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Biomedical subjects

M Pfeiffer

Publications and source records attributed to M Pfeiffer.

At least 91 records · Page 5Linked to original sources
PubMed1994

Long-term follow-up of lipid metabolism and rheologic properties after successful pancreas and kidney transplantation.

The long-term effect of pancreatic and kidney transplantation (spkt) on blood viscosity, lipid metabolism and skin microcirculation in insulin-dependent diabetes mellitus (IDDM) was studied because impaired rheological properties of blood may play a role in the development of diabetic micro- and macroangiopathy. 46 IDDM-patients (16 f/30 m; 23 +/- 34 y mean duration of diabetes; 60 +/- 14 mos mean follow up period) underwent spkt (Gr.I: n = 28) or solitary kidney (Gr.II: n = 18) transplantation, and were compared with healthy controls (C). Rheological measurements were performed with Mooney-Ewart rotation-viscosimeter determining whole blood viscosity (WBV), at shear rates 1, 5, 10, 20, 50, 100, 200 sec(-1). Triglycerides, total and HDL-, LDL- and VLDL cholesterol and fibrinogen were measured. Microcirculation was estimated by transcutaneous oxygen tension measurement (tcpO2) and laser speckle method, in the forefoot area. Hemoglobin A1 was normalized only in group I (I: 7.2 +/- 0.2%; II: 8.3 +/- 0.3%; C: < 8%). WBV at low shear (1, 5, 10) was increased in both groups, when compared to healthy controls (I: 12.4 +/- 2; 12.5 +/- 1; 6.8 +/- 0.5 mpas; II: 18.7 +/- 2; 13.4 +/- 15; 9.4 +/- 1 mpas; C: 7.5 +/- 0.5; 6.7 +/- 0.3; 5.4 +/- 0.2 mpas; P < 0.05). Plasma fibrinogen was elevated in both groups compared to normals: (I: 384 +/- 19; II: 448 +/- 20; C: 250 +/- 50 mg/dl; P < 0.05). There was a positive influence of spkt on skin microcirculation: tcpO2/prior tx: I: 44 +/- 3; II: 49 +/- 6 mmHg; post tx: I: 59 +/- 4; II: 42 +/- 3 mmHg. Laser speckle prior tx I: 3.3 +/- 0.3; II: 4.7 +/- 0.2 rel. U.; post tx: 3.8 +/- 0.2; II: 4.3 +/- 0.2 rel. U. Patients with progression of angiopathy showed still higher fibrinogen and shear rates (P < 0.05). There was no significant difference for total HDL-, LDL- and VLDL cholesterol. Despite normalization of glucose metabolism and significant improvement of microcirculation in spkt patients, fibrinogen and the shear rates are increased indicating a persisting "individual" vascular risk. It is suggested that an additional hemorheological approach in the treatment posttrransplant might prevent the progression of vascular complications.

Adult↗
PubMed1994

Medical malpractice reform as a part of health care reform.

It appears that any health care reform will include tort reform. Since health care reform is aimed at reducing the cost of providing health care and since medical malpractice is believed to be a significant portion of that cost, any health care reform bill passed under the current political climate will most likely include provisions for limiting the costs associated with medical malpractice.

Defensive Medicine↗
PubMed1993

Effect of dietary restriction on in vivo somatic mutation in mice.

Dietary restriction is the one experimental variable which has been shown reproducibly to retard ageing. The effect of dietary restriction on in vivo mutation was studied in mice by feeding experimental mice 60% of the amount eaten by control mice and measuring mutations in lymphocytes at the hypoxanthine phosphoribosyl transferase locus at 4 weeks, 6 months and 12 months of age. Dietary restriction markedly decreased the age-associated accumulation of mutations observed in control mice, which suggests that somatic mutation is involved in the ageing process and that the majority of in vivo mutations result from dietary factors.

Aging↗
PubMed1992

[Craniocerebral trauma and aseptic osteonecrosis. Steroid-induced sequelae after therapy of brain edema].

In this publication we present three cases of avascular osteonecrosis (AON) of the femoral head and the talus in adolescent and young adult patients following short-term, high-dose steroid therapy for cerebral trauma. All patients were proven to be free of other risk factors for AON. The latency period between the steroid therapy and the occurrence of AON ranged from 12 to 60 months; steroid therapy lasted for 12 to 16 days with a total dosage equivalent to 2370-7180 mg prednisolone. Our case reports are added to a review of the literature with 14 similar cases reported receiving short-term, high-dose steroid therapy; 2 of them were also after brain trauma. To the best of our knowledge, 1 of our cases shows the longest latency period ever described after such therapy, and all our cases had a shorter therapy time than reported by other authors who have mentioned brain trauma patients. Additionally, bilateral necrosis of the talus due to short-term, high-dose steroid therapy has also not previously been described. Whereas AON is quite common after long-term steroid therapy (e.g., for immunosuppression and rheumatic disorders), our cases prove that serious complications can occur even after a short period of emergency steroid therapy in cerebral trauma, a possibility that is generally unknown. The minimal dosage and the maximum time steroids can be applied to exclude the risk of AON has not yet been determined, although we do recognize that steroids are useful for the prevention of brain edema.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Vertebral body replacement with homologous femoral head transplants.

