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Biomedical subjects

R Hauser

Publications and source records attributed to R Hauser.

At least 37 records · Page 2Linked to original sources
PubMed2001

A randomized, controlled trial of remacemide for motor fluctuations in Parkinson's disease.

BACKGROUND: Preclinical studies suggest that glutamate antagonists help ameliorate motor fluctuations in patients with PD treated with levodopa. METHODS: In a multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-ranging study, the authors assessed the safety, tolerability, and efficacy of the glutamate receptor blocker remacemide hydrochloride in 279 patients with motor fluctuations treated with levodopa. The primary objective was to assess the short-term tolerability and safety of four dosage levels of remacemide during 7 weeks of treatment. Patients were also monitored with home diaries and the Unified PD Rating Scale (UPDRS) to collect preliminary data on treatment efficacy. RESULTS: Remacemide was well tolerated up to a dosage of 300 mg/d on a twice daily schedule and 600 mg/d on a four times daily schedule. The most common dosage-related adverse events were dizziness and nausea, as observed in previous studies of remacemide. The percent "on" time and motor UPDRS scores showed trends toward improvement in the patients treated with 150 and 300 mg/d remacemide compared with placebo-treated patients, although these improvements were not significant. CONCLUSION: Remacemide is a safe and tolerable adjunct to dopaminergic therapy for patients with PD and motor fluctuations. Although this study had limited power to detect therapeutic effects, the observed improvement is consistent with studies of non-human primates with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced parkinsonian signs and symptoms. Additional studies are warranted to confirm these results over an extended period of observation, and to explore the potential neuroprotective effects of remacemide in slowing the progression of PD.

Acetamides↗
PubMed2001

A prospective study of lung function among boilermaker construction workers exposed to combustion particulates.

BACKGROUND: Given the evidence of both acute cross-shift and short-term decrements in lung function in boilermaker construction workers following occupational exposure to combustion particulates, we sought to determine whether exposure is associated with an annual loss in lung function. METHODS: As part of an ongoing investigation, we conducted a 2-year longitudinal study of lung function among 118 boilermakers. Exposure was assessed with a work history questionnaire. Spirometry measurements were performed annually. RESULTS: We found an association between annual FEV(1) and hours worked at a gas-fired plant during the previous year, beta = - 9.8 mls/100 hours worked (95% CI: - 16.0, - 3.5) after adjustment for age, baseline FEV(1) and cigarette smoking status. The adjusted association between FEV(1) and "ever" worked at a gas-fired plant was - 99.7 mls (95% CI: - 154.8, - 44.5). There was also evidence of a negative association between FEV(1) and "ever" worked and hours worked at oil and coal-fired plants. CONCLUSIONS: These data suggest an association between annual lung function loss and working at gas, coal and oil-fired plants. Further follow-up of this cohort of boilermakers is in progress.

Adult↗
PubMed2001

Spontaneous volume changes in gastric banding devices: complications of a semipermeable membrane.

The goal of this study was to prove that adjustable laparoscopic gastric banding (LAP-BAND) is semipermeable and that luminal adjustment with saline leads to spontaneous fluid loss, luminal widening, and effect loss which makes repeated readjustments necessary. In 64 patients stoma adjustment was performed with saline according to the guidelines of the manufacturer (group 1). In 32 patients hyperosmolar contrast material was used for stoma readjustments with the intention to detect a system leakage after spontaneous fluid loss and spontaneous luminal widening was observed (group 2). After spontaneous luminal narrowing had occurred in group 2, all patients from group 2 and all additional patients (n = 148) underwent stoma (re-) adjustment with iso-osmolar contrast material (group 3). Spontaneous fluid changes which led to spontaneous changes of the luminal width were then analyzed for the different filling substances in each group. Fifty-two patients from group 1 presented with effect loss because a spontaneous luminal widening had occurred secondary to a fluid loss of 0.1-0.2 ml/month. All 32 patients from group 2 presented with increasing obstruction and food intolerance because a spontaneous luminal narrowing had occurred secondary to a spontaneous fluid gain of 0.1-0.3 ml/month. In our patients from group 3, where stoma adjustment was performed with iso-osmolar contrast material, no spontaneous fluid changes were observed and luminal width/degree of obstruction did not change. The LAP-BAND is semipermeable. Stoma adjustment should not be performed with saline in order to avoid spontaneous luminal widening and the need for repeated readjustments. Stoma adjustments with hyperosmolar contrast material are clearly contraindicated since osmotic fluid gain leads to increasing obstruction. Stoma adjustments should be performed using iso-osmolar filling media which provide a stable luminal obstruction.

