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Biomedical subjects

A Meissner

Publications and source records attributed to A Meissner.

108 records · Page 6Linked to original sources
PubMed1989

Kidney- and serum derived proteins in urine of patients suffering from renal diseases or arterial hypertension.

Excretion patterns of kidney related urinary proteins such as lysosomal beta-N-acetylglucosaminidase (beta NAG), brush-border Ala-(Leu-Gly)-aminopeptidase (AAP), gamma-glutamyl transpeptidase (GGT), and alkaline phosphatase (AP) as well as of IgG, albumin, and alpha-1-microglobulin, were assessed in patients with chronic glomerulonephritis (n = 53), pyelonephritis (n = 27), systemic lupus erythematodes (n = 5), and patients with essential arterial hypertension (n = 18). Excretion of tubular marker enzymes and serumproteins (related to urine creatinine concentration = protein creatinine index) in spontaneously voided second morning urine was significantly higher as compared to the controls (n = 2). Alpha-1-microglobulin was markedly elevated in both pyelonephritis and glomerulonephritis indicating disturbance in tubulointerstitial handling of microglobulins also in cases with primary glomerulopathy. Rise of albumin, IgG, and alpha-1-microglobulin as well as of tubular kidney markers AAP, AP, GGT, and beta NAG in cases with arterial hypertension without preexisting nephropathy support the hypothesis of a defect in charge and size permselectivity in these patients which is probably due to an increase in glomerular capillary perfusion pressure and hyperfiltration.

Adult↗
PubMed1989

[Lack of tolerance development with low dose nitrate administration in acute myocardial infarct].

Reports on the development of tolerance have modified the use of nitrates in the treatment of coronary heart disease. Dosage limitations and nitrate-free intervals are frequently recommended to solve this problem (4, 5). In the clinical setting of acute myocardial infarction continuous application of glyceryl trinitrate (GTN) is still a widely used therapy (1). In this study we investigated whether a low-dose intravenous GTN administration leads to a rapid development of tolerance. During the observation period of 60 h, no attenuation of drug effects on the pulmonary pressures could be detected. Subsequent oral medication also showed an undiminished nitrate response.

Aged↗
PubMed1989

[Plate osteosynthesis of forearm fractures in adults and adolescents. Long-term results and problems].

Based on the results reported in the literature, the method applied by us in the management of forearm shaft fractures is presented and explained. The advantages and remaining problems of the method are discussed on the basis of the results obtained in the follow-up of 45 ulna-, radius- or forearm shaft fractures treated by means of DC-plate osteosynthesis. The procedure is complication-free and has a low pseudarthrosis rate. To avoid refractures, the material should not be removed earlier than one and a half year following osteosynthesis. Axis shifts of more than 10 degrees and differences in length of more than 2 mm should be avoided and should be corrected in working patients.

Adolescent↗
PubMed1989

[Intrathoracic hemorrhage of the intra-abdominal organs following diaphragmatic rupture. A rare cause of hemothorax].

After posttraumatic diaphragm ruptures in some cases life threatening haemorrhages from intraabdominal organs (especially from the spleen) into the thorax were found. In general, the diagnosis cannot be established by peritoneal lavage or abdominal sonography. And in case of emergency, there is often not enough time to obtain a computed tomography. It is therefore extremely important for the patient's prognosis that the surgeon initially performing treatment be aware of this cause of bleeding. Correct interpretation of the chest x-ray, for instance in the case of stomach air in a left basal shadow above the diaphragm, can confirm the suspicion, and the urgently required operation can be performed in time.

Abdominal Injuries↗
PubMed1989

[Developments in the treatment of fractures of the coxal end of the femur].

The therapeutic concept for proximal femur fractures has changed to varying degrees from 1978 to 1988 in the Department of Traumatology and Reconstructive Surgery at Steglitz Medical Center. In general, conservative therapy has been abandoned. Alloplastic joint replacement is performed in patients with coxarthrosis in the fracture area. A head prosthesis is chosen for those with a life expectancy of less than eight years. Clearly favourable results have been achieved in our department with the Duokopf prosthesis. Patients with a higher life expectancy are submitted to a total hip endoprosthesis, preference being given in cases of collum femoris fractures to the combination of a Spotorno shaft and a Morscher acetabulum. Loading should only be partial for five weeks in patients treated with this cement-free total endoprosthesis. We use the Duokopf prosthesis in the combination of a Spotorno shaft with a Uni-Hip head. We submit these patients to full loading primarily. --We have completely abandoned Ender nailing. We prefer the dynamic hip screw for per- and intertrochanteric femur fractures. For subtrochanteric femur fractures, we use the condyl plate. For lateral collum femoris fractures we have used the four-hole angle plate until 1988. Since 1989 we also use the dynamic hip screw. The one-hole angle plate is used for osteosynthesis in cases of medial collum femoris fractures.

