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T Binder

Publications and source records attributed to T Binder.

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

Increased diversity within the HLA-A*66 group: implications for matching in unrelated bone marrow transplantation.

We have identified a new A*66 allele (A*6603) in three related individuals, an Arabic patient suffering from acute myeloid leukemia and two of her relatives. The A*66 alleles differ in three amino acid residues at positions 70, 90 and 163. The closer relationship between A*6602 and A*6603, which only differ at amino acid 70, replacing GLN with HIS, suggests that the alloreactive potential in this mismatch combination is lower than in all other mismatched A*66 donor-recipient combinations, which exhibit two (A*6601 versus A*6602) and three (A*6601 versus A*6603) differences at the pivotal positions, respectively. This emphasizes the potential role of the A*66 subtypes in bone marrow transplantation with alternative donors. For that reasons, allelic subtyping should be considered in donor-recipient matching to identify the kind of disparity.

Amino Acid Sequence↗
PubMed1997

Relation between left atrial size and secondary atrial arrhythmias after successful catheter ablation of common atrial flutter.

Catheter ablation provides an effective cure for patients with typical atrial flutter. However, these patients may have the potential to develop atrial tachyarrhythmias other than common atrial flutter. This study examines clinical and echocardiographic predictors for the occurrence of uncommon atrial flutter or atrial fibrillation after abolition of common atrial flutter. The study population comprised 17 patients (12 men, 5 women, age 32-74 years) who underwent successful radiofrequency catheter ablation of common atrial flutter. Common atrial flutter did not recur in any patient during a median follow-up time of 8 (range 1-25) months. Within a median of 7 (range 1-223) days, however, symptomatic atrial tachyarrhythmias occurred in 8 of 17 patients (47%): uncommon atrial flutter (n = 4); atrial fibrillation (n = 3); and both uncommon atrial flutter and atrial fibrillation in one patient. Preablation left atrial volume was significantly larger in patients who developed secondary arrhythmias compared with patients who remained in sinus rhythm (57.9 +/- 15.6 vs 43.7 +/- 16.4 cm3, P < 0.05). Enlarged left atrial volume dichotomized at 51 cm3 independently predicted postablation atrial arrhythmias (X2 = 5.11, rel. risk = 5.3, P < 0.05). On Kaplan-Meier analysis, time to occurrence of postablation atrial arrhythmias was significantly shorter in patients with enlarged left atrium (P < 0.02). In conclusion, symptomatic uncommon atrial flutter and atrial fibrillation develops in a substantial proportion of patients after successful ablation of common atrial flutter. Out of a series of clinical and echocardiographic parameters, preablation left atrial size is the best predictor for the occurrence of these postablation atrial arrhythmias.

Adult↗
PubMed1997

[Comparison of the DNA-GEN Probe PACE 2 method and the LCR method for the detection of Chlamydia trachomatis in the female genital tract].

OBJECTIVE: Comparison of two methods of so-called rapid assessment of Chlamydia trachomatis in the urogenital system, i.e. the hybridization method GEN-Probe PACE 2 and the amplification LCR (ligase chain reaction) method. In 1995-1996 the authors made a screening examination to detect Chlamydiae in the urogenital tract by means of the hybridization method GEN-Probe PACE 2 and the amplification LCR method in selected groups of patients of the Second Gynaecological and Obstetric Clinic, First Faculty Hospital, Prague. The methods were evaluated as to their sensitivity. The examinations of the samples were made in the serological laboratory of the First Dermatological Clinic of the First Faculty Hospital Charles University, Prague. The amplification method is twice as sensitive as the hybridization method.

Adult↗
PubMed1996

New diagnostic imaging procedures in Hodgkin's disease.

A variety of new diagnostic imaging methods have been developed in recent years for patients with Hodgkin's disease in an attempt to improve the detection of spleen and bone marrow involvement within the scope of staging and to discriminate between fibrosis and vital lymphoma after treatment. Somatostatin receptor scintigraphy has been performed only in a small number of patients to date and further studies must be conducted. Magnetic resonance imaging (MRI), as the established method, has shown its potential in several studies in detecting both spleen and bone marrow involvement; MRI investigations, however, only visualize a limited portion of the body and therefore must be performed in areas of clinically suspected disease. Immunoscintigraphy with radiolabeled antibodies is still in a preclinical or at most early clinical stage of evaluation and first results have to be confirmed in a controlled trial. Positron emission tomography (PET) with [18F]fluorodeoxy-glucose (FDG) is a technique which is still not a routine clinical procedure. However, whole-body FDG-PET seems to be a promising method in staging and follow-up of lymphoma, because it offers the unique capability of visualising metabolic activity throughout the entire body. Long-term multicenter studies are necessary to confirm these promising initial data. In the future, wholebody FDG-PET will probably be the technique of choice for immunoscintigraphic studies with radiolabeled monoclonal antibodies and studies on the pharmacokinetics of cytostatic compounds.

