Search PubMed⌕ Search

Biomedical subjects

C Bartels

Publications and source records attributed to C Bartels.

At least 55 records · Page 3Linked to original sources

[Mining in the Harz Mountains in the times thereafter and its effects on the environment].

Not only during the industrial age have mining and metallurgy strongly influenced environmental developments. Since the beginning of mining activities and smelting ores, parts of the processed minerals, especially various heavy metals, have been lost during various technical operations and been distributed by water and wind over large areas. A good example for the Middle Ages and thereafter was the silver, lead, and copper mining district of the Harz Mountains in northeastern Germany. Environmental problems caused by the activity in this mining center have been known since the Renaissance. The rivers transported sand-like lead minerals over long distances, which were distributed over large areas by floods, especially in spring when the snow melted. The lead got into the food of various farm animals and poisoned them, as we know from the complaints of inhabitants of the area to the authorities particularly during the 17th-19th centuries. These environmental problems have been the subject of scientific studies as early as the first half of the 19th century.

Animals↗

Intraoperative autotransfusion in aortic surgery: comparison of whole blood autotransfusion versus cell separation.

OBJECTIVE: Differences concerning alteration of hemostatic, hemolysis, and hematologic parameters after transfusion of blood from a cell-separation (CS) device or whole blood autotransfusion (WBA) were prospectively evaluated during major aortic surgery. METHOD: Thirty-two patients were randomly selected to receive autologous retransfusion by using either WBA or a CS device. Coagulation and hematologic parameters and levels of hemolytic degradation products (HDP) were assessed in the retransfused blood and in the patients' plasma preoperatively and until 24 hours after autologous retransfusion, respectively. RESULTS: Mean volume of retransfused blood was 1072 +/- 473 ml in the WBA group and 556 +/- 504 in the CS group. Level of HDP (bilirubin, free hemoglobin [free HB], and lactic dehydrogenase [LDH] and hemostatic disturbances (d-dimer value, fibrin degradation products) were significantly higher in the WBA device compared with the CS blood. Blood samples taken from the WBA group revealed significantly higher level of HDP (free HB, LDH) and of d-dimer values after autotransfusion compared with the CS group. CONCLUSION: Levels of HDP and the degree of hemostatic disturbances were significantly higher in retransfused whole blood compared with CS blood. Hemostatic disturbances and levels of HDP were significantly pronounced in the patients' plasma after WBA compared with CS. CS retransfused blood seems to be of superior quality compared with WBA and the degree of hemolysis and hemostatic disturbances is minor after CS retransfusion.

Aged↗

Freud's impact on aphasiology--aphasiology's impact on Freud.

In 1891, Sigmund Freud published a book on aphasia. Although Freud's contribution to aphasiology could have been important in retrospect, it was hardly acknowledged for three quarters of a century. It may have had an impact on psychoanalytic theory, but this was not acknowledged by Freud. If there are neurological roots in psychoanalysis, they are buried by paradigmatic shifts in Freud's theory.

Aphasia↗

Significance of radiological diagnosis for detection and staging of inflammatory abdominal aortic aneurysm.

Operative morbidity and mortality are elevated in patients with inflammatory abdominal aortic aneurysm. Preoperative identification of inflammatory abdominal aortic aneurysm. the detection of the proximal level and of adhesions to adjacent structures are important for surgical management. The sensitivity and specificity of ultrasonography and computed tomography (CT) for identification and staging in 13 patients with inflammatory abdominal aortic aneurysm were studied. Preoperative radiological diagnoses were validated by intraoperative findings. Correct identification of inflammatory abdominal aortic aneurysm could be achieved in 85% by the use of CT and in 62% by ultrasonography. The proximal level of inflammatory abdominal aortic aneurysm was correctly determined by CT in all patients and by ultrasonography in 62%. Using a transperitoneal approach, the condition was considered inoperable in two patients as a result of the suprarenal extent of the aneurysm and because of unremovable adhesions in two other cases. In the latter pair, it was impossible to predict inoperability by radiological findings. Sensitivity (85%) and specificity (100%) of standard radiological techniques to identify inflammatory changes are high. Inoperability caused by suprarenal extent could be detected correctly by routine radiological procedures. However, identification of dense adhesions appears uncertain.

