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Biomedical subjects

V Fischer

Publications and source records attributed to V Fischer.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Diagnosis and therapy of acute rejection in patients after orthotopic heart transplantation].

OBJECTIVE: In organ allotransplantation represents a serious problem acute rejection, which is the reaction of recipient organism aimed to reject the transplanted organ. AIM: To obtain experience in the field of routine long term are of patients after heart transplantation living in Slovakia. METHOD: 33 patients after orthotopic heart transplantation (HTx) were included in our long term care by the 1. June 1996. According to the accepted protocol we make the whole set of examinations is performed. This includes endomyocardial biopsy which is the only reliable method for the detection of rejection and also the criterion of sufficiency of immunosuppressive therapy. RESULTS: Acute rejection was revealed in 14 (43%) patients. CONCLUSIONS: Tactics of therapy and the length of the interval to subsequent biopsy were determined according to the histological findings of preceding biopsy, the clinical status and the combination of immunosuppression therapy. (Tab. 2, Ref. 13.)

Acute Disease↗
PubMed1997

[Dilated cardiomyopathy and heart transplantation].

Authors compare selected demographic, clinical, methodological and laboratory parameters in 20 patients who underwent heart transplantation (HTx) because of dilated cardiomyopathy (DKMP) with those, who have had HTx because of progressive and otherwise unresolved coronary artery disease (KCH). Patients operated because of DKMP were younger than those who underwent HTx for KCH. Women were only in the group of DKMP. Otherwise there were no differences between these two groups. The global analysis showed, that the majority of patients after HTx were asymptomatic. However, high incidence of obesity, hyperlipoproteinemia, cytopoenia, renal and hepatal dysfunction were found. Finally the authors presented an overview of standard chronic therapy after HTx and proposed some approaches to undesirable habits and disorders which aggravated the prognosis of the patients after HTx.

Adult↗
PubMed1997

[Pulmonary complications after heart surgery].

The authors present a detailed analysis of pulmonary complications after open-heart surgery and of their risk factors. The results of the presented study indicate that COPD patients with functional impairments are more sensitive to complicated postoperative outcome and to respiratory infections, in general. There is a clear relationship between artificial violation of the pleural cavity, diaphragmatic dysfunction and pleural effusion. Diaphragmatic dysfunction appears more frequently in mammarocoronary bypass patients in consequence of pleurotomy. The incidence of dysfunction could be reduced by the use of phrenic nerve insulation. Patients with pulmonary complications suffer from serious pulmonary function deficit. The possibilities of identification of the patients at risk, as well as the prevention and prophylaxis are analysed. (Tab. 7, Fig. 2, Ref. 71.)

Coronary Artery Bypass↗
PubMed1997

[Removal of the intravenous pacing system using the inflow occlusion technique].

Infection of the stimulative system with a septic state or endocarditis is the ultimate requirement for the extraction of intravenous parts of the implanted stimulative system. The extraction performed by the classical method or by means of catheter does not have to be necessarily successful. The use of extracorporeal circulation is optimal for the surgeon, however, it is expensive and not indifferent for the patient. The inflow occlusion technique under our conditions has shown to be fast, safe and an advantageous alternative. We have used it in 11 patients out of 14. All cases involved an extraction of a foreign body. 78.5% of extractions were performed due to infected stimulative system. 2 patients were subdued to a simultaneous implantation of DDD, others have had VVI system implanted by epimyocardial or transvenous way. We have not been encountered with any serious complications. (Tab. 1, Fig. 3, Ref. 7.)

Adolescent↗
PubMed1996

Induction of c-fos gene expression by the selective sigma receptor ligand EMD 57445 in rat brain.

Based on animal studies it has been reasoned that ligands to sigma binding sites might be effective in the treatment of schizophrenic disorders and may also be used to investigate this largely elusive disorder on a molecular level. Expression patterns of c-fos in rat brain were studied following treatment with single doses of the sigma ligand EMD 57445 (0.3, 1, 3, 30 mg/kg s.c.). Specific c-fos gene expression was detected at all concentrations tested in various cortical areas. The signals observed were dose-dependent with the highest intensities in the piriform cortex. Strong signals were also detected in hippocampal areas CA 1,2,3 and the gyrus dentatus, as well as in the medial habenula nuclei. In the caudate putamen, nucleus accumbens and lateral septal nucleus signals were detectable after administration of doses > or = 1 mg/kg. Furthermore, c-fos hybridization was visible in the amygdala, in the mammillary bodies, the islands of Calleja and in the olfactory tubercle. In the hypothalamus, c-fos expression was seen in the median eminence area after 30 mg/kg EMD 57445. No hybridization signals were obtained in brainstem or cerebellum. Since c-fos expression induced by EMD 57445 resembled the pattern obtained with atypical neuroleptics and studies on animal behavior point to antipsychotic activity, it is concluded that the drug might be suitable in the treatment of schizophrenia.

