgA with lambda light chains. There are some relations between POEMS syndrome and Castleman's disease. The pathogenesis of both disorders remains obscure. Treatment is most favorable in case of solitary plasmacytomas, which may be completely removed. 3) The neuropathy observed in patients with primary AL amyloidosis or amylosis associated with malignant plasma-cell dyscrasias is rare. Sensory deficit and autonomic dysfunction are related to a prominent involvement of small myelinated and unmyelinated fibers. A clinical and/or electro-physiological carpal tunnel syndrome is frequent. In a majority of cases the light chain of the M-protein is lambda. Amyloid deposits are observed on nerve biopsy. Treatment is inefficient. 4) The neuropathy associated with cryoglobulinemias may be asymmetric, painful, cryosensitive and associated with cutaneous purpura and neuromuscular vasculitis. In fact, in a majority of cases the symptoms are less suggestive raising the problem of an incidental laboratory finding. 5) A motoneuron disease-like syndrome may develop in patients with various types of monoclonal gammopathies.(ABSTRACT TRUNCATED AT 400 WORDS)

Amyloidosis↗