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Biomedical subjects

H Haas

Publications and source records attributed to H Haas.

249 records · Page 14Linked to original sources
PubMedDate not supplied

5-HT1A and 5-HT4 receptor colocalization on hippocampal pyramidal cells.

The mixed inhibitory and excitatory effects of 5-HT on hippocampal pyramidal cells were studied on hippocampal slices perfused with a low-Ca2+/high Mg2+ solution that blocked synaptic activity and induced spontaneous pyramidal cell discharge. Extracellular recordings of the spontaneous discharge revealed that, in 65% of the cells, 5-HT (0.5-10 microM) initially inhibited and then, upon washout, facilitated spontaneous discharge. Sometimes the off-stimulation persisted for the duration of the experiment. In 17% of the cells the response to 5-HT was only stimulatory, and in 15% the response was exclusively inhibitory. The 5-HT1 agonists, 8-hydroxy-dipropylamino-tetraline, and 5-carboxamidotryptamine produced inhibition with no excitatory responses upon washout. The inhibition was blocked by spiroxatrine indicating it was mediated by 5-HT1A receptors. The 5-HT3 agonist, 2-methyl 5-HT, had no effect, and the 5-HT2 antagonist, ketanserin, did not alter the excitatory responses to 5-HT. This indicates the excitatory response is not mediated by 5-HT2 or 3 receptors. Cisapride, a 5-HT4 agonist increased pyramidal cell discharge. The 5-HT3 & 4 antagonist, ICS 205-930 antagonized the excitatory responses to 5-HT, alpha-methyl 5-HT, and cisapride, indicating the excitatory response is mediated, in part, by 5-HT4 receptors. The phosphodiesterase inhibitor, isobutyl-methyl-xanthine, stimulated pyramidal cell discharge and potentiated the response to cisapride. This further suggests 5-HT4 receptor involvement since these receptors are positively coupled to adenylyl cyclase.

Animals↗
PubMedDate not supplied

[Staged diagnosis of septic hip endoprosthesis loosening with laboratory parameters and antigranulocyte scintigraphy].

AIM: The value of serial diagnosis of septic loosening of hip endoprosthesis using laboratory parameters and antigranulocytes scintigraphy was investigated and compared to joint aspiration. METHOD: In 35 patients with intraoperative verification of infection, we calculated sensitivity, specify and prevalence dependent positive and negative predictive values for antigranulocyte scintigraphy, laboratory tests and the most suitable combination of both. We also calculated predictive values of joint aspiration using sensitivity and specify values given in the literature. RESULTS: From negative and positive predictive values, of the sedimetation rate and leukocyte count provided no increase of information. We found the same result for positive predictive values of C-reactive protein. For antigranulocyte scintigraphy alone, we found a distinct but still unsatisfying increase of information. Nevertheless, in both cases infection could be excluded definitely. Therefore, the combination of C-reactive protein and antigranulocyte scintigraphy was suitable and the positive predictive values of this combination were only about 5% lower than those of joint aspiration. But with joint aspiration, infection could not be excluded. CONCLUSION: A positive result in serial diagnosis using C-reactive protein and antigranulocyte scintigraphy leads to an distinct increase in the probability of infection which is comparable to that of joint aspiration. The additional advantages of this procedure are the certain exclusion of infection and the absence of invasiveness.

Aged↗
PubMedDate not supplied

[Osteochondritis dissecans - an easy classification in MRI].

AIM: For the diagnosis of osteochondritis dissecans (OD) MRI is used besides X-ray. However, there is no consensus about the necessity of MRI or the interpretation of MRI. The aim of this prospective study was to find a diagnostic concept for OD which is simple and practicale for daily routine. METHOD: In 90 patients with OD of the knee or ankle MRI (T1- and T2-w SE) was carried out before arthroscopy. According to the interface between the osteochondral fragment and the parent bone, MRI was classified in 2 stages ("stable" or "unstable") and compared with the arthroscopic findings. RESULTS: With the 2-stage classification of MRI, a prediction of the stability of the osteochondral fragment was possible in 92 %. Out of the 90 patients 7 (8 %) differed regarding preoperative stability in MRI compared to stability in arthroscopy. Incorrect diagnosis in MRI was only found among the patients with unstable fragments. CONCLUSION: The chosen 2-stage classification in MRI is well suitable for the planning of stage-related therapy.

Adolescent↗
PubMedDate not supplied

[Stage diagnostics for postinfection revision of hip and knee replacement: value of laboratory parameters and antigranulocyte scintigraphy].

