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Biomedical subjects

F Schubert

Publications and source records attributed to F Schubert.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Secure anastomoses of the large intestine (especially with transanal drainage].

The results of colonic resections were investigated in 356 patients in a retrospective analysis. Special attention was directed to the effectiveness of a transrectal tube, leading to decompression of the anastomosis for the first five days. Under elective conditions, the overall complication-rate was 12.7%. In emergency cases, these complications were 51.5% (one third of these cases had a decompression-tube). The clinical relevant leakage-rate under elective conditions ranged to 1.7%. Postoperative mortality related to surgical complications turned out to be 1.5% under elective conditions. The emergency operations had a high mortality which ranged to approximately 15.2%. No patient with leakage of a colorectal anastomosis died when the transrectal decompression-tube was applied. Such a safety in anastomotic healing of colon and rectum anastomoses can otherwise only be achieved by using the protection of a diverting colostomy or ileostomy. The use of the transrectal decompression-tube also avoids stomal complications and the second operation. There is no indication for the decompression-tube in emergency operations with purulent or faecal peritonitis. In these cases a fundamentally different treatment is mandatory.

Adenomatous Polyposis Coli↗
PubMed1996

Preparation of solid phantoms with defined scattering and absorption properties for optical tomography.

We have developed diffusely scattering solid phantoms with optical (scattering) properties amenable to theoretical calculations. Monodisperse quartz glass spheres were used as scatterers embedded in polyester resin. An infrared dye was added to simulate absorption by biological tissue. Solid phantoms were tested for their macroscopic homogeneity. Several phantoms were built with well-defined spatial variations in their transport scattering and absorption coefficients to be used for optical tomography. Scattering, transport scattering, and absorption coefficients of solid, homogeneous phantoms and of aqueous suspensions of monodisperse quartz glass spheres were derived from measurements of time-integrated collimated transmittance and time-resolved diffuse transmittance. For aqueous suspensions of monodisperse quartz glass spheres at known number density scattering and transport scattering coefficients calculated by Mie theory are in quantitative agreement with experimentally derived values. In addition, diffuse reflectance and diffuse transmittance of aqueous suspensions at various number densities were measured and found to be in excellent agreement with results of Monte Carlo calculations using theoretical values for the scattering coefficients and anisotropy parameters.

Humans↗
PubMed1996

Intradural lipoma.

A case of an intradural lipoma in the region of the thoraco-lumbar junction in a 24 year old female is reported.

Adult↗
PubMed1996

Canadian guidelines for economic evaluation of pharmaceuticals. Canadian Collaborative Workshop for Pharmacoeconomics.

In 1994, Canada became the second country to release national guidelines for the economic evaluation of pharmaceuticals. The guidelines were developed over a period of 18 months through an elaborate process of broad consultation with a wide variety of relevant stakeholders. The intent of the guidelines is to provide guidance to doers and users of studies, by laying out the general 'state of the art' regarding methods, and by providing specific methodological advice on many matters. The aim is to improve the scientific quality and integrity of studies, and to enhance consistency and comparability across studies. This article presents the Canadian guidelines, both in summary and in detail. Because the techniques of economic evaluation are widely applicable beyond pharmaceuticals, the guidelines will be of interest to researchers and decision makers in all fields of healthcare. Because the methods are not country specific, the guidelines will be of interest to those in other countries as well as in Canada.

Canada↗
PubMed1996

Pulmonary sarcoidosis coexisting with systemic lupus erythematosus.

A 23 year old female presented with fatigue, Raynaud's syndrome, symmetric polyarthritis, lymphocytopenia, hypocomplementemia, IgG elevation, and antinuclear antibodies with anti-U1RNP specificity. A diagnosis of systemic lupus erythematosus (SLE) was made. Disseminated micronodular infiltration in the chest X-ray, a pattern of lymphocytic alveolitis by bronchoalveolar lavage, histologic demonstration of non-caseating epitheloid microgranulomas, and rapid reversal of lung disease upon low-dose methylprednisolone treatment led to a diagnosis of concomitant sarcoidosis. Clues to the diagnosis of sarcoidosis coexisting with SLE are discussed.

