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Biomedical subjects

M Bauer

Publications and source records attributed to M Bauer.

At least 523 records · Page 29Linked to original sources
PubMed1987

[Follow-up of patients with burn injuries following long-term ventilation].

Follow-ups were performed five years post burn on 13 severely burned patients after long-term ventilation in order to identify damage to the trachea and lung. The study comprised clinical examination, tracheal X-rays, pulmonary function tests with whole-body plethysmography for thoracic compliance, and spiroergometry. Tracheal stenosis was detected in five patients (38%), two patients had reduced total lung capacity and functional residual capacity was increased. Six patients had high values of pulmonary resistance. The comparison between actual and predicted physical work capacity in the spiroergometry showed a reduction below 85% of normal in five patients, but only one patient had a marked low output (51%). It is remarkable that patients after long-term ventilation, even after inhalation trauma have only minimal impairment of pulmonary function and physical work capacity five years after trauma. The high incidence of tracheal-stenosis after tracheotomy has to be considered as a serious finding.

Burns, Inhalation↗
PubMed1987

[Psychiatry in the general hospital--between crisis and chronicity].

Important parts of the work of a psychiatric department of a district general hospital with regional care duty (115,000 people) are shown by an empirical study. For a period of 4 weeks all emergency and crisis situations in which patients appeared on the ward directly were registered. All telephone calls made for the same purpose were registered, too. The kind of the crisis and the kind of help were put into categories. The result of this study was, that in an urban area with approx. 100,000 people one can expect approx. 200 persons (2% of the population) to be in need of a frequent in many cases ward supported crisis intervention. The second part of the study shows with a patients case report, what possibilities do exist in the field of rehabilitation of chronic psychiatric patients within the community and what inherent difficulties there are.

Adult↗
PubMed1987

[Rupture of the membrane of the round window in stapes fixation].

A case of sudden deafness is described. Examination showed a mixed deafness on the left side, suspected to be due to fixation of the stapes and a simultaneous perilymph fistula. These lesions were proved by an exploratory tympanotomy. The interesting aspects of the case are emphasized: firstly recruitment caused by a perilymph fistula, present for 5 months without causing complete deafness; secondly improvement of hearing after surgical treatment of both pathological conditions; and finally the complete absence of vestibular signs.

Adult↗
PubMed1986

Sodium balance and osmolarity in burn patients.

In 12 severely burned patients the input of fluid and sodium, as well as sodium concentration in plasma and urine, was studied. The osmolarity in plasma and 24-h urine was measured. The high initial sodium input is noted. Plasma sodium levels stay within the normal range when the amount of sodium given during the further treatment is reduced. The importance of urea production in affecting plasma osmolarity is demonstrated.

Adult↗
PubMed1986

Plasma lipids and composition of red cells in four cases of Werner's syndrome.

Four cases of accelerated aging, known as Werner's syndrome (WS), are presented. Plasma lipid and lipoprotein findings and lipid compositions of red cell membranes are compared to those of old and young healthy people. Typical clinical findings, as reported in the literature, confirmed the diagnosis. Furthermore, an elevated osmotic fragility of red blood cells (RBC) was observed. RBC membranes of WS patients showed phospholipid concentrations similar to those found in people aged over 70 years, which have been reported to be lower than those of mature donors aged below 30 years. Fatty acid patterns of RBC membranes and plasma phospholipids were indicative of some disturbance in phospholipid subclass distributions in WS-patients.

Adult↗
PubMed1986

Impact of tumor control on survival in carcinoma of the lung treated with irradiation.

