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Biomedical subjects

C Muller

Publications and source records attributed to C Muller.

At least 181 records · Page 10Linked to original sources
PubMed1987

[Postoperative recurrent gastroduodenal ulcer: pathogenesis--reinterventions--results].

High 10-year recurrence rates following proximal gastric vagotomy (PGV) for pyloric/prepyloric ulcer (31.6%, European trial) result from antral stasis (Dragstedt-mechanism). Additional pyloroplasty reduces the recurrence rate to 16.6%. General causes of recurrence following PGV are primarily incomplete vagotomy and smoking: For incomplete vagotomy (Burge-test) 24.4% recurrences, for complete vagotomy 13.6% (10-year results); in smokers 38%, non-smokers 12%. Therapy is conservative in 80%. Selective gastric revagotomy and antrectomy as reoperation shows lowest recurrence rate (1.2%). The major cause of recurrence after partial gastrectomy is inadequate resection. Conservative therapy is successful in 76%. Reoperation should be transthoracic vagotomy with no mortality in 11 centers.

Gastrectomy↗
PubMed1987

[Hiatal hernia and reflux disease--long-term results following fundoplication and consequences in therapeutic failures].

UNLABELLED: 10 to 20 years (median 15.1 years) after fundoplication for primary reflux disease 257 patients were questioned about their symptoms. Data of 163 patients could be analyzed. RESULTS: 21.4% of the patients have persistent or recurrent reflux symptoms, about half of them (9.8%) need medical treatment. Adverse side-effects of the fundoplication are frequent: dysphagia in 28.2%, gas-bloat in 50.3%. Using the Visick criteria for classification we found Visick grade I and II for 75.5%, grade III for 17.2%, and IV for 7.4%. Diagnostic and therapeutic concepts in case of failed reflux control are discussed.

Esophagogastric Junction↗
PubMed1987

Intracardiac thrombosis associated with an acute consumption coagulopathy.

A 53-year-old man with a prior history of myocardial infarcts and small cell lung cancer presented with lower limb ischemia. Laboratory tests revealed acute consumption coagulopathy and echocardiography showed massive intracavitary thrombi in the right atrium and both ventricles. Despite the administration of heparin, the patient died 3 weeks later of ventricular fibrillation. Autopsy demonstrated no relapse of lung cancer but large old myocardial infarcts.

Disseminated Intravascular Coagulation↗
PubMed1986

[Mesenteric infarction. 17-year retrospective study].

Almost half of our patients admitted with mesenteric infarction (MI) (n = 81) were inoperable. In the group (n = 44) who underwent curative therapy, 45% have survived, 32% died of recurrent MI and 23% from causes other than intestinal ischemia. In view of this high rate of recurrence our therapeutic strategy in MI needs to be reconsidered. Postischemic vasoconstriction may be the main cause of the progression of mesenteric ischemia despite apparently curative treatment. Selective injection of vasodilators in the superior mesenteric artery may improve prognosis.

Aged↗
PubMed1986

Health and health care of employed women and homemakers: family factors.

Women's increasing participation in the labor force has resulted from availability of fertility control, changed attitudes toward family size, a strong demand for occupations traditionally filled by women, and other factors. Despite many social changes, employed women continue to be concentrated in lower-income pursuits and frequently have major responsibility for the household. This paper is drawn from a study that explored the association of occupation and home responsibilities with the health of employed women and men and compared them with female homemakers. It also examined variations in the use of physician and hospital services. The principal data source was the National Health Interview Survey tapes for 1975-77. Nurturant role responsibilities were derived from records of members of the index adult's household. This paper reports on comparisons of employed women with homemakers using multiple regression analysis, and also on direct comparisons of the three work-sex groups. Study findings suggest that better health is associated with desired, positive roles such as marriage and married parenthood. Worse health is associated with unwelcome role expansions such as single parenthood, child disability, having a sick spouse and marital dissolution. Effects vary by both sex and work status. It is suggested that it is not the number of activities that may be burdensome to women's health but inability to choose one's roles and organize one's resources to meet their demands.

Absenteeism↗
PubMed1986

Health and health care of employed adults: occupation and gender.

