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Biomedical subjects

K Speer

Publications and source records attributed to K Speer.

10 recordsLinked to original sources

[Long-term side-effects following cyproterone acetate containing therapy in gynecology].

It has been suggested that cyproterone acetate (CPA) has a mutagenic potency. It has been postulated that a threshold dosage of CPA has mutagenic effects, but in the same way data have been published documenting that a continuous low dosage of cyproterone acetate leads to a reduction of mutagenic episodes. Despite published data about higher levels of DNA adduct creations due to CPA an international multicentre study analysing 2,506 patients with 7,971 patient-years that used CPA could not find any liver cell cancers, even if due to epidemiological data 6 liver cell cancers should have occurred upon this study group. The present study deals with the evaluation of 57 women which received CPA in combination with EE2 11-13 years before. The daily dosage was 2 mg CPA in combination with 35 mg or 50 mg EE2. In Germany these drugs were registered under the name of Diane 35 or Diane 50. Long-term follow-up evaluation concerning side effects, especially the appearance of liver cell carcinomas, were the aim of this study. With the records of 32% (18/57) of the above mentioned patient group the following long-term follow-up side effects could be observed: 1) weight gain, 2) headache, 3) migraine, 4) gastrointestinal disorders, 5) mood affections/depressions, 6) oedema of the legs, 7) skin affections, 8) mastodynia. No benign liver tumor or liver cell carcinoma was detected upon our group of investigated patients. In conclusion we can affirm that the use of CPA in a dosage of 2 mg per day does not lead to serious side effects under long-term follow-up observation conditions and that it's use does not correlate with a higher appearance of liver cell carcinomas.

Adult↗

Challenges of rehabilitation after shoulder surgery.

The shoulder joint is a complex structure that requires intricate precision to function purposefully, with full motion, synchronous patterns, and high endurance. Injury and trauma hamper this process, and surgery represents significant traumatic stress for any joint. Any surgical procedure may be accompanied by consequences that, left untreated, can develop into problems that result in dysfunctional performance of daily living and sports activities. This article addresses common challenges resulting from shoulder surgery and some of the treatments that can be administered to minimize problems.

Activities of Daily Living↗

Penetration of cryotherapy in treatment after shoulder arthroscopy.

Fifteen patients undergoing shoulder arthroscopy had indwelling temperature probes placed in the glenohumeral and subacromial spaces. All shoulders underwent diagnostic arthroscopy and debridement of the subacromial space. Cryotherapy was delivered to the shoulder via a Cryo/Cuff (AirCast, Summit, NJ) and temperatures were monitored for 90 minutes. Ten shoulders received cryotherapy and 5 were used as controls. Before cryotherapy, temperature averaged 34 degrees C in the glenohumeral joint and 31 degrees C in the subacromial space. No significant difference was seen between the temperatures recorded in the cold therapy and control groups for either the glenohumeral or subacromial space. In all cases, the subacromial space averaged 1 degree cooler than the glenohumeral joint at the conclusions of arthroscopy. These slowly equalized to an average of 35 degrees postoperatively. The present study shows that surface-applied cryotherapy does not penetrate either the glenohumeral joint or the subacromial space. Attention must be turned elsewhere to delineate how cryotherapy works.

Adult↗

Comparative results with different cochlear implants.

The cochlear implant program in Budapest began in 1985, since when 60 operations have been performed, 14 of them on children (51 primary procedures and 9 reimplantations). Different devices and also different techniques have been used: extracochlear promontory, extracochlear round window and intracochlear implants. Various speech processors were applied; at first a digital pulsatile sound-encoding system, later on analog processors were used, while processors operating on the basis of the CIS strategy are preferred nowadays. The operations were performed on both pre- and postlingual patients. In several cases contralateral hearing improvement was observed 6 months after the operation. Considerable experience has been gained of unique cases, such as a deaf-blind prelingual child and prelingual twins. Evaluating cochlear implant performance, in addition to the usual audiological tests measuring postoperative speech understanding, warble tone sound field thresholds were also established.

Adolescent↗

Hearing improvement achieved by different cochlear implantation techniques on the same and contralateral ears.

The authors have performed cochlear implantation since 1985. Different implantation techniques have been used: extracochlear, round window and intracochlear implantation combined with different receivers. Right at the beginning, the 8-channel extra-cochlear implant produces good results due to the gradually increasing current needed to obtain the same effectivity (transduction energy). However, no great differences can be observed in speech reception whether round window or intracochlear implants be used. In addition to audiological results, we briefly outline surgical implantation techniques and implant fixation methods and summarize the outlook for long-term cochlear implantation. Six months after operation, contralateral hearing was observed. The hearing presented itself at one or two frequences.

Auditory Threshold↗

[The analysis of polycyclics in vegetable samples].

PAH analyses in vegetables are often difficult to carry out; therefore two different clean-up methods, which allow elimination of interfering matrix components such as essential oils, waxes, carotinoids and chlorophylls were developed. Clean-up of 32 different vegetables samples consisted of either Bio-Beads S-X3 chromatography or semi-preparative HPLC on silica gel Si-60. PAH were determined by capillary GC-MS, which allowed the application of deuterium-labeled internal standards. The results are presented; higher PAH contamination was detected in kale and parsley.

Chromatography, Gel↗

Rapid multimethod for verification and determination of toxic pesticides in whole blood by means of capillary GC-MS.

A rapid and single multimethod was developed to determine substances of different pesticide classes in whole blood in the event of acute human intoxications, as required by EU Commission Directive 96/46. The method was validated by an in-house and an independent laboratory validation. Whole blood is hemolyzed and then deproteinized. After extraction of the supernatant, blood levels are determined by gas chromatography-mass spectrometry. The method, which can be performed within 120 min, covers 15 active substances (8 organophosphate pesticides, 2 carbamates, 3 pyrethroids, 1 azole, and 1 organochlorine pesticide) classified as toxic or very toxic. These compounds can be identified down to concentrations between 100 and 1000 ng/mL by comparison of their mass spectra to those in a commercial pesticide mass spectra library. Using the standard addition method, they can be quantitated down to concentrations between 30 and 200 ng/mL. These limits of quantitation are considered to be sufficient in comparison to respective LD50 values.

Forensic Medicine↗