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Biomedical subjects

H Bauer

Publications and source records attributed to H Bauer.

At least 145 records · Page 8Linked to original sources
PubMed1995

Operative reconstruction of the external and internal genitalia in female patients with bladder exstrophy or incontinent epispadias.

PURPOSE: Urologists and gynecologists rarely encounter questions on cohabitation and pregnancy in female patients with bladder exstrophy or incontinent epispadias. MATERIALS AND METHODS: Until 1994, 41 female patients underwent surgery at our institution (vaginal cutback or vaginoplasty in 23, correction of the external genitalia in 25 and uterus fixation to correct or prevent prolapse in 13). RESULTS: Followup was available in 37 patients (mean 16.8 years, with followup of 18 years or longer in 19). Of the patients 94% are satisfied with the cosmetic results. All adults engage in sexual intercourse, 4 delivered 6 children by cesarean section and 5 presently desire children. CONCLUSIONS: Fertility in patients with bladder exstrophy or incontinent epispadias is normal, and pregnancy is possible. Patients and parents should be well informed. Besides urinary tract reconstruction, correction of the external and internal genitalia should be discussed in detail.

Adolescent↗
PubMed1995

[Implementation of the public health reform law--experiences with diagnosis related case payment in surgery].

According to new German health care laws (Gesundheitsstrukturgesetz, Bundespflegesatzverordnung) hospital payment will be given a new basis. Abandoning the "length of stay"--related compensation in the future surgical services should be refunded either by special payments for a given surgical procedure (covering anesthesia, surgery, instruments), or by case-related payments (including all costs of stay, medical as well as room-and-care and administrative). This should lead to a more equitable payment getting a transparent insight into the relation service/cost. Calculations for the so far 103 special payment and 40 case related payment items have been obtained by a nationwide analysis in reference hospitals. Besides numerous problems introducing these new refund systems in very different hospital structures, our own 3-year experience using case related payment on our surgical department (based on individual calculation) shows promising results. The main intention still has to be--by setting free economic resources--to avoid rationing though rationalization.

Cost Control↗
PubMed1995

[The so-called specialist status from the physician's viewpoint].

The theoretical knowledge and practical experience necessary for the certification as a specialist are laid down in the rules for continuing medical education and are acquired during the time as a resident usually in a curricular manner. After a final exam, the formal graduation as a specialist is confirmed by handing over a specialist certificate by the society of physicians of Germany. According to the current jurisdiction (so-called "specialist" judgment by the German court of justice from March 3, 1992) and the arrangement of the self-administration, the terms "specialist quality" and "specialist certification" got a particular meaning which may not be set to equal from the medical point of view. This is demonstrated by a critical comment to the "specialist" judgment. Future problems of the specialist training in hospitals are pointed out.

Certification↗
PubMed1994

[Rupture of a splenic artery aneurysm intra partum].

The rupture of a splenic artery aneurysm in pregnancy and during labour is a rare event with a high maternal and fetal mortality rate. This report is, in view of previously reported cases, on the thirteenth case of a ruptured splenic artery aneurysm reporting survival of both mother and fetus. The etiology, clinical signs, diagnosis and therapy are discussed with reference to consideration of the literature. The necessity of an early differential diagnostic consideration of this rare occurrence is discussed, because this is the only way to achieve survival of mother and fetus.

Adult↗
PubMed1994

Influence of gadolinium chelates on phosphorus-31 magnetic resonance spectroscopy of the liver.

RATIONALE AND OBJECTIVES: The potential of gadolinium compounds (Gd-ethoxybenzyl-DTPA [Gd-EOB-DTPA], gadopentetate dimeglumine [Gd-DTPA], and Gd-chloride [GdCl3]) to enhance the signals from intracellular phosphorus-31 nuclei in the liver was investigated. METHODS: After intravenous administration of Gd-EOB-DTPA, Gd-DTPA, and GdCl3 to rats, liver phosphorus metabolites (inorganic phosphate [Pi], phosphomonoester [PME], and adenosine triphosphate [ATP]) were measured by phosphorus-31 magnetic resonance spectroscopy (MRS). The dose of each compound was 0.2 mmol Gd/kg. Saline was used as a control. RESULTS: The intensities of the phosphorus metabolite signals in the liver showed only minor changes after administration of Gd-DTPA and GdCl3, but increased after Gd-EOB-DTPA. The signals of Pi and PME were enhanced more than those of ATP. The alpha peak of ATP increased by 21.7%, Pi by 61.2%, and PME by 49.2%. CONCLUSIONS: The signal intensities of the phosphorus metabolites in the liver were not influenced by GdCl3. Using Gd-DTPA, only a slight enhancement could be detected. The greatest enhancement was observed with Gd-EOB-DTPA, which has access to the phosphorus metabolites within the hepatocytes. The injection of Gd-EOB-DTPA results in better detectability of the Pi signal.

