Post-traumatic focal EEG activity in correlation with the direction of the blow to the head.
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Craniocerebral Trauma↗
Biomedical subjects
K Meissner
Publications and source records attributed to K Meissner.
Carotenoid supply in breast-fed and formula-fed neonates.
UNLABELLED: Carotenoids have various biological functions including their role as antioxidants. For humans fruits and vegetables are the only source of carotenoids. In the first months breast milk and/or formula preparations are the only nutrition for infants. To study the influence of nutrition on the plasma carotenoid profile in newborns, breast milk, different formula preparations, and the plasma of breast-fed (BF) and formula-fed (FF) newborns were analyzed by high-performance liquid chromatography. The method used allowed beta-carotene, alpha-carotene, lycopene, and beta-cryptoxanthine to be detected and all four were found in breast milk. In colostrum carotenoids were up to five times higher than in mature breast milk (P<0.05). In contrast, not all carotenoids could be found in formula preparations. Beta-carotene was detected in four out of eight, and beta-cryptoxanthine in three out of eight formula preparations. Lycopene and alpha-carotene were not detectable in any of the formula preparations. Four formula preparations did not contain any carotenoids. FF infants had different plasma carotenoid profiles compared to BF infants. beta-carotene was significantly lower in FF infants [14 (0-32) microg/l, median and interquartile ranges] than in infants after birth [24 (19-310) microg/l, P<0.05], and BF infants [32 (22-63) microg/l, P<0.05]. While newborns after birth had measurable plasma concentrations of lycopene (16 [14-18] microg/l) and of alpha-carotene [5 (0-8) microg/l), these carotenoids were no longer detectable in FF infants after day 14. CONCLUSION: FF and BF infants show significant biochemical differences in plasma carotenoid concentrations.
Antioxidants↗
A sensitive non-isotopic assay specific for HIV-1 associated reverse transcriptase.
A sensitive non-isotopic assay for specific detection of reverse transcriptase (RT) of the human immunodeficiency virus type 1 (HIV-1) is described using 5-bromo-2'-deoxyuridine triphosphate (BrdUTP) instead of tritiated thymidine triphosphate. After the RT reaction the template primer is degraded by alkaline hydrolysis. Single-stranded poly.(BrdU) is detected in an immunoenzymometric assay using monoclonal anti-BrdU antibodies. The specificity of the assay is demonstrated by the isolation of RT from virus lysate by an insolubilised monoclonal anti-HIV-1 RT antibody prior to the RT reaction. Immunological RT binding leads to a tenfold increase in analytical sensitivity since substances inhibiting the RT reaction can be removed. This non-isotopic assay is some 30 times more sensitive than the classical radioisotopic RT assay. In terms of RT determination, however, there is a good correlation between these tests (r = 0.96). Several filtrations are no longer necessary to remove non-incorporated nucleotides. The test can be adapted to microtitre plates and hence is easy to automate.
Antibodies, Monoclonal↗
Intrathecal local anesthetic distribution with the new spinocath catheter.
BACKGROUND AND OBJECTIVES: Microcatheters have been linked in some cases to the development of cauda equina syndrome, which may be further traced to the maldistribution of the local anesthetic. A long injection time via the microcatheters contributes to the inadequate mixing. With the new Spinocath catheter, considerably shorter injection times can be achieved due to larger internal size. This study examined whether this leads to more homogeneous intrathecal distribution without causing greater trauma to the dura. METHODS: In an in vitro model of the spinal canal, the distribution of hyperbaric and isobaric 0.5% bupivacaine (2.5 mL) as well as 5% lidocaine (2.5 mL) was examined after injection via the 28-gauge CoSpan catheter (Kendall, Healthcare, Mansfield, MA), the 22-gauge Spinocath catheter (Braun, Melsungen, Germany), and a 29-gauge Quincke needle (Becton Dickinson, Rutherford, NJ). The local anesthetic concentration in the vertebral interspaces T12-L1 to L5-S1 was measured via gas chromatography 3 and 10 minutes after injection. In addition, the morphologic puncture characteristics of human dura were examined with the halftone electron microscope, after puncture with the catheters and needle. RESULTS: After injection through the 28-gauge CoSpan catheter, caudal segments of the spinal canal showed peak concentrations up to a maximum of 1,147 microg/mL bupivacaine or 8.5 mg/mL lidocaine with hyperbaric solutions, which did not decrease over the 10 minutes of measurement. After injection through the Spinocath catheter, there was a homogeneous distribution with data peaks of approximately 350 microg/mL bupivacaine or 4.2 mg/mL lidocaine similar to the data found after injection through the spinal needle. CONCLUSIONS: The new Spinocath catheter allows a better mixing of the local anesthetic with the cerebrospinal fluid. Because of significantly shortened injection times, hyperbaric solutions also show a more homogeneous distribution. Although the Spinocath catheter has a larger inner diameter than the other microcatheters, it appeared to cause less trauma to the dura.
