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Biomedical subjects

M Langer

Publications and source records attributed to M Langer.

At least 361 records · Page 20Linked to original sources
PubMed1987

[Functional disorders of the lower urinary tract following radical abdominal and vaginal surgery of cervix cancer].

To establish the prevalence and extent of lower urinary tract dysfunction after radical surgery for cervical cancer, we evaluated 121 patients who underwent surgery between 1978 and 1984. 91 women underwent radical abdominal hysterectomy for disease in stage Ib or IIb; 30 patients underwent radical vaginal hysterectomy for stage Ib disease. Evaluation, at 12-72 months postoperatively, included pelvic examination, urinary history (explored via a specially designed questionnaire), measurement of residual urine, urine culture, and urodynamic studies. All patients underwent urethrocystoscopy and intravenous urography. Results showed 36 patients completely free of complaints, namely, 17 (18.7%) after radical abdominal hysterectomy and 19 (64%) after the vaginal produce. 85 patients (70%) had complaints, most commonly difficult spontaneous micturition (81.4% after abdominal, 17% after vaginal surgery). Other pathologic conditions were identified as follows: stress incontinence in 52.8% of patients after abdominal and 24% after vaginal surgery; impaired bladder sensation in 48.4% after the abdominal procedure but in only 13% after the vaginal; residual urine volume exceeding 10% of maximum bladder capacity in 13.2% after abdominal surgery (range: 40-220 ml) and 24.2% after vaginal surgery (range: 30-200 ml); significant bacteriuria in 21 patients (23%) after abdominal hysterectomy and 3 patients (9%) after vaginal. Urodynamic studies showed that, after abdominal surgery, bladder compliance was normal in 41.8% of patients, high in 39.6%, and low in 18.7%. After vaginal surgery, bladder compliance was normal in 66% of patients and abnormal in 34%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Clinical pharmacological and therapeutic considerations in general intensive care. A review.

The application of clinical pharmacological concepts and therapeutic standards in intensive care settings presents particularly difficult problems due to the lack of adequately controlled background information and the highly variable and rapidly evolving clinical conditions where drugs must be administered and their impact evaluated. In this review, an attempt has been made to discuss the available knowledge within the framework of a problem-oriented approach, which appears to provide a more clinically useful insight than a drug-centred review. Following a brief discussion of the scanty data and the most interesting models to which reference can be made from a pharmacokinetic point of view (the burn patient being taken as an example), the review concentrates on the main general intervention strategies in intensive care patients. These are based mainly on non-pharmacological measures (correction of fluid and electrolyte balance, total parenteral nutrition, enteral nutrition, oxygenation and ventilatory management) and are discussed with respect to the specific challenge they present in various clinical conditions and organ failure situations. In addition, 4 major selected clinical conditions where general management criteria and careful use of prophylactic and therapeutic drug treatments must interact to cope with the variety of presentations and problems are reviewed. These include: acute cerebral damage; anti-infective prophylaxis and therapy; cardiovascular emergencies; and problems of haemostasis. Each problem is analysed in such a way as to frame the pharmacological intervention in its broader context of the underlying (established or hypothesised) pathophysiology, with special attention being paid to those methodological issues which allow an appreciation of the degree of reliability of the data and the recommendations which appear to be practiced (often haphazardly) in intensive care units. The thorough review of the published literature provided (up to mid-1986) clearly shows that in this field the quality of randomised controlled and epidemiological studies is rather unsatisfactory. It would be highly beneficial to research and to clinical care if larger multicentric protocols and prospective epidemiological comparative investigations could be carried out to investigate more timely and adequately the variables which determine drug action, and the final outcome in the many subgroups of patients which must be considered in a proper stratification of intensive care unit populations.

Critical Care↗
PubMed1987

Microimmunohistology of hematopoietic colonies.

A new method is described which allows immunohistological analysis of hematopoietic colonies grown in methylcellulose. With the use of a specific embedding technique, we prepared cryostat sections that facilitated multicell marker studies as well as the evaluation of the in situ organization of individual colonies.

