Biomedical subjects

A Schulz

Publications and source records attributed to A Schulz.

At least 19 recordsLinked to original sources

PubMed2007

[Perioperative pain management in orthopaedics].

Organized orthopaedic pain management is a major part of successful patient treatment. Therefore pain management should start before surgery. Patients need to be informed about the operation and the subsequent procedures. Clinical pain management is based on continuous pain documentation with pain as the fifth vital sign. Surgery should be minimally invasive bewaring a peripheral modulated nociceptive sensitization. In order to prevent chronic pain preemptive analgesia should be employed followed by an individually tailored regimen of post-operative analgesia. In consideration of the documented pain levels post-operative pain therapy consisting of a standing medication and a rescue medication should by adjusted daily. Due to the fact that the highest pain levels after surgery were reported within the first 48 h pain medication should be reduced in the ensuing days, again taking the documented pain levels into account. Supportive treatment approaches such as cryotherapy or transcutaneous electrical nerve stimulation (TENS) are useful in the post-operative period. Physiotherapy after surgery should be extended stepwise regarding the operative device and it is of particular importance to respect pain intensities. The post-hospital regimen for a continuous pain medication should be given to the orthopaedic specialist.

Analgesics↗

PubMed2006

[Insufficiency fractures in rheumatology. Case report and overview].

Stress fractures occur as insufficiency fractures, with a prevalence of 0.8% in patients with rheumatological illness. The main sites of insufficiency fractures are the pelvis and sacrum, parts of the tibia and fibula that are close to the joints, and the calcaneus and hip. Since the painful symptoms overlap with the clinical picture of the painful joint diseases and because of the low sensitivity of conventional diagnostic X-ray, insufficiency fractures are not diagnosed directly or their diagnosis is delayed. The high sensitivity of computer tomography, skeletal scintigraphy and nuclear magnetic resonance imaging should be exploited in the diagnosis of insufficiency fractures. The case report presented describes insufficiency fractures of the distal right tibia and fibula in an elderly female patient with rheumatoid arthritis being treated with long-term glucocorticoids. In addition to advanced age, female gender, immobility and rheumatoid arthritis requiring long-term cortisone, there are further risk factors for insufficiency fractures: fluoride treatment over many years in the past, hypovitaminosis D3, renal failure. The DXA bone density values of the neck of the femur and the lumbar vertebrae do not show any osteoporosis, and the calcium concentration in the serum is low; phosphate is raised and parathormone is normal; osteocalcin, beta crosslaps and alkaline phosphatase are raised. Bone biopsy specimens taken from the iliac crest and the proximal femur and investigated for the purpose of differential diagnosis revealed renal osteopathy with secondary hyperparathyroidism and osteomalacia. In elderly patients with kidney failure, the possibility of renal osteopathy must be considered as the possible cause of reduced bone quality with a raised risk of insufficiency fractures, even when the parathormone levels are normal. In view of the frequency of osteopathies in rheumatological patients, osteology is of enormous significance in rheumatology.

Aged↗

PubMed2006

Yield strength of zirconia and glass fibre-reinforced posts.

The aim of this in vitro study was to evaluate the yield strengths of glass fibre-reinforced composite (FRC) posts and zirconia dioxide ceramic (ZDC) posts. Tapered glass FRC posts (DentinPost) and ZDC posts (Cerapost) of three sizes in diameter (ISO 50, 90, 110) were used for bending tests. Conventional prefabricated titanium posts of the same sizes served as control groups. The 0.2% yield strengths (R(0.2)) were tested on a universal testing machine. As zirconia posts fractured before they were yielded 0.2%, the fracture strength instead of the yield strength was recorded for these posts. One-way and two-way anova and Bonferroni-Dunn's multiple comparison tests were performed for the statistical analysis. The mean 0.2% yield strengths of the posts were 27 +/- 1 N for glass fibre-reinforced posts and 58 +/- 4 N for zirconia posts of ISO 50 (control group: 54 +/- 3 N). For ISO 90 yield strengths of 52 +/- 4 N for glass fibre-reinforced posts, 117 +/- 20 N for zirconia posts and 117 +/- 11 N for the control group were obtained. For ISO 110 mean yield strengths amounted to 73 +/- 5 N for glass fibre-reinforced posts, 166 +/- 23 N for zirconia posts and 141 +/- 12 N for the control group. Significantly higher yield strength was recorded for the zirconia and the titanium posts compared with the glass fibre-reinforced posts for the tested ISO sizes.