The long-term results in tumor response, intrathoracic tumor control and survival are reported in patients with medically inoperable or unresectable non-oat cell and small cell carcinoma of the lung. In 376 patients with stages T1-3, NO-2 carcinoma of the lung tumors, accessioned to a Radiation Therapy Oncology Group (RTOG) randomized study to evaluate different doses of irradiation, a higher complete response rate (24%), intrathoracic tumor control (67%) and three year survival (15%) was observed with 6000 cGy, compared with lower doses of irradiation (4000 or 5000 cGy). Increased survival was noted in patients with complete tumor response. Three year survival in complete responders was 23%, in partial responders, 10%, and in patients with stable disease, 5%. Patients treated with 6000 cGy had an overall intrathoracic failure rate of 33% at 3 years, compared with 42% for those treated with 5000 cGy, 44% for patients receiving 4000 cGy with split course, and 52% for those treated with 4000 cGy continuous course (p = 0.02). Patients surviving 6 or 12 months exhibited a statistically significant increased survival when the intrathoracic tumor was controlled. Patients treated with 5000-6000 cGy, showing tumor control, had a three year survival of 22%, versus 10%, if they had intrathoracic failure (p = 0.05). In patients treated with 4000 cGy (split or continuous), the respective survival was 20% and 10%, if the intrathoracic tumor was controlled (p = 0.001). In patients surviving 12 months after treatment with 5000-6000 cGy, on whom the intrathoracic tumor was controlled, the median survival was 29 months, in contrast to 18 months, if they developed intrathoracic failure (p = 0.05). In patients treated with 4000 cGy, the median survival was 23 months with control and 18 months without control of the intrathoracic tumor [corrected] (p = 0.008). In another RTOG study for patients with more advanced tumors (T4 or N3), those with local tumor control at 12 months had a three year survival rate of 25%, compared with 5% for those with thoracic failures. These differences are statistically significant (p = 0.006). Higher doses of irradiation yield a greater proportion of complete response, higher intrathoracic tumor control and better survival in non-oat cell medically inoperable or unresectable carcinoma of the lung.(ABSTRACT TRUNCATED AT 400 WORDS)

Carcinoma, Bronchogenic↗
PubMed1986

Effect of misonidazole dose on survival in patients with stage IIIB-IVA squamous cell carcinoma of the uterine cervix: an RTOG randomized trial.

Between August 1980 and November 1984, 120 patients with FIGO Stage IIIB or IVA squamous cell carcinoma of the uterine cervix were randomized to receive radiation therapy (RT) (46 Gy pelvis + 10 Gy parametrial boost) followed by intracavitary or external boost to the primary +/- misonidazole (MISO) (400 mg/M2 2-4 hours prior to RT daily, maximum 12 gm/M2). The median at 24-28 hr misonidazole plasma level was 20 micrograms/ml 2-6 hr and 3.5 micrograms/ml. Approximately 60% of the patients on RT + MISO received 100% of expected total Misonidazole dose; peripheral neurologic toxicity was reported for nine patients receiving misonidazole (8 with mild and 1 with moderate paresthesia or pain). Time-dependent regression analyses found that actual cumulative misonidazole dose was not related to duration of survival from start of treatment (p = 0.5). MISO dose expressed as a percent of expected dose was marginally related to increased survival measured from 14 weeks on on study (p = 0.1). No improvement in survival was observed with the addition of misonidazole to RT (64% of the patients on RT alone were alive at 18 months versus 54% of those on RT + MISO).

Carcinoma, Squamous Cell↗
PubMed1986

Intra-articular pressure in the knee during routine arthroscopy.

The intra-articular pressure in 19 knees was studied during routine knee arthroscopy with saline insufflation. Filling pressures of up to 300 mm Hg were noted. The average range of intra-articular pressure during the procedure was found to be 40-70 mm Hg. Higher pressures were usually needed to keep good distension while performing arthroscopic surgery in the suprapatellar pouch, whereas the pressure could be as low as 20 mm Hg and still enable good vision in the tibio-femoral compartments.

Adolescent↗
PubMed1986

[Magnetic resonance tomography in suspected acoustic neurinoma: technic and differential diagnosis].

