Biomedical subjects
R Becker
Publications and source records attributed to R Becker.
Serum T4, T3 and TBG concentrations during puberty in males.
Measurements of serum thyroxine (T4), thyroxine binding globulin (TBG), and triiodothyronine (T3), using RIA, were conducted in healthy Israeli boys, 149 children from the age 8 years were divided into five groups according to Tanner's puberty stages. The correlation with Tanner's staging showed a significant decrease in T4 and TBG concentrations during puberty. However, T3 decreased only toward the last stage of puberty (between P4 to P5). Our data indicate that during puberty in male subjects the decrease in TBG plays a significant role in the decrease of thyroid hormone concentrations.
Diagnostic and therapeutic aspects of multiple sclerosis in urology: use of urodynamic methods of investigation.
Multiple sclerosis, one of the commonest neurological diseases, is associated in a large number of cases with micturition disorders in both its early stage and its later course. Urological complications play a decisive part in mortality. Urodynamic methods have greatly contributed to the diagnostic spectrum in this disease by permitting to demonstrate and classify neurogenic disorders of bladder function and providing the neurologist with closer information on the sites of the lesion. They are also apt to confirm diagnostic conjectures and may help to adapt the therapeutic measures to the special situation.
Effect of induced erythrocythemia on hypoxia tolerance during physical exercise.
The effect of induced erythrocythemia on hypoxia tolerance during physical exercise was determined for five male mountain climbers. Treadmill testing was performed under four conditions: 1) prereinfusion, normoxia (Pre-N); 2) prereinfusion, hypoxia (Pre-H); 3) postreinfusion, normoxia (Post-N); and 4) postreinfusion, hypoxia (Post-H). An altitude of 3,566.2 m was simulated by having subjects breath a gas mixture of 13.5% O2-86.5% N2 at normal barometric pressure. Tests were administered immediately before and 24 h after autologous transfusion of 750 ml of red blood cells. Hematocrit increased from 43.3% at prereinfusion to 54.8% at postreinfusion. Hemoglobin concentration increased from 13.80 g X 100 ml-1 at prereinfusion to 17.63 g X 100 ml-1 at postreinfusion. Maximal O2 uptake (VO2 max, 1 X min-1) increased (P less than 0.05) by 12.8% (3.28 to 3.70) from Pre-N to Post-N and 13.0% (2.62 to 2.96) from Pre-H to Post-H. Treadmill performance time (s) increased (P less than 0.05) by 15.8% (793 to 918) from Pre-N to Post-N and 8.9% (687 to 748) from Pre-H to Post-H. VO2 max decreased by 20.1% from Pre-N to Pre-H and by 9.8% from Pre-N to Post-H. Treadmill time decreased by 13.4% from Pre-N to Pre-H and 5.7% from Pre-N to Post-H. The calculated change in hypoxia tolerance following reinfusion indicated that physiological altitude was improved by 463.6 m. It was concluded that induced erythrocythemia increased hypoxia tolerance during physical exercise.
[The etiology, course and prognosis of dilated cardiomyopathy].
UNLABELLED: In order to study the etiology, the clinical course and the prognosis of patients with DCM, clinical, morphological (endomyocardial catheter biopsy), angiographic and hemodynamic data of patients with DCM were studied. The total number of patients was 396. In 258 patients definite DCM was diagnosed, in 138 patients DCM was suspected, e.g., because of an additional history of alcoholism. ETIOLOGY: In no case acute subacute or chronic myocarditis was found in myocardial biopsies (n = 114) and at autopsy (n = 18). However, from the history strong evidence was obtained for DCM being the late stage of diphtheric heart disease predominantly among patients with complete left bundle branch block. As far as the alcoholic etiology is concerned, the only significant difference between DCM and alcoholic heart disease was a higher proportion of women among patients with DCM (28% and 5%, resp.). Clinical course and prognosis: 221 patients were studied prospectively (mean follow-up time 3.1 +/- 2.3 years), 44% of patients died or deteriorated. However, in patients with normal cardiothoracic ratio this rate amounted only to 12%. The mean annual mortality rate was 9.8% and varied significantly in relation to different subsets of patients from 0% to 17%. A bad prognosis was significantly indicated by young age, high cardiothoracic ratio, pronounced elevation of enddiastolic volume index and of left ventricular enddiastolic pressure at rest and of mean pulmonary artery pressure at exercise, by severe morphologic changes of myocardial biopsies, severe ventricular arrhythmias, the absence of transient abnormal elevation of arterial blood pressure during follow up, of complete left bundle branch block and of a positive history of diphtheria. However, the wide scatter of data diminished the significance of them for the definite prognostic evaluation of individual case. The cumulative survival curves of patients with a history of alcohol abuse did not differ from that of patients with DCM. The data demonstrate that DCM in patients with the history of diphtheria together with left bundle branch block is possible caused by an inflammatory process. According to the analysis of the clinical course and the prognosis, DCM is one of the most severe heart disease. However, in different subsets of patients, the clinical course may be stable for long time and even normal longevity cannot be excluded.
Influence of prostacyclin on regional blood flow distribution in anesthetized dogs.