Contrast Media↗
PubMed2001

Vascularity index distribution within the testis: a technique for guiding testicular sperm extraction.

Azoospermia is defined as the absence of spermatozoa in the ejaculate, although some foci of spermatogenesis may exist in the testes of these men. Currently, there are no clinical, seminal or hormonal parameters for identifying spermatogenesis within the testis sufficient for achieving genetic offspring. As a result, multiple biopsies are performed at several arbitrary sites of both testes in search of spermatozoa. We developed a power Doppler (PD) ultrasound (US) image-based technique that predicts sites with the greatest potential for spermatogenesis. PDUS images of the testes of azoospermic men were acquired at seven cross-sections to reconstruct a 3-D matrix for constructing a spatial map of preferential regions where spermatozoa are most likely to exist. This technique may obviate the need for arbitrary multiple biopsies that inflict some degree of damage upon testicular tissue, and may increase the success rate of identifying viable spermatozoa in testicular biopsies.

Biopsy↗
PubMed2001

Intrauterine insemination in male factor subfertility: significance of sperm motility and morphology assessed by strict criteria.

The study was conducted to evaluate the results of IUI treatment in a homogenous group with male factor infertility, and to assess the correlation of sperm variables, including sperm morphology by strict criteria, with pregnancy achievement after IUI. A total of 108 couples with no apparent female aetiology for infertility underwent 264 intrauterine insemination treatment cycles. A comparison was made between the sperm variables in two groups in which the achievement of pregnancy differed. The percentage of motile spermatozoa, degree of motility and normal morphology (by strict criteria) were significantly higher in the pregnant group compared with that of the nonpregnant group. A significant difference in pregnancy rates per couple after intrauterine insemination was demonstrated among three groups according to the percentage of sperm morphology, i.e. poor (< 4%), fair (4-14%) or good (> 14%) (11.1%; 36.1% and 50.0%, respectively). Intrauterine insemination is a valid mode of treatment in cases with male infertility, provided that normal morphology by strict criteria is higher than 4%.

Adult↗
PubMed2001

Feasibility and initial results of an Internet-based pacemaker and ICD pulse generator and lead registry.

The medical community has no independent source of timely information regarding the performance of pacemaker and ICD pulse generators and leads. Accordingly, the authors established an Internet-based registry of pacemaker and ICD pulse generator and lead failures (www.pacerandicregistry.com). During the first year, they found three previously unreported device problems that were promptly communicated to the participants. Of the failures reported, 11% of ICD and 10% of pacemaker pulse generator failures were heralded by signs other than the expected elective replacement indicator (ERI). Average ICD battery longevity was 4.0 +/- 0.7 years, and average dual chamber pacemaker battery longevity was 6.8 +/- 2.6 years. Disrupted insulation accounted for 54% of pacemaker and 29% of ICD lead failures. Compared to pacemaker pulse generator and lead failure, ICD device failures were more likely to cause severe clinical consequences. In conclusion, an Internet-based registry is feasible and capable of providing timely data regarding the signs, causes, and clinical consequences of pacemaker and ICD failures.

Canada↗
PubMed2001

The contribution of RNA-binding motif (RBM) antibody to the histopathologic evaluation of testicular biopsies from infertile men.

