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Biomedical subjects

S Conrad

Publications and source records attributed to S Conrad.

At least 55 records · Page 3Linked to original sources
PubMed1997

Long-term results of the Stamey bladder neck suspension procedure: a patient questionnaire based outcome analysis.

PURPOSE: Reported success rates of the Stamey bladder neck suspension procedure vary from 39 to 91%. The disparity is substantially influenced by the methods used to assess the surgical outcome, with best results being found consistently in retrospective chart review studies. We assessed the true long-term outcome of the Stamey bladder neck suspension with a patient questionnaire based outcome analysis using strict definitions for cure and recurrence. MATERIALS AND METHODS: Of 172 consecutive patients 138 (80.2%) returned a questionnaire designed to assess the outcome of the procedure and the subjective satisfaction with the operative result. To our knowledge we report the longest mean followup for this procedure (66 months). RESULTS: Of 130 evaluable patients with hypermobility or intrinsic sphincter deficiency leading to urinary stress incontinence 65 (50.0%) remained completely continent, 15 (11.5%) never became continent and 50 (38.5%) had recurrence 6 to 90 months after initial operative success. However, approximately two-thirds of the patients believed they were cured or substantially improved more than 5 years postoperatively. CONCLUSIONS: Despite the considerable failure rate, the substantial improvement in the quality of life of almost two-thirds of the patients during long-term followup and the lack of superior techniques qualify the Stamey bladder neck suspension as a treatment of choice for urinary stress incontinence in women. We strongly emphasize the need for standardized questionnaire based outcome analyses for the evaluation of incontinence surgery.

Adult↗
PubMed1996

gyrA mutations in high-level fluoroquinolone-resistant clinical isolates of Escherichia coli.

Double mutations in the quinolone resistance determining region of the gyrase A gene (gyrA) have recently been reported to be associated with high-level resistance to fluoroquinolones in clinical isolates of Escherichia coli. We examined the type and frequency of such mutations in a large number of clinical isolates that were obtained from ten different geographical locations and had been genotypically characterized by pulsed field gel electrophoresis (PFGE) of chromosomal DNA digests. Of 36 isolates with ofloxacin MICs > or = 4 mg/L that represented at least 24 distinct genotypes, 35 had double mutations at amino acid codons 83 and 87 of gyrA, while two isolates with ofloxacin MICs of 0.5 and 4 mg/L, respectively, each had a single mutation at codon 83. Mutations at codon Ser-83 were uniform, resulting in substitution by Leu. The additional mutations at amino acid codon 87 in the 35 double-mutants were diverse, resulting in Asp-87 substitutions by residues Asn (23 isolates), Gly (7 isolates), Tyr (4 isolates), or His (1 isolate) without a discernable correlation with fluoroquinolone MICs or with phenotypic resistance to chemically unrelated antibacterial agents. Maximal differences between MICs of double-mutants with the same amino acid substitution were eight-fold. The changes of amino acid residues at codon Asp-87 differed between individual patient isolates with the same genotype (and similar MICs), suggesting that the amino acid codon 87 mutations (and possibly the development of high-level fluoroquinolone resistance) might have occurred after the transmission and sharing of a precursor strain carrying the Ser-83-->Leu mutation.

Anti-Infective Agents↗
PubMed1996

Molecular epidemiology of fluoroquinolone-resistant Escherichia coli bloodstream isolates from patients admitted to European cancer centers.

