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Biomedical subjects

M Franz

Publications and source records attributed to M Franz.

At least 91 records · Page 5Linked to original sources
PubMed1995

Occult vascular injuries following gunshot wounds resulting in long bone fractures of the extremities.

The routine use of arteriography following penetrating injuries to the extremities has declined in popularity in recent years. A careful physical examination coupled with Doppler-derived blood pressure has been shown to be sufficient to determine the presence of significant vascular injuries in most circumstances. Evaluating for occult vascular injuries in the presence of a complex wound involving the fracture of a long bone, however, seems to be an exception to this trend in management. This study was undertaken to ascertain the incidence of occult versus clinically apparent vascular injuries in patients suffering gun shot wounds (GSW) to the extremities that were associated with a long bone fracture. To address the value of invasive arteriographic evaluation, physical examination (pulse palpation, Doppler-derived limb blood pressure) was compared to arteriography in 75 consecutive patients following a GSW that resulted in fracture of the tibia/fibula (n = 28), femur (n = 19), humerus (n = 17), or radius/ulna (n = 11). Fourteen patients (19%) had an abnormal physical examination, with 13 (93%) of these also having an abnormal arteriogram. Of the 61 (81%) patients with a normal physical examination, an occult vascular injury was found on subsequent arteriography in 17 (28%). These occult injuries were classified as minor (intimal flap less than one-fourth the diameter of the vessel, segmental narrowing, noncritical branch vessel injury) or major (large intimal flap, occlusion, pseudoaneurysm, A-V fistula). The majority (83%) of occult injuries were minor and did not require operative intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Indicators and factors of influence on the long-term follow-up of psychogenic diseases--a comparison of extreme groups].

The present investigation aimed at the identification of possible indicators of course, predictors, and etiologically relevant factors of psychogenic diseases. According to their complaints a sample of probands suffering from psychogenic impairment of medium degree (n = 240) was chosen out of a representative sample of an urban adult population (n = 528). This procedure should ensure a relatively high intraindividual variance of course of the criterion, since a sufficient variability of course seems improbable with chronic and severe psychogenic impaired or stabile healthy probands. Within 10 years the sample was investigated three times by psychodynamically trained physicians and psychologists. By means of cluster analysis the sample was subdivided in different types of course of psychogenic impairment. Both extreme types of course-the probands who showed the most positive and the most negative spontaneous longterm course-were investigated univariately and by means of a multivariate discriminant analysis with regard to potentially course determining variables. It became obvious that personality variables and conditions of early childhood considerably influenced the spontaneous longterm course of psychogenic impairment.

Activities of Daily Living↗
PubMed1995

The compositional approach for representing medical concept systems.

The representation of patient-specific information in the computer-based medical record requires an expressive formalism, which supports computational services particularly with respect to subsumption. These demands are not sufficiently met by conventional medical terminology and classification systems. This paper investigates the weaknesses of conventional systems, which are primarily coding systems and contain a certain amount of implicit knowledge. The alternatives are logic-based formalisms, particularly languages of the KL-ONE-family and conceptual graphs, which are based on the formal representation of meanings. Principles of these approaches are reported and compared to the concept representation language developed in the GALEN project. Finally, an overview on the BERNWARD model is given, which aims at the formal description, classification, and composition of medical concepts. In BERNWARD subsumption and part-whole relation are treated in a symmetrical manner. There are explicit and formal criteria for supporting the inference of generic and partitive relations.

Disease↗
PubMed1994

Functional glucocorticoid receptor modulates pancreatic carcinoma growth through an autocrine loop.

Several peptide hormones have been shown to influence growth and function in pancreatic carcinoma and have given evidence for an autocrine feedback loop governing the proliferation of these malignant cells. Conversely, steroid hormones including glucocorticoids have been shown to inhibit the growth of pancreatic cancer cells; however, the prevalence of the glucocorticoid receptor or its mechanism of growth suppression in these tumors is unknown. The ability of growth factors thought to be active in this autocrine loop to reverse the glucocorticoid-induced growth inhibition was studied in vitro in a human pancreatic adenocarcinoma (HPAC) cell line with a well-characterized glucocorticoid receptor (GR). The glucocorticoid dexamethasone (DEX) inhibited growth in a dose-dependent manner as measured by a [3H]thymidine incorporation assay as well as an MTT cell proliferation assay. Maximal effects were seen within 48 hr at a concentration of 100 nM DEX, suppressing growth to approximately 18% of control. When the maximally suppressed DEX-treated cells were exposed to exogenous growth factors, they rapidly attained or exceeded the growth rate of control cells: insulin-like growth factor = 106%, transforming growth factor-alpha = 134%, insulin = 151%, and epidermal growth factor = 187% (all P < 0.05, Student's t test). In order to determine the frequency of the GR in pancreatic cancer and the clinical relevance of our findings, immunohistochemical staining for the GR was performed on 20 human tumors. Twelve (60%) of all cancers, as well as all normal pancreatic tissues (n = 4), stained positively for cytoplasmic and/or nuclear GR with expression correlating highly with degree of tumor differentiation (Kruskal-Wallis test, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma↗
PubMed1994

[Inadequate utilization of somato-medical services by psychogenically ill patients].

