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Biomedical subjects

M Braun

Publications and source records attributed to M Braun.

At least 55 records · Page 3Linked to original sources
PubMed2003

[Workflow involving preventive health care promotes the economic development of a company].

Today's working society obviously develops from industrial production to knowledge-intensive service. In service-oriented working conditions, the importance of the human being as a main performer of economic success increases. Thus, the development leads to a changing spectrum of occupational health risks. Together with socio-demographic developments, individual strain-oriented health disorders connected to one's occupation might endanger an enterprise's capacity of performance and innovation as well as its sustainable enterprise development. Only healthy, motivated and qualified employees are able and ready to keep their creative and customer-oriented potential harnessed and thereby work to the best of their ability. Consequently, occupational health gains a more important role within the enterprise. Although in many enterprises the benefit contribution of preventive work design has not yet been considered that relevant, enterprises have realised that a preventive health-oriented work design might help to better manage current business challenges. An up-to-date definition of health includes the goals of health improvement, personality development as well as a comprehensive well-being. Health is a prerequisite and result of a productive reflection upon the conditions and challenges of work. Business practice shows that a preventive work design should involve an economic benefit for the enterprise. If occupational health is seen as a characteristic of quality and a prerequisite for sustainable enterprise development, economic potentials of preventive work designs will expand considerably.

Humans↗
PubMed2003

Image-guided percutaneous laser disk decompression for herniated lumbar disks: a 4-year follow-up in 200 patients.

OBJECTIVE: The purpose of this study was to describe the long-term effect of image-guided percutaneous laser disk decompression (PLDD). BACKGROUND DATA: PLDD has been reported to be an alternative method to treat herniated lumbar disks. It has proved to be effective on a short-term basis. Although the procedure has been used for several years, few articles report on the long-term effect of the intervention. MATERIALS AND METHODS: Two hundred patients, who were treated with image-guided PLDD for herniated lumbar disks, were observed over a period of 4 +/- 1.3 years. Treatments were carried out under CT/fluoroscopy guidance with local anesthesia on an outpatient basis with an Nd:YAG laser of 1064 nm. RESULTS: At follow-up, back pain was eliminated or reduced in 73% of the patients. Regarding sensorimotor impairment, PLDD did have a positive effect on 74% of the patients. In the majority of patients, the number of sick days and consumption of pain medication was reduced. In one patient, diskitis occurred as a complication of PLDD; 74% of the patients said they were satisfied with the outcome of the therapy; and 81.5% of the patients would have required another PLDD in cases of disk herniation. CONCLUSION: From our clinical results, we conclude that image-guided PLDD is an effective and secure method to treat contained herniated lumbar disks. Advantages of the procedure include the minimally invasive approach on an out-patient basis and the low complication rate.

Adult↗
PubMed2003

[Histologic and anatomic correlation of the infraorbital region].

The infra-orbital area has not been well studied although it represents an interesting area in plastic surgery because of its implication in malarplasty reduction or transplantation for facial tissue repair. This work comprises an anatomic dissection layer by layer and a histologic study describing the various structures of this area. It was performed on 10 heads taken from cadavers (mean age 70 years old). The anatomic and histologic study found four layers: a subcutaneous fat layer, a muscular layer, a deep fat layer and a deep muscular layer. The superficial fat layer constitutes the convexity of the cheek and can be removed in plastic surgery reduction or reconstituted after atrophy following nasolabial musculo cutaneous flaps.

Aged↗
PubMed2002

CT-guided percutaneous radiofrequency denervation of the sacroiliac joint.

Defining the origin of low back pain is a challenging task. Among a variety of factors the sacroiliac joint (SIJ) is a possible pain generator, although precise diagnosis is difficult. Joint blocks may reduce pain, but are, in cases, of only temporary effect. This study was conducted to evaluate CT-guided percutaneous radiofrequency denervation of the sacroiliac joint in patients with low back pain. The procedure was performed on 38 patients who only temporarily responded to CT-guided SIJ blocks. The denervation was carried out in the posterior interosseous sacroiliac ligaments and on the dorsal rami of the fifth spinal nerve. All interventions were carried out under CT guidance as out-patient therapies. Three months after the therapy, 13 patients (34.2%) were completely free of pain. Twelve patients (31.6%) reported on a substantial pain reduction, 7 patients (18.4%) had obtained a slight and 3 patients (7.9%) no pain reduction. The data of 3 patients (7.9%) was missing. There were no intra- or postoperative complications. Computed tomography-guided percutaneous radiofrequency denervation of the sacroiliac joint appears safe and effective. The procedure may be a useful therapeutic modality, especially in patients with chronic low back pain, who only temporarily respond to therapeutic blocks.

Adult↗
PubMed2002

Bone remodelling along a titanium hip arthroplasty stem after resection of a chondrosarcoma.

Long-term anchorage of cementless total hip arthroplasty relies on a direct bone to implant bonding. Several factors including material properties and surface treatment determine the interfacial response of the host bone to a foreign material. In the case presented, a chondrosarcoma of the proximal femur required an extended extraperiosteal resection. Reconstruction was possible with a titanium-alloy revision stem. A bony remodelling of the proximal femur was observed along the surface of the stem.