Animals↗
PubMed1996

Teens teach skin cancer prevention.

Cumulative sun exposure has been linked to about 95 percent of all skin cancers. Farmers and their families, by nature of their occupations, are exposed to an abundance of sun over a long period of time and, therefore, are at an increased risk for skin cancer. Because education is known to be a primary means of health, Future Farmers of America (FFA) peer facilitators (teen educators) provided third graders in rural communities sun protection education with the hope that the message would reach the entire family. The FFA facilitators (n = 217) from 39 FFA organizations throughout Wisconsin were trained with skin cancer and sun protection information. The FFA facilitators then gave presentations on sun protection to third graders (n = 2,007) in their school districts. Control schools included 57 facilitators and 669 third graders. Evaluation involved pre-, post-, and six-month follow-up surveys testing knowledge gained by the third graders. Students who correctly responded to a question on the post-survey after incorrectly answering it on the pre-survey were said to have had a knowledge gain for that question. By using chi-square tests, the intervention group demonstrated a statistically significant (P < 0.001) higher proportion of students experiencing knowledge gain than did the control group from pre- to post-surveys for nine of the 10 questions. Summary statistics were used to describe the study population. In addition to skin cancer knowledge questions, the survey of facilitators included sun protection behavior and attitude questions. This intervention was able to use peer educators as instructors to demonstrate knowledge gain in the youths of the target population. The pilot project materials costs were +0.55 per third grade student and +3.50 per facilitator. Using a school-based organization such as FFA provided a cost-effective means of reaching the rural population.

Adolescent↗
PubMed1996

[Heart transplantation--one possibility in the treatment of advanced congestive heart failure].

The authors present epidemiological data about congestive heart failure, its most common etiology and prognosis. They justify the performance of heart transplantation (HTx) in the treatment of congestive heart failure. They analyze the present state of HTx in the world and describe also the history of HTx in Slovakia. They present the review of contraindications and indications for the inclusion of recipients into the HTx programme and describe the further fates of these patients. They regard the HTx as an integral component of the therapeutical approach to the precisely defined group of patients with otherwise refractory congestive heart failure. (Tab. 4, Fig. 6, Ref. 38.)

Animals↗
PubMed1996

[Aneurysms of the extracranial supraaortic vessels--8 years' experience].

BACKGROUND: There has been an obvious evidence of a rising incidence of the supraaortic arteries aneurysms during the last 10-15 years. It is probably the consequence of both improved diagnostics and surgical technique. MAIN PURPOSE AND STARTING POINTS (OBJECTIVES). Because of a relatively high incidence of this group of aneurysms the authors of this paper analyzed their own patients population. METHODS: From 1st Jan. 1987 to 31st Dec. 1994 10 patients were admitted 10 patients with altogether 11 supraaortic trunk aneurysms. Last year 5 patients with 5 aneurysms (45 percent) were admitted. The mean age of all patients was 57.5 (20-88) years. The mean age in the group of carotid artery aneurysms was 75.2 (71-88) years, and 31 (20-43) years in the group of subclavian artery aneurysms, respectively. Both carotid and subclavian arteries aneurysms were managed by the same technique--aneurysm resection and graft interposition. There were two exceptions. One of them was a young woman with a small asymptomatic subclavian artery aneurysm in connection with the thoracic outlet syndrome. The aneurysm has been left in its place and followed up. The second exception was a young man with a posttraumatic false aneurysm of the intrathoracic part of the right subclavian artery. He died without surgery because of massive haemorrhage due to the a false aneurysm rupture. MAIN RESULTS: The hospital mortality of the group of operated patient was zero. There has been one head nerve injury in this group and 100 percent immediate patency, as well. All patients have been followed up. There have been found an asymptomatic internal carotid artery occlusion, the rest of reconstructions has been functioning. CONCLUSIONS: The aneurysms of the extracranial supraaortic arteries are rare vascular lesions. They have, however, a high incidence of unfavorable sequelae, most of them of neurologic nature. The authors emphasize the importance of proper diagnosis and early surgical intervention in selected cases put into the hands of an experienced vascular surgeon. (Tab. 2, Fig. 1, Ref. 17.).

Adult↗
PubMed1995

Uptake and metabolism of cyclosporin A and SDZ IMM 125 in the human in vitro skin2 dermal and barrier function models.

