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Biomedical subjects

J Busse

Publications and source records attributed to J Busse.

At least 19 recordsLinked to original sources

Life-threatening postoperative blood loss in a Jehovah's Witness, treated with high-dose erythropoietin.

Six hours after an uncomplicated extended resection of ovarian cancer, postoperative arterial bleeding led to life-threatening blood loss in a 44-yr-old Jehovah's Witness who refused blood transfusion. Haemoglobin (Hb) decreased from 2.5 g dl(-1) directly after the emergency laparotomy, followed by a 10 h immeasurable period (below detectable minimum value of the analyser), to a measurable minimum of 1.5 g dl(-1) after 20 h. Haematopoiesis was induced by high-dose i.v. erythropoietin therapy (600 IU kg(-1)) and continued on days 3, 6, 8, 10 and 13. Iron, folic acid and vitamins were given as supplements. The patient needed ventilatory assistance for 18 days and some inotropic support. Complications included increases in pancreatic enzymes and liver enzymes, jaundice and skin necrosis at the fingertips and toes. Myopathy led to transient tetraparesis. Haemoglobin rose from 1.5 to 3.4 g dl(-1) (day 10) and the patient was discharged from the intensive care unit with haemoglobin 6.5 g dl(-1) on day 24. She made a full recovery and is still free of cancer in remission.

Adult↗

Chromatography and electrophoresis on chips: critical elements of future integrated, microfluidic analytical systems for life science.

Liquid chromatography and electrophoresis played a major role in the life-science revolution, most strikingly in protein purification, peptide fractionation and sequencing, amino acid analysis, and DNA sequencing. The objective of this article is to examine the potential role of separation systems in the continuing evolution of biochemistry, biotechnology and molecular biology. Very small chip-based systems may change how chemical analyses in biology, medical research and health care evolve over the next decade.

Biological Science Disciplines↗

[Distal femoro-popliteal bypass using Esmarch tourniquet ischemia].

The Esmarch bandage is an effective substitute for vascular clamps in distal femoro-popliteal or tibial bypass surgery. Intimal trauma caused by clamping is avoided, vasa vasorum are preserved due to only semicircumferential dissection of vessels. This method is particularly suitable for heavy calcified rigid vessel walls. We demonstrate this technique, which was employed in 8 patients (10 bypasses). The use of this technique requires neither a longer operation- nor clamping time. The postoperative course of all but one patients develops normally and the technique does not provoke any pathological results in the area of operation. Advantages of the procedure compared to conventional techniques will be discussed.

Aged↗

Receptor affinity purification of a lipid-binding adhesin from Haemophilus influenzae.

Thirteen clinical strains of Haemophilus influenzae, including types b, d, and untypeable, in vitro specifically recognize phosphatidylethanolamine (PE), gangliotetraosylceramide, gangliotriosylceramide (Gg3), sulfatoxygalactosylceramide, and to a lesser extent sulfatoxygalactosylglycerol. A PE affinity matrix was used to purify an adhesin of approximately 46 kDa from both type b and untypeable H. influenzae. This adhesin was a potent inhibitor of H. influenzae Gg3 and PE binding in vitro, and polyclonal antibodies specific for this protein prevented the attachment of H. influenzae Gg3 and PE and cultured HEp-2 epithelial cells in vitro.

Adhesins, Bacterial↗

Cyanide toxicity of sodium nitroprusside in therapeutic use with and without sodium thiosulphate.

Sodium nitroprusside (SNP) as a mono-infusion was administered to 51 patients for periods of a few hours. A further group of 19 patients received SNP for periods of several days as a combination solution of SNP mixed with sodium thiosulphate. The concentrations of cyanide and of thiocyanate in the blood of all patients were measured. In seven of the patients the level of thiosulphate was also measured. Infusion of SNP on its own at levels exceeding 2 microgram/kg/min led to the rising of cyanide levels in the blood being proportional to dosage. Infusion of SNP mixed with thiosulphate showed no such accumulation of cyanide in any patient, irrespective of dosage level and duration. The efficacy at lowering blood pressure was fully maintained in the mixed infusion. The elimination half-life for thiosulphate was 16.5 min. Pharmacokinetic calculation of the rise in cyanide level showed that mono-infusions of 5-10 micrograms SNP/kg/min could within 5-10 h cause a life-threatening cyanide level in the blood. By contrast, mixed infusion of SNP together with thiosulphate, for which light-opaque syringes and tubing must be used, is a procedure free of danger and should become the technique of choice when therapeutically administering SNP in order to lower blood pressure.