Arthroplasty, Replacement, Hip↗
PubMed2002

Epidemiology of Peyronie's disease.

Francois Gigot de la Peyronie, surgeon to Louis XV of France, has become synonymous with the rather enigmatic though not uncommon condition of Peyronie's disease (PD), a localized connective tissue disorder of the penile tunica albuginea. The true prevalence of Peyronie's disease is unknown. Therefore, we decided to perform an evaluation of existing epidemiological data. A prevalence rate of 3.2% was determined in male inhabitants of the greater Cologne area. This is much higher than revealed by the data reported up to now, thus rendering the accepted prevalence rates of 0.3% to 1% untenable. The actual prevalence of Peyronie's disease may be even higher, considering many patients' reluctance to report this embarrassing condition to their physicians. Along these lines, most clinicians note that the number of Peyronie's patients has increased since the advent of oral sildenafil. Comparably high prevalences are known for diabetes and urolithiasis, suggesting a greater frequency of this rare disease than formerly believed.

Age Distribution↗
PubMed2002

Indirect coronary angiography: a feasibility study.

The diagnostic method of choice to proof coronary artery disease and to localize stenoses and to judge the stage of the disease is coronary angiography. A new angiographic technique invented by. Wolffgram and Krieter that works without cannulation of the coronary arteries could simplify the interventional procedure. In addition, a technique like this could be used for angiography after CABG surgery directly on the table for quality assurance reasons. This angiography could be performed by the cardiac surgeon without necessarily involving a cardiologist. A feasibility study was successfully done in a cooperation of the Departments. for Cardiology and Cardiac Surgery, Munich University, Steinbeis Transfer Centre for rHealthcare Technologies, Tuebingen and Fraunhofer Technology Development Group (TEG), Stuttgart.

Animals↗
PubMed2001

Substrate specificity determinants of human macrophage elastase (MMP-12) based on the 1.1 A crystal structure.

The macrophage elastase enzyme (MMP-12) expressed mainly in alveolar macrophages has been identified in the mouse lung as the main destructive agent associated with cigarette smoking, which gives rise to emphysema, both directly via elastin degradation and indirectly by disturbing the proteinase/antiproteinase balance via inactivation of the alpha1-proteinase inhibitor (alpha1-PI), the antagonist of the leukocyte elastase. The catalytic domain of human recombinant MMP-12 has been crystallized in complex with the broad-specificity inhibitor batimastat (BB-94). The crystal structure analysis of this complex, determined using X-ray data to 1.1 A and refined to an R-value of 0.165, reveals an overall fold similar to that of other MMPs. However, the S-shaped double loop connecting strands III and IV is fixed closer to the beta-sheet and projects its His172 side-chain further into the rather hydrophobic active-site cleft, defining the S3 and the S1-pockets and separating them from each other to a larger extent than is observed in other MMPs. The S2-site is planar, while the characteristic S1'-subsite is a continuous tube rather than a pocket, in which the MMP-12-specific Thr215 replaces a Val residue otherwise highly conserved in almost all other MMPs. This alteration might allow MMP-12 to accept P1' Arg residues, making it unique among MMPs. The active-site cleft of MMP-12 is well equipped to bind and efficiently cleave the AlaMetPhe-LeuGluAla sequence in the reactive-site loop of alpha1-PI, as occurs experimentally. Similarities in contouring and particularly a common surface hydrophobicity both inside and distant from the active-site cleft explain why MMP-12 shares many substrates with matrilysin (MMP-7). The MMP-12 structure is an excellent template for the structure-based design of specific inhibitors for emphysema therapy and for the construction of mutants to clarify the role of this MMP.

Amino Acid Sequence↗
PubMed2001

The relaxation dynamics of the excited electronic states of retinal in bacteriorhodopsin by two-pump-probe femtosecond studies.

We present the results of two-pump and probe femtosecond experiments designed to follow the relaxation dynamics of the lowest excited state (S(1)) populated by different modes. In the first mode, a direct (S(0) --> S(1)) radiative excitation of the ground state is used. In the second mode, an indirect excitation is used where the S(1) state is populated by the use of two femtosecond laser pulses with different colors and delay times between them. The first pulse excites the S(0) --> S(1) transition whereas the second pulse excites the S(1) --> S(n) transition. The nonradiative relaxation from the S(n) state populates the lowest excited state. Our results suggest that the S(1) state relaxes faster when populated nonradiatively from the S(n) state than when pumped directly by the S(0) --> S(1) excitation. Additionally, the S(n) --> S(1) nonradiative relaxation time is found to change by varying the delay time between the two pump pulses. The observed dependence of the lowest excited state population as well as its dependence on the delay between the two pump pulses are found to fit a kinetic model in which the S(n) state populates a different surface (called S'(1)) than the one being directly excited (S(1)). The possible involvement of the A(g) type states, the J intermediate, and the conical intersection leading to the S(0) or to the isomerization product (K intermediate) are discussed in the framework of the proposed model.

Bacteriorhodopsins↗
PubMed2001

Arabidopsis thaliana Rop GTPases are localized to tips of root hairs and control polar growth.