Dental Materials↗

PubMed2006

Bending resistance of unit cast posts-and-cores compared with noble posts following molten cast core attachment.

The aim of this in vitro study was to evaluate the bending resistance of unit cast posts-and-cores (UPC) and prefabricated high noble posts with cast-on cores. Tapered posts (ER post-restoring system) of three sizes in diameter (ISO 50, 90, 110) were investigated: UPC were cast of three different alloys (Au-Pt-Pd, Au-Ag-Pt, Co-Cr-Mo). Also, prefabricated tapered noble posts (Heraplat and Pt-Ir) were cast over with metal cores of the different alloys. Prefabricated titanium posts of each size were precision fit into the central core channels of the Co-Cr-Mo cores to serve as control specimens. The 0.2% yield strengths (R(0.2)) of all specimens were tested on a universal testing machine. One-way and three-way anova and Bonferroni-Dunn's multiple comparison tests were performed for the statistical analysis. The mean bending resistance R(0.2) of the unit cast posts-and-cores was 45 +/- 4-46 +/- 5 N for ISO 50 (control group: 54 +/- 3 N), 91 +/- 9-93 +/- 7 N for ISO 90 (control group: 117 +/- 11 N) and 115 +/- 13-130 +/- 12 N for ISO 110 (control group: 141 +/- 12 N). Except for the Au-Pt-Pd UPC of ISO 110, the yield strengths of the control groups were significantly superior to all unit cast alloy combinations (P < 0.05). Significantly lower bending resistance was found for Co-Cr-Mo cores cast over Heraplat and Pt-Ir posts compared with the corresponding Heraplat/Au-Ag-Pt, Heraplat/Au-Pt-Pd and Pt-Ir/Au-Ag-Pt posts-and-cores.

Dental Alloys↗

PubMed2005

Influence of peroxisome proliferator-activated receptor gamma gene polymorphism on 24S-hydroxycholesterol levels in Alzheimer's patients.

The peroxisome proliferator-activated receptor gamma (PPARgamma) is a nuclear hormone receptor, that is involved in lipid and glucose metabolism, which both seem to influence the risk of Alzheimer's disease (AD). 24S-Hydroxycholesterol is the major cholesterol elimination product of the brain and plasma and CSF 24S-hydroxycholesterol levels are altered in patients with neurodegenerative diseases. We investigated the effect of the common Pro12Ala variant of the PPARgamma gene on plasma cholesterol levels and 24S-hydroxycholesterol/ cholesterol ratios in 124 AD patients and 77 healthy controls. Furthermore, the influence of PPARgamma polymorphism on the risk of AD in 247 AD patients and 324 healthy controls was investigated. We found that PPARgamma Pro12Ala polymorphism influenced plasma 24S-hydroxycholesterol/ cholesterol ratios in AD patients in that carriers of the Ala allele presented with higher ratios than homozygote carriers of the Pro-allele. PPARgamma polymorphism did not influence the risk of AD. These results might point to an influence of PPARgamma Pro12Ala polymorphism on the elimination of 24S-hydroxycholesterol.

Aged↗

PubMed2005

Hepatoblastoma in a child with progressive familial intrahepatic cholestasis.

End-stage liver cirrhosis because of metabolic or infectious diseases predisposes to hepatic malignancies like hepatocellular carcinoma. We report the first case of hepatoblastoma incidentally detected in the explanted liver of a 2-yr-old child undergoing liver transplantation for cirrhosis because of progressive familial intrahepatic cholestasis (PFIC). The diagnosis was difficult to obtain. The hepatoblastoma was not seen on ultrasound examination of the cirrhotic liver. As we could confirm retrospectively, alpha fetoprotein (AFP) was found elevated prior to transplantation. Two years after successful transplantation, there are no signs of malignancy detectable by clinical and radiological methods. We conclude from this case that PFIC may induce hepatoblastoma and that children with liver cirrhosis should undergo routine screening of serum AFP concentration.

Child, Preschool↗

PubMed2005

[Animal welfare aspects regarding the raising of breeding ostriches in Germany].

