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Biomedical subjects

K Schmidt

Publications and source records attributed to K Schmidt.

At least 757 records · Page 42Linked to original sources
PubMedDate not supplied

[Successful partial lysis of a 4-level-thrombosis by rt-PA - case report].

Thromboembolism of the vena cava, the venae iliaca communis, externa, femoralis, poplitea, and the fibular vein group of the left lower limb was diagnosed in a 13 year old girl. Several thrombogenic risk factors (APC-resistence, homocystinuria, contraception, smoking) were identified. Due to painful symptoms and for prevention of postthrombotic syndrome continuous systemic thrombolysis with rt-PA (0,5 mg/kg/d), in addition to heparine, was performed for 6 days. Diagnostic imaging at the end of therapy demonstrated complete and partial recanalization of the vena cava inferior, venae iliaca communis and externa. The distal veins of the leg remained occluded. After catheterization of the internal jugular vein and placement of a cava filter only mild pulmonary embolism occurred during systemic thrombolysis. No further complications were observed. All in all, therapy was tolerated well. Systemic thrombolysis with rt-PA in children and adolescents, although not established for regular treatment, is an effective therapeutic option in severe venous thrombosis.

Activated Protein C Resistance↗
PubMedDate not supplied

[Successful surfactant therapy of ARDS in an immunodepressed child].

The acute respiratory distress syndrome in childhood is a rare disease, but as in the past still plagued with a high mortality rate. It is caused by severe pneumoniaes or infectious diseases with multiorgan failure, aspiration, trauma or immunodepression. There are no therapeutic guidelines based on controlled studies. Therefore different therapies i. e. high frequency oscillatory ventilation, nitric oxide application, surfactant therapy, extracorporal membrane oxygenation or a combination of these methods are used. We present the case of a 4 (3)/ 12 year old boy, who suffered from an acute lymphatic leukaemia. Caused by immunosuppressive therapy he got a severe broncho-pneumonia. During ventilation therapy an acute respiratory distress syndrome occurred. Due to a surfactant application over 7 days with a doses of 360 mg/kg body weight this RDS could be dominated. The extubation was possible after 17 days of ventilatory support. 3 weeks later the lung function was normalized and the chemotherapy resumed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[A case report: ochronosis in combination with chondrocalcinosis].

We report the case of a 70 year old female patient suffering from Cox- and Gonarthrosis, a massive loss of function of the whole vertebral spine caused by a combination of Ochronosis and Chondrocalcinosis. The patient's anamnesis, the clinical findings and the pathology with the possible clinical manifestations are being described with a review on the existing literature.

Aged↗
PubMedDate not supplied

[Rapunzel syndrome, an rare form of intestinal trichobezoars].

Rapunzel syndrome is a rare cause of intestinal trichobezoar. Especially adolescent girls with uncharacteristical abdominal symptoms as well as weight loss and trichophagia are affected. The symptoms are caused by large amounts of swallowed hair within the stomach which can extend far into the intestinuum. Beside conventional radiology and sonography the diagnostic procedure of choice is endoscopy. If endoscopic removal of the bezoar fails surgical intervention is mandatory. As many of these patients show emotional disorders psychiatric evaluation and treatment has to be done to prevent recurrence. We report on a 12 year old girl with a huge trichobezoar which completely filled the stomach and extended far into the small bowel. As the bezoar could not completely be removed by endoscopy the girl had to be treated by surgery.

Bezoars↗
PubMedDate not supplied

[Treatment of splay foot with the Helal metatarsal osteotomy].

Between 1983-1987 Helal's metatarsal II-IV osteotomy was performed on 135 feet because of painful splayfoot. Follow-up examinations of 93 feet 22 month post up on average showed subjectively and objectively good results in about 80% of the cases. In case of overlength of single metatarsalia we modified Helal's osteotomy by resecting a boneslice instead of performing a simple osteotomy. In order to reduce the incidence of the disturbance of wound healing and longlasting swelling we recommend a modification of post-op treatment.

Adult↗
PubMedDate not supplied

[Defect replacement with osteogenin containing gelatin].

