Biomedical subjects
Publications and source records attributed to M Bauer.
The authors present a case of a giant cell tumor of the mandibular condyle, which is a very rare condition. Problems relating to diagnosis and treatment are examined. Specifically non neoplastic and neoplastic lesions in which giant cells are identified have been evaluated.
INTRODUCTION: Microcirculatory disturbances and increased adhesion of leukocytes to the hepatic endothelium immediately following hemorrhagic shock have been observed. It is currently discussed, that mediators released by activated macrophages may have regulative functions for these alterations. The aim of the study performed was to investigate the effects of platelet activating factor (PAF) by application of PAF-receptor antagonists in respect to disorders of liver microcirculation and leukocyte adhesion following hemorrhagic shock. METHODS: Sprague-Dawley rats, anesthetized with pentobarbital, were exposed to hemorrhagic shock by depression of the mean arterial blood pressure (MABP) to 40 mmHg for 60 min by controlled blood removal. Three hours following adequate volume replacement together with blood retransfusion (60%) and at normalized MABP as well as supranormal cardiac output levels, the livers of the animals were investigated by intravital microscopy in respect to leukocyte adhesion and microcirculation. Evaluation of the microcirculation of 5 liver lobules/animal was performed on SVHS recorded images using a computer-assisted image analysis system. Three shock groups (n = 6 rats) and one sham-operated control group (n = 8) were compared. Shock/NaCl group received 0.1 ml NaCl 0.9% 15 min prior to shock induction and 1 min prior to shock therapy i. v., respectively. Shock/BN group received a total of 10 mg/kg of the PAF-antagonist BN 52021 (Dr. Braquet, Paris) and Shock/WEB group 2 mg/kg of the PAF antagonist WEB 2086 (Boehringer, Ingelheim), respectively in 2 injections with identical volume. RESULTS: The course of hemodynamic parameters MABP and cardiac output were comparable in all 3 shock groups. Metabolic parameters such as acid-base state and hematocrit values did not reveal differences. Evaluation of liver microcirculation indicated in all shock groups a reduction of sinusoidal diameters and a slight increase of velocity of leukocytes. The significantly increased temporary adhesion of leukocytes with an adhesion time shorter than 20s in the shock/NaCl group (adhesion index 154.1 +/- 63.2s/100 leukocytes; mean +/- SD) was reduced significantly by the PAF antagonists BN 52021 (82.2 +/- 24.2) and WEB 2086 (86.0 +/- 30.0). Permanent adhesion with an adhesion time longer than 20s was increased significantly particularly in zone I of the liver acinus (portal region) in all shock groups without specific effects of the PAF antagonists. CONCLUSIONS: Liver microcirculation following adequately treated hemorrhagic shock was disturbed, as indicated by narrowed sinusoids and increased adhesion of leukocytes. PAF seems to have no effect on sinusoidal narrowing in this period, however, it seems involved in temporary adhesion of leukocytes. The relevance of these early changes following hemorrhagic shock in respect to the development of organ dysfunction should be further addressed.
Despite its potentially fatal side effect--agranulocytosis--clozapine has become an important drug in antipsychotic treatment. With this in mind, this report presents the case of a 23-year-old schizophrenic who had suffered from agranulocytosis after simultaneous short-term treatment with butyrophenone and phenothiazine neuroleptics 3 years ago. After nonresponse to two other classic neuroleptics, the administration of high-dose clozapine led to a full recovery without the recurrence of hematologic disorders during 24 months of follow-up examinations. Although patients with a known history of agranulocytosis are usually excluded from treatment with clozapine, we propose that, in very severe or otherwise therapy-resistant cases, clozapine be administered and then white blood cell counts monitored very stringently. Although a single case can prove little, our case provides further evidence for the presumption that noncross-reactivity exists between clozapine and other neuroleptic drugs in the induction of agranulocytosis.
We present the results of a follow-up of 150 patients after breast reduction by superior pedicle technique performed within the last five years. Objective results, such as scar formation and reduction mass, are presented as well as important subjective results from the point of view of the patients. Pain, sensitivity of the nippel-areola complex and the rate of breast feeding are demonstrated. Problems in sexual behavior and the influence of breast reduction in daily life are discussed.