Adult↗

Poststroke depression. Is there a pathoanatomic correlate for depression in the postacute stage of stroke?

BACKGROUND AND PURPOSE: This study is aimed at the pathoanatomic correlates of depression in the postacute stage of patients with stroke. METHODS: Of a consecutive series of 104 stroke patients, a subgroup of 47 patients with single demarcated unilateral lesions was selected. Clinical examination, neuroradiological CT scan examination, and psychiatric assessment were performed within a 2-month period after the acute stroke. Depression was assessed with the Cornell Depression Scale, the Montgomery-Asberg Depression Rating Scale, and according to modified DSM-III-R criteria. The neuroradiological examination of all patients was performed on the same scanner, and lesion location, lesion volume, and ventricle-to-brain ratio were analyzed. RESULTS: We found no significant differences in depression scores between patients with left and right hemisphere lesions and no correlation between the severity of depression and the anteriority and the volume of lesion or brain atrophy. Major depressive disorders were only found in nine patients with left hemisphere lesions, all involving the basal ganglia, whereas none of the patients with right hemisphere stroke exhibited major depression. CONCLUSIONS: Lesions in the vicinity of the left hemisphere basal ganglia tend to play a crucial role in the development of major depression after the acute stage of stroke. The pathophysiological implications of this finding are discussed.

Brain↗

Classification of congenital arterial and venous vascular malformations.

Arterial and venous vascular malformations due to congenital abnormalities rarely occur in the daily practice of vascular surgeons. These malformations represent a heterogeneous group of isolated or multiple congenital abnormalities, sometimes associated with complex congenital syndromes. Correct recognition and classification of these rare abnormalities may sometimes be difficult. No systematic classification of arterial and/or venous vascular malformations due to congenital abnormalities is currently available. On the basis of embryologic and pathophysiologic considerations, a rational and simple classification of arterial and venous vascular malformations due to congenital abnormalities can be performed. This contribution presents an appropriate classification of clinically important arterial and venous vascular malformations due to congenital abnormalities.

Abnormalities, Multiple↗

F.P. Weber syndrome associated with a brachial artery aneurysm. A case report.

Klippel-Trenaunay syndrome is characterized by the triad of unilateral port-wine hemangiomas, varicose veins, and hypertrophy of bone and soft tissue affecting one or more limbs. The rare F.P. Weber syndrome describes the mentioned entity and additional arteriovenous malformations. The association of an arterial aneurysm with the F.P. Weber syndrome has never been described in the current literature. A case of a brachial artery aneurysm in a patient with F.P. Weber syndrome is presented and the etiology of arterial aneurysm combined with congenital vascular abnormalities is discussed.

Adult↗

[Determining patient staff with regard to needs and requirement profile for neuropsychologists, speech therapists and occupational therapists of acute care neurologic clinics in Germany].

The directors of neurological emergency-care departments were asked about the number and work profile of psychologists, occupational and speech therapists in their institutions. A majority of departments in West Germany employed their own speech and occupational therapists. In East Germany, a majority had their own psychology service. Work profiles and demands for personnel did not differ between the East and West. On the basis of the results, recommendations are made for the number of therapists required in neurological emergency-care departments.

Acute Disease↗

The importance of colloid osmotic pressure measurements to prevent oncotic overdosage during cardiac surgery.

