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Biomedical subjects

A Kopf

Publications and source records attributed to A Kopf.

At least 19 recordsLinked to original sources
PubMed2001

[Differential diagnosis of pain experience. Chronic pain and depression].

Chronic pain and depressive symptoms often occur together. The relationships between these two conditions are, however, still controversial. On the neurobiological level, features common to both disorders are to be found. Mental coping patterns favor the development of depressive symptomatology in patients suffering from pain, or of pain within the framework of a psychiatric illness. For the diagnostic work-up, the case history, exploration, organic investigations and, where indicated, psychological tests are employed. A well-proven strategy in the areas of diagnosis and therapy is interdisciplinary cooperation involving physicians, psychologists and--within relevant institutions--nursing staff.

Adaptation, Psychological↗
PubMed2001

[Sonographic findings in interstitial lung diseases].

UNLABELLED: Up to now, sonography of the thorax has not been taken into consideration in cases of interstitial lung disease because of its technical limitations. This study was aimed at examining pleural and subpleural alterations in cases of interstitial lung disease and comparing the sonographic method with the usual imaging procedures such as x-ray and computer tomography. PATIENTS AND METHODS: 24 patients, aged 25 to 70 who were diagnosed as suffering from an interstitial lung disease and underwent sonography of the thorax, were analysed with regard to the following criteria: 1 pleural effusions, 2 pleural fragmentations, 3 subpleural infiltrations > 2 mm, 4 pleural nodules. RESULTS: Six patients were diagnosed to have small pleural effusions which had not been visible on x-ray-scans. 14 patients showed pleural fragmentations, 10 patients had subpleural infiltrations, and in one patient pleural nodules could be detected. Out of the 24 patients suffering interstitial lung disease, sonographic alterations were diagnosed in 17 cases (= 71%). Among the 9 patients definitively suffering from sarcoidosis, five had had a completely inconspicuous ultrasonic result, four of them with sarcoidosis stage I. CONCLUSION: Sonography of the thorax has proved to be an excellent complementing examination method in cases of interstitial lung disease. The advantages lie in the possible detection of small pleural effusions and small subpleural infiltrations, where this method can also be used to monitor therapy.

Adult↗
PubMed2000

Pyruvate formate-lyase-activating enzyme: strictly anaerobic isolation yields active enzyme containing a [3Fe-4S](+) cluster.

Pyruvate formate-lyase-activating enzyme (PFL-AE) from Escherichia coli (E. coli) catalyzes the stereospecific abstraction of a hydrogen atom from Gly734 of pyruvate formate-lyase (PFL) in a reaction that is strictly dependent on the cosubstrate S-adenosyl-l-methionine (AdoMet). Although PFL-AE is an iron-dependent enzyme, isolation of the enzyme with its metal center intact has proven difficult due to the oxygen sensitivity and lability of the metal center. We report here the first isolation of PFL-AE under nondenaturing, strictly anaerobic conditions. Iron and sulfide analysis as well as UV-visible, EPR, and resonance Raman data support the presence of a [3Fe-4S](+) cluster in the purified enzyme. The isolated native enzyme, but not apo-enzyme, exhibits a high specific activity (31 U/mg) in the absence of added iron, indicating that the native cluster is necessary and sufficient for enzymatic activity.

Acetyltransferases↗
PubMed2000

Exercise therapy for craniomandibular disorders.

OBJECTIVE: To evaluate the use of exercise therapy for the treatment of craniomandibular disorders (CMDs). DESIGN: Before-after trial. All patients were assigned to a waiting list, serving as a no-treatment control period. SETTING: Outpatient clinic for physical medicine and rehabilitation of the University of Vienna. PATIENTS: Thirty consecutive patients suffering from CMD with anteridr disc displacement with reduction who were consulting a CMD service. INCLUSION CRITERIA: (1) symptoms lasting at least 3 months, (2) pain in the temporomandibular region, (3) a positive axiography, and (4) evidence of postural dysfunction. Twenty-six patients completed the study; no adverse effects occurred. INTERVENTIONS: Active and passive jaw movement exercises, correction of body posture, and relaxation techniques. MAIN OUTCOME MEASURES: (1) Pain at rest, (2) pain at stress, (3) impairment, and (4) mouth opening at baseline, before and after treatment, and at 6-month follow-up. RESULTS: During the control period, no changes occurred. After the treatment, pain and impairment were significantly reduced (Wilcoxon test, p < .001). Four patients had a restricted mouth opening, in contrast to 15 before treatment (chi2 test, p < .005). Joint clicking vanished in 13.3% and was reduced in another 13.3% (chi2 test, p < .01). These results did not change until follow-up. Seventy-five percent of the patients were treated successfully. CONCLUSION: Exercise therapy seems to be useful in the treatment of anterior disc displacement with reduction.

Adult↗
PubMed2000

Melanoma in a psoriatic plaque.

This is the first reported case of a melanoma in a psoriatic plaque. The clinical, dermoscopic, and histologic features of this case are detailed. A review of the risk of melanoma among patients treated with psoralen-ultraviolet A is presented.

