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Biomedical subjects

G Müller

Publications and source records attributed to G Müller.

At least 199 records · Page 11Linked to original sources
PubMed1997

[Treatment strategy in inguinal injection abscess and complications].

From 1994 to March 1997, 12 patients with 15 drug-related abscesses of the groin were treated at the Surgical Department of Lübeck Medical University. Besides laboratory, serological and microbiological examinations, the standard diagnostic investigation consisted of sonography or duplex sonography. If indicated, the diagnosis was extended to include, for example, clarification of the retroperitoneum by CT. The most common accompanying disease was deep femoral vein thrombosis. Substitution was planned individually. After surgical débridement and perioperative administration of a beta-lactam-protected acylaminopenicillin, open wound treatment was successfully carried out in 13 cases; secondary closure was performed four times in cases of good compliance. One abscess led to necrotising of the femoral artery; saphenous vein was interposed because of erosion bleeding and formation of aneurysm. In a second case, the bifurcation was reconstructed with saphenous vein after external resection of an infected false aneurysm and early occlusion. Both defects were covered by rotation of sartorius muscle and mesh graft. On the basis of the treatment concept, a rapid and successful intervention was possible; complications such as sepsis, amputation or withdrawal delirium did not occur. Resistance against the antibiotic was not observed. In the case of infected aneurysm, we prefer the autogenous saphenous vein graft followed by rotation of sartorius muscle and mesh graft. Ligation or excision leads to high rates of claudication or amputation; extended reconstructions are threatened by insufficient compliance of the patients; the use of synthetic grafts is endangered by further bacteraemia or infections.

Abscess↗
PubMed1997

[An implantable piezoelectric hearing aid transducer for inner ear hearing loss. I: Development of a prototype].

Implantable hearing aids can form the basis of new surgical techniques for dealing with hearing problems originating in the inner ear, provided they are fully implantable. Accordingly, a comprehensive, interdisciplinary, combined project was initiated at the ENT clinic of the University of Tübingen which was to conclude with operations to improve hearing via fully implantable hearing aids. A novel electromechanical transducer for implantable hearing aids based on the piezoelectric principle is described. Unlike the piezoelectric transducers reported so far, this transducer does not rely on the bimorphic principle but on a circle-shaped, heteromorphic combination system consisting of a piezoceramic disc and metal membrane. The transducer can be hermetically sealed and is designed for implantation into the mastoid. Transfer of mechanical oscillations to an ossicle in the middle ear is effected by a directly fixed coupling rod or via suitable coupling elements. The transducer is highly tuned with a resonance frequency at the upper end of the spectral transfer range (greater than 10 kHz). Below this resonance and down to low frequencies, the frequency response of elongation is smooth with amplitudes of around 20 nm. At low and middle frequencies of up to 1 kHz, these vibration amplitudes correspond to sound-pressure levels of around 90 dB SPL. At higher frequencies of up to 10 kHz, the output level increases to about 130 dB SPL. Nonlinear distortions are also very small at the highest levels (less than 0.1%) throughout the whole transfer range. Electric power consumption at maximum levels is in the range of a few microwatts and is therefore significantly lower than that of electromagnetic systems. Particularly, this makes it possible to use the transducer in fully implantable hearing aids for rehabilitation of sensorineural hearing loss.

Cochlear Implants↗
PubMed1997

[An implantable piezoelectric hearing aid transducer for inner ear deafness. II: Clinical implant].