In order to demonstrate an alternative way to correct diaphyseal defects allogenic cortical bone prepared as "osteogenin containing gelatine (OCG)" was used in sheep. Animals without any implants served as controls. Healing was assessed by radiological examination after 3, 6, 9 and 12 weeks and histological examination after 12 weeks. In the control group there was no bridging of the defect in all of the four animals. Out of the six animals of the OCG-group one animal suffered from a postoperative infection and one animal failed because of a breakdown of the osteosynthesis. The other four animals exhibited a complete reconstruction of the former defect roentgenologically after 9 weeks. Histologically a new formed spongious bone could be demonstrated in the former defective site. The OCG-implants were completely resorbed after 12 weeks.

Animals↗
PubMedDate not supplied

Application of the novel immunoassay TRIAGE to a rapid detection of antemortem drug abuse.

The applicability of the immunoassay TRIAGE (E. Merck, Darmstadt, Germany) as a simple and rapid assay for antemortem drug abuse was tested on 100 urine samples from forensic autopsies. The samples were also analyzed by fluorescence polarization immunoassay and by chromatographic methods. The confirmation rate of the TRIAGE results by chromatographic analysis was 92% for benzodiazepines, 95% for cannabinoids, 96% for cocaine, 100% for opiates and barbiturates, and 82% for amphetamines. Because the urine samples were taken from corpses, the latter finding can be explained by false-positive amphetamine results due to cross-reactivity of the antibodies used in current immunoassay technologies with phenylalkylamines, which are generated in postmortem decomposition processes. In fact, tyramine, a typical product of putrefaction, was identified by gas chromatography-mass spectrometry in 11 samples of false-positive amphetamine determinations. TRIAGE produces positive amphetamine results for samples containing tyramine in concentrations of more than 5 mg/L. The detection limit of the TRIAGE assay for 7-aminoflunitrazepam, the major urinary metabolite of flunitrazepam, is within the range of 0.5-1 mg/L.

Chromatography, Thin Layer↗
PubMedDate not supplied

An interdisciplinary educational model for health professions students in a family practice center.

Health professions students have little or no opportunity to practice together during their formative stages of development. Therefore, can we realistically expect them to practice together as professionals? This is an important area for educators to address, given the current emphasis on interdisciplinary collaboration. The authors describe an interdisciplinary education program model for nursing, medicine, and social work students in a family practice center.

Area Health Education Centers↗
PubMedDate not supplied

[Principles and experiences for modeling chaotic attractors of heart rate fluctuations with artificial neural networks].

The aim of the present paper was, using artificial neural networks, to identify chaotic attractors presumed to be responsible for heart rate fluctuations. Chaotic behaviour is based on low-dimensional deterministic processes which are highly sensitive to initial conditions and therefore of limited predictability. Chaotic attractors produce orbits in the phase space where the points are dense. Following transformation of measured heart rate date into the phase space, such heart rate prediction characteristics were found in 6 adult rabbits. A low-dimensional deterministic model was designed by means of an artificial neural network [2*dimension of the time series +1) input neurons, 1 hidden layer, 1 output neuron and was successfully employed to predict the next 5 heart beats. Training of the neural network in terms of the prediction of the suspected chaotic orbits was dramatically improved by considering all possible prediction intervals within the prediction horizon. The trained models enabled the heart rate fluctuations to be distinguished during consciousness, under anaesthesia and additional vagal blockade.

Animals↗
PubMedDate not supplied

Incidence and prognostic significance of skin disease in patients with HIV/AIDS: a 5-year observational study.

Mucocutaneous diseases are common in HIV-infected patients. The aim of the present study was to determine the observed frequency of skin diseases and their prognostic significance for the progression of HIV infection. In a cohort of 150 HIV-infected patients diagnosed from 1986 to 1987 the number of mucocutaneous diseases, the CD4+ cell count, time to development of AIDS and survival time were registered for a period of 5 years. Eight patients were lost for follow-up. In the remaining 142 patients the number of mucocutaneous findings increased markedly during the observation period. The most frequent registered diseases and these with the highest increase were oral candidiasis, hairy leukoplakia, seborrhoeic dermatitis and herpes simplex. On average, 5.2 different diagnoses were registered per patient at the end of the follow-up period. The study showed that the total number of mucocutaneous diseases and the CD4+ cell count were significantly correlated to survival time and time to development of AIDS. The number of mucocutaneous diseases, like the CD4+ count, is an indicator of the immune system and the prognosis of HIV infection.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Hog wild.

In a little over a decade, Harley-Davidson went from being a symbol of everything that was wrong with American manufacturing to the archetypal American success story, a company that was able to beat the Japanese at their own game. Its secret: combining the best of Japanese business practices with closeness to the customer that is so intense it's scary.