AIM: In the case of two-stage infect revision arthroplasties of hip and knee joint, of primary resection arthroplasties and before implantation of arthroplasties after septic arthritis the accuracy of preoperative laboratory parameters and antigranulocyte scintigraphy was analysed. Furthermore, we stained the intraoperatively taken joint synovial samples with hematoxylin-eosin and also with antibodies against human neutrophil elastase in order to investigate if immunohistological examination provides further or different information. METHOD: In 24 patients with intraoperative verification of infection we calculated sensitivity, specificity, positive and negative predictive values for laboratory tests, antigranulocyte scintigraphy and the most suitable combination of both. The joint synovial samples stained with antibodies against human neutrophil elastase were compared to those stained with hematoxylin-eosin according to the criteria of Mirra. RESULTS: We observed the best results for the combination of C-reactive protein and antigranulocyte scintigraphy with a sensitivity of 1, a specificity of 0.92, a positive predictive value of 0.75 and a negative predictive value of 1. No additional or different information was observed by the immunohistological stained samples. CONCLUSION: Stage diagnostic using C-reactive protein and antigranulocyte scintigraphy provides accurate information to assess the status of infection before hip and knee replacement after infect revision. Additional immunohistological staining besides the routinely taken hematoxylin-eosin staining of joint synovial samples is not recommended.

Aged↗
PubMedDate not supplied

[Patella resurfacing in patients without substantial retropatellar knee pain symptoms?].

OBJECTIVE: The aim is of this prospective randomised study was to investigate the necessity of resurfacing the patella in combination with total knee arthroplasty in patients without or mild anterior knee pain before undergoing total knee replacement. METHODS: Between May 1999 and May 2000 fifty patients were enrolled in a prospective, randomised study. All patients received the same posterior-cruciate-sparing total knee replacement and were randomised to treatment with and without resurfacing of the patella. Inclusion criteria were primary osteoarthritis of the knee, preoperatively no pain when the patella was shifted during clinical examination, a maximal grade III radiological degeneration of the patella according to Sperner et al. and at most a mild anterior knee pain in preoperative interview. Evaluations consisted of the determination of the Knee Society clinical score, the completion of a patient satisfaction questionnaire, and radiographic assessment basing on the Knee Society roentgenographic evaluation and scoring system. All patients were examined preoperatively and 3, 6, and 12 months postoperatively. RESULTS: In all postoperative examinations patients with patella resurfacing demonstrated a higher overall Knee Society score. At month 6 the difference was statistically significant. The patient satisfaction questionnaire demonstrated no significant difference between both groups. However, regarding to relief of anterior knee pain and improvement of pain in general patients with nonresurfacing were less satisfied at all follow-ups. Furthermore, after 12 months all answers to the patient satisfaction questionnaire of the resurfaced group were better. Patella-associated revisions were performed in two patients without resurfacing. Radiographic analysis demonstrated no loosening, fracture, subluxation or dislocation. CONCLUSION: The presented study demonstrated after one year follow-up a better functional result, a higher degree of contentment and fewer complications after total knee replacement with patella resurfacing in patients without or mild preoperative anterior knee pain.

Aged↗
PubMedDate not supplied

[Infection diagnosis after knee-TEP-implantation].

AIM: In this study, the accuracy of antigranulocyte scintigraphy as a diagnostic means prior to revision in infected total knee replacement was compared to that of preoperative joint aspiration and laboratory parameters. The most efficient combination of all diagnostic methods was calculated and thus a diagnostic algorithm recommended. The value of PCR was compared to commonly used techniques of microbiological culturing. METHODS: Preoperative diagnostic means for infection of 50 total knee replacements in 45 patients requiring revision surgery, were retrospectively analyzed. Inclusion criteria were the intraoperative microbiological and histological verification of infection. Sensitivity, specificity, negative and positive prediction value of C-reactive protein (CRP) and leukocytes, antigranulocyte scintigraphy with (99m)Tc-labeled antibodies, and preoperative joint aspiration were calculated. Furthermore, the accuracy of the different techniques of culturing was compared to that of the polymerase chain reaction (PCR) based on the intraoperative histological findings. Two blinded examiners evaluated specimens taken intraoperatively according to the criteria of Mirra. RESULTS: We observed a sensitivity of 1.0, a specificity of 0.82, a positive prediction value of 0.83 and a negative prediction value of 1.0 for the antigranulocyte scintigraphy. The sensitivity of preoperative joint aspiration was 0.5, the specificity 1.0, and the positive and negative prediction values were 1.0 and 0.5. Correlated to the intraoperative histological findings the accuracy of PCR and culturing was comparable. The highest accuracy was obtained for blood culture samples. CONCLUSION: Compared to preoperative joint aspiration the antigranulocyte scintigraphy proved to be more sensitive in the diagnosis an infected knee replacement while having a high specificity. An advantage of PCR compared to the common microbiological culturing techniques was not observed.