Hodgkin Disease↗
PubMed1996

Assessment of myocardial injury by serum tumour necrosis factor alpha measurements in acute myocardial infarction.

Clinical and experimental data have shown that after acute myocardial infarction there is a significant release of tumour necrosis factor alpha. Therefore, an attempt was made to correlate changes in serum tumour necrosis factor alpha concentrations with indices of infarct extent in patients with acute myocardial infarction. In 50 patients with acute myocardial infarction, blood samples for evaluation of tumour necrosis factor alpha and alpha-hydroxybutyrate-dehydrogenase were collected every 6 h until 120 h after admission. Infarct extent was estimated by clinical parameters such as the occurrence of heart failure and rhythm disturbances, by enzymatic methods such as cumulative release of alpha-hydroxybutyrate-dehydrogenase and imaging techniques, by late resting single photon emission tomography--201 thallium scintigraphy--using an extent score and by echocardiography using a wall motion index. The maximum change in serum tumour necrosis factor alpha after infarction (delta TNF) was calculated by subtracting tumour necrosis factor alpha concentration on admission from peak tumour necrosis factor alpha concentration. The average peak tumour necrosis factor alpha level was observed 84 h after admission (median: 12 pg.ml-1). Between the 72nd and the 96th h no significant changes in tumour necrosis factor alpha values were observed. Analysis of the data showed that larger delta (TNF) values were found to be associated significantly with signs of heart failure (P = 0.003), the presence of rhythm disturbances (P = 0.001), increased enzymatic infarct extent indicated by cumulative release of alpha-hydroxybutyrate-dehydrogenase (r = 0.74; P < 0.001), large myocardial perfusion defects measured with 201 thallium scintigraphy (r = 0.80; P < 0.001), and a considerable number of left ventricular wall motion abnormalities (r = 0.57; P < 0.001). In conclusion, delta (TNF) is a reliable method of assessing damage severity in the myocardium after acute myocardial infarction. As only two blood samples are necessary within 84 h, the method may be one of the more convenient for the assessment of infarct size in clinical practice.

Adult↗
PubMed1996

Three-dimensional echocardiography using a transoesophageal imaging probe. Potentials and technical considerations.

Appreciation of three-dimensional relationships could be useful in cardiac diagnosis, decision making and planning of surgery. However, current ultrasound techniques provide only two-dimensional views. A recently developed echocardiographic computerized tomography unit allows reconstruction of three-dimensional images from a series of transoesophageal slices. To evaluate the potentials and limitations of this technique we performed echo computer tomographic examinations in 104 patients with a total number of 227 scans. All but two patients tolerated the procedure well and no serious complications were encountered. Indications for echo computer tomography included coronary artery disease, valvular heart disease, atrial masses, myocardial infarction, mitral and aortic valve replacement, aortic aneurysm and congenital defects. Most of the anatomical structures could be visualized with the best results obtained for the left atrium, the left ventricular outflow tract and the aortic and mitral valve apparatus. However, a variety of technical factors must be considered to achieve optimal results and to avoid misinterpretation. In 86% of patients the underlying pathology could be visualised by echo-computed tomography, particularly congenital defects such as those of the atrial or ventricular septa, but mitral valve pathologies provided the best results. In these cases three-dimensional imaging led to a better perception and understanding of structural relationships. In conclusion, despite current limitations in data acquisition, processing and computing power, echo computer tomography has the potential to provide relevant information in selected clinical settings.

Aortic Valve↗
PubMed1996

Diagnosis and management of prosthetic valve dysfunction.

Immediate and long-term prognosis of patients with prosthetic valves critically depends on prevention, rapid diagnosis, and optimal treatment of complications. This review describes the current practice in management of prosthetic dysfunction and discusses unresolved or controversial issues such as: what is the optimal anticoagulation regimen in both mechanical and bioprosthetic heart valves? Is thrombolysis superior to surgery in thrombotic valve obstruction? Is valve replacement superior to conservative therapy for prosthetic valve endocarditis? In addition, recently obtained data relating to the incidence of early and late mortality, thromboembolism, anticoagulation-related hemorrhage, valve thrombosis, hemolysis, paravalvular leakage, and the necessity and risk of reoperation are presented.