This paper reports on a study of health and health care of employed women and men that used the National Health Interview Survey of 1975-1977 as the data source. Materials from the Dictionary of Occupational Titles and other government sources were used to develop scales for psychosocial and physical health features of individual occupations. Multiple regressions were then used to study the relation of occupational factors and gender along with family factors, to health status, chronic limitations, and use of physician and hospital services. The study shows a correlation of the jobs that are more complex and challenging and offer more autonomy with better health status. The current job structure shows more variation in psychological level of occupations than in physical healthiness; women are concentrated in the less desirable occupations. The study also examines gender differences in illness-day measures and health care utilization in 36 occupations with substantial employment of both sexes, and finds considerable variability among occupations in the extent of gender differences.

Absenteeism↗
PubMed1986

Review of twenty years of research on medical care utilization.

A wide variety of issues in social distribution and system performance are approached through analysis of utilization, as shown by this review of twenty years of research. Utilization studies have been used to examine social norms with respect to dying and to geographical and class diffusion of access to the most useful diagnostic procedures. Prevention utilization is selected for special study but is difficult to analyze because both the boundary between prevention and treatment services and the unit of observation are ill defined. A series of studies of the class gradient in use of care under conditions of reduced barriers to care indicate that equity can be improved through program design even though deficits remain at this time. For health plans with social objectives, a stable low-user group presents a challenge to outreach rather than a source of financial comfort. Other work on utilization examines unnecessary care through study of interregional variation in surgical rates and the phenomenon of physician-induced demand; cost-sharing; the HMO model in its attempt theoretically to reconcile equity with cost-containment; the role of sex differences in utilization; and the influence of women's social roles and traditional/contemporary cultural relationships on access.

Culture↗
PubMed1985

Characterization of a monoclonal anti-Bw4 antibody (Tü109): evidence for similar epitopes on the Bw4 and Bw6 antigens.

The production and serologic, as well as immunochemical properties of a cytotoxic murine IgG monoclonal antibody (Tü109) that precipitates HLA-class I molecules, are described. In the microcytotoxicity assay Tü109 supernatant was demonstrated on a panel of 424 HLA-ABC, -DR, -DQ, -MT typed normal Caucasian blood donors to define an epitope on HLA-B locus molecules in great association with the supertypic specificity Bw4. Reactivity of supernatant showed MHC linked inheritance of the Tü109 determinant and discriminated the HLA-Bw4/Bw6 associated HLA-B locus split antigens. Weak or lack of binding on lymphocytes from some HLA-Bw4 heterozygous individuals, particularly typing for HLA-Bw44, appeared to be due to qualitative and/or quantitative variations of HLA-B locus molecules on the cell surface. With Tü109 ascites fluid, however, extra-reactivity on all HLA-Bw6+ cells was demonstrated. Preferential binding of supernatant to HLA-Bw4, but reactivity of ascites fluid with HLA-Bw6+ molecules in addition, was furthermore confirmed by IEF analysis of antigens immunoprecipitated with Tü109 from cell lysates. Thus the antibody may help to analyze the evolutionary relationship of the diallelic specificities Bw4 and Bw6.

Antibodies, Monoclonal↗
PubMed1985

Divergent expression of HLA-DC/MB, -DR, and -SB region products on normal and pathological tissues as detected by monoclonal antibodies.

A group of eight monoclonal antibodies directed against different monomorphic determinants of HLA-class II molecules was used to investigate the distribution of HLA-DC/DS/MB, -DR and -SB-like antigens on normal and pathological lymphoid and nonlymphoid tissues of human adult and fetal donors. HLA-MB/DC/DS-like molecules, as defined by the antibody TU 22, showed the most limited distribution as they were detected on B-lymphocytes, monocyte/macrophage subpopulations and distinct interstitial cells of various organs. HLA-DR and -SB-like antigens characterized by the other anti-HLA-class II reagents (TU34, TU35, TU37, TU39, TU43, TU58) were also present on these cell types. However, selective expression of HLA-DR and/or -SB like molecules was demonstrated with these antibodies on certain vascular endothelia, as well as different B-cell lymphomas and distinct epithelial cells in adults. Exclusive reactivity of the antibody TU39 shown on endothelial cells of fetal liver and kidney suggested specific functions of HLA-SB antigens during ontogeny. Furthermore, HLA-DR and/or -SB like molecules but not TU22+ HLA-DC/MB antigens were found to be inducible on normally Ia-like antigen negative epithelial cells of various diseased organs. Implications of this differential tissue distribution of HLA-DC/MB/DS, -DR and -SB like products in relation to organ transplantation, regulation of immune responses and cell differentiation are discussed.

Adult↗