Sixty-five patients with suspected acoustic neuromas were examined by CT and MR; the optimal diagnostic procedures are discussed. Extrameatal acoustic neuromas (11 cases) were all diagnosed by CT and MR, but only 82% of intrameatal tumours could be diagnosed by CT combined with air cisternography. Using special surface coils and the paramagnetic contrast medium Gd-DTPA, the accuracy of MR was 100%. All tumours greater than 4 mm were demonstrated. Following clinical and neurological examination, MR is the primary diagnostic method in the investigation of acoustic neuromas.

Diagnosis, Differential↗
PubMed1986

Fast neutron and mixed beam radiotherapy for inoperable non-small cell carcinoma of the lung. Results of an RTOG randomized study.

From July 1979 through March 1984 the Radiation Therapy Oncology Group conducted a randomized study comparing fast neutron radiotherapy versus mixed beam (neutron/photon) radiotherapy versus conventional radiotherapy for patients with non-small cell carcinoma of the lung. Patients were either medically or technically inoperable. One hundred two evaluable patients were placed on the study. The radiation doses were approximately 60 Gy-equivalent on each arm. Patients were stratified according to size of primary, histology, Karnofsky performance status, and age distribution. Overall local response rates as measured by serial radiographs were the same on the three arms, and an actuarial analysis showed no significant differences in either median or long-term survival. However, for the subgroup of patients exhibiting a complete or partial tumor response at 6 months there was a suggestion of improved 3-year survival on the two experimental arms (mixed beam, 37%; neutrons, 25%; photons, 12%). The p value for the difference between the mixed beam and photon curves is 0.14 (two-sided test). The incidence of major complications was higher on the neutron and mixed beam arms. These complications included four cases of myelitis which are analyzed in detail. The results are placed in the context of other published work on the use of neutrons in the treatment of lung cancer.

Fast Neutrons↗
PubMed1986

[Report of experience in 424 burn injuries 1970 to 1982].

Third-degree burn management with state-of-the-art surgery and intensive care technique has been available in Innsbruck since 1969. This statistical survey covers the period 1970 to 1982, with follow-ups on a total of 424 burn patients. Dividing the study into two periods, namely 1970-1976 and 1977-1982, permits a critical assessment of progress in burn management. A comparison of our results with those from other prominent burns units shows that the survival rate is considerably lower in Innsbruck, especially in the case of patients with burns of over 60% of body surface area. It is essential that similar burns units should be set up elsewhere in Austria.

Adolescent↗
PubMed1986

[An analysis of clinical aspects and autopsy protocols of 52 deceased patients with burn injuries].

Post mortem examinations were carried out on 52 patients who died from major burn injury from 1971-1985. Causes of death were accounted for by pneumonia and sepsis 44.2%, shock syndrome 21.2%, and cardiac failure 19.2%. The relationship between duration of survival and cause of death revealed that if the patient died in the first three days after burn injury it was usually due to "shock", if between the fourth to twentieth day then 34.6% had pneumonia and 30.8% cardiac failure. "Accidental" sepsis (46.1%) was the most frequent cause of death after three weeks. Clinical and pathological diagnosis varies between burns centers and may cause confusion. An international standardization register should be sought to permit comparison of results.

Adolescent↗
PubMed1985

Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer.

In 1976 we began a randomized trial to evaluate breast conservation by a segmental mastectomy in the treatment of Stage I and II breast tumors less than or equal to 4 cm in size. The operation removes only sufficient tissue to ensure that margins of resected specimens are free of tumor. Women were randomly assigned to total mastectomy, segmental mastectomy alone, or segmental mastectomy followed by breast irradiation. All patients had axillary dissections, and patients with positive nodes received chemotherapy. Life-table estimates based on data from 1843 women indicated that treatment by segmental mastectomy, with or without breast irradiation, resulted in disease-free, distant-disease-free, and overall survival at five years that was no worse than that after total breast removal. In fact, disease-free survival after segmental mastectomy plus radiation was better than disease-free survival after total mastectomy (P = 0.04), and overall survival after segmental mastectomy, with or without radiation, was better than overall survival after total mastectomy (P = 0.07, and 0.06, respectively). A total of 92.3 per cent of women treated with radiation remained free of breast tumor at five years, as compared with 72.1 per cent of those receiving no radiation (P less than 0.001). Among patients with positive nodes 97.9 per cent of women treated with radiation and 63.8 per cent of those receiving no radiation remained tumor-free (P less than 0.001), although both groups received chemotherapy. We conclude that segmental mastectomy, followed by breast irradiation in all patients and adjuvant chemotherapy in women with positive nodes, is appropriate therapy for Stage I and II breast tumors less than or equal to 4 cm, provided that margins of resected specimens are free of tumor.