Treatment of psoriasis with the immunosuppressant cyclosporin A (CSA) is beneficial orally but topical treatment is less efficacious. A comparison of CSA to its hydroxyethyl derivative SDZ IMM 125 (IMM) as to bioavailability to epidermal and dermal cells and the potential for inactivation by biotransformation was investigated using a human dermal skin model (skin2 ZK1100) and a barrier function model (skin2 ZK 1300). The dermal ZK1100 model demonstrated that both cyclosporins could be metabolized by human dermis to the known primary hydroxylated metabolite, M17/AM1 for CSA and the hydroxylated analogue of IMM, IMM1. Application of the cyclosporins to the stratum corneum of the barrier function model ZK 1300 demonstrated that both CSA and IMM would be bioavailable to the epidermal and dermal skin cells. Systemic concentrations would be expected to be low due to the slow permeation of the compounds and because mostly metabolites would reach the circulation. The difference between the two cyclosporins was the rate and extent of biotransformation with IMM metabolite formation being about 1/4 that of CSA.

Biological Availability↗
PubMed1995

Sites of biotransformation for the cyclosporin derivative SDZ IMM 125 using human liver and kidney slices and intestine. Comparison with rat liver slices and cyclosporin A metabolism.

SDZ IMM 125 (IMM), the hydroxyethyl derivative of cyclosporin A (CSA), is metabolized by human liver slices to analogous primary metabolites, hydroxylated IMM1 and IMM9 and N-demethylated IMM4N, as for CSA (M17/AM1, M1/AM9, and M21/AM4N), but the rate and extent of IMM biotransformation is less than for CSA. Initial rates of IMM metabolite formation in the human liver slice cultures are 6.6 +/- 2.8 nmol/hr/g liver at 1 microM IMM and 24.3 +/- 22.9 nmol/hr/g liver at 10 microM IMM, whereas the rate of CSA metabolite formation is 1.8-fold faster at both concentrations. The percentage of unchanged IMM is 73% at 1 microM and 80% at 10 microM after 24 hr, reflecting the lower extent of IMM metabolism, about one-third (1 microM) and one-half (10 microM) that of CSA. In rat liver slices, IMM is metabolized to the same primary metabolites as in human liver slices, but more slowly and remains 90% unchanged at 24 hr. Human jejunum formed the same primary metabolites of IMM and CSA as in liver. Upscaling the slice rate of biotransformation revealed that human jejunum would contribute considerably to the first-pass of IMM and CSA, being approximately 2 to 3-fold slower than the rate in liver. The inhibition of both IMM and CSA biotransformation by triacetyloleandomycin implicates the involvement of cytochrome P4503A proteins. Human kidney cortex slices metabolized IMM to IMM1 and IMM9, accounting for approximately 75% of the total metabolites. Total metabolite formation represented approximately 64% of liver metabolite formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Analysis of risk factors for perioperative myocardial infarct in aortocoronary bypass].

BACKGROUND: Perioperative myocardial infarction (PMI) belongs to the main complications of revascularization surgery of the heart. Perioperative analysis of PIM risk factors can aid the cardiosurgeons, anestesiologists and cardiologists to stratify the group exposed to the risk of PIM origin and to prepare the most appropriate complex peroperative procedure for this group of patients. AIM: The particular aim is to evaluate and analyze some PIM risk factors prior to and during surgery. METHODS: The paper represents a retrospective study which analyzes two period (1984-1986 and 1992). The total number of patients in the investigated group is 277. The group afflicted with PIM is constituted of 29 patients. The following clinical, hemodynamic, angiographic risk factors are analyzed prior to surgery: age, sex, precedence of infarction of myocardium, arterial hypertension, instabile angina pectoris, end-diastolic pressure and left ventricular ejection fraction, affliction of the main trunk of the left coronary artery and some peroperattive factors (number of grafts, sequence bypass, endarterectomy, completion of revascularization, a. mammaria interna graft, duration of the artificial vascular circuit and clamping of the aorta). RESULTS: Significant relation for the pIM origin was found in arterial hypertension (p<0.05), affliction of the main trunk (p<0.05), prolonged period of clamping of the aorta (p<0.05 in 1984-86, p<0.01 in 1992) and artificial vascular circuit (p<0.001). CONCLUSION: The basic PIM risk factors include the following: arterial hypertension prior to surgery, affliction of the main trunk of the left coronary artery, prolonged duration of the artificial vascular circuit and clamping of the aorta. MEANING FOR PRACTICE: 1. The analyzed problem represents a positive feedback for cardiosurgeons, anestesiologists and cardiologists. 2. The analysis of the risk factors can be utilized also by future surgical workplaces in the Slovak Republic.

Adult↗
PubMed1995

Skin cancer prevention: a peer education model.