Consumer Behavior↗
PubMedDate not supplied

[Death in homes for the aged/nursing homes from the legal medicine viewpoint].

Following the death of 16 inhabitants of a nursing home within a period of 2 weeks, the prosecution ordered legal autopsies in all of the cases, which had not yet been buried or cremated, suspecting a neglect of nursing or active euthanasia respectively. Two out of a total of ten cases revealed drug overdoses which could have explained death. However, due to concurring causes of death, the evidence could not be furnished with adequate security. In the present case, the examinations helped--already in a preliminary stage of the investigations--to prevent the authorities from more expensive proceedings as well as the respective nursing home from being unjustly suspected of having committed a criminal offense.

Aged↗
PubMedDate not supplied

Nitric oxide synthase expression and enzymatic activity in human brain tumors.

Nitric oxide (NO) is synthesized by NO synthases (NOS), existing in 3 isoforms. NO influences a great variety of vital functions including vascular tone and neurotransmission. Under conditions of excessive formation, NO emerges as an important mediator of neurotoxicity in a variety of disorders of the central nervous system (CNS). Inhibitors of NOS are available that may modify the activity of all isoforms, which may be of clinical relevance. The expression of the 3 NOS isoforms nNOS, iNOS and eNOS and NOS enzymatic activity was examined in 40 patients with primary CNS tumors (gliomas WHO grades I - IV and meningeomas WHO grades I - III) and in 13 patients with metastases from adenocarcinomas or malignant melanomas. A polyclonal antibody directed against nNOS and monoclonal antibodies directed against iNOS and eNOS were used for immunohistochemical staining. NOS enzymatic activity, measured by labeled arginine to citrulline conversion, was assessed in tissue specimens obtained from the same tumors. NOS data were compared with clinical variables and the degree of edema as judged from MR scanning. nNOS expression was increased in tumor cells of glial neoplasms and most pronounced in high-grade tumors, WHO grades III and IV, and in the carcinoma and melanoma metastases. Low-grade gliomas, WHO grades I and II and meningeomas expressed no or only little nNOS. iNOS was only expressed in a few tumors. eNOS was expressed sporadically in the tumor cells while the expression was increased in vascular endothelial cells in both the tumor itself and the peritumoral area of glial neoplasms, and in metastases. eNOS expression was sporadic in endothelial cells of meningeomas. NOS enzymatic activities were heterogeneous among tumor types (0 - 13.8 pmol/min/mg of protein) without correlation to the NOS expression found by immunohistochemical techniques. Likewise, NOS activity and expression was not correlated to the clinical scores or brain edema. In conclusion, nNOS expression may be a putative useful indicator of brain tumor differentiation and malignancy. The enhanced expression of eNOS in vascular endothelial cells of glial neoplasms and metastases raises the possibility that NO production in tumor endothelial cells may contribute to tumor blood flow regulation and possibly brain edema.

Adenocarcinoma↗
PubMedDate not supplied

Visual-vestibular interaction with telescopic spectacles.

Vestibularly and visually driven eye movements interact to compensate for head movements to maintain the necessary retinal image stability for clear vision. The wearing of highly magnifying telescopic spectacles requires that such compensatory visual-vestibular interaction operate in a quantitative regime much more demanding than that normally encountered. We employed electro-oculography to investigate the effect of wearing of 2x, 4x, and 6x binocular telescopic spectacles on visual-vestibular interactions during sinusoidal head rotation in 43 normal subjects. All telescopic spectacle powers produced a large, immediate increase in the gain (eye velocity/head velocity) of compensatory eye movements, called the visual-vestibulo-ocular reflex (VVOR). However, the amount of VVOR gain augmentation became limited as spectacle magnification and the amplitude of head velocity increased. Optokinetic responses during wearing of telescopic spectacles exhibited a similar nonlinearity with respect to stimulus amplitude and spectacle magnification. Computer simulation was used to demonstrate that the nonlinear response of the VVOR with telescopic spectacles is a result of nonlinearities in visually guided tracking movements. Immediate augmentation of VVOR gain by telescopic spectacles declined significantly with increasing age in the subject pool studied. Presentation of unmagnified visual field peripheral to the telescopic spectacles reduced the immediate VVOR gain-enhancing effect of central magnified vision. These results imply that the VVOR may not be adequate to maintain retinal image stability during head movements when strongly magnifying telescopic spectacles are worn.

Adaptation, Ocular↗