Previous reports have suggested an increasing incidence of highly fluoroquinolone-resistant Escherichia coli causing bacteremia among cancer patients on prophylactic therapy. We used genotyping by pulsed-field gel electrophoresis of chromosomal DNA digests and random amplified polymorphic DNA fingerprinting to study clonal relationships among such isolates obtained at 10 cancer centers located across Europe and the Middle East. Analysis by both methods indicated that isolates from different centers were genotypically unrelated to each other. There were five centers from which more than one individual patient isolate was available, and most demonstrated significant within-center genetic diversity of strains. Strains shared among patients could be identified at two centers. At the center with the largest number of bloodstream isolates from cancer patients available, fluoroquinolone-resistant control isolates from surgical patients and fluoroquinolone-susceptible control isolates from patients admitted to medical services during the same time period were unrelated to resistant cancer patient isolates and to each other as well. A substantial number of fluoroquinolone-resistant isolates (19 of 58) were nontypeable by pulsed-field gel electrophoresis. Fluoroquinolone resistance was commonly associated with multiple antibiotic resistance to chemically unrelated antibacterial agents irrespective of the origin of the isolates.

Anti-Infective Agents↗
PubMed1996

[Perioperative antibiotic prophylaxis in breast surgery: cefotiam versus clindamycin].

97 patients undergoing breast surgery received either 2 g cefotiam or 1200 mg clindamycin as i.v. singleshot application in the course of an open randomised comparison of parallel groups to evaluate the efficacy and tolerability of both antibiotic regimens. Both regimens proved to be well to-lerated and equally suitable for the prophylaxis of postoperative infections in breast surgery.

Adolescent↗
PubMed1995

Characterization of coagulase-negative staphylococci causing nosocomial infections in preterm infants.

The species spectrum, antibiotic susceptibility, and genomic profile of coagulase-negative staphylococci (CNS) isolated from infected preterm infants were compared with those obtained in CNS from nursery personnel. Staphylococcus epidermidis was the predominant species in the 66 investigated preterm infants (171 isolates), accounting for 64% of all isolates. A high proportion of Staphylococcus haemolyticus (32%) could be detected. In contrast to the results in patients, the spectrum in nursery personnel was broad and included more species of CNS. All isolates of CNS from preterm infants demonstrated a low rate of susceptibility to the beta-lactam antibiotics (2% sensitivity to penicillin and 6% sensitivity to oxacillin). Sensitivity to gentamicin (9%) was also rare. An unexpected observation was susceptibility to teicoplanin in only 70% of all CNS isolated from patients due to the high proportion of Staphylococcus haemolyticus. Analysis of the genomic profile of 33 isolates of Staphylococcus haemolyticus by pulsed-field gel electrophoresis revealed a relationship between the strains. An outbreak of one particular strain of Staphylococcus haemolyticus in the neonatal intensive care unit investigated can therefore not be excluded.

Coagulase↗
PubMed1995

Generation and characterization of monoclonal antibodies specific for members of the mammalian 70-kDa heat shock protein family.

The 70-kDa heat shock proteins (hsp70) are a highly conserved, abundant, and ubiquitous family of proteins expressed by all organisms from bacteria to humans. It is well established that hsp70 family members function as molecular chaperones and aid in the intracellular folding of newly synthesized or denatured proteins. Current evidence suggests an emerging role for hsp70 family members in immune responses and in clinically important responses to stress and tissue damage. Here we report the generation and characterization of several MAbs to hsp70 family members. Immune responses to this highly conserved family were induced in mice by immunization with synthetic peptides that contain regions of the mouse mitochondrial hsp70 coupled to a potent helper T cell epitope derived from tetanus toxoid. The resulting MAbs include ones specific for the human and mouse mitochondrial hsp70 and others that show cross-reactivity among the family members and recognize the mitochondrial hsp70, the endoplasmic reticulum resident hsp70, Bip/grp78, the constitutively expressed cytosolic hsp70, hsc70, and the heat-induced member, hsp70. Significantly, these MAbs are effective in Western blotting, in immunoprecipitation, and in immunofluorescence, and thus should find applications in the purification and detection of members of this important family.

Amino Acid Sequence↗
PubMed1995

[Transurethral laser therapy of benign prostatic hyperplasia].