Adult↗
PubMed1989

[Gastric cancer: surgical results and survival].

From 1975 to 1984, 292 patients with gastric cancer were treated according to a prospective and standardized surgical protocol. This series included 195 men and 97 women, with an average age of 62.5 +/- 11 years (SD). In 20 patients (6.8%) surgery was not performed and 99 were considered unresectable at laparotomy. Gastric resection was performed in 173 (63.3%) (distal subtotal gastrectomy in 94 and total gastrectomy in 79). Operative mortality for subtotal gastrectomy was 3.1% and 6.3% for total gastrectomy. Early gastric cancer was found in 21 patients (none presented lymph node metastases). The cancer invaded the muscular layer in 18 (31% with lymph node metastases) and reached beyond the muscular layer in 134 patients (60.8% with lymph node metastases). The five year actuarial survival was 0% in patients who did not undergo gastric resection, 35.5% for those patients with tumor invading the serosal layer or beyond who were resected, 56.5% for those with invasion up to the muscular layer and 91.8% for patients with early gastric cancer. For those patients who underwent a curative resection, actuarial five year survival was 81%.

Actuarial Analysis↗
PubMed1988

[Intrapericardial teratoma in an adult].

The intrapericardial teratoma is a very rare congenital tumor of the heart which today is mostly diagnosed in early childhood using modern imaging devices. The course of a 46-year-old male who suffered from a pericardial effusion for the first time at the age of 13 is reported. During the subsequent three decades, the patient recurrently complained of chest pains. The final diagnosis was determined following surgical removal of the tumor and upon histological evaluation. The case reported here is unique because of clinical signs and symptoms of an intrapericardial teratoma documented in adolescence and adulthood over a period of 34 years.

Adult↗
PubMed1987

[Surgical therapy of dislocation fractures of the head of the humerus in adults. Personal procedure and results].

Surgical intervention is indicated in the vast majority of humerus head fracture dislocations. In the present paper, we report on the results of 24 such interventions performed between 1975 and 1984. Implantation of a T-plate is considered the standard procedure to obtain osteosynthetic stability during exercise. However, in elderly patients or in cases of multiple fragment fracture, this procedure is inadequate to achieve the required stability. In such cases, development of a humerus head necrosis would rather be promoted. If a sufficiently stable osteosynthesis without the risk of necrosis cannot be achieved, we prefer replacement of the humerus head by a shoulder prosthesis to humerus head resection, resection-interposition-arthroplasty or shoulder arthrodesis. However, not only optimal surgical management of humerus head fracture dislocations has a decisive influence on the later function of the most flexible human joint with the important rotator cuff, but also properly performed active and systematic postoperative physiotherapy.

Adult↗
PubMed1985

[Tendon rupture of the extensor muscles of the knee].

Five cases of rupture of the quadriceps tendon and two cases of rupture of the patellar ligament form the authors' own patient material (1975-1984) are reviewed. It seems we must differentiate between rupture of the quadriceps tendon (namely, rupture in an elderly patient with degeneratively changed tendon in trivial traumas) on the one hand, and rupture of the patellar ligament (rupture in the young patient with considerable trauma, as in sports) and hence a more or less purely traumatically caused rupture, on the other. Except for one case of spontaneous rupture associated with cortison treatment for several years, the four remaining quadriceps tendon ruptures were based on the same accident mechanism, the average age of these patients being 65 years: on trying to stabilize themselves while stumbling, the quadriceps muscle was suddenly tensed. In both cases of rupture of the patellar tendon, rupture occurred while jumping off a springboard during sports activities. The authors advocate protecting the tendon suture in quadriceps tendon rupture via a walking cast of the femur; in rupture of the patellar ligament, it is recommended to effect wire cerclage between patella and tuberositas tibiae. In each case, functional exercise should be initiated as early as possible.

Accidents↗
PubMed1983

The positive inotropic effect of aconitine.