Humans↗
PubMed1999

Reliability of surface electromyographic measurements.

OBJECTIVES: The aim of the study was to investigate short-term, intermediate-term and long-term reliability of surface electromyographic (EMG) measurements. METHODS: Eighteen healthy subjects performed 810 isometric knee extension tests. Reliability for maximum voluntary contraction (MVC) and 50% MVC was assessed with retest intervals of 3 min, 90 min and 6 weeks. Reliability for sustained contractions was assessed with retest intervals of 90 min and 6 weeks. EMG was recorded from the rectus femoris, vastus lateralis and vastus medialis muscles. The root mean square (RMS) and the median frequency (MF) parameters were extracted. At sustained contraction tasks, estimated linear regression values of both parameters were analyzed. Bland-Altman-plots, coefficient of repeatability, Pearson's coefficient of correlation and intra class correlation (ICC) procedures were applied to assess test-retest reliability. RESULTS: EMG recordings taken at short-term intervals were generally better reproducible than those of the longer-term intervals. Moreover, 50% MVC EMG recordings demonstrated better reproducibility than 100% MVC measurements, and EMG recorded from the rectus femoris were more constant than that from the vastus lateralis or vastus medialis. The MF parameter recorded from the rectus femoris was the only reliable parameter of EMG fatigue change. CONCLUSION: In our set up, EMG measurement is best suited for clinical applications if submaximal MVC measurements are performed and signal is taken from rectus femoris muscle.

Adult↗
PubMed1999

[Co-analgesics in the treatment of chronic pain].

Opioids do not yield adequate analgesic effects in at least one-third of all patients suffering from chronic pain. Nonetheless, in contrast to former opinion there is no type of pain that is principally resistant to opioids, which means that the individual patient's response to opioid administration has to be investigated to determine adequate treatment. Opioids fail most frequently in cases of neuropathic, osseous or sympathetically maintained pain. In these cases there is an indication for early use of co-analgesics. The analgesic potency of anticonvulsives and tricyclic antidepressants has been best documented. A differential indication of the large number of possible coanalgesics should be determined with the help of a detailed pain history focussing on the pain quality. Similar to the WHO analgesic ladder used in (tumor) pain therapy, co-analgesic therapy should only be supplemented by invasive therapeutic procedures after various combinations and alternative substances have proven fruitless. Experience shows that this is necessary only for a small number of patients.

Analgesics, Non-Narcotic↗
PubMed1999

[Formulary].

Explore the source record for details and available documents.

Analgesics↗
PubMed1999

Chest ultrasound in diagnosis of pulmonary embolism in comparison to helical CT.

UNLABELLED: To many people die because of undiagnosed pulmonary embolism. Common pulmonary embolism is the most unexpected mortal event in necropsy, antemortem correctly diagnosed in 18-39%. The diagnostic value of chest ultrasound (CUS) has been investigated. METHODS: 117 (68 women, 49 men) patients with clinical suspicion of pulmonary embolism underwent chest sonography and spiral computed tomography (CT). Final diagnosis has been made by CT respective with echo-cardiography, venous duplex sonography and fibrin dimer tests. RESULTS: Finally, 70 patients suffered from pulmonary embolism. The chest sonograms showed averaged 1.5 x 2.8 cm (0.5-8.5) large triangular or rounded hypoechoic lesions, mean 2.6 pro patient, similar in form and size as in CT. Fresh reperfusionable infarcts were homogenous and hypoechoic. Older infarcts were well demarcated, mainly wedge shaped. A hyperechoic reflex in the center corresponds to the bronchiole: a sign of segmental involvement. The sensitivity of chest ultrasound was 94%, the specificity 87%, positive predictive value 92%, negative predictive value 91%, accuracy 91%. Overall 61 patients had PE in CT, in 47 (67%) cases a direct emboli detection was possible. 14 patients had peripheral lung consolidations without detectable emboli, but fibrin-dimer tests were positive in all cases, there was deep vein thrombosis diagnosed and they showed signs of PE in echocardiography. Spiral CT showed a sensitivity of 85%, a specificity and a positive predictive value of 100%, a negative predictive value of 83% and an accuracy of 92%. CONCLUSION: CUS can improve diagnosis of pulmonary embolism. Sonography also reveals small infarcts which remain undetected with other imaging procedure such as helical CT.

Adult↗
PubMed1999

Spitz nevus: a case report.

The case of a 2-mm Spitz nevus is reported. We comment on the case and describe the skin-surface microscopy features.

Adult↗
PubMed1998

The role of the biarticular agonist and cocontracting antagonist pair in isometric muscle fatigue.