The commercial housing of African Ostriches in Germany for the breed and meat production still represents a disputed topic under the criterion of the animal's welfare. Above all critics state that the frequently wet-cold weather in Germany impairs the well-being and health of the animals. So far however there are just a few scientifically documented data about requirements for housing conditions of ostriches in Central Europe and thus hardly answers whether housing in Germany is possible under the criteria of the animal's welfare. This study tried to evaluate ostrich housing under South German climatic conditions (Rhine level), on the basis of behavioral observations of breeding ostriches. The use of the stable and the influence of different climatic parameters on the behavior were considered. In addition the behavior of 18 adult animals in 5 breeding groups from January to December 2002 was observed. Parallel various climatic data were raised. The housing of the animals took place in open stables with unrestricted pasture possibility. The ostriches reacted in their behavior to different climatic conditions. Particularly at cold weather and adverse soil conditions they used the open stable increasingly as weather protection. In addition, with increased wind velocities the animals spent more time in the stables. The daily amount of precipitation showed no influence on the frequency or duration of the stable use. Rainfall did not animate the animals to look for protection within the stable, but more to set itself on the ground in the external enclosure. The locomotion activity of the animals was strongly in dependence to the reproduction time and the territorial behavior and therefore highest in spring. On cold days the animals performed their reproduction behavior mainly in the stable. For the comfort behaviour distinct weather dependence was seen particularly for sand bathing. Warm temperatures and dry sand were the preconditions for it. Regarding the results it seems, that with the conditions existing on the examined farm, housing of ostriches under respect of animal welfare in Germany is possible. New regulations are to be demanded, adjusted to the newest level of knowledge about ostrich husbandry, with requirements for care, support, accommodation and nutrition of the animals as well as about the qualification of the owners. An occasional hobby animal husbandry limited to few single ostriches is to be rejected. Further scientific investigations at other farms, possibly also under variable climatic conditions are however necessary.

Animal Welfare↗

PubMed2004

Polymorphisms in glutathione S-transferase omega-1 and AD, vascular dementia, and stroke.

BACKGROUND: Glutathione S-transferase omega-1 (GSTO1) protects from oxidative stress, a risk factor for Alzheimer disease (AD), vascular dementia (VaD), and stroke. Polymorphisms in GSTO1 might influence the function of the protein and thus the risk of AD, VaD, and stroke. METHODS: The GSTO1 gene was screened for variations. The effect of the detected polymorphisms on the risk of AD, VaD, and stroke was evaluated. CSF levels of cholesterol and plasma homocysteine levels were compared according to the GSTO1 genotype. RESULTS: Two missense polymorphisms in exon 4 of GSTO1 (Ala140Asp and Glu155DeltaGlu) were detected and tested for their association with AD, VaD, and stroke. The Asp/Asp and Ala/Asp genotypes increased the risk of stroke (p = 0.003, OR = 2.1), and the Asp/Asp genotype increased the risk of VaD (p = 0.02, OR = 2.2). GSTO1 polymorphisms did not influence the risk of AD, but the Asp allele influenced the age at onset (p = 0.05). In nondemented probands CSF levels of cholesterol were increased in carriers of the Asp/Asp genotype (p = 0.004); however, in patients with manifest dementia the authors found decreased CSF levels of cholesterol in carriers of the Asp/Asp genotype (p = 0.028). Serum homocysteine levels in stroke patients were higher in carriers of at least one Asp allele (p = 0.011). CONCLUSION: The GSTO1 Asp allele may be a genetic risk factor for cerebrovascular diseases, and might influence the course of Alzheimer disease, even though effects vary in different studies.

Adult↗

PubMed2004

Continuous measurements of cerebral tissue oxygen pressure during hyperbaric oxygenation--HBO effects on brain edema and necrosis after severe brain trauma in rabbits.

