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Biomedical subjects

G Böhm

Publications and source records attributed to G Böhm.

At least 19 recordsLinked to original sources
PubMed2006

The fate of the rectal stump after subtotal colectomy for ulcerative colitis.

OBJECTIVE: To review the outcome of patients who had undergone subtotal colectomy for ulcerative colitis with formation of a rectal stump. To specifically look at the fate of the rectal stump, whether patients underwent emergency colectomy as opposed to urgent or elective resection. PATIENTS AND METHODS: Between January 1990 and August 2000, a total of 31 patients underwent subtotal colectomy for ulcerative colitis. Patients were identified using the computerized coding system for the years 1995 to 2000, supplemented by pathology records, discharge letters, and operation notes. Postal and telephone surveys were undertaken using a standard questionnaire assessing social, physical, sexual, and bowel activities of patients. RESULTS: In 28 out of 31 patients, the follow-up was complete. Twenty-four of 28 patients (86%) underwent excision of rectal stump. Four patients (14%) preferred to undergo excision of rectum only, resulting in a permanent ileostomy; 20/28 (71%) had attempted ileal pouch-anal anastomosis, with success in 85%. In four patients (14%), the rectal stump remained in situ and was associated with a decrease in the quality of life. There were no perioperative deaths and morbidity was low for all procedures. CONCLUSION: These data show that after subtotal colectomy, the majority of our ulcerative colitis patients undergo ileal pouch-anal anastomosis. Patients' satisfaction is high with reasonable social and excellent sexual function on quality of life assessment. During its retention, the rectal stump causes considerable symptoms. When left in situ, it is associated with a decrease in the quality of life.

Adult↗
PubMed2004

Results after endoscopic treatment of postoperative upper gastrointestinal fistulas and leaks using combined Vicryl plug and fibrin glue.

BACKGROUND: The incidence of clinically relevant anastomotic leaks after upper gastrointestinal surgery is approximately 4% to 20%, and the associated mortality is up to 80%. Depending on the clinical presentation, the treatment options include surgery, conservative treatment with or without external drainage or endoscopic treatment. METHODS: This report presents nine cases of anastomotic leaks or fistulae after surgery for upper gastrointestinal cancers that were treated by insertion of a Vicryl plug and sealing with fibrin glue. Under sedation, all nine patients underwent endoscopic lavage of the cavity at the site of anastomotic leakage. The entrance to the cavity then was filled with Vicryl mesh and sealed off with fibrin glue. After the procedure, the patients underwent endoscopy and a water-soluble contrast study for assessment of the result. RESULTS: Seven of the nine patients had complete healing of the anastomotic leak or fistula after one to two endoscopic treatments. In one case, the treatment failed immediately because of a large and direct tracheoesophageal fistula. Another patient experienced recurrent intrathoracic abscesses after initial technical success. CONCLUSIONS: Postoperative upper gastrointestinal fistulas or anastomotic leaks can be managed successfully with little morbidity by means of endoscopic insertion of Vicryl mesh with fibrin glue, thereby avoiding repetitive major surgery and its associated risks.

Adult↗
PubMed2003

Venocutaneous fistula.

This is the first description of venocutaneous fistula, a late complication of elective laparoscopic cholecystectomy that arose 18 months after the initial operation. Postoperatively, the patient twice developed an abscess in the abdominal wall at the former site of the umbilical trocar. The first abscess occurred on the 6th postoperative day; the second, after 14 months. After an additional 4 months, a fistula opening appeared just below the umbilicus. Fistulography revealed a connection with the venous system of the omentum majus. During subsequent resection of the fistula, a pigment gallstone was retrieved from the base of the fistula.

Abdominal Abscess↗
PubMed2003

Inguinal hernia on the internet: a critical comparison of Germany and the UK.