During the last 4 years, transurethral laser therapy for benign prostatic hyperplasia (BPH) has become an increasingly popular alternative to transurethral resection of the prostate (TURP) for the treatment of obstructive BPH symptoms. Clinical data so far published prove the efficacy of this new therapeutic modality, although the results are up to now possibly inferior to those achieved with TURP. On the other hand, the incidence of severe perioperative complications is significantly lower in patients treated with laser prostatectomy than in those undergoing TURP. Therefore, laser prostatectomy is a reasonable adjunct to the therapeutic spectrum for BPH in high-risk patients. Nevertheless, its role in the treatment of obstructive BPH in low-risk patients cannot be defined until long-term follow-up data are available.

Contraindications↗
PubMed1994

Endo-urological cold-knife incision for ureteral stenosis after renal transplantation.

Cold-knife incision of stenoses in the transplant ureter was performed in 11 patients with upper urinary tract obstruction in renal transplants. The operations were complicated by bleeding in 2 patients and the graft had to be removed in 1 of them. The stenoses could be treated successfully in 10 of the 11 patients (91%) and the mean serum creatinine concentration decreased significantly from 3.4 to 1.8 mg./dl. After a mean of 26 months only 1 obstruction recurred, so the long-term success rate was 82%. Because of the favorable long-term results and the low incidence of complications, we recommend endo-urological cold-knife incision of ureteral stenosis as the first-line treatment for upper urinary tract obstruction in renal transplants.

Adult↗
PubMed1994

[Primary localization of malignant lymphoma in the urinary bladder?].

We report on the case of a malignant non-Hodgkin lymphoma with primary location in the urinary bladder of an 83-year-old woman. Diagnosis was established by transurethral resection of the tumor and histological examination. No clinical signs (e.g. alterations of peripheral blood count) or tumor generalization were observed. To date only 86 cases of primary localization of lymphoma in the urinary bladder have been described, whereas secondary involvement occurs in 5.4-13% of cases.

Aged↗
PubMed1994

[Urologic complications after kidney transplantation. Experiences in a center with 539 recipients].

A total of 539 renal transplantations were performed at the Department of Urology of the University Hospital of Hamburg between 1984 and 1991. 132 (24.5%) patients developed urological complications (by definition, complications occurring as a result of the operative procedure). In 31 cases the transplants had to be removed secondary to urological complications, and 4 patients died of such complications (mortality 0.7%, lethality 3.0%). Urinary tract infections occurred in 13.2% of all patients during the first postoperative year and were by far the most frequent complication, followed by haematomas, which occurred in 9.6%. The incidence of urinary tract and wound infections was significantly reduced during the 8-year period studied by improving antibiotic prophylaxis and adopting a strategy of early removal of indwelling catheters (P < 0.05). Stenting the ureteroneocystostomy with a double-J stent instead of an external ureteral catheter resulted in a definite decrease in the incidence of ureteral leaks (P < 0.05). Continuous control of operative results and efforts to improve operative and perioperative strategies make it possible to reduce the incidence of urological complications in renal transplantation and thus result in an improved graft function and patient survival.

Adolescent↗
PubMed1994

[Multilocular, giant angiomyolipoma of the kidney, adrenal gland and para-aortic lymph nodes. Case report of a 9-year-old boy with tuberous sclerosis].

The symptoms and therapy of a multicentric angiomyolipoma of the kidney, adrenal gland, paraaortic lymph nodes and renal fat tissue in a 9-year-old boy with tuberous sclerosis are reported. Angiomyolipomas are benign mesenchymal tumours that often occur together with tuberous sclerosis. Renal cell carcinoma in an angiomyolipoma is rare. Multicentricity and lymph node involvement is not a sign of malignancy or metastatic disease. Radiological characteristics in CT and plain X-ray may help in the diagnosis. Characteristically, the renal lesions are asymptomatic. Patients with incidental symptom-free angiomyolipoma should be followed. In other patients with pain in the loin, or when a solid tumour cannot be confidently excluded, conservative surgery or nephrectomy should be performed.