Testicular biopsies of infertile men are often characterized by mixed histologic patterns, with different types of spermatogenic impairments being found in adjacent seminiferous tubules. RNA-binding motif (RBM) is a nuclear protein expressed exclusively in the male germ cell line. We reasoned that RBM might be a useful marker to identify germ cells in testicular sections, particularly in biopsies with mixed histologic phenotype and small focal concentrations of spermatogenesis. Testicular biopsies from azoospermic men were immunohistochemically evaluated for RBM expression. RBM expression was detectable in spermatogonia, spermatocytes, and round spermatids in biopsies of men with obstructive azoospermia and normal spermatogenesis. No specific cell staining was shown in cases of Sertoli-cell-only (SCO) syndrome. In biopsies of patients with spermatogenic disorders, all the germ cells were stained up to and including the stage level of the arrest in spermatogenesis. This approach enabled identification of small focal concentrations of spermatogenesis in a biopsy previously classified as being SCO by hematoxylin and eosin staining. Thus, RBM can be a useful immunohistochemical marker for the specific identification of germ cells and provide greater accuracy in the histopathologic evaluation of testicular biopsies.

Antibodies↗
PubMed2001

Results of 6139 artificial insemination cycles with donor spermatozoa.

BACKGROUND: Artificial insemination by donor spermatozoa (AID) can prove a valuable treatment for a number of male factor disorders, although its success rate is variable. METHODS: Retrospective analysis of the results of 6139 cycles performed in 1001 women during an 18 year period is presented. Pregnancy rates per cycle are presented as a function of: female fertility history, treatment modalities, medication used for induction of ovulation, female age, year of treatment, consecutive cycle effect and the use of fresh versus frozen-thawed spermatozoa. RESULTS: Overall pregnancy rate of 12.6% and cumulative pregnancy rate after 12 months of treatment of 75% were achieved. Age was found to be the most important determinant for success rate. CONCLUSIONS: Since the establishment of AID treatments, the mean age of the population of women receiving treatment has increased each year. Consequently, success rate did not improve, even with the use of more sophisticated medical modalities.

Abortion, Spontaneous↗
PubMed2001

The effects of laparoscopic adjustable gastric banding on the proximal pouch and the esophagus.

BACKGROUND: Pouch development is a potentially serious problem following gastric banding, and reoperation is often demanded to maintain long-term function of the lap band. Laparoscopic gastric banding was performed with two different calibrations of the pouch. Within a period of 12 months, postoperative pouch behavior with regard to volume and shape was evaluated retrospectively, as were changes in the distal esophagus. METHODS: The pouches of 14 patients with intraperitoneal band positioning were calibrated at 25 ml. The volumes of 54 patients operated by a suprabursal technique were set at 15 ml. We performed three radiological examinations and calculated the volumes using the ellipsoid formula d1 x d2 x d3 x pi/6. Four morphologically different pouch types have been observed: regular, concentric, eccentric-medial and eccentric-lateral. The phi-angle corresponds to the angle between the spinal column and the gastric band. RESULTS: In the first group, the pouch volume increased from 21.2 ml +/- 21.2 to 87.9 ml +/- 64.6 (p=0.006) and the BMI fell from 47.1 kg/m2 +/- 8.4 to 38.1 kg/m2 +/- 7.0 (p=0.001). The pouch volume of the second group increased from 10.4 ml +/- 5.8 to 38.8 ml +/- 29.1 (p<0.001), and the BMI reduced from 48.4 kg/m2 +/- 6.9 to 39.3 kg/m2 +/- 6.7 (p<0.001). If the phi-angle is smaller than 4 degrees, the pouch is of the eccentric-medial type. CONCLUSIONS: The transbursal operative technique is responsible for the development of the eccentric-medial pouch. If the anterior sero-muscular fixative sutures tear, an eccentric-lateral pouch results. All pouch types are affected by changes at the pouch-esophageal junction and by pathological developments in the distal and middle oesophagus.