Antibodies, Monoclonal↗
PubMed1987

[Combined use of duplex sonography and CW Doppler in diseases of the carotid arteries].

740 patients with findings of cerebrovascular insufficiency were investigated by duplex sonography and frequency-analysing cw doppler. In 620 pathological arteries not stenosing lesions of the carotid bifurcation were found most frequently (93%). In 35% moderate-severe stenoses of the a. carotis interna were diagnosed. The advantage of duplex sonography and cw doppler in combination is the addition of both methods, so that a very reliable diagnosis of the extracranial carotis is possible.

Blood Flow Velocity↗
PubMed1987

[Use of nonionic contrast media in computerized tomography].

In a prospective multicentre study of 4,970 contrast enhanced CT's with intravenous application of lohexol, no contrast medium induced side effects could be diagnosed in 98.4% of the patients. Patients with a positive history of allergic diathesis had an increased risk of unexpected contrast-medium induced systemic reactions (factor 2 to 3). In 21% the diagnosis could not be established by non-enhanced CT alone, whereas in 56% the diagnostic accuracy was improved by intravenous contrast medium injection.

Adult↗
PubMed1987

[Nuclear magnetic resonance tomography studies of orbital space occupying lesions].

A comparative study of MRI, CT and ultrasound of orbital tumors revealed that only for malignant melanomas and orbital pseudotumors MRI had the most diagnostic relevance. Malignant melanomas could be differentiated from a haematoma due to their characteristic T1 and T2 signal intensity. MRI is impaired by its long examination time and the danger of quality reduction caused by motion artifacts.

Diagnosis, Differential↗
PubMed1986

Radiation therapy alone or in combination with surgery in the treatment of carcinoma of the esophagus.

The role of radiation in the treatment of squamous cell carcinoma of the esophagus was examined in a review of 74 patients treated with curative intent between 1974 and 1981. Aspects studied included the pattern of failure, the use of radiation as a surgical adjuvant, achievement of palliation, and the presence of technical or clinical factors predicting for a better outcome. The group was divided into 9 patients irradiated after esophageal resection, 14 patients irradiated before resection, and 51 patients treated with radiation and no resection. Median and 2-year survival rates among 51 patients treated by radiation without esophagectomy were 8.8 months and 11%, whereas they were 9.7 months and 0% in patients treated by radiation followed by resection, and 9.5 months and 28% in patients undergoing resection followed by radiation. Local failures were suffered in 28/51 patients treated without esophagectomy with rates of 2/4, 7/10, 7/15, and 5/10 after 50-55 Gy, 55-60 Gy, 60-65 Gy, and 65-69 Gy, respectively. Although prognosis for patients presenting with unresectable disease remains poor, a somewhat better outcome may be expected in patients treated with postoperative radiation after potentially unfavorable resections. Other predictors include sex and disease stage.

Carcinoma, Squamous Cell↗
PubMed1986

Magnetic resonance imaging (MRI) in different stages of myocardial infarction using the contrast agent gadolinium-DTPA.

We investigated 26 patients admitted to our catheterization laboratory with a diagnosis of acute myocardial infarction. In each case acute revascularization was unsuccessful, but the diagnosis was confirmed by angiography. In 11 patients with an uncomplicated course of acute myocardial infarction magnetic resonance imaging was carried out within 7 days of the acute event. In three additional cases imaging was performed within 3 weeks, while a remaining 12 patients underwent studies more than 3 weeks after the onset of symptoms. We determined signal intensity at three points within the area of infarction and at three other points in adjacent myocardial tissue. Decreased signal intensity within the area of infarction was present in native scans in 60% of all cases. Application of 0.1 mmol/kg body weight gadolinium-DTPA was followed by an average 70% increase in signal intensity within zones of acute infarction, as compared to a 20% increase in surrounding myocardial tissue. In cases of subacute and chronic infarction there was no significant signal enhancement after administration of gadolinium-DTPA. Uptake of gadolinium-DTPA in the area of acute myocardial infarction may be a positive marker of acute myocardial necrosis, which may be of potential clinical benefit.