Isometric knee extensions until exhaustion at 30%, 50%, and 70% of maximum voluntary contraction were performed by 18 healthy subjects. During muscle fatigue, surface electromyographic activity was recorded from the knee-extensors vastus lateralis, vastus medialis, and rectus femoris, and the coactive antagonistic biceps femoris. The electromyographic parameter median frequency (MF) served as a measure of fatigue. Coefficients of regression of the MF fatigue changes were analyzed statistically. MF fatigue occurred within the coactive biceps femoris and was significantly more pronounced than in the quadriceps. When the MF fatigue shifts of the coactive biceps femoris were compared with each of the three investigated parts of the quadriceps separately, MF fatigue shifts were similar in shape for the biarticular coactive biceps femoris and the biarticular rectus femoris, but differed significantly between the biceps femoris and the two monoarticular muscles, vastus medialis and vastus lateralis. As both the biarticular agonist and coactive antagonist muscles fatigued at a higher rate than the two monoarticular muscles, it seems likely that this biarticular agonist/antagonist pair determines the time to the limit of endurance.

Adult↗
PubMed1998

[Clinical gait analysis--methods, limitations and possible applications].

Human gait is a complex and cyclic movement. Gait analysis of human walking can be done either without any technical support, or in combination with complex and expensive equipment. Modern gait analysis is based on the integration of multiple components to derive a complete analysis of gait. These methods may include observation, videotaping, electromyography, kinematics, kinetics and energetics. The results gained from these methods may then be used to determine the treatment course of a subject with gait abnormalities or to document the effects of therapeutical intervention. The purpose of this article is to provide an overview of the most common used methods in gait analysis. Emphasis will be placed on the type of information that can be derived from each component and how this information can be used clinically.

Electromyography↗
PubMed1997

[Importance and physiologic nutritional requirement of the selenium trace element within the scope of parenteral nutrition (TPN)].

BASIS: Selenium-responsive clinical manifestations of selenium deficiency and elucidation of the biochemical and molecular biological basis of the essentiality of selenium give evidence for the biological importance of the trace element in human nutrition. CONCLUSION: The dietary parenteral selenium requirement can be calculated on the basis of the maximal gene expression of the selenoprotein plasma glutathione peroxidase (plGPx). In total parenteral nutrition a daily requirement of 0.01 mumol/kg body weight for adults and 0.025 mumol/kg body weight for children can be seen as adequate and safe.

Adult↗
PubMed1997

Comparison of two insole materials using subjective parameters and pedobarography (pedar-system).

INTRODUCTION:: The objective of this trial was to investigate two commonly used insole materials prescribed for shock-absorption and cushioning concerning subjective and pedobarographic parameters. The design was prospective, controlled, randomized and single-blinded. MATERIAL AND METHODS:: A convenient sample of six healthy male adults without any history of leg or foot injury or pain wore -- in random order -- the custom-made insoles for one week. For both insoles the same base material (TEPEFON(R)) was used, insole 1 was covered with PLASTAZOTE(R) I, 3 mm, insole 2 with PPT, 3 mm. Both insoles had a metatarsal pad. After one week of wearing, in-shoe plantar pressures, measured at the same time of day and within the same type of indoor tennis shoes (sockliner removed), were obtained using the PEDAR-System(R) (Novel GmbH, Munich, Germany). Before each measurement the PEDAR-insoles were calibrated and the subject walked around for 5 minutes to get aquainted with the device. Three trials were performed for three different conditions and average values were determined: PEDAR-insole alone, with PLASTAZOTE(R) insole, with PPT(R) insole. Data were collected at self selected speed, gait velocity was determined using two optical switches on a 10 m walkway. Pressures were normalized to body weight. Main outcome parameters were 'Maximal Peak Pressure' (MPP) and 'Pressure Time Integral' (PTI). These parameters were determined for the whole footsole, medial and lateral heel, medial and lateral midfoot, medial, middle and lateral forefoot, hallux and toes II-V. Additionally the subjects filled in a questionnaire including: time wearing the insoles daily (in hours), sweating (visual analogue scale -- VAS), wearing comfort (VAS), perceived discomfort (location). Three months after the trial they were asked via telephone call whether they were still using the insoles. RESULTS:: 1. The overall MPP and PTI values did not differ significantly between the PEDAR-insole alone and the investigated inserts. There was a tendency for both insoles towards lower MPP and PTI values in all regions except for the toes, especially for the PPT(R) insole. 2. The questionaire showed a significantly higher wearing comfort for the PPT(R) insole in contrast to the PLASTAZOTE(R) insole, though all subjects sweated more with the PPT(R) material. Four of the six subjects experienced discomfort due to the metatarsal pad within the PLASTAZOTE(R) insole, only one within the PPT(R) insole. 3. None of the subjects continued to use the PLASTAZOTE(R) insole, but three continued to use the PPT(R) insoles. DISCUSSION:: Despite the significant differences in the subjective parameters, especially wearing comfort, no statistical significant difference for the overall MPP and PTI values between the PEDAR-insole alone and the investigated insoles or in between the insoles tested could be obtained. Yet there was a tendency for both insoles to lower MPP and PTI values in all regions except for the toes. This might be due to the thickness of the insoles and the reduced space within the toe box. The subjectively better tolerated PPT(R) insole tended to lower MPP and PTI more than the PLASTAZOTE(R) insole. CONCLUSION:: Wearing comfort and pedobarographic outcome measurements did not correlate significantly in this trial. Yet there was a tendency for the subjectively better tolerated PPT(R) insole to lower MPP and PTI more.

Journal Article↗