Analysis of Variance↗
PubMed2001

[Alterations of the integument of fattening pigs in different housing systems].

Alterations of the integument of fattening pigs were investigated on a total of eleven farms with the following housing systems: "Krieger" system, fully slatted floors, partially slatted floors and kennel housing systems. For this purpose, the alterations of the integument of the animals were visually assessed at different times during fattening. In addition, spot investigations were carried out on three farms with deep litter systems. In the non-littered systems, significantly more changes at the limbs were observed than in the littered systems. The least damages occurred in the deep litter system. Similar as with cattle, soft and deformable lying areas seem to be a prerequisite for the prevention of such alterations. With respect to injuries caused by tailbiting, apart from possibilities of activity, other parameters such as air quality and space availability also play an important role.

Animals↗
PubMed2000

Behaviour and leg injuries in dairy cows kept in cubicle systems with straw bedding or soft lying mats.

In order to reduce straw input, soft lying mats are used increasingly instead of straw bedding in cubicle systems for dairy cows. This study aimed at comparing different types of soft lying mats with straw bedding regarding cow behaviour and leg injuries. Data were collected on five farms with straw bedding and on 13 farms using four types of soft lying mats consisting of different materials. On each farm, lying behaviour of 10 cows was recorded automatically during 3 days by means of a pneumatically operated resting sensor fitted in a belt. In addition, standing up and lying down behaviour of cows was quantified by direct observations, and all cows on a given farm were checked once for leg injuries.There were no significant differences between cows kept in cubicle systems with soft lying mats and straw bedding regarding the total time spent lying per day and the number of lying bouts per day. Standing up and lying down behaviour also did not differ between cows with access to soft lying mats and straw bedding. Leg injuries were most frequent in the tarsal and carpal joints. Cows kept in cubicle systems with soft lying mats had a significantly higher incidence of both hairless patches more than 2 cm in diameter (P<0.001) and scabs or wounds less than 2 cm in diameter (P<0.001) located in the tarsal joints than cows in cubicle systems with straw bedding. With the carpal joints, on the other hand, the incidence of leg injuries did not differ significantly between these two housing conditions. In conclusion, the results of this study indicate that soft lying mats are equivalent to straw bedding in terms of cow behaviour but less favourable with respect to leg injuries located in the tarsal joints.

Journal Article↗
PubMed2000

[Psychological comorbidity and quality of life of patients with morbid obesity and requesting gastric banding].

Bariatric surgical operations are well established in the treatment of morbid obesity. In this study, 79 consecutive applicants for laparoscopic gastric banding (60 females with a mean BMI of 47.4 kg/m2 and 19 males with a mean BMI of 48.9 kg/m2, mean age 39.6 years) were examined preoperatively by structured psychiatric interview and questionnaire. GOAL AND QUESTIONS: The aim of the study was to determine physical and psychological symptoms, specific eating problems, life satisfaction and incidence of psychiatric comorbidity, as well as the relations between psychological and psychosocial markers on the one hand, and demographic and somatic parameters on the other. RESULTS: Most patients displayed multiple somatic symptoms and diseases, in particular orthopaedic problems, exertion dyspnoea, hyperlipidaemia, hypertension, diabetes mellitus or sleep apnoea. The averages of all psychometric scales (General Symptomatic Index of Symptom Checklist [SCL-90-R], anxiety and depression states of the Hospital Anxiety and Depression Scale [HADS]) were higher than normal. General life satisfaction and satisfaction with health (FLZM) were low. Eating behaviour in both sexes was characterised by marked irritability, disinhibition and ravenousness. Binge eating was common, 27% reporting binges at least weekly and only 37% no binges at all. 46% were found to suffer from at least one psychiatric disorder, while half had an eating disorder with frequent bingeing and loss of control. 6.3% were diagnosed with atypical bulimia, 15.2% had an adaptational disorder and 10% a personality disorder. The HADS scales did not correlate with BMI or other somatic factors and the correlation between the SCL-90-R and BMI was low (r = 0.36, p = 0.01). However, patients with psychiatric disorders had significantly higher BMIs and higher averages on all scales except overall life satisfaction. There was no direct relation between psychosocial and sociodemographic variables (educational level, living alone). CONCLUSION: Morbidly obese patients desiring laparoscopic gastric banding display many physical and psychological symptoms with a higher preference for psychiatric (especially eating) disorders. Since there is no close relationship between psychosocial and somatic aspects in this group of patients, routine psychiatric evaluation appears to be of importance.

