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Biomedical subjects

C Muller

Publications and source records attributed to C Muller.

At least 199 records · Page 11Linked to original sources
PubMed1984

[The effect of proximal-selective vagotomy in gastroduodenal ulcer].

In a recently concluded prospective multicenter trial, pyloric (PU) and prepyloric (PPU) ulcers showed a significantly higher recurrence rate after proximal gastric vagotomy (PGV) without drainage than duodenal (DU) or gastric ulcers (GU). The secretory pattern of the PU and PPU cannot explain the failure of PGV. However, PU and PPU (and some GU) exhibit a distinct and probably irreversible alteration of the muscular layer at the pylorus and distal antrum. This could be one factor which helps to explain the failure of vagotomy alone in these ulcer types. To deal with this antropyloric distrophy, addition of drainage or antrectomy to PGV must be considered. A refined concept for surgical treatment of peptic ulcer is proposed.

Humans↗
PubMed1984

Binding of mouse spermatozoa to the zonae pellucidae of mouse eggs in cumulus: evidence that the acrosomes remain substantially intact.

Cumulus-intact mouse eggs inseminated in vitro with capacitated mouse sperm have sperm bound to the zonae pellucidae as early as 20 min postinsemination. Maximal sperm binding was observed at 60 min, after which time the number of sperm bound per egg decreased to about 30% of maximal. This extent of binding remained constant from 120 to 180 min postinsemination. All the sperm bound to the zonae had intact acrosomes as determined by chlortetracycline fluorescence assay. The sperm binding was retarded during the first 60 min by 3-quinuclidinyl benzilate, a specific inhibitor of the acrosome reaction induced by zona glycoprotein, but this compound had no effect on sperm binding during the next 60 min. The observation that sperm, which bind to zonae pellucidae after traversing the cumulus, have intact acrosomes is consistent with the same observation of intact acrosomes made with sperm binding to cumulus-free eggs [Saling and Storey (1979). J. Cell Biol. 83:544-555], and further supports the hypothesis that the sequence of events leading to fertilization of mouse eggs is: binding of intact sperm to the zona pellucida followed by the acrosome reaction induced by zona glycoprotein.

Acrosome↗
PubMed1984

The different outcome of duodenal and pyloric channel ulcers after proximal gastric vagotomy. Clinical and morphological results.

Pyloric channel ulcers have a significantly higher recurrence rate than duodenal ulcers after proximal gastric vagotomy (PGV) without drainage. The failure of PGV cannot be explained by the pre- and postoperative secretory pattern of pyloric (PU) and prepyloric (PPU) ulcers. The morphological assessment of the pyloric and antral wall in DU, PU and PPU shows a significant thickening of the muscular layer in PU and PPU compared with DU. Histologically there is a muscular hypertrophy combined with muscular and ganglionic cell damage and fibrosis. The observed antropyloric dystrophy might be one factor for explaining the failure of PGV alone in pyloric channel ulcers. Addition of a drainage procedure for PU or even of a limited antrectomy for PPU might improve the postoperative results and must be discussed when planning surgical treatment of pyloric channel ulcers which seem to characterise as a distinct entity of peptic ulcer disease.

Adolescent↗
PubMed1983

[Endometrial biopsy in hormonal imbalance].

Despite the new techniques of biochemical evaluation of steroid hormones in the plasma and urines, the endometrial biopsy remains an easy valuable method of evaluation of ovarian activity. The clinical indications of the endometrial biopsy are mainly a history of sterility or an abnormal uterine bleeding if we exclude the diagnosis of cancer. Different technical procedures should be followed carefully in order to get a valuable answer. The biopsy should be taken at the right time of the cycle which means 10 to 12 days after ovulation. The danger of interrupting a pregnancy is minimal but in a case of sterility, the biopsy can be performed 4 to 6 days after ovulation to prevent any interference with a early pregnancy. Proper fixation, embedding and staining must be the rule. A fragment of the middle layer of the functionalis must be present to evaluate accurately the hormonal stimulation. Isthmic or cervical tissues are unsuited for functional diagnosis. The existence of an endometritis or the administration of steroid hormones are clinical circumstances which prevent any functional evaluation. The normal menstrual cycle can be divided into different functional phases: the early, the middle and the late proliferative phases, and the early and late secretory phases followed by the menstruation period. The different cellular components of the endometrial mucosa will exhibit various changes corresponding to each of the phases. The interpretation of the endometrial biopsy lies in the correlation between the observed image and the image corresponding to that date of the cycle. The functional disturbances are associated with absent, deficient or excessive function of the ovarian hormonal secretion. The endometrial mucosa will reflect these anomalies revealing atrophic, hypoplastic or hyperplastic conditions of the glandular and stromal components. It is essential to obtain the clinical informations including the knowledge of any hormone administration to provide a valuable diagnosis. Properly interpreted, the endometrial biopsy remains a very useful technique in the study of hormonal ovarian disturbances.