INTRODUCTION: Severe brain injury is one of the most frequent causes of severe disability in the young. In acute management of brain trauma, new approaches based on experimental animal investigations should be sought. METHODS: Twenty male, juvenile Chinchilla-Bastard rabbits received standardized cold-injury-induced-brain-trauma (CIBT). A metal probe (temperature -196 degrees C) was applied epidurally over 10 s. The hyperbaric oxygenation (HBO) group (n=10) underwent 90-min HBO sessions with 100% oxygen at 2.5 atmospheres absolute (1 h, 24+/-2 h, 48+/-2 h after CIBT). Cerebral tissue pO2-measurements were performed 60 min after CIBT, during the three HBO sessions and on day 4. The control group (n=10) underwent no treatment. Animals were sacrificed on day 4, and brains were analyzed histologically. RESULTS: In the HBO group, pO2 measurements showed a significant increase in pO2 between day 1 and day 4, whereas no significant changes were observed in the control group. During the first HBO session, mean pO2 was 169 mm Hg, during the second 305 mm Hg and during the third 420 mm Hg. The mean area of necrosis was 16.2 mm2 in the HBO group, in the control group 19.9 mm2. The areas of brain edema were significantly smaller in the HBO group. Mortality in the HBO group was 0%, in the control group 20%. CONCLUSION: HBO appears to be beneficial as an adjunct treatment of severe head trauma. To find optimal treatment protocols, further clinical studies must be developed.

Animals↗

PubMed2004

Caged probes: a novel tool in studying symplasmic transport in plant tissues.

Caged probes offer a novel approach to study plant cell-to-cell communication. Instead of introducing fluorescent molecules into cells by microinjection, their caged counterparts can be preloaded into the tissue by diffusion. Following spatially controlled photoactivation, movement of the uncaged fluorochrome can be followed in time and direction by confocal laser scanning microscopy. In the onion bulb scale epidermis used as a model system, symplasmic transport of the tracer out of a target cell was followed. Transport via the symplasmic pathway was challenged by plasmolysing the tissue. The experiments confirmed the symplasmic nature of tracer transport.

Biological Transport↗

PubMed2004

C2 blood concentrations of orally administered cyclosporine in pediatric liver graft recipients with a body weight below 10 kg.

Pharmacokinetic studies in adult and pediatric liver transplant recipients have shown that the C(2) monitoring is superior to the traditional determination of CsA trough levels (C(0)) as an estimate of CsA exposure. However, target reference values for C(2) in very small infants have not been established yet. The objective of our study was to assess the distribution of C(2) levels in the first week following Ltx and to analyze enteral absorption of CsA for this group of patients. We documented CsA C(0) and C(2) levels in 25 infants with a body weight below 10 kg (median 6.8 kg; range 3.0-9.8 kg) in the first 7 days after Ltx. The infants had a median age at transplantation of 7 months (range 0.3-20.0 months). The underlying diagnoses were biliary atresia (n = 17), acute liver failure (n = 4), metabolic disease (n = 4). All children received CsA microemulsion (Neoral, initial 10 mg/kg/day), prednisolone, and two single doses of basiliximab as immunosuppressive drugs. The mean C(0) and C(2) levels were as follows: day 1: C(0) 77.0 +/- 39.6, C(2) 340.5 +/- 140.0 ng/mL; day 2: C(0) 135.5 +/- 53.2, C(2) 467.0 +/- 168.2 ng/mL; day 3: C(0) 146.5 +/- 70.8, C(2) 519.0 +/- 219.1 ng/mL; day 4: C(0) 168.5 +/- 55.1, C(2) 570.0 +/- 163.7 ng/mL; day 5: C(0) 156.5 +/- 38.0, C(2) 612.0 +/- 132.4 ng/mL; day 6: C(0) 177.0 +/- 41.1, C(2) 606.0 +/- 149.2 ng/mL; day 7: C(0) 174.0 +/- 27.2, C(2) 622.0 +/- 98.8 ng/mL (r = 0.82, p < 0.05). This analysis demonstrates that there is a good enteral absorption of CsA in very small children post-Ltx in the early post-operative period. Based on the C(2) levels achieved, we conclude that there is a good correlation between C(0) and C(2) levels even in very small infants.

Administration, Oral↗

PubMed2004

Reappraisal of thromboangiitis obliterans--a pathological contribution.

Thromboangiitis obliterans (TAO), the Winiwarter-Buerger disease, is a vasoocclusive disease of unknown etiology which typically affects medium-sized extremital vessels of young male smokers. While the diagnosis of TAO is largely based on patients' presentation and clinical criteria, pathological substrates have been poorly defined and repeatedly disputed. Comparing the histology and immunohistochemistry of TAO especially with those of arteriosclerosis obliterans (ASO) and thromboembolism in two larger studies, we recently identified several features with significant meaning for the differential diagnosis. The unique tissue appearance of TAO is in favor of a general disorder of minute vessels indicating periarteritis rather than pure endarteritis, whereas an inflammatory reaction directed to the internal elastic lamina corresponds with the severity of disease. Since TAO or its syndromic equivalent is probably more common than currently diagnosed, the presented pathological criteria may help to identify latent cases, the overlap with ASO, and untypical organ involvement of TAO.