1. The inotropic and electrophysiological effects of aconitine were measured in the isolated, isometrically contracting guinea-pig papillary muscle during the prearrhythmic phase of alkaloid action. 2. In muscles stimulated continually at 1 Hz, 1 mumol/l aconitine produced a positive inotropic effect that reached 38 +/- (SEM) 9% immediately before the onset of arrhythmia (n = 3). 3. If aconitine (0.5 mumol/l) was applied to non-stimulated (resting) muscles for 30 min and 1-Hz stimulation resumed thereafter, the arrhythmia occurred after 724 +/- 101 beats. Prolongation of the rest exposure to 2 h did not significantly diminish the number of prearrhythmic beats. Thus, the onset of aconitine action is critically determined by muscle activity (rather than by time), and a 30-min aconitine application to the resting muscle suffices for complete equilibration of the tissue. 4. Using the preequilibration-at-rest procedure, the positive inotropic effect of aconitine (0.25 - 4 mumol) was found (a) to be absent in the rested-state contraction, (b) to grow with both number of subsequent beats and alkaloid concentration, and (c) to reach a similar prearrhythmic maximum at all concentrations. This maximum amounted to about 1/4 of the maximum positive inotropic effect of dihydroouabain. It was not influenced by reserpine pretreatment of the guinea pig. 5. Aconitine (1 mumol/l) delayed the repolarization phase of the action potential by establishing a secondary plateau at approximately -60 mV. This effect paralleled the positive inotropic effect and, like the positive inotropic effect, was abolished by 10 mumol/l tetrodotoxin (TTX). In partially depolarized muscles ([K]0 = 24 mmol/l) aconitine (8 mumol/l) produced a TTX-sensitive increase in amplitude and rate of rise of the rested-state contraction; this indicates a voltage-dependent effect on some resting Na channels. 6. While delaying the late repolarization phase, aconitine markedly shortened the early repolarization at levels positive to -40 mV, reduced the overshoot and decreased the maximum rat of depolarization of the action potential. Slow action potentials ([K]0 = 24 mmol/l; 10 mumol/l TTX) were insensitive to aconitine. 7. We conclude that the well known property of aconitine to prolong the Na influx during the action potential leads to a positive inotropic effect, thus confirming the importance of Na influx for the regulation of myocardial contractility. The exact mechanism of an additional effect by which aconitine reduces the overshoot and shortens the plateau phase of the action potential awaits further study.

Aconitine↗
PubMed1976

Effects of ambient and stagnant hypoxia on the mechanical and electrical activity of the canine upper jejunum.

The effects of ambient and stagnant hypoxia on the mechanical and electrical activity of the upper jejunum were studied in 32 anesthetized dogs. A 50 or 75% reduction in oxygen content of inhaled air produced ambient hypoxia; superior mesenteric artery (SMA) occlusion or thrombin-induced mesenteric thrombosis resulted in stagnant hypoxia. Induction of hypoxia was immediately followed by a transient increase in mechanical activity. A 50% reduction in oxygen content had no other effect. A 75% reduction in oxygen content resulted in a gradual decrease in electrical control activity (ECA) frequency and in the disappearance of electrical response activity (ERA), and in jejunal contractions; however, ECA persisted until cardiac arrest occurred after 30 to 45 minutes of hypoxia. Occlusion of the SMA resulted in a significant decrease in contractile activity but ECA was not affected. Thrombin-induced mesenteric thrombosis produced rapid and irreversible disappearance of both electrical and mechanical activities. Jejunal contractions and ERA are dependent upon an adequate oxygenated blood supply. ECA however, is highly resistant to reduction in oxygen content of perfused blood and continues until perfusion stops.

Animals↗
PubMedDate not supplied

Adjuvant fosfomycin medication in chronic osteomyelitis.

The therapeutic effectiveness of adjuvant therapy with fosfomycin was studied in a prospective clinical trial of 60 patients suffering from chronic post-traumatic osteomyelitis. The patients were aged between 17 and 78 years (mean 37.4 years). The chronic osteomyelitis was predominantly located in the tibia (43 patients) and in the femur (13 patients). Most of the pathogens isolated were Staphylococcus aureus (42%), coagulase-negative staphylococci (19%), Pseudomonas aeruginosa (12%), streptococci (7%) and enterococci (5%). The pathogens isolated from the osteomyelitic foci were sensitive to fosfomycin. Fosfomycin concentrations in bone samples were determined in 19 patients. In the group of patients receiving initially 5 g fosfomycin, bone concentrations ranged between 119.4 and 451.2 mg/l of interstitial fluid. In the group of patients receiving initially 10 g fosfomycin, bone concentrations ranged between 117.1 and 3684.2 mg/l of interstitial fluid. The mean MIC90 values of the isolated pathogens ranged between 2 and 64 mg/l (S. aureus and Escherichia coli 2 mg/l, Proteus vulgaris 8 mg/l, streptococci groups A and B 32 mg/l and coagulase-negative staphylococci, enterococci and P. aeruginosa 64 mg/l). The outcome of treatment was assessed after a minimum of seven and a maximum of 53 months (mean 37 months). The results were: very good 54.7%, good 3.8%, satisfactory 15.1% and unsatisfactory 26.4%.

Adolescent↗
PubMedDate not supplied

[Vector mathematical model for the analysis of complex movements in 3-dimensional space exemplified by the divided symphysis].

For the analysis of complex movements in the divided pubic symphysis of cadavers a vector-mathematical model was developed. Overall movements is analysed in components, as translations in the three dimensions of space and rotations around the three axes of space, as error-free and as simply as possible by measuring the distances to different defined points. Experimental conditions, the development of a vector-mathematical system of analysis, error analysis and interpretation of results are shown. With this method it also possible to analyse similar problems in the same way.

Biomechanical Phenomena↗