Bioprosthesis↗
PubMed1995

[The fine-needle aspiration cytology of lymph nodes suspected of malignancy. Its diagnostic value and capacity to predict the histogenesis].

To examine the usefulness of fine needle aspiration cytology in the investigation of patients with enlarged lymph nodes, the authors made a retrospective evaluation of the results of 1158 aspirations in 838 patients (630 male, 208 female, mean age 44 [4-90] years). In these 1158 cases the diagnosis was verified histologically, serologically or by follow up extending over at least six months. In 94.6% (n = 1096) the aspirate gave an unequivocal diagnosis, in 4.2% (n = 48) the diagnosis was equivocal and in 1.2% (n = 14) no diagnosis was reached. There were 773 correct malignant results, 368 correct benign results and 16 false benign; in one case the assessment was false malignant. Sensitivity was 98% and specificity 99.7%. In benign lymphadenopathies the investigation achieved a specificity of 99.7%, and in metastases and malignant lymphomas the sensitivity was 97.8% and 98.2% respectively. In 211 out of 286 aspirations the cytological diagnosis correctly predicted the subsequent histological diagnosis; in 58 cases correct though imprecise expressions such as "highly malignant non-Hodgkin's lymphoma" were employed. No serious complications were encountered. Fine needle aspiration cytology enables the clinician to devise an exact diagnostic and therapeutic plan in nearly every patient with unexplained lymph node enlargement.

Adult↗
PubMed1995

Large-cell anaplastic lymphoma-specific translocation (t[2;5] [p23;q35]) in Hodgkin's disease: indication of a common pathogenesis?

Chromosomal aberrations are characteristic and specific events; the detection of chromosomal abnormalities often provides information on diagnosis and prognosis of disease. Some patients with large-cell anaplastic lymphoma (Ki 1 lymphoma) have the translocation t(2;5) (p23; q35), involving a possible growth-regulating tyrosine kinase. We found this translocation in 11 patients with Hodgkin's disease of nodular sclerosis and mixed-cellularity types. This finding has implications for the understanding of the relation between large-cell anaplastic lymphoma and Hodgkin's disease, diseases with morphological and immunophenotypical similarities. Study of this translocation may help understanding of the origins of cancer and cancer growth. It also allows a more precise definition of Hodgkin's disease and may be used as an indicator for clonality--which has long been sought.

Actins↗
PubMed1995

Diurnal variation of ventricular response to atrial fibrillation in patients with advanced heart failure.

Variability of ventricular rate was quantified by two measures of heart rate variability: the SD of the mean R-R interval (SDNN) and the SD of the 5-minute mean R-R interval (SDANN). In 35 patients with atrial fibrillation and advanced heart failure (left ventricular ejection fraction 20% +/- 9%, cardiac index 2.4 +/- 0.7 L/min/m2), SDNN and SDANN were compared to 13 preselected clinical and hemodynamic variables for prediction of outcome. During a 12-month follow-up period, 8 (23%) patients deteriorated clinically; 3 (9%) died, and 5 (14%) underwent heart transplantation. SDNN and SDANN correlated to the difference of the mean R-R interval between night (2 AM to 3 PM) and day (11 AM to noon) with r values of 0.62 and 0.77, respectively. From 15 preselected variables, only SDANN (chi 2 = 6.7, p = 0.01) was independently associated with survival on multivariate analysis. Dichotomized SDANN at 100 msec accurately predicted 12-month survival in 28 (80%) patients (relative risk = 9.77, p = 0.001). In conclusion, analysis of heart rate variability is useful in quantifying diurnal variation of ventricular rate in atrial fibrillation and might be useful in predicting survival in patients with advanced heart failure.

Aged↗
PubMed1995

Suggestions for implementing community psychiatry training in existing residency programs.

OBJECTIVE: To demonstrate how an experience of partnership evolved when a group of psychiatry residents moved beyond the traditional hospital setting and began to question their current training. METHOD: We describe our experience in the context of the current literature and suggest ways of implementing community psychiatry training in existing residency programs. RESULTS: Principles of community psychiatry--partnership, respect and shared responsibility--are good standards in psychiatric care. CONCLUSIONS: Community psychiatry training may be possible in existing resident rotations, although teaching in the community setting may also be of value. Research and clinical work in "community psychiatry" need to be valued. Problems may be enriching if they are resolved collaboratively.

Canada↗