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Biomedical subjects

J Bommer

Publications and source records attributed to J Bommer.

At least 127 records · Page 7Linked to original sources
PubMed1977

Vascular calcifications under maintenance hemodialysis.

In a cross-sectional study X-rays of the forefoot and the pelvis of 101 adult dialysis patients were taken. Vascular calcifications (forefoot) were observed in 20 patients. The incidence was higher in patients who had been started on dialysis several years ago. However, in a longitudinal prospective study de novo appearance of vascular calcificaitons was observed only in 1 out of 50 dialysed patients, although hyperparathyreoidism and moderate hyperphosphatemia persisted. Vascular calcifications were seen only once in 138 uremic children (56 uremic children without dialysis; 82 uremic children on maintenance hemodialysis). However at autopsy visceral calcifications of the lung were found in three (out of 11) children who did not have vascular calcificaitons on X-rays.

Adolescent↗
PubMed1977

[Raynaud's phenomenon in dialysed patients (author's transl)].

In 158 uraemic patients on haemodialysis complaints resembling Raynaud's disease were observed more frequently (85 patients = 54%) than in an equal number of age and sex matched control persons (10 probands = 6%). The complaints were also registered in the arm without the fistula. Triggering causes were exposure to cold or isometric muscular exercise. The complaints were slightly more frequent in women and occurred in 28% prior to dialysis in the terminal stage of renal insufficiency. They were improved only in a minority of those treated with haemodialysis, however they disappeared after successful renal transplantation. Veno-occlusive plethysmographic investigations showed that in asympatomatic patients the resting perfusion at room temperature, the perfusion in reactive hyperaemia, and perfusion at 0 degrees C were not different from control persons. Patients with Raynaud's phenomenon had on average a diminished resting perfusion and a normal perfusion after reactive hyperaemia. The perfusion at 0 degrees C was lower than in asymptomatic patients but still higher than in patients with Raynaud's disease. Increased cooling of the skin and delayed rewarming were objectively measured by using skin temperatures. There was not correlation between the complaints or perfusion values and the vibration threshold.

Adolescent↗
PubMed1976

[Management of slipped epiphyses in renal osteodystrophy (author's transl)].

Epiphyseal slipping in uraemia differs strikingly from juvenile epiphyseal slipping with respect to pathology and therapy. Based on our own experience with the treatment of 8 uraemic children with epiphyseal slipping, an effort was made to establish the respective indications for conservative and surgical treatment. Mechanical stabilization of slipped epiphyses was achieved within a few weeks without any surgery and usually without parathyreoidectomy by vitamin D3 alone. The initial dose was 10,000 to 30,000 I.U./day, the total curative dose 1.8 to 5.6 millions I.U. Prolonged immobilization was unnecessary. Rising urinary calcium excretion was a valuable indicator of vitamin D intoxication even in advanced renal failure. In one case, pronounced metaphyseal deformations (distal femur, distal tibia) required surgical correction before the ability to walk normally was restored. - The following therapeutical approach is recommended: metabolic bone disease must be cured by vitamin D therapy with or without parathyreoidectomy. Osteotomy to correct metaphyseal deformities or coxa vara epiphysaria never should be performed before metabolic bone disease is healed.

Adolescent↗
PubMed1976

The influence of immobilization on osteocyte morphology: osteocyte differential count and electron microscopical studies.

Differential counts and electron microscopical studies of osteocytes were performed on rats immobilized by spinal cord severing, plaster cast and ischiatic nerve dissection. In undecalcified ground sections of tibia and femur (100 micron) stained with basic fuchsin, osteocytes were differentiated into small (metabolically inactive) osteocy es enlarged (metabolically activated) osteocytes and empty lacunae. In rats (immobilizedfor' three weeks) with functioning parathyroid glands, but not after parathyroidectomy, the number of activated cells is markedly increased, whereas the number of small osteocytes is reduced. In animals with spinal cord severing the number of empty lacunae is also increased. Electron microscopical studies of undecalcified tibiae taken from rats immobilized for ten days showed a periosteocytic osteolysis with destruction of the lacunar wall, fragmentation of collagen fibres and loss of mineral crystals. The cytoplasmic seams of osteocytes were broadened, mitochondria were enlarged, and the cytoplasma showed vacuoles containing amorphous material which could be found in the pericellular space. Deep invaginations of the cytoplasma and an increase of the cell processes were typical findings. The results of the investigation point to an activation of osteocyte metabolism by immobilization. The osteocytes thus play an important part at the onset of immobilization osteoporosis. Periosteocytic osteolysis can be inhibited by parathyroidectomy. Therefore, the response of osteocytes to endogenous parathyroid hormone must be altered under conditions of immobilization.

Animals↗
PubMed1976

Sexual behaviour of hemodialyzed patients.

18 married men on home dialysis and 10 of their wives were interviewed (structured interview) to evaluate sexual adjustment. The frequency of intercourse prior to the onset of their disease was reported to be 3.4/week by the patients and 2.4/week by their wives. During maintenance hemodialysis, frequency was reported to be 1.7/week by the patients and 1.0/week by their wives. If libido prior to the disease was rated 100%, the patients reported their libido at the time of the interview as 66+/-34%; only 5 rated their libido as less than 50% of their libido prior to the onset of their disease. After the start of dialysis, considerable time was required before a stable state of sexual activity was reached (13.9+/-7.4 months), presumably reflecting the time required for adaptation to the procedure, loss of anxiety and restoration of physical well-being. Except in older patients, there was good agreement between the feeling of physical fitness as reported by the patients and sexual performance as reported by both the patient and his spouse.

Adult↗
PubMed1975

[Thrombotic occlusion of an arteriovenous Cimino shunt in acute pancreatitis (author's transl)].

An arteriovenous (Cimino) shunt in both right and left forearms clotted during an episode of acute pancreatitis in two patients on chronic haemodialysis. Systemic hypercoagulability (circulating fibrin monomers, shortening of r and k time in the thrombelastogram and shortening of the PTT-time) occurred in association with inhibition of fibrinolysis (prolongation of euglobulin lysis time). Localized thrombosis at the shunt is thought to be due to superimpostition of systemic hyper-coagulability on a local increase in platelet adhesiveness.

Acute Disease↗