Despite containing an increasing amount of medical information, the Internet provides only rare benefits for surgical patients. Using "inguinal hernia" as a catchword, an amateur search was imitated on the British Internet market. Sixty-five pages, standardised regarding quality and efficiency, were evaluated. A comparison to the German Internet market was added. In summary, the broad majority of the pages revealed poor results. Technical appearance, quality of content, and target grouping show big deficiencies. The applicable laws on the European market are not yet established. The ranking lists of the search engines do not reflect the quality of the pages. Patients need competent guides to process surgical information from the Internet. The establishment of specialised institutions to control surgical Web sites according to quality, content, and legality on the European level is urgent.

Germany↗
PubMed2003

Thrombophilia and arterial disease. An up-to-date review of the literature for the vascular surgeon.

Thrombophilia may be defined as the tendency to arterial or venous thrombosis. Thrombophilia can be acquired or hereditary. Acquired conditions leading to arterial thrombosis are commonly encountered in vascular surgical practice, but less well known is the potential influence of genetic factors. In recent years, evidence has accumulated for a crucial role of genetic factors in the pathogenesis of venous thrombosis, many previously unknown genetic defects having been recently identified. The role of genetic predisposition for the pathogenesis of arterial occlusive disease on the other hand is unknown, although recent publications suggest a definite link. This may have implications for the vascular surgeon in the management of patients with arterial disease. A medline search was performed in order to identify papers published between 1990-2002 on thrombophilia, arterial disease and peripheral arterial occlusive disease (PAOD). With regard to venous thrombosis we obtained a much wider knowledge about genetic defects leading to thrombophilia. This has altered the diagnostic and therapeutic approach to patients with venous thrombosis, and has had an important influence on counselling and screening of family members, especially females of childbearing age. With regard to arterial thrombosis, certain thrombophilic disorders have a definite pathophysiological role. Hyperhomocysteinaemia, inherited or acquired, has been demonstrated to be an independent risk factor for athero-thrombosis. The antiphospholipid antibody syndrome (APS), an acquired condition, also predisposes to arterial thrombosis. Other thrombophilic conditions, such as prothrombin gene G20210A variant or factor V Leiden, have been investigated, but current evidence does not unequivocally support the hypothesis of a pathophysiological role in athero-thrombosis. Routine screening for thrombophilia in patients with athero-thrombosis is therefore not generally recommended on the basis of current evidence, but there is a role for selective screening.

Arterial Occlusive Diseases↗
PubMed2001

Glyco- and immunohistochemical refinement of the differential diagnosis between mesothelioma and metastatic carcinoma and survival analysis of patients.

The aim of this study was to analyse the diagnostic value of selected glyco- and immunohistochemical probes for discrimination between mesotheliomas and metastatic carcinomas within the pleura, and to evaluate prognostic indicators in the tested panel. A panel of nine markers (five antibodies, two neoglycoproteins, and labelled hyaluronic acid) was applied to a total of 264 specimens with mesotheliomas (118 cases) and metastatic carcinomas in the pleura (146 cases); the material consisted exclusively of surgical specimens. The diagnosis obtained by standard procedures was further substantiated through a detailed follow-up and clear-cut descriptions of primary sites. The metastatic tumours originated from the lung (82 cases), breast (47 cases), colon (three cases), and kidney (two cases); in 12 cases, however, the tumour origin could not be ascertained. In detail, the probes tested included antibodies against carcinoembryonic antigen (CEA), vimentin, calretinin, mesothelial cells (HBME-1), calcyclin and keratin-5; and also biotinylated neoglycoproteins with ganglioside GM1 and N-acetyl-D-glucosamine (GlcNAc) as the ligand part, and hyaluronic acid. Carrier-immobilized ganglioside GM1 and hyaluronic acid displayed the highest specificity and sensitivity for mesotheliomas, followed by calretinin and HBME-1, whereas keratin-5 and vimentin were of low specificity (43% and 52%, respectively). Metastatic carcinomas could be discerned by CEA detection and application of GlcNAc-bearing neoglycoprotein with similar sensitivity (76% and 72%, respectively) and specificity (91% and 86%, respectively). In cases of breast carcinoma, the maximum specificity (59%) and sensitivity (67%) were low for all markers. Patients with mesothelioma survived longer than those with metastatic carcinoma, especially those with detectable binding sites for hyaluronic acid. No association of tumour type and binding properties of the other applied probes with survival of the patients could be found at a statistically significant level. It is concluded that in routine practice, the application of carrier-immobilized GM1, hyaluronic acid, and antibodies against calretinin and HBME-1 is useful for confirmation of mesothelioma, whereas the detection of CEA and GlcNAc-specific binding sites is useful for distinguishing metastatic carcinoma from mesothelioma. Despite the rather infrequent occurrence of mesotheliomas in women, particular attention should be given to exclude or confirm metastatic breast carcinoma in cases of unknown history or long metastatic interval.