Plants contain a novel unique subfamily of Rho GTPases, vital components of cellular signalling networks. Here we report a general role for some members of this family in polarized plant growth processes. We show that Arabidopsis AtRop4 and AtRop6 encode functional GTPases with similar intrinsic GTP hydrolysis rates. We localized AtRop proteins in root meristem cells to the cross-wall and cell plate membranes. Polar localization of AtRops in trichoblasts specifies the growth sites for emerging root hairs. These sites were visible before budding and elongation of the Arabidopsis root hair when AtRops accumulated at their tips. Expression of constitutively active AtRop4 and AtRop6 mutant proteins in root hairs of transgenic Arabidopsis plants abolished polarized growth and delocalized the tip-focused Ca2+ gradient. Polar localization of AtRops was inhibited by brefeldin A, but not by other drugs such as latrunculin B, cytochalasin D or caffeine. Our results demonstrate a general function of AtRop GTPases in tip growth and in polar diffuse growth.

Arabidopsis↗
PubMed2001

[Chronic non radicular cervicocephalic syndrome: CT-guided percutaneous RF-thermocoagulation of the zygapophysial joints].

PURPOSE: The objective of this study was to evaluate the clinical outcome of CT-guided radiofrequency- (RF-)thermocoagulation of cervical zygapophysial joints for chronic non radicular cervical pain syndrome using an improved posterior approach. METHODS: 169 patients were treated with CT-guided pericapsular drug instillation of steroids and local anaesthesia on the symptomatic and adjoining segments. 46 patients experienced an only short term pain relief after repeated CT-guided blocks and were therefore treated with CT-guided RF-neurolysis. For the microtherapeutic procedure the patients were placed on the CT-table in prone-position. A 23-gauge isolated aspiration canula (Leibinger) was placed vertically, under CT-guidance lateral to the zygapophysial joint to coagulate the capsular nerve endings. The probe was then repositioned to coagulate the medial and lateral branches of the corresponding segment-nerves' dorsal branches. The thermocoagulation was applied 3-4 times with 90 s. duration and a coagulation temperature of 70 degrees C. The coagulation-probe was drawn back 3-5 mm each time. No sedation or general anaesthesia was required. The treatments were carried out on out patient basis in local anaesthesia. Statistical data on pain sensation was acquired with the help of a standardized visual analogue pain scale (VAS) and by a questionnaire on treatment satisfaction and every day activities. Patients were examined and questioned on the 2nd, 7th, 30th and 90th day after the operation. RESULTS: After 90 days, 26 (56,5%) patients had experienced a definite pain reduction of >75% (VAS). 13 (28,3%) patients obtained alleviation of <50% (VAS), within the first three postoperative months. Seven (15,2%) patients reported <25% (VAS) pain relief. No intra- and postoperative complications were reported. CONCLUSIONS: CT-guided radiofrequency thermocoagulation is an effective, precise and secure, minimally invasive treatment for non radicular cervical pain that is caused by zygapophysial joint arthropathy, when CT-guided, lateral drug instillation does not cause a lasting improvement.

Electrocoagulation↗
PubMed2001

[An important differential diagnosis for persistent back pain].

PATIENTS: Between 1/1994 and 12/1998 40 patients with a vertebral osteomyelitis were treated at the Orthopedic University Hospital of Witten/Herdecke. All data of 15 female and 25 male patients with an mean age of 61 years (25-87 years) were analyzed in a retrospective study. Diagnosis of vertebral osteomyelitis was made between 1 and 84 weeks after onset of symptoms. Before admissions in our hospital up to 4 hospitalizations without proper diagnosis were reported. TREATMENT: The treatment consisted bed-rest in an individual orthesis and percutaneous discovertebral biopsy before systemic administration of antibiotics. In 11 from a total of 21 biopsies we could prove bacteria as follows: 6 times Staphylococcus aureus, 2 times E. coli and 3 times Mycobacterium tuberculosis. Radiological diagnosis was made by conventional x-ray in 2 dimensions and nuclear magnetic resonance. Together with radiological, histological, microbiological and laboratory investigation we found 11 patients with a specific tuberculosis of the spine, 25 patients with a pyogenic vertebral osteomyelitis and 4 patients with a post-nucleotomy osteomyelitis. 14 patients underwent operative treatment. All patients were mobilized in an individual brace after CRP and ESR indicated remission of inflammation. DURATION OF HOSPITAL TREATMENT: Duration of the hospital treatment lasted between 33 and 137 days. At follow-up 12 months after demission 35 patients were free of symptoms, two patients had still signs of osteomyelitis, two patients, one of them with recurrence of spondylitis, were reoperated because of dislocation of the implants, and one patient died after surgery suffering from severe peritonitis and multi-organ-failure. DISCUSSION: We report pathogenesis and the current diagnostic and therapeutic concept of treatment of the vertebral osteomyelitis. Despite modern diagnostic possibilities, diagnosis of vertebral osteomyelitis is often made very late. Vertebral osteomyelitis is an important differential diagnosis for persistent back pain and needs to be considered more often.

Adult↗