OBJECTIVE: Colloidal infusion therapy during cardiac surgery has changed from the principal use of human albumin to the preference for synthetic colloids. Despite the possible interference of synthetic plasma expanders with the biuret determination of total plasma protein (TPP), perioperative infusion therapy is frequently directed on the basis of TPP and albumin levels. The hypothesis that the level of TPP or albumin does not reflect the plasma colloid osmotic pressure (COP) if synthetic plasma expanders are used was studied. MATERIALS AND METHODS: In 61 patients undergoing elective cardiac surgery the course of COP and its correlation to the TPP and albumin levels were investigated. Natural and artificial colloids were used for colloidal infusion therapy. RESULTS: No correlation between TPP/albumin levels and COP was found preoperatively and on arrival at the ICU, only a weak correlation was observed at 24 hours and 48 hours postoperatively. The wide range of the confidential interval indicates that the COP cannot be estimated correctly neither from the TPP nor the albumin level. The postoperative COP was significantly increased compared to the preoperative levels indicating oncotic overdosage. CONCLUSIONS: In order to avoid oncotic disturbances, indication for colloidal volume replacement during cardiac surgery should be controlled by oncometry if natural and synthetic colloids are administered.

Blood Proteins↗

The significance of anticardiolipin antibodies and anti-heart muscle antibodies for the diagnosis of postpericardiotomy syndrome.

Postpericardiotomy syndrome (PPS) is a frequent complication after cardiac surgery. In a recent study, elevated anticardiolipin antibody (ACLA) titres were observed in patients with PPS. The value of anti-heart muscle antibodies (AHA) for the diagnosis of PPS remains controversial. Therefore, a prospective double-blind study was performed to test the sensitivity and specificity of ACLA and AHA for the diagnosis of PPS. ACLA titres (ELISA) and AHA, elevated by immunofluorescence, the clinical course and routine laboratory parameters were assessed in 57 patients before and after elective cardiac surgery. ACLA increased and AHA first appeared after surgery in patients both with and without PPS. The sensitivities of a > or = 1.5-fold increase in IgM-ACLA titres, of a > or = 2-fold increase in IgG-ACLA titres and of the occurrence of AHA > or = 2+ for the diagnosis of PPS were 60%, 20% and 20%. The respective specificities were 43%, 79% and 85%. Thus, after cardiac surgery, increased ACLA titres and the occurrence of AHA, as assessed by immunofluorescence, may only contribute to the diagnosis of PPS to a limited extent.

Aged↗

Intraoperative whole blood autotransfusion during venous thrombectomy.

OBJECTIVE: Intraoperative autotransfusion is currently performed using two different systems, the relatively expensive cell-saving device washes and concentrates red cells and the more simple, economical total disposable device for whole blood collection and retransfusion. Some institutions prefer the cell-saving device because of previously documented side-effects of whole blood autotransfusion. As some investigators more recently reported the application of whole blood autotransfusion without clinical complications, the potential hazards of whole blood autotransfusion are now being controversially discussed. MATERIALS AND METHODS: The potential side-effects using whole blood autotransfusion were studied in 100 patients prospectively undergoing venous thrombectomy. The effectiveness of homologous transfusion reduction was assessed in comparison with an historical patient group (n = 10, control group). RESULTS: In the study population a mean of 1064 ml shed blood (67% of total blood loss) was retransfused. A mean of 247 +/- 292 ml of homologous blood was transfused in the study group. In contrast, homologous blood requirement was significantly higher (1056 +/- 659 ml, p < 0.006) in the control group. No hematologic, hemeostatic, renal or pulmonary complications occurred after intraoperative whole blood autotransfusion. CONCLUSIONS: Whole blood autotransfusion is a safe, easy and economical procedure and highly effective in reducing homologous blood transfusions and costs.

Blood Loss, Surgical↗

Depression in acute and chronic aphasia: symptoms, pathoanatomical-clinical correlations and functional implications.