Adult↗
PubMed2000

Acute respiratory symptoms in workers exposed to vanadium-rich fuel-oil ash.

BACKGROUND: Occupational exposure to fuel-oil ash, with its high vanadium content, may cause respiratory illness. It is unclear, however, what early acute health effects may occur on the pathway from normal to compromised respiratory function. METHODS: Using a repeated measures design, we studied prospectively 18 boilermakers overhauling an oil-fired boiler and 11 utility worker controls. Subjects completed a respiratory symptom diary five times per day by using a 0-3 scale where 0=symptom not present, 1=mild symptom, 2=moderate symptom, and 3=severe symptom. Daily symptom severity was calculated by using the highest reported score each day for upper and lower respiratory symptoms. Daily symptom frequency was calculated by summing all upper or lower airway symptom reports, then dividing by number of reporting times. Respiratory symptom frequency and severity were analyzed for dose-response relationships with estimated vanadium and PM(10) doses to the lung and upper airway by using robust regression. RESULTS: During the overhaul, 72% of boilermakers reported lower airway symptoms, and 67% reported upper airway symptoms. These percentages were 27 and 36 for controls. Boilermakers had more frequent and more severe upper and lower respiratory symptoms compared to utility workers, and this difference was greatest during interior boiler work. A statistically significant dose-response pattern for frequency and severity of both upper and lower respiratory symptoms was seen with vanadium and PM(10) in the three lower exposure quartiles. However, there was a reversal in the dose-response trend in the highest exposure quartile, reflecting a possible healthy worker effect. CONCLUSIONS: Boilermakers experience more frequent and more severe respiratory symptoms than utility workers. This is most statistically significant during boiler work and is associated with increasing dose estimates of lung and nasal vanadium and PM(10).

Adult↗
PubMed2000

Online head motion tracking applied to the patient registration problem.

Image-guided systems for surgical procedures in the region of the head require a method to correlate the diagnostic image data with the corresponding site of pathology in the patient. Considering that patient movement can occur, detection and correction of such movement errors during the acquisition of images is a basic prerequisite for accurate treatment. For this reason, we developed a new registration method based upon on-line tracking of the patient's head to solve the problem of registration in the presence of head motion. The method provides non-invasive active patient registration for correction of movements during imaging and continuous update of the patient's head position during surgery. The patient motion correction applies the rigid body model to register the images using feature correspondence. The new registration method is described, and results of experiments that were performed to evaluate its accuracy and reliability in a plastic skull model and in patients are presented. The error analysis resulted in a final target registration error of 0.90 mm +/- 0.16 mm using experimental model data and 1.58 mm +/- 0.26 mm using clinical patient data. In addition, the residual registration error is modeled as a function of the measured and predicted head motion in order to determine the error that is introduced by motion tracking during image data acquisition. Furthermore, the clinical application of the method is demonstrated for oto-, rhino-, and neurosurgical procedures in the region of the head.

Algorithms↗
PubMed2000

Zona pellucida binding improvement effect of different sperm preparation techniques is not related to changes in sperm motility characterizations.