Prostacyclin (PGI2), a major metabolite of arachidonic acid, is widely distributed throughout the cardiovascular system and may influence vascular smooth muscle tone. To evaluate the effects of PGI2 on regional blood flow distribution in anesthetized dogs, the tracer microsphere reference sample method was used. Intravenous PGI2 infusions (0.5 and 1.0 microgram/kg/min) increased renal, adrenal, splenic, small intestinal, brain and pituitary blood flow, whereas pancreatic, fundic and skeletal muscle perfusion were diminished by PGI2. Hepatic and myocardial blood flow remained unchanged. This study demonstrates striking differences in regional vascular sensitivity to PGI2, which should be kept in mind when evaluating the potential therapeutic usefulness of PGI2 in a variety of clinical situations.
The metabolic fate of supidimide in the rat.
The absorption, metabolism and excretion of 3-(2,3-dihydro-1,1-dioxido-3-oxo-1,2-benzisothiazol-2-yl)-2-oxopiperidine (supidimide) in the rat are investigated. Following oral administration of 35S-labelled supidimide (12.5 and 25 mg/kg), the radioactivity is rapidly absorbed and excreted almost quantitatively within 72 h. 85% of the radioactivity administered is recovered from urine. In the faeces a further 14% is found predominantly resulting from biliary excretion. Excretion rates of urinary radioactivity show a 2-phase course with half-lives of 2.6 h and 10 h. Unchanged supidimide is eliminated with a half-life of 2.1 h. A total of 10 metabolites are identified in urine, faeces or in vitro systems and quantified. Identification of the metabolites is achieved by co-crystallization or co-chromatography with synthetic reference compounds, chemical analysis, mass spectrometry or combinations of these techniques. The pattern of metabolites observed in vivo and in vitro studies reveal that supidimide is primarily oxidized in the piperidone moiety of the molecule by the microsomal drug metabolizing system. Largely spontaneous hydrolysis of preexisting or newly formed carbonamide bonds gives rise to the variety of metabolic products. Hydrolysis of the sulfonamide bond and oxidation of the benzene moiety are not detectable. Only after subchronic treatment with an elevated dosage of supidimide (greater than or equal to 150 mg/kg) is a reversible induction of cytochrome P-450 observed.
Sudden death due to cuspal dehiscence of the Ionescu-Shiley valve in the mitral position.
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[Primary therapy of breast cancer].
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[Mistletoe therapy in modern cancer treatment?].
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Non-invasive detection of late potentials in man--a new marker for ventricular tachycardia.
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Extracellular androgen binding proteins.
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[Discussion comment on R. Will's article, "Wound Sealing and Clot Stabilization with Human Fibrin Adhesive in Oral Surgery", Dtsch. zahnärztl. Z. vol. 36, 74-8 (1981)].
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[Chronic apical periodontitis: borderland between surgical and conservative treatment].
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[Non-invasive recording of late ventricular potentials--methodology and first clinical experiences (author's transl)].
Late potentials occurring after the QRS complex were searched for from the body surface using high-gain amplification and signal-averaging techniques with filter settings between 100 and 300 hz at a sampling rate of 10 khz. The number of repetitions of the averaging process ranged between 150 and 300. 52 patients were studied. In 11 control subjects, no late potentials were detected within the ST segment. Late potentials were observed in 3/27 patients without previously documented ventricular tachycardia, all having left ventricular aneurysms. All three patients had evidence of increased ventricular vulnerability (one dying from ventricular tachycardia, one with stimulus-inducible ventricular tachycardia, one with multiple episodes of ventricular fibrillation after surgery). In patients with previously documented ventricular tachycardia and/or fibrillation, late potentials occurred in 7/14 cases (50%), mainly in those with aneurysms (6/8 pts = 75%). Mean onset of late potentials after the QRS complex was 38 +/- 20.1 ms, mean amplitude was 3.9 +/- 2.0 uV, and mean duration was 17.1 +/- 5.4 ms. We conclude that late potentials, which represent late depolarization of a mass of ventricular tissue after slow conduction, herald increased susceptibility to ventricular tachycardia mainly in patients with ventricular aneurysms.
[Morphological and stereological examinations of placenta of patient with unruptured tubal pregnancy at full term (author's transl)].
Optimum conditions for foetal life were recorded from morphological and stereological findings obtained from a patient at full-term tubal pregnancy. Basiotrophic implantation, no reduction of chorion frondosum, large placental exchange surface, and extremely good capillarisation of chorionic villi proved to be the conditions for survival of the child.
[The general practitioner and the psychiatric emergency].
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The demonstration of vegetations by echocardiography in bacterial endocarditis. An indication for early surgical intervention.
The visualization of vegetations by M-mode echocardiography in patients with infective endocarditis has been suggested to imply a poor prognosis regarding the development of major systemic emboli, congestive heart failure and the need for early surgical intervention. The question of using the finding of vegetations by echocardiography as an indication for surgery is controversial. To answer this question, 30 patients with the clinical diagnosis of endocarditis were studied by echocardiography. In 17 of the 30 (57 per cent) vegetations were present (aortic eight, mitral four, both mitral and aortic five), whereas in 13 (43 per cent) no vegetations were visualized. Infecting organisms were similar in each group; Streptococcus viridans being the most common. The patients with echocardiographically demonstrable vegetations had a higher incidence of congestive heart failure compared to the patients without (14 of 17 versus six of 13, p less than 0.05), major emboli (eight of 17 versus two of 13, p = NS) and need for valve surgery (17 of 17 versus two of 13, p less than 0.001). Mortality was not significantly different in the two groups (six of 17 versus three of 13, p = NS). Urgent or emergency surgery was required in 16 of 17 patients with vegetations. Thus, the demonstration of vegetations by echocardiography identified a subset of patients with more severe disease in whom early operative intervention was required.