Anovulation↗
PubMed1979

Carrier discretionary practices and physician payment under Medicare Part B: a preliminary report.

Although Medicare is a national program, administration of Part B payments to physicians is in the hands of insurance organizations in ten Medicare regions. The carriers follow varying practices in using actual charges within localities as the basis for determining reasonable charges for physicians' services. While some of these practices have already been shown to influence fee levels, reasonable charge determination involves many more whose influence has not been systematically studied. This paper reviews preliminary findings from a study which examines carrier differences in discretionary practices as to specialties, localities and other claims data that may be merged or compared with Medicare data in determining customary and prevailing prices used to set limits on Medicare payments, and other practices reported in an official questionnaire to carriers. The effect on fee levels and other measures of program performance is being studied after taking into account social, economic and health resource variables extracted from the Area Resource File, that are expected to influence local medical prices through the demand for and supply of physicians' services. Dependent variables representing fees are the 50th percentile of the distribution of weighted customary charges of individual physicians in an area and Supplementary Medical Insurance expenditure per enrollee. The preliminary findings in this paper concern discretionary practices, socioeconomic variables and fee distributions.

Decision Making↗
PubMed1979

Modulation of transferrin receptors in bone marrow cells by changes in lipid fluidity.

The hypothesis that modulation of transferrin receptors during haematopoiesis is mediated by changes in the lipid fluidity of the cell membranes was tested in this study with bone marrow cells. Binding conditions were first established, under which internalization of fluorescently-labelled transferrin was reduced to a minimum during the binding assays. Cholesterol depletion, which was achieved by a mild physiological treatment, and which increased the membrane-lipid fluidity, resulted in a substantial increase in the average number of the available transferrin receptors per bone marrow cell. Cholesterol enrichment mediated a converse effect. These findings correlate well with the changes observed in the availability of transferrin receptors and membrane microviscosity during differentiation of erythroid cells. In line with the notion of passive modulation, it is proposed that the transferrin receptor is a cross-membrane protein with a substantial portion facing the cytoplasm.

Animals↗
PubMed1979

Women and health statistics: areas of deficient data collection and integration.

Improved data on women's health should be based on a definition of health capital for women that takes into account reproductive efficiency and the life experience of women in relation to fertility, general health, employment, and household responsibilities. More information is needed about the conduct of household roles related to investment in health capital for family members. Definitions of health are pragmatic and are related to social systems, including health care providers, for which the definitions serve as signals for certain actions. Women can seek to modify these definitions, which have expressed historical biases about women. Data collection should include information about the extent to which privacy as a dimension of access to health care is achieved. Longitudinal and other approaches to health history data should be explored. Fertility and general health data statistics in federal data systems need to be integrated. Insurance adequacy must be determined in relation to benefit scope, relation to prices, employment requirements, and family contracts. Data that will be helpful in adapting industrial environment to health goals are needed. Provider characteristics relevant to women as patients and workers, and qualities of residential environments pertaining to health, need to be studied. Future research should include evaluation of women's health capital and opportunities for programmatic investment to improve household efficiency in conduct of health-related affairs.

Employment↗
PubMed1979

[Necrosis of the lesser curve of the stomach after proximal selective vagotomy].

Necrosis of lesser curve of stomach after proximal selective vagotomy is a specific but rare hazard of this operation. Anatomical and pathophysiological findings speak in favour of ischaemic pathogenesis, even if a peptic factor may exceptionally play a role in some cases. Local tissue trauma enhances the risk of later sloughing of lesser curve. Three own reported cases without fatality point out the importance of previous massive ulcer bleeding with hypovolemic shock and severe anaemia. Early recognition and immediate reoperation only may avoid an otherwise fatal course. Simple oversewing has proved successful in treating even large lesions. Careful, atraumatic technique of skeletonization and reperitonealization of lesser curve help to prevent this life threatening complication.

Humans↗
PubMed1978

Hormonal control of male reproductive behavior in the lizard, Anolis carolinensis: role of testosterone, dihydrotestosterone, and estradiol.

The androgen aromatization hypothesis was examined in the male lizard, Anolis carolinensis. After castration, sc silastic implants of testosterone (T) restored both challenge and courtship behavior, while dihydrotestosterone (DHT) or 17beta-estradiol (E) had no effect on male behaviors. Both T and DHT, but not E, stimulated hypertrophy and colloid production by the renal sex segment, a secondary sexual characteristic of male lizards. In two separate studies, castrates received DHT in combination with E. In each replicate, half of the castrates responded with increases in courtship behavior after hormone treatment. Epithelial cell height of the sex segment of all DHT and E-treated castrates was comparable to T- or DHT-treated castrates, but colloid production was not stimulated. These experiments indicate that in this species, treatment with T stimulates both sexual behavior and secondary sex character development, whereas treatment with E alone is without effect centrally or peripherally.

Animals↗