Aged↗
PubMedDate not supplied

[Usefulness of 16S rDNA polymerase-chain-reaction (PCR) in the intraoperative detection of infection in revision of failed arthroplasties].

AIM: In this study the accuracy of the 16S DNA polymerase chain reaction (PCR) in revision arthroplasties was compared to that of conventional bacterial culture when correlated to intraoperative histological findings. Furthermore, the influence of antibiotic treatment and different ways of collecting samples was evaluated. METHOD: In a prospective study we collected samples of tissues, aspiration fluids and swabs during revision arthroplasty surgery and examined them with PCR as well as conventional bacterial culturing methods. Also, we correlated these two methods with the histological findings of intraoperative tissue samples. Two independent examiners evaluated the samples according to the criteria of Mirra et al. Sensitivity, specificity, positive and negative prediction value and the accuracy were calculated for the molecular biological and culture methods. Three groups were defined to evaluate the influence of accompanying antibiotic treatment and the way of collecting the microbiological samples. RESULTS: Nine periprosthetic infections could be detected by PCR as well as by conventional bacterial culturing. Correlated with the 25 positive histological findings this resulted in a sensitivity of 0.36, a specificity of 1.0, a negative prediction value of 0.61, a positive prediction value of 1.0 and an accuracy of 0.68 for both methods. Swabs compared to aspiration fluids and tissues samples showed the highest sensitivity with both methods. No higher sensitivity of PCR compared to conventional bacterial culturing could be observed in patients with accompanying antibiotic treatment. CONCLUSION: Although PCR is more rapidly available for the diagnosis of periprosthetic infection, a definite advantage of this more expensive method could not be demonstrated in view of the same low sensitivity of PCR and conventional bacterial culturing.

Arthroplasty↗
PubMedDate not supplied

[Health-economic considerations for the use of BMP-2 for spinal surgery in Germany].

INTRODUCTION: BMP-2 can replace autogenous bone grafting in lumbar one-level anterior lumbar interbody fusions (ALIF). The current G-DRG system does not reimburse the upfront price of 2,970 euro per BMP-2 application for hospitals in Germany. The purpose of the current study was to create a health economic model to evaluate the financial savings for health care providers (hospitals) and health care payers (health care insurance) that can be achieved by the use of BMP-2 in spine surgery. METHODS: A previously published pooled data analysis was used in which BMP-2 showed significant improvements in the treatment after ALIF surgery compared to autogenous bone grafting, including earlier return to work time and reduced revision rates. These medical findings were transformed into economic data based on the regulations of the German health system of 2005. RESULTS: The significantly shorter return to work time under BMP-2 treatment generates important financial savings for health care insurances offsetting the upfront prize of 2,970 euro for BMP-2. Savings for hospitals are mainly related to shorter surgery time due to the absence of the bone grafting procedure and faster discharge of the patient. CONCLUSIONS: The combination of improved medical outcome by BMP-2 treatment for the patient and net savings for the entire health care system in Germany represents a "dominant" strategy from a health economic perspective. This implicates that BMP-2 in ALIF procedures is to be recommended from a health economic point of view for the German health care system.

Bone Morphogenetic Protein 2↗
PubMedDate not supplied

[Mammary staphylococcal cellulitis of the newborn].

BACKGROUND: Neonatal cellulitis is usually caused by staphylococcal infection of the mammary gland which has generally reached the stage of abscess formation at the time of diagnosis. The circumstances of onset and possible complications remain poorly known. We report a recent case. CASE REPORT: A female neonate developed major bilateral mammary hypertrophy. Her mother had tried to express the breasts, fearing "congestion". Three days later, the right breast showed signs of inflammation with a fluctuant central zone suggestive of a cellulitic infectious abscess confirmed at ultrasound. Recovery was achieved with incision and antistaphylococci antibiotic therapy. DISCUSSION: Mammary cellulitis of the newborn appears to generally occur following an attempt to manipulate a pre-existing physiological hypertrophy of the breast. Staphylococcus aureus is the most commonly found agent. Early surgical care is generally required as there is a real risk of progression to necrotizing faciitis.