Anesthesia, Spinal↗
Adjuvant surgical decompression gastrostomy: audit of a procedure coming of age.
BACKGROUND/AIMS: Adjunctive decompression gastrostomy has been a popular alternative to nasogastric suction in the care for general surgical patients suffering from postoperative ileus--avoiding discomfort and adverse sequelae of nasogastric tubes. Patient benefit thus correlates with procedural safety and ileus duration. These baseline data of decision-making were scrutinized in a general surgical patient population. METHODOLOGY: Retrospective analysis of a prospective data set. Two hundred and fifty-nine patients undergoing emergency (n=208) or elective procedures (n=51) received decompression gastrostomy when prolonged ileus or noncompliance with nasogastric suction were anticipated. Procedural complications, incidence of postoperative pneumonia and duration of postoperative ileus assessed by daily oral fluid intake vs. gastric drainage volumes were prospectively documented. RESULTS: Gastrostomy complications comprised 0.4% with minor morbidity only. The incidence of pneumonia was 4.5%. Postoperative ileus was nil in 17%, 1-3 days in 48%, 4-5 days in 16%, 6-8 days in 12% and 9-23 days in 7%. CONCLUSIONS: Adjuvant Stamm-Kader gastrostomy is a safe procedure. The incidence of pneumonia was comparatively low and a pertinent prophylactic effectivity appears plausible but remains unproven due to study design. Postoperative ileus exceeding 3 days affects 35%, exceeding 5 days 19% and exceeding 8 days only 7% of pertinent patients, and ileus duration cannot be predicted at the time of surgery. Thus, a substantial number of patients may be overtreated by prophylactic adjuvant surgical gastrostomy. The procedure improves patient's comfort and avoids complications of nasogastric suction. Prophylactic surgical gastrostomy remains a timely adjunct to general surgery but the indication should be individualized.
Adult↗
Epidermal Langerhans cells and prognosis of patients with mycosis fungoides and Sezary syndrome.
Langerhans cells (LC) (CD1a-positive dendritic epidermal cells) have been proposed to favour the pathogenesis of mycosis fungoides (MF) and Sézary syndrome (SS). We therefore examined the influence of LC retrospectively on the survival of 35 patients. Two clinical parameters (age, stage of disease) were additionally evaluated. LC densities were morphometrically assessed on immunohistochemically stained cryostat sections of the respective diagnostic specimen. Death resulting from MF and SS was significantly (p = 0.003) less frequent in patients with CD1a-positive epidermal cell densities higher than 90 cells/mm2 (optimal break point) as compared with patients with lower numbers, independently of the stage of disease. This result suggests that LC have a significant impact on the prognosis of patients with MF and SS, playing an important role in the host defense mechanisms against these lymphomas.
Epidermal Cells↗
Intestinal splinting for uncomplicated early postoperative small bowel obstruction: is it worthwhile?
BACKGROUND: Established indications (obstructing extensive fibrous adhesions) and contraindications (solitary band- and short segment midgut adhesive obstruction, purulence) of intestinal tube splinting have emerged from clinical practice. The benefit of tube splinting for early postoperative small bowel obstruction (SBO), however, is still a matter of debate. METHODS: From Jan 1980 until Dec. 1989, all patients undergoing relaparotomy for uncomplicated early postoperative SBO were randomized for enterolysis, gut decompression and repair (group A, 28 patients) or the same procedure plus tube splinting (group B, 28 patients). The patients were comparable with respect to gender, age and type of preceding operations; they were followed for 5-14 years or until death. RESULTS: In the early postoperative period, 3 incidences of reobstruction and 8 of other complications were observed in group A vs. 0 and 2, respectively, in group B. No patient died. During follow-up, one patient suffered late SBO, 2 patients recurrent partial SBO and one patient died of bowel perforation in group A vs two incidences of late SBO in group B. CONCLUSIONS: Intestinal splinting performed for early postoperative SBO rendered a significant reduction of early postoperative complications; the protective efficacy against early reobstruction was clinically apparent but reached borderline significance only. In respect to late intestinal complications, splinting was not superior to simple enterolysis. Early and late complications taken together and intestinal complications considered separately were significantly more frequent in patients without splinting.
Decompression, Surgical↗
Hemorrhage caused by ruptured liver cell adenoma following long-term oral contraceptives: a case report.
A 41-year-old woman who had taken oral contraceptives for 14 years was admitted to the hospital with pain in the left shoulder region and epigastrium arising after regurgitation. Sonography and CT revealed a ruptured liver tumor with sealed-off liver hemorrhage. The resected specimen revealed a ruptured and partially necrotic liver cell adenoma. This paradigmatic case illustrates a rare but well known entity: liver cell adenomas prone to necrosis and hemorrhage, requiring emergency intervention, in women on long-term oral contraceptive therapy.
Adenoma, Liver Cell↗