A miniature, hermetically sealed implant was development and manufactured in several clinical and technical iteration steps based on the prototype of an implantable piezo-electric hearing-aid transducer described in Part 1 of the work presented here. The transducer is made of pure titanium (medical grade 2, ASTM F67) and designed to be implanted into the mastoid cavity. Transfer of mechanical oscillations to an ossicle in the middle ear is effected by a fixed directly coupling rod of pure titanium or via suitable coupling elements. The transducer is highly tuned with a resonance frequency in the range of 7-10 kHz, depending on the dynamic mass load. Below this resonance and down to low frequencies, the frequency response of elongation is smooth with a very small ripple of less than +/- 1 dB. Unlike the prototype, an increase in vibration amplitude of around 10 dB was achieved for a comparable power consumption. Vibration amplitude at low and middle frequencies is about 60 nm with a transducer voltage of 1 V, corresponding to an equivalent sound-pressure level of around 100 dB SPL at up to 1 kHz. At higher frequencies of up to 10 kHz, the output level increases to beyond 130 dB SPL. Nonlinear distortions at maximum volume (1 V) are extremely small (THD < 0.1%) throughout the whole transfer range. Due to an extremely short attack time (50 microseconds) and short release time (approximately 2 ms), the dynamic properties of the transducer allow good transmission of audio signals with fast changes in the time domain, i.e., plosives in speech signals. Electric power consumption at full volume and broadband signals is in the region of 1 microW. Unlike electromagnetic transducers described in the literature, the low power consumption of this piezoelectric transducer allows the realization of fully implantable hearing aids for rehabilitation of moderate to severe sensorineural hearing loss.

Auditory Threshold↗
PubMed1997

[An implantable microphone for electronic hearing aids].

Fully implantable hearing aids and cochlea implants of the future require an implantable microphone. A hermetically sealed implantable microphone based on the idea of a microphone implanted in the posterior wall of the auditory canal, as suggested by Ohno et al. in 1988, is presented. Through consistent technological and clinical design optimization, it was possible to achieve a membrane diameter of only 4.5 mm (as opposed to 8 mm in the Japanese system) and a significant volume reduction of nearly 50%. The microphone weights only 0.4 g. In spite of this miniaturization, the performance characteristics of the microphone equal those of the Japanese model or are superior. The sound-pressure transfer function shows a very small ripple and the bandwidth amounts to approximately 10 kHz. Because of its high tuning and high no-load resonance frequency, the microphone is mostly insensitive to post-operational changes to the loading mass on the microphone membrane initiated by the covering skin of the auditory canal. The sound-pressure transfer factor at 1000 Hz is approximately 1.5 mV/Pa. Using different manufacturing technologies, this value can be increased in the range of 6-8 dB with a corresponding reduction in bandwidth. Due to the small mass, the microphone is highly insensitive to environmental mechanical disturbances. The module is made of pure titanium and is hermetically sealed according to Mil-Std 883 D. Full metal encapsulation and additional internal electronic components protect the microphone well against environmental electromagnetic influences (EMC).

Animals↗
PubMed1997

[Adjusting the geometry of implantable hearing aid components to human temporal bone. I: Electromechanical transducer].

Prerequisite to implantation of a piezoelectrical transducer of an implantable hearing aid is a shape allowing its implantation into human mastoid and middle ear. To approach this problem, a consecutive series of six transducer prototypes was created in an iterative process. Their functional geometry was evaluated in 50 human temporal bones. A shape for a functioning transducer was found which will enable implantation in 78% of the cases examined (confidence interval: 61.5%-89.2%). It will allow simultaneous implantation of the transducer into the mastoid and microphone, which is situated transmastoidal in the posterior wall of the ear canal. Furthermore, the transducer may be coupled to the ossicular chain or the perilymph.

Cochlear Implantation↗
PubMed1997

[Adjusting the geometry of implantable hearing aid components to human temporal bone. II: Microphone].

Recently, an implantable hearing aid for rehabilitation of sensorineural hearing loss has been developed. One component of the device is the microphone for implantation into the posterior canal wall. The membrane of the microphone can be covered by skin, cartilage, or fascia, avoiding reduction in sound transmission at the same time. In the study presented here, the microphone was implanted into 50 cadaver specimens of human temporal bone. Localization of the microphone was determined by the anatomical situation of the facial nerve. The microphone and the piezoelectric transducer could be implanted in 78% of the temporal bones after total mastoidectomy. In the final version of the microphone, the size was 4.5 mm and total weight 400 mg.

Cochlear Implantation↗
PubMed1997

Prognostic significance of dysplastic features of hematopoiesis in patients with de novo acute myelogenous leukemia.

