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Biomedical subjects

M Nerlich

Publications and source records attributed to M Nerlich.

60 records · Page 4Linked to original sources
PubMed1982

Animal research on hypovolemic shock and resuscitation: an update.

Animal studies have indicated that volume resuscitation is successful with salt-containing crystalloid solutions as well as colloid solutions. Hyperosmolar salt solutions appear to have benefits over isosmolar solutions. Both, however, produce hypoproteinemia, which can lead to edema formation due to changes in the transcapillary oncotic gradient and possibly by changing the interstitial matrix. The lung appears to be much more resistant to edema formation than the soft tissues. Except for the dog, the lung does not appear to be significantly altered from shock with no substantial increase in protein permeability being evident in most studies. Colloid therapy, either proteins or dextran, effectively restores cardiovascular stability after hypovolemia and also prevents the increased transcapillary fluid flux seen in the lung and soft tissues, the former not appearing to be of much clinical significance, while the latter may lead to significant tissue edema. Blood replacement is necessary to restore adequate oxygen delivery to the tissues. The ideal hematocrit appears to be around 30-35.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Effect of prostaglandin E1 on chemiluminescence response and adherence of human polymorphonuclear leukocytes to human cultured endothelial cells of prostaglandin E1 treated polytraumatized patients.

We investigated the effect of prostaglandin E1 on human polymorphonuclear leukocytes, in vivo. Polymorphonuclear leukocytes of a prostaglandin E1 and placebo study group were harvested and their function, as production of oxygen-derived metabolites and adherence to human cultured endothelial cells, was compared. Additionally, data obtained from polymorphonuclear leukocytes of a prostaglandin E1 and placebo group were compared with data obtained from polymorphonuclear leukocytes from 28 blood donors, who served as a control group. Production of oxygen-derived metabolites by polymorphonuclear leukocytes during contact with endothelial cells was measured by chemiluminescence. Chemiluminescence was significantly (p < 0.01) increased in the placebo group in comparison to the control group decreasing to values of control group after 6 d (post-trauma). Chemiluminescence response was not significantly suppressed in patients treated with prostaglandin E1 in comparison to the placebo group. Adherence of polymorphonuclear leukocytes (placebo group) to endothelial cells was significantly increased (p < 0.01) within the first 6d post-trauma. Following day 6, values were in the same range as values for the control group. Adherence was not significantly suppressed in patients treated with prostaglandin E1 in comparison to the placebo group. In conclusion, prostaglandin E1 at a dose of 20 ng/kg bw/min does not influence production of oxygen-derived metabolites and adherence in polytraumatized patients in comparison to a placebo group. Additionally, production of oxygen-derived metabolites by polymorphonuclear leukocytes in response to endothelial cells is shown and it is evident that endothelial cells might influence production of oxygen derived metabolites by polymorphonuclear leukocytes.

Alprostadil↗
PubMedDate not supplied

[ How to gauge the importance of sports medicine for the medical training of medical students?].

AIM: Education in sports medicine is offered heterogeneously in German medical schools. The self-image of sports has changed from a traditional, competition-oriented way to adventure, entertainment, wellness and health. Therefore, changes of our curricula to a practical-oriented way of teaching are required. In a first step the motivations and expectations of the students have to be evaluated. METHODS: 90 students enrolled in a sports medicine class were evaluated using a questionnaire and compared to 60 students not participating in the sports medicine class. RESULTS: The main motivation for the students to sign in was the future possibility to subspecialize in sports medicine, followed by interest in the subject. The main reasons not to participate were the time factor followed by lack of interest. 80 % of the students were regularly practising sports. 66 % commented on having been involved in sports trauma. 90 % of the students believe that practical-oriented education is absolutely necessary. CONCLUSION: Evaluation of the students motivation, knowledge as well as a discussion of the current practice to teach sports medicine at medical school confirm the need for modification of our curricula to a more practical-oriented education.

Curriculum↗
PubMedDate not supplied

[Ambulation training with bilateral limited weight bearing after foot injuries].

AIM: Bilateral foot injuries are not uncommon. Operative treatment usually requires partial weight bearing over several weeks. This is a challenge for physiotherapy especially for ambulation training. We describe a new rehabilitation aid allowing for bilateral limited weight bearing during ambulation. METHODS: Ambulation training was initiated in the early postoperative period using the Regensburg ambulation aid. A lift system allows for exact limitation of weight bearing on both sides controlled by balances integrated into the floor. Using a rail system a 15 m free walking distance is available. This study included 10 patients with bilateral foot fractures. The functional outcome was assessed using the AOFAS score and quality of life with the SF-36 score. Plain X-rays were used to evaluate loss of correction. The control group consisted of 20 patients where ambulation training was discontinued for at least 6 weeks postoperatively. RESULTS: The system is very safe, during the entire period no complication was recorded. Acceptance among the patients was extremely high. Worries about unwanted weight bearing could be reduced. Patients mobilized with early ambulation training showed a better compensation of gait if compared to the control group. Secondary problems in the knee, hip or spine, as well as muscular deficiencies had a significantly lower incidence. No loss of correction could be seen in either of the two groups. CONCLUSION: The presented ambulation aid is a significant contribution to the physiotherapy of bilateral foot injuries.

Equipment Design↗
PubMedDate not supplied

Treatment of human mesenchymal stem cells with pulsed low intensity ultrasound enhances the chondrogenic phenotype in vitro.

This study examined the effects of low intensity pulsed ultrasound (LIPUS) on human bone marrow-derived mesenchymal stem cells undergoing chondrogenic differentiation. Aggregates of mesenchymal stem cells and mesenchymal stem cells seeded in three dimensional matrices were cultured in a defined chondrogenic medium and subjected to LIPUS for the first 7 days of culture. At 1, 7, 14 and 21 days, samples were harvested for histology, immunohistochemistry, RT-PCR, and quantitative DNA and matrix macromolecule analysis. Cell aggregates with daily treatment for 20 minutes showed no significant differences for proteoglycan and collagen content during chondrogenic differentiation. However ultrasound application for 40 minutes daily resulted in a statistically significant increase of the proteoglycan and collagen content after 21 days in culture. Aggregates treated for 20 minutes daily showed decreased expression of chondrogenic genes at all time points. In contrast, 40 minutes of daily treatment of aggregates resulted in a significant increase of chondrogenic marker genes after an initial decrease at day 7 with time in culture. Ultrasound treated cell-scaffold constructs showed a significant increase of chondrogenic marker gene expression and extracellular matrix deposition. This study indicates that LIPUS can be used to enhance the chondrogenesis of mesenchymal stem cells in cell aggregates and cell-scaffold constructs. We have found a dependency on the specific treatment parameters. We hypothesize that LIPUS can be used for an improved in vitro preparation of optimized tissue engineering implants for cartilage repair. Furthermore this non-invasive method could also be of potential use in vivo for regenerative therapy of cartilage in the future.

Aggrecans↗