Adult↗
PubMed1996

[Position of the disc in collum mandibulae fractures--a magnetic resonance tomography study].

39 condylar mandibular fractures were examined by magnetic resonance imaging (MRI) within the first 12 hours after trauma prior to therapy. A new classification has been applied on the traumatic disc displacements. Three types A, B, C can be distinguished. Type A means no displacement in relation to the condylar fragment and the fossa. Type B means a displacement in the transversal plane exceeding the physiologic range of movement. Type C means displacement in the sagittal as well as in the transversal plane which exceeds the physiologic range of movement of the disc. The classified type of displacement could not be correlated exactly with dislocation and position of the bony fragments. Therefore the type of displacement cannot be predicted from conventional radiographs. Three cases of evident rupture of the disc in the biconcave zone could be shown by MRI. This kind of displacement has not been represented in the classification yet. In a presented case a rupture of the disc had been depicted preoperatively and the disc could be repaired via an preauricular approach. By means of MRI surgeons in future are able to pay more attention to the traumatology and reconstructive surgery of the temporomandibular disc.

Fracture Healing↗
PubMed1995

Non-radioactive detection of oligonucleotide probes by photochemical amplification of dioxetanes.

We describe a new method of non-radioactive labelling and detection of oligonucleotide probes. The approach is based on a simple chemical principle. Oligonucleotides labelled with methylene blue (a photosensitizer) are hybridized on a membrane to immobilized DNA target sequences. After hybridization and stringency washing 2(-)[3-(hydroxyphenyl)methoxymethylene] adamantane is added to the membrane and the membrane is irradiated with a tungsten lamp light source through a cut-off filter. Thermally stable dioxetanes are amplified during irradiation at the positions of the labelled probe. These amplified dioxetanes are detected using chemically triggered chemiluminescent decay. Signals are recorded on commercial X-ray film. Detection is possible immediately after the last washing step and a hard copy of the blot is obtained within 1 h. Dependent on the level of the target sequences, the sensitivity of the method allows detection of 0.3 pg single-stranded M13mp18(+) plasmid DNA in dot blots and 75 pg in Southern blots. Additional immunological reaction steps and washing steps with blocking reagents and buffers are avoided. Furthermore, expensive reagents and equipment for physical detection are not necessary. The method might be particularly useful for fast routine analysis in forensic and medical applications. The synthesis of the olefin, conditions of hybridization and the protocol of detection are described in detail.

Adamantane↗
PubMed1995

Giant aneurysm of the abdominal aorta.

A giant aneurysm of the abdominal aorta presented with a 2-3 h history of right loin pain radiating to the groin and was associated with microscopic haematuria. The pain settled and a urogram was performed 2 days later. Considerable calcification in its wall outlined a very large aneurysm of the abdominal aorta with a maximum transverse diameter of 13.5 cm. The patient underwent successful emergency surgery, at which time a right-sided posterolateral rupture of the aneurysm was present. The patient remains alive and well 4 years later.

Aged↗
PubMed1995

[Spiral CT of the thorax with double table feed in relation to slice thickness].

PURPOSE: The aim of the study was to reduce investigation time, radiation dose, and contrast material when performing spiral-CT of the thorax. METHODS: 50 patients with different clinical diagnoses underwent spiral-CT of the thorax with double table feed and 45 ml contrast material (lopentol) were injected. Density measurements were performed as follows: main pulmonary artery without contrast injection, carotid artery, subclavian artery, ascending and descending aorta, aortic arch, main pulmonary artery and thoracic aorta after contrast injection. RESULTS: In comparison to the density of the main pulmonary artery without contrast injection there was an increase of density of 134 HU. 45 ml of the contrast agent were sufficient in all cases for delineation of the mediastinal vessels. Investigation time was 16-18 s and all patients were able to hold their breath during this time, so no artifacts were seen. Radiation dose was cut in half. CONCLUSION: Spiral-CT with double table feed enables investigations of the thorax in less than 20s. 45 ml of a contrast agent are sufficient for performing this examination. There are no essential diagnostic deficits with this technique.