Adrenal Gland Neoplasms↗
PubMed1994

[Kidney cancer and angiomyolipoma in lymphangiomyomatosis].

Lymphangiomyomatosis is an extremely rare benign disease characterized by extensive proliferation of smooth muscle cells within lymphatic vessels and lymph nodes. While 10-15% of all patients show concomitant renal angiomyolipomas, no association so far has been reported with renal cell carcinoma. We present a case with coincident lymphangiomyomatosis, renal cell carcinoma and renal angiomyolipoma. The possible underlying pathogenesis is discussed. Classifying lymphangiomyomatosis as a "forme fruste" of tuberous sclerosis allows postulation of a common pathogenesis for all three entities.

Adrenalectomy↗
PubMed1993

Evidence for a clustered genomic organization of FAX-zinc finger protein encoding transcription units in Xenopus laevis.

Finger associated box-zinc finger proteins (FAX-ZFPs) constitute a subfamily of the many C2H2 type ZFPs in Xenopus laevis. FAX is a highly conserved protein domain connected to variable zinc finger clusters. Three different FAX-ZFPs encoding genomic fragments were isolated and subjected to a detailed structural characterization. All three exhibit a common, highly conserved exon/intron organization, with the variant zinc finger clusters organized in a single exon for each gene analysed. Two of the three genomic fragments contain a second FAX-ZFP encoding (partial) transcription unit each. Further evidence for a clustered organization of FAX-ZFP transcription units is provided by Southern blot analysis of large genomic restriction fragments separated by transverse field gel electrophoresis, and by in situ hybridization on intact chromosomes. Comparative sequence analysis of the genes isolated reveals an exceptional degree of DNA sequence conservation in both exon and intron regions in one part of the FAX encoding region, suggesting that recent gene conversion has led to the combination of these sequence elements with DNA segments including regions encoding variant zinc finger clusters. Overexpression of the FAX domain by itself or of a full-length FAX-ZFP in X. laevis embryos by means of mRNA injection does not interfere with the normal developmental program, suggesting general and not cell specific/regulatory functions for X. laevis FAX-ZFPs.

Amino Acid Sequence↗
PubMed1993

PCR-dependent amplification and sequence characterization of partial cDNAs encoding myosin-like proteins in Anemia phyllitidis (L.) Sw. and Arabidopsis thaliana (L.) Heynh.

Partial cDNAs encoding for myosin-like proteins from Anemia phyllitidis and Arabidopsis thaliana have been isolated using PCR technology. The deduced amino acid sequences show an average similarity up to 62% with known myosin heavy chain genes. From northern blot analysis we were able to estimate that transcripts of ca. 6.1 kb size are expressed in A. phyllitidis.

Amino Acid Sequence↗
PubMed1992

Apnea testing for the determination of brain death: a modified protocol. Technical note.

The absence of spontaneous respirations at a PaCO2 of 60 mm Hg or above has traditionally been accepted as the respiratory criteria for the determination of brain death. The testing of patients for the presence or absence of apnea has been complicated because the rate of PaCO2 elevation may vary substantially from patient to patient, and a nonlinear relationship exists between the rate of PaCO2 increase and the duration of apnea. In an attempt to refine the apnea test and to further elucidate the physiology of hypercapnia in humans, 11 patients who met all but the respiratory criteria for brain death were evaluated using a modification of a previously utilized apnea testing protocol. All patients were brought to a PaCO2 of 40 mm Hg or above prior to the apnea test. Baseline PaCO2 ranged from 40 to 45 mm Hg in six patients (Group I) and from 46 to 51 mm Hg in five patients (Group II). The mean rate of PaCO2 increase was 5.1 +/- 1.4 mm Hg/min in Group I and 6.7 +/- 3.1 mm Hg/min in Group II. No problems with cardiovascular instability or hypoxia were encountered during testing in this series. This refinement of the apnea test allows for a streamlined and safe approach to brain death detection.

Adolescent↗