Results from a quasi-experimental project indicate that skin cancer prevention and sun protection education can successfully be promoted by using peer educators. Senior high students (40) facilitated and taught a sun protection curriculum to third-grade students (508) enrolled at the experimental sites. The curriculum's effects were assessed with pre-program, post-program, and 6-month follow-up survey-instruments. The experimental sites using high school (peer) facilitators were effective in conveying knowledge to younger students based on knowledge gained on the post-program surveys. Overall, the intervention group demonstrated a mean improvement of 3.4 questions on the post-program survey, while the control group improved 0.1 questions (p < 0.01). Additional benefits included a knowledge gain by the peer facilitators, a self-reported possible increase in desired behavior change, and an improved attitude about sun protection. Implications for pediatric clinical practice are noted.

Adolescent↗
PubMed1994

Health education delivery by Wisconsin veterinarians.

Established methods of health promotion for the general population are not as effective with rural populations, in part because conventional health education delivery systems may not penetrate isolated rural areas. In particular, the self-reliant behaviors of farmers make them less likely to seek traditional forms of health care, including health promotional activity. Yet farmers place a great deal of trust in their veterinarian and highly rate veterinarian integrity. Wisconsin veterinarians expressed an interest in the health of their human clients as well as the health of the animals in their care. An education demonstration project was developed to determine farmers' acceptance of veterinarians delivering human health information to their workplace (farms). Thirteen veterinarians who provide services in one north central Wisconsin county delivered skin cancer and sun protection information to farmers as part of their routine herd health checks. Participating farmers reported this to be an acceptable way to receive information about human health issues. This novel method of education delivery may be an effective means to disseminate human health information to difficult-to-reach rural populations.

Adult↗
PubMed1994

[Revascularization procedures on coronary vessels. Development of techniques, indications and results].

Hitherto assembled experience indicates that the principles and immediate results of surgical and reconstructive intervention surgery of coronary arteries are very close and similar. Criteria of indication and technical possibilities in both these areas are developing and improving steadily. Accurate definition of the optimal use of these techniques does not exist so far. At present several perspective investigations are under way and they could provide within the next few months an answer and define the areas of these two basic reconstruction operations of the coronary arteries. Regardless of that the two methods are nowadays already a routine procedure in the care of patients with coronary disease.

Angioplasty, Balloon, Coronary↗
PubMed1994

Triple valve surgery with triple aorto-coronary bypass and endarterectomy of the right coronary artery.

This paper presents the case report of a 50-year-old woman with a triple valve lesion of rheumatic origin and ischemic coronary disease. The patient underwent successful simultaneous triple valve surgery; the aortic and mitral valves were replaced by mechanical prostheses, and the tricuspid valve was repaired by annuloplasty, together with three aorto-coronary bypasses and endarterectomy of the right coronary artery. The peri- and postoperative courses were uneventful and the patient was discharged from hospital in good clinical condition 12 days after surgery.

Aortic Valve↗
PubMed1994

[Dysfunction of valvular prostheses].

Implantation of artificial mechanic valvular prostheses significantly improves and prolong the life of patients with valvular defects with a haemodynamic impact. This therapeutic method does not cure the patients and operation switches the problem of a natural dysfunctional valve to that of a functional artificial valve with improvement of the quality of life and its prolongation. The long-term effect and thus the general prognosis--the patient's "fate" depends above all on complications such as infections and haemocoagulation which are the main cause of dysfunction of artificial prostheses. The authors describe in the submitted paper basic principles of prevention of these undesirable events and decisive steps which must be taken to ensure a rapid and accurate diagnosis of imminent of already developed dysfunction of the prosthesis and its solution under the given conditions.

Heart Valve Prosthesis↗
PubMed1992

Possible role of free radical formation in drug-induced agranulocytosis.

The use of clozapine, a unique antipsychotic drug, has been restricted due to a 1 to 2% incidence of drug-induced agranulocytosis. Many other drugs, including paracetamol (acetaminophen), can cause agranulocytosis, although with a much lower incidence. Metabolic activation of these drugs by neutrophils or stem cells could be the molecular mechanism underlying this adverse effect. Drug oxidation by myeloperoxidase leads to free radical metabolite formation; these reactive free radicals can oxidise glutathione to a thiyl free radical, which in the presence of oxygen forms oxygen-derived free radicals. In contrast to glutathione, when these free radical metabolites oxidise ascorbate an unreactive free radical is formed, which does not even react with oxygen. In both reactions, the free radical metabolite is reduced to the original drug, although ascorbate is the more effective reducing agent. Thus ascorbate, when coadministered with agranulocytosis-causing drugs, may inhibit free radical chain reactions and other free radical-mediated reactions, such as protein adduct formation, and thereby prevent drug-induced agranulocytosis.

Agranulocytosis↗