Acetylglucosamine↗
PubMed2001

Binding of external ligands onto an engineered virus capsid.

The development of novel delivery systems for therapeutic substances includes targeting of the carriers to a specific site or tissue within the body of the recipient. This can be accomplished by appropriate receptor-binding domains and requires linking of these domains to the carrier. We have used recombinantly expressed polyomavirus-like particles as a model system and inserted the sequence of a WW domain into different surface loops of the viral capsid protein VP1. In one variant, the WW domain maintained its highly selective binding properties of proline-rich ligands and showed an increased affinity but also an accelerated association/dissociation equilibrium compared to the isolated WW domain, thus allowing a short-term coupling of external ligands onto the surface of the virus-like particles.

Animals↗
PubMed2001

Morphometric examination of straight, tapered titanium stems: a retrieval study.

Cementless straight, tapered rectangular cross section titanium stems have been used by the senior author since 1979. Thirty-four stems retrieved postmortem, after between 10 days and 15.2 years in situ, were studied morphometrically and histologically. Nineteen stems were first generation (1979-1986), with an incomplete sagittal taper and a mean surface roughness of 1 microm (Ra 1.23 +/- 0.3 microm); 15 stems were second generation after 1986, with a full biplane taper and a mean surface roughness of 4 microm (Ra 4.14 +/- 0.36 microm). Implant surface bony coverage was determined morphometrically in 10 segments of the stems, and expressed as a bone implant contact index. Histologically, there were no differences between implants with different levels of roughness. Morphometrically, the first-generation stems showed significant differences in coverage (distal > proximal); second-generation stems had a more uniform pattern. Stems retrieved early after arthroplasty had a mean bone implant contact index of 10%. The mean bone implant contact index showed attainment of maximum coverage by 5 years after arthroplasty, without additional apposition or loss thereafter. Patients younger than 65 years at arthroplasty had similar bone implant contact indices to patients 65 years or older; coverage in the six patients 80 years of age at retrieval did not differ from the rates in the other patients. Morphometry was able to provide objective evidence of design change effects. No differences in coverage were found in terms of times in situ, patient age at arthroplasty and at retrieval, and degree of stem surface roughness.

Aged↗
PubMed2000

Neuropathology and general autopsy findings in AIDS during the last 15 years.