Abscess↗
PubMedDate not supplied

[Parasuicide and violence: criminological aspects from a study of 21,314 male army recruits in Switzerland].

Suicidal behaviors are not uncommon, but rarely admitted in the families and in society at large. Violence is a public health and social problem of growing concern. Research on the relationship between violence and suicidal behaviors is scarce for the last decades, perhaps because suicide is no longer considered an offense. The present study is based on a sample of 21,314 valid interviews with 20 year old Swiss men, representing over 70% of this cohort. The questionnaire contained over 900 variables, addressing issues such as previous history of parasuicide, self-reported violent acts and injuries, during childhood and adolescence, as well as over the last year before recruits training. The questionnaire also contains various items about mental health, familial and social conditions and situational factors. We used an ordinal scale for measuring violence and operationalisations of mental disturbances according to theoretical and empirical concepts such as conduct disorder and antisocial personality disorder according to DSM IV, the dissocial syndrome according to Rauchfleisch's (1981) definition; 2,6% of the recruits reported at least one suicide attempt during the last year, one third even multiple attempts. Life-time prevalence at age 20 was 3,9%. Suicide attempters often showed signs of psychiatric disorders, especially for a dissocial (OR=6,9) or an antisocial (OR=5,8) syndrome. Other studies have shown that the rate of suicide in France and Switzerland is very high compared to other European countries. Our study confirms the existence of a real behavioural and existential problem among young Swiss men. Half of the suicide attempters had a history of physical violence against others and 20% were themselves victims of violent acts during the previous year. Suicide attempters who were victims were also more violent than those who were not victimized. A suicide attempt during the previous year is a marker for violent behaviours (OR=2,1) and victimisation (OR=1,9) during this same year. We also found a positive link between multiple attempted suicides and the commission of serious violence. It is concluded that parasuicide among young men is related to other violent acts and should be considered as a positive marker of violent behavior in general and victimisation by crime. It seems that suicide is a transgression of social and cultural values because of the amount of aggression behind it, even if it is not a criminal offense. Suicide attempts of young men should receive more attention by professionals in the field of medicine, psychology and social work. Treatment of these men not only prevents an individual mental health problem but also contributes to crime prevention at the community level. Criminological theories could inspire further studies in suicidology, in order to improve the multidisciplinary knowledge of the phenomenology and etiology of parasuicide. In the same way, criminologists as policy makers should attach more attention to parasuicide given its many theoretical and practical connections with crime.

Adult↗
PubMedDate not supplied

[Effect of age on the activity of Mg-Na-K-ATPase, as well as on the K and Na concentration in human erythrocytes].

42 persons of two age groups (14--28 years and 70--87 years) free of liver and hematological diseases without treatment with cardiac glycosides were investigated in this study. The activities of Mg++-ATPase and Na+-K+-ATPase were measured in red cell membranes. Furthermore the intracellular concentration of sodium and potassium was measured in erythrocytes of 10 persons. These results display a significant age dependent decrease of enzyme activities. Contrary to this, measurements of intracellular sodium and potassium concentrations disclosed no age dependent changes. There was no positive or negative correlation between the enzyme activities and the intracellular concentrations of sodium and potassium. The influence of 8 different drugs on Mg++-ATPase activities was proofed. The results displayed changes dependent on age and drug concentrations. The results were discussed with those of the literature.

Adult↗
PubMedDate not supplied

[Possibilities of DNA sex determination in hair roots].

Species- and sex-determination on hair roots were simultaneously performed using extracted DNA and a human Y chromosomespecific probe. (pH Y 2.1) After Southern hybridization, Hae III-digested DNA fragments were detected by non-radioactive digoxigenin detection system. DNA was extracted from one to five freshly plucked hair roots. The specific 2.12 kb fragment was successfully detected in male DNA samples from a single hair root. A positive identification of female DNA was more difficult. The hair root DNA was revealed to be stable at room temperature for at least 2 weeks (examination time) and produced the same specific band pattern as the DNA of fresh hair roots. In the blind tests with DNA samples from randomly plucked one to four hair roots, the rate of successful sex-determination was 95.8% on male samples (23 out of 24 samples) and 25% on female samples (4 out of 16 samples).

DNA Probes↗