The detection of dysplastic features of hematopoiesis in de novo acute myeloid leukemia (AML) by light microscopy is defined as AML with trilineage myelodysplasia (AML/TLMD). The prognostic relevance of these dysplastic features for patients with de novo AML remains unclear. In order to evaluate the role of dysplasia in de novo AML, bone marrow aspirates from 69 patients were analyzed prospectively and investigated separately for erythropoiesis, granulopoiesis and megakaryopoiesis by three independent investigators. The overall complete remission (CR) rate was 48.8% and partial remission (PR) or nonresponders constituted 52.2% of the patients investigated. The median overall survival time was 5 months with a disease-free interval of 3.5 months for all patients. Dysgranulopoiesis (DysG) was observed in 30.4%, dysmegakaryopoiesis (DysM) in 50.7%, and dyserythropoiesis (DysE) in 43.5%. Of all patients, 26.0% showed trilineage dysplastic features and were thus classified as AML/TLMD. A significantly worse prognosis (Kaplan-Meyer plot, Student's t-test) was calculated for those patients with detection of only DysG (p = 0.002), DysM (p = 0.02), DysE (p = 0.04) as compared with patients without any dysplastic signs. An unfavorable karyotype was correlated with patients showing DysG (P = 0.02) and DysM (P = 0.04). For these patients with an unfavorable karyotype, the occurrence of any dysplastic features had no additional prognostic impact. Dysplastic features (DysG, DysM, DysE) seem to be an important prognostic factor in de novo AML correlating with short overall survival. DysG and DysM correlated well with the appearance of unfavorable chromosomal abnormalities. It may be reasonable to assume that patients with dysplastic features should be considered for more aggressive treatment schedules at the time of diagnosis.

Adolescent↗
PubMed1997

Bleomycin hydrolase (Blh1p), a multi-sited thiol protease in search of a distinct physiological role.

Bleomycin hydrolase, Blh1p, from yeast was co-purified with Gce1p, a cAMP-binding ectoprotein, anchored to the plasma membrane by a glycosyl-phosphatidylinositol (GPI) anchor. Blh1p is a hydrophilic thiol protease lacking transmembrane domains. We have used polyclonal antibodies to study the topology of the over-expressed protein in yeast and have found that it is amphitropic. Part of Blh1p is associated with plasma membranes, and most of the rest occurs in the cytosol. Both the growth conditions and calcium were found to have minor influences on the topology of Blh1p, in that glucose and the earth-alkali ion slightly enhanced recruitment to the membrane. We have examined the possibility that co-purification of Blh1p with Gce1p has a functional basis, and have observed that over-expression of BLH1 in yeast leads to an acceleration of the glucose-induced amphiphilic to hydrophilic conversion of Gce1p, wherein Blh1p could either directly catalyse the proteolytic removal of the polar head-group of the GPI anchor subsequent to an initial lipolytic cleavage by a GPI-specific phospholipase C or indirectly modulate the reaction. The data show that a thiol protease is involved, but point to an indirect role of Blh1p in GPI processing. Proteases with similar or overlapping substrate specificity are likely to exist, since deletion of BLH1 neither entails a growth-defect on any carbon source tested, nor the loss of proteolytic processing of the GPI anchor of Gce1p. Reduced proteolytic GPI processing is, however, observed in the blh1 mutant and the corresponding acceleration in the respective BLH1 multi-copy transformant.

Calcium↗
PubMed1997

Trunk muscle fatigue and associated EMG changes during a dynamic iso-inertial test.