Depressive alterations were investigated in 21 acute and 21 chronic aphasic patients with single left sided strokes. The assessment of depression was based on a psychometrically evaluated German version of the Cornell Scale for Depression (CDS) and the Research Diagnostic Criteria (RDC). No significant difference was found concerning depression sum-scores between the two aphasic groups. The acute group, however, exhibited significantly higher ratings in items related to physical signs of depression and disturbances of cyclic functions. Patients corresponding to the RDC-syndrome of major depression were only found in the acute group. Neither age, sex nor degree of hemiparesis discriminated the patients on the severity of depressive symptoms. In the acute patient group, nonfluency of aphasia was the only parameter that could be identified which had an effect on the mood symptom scores. A CT scan analysis in the acute patient group showed an association between the severity of depression and anterior lesions. A significant correlation was found between CDS sum-scores and the proximity of the anterior border of the lesion to the frontal pole of the hemisphere whereas the volume of lesions seemed to have no effect on depressive alterations in acute aphasic patients. Superimposition of the lesions of the aphasic patients with major depressive disorders showed a common subcortical lesion area involving putaminal and external pallidal structures.

Acute Disease↗

Size and physical map of the Campylobacter jejuni chromosome.

The chromosome of Campylobacter jejuni is circular and approximately 1700 kb in circumference. The size of the genome was determined by field inversion gel electrophoresis of restriction endonuclease fragments using lambda DNA concatamers and yeast chromosomes to calibrate the size of the fragments. In view of the low (32-35%) G + C content of the campylobacter genome, enzymes that recognizes GC-rich sequences were used. Of the enzymes tested BssHII (G/C(G)CGC), NciI (CC/CGCG) and SalI (G/TCGAC) appeared to be usable. Hybridization of labeled fragments with two or more fragments from digests with a different restriction enzyme gave the information to order the fragments on the C jejuni chromosome. The localization on the genome of the flagellin and ribosomal gene clusters was determined.

Base Sequence↗

Taxonomic and phylogenetic studies on a new taxon of budding, hyphal Proteobacteria, Hirschia baltica gen. nov., sp. nov.

Four strains of budding, hyphal bacteria, which had very similar chemotaxonomic properties, were isolated from the Baltic Sea. The results of DNA-DNA hybridization experiments, indicated that three of the new isolates were closely related, while the fourth was only moderately related to the other three. Sequence signature and higher-order structural detail analyses of the 16S rRNA of strain IFAM 1418T (T = type strain) indicated that this isolate is related to the alpha subclass of the class Proteobacteria. Although our isolates resemble members of the genera Hyphomicrobium and Hyphomonas in morphology, assignment to either of these genera was excluded on the basis of their markedly lower DNA guanine-plus-cytosine contents. We propose that these organisms should be placed in a new genus, Hirschia baltica is the type species of this genus, and the type strain of H. baltica is strain IFAM 1418 (= DSM 5838).

Bacteria↗

[Morphologic findings in dilated cardiomyopathy and their relation to hemodynamics and catecholamine concentrations in the plasma and myocardium].

In 72 patients with dilated cardiomyopathy the degree of morphological alterations were studied by transvenous endomyocardial biopsy. These findings were correlated to the clinical status, left ventricular ejection fraction, and to the catecholamine concentrations in plasma and myocardium. Muscle fiber diameter was negatively correlated to ejection fraction (r = -0.3, p = 0.02) and to the volume fraction of mitochondria (r = -0.32, p = 0.001). Between plasma norepinephrine concentration and ejection fraction a significant negative correlation was found (r = -0.37, p = 0.001). In contrast, myocardial norepinephrine concentration was positively correlated to ejection fraction (r = 0.25, p = 0.04). Between myocardial norepinephrine concentration and muscle fiber diameter a negative correlation was found (r = -0.46, p = 0.004). Patients with an EF of less than 30% and an EF of greater than 45% could be differentiated with an accuracy of 79%, when muscle fiber diameter, plasma norepinephrine concentration, and the density of capillary vessels were entered into a multi-variant analysis. In conclusion, dilated cardiomyopathy is associated with morphological alterations and alterations in plasma and myocardial catecholamine concentrations. Patients with highly reduced ventricular function could be best identified by the combined assessment of plasma catecholamine concentration, muscle fiber diameter, and density of capillary vessels.

Adult↗