Adolescent↗

In situ carcinoma of the vocal cords.

Eighty-one patients with preinvasive carcinoma of the vocal cord, seen over a thirteen year period, were reviewed histologically and analyzed for response to treatment. Sixty-seven cases were clinically T1 and fourteen cases T2 (by virtue of extension of disease beyond the vocal cord). All patients had mobile cords. Histological criteria for in situ carcinoma and the spectrum of microscopic patterns are presented. Sixty-nine patients were treated by external beam radiotherapy--the remainder by a variety of surgical procedures. Five and ten year actuarial, recurrence-free rates 83% and 75%, respectively for the group treated by irradiation. No difference in local control was observed when analyzed for: 1) dose response, 2) initial extent of disease, 3) treatment plan, or 4) histologic diagnosis. Analysis of failures reveals that 15/17 patients with local failure were salvaged, eleven of these patients requiring laryngectomy. Time to appearance of recurrence ranged from seven to one hundred and seven months.

Aged↗

[The computerized anaesthetic record of the 'Universitätsklinik Köln' (author's transl)].

Some of the main arguments are presented which led us to develop our present anaesthetic record. This record system and a part of its voluminous code is described. The new version provides for the documentation of arbitrarily complicated status, which are due to the preoperative condition of the patient. Furthermore, the course of aneaesthesia and its effects upon the patient can be numerically recorded in a detailed fashion. The punching is affected by a small rate of error only.

Anesthesia↗

[Anaesthetic problems during resection of the carina (author's transl)].

Benigne tracheo-bronchial constriction is an infrequent indications for resection of the bifurcation of the trachea. In former times resection and reconstruction of the bifurcation have been performed using extracorporal oxygenation. Nowadays, the method of separate ventilation of both lungs is used more frequently. Pathophysiological variations should be taken into consideration, which may occur during interruption of the ventilation of one side of lung caused by operating procedures. Rapidly developing atelectasis of the non-ventilated but perfused lung endangers the patient, as a result of an increased intrapulmonary right-to-left-shunt. Hypoxaemia can be prevented by temporary occlusion of the pulmonary artery of the nonventilated lung. This procedure is to be recommended in view of the fact that there is no prompt constriction of the vessels. Investigations with dogs show that a slightly developing accommodation of the perfusion can be disturbed by variations of cardiac output or mean pressure of ventilation.

Child↗

[Cardiovascular effects produced by prophylactic digitalization during introduction of anaesthesia (author's transl)].

The narrow field of non-controversial indications concerning the application of digitalis glycosides is pointed out. Problems of routine digitalization of older patients not suffering from cardiac insuffiency are discussed with special regard to preparing them for operations. Up to now, from the viewpoint of anaesthesiologists no benefits of prophylactic digitalization have been found. In a retrospective computerized study, clinical hemodynamic parameters during introduction of anaesthesia have been investigated by means of anaesthetic data recorded during three years. Nondigitalized patients older than fifty years showed satisfactory cardiac functions, whereas prophylactically digitalized patients--compared with the control group--have been treated with plasma expanders earlier and at a double rate. Furthermore, higher heart frequencies and greater tendency to arrythmias were observed. Consequently, prophylactic digitalization cannot be recommended in general.

Age Factors↗

Mobile velocity-controlled respirometer: description and performance capabilities.

An apparatus modeled after the Scram respirometer designed by Corcoran is described in terms of design, specifications and performance capabilities. The results with the use of this apparatus in a study of 14 able-bodied adults of five controlled walking speeds are compared to those of a similar study previously reported by Corcoran and Brengelmann. Oxygen consumption (ml O2/kg body wt/min) increases proportionately to the square of the velocity of walking. Results of the two investigations are parallel, although the present report demonstrates a greater male-female difference at all speeds. Uses and limitations of the apparatus are considered.

Adult↗