Age of Onset↗

PubMed2003

[American cutaneous leishmaniasis: special features in diagnosis and therapy].

HISTORY AND CLINICAL FINDINGS: Three weeks after returning from a trip to Guatemala, a 33-year-old man developed two ulcers with indurated edges on his right leg and painful lymph nodes in the right groin. His general condition was not impaired. EXAMINATIONS: Histological examination revealed cellular infiltrates of the corium by lymphocytes and plasma cells, always accompanied by epithelial cells and multinuclear giant cells. Special stainings were unable to detect pathogens but Leishmania brasiliensis was identified using PCR. The Leishmania culture remained negative. THERAPY AND COURSE: After 7-day intravenous therapy with 20 mg/kg/d pentostam (pentavalent antimonial compound), the patient developed gastrointestinal complaints, coupled with a marked elevation of transaminases. Therapy was discontinued until the transaminase values normalized, then continued in reduced dosage (12 mg/kg body weight) for 23 days. The ulcers and lymphadenitis healed under this therapy. CONCLUSION: The diagnosis of American cutaneous Leishmaniasis may be complicated by the relative lack of pathogens in the lesions. PCR diagnosis are very helpful here. The therapy must be systemic owing to the danger of progression to mucocutaneous Leishmaniasis. The standard therapeutic pentostam has, however, a high rate of side effects and administration is exclusively intravenous.

Adult↗

PubMed2003

Polymorphism in the peroxisome proliferator-activated receptor alpha gene influences the risk for Alzheimer's disease.

The peroxisome proliferator-activated receptor alpha (PPAR-alpha) is a member of the steroid hormone super family of ligand-inducible transcription factors, involved in glucose and lipid metabolism. We screened for polymorphisms in the PPAR-alpha gene and detected two known polymorphisms located in exon 5 and intron 7. These polymorphisms were investigated for their possible association with Alzheimer's disease (AD) and for their effect in carriers of an insulin gene (INS) polymorphism. The PPAR-alpha C --> G polymorphism in exon 5 (L162V) was associated with AD, in that the V-allele was more frequent in AD patients than in healthy subjects. Further data analysis revealed that carriers of an PPAR-alpha L162V V-allele and an INS-1 allele presented with an increased risk for AD. Cerebrospinal fluid amyloid-beta levels were influenced by PPAR-alpha L162V genotype. These results suggest, that PPAR-alpha polymorphism may be a risk factor for AD.

Aged↗

PubMed2003

Development of Cuscuta species on a partially incompatible host: induction of xylem transfer cells.

The growth of dodders, Cuscuta reflexa and Cuscuta japonica, on the partially incompatible host poinsettia ( Euphorbia pulcherrima) is studied. Poinsettia responds by bark growths to the formation of the dodder haustoria and prevents dodder from obtaining normal growth. The growth instead becomes extremely branched, coral-like, and dodder lacks the ability to form haustoria. After a period of coral-like growth, long shoots sprout, resembling the normal growth. These long shoots mark an ending phase for dodder, which dies shortly after without having flowered. During the coral-like growth phase, dodder develops transfer cells in the parenchyma cells bordering the vessels of the xylem in the shoot. The transfer cells have not been observed when dodder is grown on the compatible host Pelargonium zonale. A coral-like growth phase has also been observed at the establishing phase when dodder is grown in vitro on agar; later a more normal growth form takes over. In this coral phase, xylem transfer cells are also developed. The fluorochromes carboxyfluorescein and Texas Red were loaded into the host in the phloem and xylem, respectively, and detection of these fluorochromes in the dodder stem indicated that a functional haustorial contact developed for both vascular systems. The results show that Cuscutaspp. have the genetic ability to develop xylem transfer cells and use this in response to developmental stress.

Cuscuta↗

PubMed2003

Chronic cutaneous sclerodermoid graft-versus-host disease: evaluation by 20-MHz sonography.