Adenosine Triphosphate↗
PubMed1993

Neovascularization and the appearance of morphological characteristics of the blood-brain barrier in the embryonic mouse central nervous system.

Vascularization and expression of blood-brain barrier (bbb)-associated morphological characteristics during the embryonic development of the mouse central nervous system (CNS) was studied by ultrastructural analysis. At embryonic day 9 (E9) capillaries were only found in the perineural mesenchymal tissue. These capillaries showed fenestrations, and pericyte like cells (PC) were found joined to the vessel walls. Around E10 endothelial cells (EC) together with PC started invading the intraneural section. At this stage, the immigrating endothelial cells lost their fenestrations and exhibited numerous, partly extended junctional complexes, which appeared 'tight' in some places. A first intraneural anastomotic plexus was observed at E10, as evidenced by the presence of blood cells in all capillary lumens. While the number of junctional complexes remained constant in intraneural capillaries, the frequency of pinocytotic vesicles decreased significantly from E10 to E17. These findings indicate that from the first day of intraneural vascularization onwards, the morphological properties of the bbb are present in the early embryonic mouse cerebral cortex.

Animals↗
PubMed1993

The 'oddball CNV' as an indicator of different information processing in patients with panic disorders.

In previous studies we found an inverse relationship between CNV amplitude and the probability of the occurrence of the warning stimulus (S1) in a cued reaction time task. The aim of the present study was to investigate this 'oddball effect' on CNV amplitude (Oddball CNV) in patients with anxiety disorders, since this effect describes the influence of event probability on reactive as well as proactive components of information processing. Patients suffering from panic disorders with or without agoraphobia and controls participated in a choice reaction time experiment. The subjects' task was to respond to flashes (S2s), cued 4 s in advance in random order by one of two easily distinguishable acoustic stimuli (S1a, S1b). In condition 1 the probability of S1a and S1b was 0.2 and 0.8, respectively, and in condition 2 0.5 for both S1s. The DC-EEG was recorded from F3, F4, C3, Cz, C4 and P3, linked mastoids as the reference. The data obtained confirm the oddball effect on the CNV amplitude, show clear deviations of patients in this effect, and also indicate remarkable differences in CNV shape between patients and controls. These observations are discussed as differences in information processing and information utilization.

Adult↗
PubMed1993

[Tuberculous mastitis--a rare differential diagnosis of non-puerperal mastitis].

Tuberculosis in a case of non-puerperal mastitis is a rare clinical finding. A special case of a 28-year old Thai patient was diagnosed and successfully treated with an antituberculous chemotherapy. The most important diagnostic procedure was the microbiological and histological investigation to enable the diagnosis to be made. Surgical therapy was not necessary.

Adult↗
PubMed1993

Transcription-independent activation of ornithine decarboxylase activity by heparin in cloned cerebral endothelial cells.

Heparin, a highly sulfated glycosaminoglycan, is known to be obligatory for long-term endothelial cell cultures; it potentiates the mitogenic activities of endothelial cell growth factors and prolongs the replicative life span of the cells. Here we have shown that besides its growth factor-supportive role, heparin exerts a specific action on cerebral capillary endothelial cells (cECs), unrelated to serum or growth factors, by increasing activity of ornithine decarboxylase (ODC; EC 4.1.1.17) in these cells. For our experiments we have used two different types of cloned cECs: type I cECs, grown in the presence of endothelial cell growth factor and heparin, and type II cECs, usually cultivated without growth factors. Heparin action on ODC activity was shown to be dose dependent within the range of 1-100 micrograms/ml. Increasing concentrations of or depletion of endothelial cell growth factor from type I cultures had no effect on ODC activity. The increase in enzyme activity was highest after 30 min to 1 h of heparin treatment. As evidenced by northern analysis, the heparin-mediated enhancement of ODC activity was not accompanied by changes of ODC mRNA levels. Studies of DNA replication revealed that in the absence of heparin-binding growth factors, heparin did not affect the proliferative activity of cloned cECs.