From 1978 to 1989, we carried out 15 resections of single vertebral bodies, with homologous femoral head transplantation, for malignant and benign lesions of the spine. The advantages of this procedure are compared to fixation with bone cement, autologous bone grafts and other materials. The results are discussed.

Adolescent↗
PubMed1991

[Wound secretions in standard orthopedic surgery interventions using a new kind of closed vacuum drainage. A report of experiences].

One year's experience with 400 closed Redyrob drainage systems in 267 male and female patients has yielded encouraging results, which led to the replacement of the drainage system formerly used in the orthopaedic university clinic in Marburg by the new system. This makes it possible to regulate the suction strength between 0 and 900 mbar and to couple two suction tubes with one container. Drainage without suction and changing of the containers, which may be necessary in the case of large wound surfaces, can be performed without opening the system, which would endanger both patients and clinic personnel. Additional containers were only needed in 2.3%, because of the better filling volume. Thus, the new drainage system also proved to be superior with respect to cost efficiency and disposal. The total amount of wound secretion never exceeded 1620 ml, depending on the type of surgery performed, and there were no cases of infection or bleeding complications. The suction was regulated in 74% of all systems, and after most of the operations for insertion of endoprostheses. The handling of the systems was classed by the staff on the ward as "very good" or "good" in 96% of all cases. These results are discussed in the light of important aspects of wound drainage already mentioned by other authors.

Adult↗
PubMed1990

[Puncture track metastasis after ultrasound-guided fine-needle puncture biopsy. A rare complication?].

Bilaterally enlarged adrenals were diagnosed by ultrasonography in a 57-year-old man with a potentially resectable adenocarcinoma of the lung. Ultrasound-guided fine-needle biopsy of the left adrenal revealed a metastasis, proven cytologically. Chemotherapy was tried but failed to influence tumour growth. Three months later a painful subcutaneous nodule was noted in the area of the previous needle puncture, which on removal proved to be a skin metastasis. The patient died later from the underlying tumour.

Adenocarcinoma↗
PubMed1990

Automated percutaneous lumbar discectomy with and without chymopapain pretreatment versus non-automated discoscopy-monitored percutaneous lumbar discectomy. An experimental study in human cadaver spines.

Percutaneous lumbar discectomy has gained growing interest during recent years as an alternative to open surgery for protrusions and non-sequestrated subligamentous intervertebral disc herniations. As a less invasive method it competes with chemonucleolysis. At least two modifications are known to date: automated percutaneous lumbar discectomy (APLD) with a 2-mm suction probe and non-automated, discoscopy-monitored percutaneous lumbar discectomy with a suction rongeur and a motor-driven shaver (NAPLD). In this study these two methods are compared for the amount of material extracted, dependence upon the degree of degeneration of the disc and intrinsic technical problems, using 20 human cadaver lumbar specimens for experimental testing. Total nucleotomy was not possible with either method. APLD yielded significantly less material and proved to be less effective in severely degenerated intervertebral discs than the NAPLD procedure, as preexisting gaps within the degenerated nucleus pulposus allowed the tissue to shift away from the tip of the 2-mm probe and facilitated displacement of the probe within the anulus fibrosus. By contrast, the rongeur, which first cuts the material to be removed and then carries it away by suction, was much more effective. Further data to support the advantages of non-automated percutaneous nucleotomy are discussed. Pretreatment of the disc with chymopapain did not result in a higher yield of nucleus material when combined with APLD.

Chymopapain↗
PubMed1990

Regulation of rat ileal water absorption by central alpha 2 adrenergic receptors.

This study examined the role of central adrenergic receptors in the regulation of water absorption by the rat ileum. Clonidine, an alpha 2-adrenergic receptor agonist, increased water absorption in vivo following intracerebroventricular but not intravenous injection. Intracerebroventricular injection of prazosin, an alpha 1-adrenergic receptor antagonist, did not alter basal water absorption. Prazosin did not prevent the clonidine effect. In contrast, the alpha 2-adrenergic receptor antagonist, yohimbine, reduced basal absorption and prevented the intracerebroventricular clonidine effect. Treatment with reserpine reduced ileal norepinephrine content by 98%, reduced basal water absorption consistent with a loss of sympathetic outflow to the mucosa, but did not prevent the increase in water absorption due to intracerebroventricular clonidine. These results suggest that central alpha 2 receptors regulate water absorption by the rat ileum. The clonidine-induced increase in water absorption is not mediated by the sympathetic nerves innervating the intestine.

Absorption↗
PubMed1990

[Modification of lipoxygenase products in bone by the linoleic acid content of the diet].

Eicosanoids are supposed to participate in the regulation of bone metabolism. 30 male white rats of the wistar strain were fed on a diet rich in linoleic acid (LA), on a diet poor in LA and on a pellet diet after 3 month up to an age of 5 month. The formation of leukotrienes (LT) C4, D4, and E4 from the proximal tibia metaphysis after LA rich diet has been compared to the formation from LA poor and pellet diet. LA rich diet increased the formation of LTC4, D4 and E4 in the proximal tibia metaphysis. The properties of eicosanoids as local mediators in the bone were discussed.

Animals↗