From 6/90-2/91 the daylight system EC (Fuji Ltd.), developed only for mammography, was used in the Department of Gynaecological Radiology of the Radiological Centre of the University of Freiburg for the first time in Germany. We examined 4000 patients (respectively 14,000 mammographies). We controlled the quality of the x-ray photographs every day (n = 175) and compared the results with the controls of quality, which had been carried out from 9/89-5/90 with the conventional technique (n = 175). During the entire period of research (9/89-2/91) at both systems the results of Dmin were inferior to the standard. Using the daylight system the measurements of the index of sensitivity were in 91% of the cases (n = 160), and the index of contrast in 88% (n = 154) within the range--much better than with the conventional system with 74% (130 measurements), respectively 70% (123 measurements). We also found an evident advantage of time and in future it is to be expected that the conventional system will be replaced by the daylight system in mammography.
There is growing evidence, that Borna Disease virus (BDV) or a variant may cause neuropsychiatric disorders in humans. The presence of specific BDV serum antibodies indicates an earlier contact with BDV. Earlier MRI results showing a raised prevalence of white matter lesions in BDV-seropositive psychiatric patients, possibly indicating encephalitic lesions, are not confirmed in this extended study, however in BDV-seropositive psychiatric patients the occurrence of cerebral atrophy seems to be more frequent, a finding compatible with hydrocephalus e vacuo found in animals after BDV-encephalitis. Because encephalitic lesions in BD are predominantly found in the gray matter of the brain, which is hardly visualized by MRI, the failure to detect lesions in BDV-seropositive patients could be due to methodological problems.
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Cervical vertebral artery fistulas are rare arteriovenous malformations between the vertebral artery and veins of the neighbourhood. The etiology of the fistulas may be traumatic or spontaneous. Management and the results in two patients with large arterio-venous fistulas of the cervical vertebral artery with severe deterioration of spinal function by using the detachable balloon technique are discussed. Complete angiographic and clinical cure was achieved in both patients and no complications related to the embolization procedure occurred. The detachable balloon technique is an effective method for selective occlusion of the fistula. Good radiographic monitoring facilities are required to make endovascular procedures effective and safe.
Echistatin is a 49-amino-acid protein from Echis carinatus venom. It contains four disulfide bonds. Since the disulfide bonding is critical for biological activity; it is very important to assign the disulfide linkage in this protein. Echistatin was incubated in 250 mM oxalic acid at 100 degrees C for 4 hr under nitrogen. Under these conditions, many overlapping disulfide-containing peptides were identified by ionspray mass spectrometry. Ionspray MS/MS data indicate that the four disulfide bonds are Cys 2-Cys 11, Cys 7-Cys 32, Cys 8-Cys 37, and Cys 20-Cys 39. To our knowledge, this is the first time all four disulfide bonds in echistatin have been assigned in one experiment without disulfide bond exchange. This approach, which combines oxalic acid hydrolysis and ionspray MS/MS, may be very useful for assigning disulfide bridges in other proteins from the disintegrin family.
To further elucidate the mechanism of impaired gallbladder emptying in diabetics with and without neuropathy, gallbladder function was assessed by ultrasonography following a medium-chain triglyceride (lipomul, 1.5 mg/kg) infusion into the duodenum and compared to that during intravenous infusion of cholecystokinin in diabetic women. Results were compared with five healthy control women. Mean (+/- SD) maximal percent gallbladder volume in diabetics following lipomul was reduced to 49 +/- 8% and after intravenous cholecystokinin to 47 +/- 9%, which was less than those in controls, 21 +/- 9% and 24 +/- 6%, respectively, but not significantly different. Further analysis of gallbladder emptying to lipomul differentiated two subgroups of diabetics: one subgroup (N = 5) had emptying comparable to controls (responders), while the other (N = 5) had very modest emptying (nonresponders). Two of the patients in the latter group had normal gallbladder emptying during exogenous cholecystokinin and their response would be compatible with visceral neuropathy. Blood levels of cholecystokinin, measured by bioassay, following lipomul and exogenous cholecystokinin were similar in controls and diabetics. Presence of diabetic neuropathy did not correlate with impaired gallbladder emptying. Follow up at 6 and 12 months of the three nonresponder diabetics revealed that no gallstones had developed and that two of them became responders to exogenous cholecystokinin.(ABSTRACT TRUNCATED AT 250 WORDS)
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In a clinical trial, the influence of repeated intermittent prone position on pulmonary gas exchange was investigated in 6 patients with severe ARDS. Despite various intra- and interindividual differences, oxygenation index (calculated by the paO2:FiO2 ratio) was improved significantly by change from supine to prone position in the first two days of treatment, whereas paCO2 remained unchanged. Later on, a significant improvement of oxygenation could not be verified. In patients with proven or presumed densities of dorsal lung regions, body position changes from supine to prone position in the early phase of treatment may improve arterial oxygenation and may be regarded as a therapeutic principle in conventional ARDS treatment.