Within the Mannheim Cohort Project on the epidemiology of psychogenic disorders 240 probands of a high risk sample (suffering from medium psychogenic impairment) were randomly selected from the general population and investigated with regard to their realized utilization of the medical and/or psychotherapeutic services of the health care system. On the basis of clinical criteria the probands were classified as case (n = 78) of psychogenic disorder or non-case (n = 162). Increased psychogenic impairment caused by psychoneurotic, character neurotic, or psychosomatic-functional disorders was primarily combined with an intensified utilization of the somatically oriented medical services. Only 2.5% of the cases indicated that the reason for their most recent visit to a physician was psychotherapeutic treatment. In view of the high percentage of psychogenic impaired patients in private practices and general hospitals this seems to be a particularly discrepant finding. In spite of the psychogenic nature of their complaints the cases were confronted with somatically oriented therapy offers like the non-cases. An increased psychogenic impairment did not lead to a qualitative alteration of the utilization of medical and/or psychotherapeutic services. Facing the fact that the utilization of somatically oriented medical services by psychogenic ill patients is still widespread but inadequate this finding is interpreted as indication for an essential demand of further studies on the determinants of psychotherapy acceptance.

Cohort Studies↗
PubMed1994

Nutrition and the global risk for chronic diseases: the INTERHEALTH nutrition initiative. The INTERHEALTH Steering Committee.

As chronic, noncommunicable diseases (NCDs) have emerged as leading causes of morbidity and mortality worldwide, the World Health Organization's INTERHEALTH Programme, an international collaboration currently involving 15 countries, has focused its attention on population-based NCD prevention. Participating nations include Australia, Chile, China, Cuba, Cyprus, Finland, Japan, Lithuania, Malta, Mauritius, Russia, Sri Lanka, Tanzania, Thailand, and the United States. This paper will review and assess global trends in food and nutrient intake among INTERHEALTH countries between 1954 and 1986.

Chronic Disease↗
PubMed1994

Food labeling.

Explore the source record for details and available documents.

Food Labeling↗
PubMed1994

[A case of paraneoplastic limbic encephalitis in autoptic occult primary malignancy].

We report a case of limbic encephalitis in a 71-year-old male who presented with amnesia, confusion and disorientation. The patient's history of long standing alcoholism suggested the diagnosis of Korsakow syndrome. Autopsy, however, revealed a regional lymph-node metastasis of a small-cell bronchial carcinoma. No primary malignoma could be detected. These findings indicate that in cases of limbic encephalitis without detectable primary malignoma a paraneoplastic syndrome cannot be excluded. This has to be taken into consideration when discussing the etiology of limbic encephalitis (paraneoplastic versus virus-induced).

Aged↗
PubMed1994

Recombinant human erythropoietin in renal transplant recipients with renal anemia.

Thirty-seven kidney graft recipients with chronically declining transplant function accompanied by renal anemia were treated with recombinant human erythropoietin for 3 months. In all these patients anemia improved and mean hemoglobin levels increased from 7.67 +/- 1.26 g/dl to 9.83 +/- 1.94 g/dl (p < 0.01). Mean creatinine increased from 4.23 +/- 1.82 to 4.62 +/- 2.42 (p < 0.05) but the progression of transplant failure was not influenced when compared with pretreatment values obtained at least 6 months before study entry. Mean blood pressure levels were not altered but 12 patients required additional antihypertensive medication.

Adult↗
PubMed1994

[Epidemiologic findings on the spontaneous long-term course of psychogenic disease over 10 years].

207 individuals were selected from a random sample of the adult urban population of Mannheim according to the criterion of medium psychogenic impairment (high-risk population) and investigated three times between 1979 and 1991 with regard to prevalence and severity of psychogenic disorders. In contrast to clinical investigations, the present data render statements on the spontaneous course of psychogenic disorders in the general population. The existing psychogenic impairment was determined by means of various operationalizations (symptomatology, ICD-diagnoses, severity of impairment). The available data indicate a high stability of psychogenic impairment in the spontaneous course. Group statistically the severity of impairment even increases in the long term course. However, different subtypes of course in the investigated high-risk population can be identified by a cluster analysis.

Adult↗
PubMed1993

Unspecific neurologic symptoms as possible psychogenic complaints.

Prevalence and course of psychogenically influenced symptoms in neurology and their dependence on age and gender are reported. The epidemiological basis of the data is a long-term follow-up investigation of a high-risk population for about 10 years (n = 240): the Mannheim Cohort Study on Epidemiology of Psychogenic Disorders. Seven psychogenic symptoms of neurologic relevance (headache, lumbar and cervical vertebral complaints, functional vertigo, hyperkinesias, pareses, sleep and concentration disturbances) are characterized in regard to frequency, course and diagnostic significance.

Adult↗
PubMed1993

Market research to recruit graduate students in dietetics.

In this study we conducted market research to develop a recruitment plan for the master's degree program in nutrition and dietetics at Louisiana Tech University. When individualized experience routes to dietetics registration were eliminated by The American Dietetic Association's Standards of Education in 1988, graduate student enrollment could not be predicted. The steps of the Baron graduate recruitment model were followed to develop and implement a recruitment plan for the master's degree program in nutrition and dietetics. The steps included (a) assessment, (b) developing recruitment and enrollment objectives, (c) developing a recruitment plan and recruitment strategies to meet the objectives, (d) implementing a recruitment program, and (e) monitoring and evaluating the recruitment program. The assessment step involved institutional, student, competitive, and job market analyses. Written questionnaires, telephone surveys, and focus group interviews completed the student analysis. Of the 92 respondents surveyed, 42 were interested in taking graduate classes. Career advancement, specialization, and personal growth were cited as reasons to pursue graduate study. The Baron model provided a useful guide for developing and implementing the graduate recruitment plan.

Certification↗