A retrospective study of 450 consecutive AIDS autopsy cases (397 males, 53 females; mean age at death 38.4 years) in Vienna, Austria, between 1984 and 1999 compares the central nervous system (CNS) findings in three cohorts: 1984-1992 (190 cases), 1993-1995 (162 cases) and 1996-1999 (98 cases, after introduction of triple antiretroviral therapy) and the relationship of CNS findings to systemic AIDS pathology in the latter two cohorts. In these two groups, following involvement of the lung (85% and 75%, respectively), the brain continued to be the second most frequently involved organ (decrease from 80% to 60%, respectively). Extracerebral protozoal (Pneumocystis carinii, toxoplasmosis), Mycobacterium avium complex, viral [e.g., cytomegalovirus (CMV)], multiple opportunistic organ and CNS infections, and Kaposi sarcoma significantly decreased over time. There was less decrease in fungal infections, while bacterial organ and CNS infections (except for mycobacteriosis), lymphomas, HIV-associated CNS lesions (around 30%), non HIV-associated changes (vascular, metabolic, etc.) and negative CNS findings (10-11%) remained unchanged. Nonspecific CNS changes (e.g., meningeal fibrosis) increased. Extracerebral pathology in subjects with advanced HIV-related CNS lesions showed more frequent but decreasing systemic bacterial and CMV infections than those with negative or nonspecific neuropathology, while other opportunistic and multiple organ infections and lymphomas showed no differences between both groups. In a cohort of drug abusers, HIV encephalitis, progressive multifocal leukoencephalopathy, bacterial infections, hepatic encephalopathy, and negative CNS findings were more frequent than in non-users who showed increased incidence of CMV, toxoplasmosis, or other opportunistic CNS infections, and nonspecific CNS findings; the frequency of lymphomas was similar in both drug abusers and non-users. Similar to a recent autopsy study from San Diego, these data suggest that despite the beneficial effects of modern antiretroviral combination therapy, involvement of the brain in AIDS subjects continues to be a frequent autopsy finding, while the increased incidence of HIV encephalitis in our small cohort of drug users was less than observed in other recent autopsy studies.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Experimental study of bone-implant contact with a parabolic acetabular component (Hofer-Imhof).

Incomplete bone contact with threaded acetabular components is usually attributable to the tapered thread design and sclerotic bone, and might be the reason for early loosening. The self-tapping flat threads of the Hofer-Imhof cup allow accurate insertion without incarceration, even in sclerotic bone. To demonstrate the effectiveness of this threaded cup design based on digitized measurements of bone contact area, six Hofer-Imhof cups were implanted into three human cadavers. The bone contact area at the threads was digitally analyzed on cadaver-explanted cups cut into horizontal and coronal sections. In cups fixed with ideal form fit, bone contact was 31.6% (range 8-55%) at the threads and 28.5% (range 0-49%) between the threads on average. In cups with incomplete bone contact secondary to insufficient reaming, the bone contact area averaged 27.4% (range 10-44%) at the threads. In sclerotic bone, the highest bone contact at the threads was 69%. The threads were the first part of the cup to achieve primary bone contact. Factors contributing to poor contact were incomplete reaming, sections which passed through the incisura of the acetabulum, and incomplete contact with the medial aspect of the acetabulum. The aim was to achieve complete bone contact. Because of the higher contact areas observed in sclerotic bone, some sclerotic bone should remain after reaming.

Acetabulum↗
PubMed2000

Action tendencies and characteristics of environmental risks.

It is assumed that the mental representation of the causal structure of environmental risks, i.e., the type of cause and the type of potential consequence, determines which sort of action tendencies are formed. We propose a model of risk evaluation that includes consequentialist and deontological judgments as well as specific emotions as mediators of action tendencies. Four hundred participants took part in an experiment which presented scenario information about environmental risks. The scenarios differed with respect to (a) causation (human vs. natural cause; single vs. aggregate causation), (b) consequence (harm to self vs. harm to other people vs. harm to nature), and (c) geographical distance (proximate vs. distant). Participants indicated how much they preferred each of 31 prospective behaviors. Factor analyses yielded five types of action tendencies: help, aggression, escape, political action, and self-focus. The causal structure of the risks was systematically related to action tendencies, e.g., environmental risks that are caused by humans, and in particular those caused by a single human agent, elicit aggressive action tendencies. The findings conform that the perceived causal structure of a specific risk determines whether the focus is upon consequentialist or deontological judgments, which, in turn, elicit specific types of action tendency, mediated by emotions.

Adolescent↗
PubMed2000

A hyperthermostable bacterial histone-like protein as an efficient mediator for transfection of eukaryotic cells.

Gene delivery has shown potential in a variety of applications, including basic research, therapies for inborn genetic defects, cancer, AIDS, tissue engineering, and vaccination. Most available systems have serious drawbacks, such as safety hazards, inefficiency under in vivo-like conditions, and expensive production. When using naked DNA, for instance, a large amount of ultrapure DNA has to be applied as a result of degradation by nucleases. Similarly, the use of eukaryotic histones, synthetic peptides, or peptide nucleic acids may be limited by high production costs. We have demonstrated a biotechnologically feasible and economical approach for gene delivery using the histone-like protein from the hyperthermostable eubacterium Thermotoga maritima, TmHU as an efficient gene transfer reagent. HU can be easily isolated from recombinant Escherichia coli, is extraordinarily stable, and protects dsDNA from thermal denaturation. This study demonstrates its use as an inexpensive tool for gene delivery.