Absorptiometry, Photon↗
PubMed1994

[High-resolution CT (HRCT) of the lung in Wegener's granulomatosis].

HRCT of the lung and plain chest X-ray were performed to reveal pulmonary manifestation in primary diagnostics or reevaluation of 35 patients with Wegener's granulomatosis. Pleural and parenchymal pathology was detected in chest X-ray of 20 (57%) and in HRCT of 30 (85.7%) patients. Granulomas with and without cavitations and with smooth or spiculated margins were deemed pathognomonic. Nonspecific findings were infiltrates, thickened interlobular septae and fibrotic changes of parenchyma and pleura. Ground glass opacities, traction bronchiectasis and small cysts were only visible on HRCT. As expected HRCT proved to be more sensitive in detecting subtle lung alterations than plain film chest X-ray. It helps to differentiate acute inflammatory and thus potentially curable processes from chronic fibrotic changes in Wegener's granulomatosis.

Adult↗
PubMed1994

A multinational pharmacoeconomic analysis of oral therapies for onychomycosis. The Onychomycosis Study Group.

Due to increased interest in economic evaluation and the rapid international spread of new healthcare technologies across borders, there is a need to interpret economic evaluations on a worldwide basis. We conducted a multinational cost-effectiveness analysis, from a government payer perspective, comparing four primary oral treatment regimens for onychomycosis of the fingernails and toenails: griseofulvin, itraconazole, ketoconazole and terbinafine. We used a four-step pharmacoeconomic research model which includes all relevant factors affecting costs in 13 countries: Austria, Belgium, Canada, Finland, France, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and the U.K. A worldwide meta-analysis of published clinical data served as the statistical input for the pharmacoeconomic model, and demonstrated that terbinafine had the highest success rates (95.0% and 78.3%) of the clinical comparators for fingernails and toenails, respectively. We found that terbinafine was the most effective therapy in relation to cost (therefore giving it the lowest cost-effectiveness ratio) for both infections in all health-care systems analysed.

Antifungal Agents↗
PubMed1994

Echogenic splenic tumours in type B Niemann-Pick disease.

A case is presented of echogenic tumours in the spleen of a patient with Niemann-Pick disease of the type B (or adult) type. A search of the literature revealed that a similar appearance has previously been reported in only one other case of Niemann-Pick disease, which was a type C.

Adult↗
PubMed1994

Longitudinal stress fracture in the femoral diaphysis.

Stress fractures occur in multiple sites but more so in the lower limbs and show a predilection for certain sites. The lower femoral shaft is not a common site and a longitudinal stress fracture is extremely rare. A case is reported of a longitudinal stress fracture in the distal femoral shaft that was not suspected initially despite the patient's athletic activities. Review of the literature did not reveal documentation of any similar case.

Adolescent↗
PubMed1994

[Magnetic resonance tomography and computerized tomography of Wegener's granulomatosis of the orbits].

Of a total of 121 patients with histological proven Wegener's Granulomatosis, orbital involvement occurred in 12 cases. Eight of them underwent magnetic resonance imaging (MRI) of the head and brain, in 2 cases computed tomography (CT) was additionally performed. With MRI orbital granulomas had a low signal intensity in T1- and T2-weighted spin-echo sequences. After i.v. contrast medium administration an inhomogeneous enhancement was found. Because of the multiple imaging planes and high soft tissue contrast, orbital granulomas were better delineate with regard to the intraorbital muscles and the optic nerve using MRI than with CT. Osseous destruction and sclerosis of the orbital walls were demonstrated more effectively using CT. MRI and CT are thus complementary for diagnosing and staging, of orbital granulomas and periorbital involvement in Wegener's Granulomatosis.

Adult↗
PubMed1994

[Stress factors in acute myocardial infarct: the role of physical exertion and unusual life events].