BACKGROUND: Chronic graft-versus-host disease (GVHD) is an immunological disorder frequently occurring as a late consequence of allogeneic bone marrow transplantation. Two variants, cutaneous lichenoid and sclerodermoid, have been described, based on clinical and histopathological examinations. It is, however, difficult to determine non-invasively the degree of cutaneous GVHD in vivo. Ultrasonographic methods have recently provided us with the means for objective and non-invasive monitoring of the dynamics of many chronic skin diseases. AIM, PATIENTS AND METHODS: In five patients with chronic cutaneous sclerodermoid GVHD skin thickness was measured with a 20-MHz B-mode ultrasound scanner (DUB 20S, taberna pro medicum, Lüneburg, Germany) in a clinically well-defined target skin lesion. Additionally cutaneous GVHD was assessed histologically before and after treatment. RESULTS: In all patients before treatment the corium of sclerotic skin was thicker than the corresponding areas of healthy skin. The skin thickness was increased from 45% to 83%. In the subcutaneous tissue proper echo-rich reflexes were prominent, representing the correlate of subcutaneous fibrotic trabeculae. In all patients ultrasonographic evidence of regression was shown (decrease of skin thickness by 18-83%). Moreover, it was demonstrated that quantitative assessment of skin thickness is feasible. CONCLUSIONS: In this paper we describe the detailed sonographic features of cutaneous sclerodermoid GVHD for the first time. As the method is simple and non-invasive, repeated examinations are possible. This provides the basis for monitoring treatment effects and efficient follow-up in these chronically progressive clinical conditions after bone marrow transplantation.

Adolescent↗

PubMed2003

Graft patency and clinical outcome of femorodistal arterial reconstruction in diabetic and non-diabetic patients: results of a multicentre comparative analysis.

OBJECTIVE: in diabetic patients with critical limb ischaemia (CLI) an inferior success rate following infrainguinal bypass surgery is quite often suggested. The aim of this retrospective analysis was, therefore, to evaluate the graft patency and, particularly, the clinical outcome at 1 year in diabetic compared with non-diabetic patients. MATERIAL AND METHODS: two hundred and eleven patients (diabetics 94; non-diabetics 117) with femorodistal reconstruction for CLI were studied. Groups were comparable with regard to the Fontaine classification, the distribution of vascular risk factors, graft material, distal anastomosis site, and the angiographic runoff grading. RESULTS: diabetes did not adversely affect graft function. For diabetics and non-diabetics primary cumulative patency rate at 1 year was found to be 66 and 56%, respectively (p=0.10) and a virtually identical limb salvage rate of 85 and 83% was achieved (p=0.76). With regard to healing of ischaemic foot ulcers a trend against diabetics was noted with a healing rate of 81% compared to 96% in non-diabetics at 1 year (p=0.067); gangrenous foot lesions could be equally remedied in 94% and in 87% among patients with and without diabetes (p=0.44). The survival rate of diabetics, however, was significantly lower with 78% at 1 year compared with 95% in non-diabetic patients (p=0.0004). CONCLUSIONS: our preliminary results support the view that infrainguinal bypass grafting can be safely done even in diabetics. Despite increased mortality in this group, liberal indication for reconstructive vascular surgery seems to be justified by favourable patency rates and clinical outcome in selected patients.

Aged↗

PubMed2003

[Morphe and function - Kurt Goldstein's understanding of the Babinski phenomenon].

Viewed in terms of the theory of science and medicine, one of the striking features characterizing the period extending from the end of the 19 (th) century to the first third of the 20 (th) century was the formulation of concepts of etiopathogenesis. Existing theories on the morphe and structure of human cells, tissues, and organs were enlarged by models focusing on the function of these elements and structures of the organism. This enlargement of etiopathogenic concepts, including biperspective observation, occurred in the fields of internal medicine (Gustav von Bergmann), psychiatry (Erwin Straus), and neurology (Kurt Goldstein). In the light of Goldsteins's understanding of the Babinski phenomenon, the present paper seeks to show what fundamental questions spring from a theory of the human organism that takes into account both morphe and structure and function. Studies of historical models of this kind are both meaningful and justified in that they include constructs and guiding theoretical principles (like, for instance, biperspective access to the patient and his/her disease) which are of immediate relevance in addressing problems with which psychosomatics and medicine are challenged today.

Germany↗