3T3 Cells↗
PubMed2000

Mechanism of assembly of recombinant murine polyomavirus-like particles.

VP1 is the major viral coat protein of murine polyomavirus and can be used for the generation of virus-like particles in vitro. Here, we demonstrate that capsid assembly is an equilibrium reaction followed by oxidation of intracapsomere disulfide bonds, which are not essential for the formation of virus-like particles but enable complete particle assembly and prevent capsid disassembly.

Animals↗
PubMed2000

[Early-summer meningo-encephalitis (ESME) and ESME-vaccination: status 2000].

Tick-borne encephalitis (TBE) is a public health problem very well under control in Austria because of a vaccination programme using a safe, efficient and well tolerated vaccine and a carefully designed social marketing concept. The Austrian vaccine underwent another technological updating and is now marketed under a new brand name (TicoVac) on the basis of an EU registration. A second product is also available (Encepur), but some limitations of use have to be taken into account. To improve the epidemiological situation even further (only 41 hospital cases in 1999) special attention has to be given to the age group 50 years and older as this is the segment of the population where the majority of cases is observed. TBE is a growing international health problem as awareness increases and cases are identified in many European countries, even in regions where TBE so far was not diagnosed. An "International Scientific Working-group on Tick-borne encephalitis (ISW-TBE)" was established to coordinate research and public health activities.

Adult↗
PubMed1999

The HU protein from Thermotoga maritima: recombinant expression, purification and physicochemical characterization of an extremely hyperthermophilic DNA-binding protein.

The histone-like protein TmHU from the hyperthermophilic eubacterium Thermotoga maritima was cloned, expressed to high levels in Escherichia coli, and purified to homogeneity by heat precipitation and cation exchange chromatography. CD spectroscopical studies with secondary structure analysis as well as comparative modeling demonstrate that the dimeric TmHU has a tertiary structure similar to other homologous HU proteins. The Tm of the protein was determined to be 96 degrees C, and thermal unfolding is nearly completely reversible. Surface plasmon resonance measurements for TmHU show that the protein binds to DNA in a highly cooperative manner, with a KD of 73 nM and a Hill coefficient of 7.6 for a 56 bp DNA fragment. It is demonstrated that TmHU is capable to increase the melting point of a synthetic, double-stranded DNA (poly[d(A-T)]) by 47 degrees C, thus suggesting that DNA stabilization may be a major function of this protein in hyperthermophiles. The significant in vitro protection of double-helical DNA may be useful for biotechnological applications.

Allosteric Site↗
PubMed1999

Randomized in vitro and in vivo evaluation of different biopsy needles and devices for breast biopsy.

In an experimental study (in vitro and in vivo) we evaluated the efficacy of various biopsy needles/devices for breast biopsy. In vitro, biopsies of five human cadaveric breast specimens were performed using 33 different needles/devices ranging from 14 to 20-gauge. Of these 33 needles/devices, 22 optimally performing needles were selected for the in vivo study. In the clinical part of the study, 44 breast lesions were randomly biopsied with each of the 22 needles/devices under stereotactic guidance. Tissue specimens were analysed quantitatively and qualitatively. Several automatic long-throw guns (Acecut, Asap, Biopty, Magnum) obtained greater tissue areas and had a better histopathologic score than the conventional type of a side-notch needle like Trucut, an aspiration needle like Surecut, or an end-cut needle like Autovac. The automatic long-throw guns performed better than the short-throw Monopty gun. Regardless of needle size (14-20-gauge), breast biopsies should be routinely performed with automated long-throw side-notch guns (Acecut, Asap, Biopty, Magnum).

Adult↗