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Biomedical subjects

J Vollmar

Publications and source records attributed to J Vollmar.

At least 73 records · Page 4Linked to original sources
PubMed1979

Dysplasia of the lymphatics with lymphoedema, generalized lymphangiectasis, chylothorax and "pseudo-storage-disease".

A patient showing an unusual association of various abnormalities of the lymphatic vascular system is reported. These abnormalities became first evident in early childhood and consisted of lymphoedema of the left leg, lymphangiectasis in various organs and occlusion of the thoracic duct at its entrance into the venous angle. Chylous effusions and subcutaneous chyloedema appeared in adolescence. Diagnostic biopsies of spleen, liver and bone-marrow revealed the presence of multiple foamcells, suggesting the diagnoses of lipid storage disease. The patient died from severe honeycomb-lungs at the age of 20. This case cannot be attributed to one of the wellknown disease entities of the lymphatic system. The "pseudo"-storage disease is regarded as secondary to the backflow of chylus into the tissues.

Adolescent↗
PubMed1978

[Results of using the reflomat for determining glucose concentration, and the influence of glycolysis inhibitors on Reflotest-glucose (author's transl)].

There was a close correlation between the hexokinase-glucose-6-phosphate-dehydrogenase method and reflomat/Reflotest-glucose on capillary blood samples without addition of glycolysis-inhibitors. The relative deviations were less than 10% over the entire range. In systematic studies set up to determine the influence of sodium fluoride and sodium monoiodo-acetate on the reflomat/Reflotest glucose system it was demonstrated that sodium monoiodo-acetate can be used when determining glucose with reflomat/Reflotest glucose, while sodium fluoride produced false values with this system.

Blood Glucose↗
PubMed1978

[Lipid-lowering effect of bezafibrate in patients with diabetes mellitus and hyperlipidaemia (author's transl)].

600 mg of bezafibrate daily were administered to 13 well controlled diabetics with hyperlipidaemia for 12 weeks. Placebo was given before and after the treatment period. Compared with pretreatment placebo, bezafibrate reduced triglycerides (between 37 and 47%) and cholesterol (between 12 and 19%) significantly. Blood glucose levels during treatment were significantly lower at 8 and 12 weeks compared with post-treatment placebo values. Urinary glucose excretion did not change. Hypoglycaemia was not observed. No change in antidiabetic medication was necessary. Bezafibrate was well tolerated. It lowered blood lipids effectively in diabetics with hyperlipidaemia. No additional precautions have to be taken to control carbohydrate metabolism during bezafibrate treatment.

Blood Glucose↗
PubMed1978

[Surgery of neck vessels (author's transl)].

The progress in vascular surgery offers to the otolaryngologist a remarkable increase of his surgical activities. This is especially true in the field of tumor surgery in the region of the carotid arteries and the jugular vein (e.g. removement of carotid body-tumor, lymphnode deposits by neckdissection etc.). Both the ligature of the internal as the common carotid arteries should be--when ever possible--avoided. The method of choice is an arterial reconstruction (by direct vascular suture or an autogenous venous graft respectively a Dacronprosthesis). In the presence of wound infection or damaged soft tissue by radiation any vascular repair is contraindicated except of an extra-anatomic bypass-procedure. Every otolaryngologist engaged with great neck surgery should be familiar with the basic principles of vascular surgery and should keep a set of vascular instruments available. Some neck interventions, dealing with the great vessels, are best performed in teamwork of laryngologist and vascular surgeon.

Adolescent↗
PubMed1978

[Surgery of congenital angiodysplasia (author's transl)].

Diagnostically and therapeutically, three types of angiodysplasias interfere with venous surgery: 1. Congenital arteriovenous fistulas (Type F.P. Weber: secondary varicosis with local gigantism)--surgical reduction of the shunt-volume is usually indicated. 2. Type Klippel-Trenaunay: Surgery for varicose veins is dangerous due to the frequent hypo- or aplasia of the deep venous system. 3. Venous hemangiomatosis (Type Servelle-Martorell or Kasabach-Merritt): Any surgical intervention is contraindicated (only external compressive therapy).

Angiomatosis↗
PubMed1978

[Reconstructive surgery on the venous system].

1. The progress of reconstructive venous surgery in recent years has been mainly based on the use of changed operative techniques (atraumatic preparation and suture technique; intraoperative vascular endoscopy or venography; temporary arteriovenous fistula). As a result, the clinical indications could be remarkably increased (acute phlebothrombosis; some types of post-thrombotic syndrome; venous substitution in tumor surgery; vascular lesions). 2. A peripheral temporary arteriovenous-fistula proves the most effective protective method both in venous thrombectomy and in graft reconstruction (full lumen restoration also in cases with incomplete disobliteration due to increase of flow velocity and flow volume; improvement of graft patency). 3. In long-standing axillar or subclavian venous thrombosis, a distal arteriovenous fistula (similar to a Cimino shunt) has a curative effect (without venous thrombectomy) via stimulation of rapid recanalisation and formation of collateral pathways. 4. Persisting central venous blocks may be corrected by a bypass procedure (great saphenous vein graft for the shoulder region; expanded PTFE grafts (Gore-Tex) for the ilio-caval segment).

Adult↗
PubMed1978

[The meso-caval shunt--a future standard operation?].