This study was designed to investigate the relationship between trunk muscle fatigue and associated changes in the electromyographic (EMG) signals during a dynamic iso-inertial test. Eleven subjects performed dynamic trunk flexion/extension movements against 40% maximum voluntary contraction (MVC) torque until exhaustion in a tri-axial trunk dynamometer. EMG parameters in the time and frequency domain were studied by analysing changes of the signal amplitudes and the spectral density (using the zero-crossing-rate and the median frequency). The kinematics of the movement were analysed according to the movement velocities and the deviations from the required movement plane. The flexion and extension velocities decreased from the beginning to the end of the test. Movement deviations from the sagittal plane into the frontal and transverse plane increased with increasing test duration, as did the EMG amplitude. The median frequency during periods with maximum muscle activity decreased, as did the zero-crossing-rate. The increase in amplitude and decrease in median frequency were more pronounced in the trunk flexors than in the trunk extensors. The parameters of median frequency, zero-crossing-rate and amplitude seem to be sensitive identifiers of muscle fatigue during well-controlled dynamic contractions. While the kinematic data did not yield any information on the mechanisms of the fatigue, changes in the EMG parameters demonstrated that the duration of the test was limited by the fatigue of the trunk flexors.

Adult↗
PubMed1997

Leukaemia and lymphoma of the appendix presenting as acute appendicitis or acute abdomen. Four case reports with a review of the literature.

Leukaemic and lymphomatous infiltration of the appendix is rare and even rarer is acute appendicitis as the initial manifestation. From our routine biopsy material we collected four cases of haematological malignancies presenting as acute appendicitis or acute abdomen, caused or accompanied by tumoral infiltration of the appendix. Appendicitis was the initial manifestation that allowed diagnosis of the underlying disease. The clinical histories and histological examinations of the appendices and of one autopsy are described. We report the first detailed description of acute myeloid leukaemia involving the appendix, and three cases of lymphomatous infiltration of the appendix presenting with appendicitis, and give an overview of the literature. In these days of budgetary cuts in national health services, where one may be tempted not to have seemingly commonplace cases of appendicitis histologically verified, our cases emphasize that careful histopathological examination of all appendectomy specimens should be mandatory. Despite the fact that leukaemia and lymphoma of the appendix are rare, our cases illustrate that these must be included in the differential diagnosis of acute appendicitis and that physicians and surgeons have to be aware of these conditions.

Abdomen, Acute↗
PubMed1997

Heterogeneity of porcine alveolar macrophages in experimental pneumonia.

The aim of the study was the morphological and the phenotypic characterization of the porcine non-lymphocytic bronchoalveolar lavage (BAL) cell population of unaffected- and intrabronchial with Pasteurella multocida- (P.m.) infected swine using flow cytometry. Three non-lymphocytic cell populations of the porcine bronchoalveolar lavage could be differentiated: (1) large, high autofluorescent cells, (LHC); (2) small, high autofluorescent cells, (SHC); (3) small, low autofluorescent cells, (SLC). In comparison with the control animals, the percentage of the LHC and SHC within the whole non-lymphocytic cell population was decreased, whereas the SLC was significantly enhanced after infection. In order to investigate the phenotype of these cell populations, monoclonal antibodies against porcine antigens (SWC1, SWC3a, MHC class II, 2G6 (against macrophages)) were used. The results showed that the cells of the SLC seem to belong to the granulocytes, whereas the LHC and the SHC are lung macrophages. After the infection of the animals the percentage of the SWC1 positive cells of LHC and SHC were significantly increased, indicating an entrance of more immature macrophages. The percentage of the MHC class II antibody binding cells of all three non-lymphocytic populations was-decreased after infection, indicating a restricted MHC class II dependent antigen recognition in P.m. pneumonia.

Animals↗
PubMed1997

Inhibition of coxsackievirus B3 carrier state infection of cultured human myocardial fibroblasts by ribavirin and human natural interferon-alpha.