OBJECTIVE: To study the relation between changes in sperm motion characteristics and sperm binding capacity to the zona pellucida (ZP) after different sperm preparation techniques. DESIGN: Prospective study. SETTING: Andrology laboratory at the Lis Maternity Hospital. PATIENT(S): Sixty-three infertile men. INTERVENTION(S): In vitro preparation of 57 sperm samples by pentoxifylline (PTX), 38 samples by SpermPrep I (SP1), and 27 samples by mini-Percoll (mPER). Sperm preparation was evaluated in comparison with the control washing technique. MAIN OUTCOME MEASURE(S): Motility variables and binding capacity. RESULT(S): Binding capacity after PTX, SP1, and mPER preparation methods was significantly higher compared with the control medium preparation. Computer-assisted sperm analysis (CASA) of sperm motility revealed a significant increase in a number of variables after the different treatments. A statistically significant but low correlation was observed between sperm binding capacity after control swim-up preparation and VAP (r = 0.27) as well as with VSL (r = 0.30). No significant correlations were found between the changes in the CASA and the improved sperm binding to the ZP. CONCLUSION(S): The two biologic effects of binding capacity enhancement and motility features improvement are not related. Furthermore, because the binding assay is highly correlated with fertilization capacity, these alterations in motility, as evidenced by CASA, probably have a minor effect on fertilization in vitro.

Electronic Data Processing↗
PubMed2000

Evaluation of meiotic impairment of azoospermic men by fluorescence in situ hybridization.

OBJECTIVE: To identify predictive criteria for the existence of spermatogenesis in nonobstructive azoospermic men. DESIGN: Prospective study. SETTING: Andrology laboratory at a teaching hospital. PATIENT(S): Twenty-two azoospermic men were divided into three groups by qualitative testicular histopathology and the presence of spermatozoa in minced biopsies. INTERVENTION(S): Testicular biopsies evaluation. MAIN OUTCOME MEASURE(S): The presence of spermatozoa and/or mature spermatids, the percentage of sex vesicle formation (X and Y chromosomes in proximity), and the pairing of the two 18 homologous chromosomes. RESULT(S): Spermatozoa and mature spermatids were found in 17 study patients. Whenever few mature spermatids and/or spermatozoa were found, the rates of X-Y and 18 bivalents were significantly higher (mean +/- SD, 73% +/- 13. 3% and 91% +/- 7.1%) than those in cases of spermatocyte maturation arrest (23% +/- 8.0% and 60% +/- 11.8%, respectively). CONCLUSION(S): Pairing of chromosomes during meiosis is apparently related to the progression of spermatogenesis. Consequently, high rates of bivalent formation increase the prospect of focal spermatogenesis in the testis, despite the failure to identify mature spermatids in the specific testicular biopsy under examination.

Adult↗
PubMed2000

Maturation phenotype of Sertoli cells in testicular biopsies of azoospermic men.

The involvement of Sertoli cells in different spermatogenic impairments has been studied by an immunohistomorphometric technique using cytokeratin-18 (CK-18) as a marker for immature Sertoli cells. CK-18 is known to be expressed in Sertoli cells during prenatal and prepubertal differentiation and is normally lost at puberty. Forty-nine azoospermic men were included in the current study. Quantitative measurements on testicular biopsies revealed the highest CK-18 expression in the mixed atrophy biopsies (22 men), a lower expression in the Sertoli cell-only (SCO) biopsies (12 men), and minimal residual staining in the group considered as representing normal spermatogenesis (six obstructive azoospermia patients). The cytokeratin immunopositive-stained tubules were associated either with arrest in spermatogenesis or with SCO. Examination of sections from nine men with microdeletions in the AZF region of the Y chromosome revealed that these men were either negative for CK-18 expression or showed only weak residual staining. This may suggest that the spermatogenic defect in the AZF-deleted men originates in the germ cell and has no impact on Sertoli cell maturation. The cause that determined the spermatogenic defect in the other cases of male infertility with high CK-18 expression may have damaged both the Sertoli and the germ cells.

Adult↗