As a result of several retrospective and prospective studies, there have been remarkable changes in surgery for portal hypertension, namely the limitation of surgical interventions to an asymptomatic time interval (without bleeding), and the preference for distal shunt operations, aiming at a lasting reduction of the portal hypertension with minimal reduction of portal liver perfusion. These requirements are best met by the mesocaval (H-) shunt, using a vascular prosthesis with sufficient wall stability and a negatively charged inner surface, such as, for example, the expanded PTFE graft (Gore-TEX). In contrast to several types of splenorenal shunt, the H-shunt in mesocaval position is characterized by the following advantages: (a) minimal operative stress, even in high-risk patients, (b) technical ease of use, (c) reduced operative mortality, especially for interval operations, (d) minimal risk of recurrent bleeding and encephalopathy. From this preliminary report it may be expected that the technique of mesocaval expanded PTFE shunt here presented is likely to become the method of choice in both elective and emergency interventions.

Humans↗
PubMed1977

[Treatment of primary hyperlipoproteinemia type IIb and IV. Comparison of the lipid lowering effect of phenformin, clofibrate, and a combination of both (author's transl)].

22 outpatients with primary hyperlipoproteinemia type IIb and IV were treated in periods of eight weeks as follows: placebo; 0,15 g phenformin/day; 0,15 g phenformin + 1,5 g clofibrate/day; 1,5 g clofibrate/day; placebo. Compared to the first placeboperiode the serumtriglycerides were significantly lowered by phenformin (about 26%), by the combined treatment with phenformin + clofibrate (60%) and by clofibrate (51%) after eight weeks of treatment. The serumcholesterol was significantly lowered by phenformin (10%) and by the combined treatment with phenformin and clofibrate (14%), but not significantly by clofibrate (8%). After eight weeks of treatment with phenformin alone or in combination with clofibrate the body weight decreased significantly (1,9% or 1,4%). These changes in body weight were not related to changes in blood lipids. In conclusion, the combined treatment with 0,15 g clofibrate/day was more effective in lowering increased serum lipids than the treatment with phenformin or clofibrate alone.

Adult↗
PubMed1977

Small numbers in mutagenicity tests.

Experimental control material for statistical analysis of the results of the micronuclei test in the mouse (NMRI strain) and the Chinese hamster and for the host-mediated assay in the mouse (NMRI strain) using auxotrophic bacterial strains are presented. The binomial distribution of the micronuclei makes it possible to analyse the sample size according to the formula of Cochran and Cox (1957). For the host-mediated assay, the experimental principles are given which make it possible to evaluate the results obtained even with a weakly mutagenic, unknown substance. Critical points in comparative tests are not only the methodological questions, but also pharmacokinetic problems of the substance being tested which can only be clarified in the species used for the mutagenicity test. If this is ignored then even experimentally based findings can only be recorded as speculations.

Animals↗
PubMed1977

Fatty acid composition of adipose tissue in patients with coronary heart disease.

In order to study the relationship between the fatty acid composition of adipose tissue and coronary heart disease (CHD), 34 consecutive male patients with acute myocardial infarction and 33 hospitalized men free of CHD were compared. Patients with diabetes mellitus, endocrine disorders, liver and kidney diseases, recent changes in body weight and deviations from the "normal", customary diet were exlcuded. A statistically significant difference between the two groups was observed only in stearic acid, its proportion being lower in CHD patients (3.25% vs. 4.13%). Using multivariate discriminant analysis, age discriminated best between the groups, followed by stearic acid. The signs observed were positive for the former and negative for the latter. All other acids, relative body weight, and skinfold measurements did not significantly contribute to the discrimination. Age did not correlate with the proportion of stearic acid. Blood lipids from samples taken within 24 h of admission did not significantly differ between the groups. Three months later they had risen considerably in the infarct patients. The metabolic basis of the relationship between CHD and stearic acid is not clear at present. Additional studies are necessary to substantiate the importance of this acid as an indicator of CHD.

Acute Disease↗
PubMed1977

Testing the mutagenic potency of chemical substances in a linear host-mediated assay (LIHMA).

Instead of comparing "mutation frequencies" as used in the conventional host-mediated assay (HMA), a modified concept of measuring mutagenic potency is introduced by using a number of time intervals for taking samples. Regression analysis methods can then be applied to the numbers of mutant bacteria (reversions). Not only the mutagenic but also an additional antibacterial potency of a compound can be detected and estimated in the sam assay. It is demonstrated that interference of (undetected) antibacterial activity with the mutagenic activity may lead to misclassification of a substance concening its mutagenicity in the conventional HMA. This kind of erroneous assessment will be avoided by the LIHMA. Another advantage of the LIHMA over the conventiona HMA is that regression analysis also allows estimation of the sensitivity and reliability of the assay. The calculative procedure may be programmed on desk computers and is then most suitable for laboratories where large numbers of substances have to be examined routinely. A numerical is given using results obtained with nitrosoguanidine.

Bacteriological Techniques↗
PubMed1977

[Tumors of the carotid body--diagnostic and therapeutic aspects (author's transl)].

The tumors of the carotid body are rare in frequency but still they give many problems in preoperative diagnosis and operative management. The pathological classification and estimation of dignity is still under discussion. Based on the experience of 5 patients we try to give a comprehensive listing of important facts and a classification for clinical use. In spite of the typical clinical signs which were described by Kocher and Fontaine the carotid body tumor is the most frequently mistaken tumor in the lateral region of the neck. If a tumor of this type is suspected a carotid arteriogram should be regularely performed. The arteriogram is the most important diagnostic procedure, and gives the final diagnosis in most cases. The therapeutic principle is the early total extirpation. In spite of the small rate of malignancy (under 10%) this challenge is based on the frequent observation of local spreading of the tumor. The excision of tumors of even large size is possible under consideration of special operative technics.

Angiography↗