Adult↗
PubMed1986

[Cleavage of 2-phenylpropan-1-ol and 2-phenylpropan-2-ol-glucuronide, 2 metabolites of isopropylbenzol (Cumol)].

The behaviour of 2-phenyl-1-propanol (I) and 2-phenyl-2-propanol (II) and their glucuronides with HCl has been investigated. While I shows a high acidic constancy, II undergoes a partial conversion into 2-phenylpropane (III) which itself yields numerous products. The glucosidic bond of glucuronide I is quantitatively split by 10.0% HCl, whereby an aglucone yield of nearly 100% is obtained. The second glucuronide behaves otherwise: the recovery of II is very low (only 40% to 45%) with HCl concentrations of 1.0%-20.0%, although with 1.0% HCl 100% of the glucuronide is hydrolysed.

1-Propanol↗
PubMed1986

[Prepartal expectations, behavior in labor and the puerperium and postpartal satisfaction with the labor experience. I. Significance of partner and prenatal preparation].

Attitudes and expectations of future parents towards the birth experience have changed thoroughly in the past years. In a prospective trial with 95 women we evaluated whether prepartal intentions for a common birth experience were actually carried out and what changes occurred during the past 5 years. 95 women with uncomplicated pregnancies filled in a questionnaire in the 38th week of pregnancy and several days after birth. Behavioural intentions and their realisation correlated well. The changes of attitude became evident comparing our results with those of a survey made 5 years ago in the same hospital. Depending on the social status of the couples, an increase in the participation of fathers of up to 30% was noted. 92% of the couples of social stratum B experienced childbirth together. Participation in any kind of birth preparation was comparably low and seems improvable. Women of lower social status, in particular, should be supported instead of discouraged to attend birth preparation courses.

Adult↗
PubMed1986

[Prepartum expectations, behavior in labor and the puerperium and postpartum satisfaction with the birth experience. II. Rooming-in and breast feeding].

Quite a number of young parents want to consciously experience and take active part in the very first days after childbirth. We interviewed prospectively 95 women as to their attitude towards rooming-in, breast-feeding and child care and how they had been able to carry out their intentions. Special consideration was given to those personal and institutional factors that might promote or reduce their feeling of satisfaction with the rooming-in experience. 89 couples made use of the rooming-in offer. 78 of them found the offered times "just right". Women wanting to go back to work used rooming-in significantly more often than housewives. 92% of the persons interviewed regretted not being allowed to change diapers or to bathe the baby. Those women who even before parturition had been wanting to bathe their infants and change diapers, returned their baby to the nurses significantly less often. Thus, both institutional and interactional problems contribute towards the successful management of the postnatal period. Women whose partners attended rooming-in, and those who retrospectively agreed with their decision of how to give birth, were significantly more satisfied with their overall experience.

Adaptation, Psychological↗
PubMed1986

[Nuclear spin tomographic imaging of aortic aneurysms. Initial results].

Thirteen patients with aortic aneurysm (abdominal 7, thoracic 4, thoraco-abdominal 2) were evaluated by magnetic resonance tomography using a super-conducting magnet of a field strength of 0.35 tesla in transversal, coronal and sagittal planes. ECG gating was used in patients with thoracic aneurysm. The results of magnetic resonance imaging (MRI) were compared to angiography, computed tomography (CT) and intraoperative findings. MRI demonstrated in all 13 patients the extent and the localisation of the aneurysm. The presence of mural thrombus was better determined by MRI (10/10) than by angiography (6/10). The relationship of the brachiocephalic arteries in thoracic aneurysm was better evaluated by MRI compared to angiography and CT. All 3 aortic dissections could be demonstrated by MRI. These first results may suggest an important role of MRI in the diagnosis of aortic aneurysms.

Adult↗