As enterovirus infections of the heart cause myocarditis and eventually congestive heart failure, the antiviral activity of ribavirin was studied in coxsackie virus B3 (CVB3)-infected carrier cultures of human myocardial fibroblasts. Cultures were infected 7 days before application of ribavirin and effects were evaluated over a period of 16 days by plaque assays and in situ hybridization. Compared to the low antiviral activity in HeLa cells, ribavirin was highly active in reducing infectious virus yields in human myocardial fibroblasts, for example, to 2.0 x 10(3) pfu/ml with 25 microg/ml and to 1.3 x 10(2) pfu/ml with 50 microg/ml (4.3 x 10(4) pfu/ml in infected controls). Moreover, 100 microg ribavirin/ml completely suppressed infectious virus progeny in two of three cultures, and reduced the number of infected cells from 14.3 to 0.3% as determined by in situ hybridization, whereas up to 3200 microg ribavirin/ml did not result in a significant cytotoxic effect. Interaction with interferon-alpha (IFN-alpha) was additive to slightly synergistic in reducing the number of infected cells and virus yields. In conclusion, our results suggest a cell-specific high activity of ribavirin in human myocardial fibroblasts and indicate the importance of using organ-specific cells for testing antiviral agents in myocarditis. Furthermore, the usefulness of in situ hybridization for determining the long term effects of antivirals in carrier state cell cultures was demonstrated.

Antiviral Agents↗
PubMed1997

In vitro model of characterizing the effects of compressive loading on proteoglycans in anatomically intact articular cartilage.

An in vitro method has been developed of cultivating anatomically intact articular cartilage (humeral head of dog) while excluding both bone tissue and other connective tissues with a condom, which controls changes in hydration and minimizes loss of proteoglycans. Compressive loading experiments were carried out with the condom-covered humeral head, to which contact stresses of 2.1 MPa, 3.3 MPa and 6.4 MPa, respectively, were applied with a rubber disc of a simple loading apparatus. The model makes it possible, to compare experimentally loaded regions with experimentally unloaded regions in both the same joint area and the contralateral control joint. Intermittent pressure loading (4-s-on/16-s-off-cycle) during 2 hours of pulse-experiment and 18 hours of chase-experiment resulted in a 40% increase in proteoglycan synthesis rate at 2.1 MPa, an unaltered synthesis rate at 3.3 MPa, and a 45% decrease in proteoglycan synthesis rate at 6.4 MPa, as measured by 35S-sulfate incorporation. No significant increase in degradation rate of proteoglycans was noted during the various loading experiments.

Animals↗
PubMed1997

Inheritance and mapping of Compact (Cmpt), a new mutation causing hypermuscularity in mice.

During selection for protein content in mice at the Technical University of Berlin, individuals showing high protein content and a compact exterior were noted. Animals showing this "Compact" phenotype were separated to form a new line. The present investigations were carried out on a Hungarian subpopulation of this line, selected for maximum expression of the Compact phenotype, and apparently at fixation for the relevant genes. Fertility and viability of the Compact subpopulation was normal. As compared to normal mice, carcass percentage values for male and female Compact mice were 9.4 and 6.8% greater, respectively; and the muscle:bone weight ratio in males was 1.61-fold greater. The Compact phenotype showed variable expressivity and was of intermediate dominance in males, but almost fully recessive in females. The hypothesis that a single gene is solely responsible for the Compact phenotype was rejected by maximum likelihood analysis. Linkage mapping using selective DNA pooling located a single locus (denoted Cmpt) strongly associated with the Compact phenotype on mouse chromosome 1. Fine mapping, using individual selective genotyping and haplotype analysis, located Cmpt to the region between D1Mit375 and D1Mit21, approximately one third of the way to D1Mit21.

Animals↗
PubMed1997

Perigraft inflammation due to Dacron-covered stent-grafts in sheep iliac arteries: correlation of MR imaging and histopathologic findings.

PURPOSE: To evaluate with magnetic resonance (MR) imaging the inflammatory perigraft response after implantation of Dacron-covered and noncovered arterial endovascular prostheses in sheep. MATERIALS AND METHODS: Four prosthesis types--two Dacron-covered nitinol stent-grafts (plain and heparin-coated) and two noncovered nitinol stents (Memotherm and Cragg)--were each inserted into the external iliac arteries of eight sheep. MR imaging before and after gadolinium enhancement was performed 5-8 days and 1 month after implantation (before the animals were killed). Macroscopic and microscopic examinations of the vessels were performed, and findings were correlated with those on MR images. RESULTS: Severe inflammatory perigraft responses to the heparin-coated Dacron-covered stent-grafts were found; MR images demonstrated contrast enhancement and edema. Macroscopic examination showed marked vascular wall thickening and adhesions around the Dacron fabric; microscopic examination showed a pronounced inflammatory foreign-body response. There was a moderate inflammatory response to the plain Dacron-covered stent-grafts and almost no response to noncovered stents. CONCLUSION: In sheep, MR imaging findings of perigraft soft-tissue edema and contrast enhancement correlated well with histopathologic findings of severe perigraft inflammation due to heparin-coated Dacron-covered stent-grafts.