In an exploratory study we examined 55 patients who had been politically imprisoned in the GDR for at least six weeks and suffered from enduring mental sequelae of that imprisonment. Views of the patients were assessed by means of standardized open questions and rating scales. Patients reported on stressful conditions in prison, fears concerning the uncertain end of imprisonment, as well as on helpful aspects during and after imprisonment. In a cluster analysis two groups were separated: one group that found social relationships helpful for coping with their experiences and another one that did not feel helped by anybody in coping, 28% of the patients stated that the symptoms were not mainly due to experiences during imprisonment; 20% saw general positive effects of imprisonment on their life. Views of the patients were correlated with other variables such as psychopathological symptoms. The relevance of the findings is discussed briefly.
PURPOSE: Five hundred fourteen consecutive patients with an isolated upper or lower extremity penetrating injury were entered into a prospective study designed to refine the indications for diagnostic arteriography. METHODS: Twenty-two (4%) patients with limb-threatening ischemia who required immediate operation and 23 (4%) who refused arteriography were excluded from subsequent analyses. The remaining 469 patients were classified as being at high, intermediate, or low risk for an arterial injury. RESULTS: Two hundred thirteen patients who were at low risk were observed for 24 hours, discharged, and monitored as outpatients. No delayed complications of an arterial injury developed in any patient in this group. The intermediate-risk group of 151 patients and the high-risk group of 105 patients underwent arteriography. Seventy-seven injuries were identified; 24 were major (limb-threatening) and 53 were minor. Fourteen major injuries required operative repair or transcatheter embolization; the remaining 10 nonocclusive major injuries were observed without sequelae. CONCLUSIONS: By step-down logistic regression only pulse deficit (p < 0.01) and an ankle/brachial or wrist/brachial index less than 1.00 in the injured extremity (p < 0.03) were found to be significant predictors of an arterial injury. The presence of either of these two clinical variables successfully predicted all major arterial injuries. This prospective study supports the proposition that arteriography that is limited only to those patients who have either a pulse deficit or minimum ankle/brachial or wrist/brachial index less than 1.00 successfully detects all significant arterial injuries.
Three MAb M2, B6, P1 (IgG1 type) against human urinary trypsin inhibitor (UTI), a glycoprotein with antiinflammatory properties, have been produced by hybridization of mouse myeloma cells P3o1 with spleen cells of immunized mice BALB/c. Competitive ELISA-examination of peroxidase conjugates of M2, B6, and P1 MAb in the presence of the trypsin binding domain shows the highest affinity of M2 antibody for this domain. On the basis of MAb M2 competitive ELISA of UTI concentration in urine is proposed. ELISA detectable changes in the UTI content of urine from patients with nephritis without renal failure can be considered as an early index of renal parenchyma damage.
This paper presents an assessment of the long-term mental sequelae of prolonged stress due to political persecution and imprisonment in the German Democratic Republic. Fifty-five former political prisoners with enduring psychiatric disorders were examined retrospectively in an exploratory study. The patients' experiences before, during, and after imprisonment were investigated using a semistructured interview. Psychopathological symptoms were assessed on clinical and self-rating scales; diagnostic classification was conducted according to DSM-III-R. The patients had experienced serious trauma, including psychological torture, long-term imprisonment, and solitary confinement. We diagnosed a characteristic syndrome involving symptoms of depression and anxiety with vegetative complaints and increased arousal. In 35 (64%) patients, the symptoms persisted over an extended period without improvement. This syndrome resembles psychiatric disorders found after other forms of political persecution. It may be concluded that prolonged individually experienced political stress situations, even if they are not life-threatening, may have long-term mental sequelae.