Animals↗
PubMed1992

Comparison of gene expression of extracellular matrix molecules in brain microvascular endothelial cells and astrocytes.

By use of random-primed cDNA probes the expression of extracellular matrix molecules in cerebral microvascular endothelial cells (cEC) and in astrocytes from mouse brain was examined. Two phenotypically different batches of cloned cEC were used. Expression of major adhesive ECM molecules, constituting the endothelial basement membrane (i.e., fibronectin, laminin A, B and collagen IV) and of other attachment factors, such as SPARC (osteonectin), tenascin and thrombospondin 1, was examined. We have demonstrated that cEC of different morphology display variations in the expression of fibronectin (FN), thrombospondin 1 (TSP1) and collagen IV (C IV). Astrocytes were shown to contain FN, TSP1, TN and SPARC mRNA. Unexpectedly, SPARC mRNA could not be detected in any of the capillary endothelial cells examined. Therefore, we suggest that astrocytes are likely to be involved in endothelial differentiation and function in the central nervous system via ECM molecule secretion.

Animals↗
PubMed1992

Embryonic development of the CNS microvasculature in the mouse: new insights into the structural mechanisms of early angiogenesis.

Vascularization and expression of blood-brain barrier (bbb) associated morphological characteristics were studied by ultrastructural analysis during the embryonic development of the mouse CNS. At day 9 (E9) capillaries were only found in the perineural mesenchymal tissue exhibiting fenestrations and loosely attached pericytes. At E10 endothelial cells (EC) together with pericytes and other mesenchymal cells invaded the intraneural domain. The immigrating EC showed numerous protrusions and lost their fenestrations as soon as the new intraneural capillaries were formed. Intraneural EC showed prominent nuclei, many pinocytotic vesicles and junctional complexes which appeared tight in some places. These results indicate that from the first day of intraneural vascularization onwards, the morphological properties of the bbb are present in the early embryonic mouse cerebral cortex.

Animals↗
PubMed1992

Effects of thiopentone/suxamethonium on intraocular pressure after pretreatment with alfentanil.

The effects of pretreatment with alfentanil on intraocular pressure (IOP) were investigated in 40 patients undergoing ophthalmic surgery. Patients were randomly allocated to two study groups. Group 1 patients (n = 20) received alfentanil 15 micrograms.kg-1, vecuronium 0.01 mg.kg-1, thiopentone 3-4 mg.kg-1, and suxamethonium 1 mg.kg-1 for anaesthetic induction, whereas patients in group 2 (n = 20) received vecuronium 0.01 mg.kg-1, thiopentone 3-4 mg.kg-1, and suxamethonium 1 mg.kg-1. A total of seven measurements of intraocular pressure were taken in each patient, starting before premedication and ending after extubation of the trachea. In group 2 patients, there was an increase in IOP after endotracheal intubation. In group 1 patients, a decrease in IOP occurred which was related to the decrease in arterial blood pressure. We conclude that alfentanil pretreatment can prevent the increase in IOP following suxamethonium administration.

Aged↗
PubMed1992

Rare events and the CNV--the oddball CNV.

Event-related brain potentials (ERPs), such as Nd and P300, change as a function of the proportion of time if a rare, significant, stimulus occurs. This 'oddball' paradigm has had a significant influence on the interpretation of ERPs in terms of the psychological and information-processing functions they reflect. Interpretations of transient components have differed considerably from that of the sustained potential known as the Contingent negative Variation (CNV), the latter appearing to reflect proactive rather than reactive brain processes. However, experiments in monkeys indicated that the CNV was also sensitive to the oddball effect. The purpose of this experiment was to replicate that finding in humans. The CNVs and P300s of five male and five female college students were studied under three conditions involving different proportions of two types of warning stimuli in a cued reaction time task (paired tone and light). The proportions of one of the warning stimuli, with respect to the total number of trials, were 0.10, 0.30 and 0.50. P300s were larger when elicited by rare warning tones only in the 0.10 condition with maximum P300 amplitude at the parietal site. CNVs at frontal and central areas were larger when the warning cue was the rare event, but there was no effect at the parietal site. These findings may require a rethinking of specific information processing interpretations of other endogenous ERPs, although the results also indicate that the 'oddball' effect on the P300 and CNV was distinctive in terms of scalp distributions and sensitivity to the manipulation.

Adult↗