Alloys↗
PubMed1997

Phosphoinositolglycan-peptides from yeast potently induce metabolic insulin actions in isolated rat adipocytes, cardiomyocytes, and diaphragms.

Polar headgroups of free glycosyl-phosphatidylinositol (GPI) lipids or protein-bound GPI membrane anchors have been shown to exhibit insulin-mimetic activity in different cell types. However, elucidation of the molecular mode of action of these phospho-inositolglycan (PIG) molecules has been hampered by 1) lack of knowledge of their exact structure; 2) variable action profiles; and 3) rather modest effects. In the present study, these problems were circumvented by preparation of PIG-peptides (PIG-P) in sufficient quantity by sequential proteolytic (V8 protease) and lipolytic (phosphatidylinositol-specific phospholipase C) cleavage of the GPI-anchored plasma membrane protein, Gce1p, from the yeast Saccharomyces cerevisiae. The structure of the resulting PIG-P, NH2-Tyr-Cys-Asn-ethanolamine-PO4-6(Man1-2)Man1-2Man1-+ ++6Man1-4GlcNH(2)1-6myo-inositol-1,2-cyclicPO4, was revealed by amino acid analysis and Dionex exchange chromatography of fragments generated enzymatically or chemically from the neutral glycan core and is in accordance with the known consensus structures of yeast GPI anchors. PIG-P stimulated glucose transport and lipogenesis in normal, desensitized and receptor-depleted isolated rat adipocytes, increased glycerol-3-phosphate acyltransferase activity and translocation of the glucose transporter isoform 4, and inhibited isoproterenol-induced lipolysis and protein kinase A activation in adipocytes. Furthermore, PIG-P was found to stimulate glucose transport in isolated rat cardiomyocytes and glycogenesis and glycogen synthase in isolated rat diaphragms. The concentration-dependent effects of the PIG-P reached 70-90% of the maximal insulin activity with EC50-values of 0.5-5 microM. Chemical or enzymic cleavages within the glycan or peptide portion of the PIG-P led to decrease or loss of activity. The data demonstrate that PIG-P exhibits a potent insulin-mimetic activity which covers a broad spectrum of metabolic insulin actions on glucose transport and metabolism.

Adipocytes↗
PubMed1997

[The development of a finger joint phantom for the optical simulation of early inflammatory rheumatic changes].

In the field of rheumatology, conventional diagnostic methods permit the detection only of advanced stages of the disease, which is at odds with the current clinical demand for the early diagnosis of inflammatory rheumatic diseases. Prompted by current needs, we developed a finger joint phantom that enables the optical and geometrical simulation of an early stage of rheumatoid arthritis (RA). The results presented here form the experimental basis for an evaluation of new RA diagnostic systems based on near infrared light. The early stage of RA is characterised mainly by a vigorous proliferation of the synovial membrane and clouding of the synovial fluid. Using a double-integrating-sphere technique, the absorption and scattering coefficients (mua, mus') are experimentally determined for healthy and pathologically altered synovial fluid and capsule tissue. Using a variable mixture of Intralipid Indian ink and water as a scattering/absorption medium, the optical properties of skin, synovial fluid or capsule can be selected individually. Since the optical and geometrical properties of bone tissue remain constant in early-stage RA, a solid material is used for its simulation. Using the finger joint phantom described herein, the optical properties of joint regions can be adjusted specifically, enabling an evaluation of their effects on an optical signal--for example, during fluorography--and the investigation of these effects for diagnostically useful information. The experimental foundation for the development of a new optical system for the early diagnosis of RA has now been laid.

Arthritis, Rheumatoid↗