Breast Neoplasms↗
PubMed1985

Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation.

In 1971 we began a randomized trial to compare alternative local and regional treatments of breast cancer, all of which employ breast removal. Life-table estimates were obtained for 1665 women enrolled in the study for a mean of 126 months. There were no significant differences among three groups of patients with clinically negative axillary nodes, with respect to disease-free survival, distant-disease--free survival, or overall survival (about 57 per cent) at 10 years. The patients were treated by radical mastectomy, total ("simple") mastectomy without axillary dissection but with regional irradiation, or total mastectomy without irradiation plus axillary dissection only if nodes were subsequently positive. Similarly, no differences were observed between patients with clinically positive nodes treated by radical mastectomy or by total mastectomy without axillary dissection but with regional irradiation. Survival at 10 years was about 38 per cent in both groups. Our findings indicate that the location of a breast tumor does not influence the prognosis and that irradiation of internal mammary nodes in patients with inner-quadrant lesions does not improve survival. The data also demonstrate that the results obtained at five years accurately predict the outcome at 10 years. We conclude that the variations of local and regional treatment used in this study are not important in determining survival of patients with breast cancer.

Breast Neoplasms↗
PubMed1985

SV40 chromatin structure is not essential for viral gene expression.

The biological activity and the fate of SV40 DNA (minichromosomes, DNA I, DNA II, DNA III) were tested in culture cells by immunofluorescence staining and blot analysis. Following microinjection of 2-4 circular SV40 molecules (minichromosomes, DNA I, DNA II) into the cytoplasm or the nuclei of monkey and rat cells, T- and V-antigen synthesis was demonstrable in nearly every recipient cell. Only linear DNA induced T-antigen synthesis with a very low efficiency after cytoplasmic injection. This low activity correlates with a rapid degradation of DNA III in the recipient cells. Further modifications observed immediately after injection are relaxation of superhelical molecules and formation of high-Mr DNA. Assembly of the injected DNA into SV40 chromatin-like structure, however, occurred only late after early viral gene expression.

Animals↗
PubMed1985

The influence of povidone-iodine treatment on thyroid hormones in severe burns.

Average iodine serum levels of 2.5 mg/100 ml were obtained in 10 patients with an average burn area of 50% and treated with povidone-iodine. Simultaneous measurements of the thyroid hormones failed to reveal any significant impairment of thyroid function apart from depressed T3 coupled with increased reverse T3. Similar findings were obtained with a control group of 10 multiply-injured patients. If renal function is unimpaired the resorbed iodine is quickly excreted. No clinical signs of iodine intoxication were observed.

Anti-Infective Agents, Local↗
PubMed1985

Prostaglandin inhibition and the rate of recovery after arthroscopic meniscectomy. A randomised double-blind prospective study.

In a double-blind, randomised, prospective study of 139 patients undergoing arthroscopic meniscectomy, those receiving a prostaglandin inhibitor (naproxen sodium) had significantly less pain, less synovitis and less effusion. They had significantly more rapid return of movement and of quadriceps function; their return to work and to sport also was significantly faster. It is recommended that, provided there are no contraindications, a prostaglandin inhibitor should be used after arthroscopic procedures.

Adolescent↗