OBJECTIVE: It is controversial whether the onset of myocardial infarction is a "random" event or whether there are triggering factors of the disease. Previous reports on possible triggers were based on case studies or inadequately controlled studies. The TRIMM study (Triggers and Mechanisms of Myocardial Infarction) was designed to determine the influence of physical activity and other external factors on the acute risk of myocardial infarction. METHODS: At Klinikum Steglitz, Berlin, all consecutive patients with myocardial infarction were included. In the Augsburg area, all patients with myocardial infarction in a prospectively defined cohort (n = 330,000) were registered by monitoring 26 hospitals. Information on the circumstances and possible triggers of the disease was obtained by standardized interviews. The control group was matched for age, sex, precinct, and time of a control event. The statistical analysis included a case-control comparison of patients with control subjects and a case-crossover comparison comparing the average exposure to a possible trigger with the time of the last exposure prior to the onset of disease. RESULTS: From January 1989 to December 1991, 1194 patients (74% men, 61 +/- 9 years) were enrolled 13 +/- 6 days after myocardial infarction. During the initial three hours after awakening, the occurrence of myocardial infarction was almost threefold compared to other times of day. A multivariate analysis yielded a twofold risk of myocardial infarction during physical exertion, statistically independently of time of day. 7.1% of patients had engaged in exertional physical activity at onset of the event, as opposed to 3.9% of control subjects. The case-crossover analysis demonstrated a relative risk of 2.1 (1.6-3.1) of exertional physical activity within 1 hour prior to myocardial infarction. Patients whose average frequency of physical exertion was < 4 versus > or = to 4 times per week had relative risks of 6.9 versus 1.3 (p < 0.01). Unusual life events within 24 hours and 24 hours to 4 weeks prior to the event occurred with similar frequencies and control subjects. CONCLUSIONS: Physical exertion appears to increase the acute risk of myocardial infarction in patients with coronary heart disease, particularly in untrained individuals. Unusual life events, however, are of less importance for the acute risk of disease. These findings are important for further investigation of triggering mechanisms of myocardial infarction and for improving preventive strategies.

Adult↗
PubMed1993

Physical exertion as a trigger of acute myocardial infarction. Triggers and Mechanisms of Myocardial Infarction Study Group.

BACKGROUND: It is controversial whether the onset of myocardial infarction occurs randomly or is precipitated by identifiable stimuli. Previous studies have suggested a higher risk of cardiac events in association with exertion. METHODS: Consecutive patients with acute myocardial infarction were identified by recording all admissions to our hospital in Berlin and by monitoring a general population of 330,000 residents in Augsburg, Germany. Information on the circumstances of each infarction was obtained by means of standardized interviews. The data analysis included a comparison of patients with matched controls and a case-crossover comparison (one in which each patient serves as his or her own control) of the patient's usual frequency of exertion with the last episode of exertion before the onset of myocardial infarction. RESULTS: From January 1989 through December 1991, 1194 patients (74 percent of whom were men; mean age [+/- SD], 61 +/- 9 years) completed the interview 13 +/- 6 days after infarction. We found that 7.1 percent of the case patients had engaged in physical exertion (> or = 6 metabolic equivalents) at the onset of infarction, as compared with 3.9 percent of the controls at the onset of the control event. For the patients as compared with the matched controls, the adjusted relative risk of having engaged in strenuous physical activity at the onset of infarction or the control event was 2.1 (95 percent confidence interval, 1.1 to 3.6). The case-crossover comparison yielded a similar relative risk of 2.1 (95 percent confidence interval, 1.6 to 3.1) for having engaged in strenuous physical activity within one hour before myocardial infarction. Patients whose frequency of regular exercise was less than four and four or more times per week had relative risks of 6.9 and 1.3, respectively (P < 0.01). CONCLUSIONS: A period of strenuous physical activity is associated with a temporary increase in the risk of having a myocardial infarction, particularly among patients who exercise infrequently. These findings should aid in the identification of the triggering mechanisms for myocardial infarction and improve prevention of this common and serious disorder.

Aged↗