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Biomedical subjects

M Schulte

Publications and source records attributed to M Schulte.

At least 55 records · Page 3Linked to original sources
PubMed1997

Glomus tumor with diffuse infiltration of the quadriceps muscle: a case report.

A case of a diffuse growing glomus tumor with interstitial infiltration of the musculus vastus medialis and intermedius (quadriceps muscle) in a 21-year-old woman is reported. The tumor was diagnosed by needle biopsy and then removed with wide margins. The typical histological appearance and the immunohistochemical findings in the resected specimen confirmed the diagnosis. Histogenesis and the biological behavior of glomus tumors are discussed.

Adult↗
PubMed1997

Serratia marcescens outbreak associated with extrinsic contamination of 1% chlorxylenol soap.

OBJECTIVES: To determine risk factors for Serratia marcescens infection or colonization, and to identify the source of the pathogen and factors facilitating its persistence in a neonatal intensive-care unit (NICU) during an outbreak. DESIGN: Retrospective case-control study; review of NICU infection control policies, soap use, and handwashing practices among healthcare workers (HCWs); and selected environmental cultures. SETTING: A university-affiliated tertiary-care hospital NICU. PATIENTS: All NICU infants with at least one positive culture for S marcescens during August 1994 to October 1995. Infants who did not develop S marcescens infection or colonization were selected randomly as controls. RESULTS: Thirty-two patients met the case definition. On multivariate analysis, independent risk factors for S marcescens infection or colonization were having very low birth weight (< 1,500 g), a patent ductus arteriosus, a mother with chorioamnionitis, or exposure to a single HCW. During January to July 1995, NICU HCWs carried their own bottles of 1% chlorxylenol soap, which often were left standing inverted in the NICU sink and work areas. Cultures of 16 (31%) of 52 samples of soap and 1 (8%) of 13 sinks yielded S marcescens. The 16 samples of soap all came from opened 4-oz bottles carried by HCWs. DNA banding patterns of case infant, HCW soap bottle, and sink isolates were identical. CONCLUSIONS: Extrinsically contaminated soap contributed to an outbreak of S marcescens infection. Very-low-birth-weight infants with multiple invasive procedures and exposures to certain HCWs were at greatest risk of S marcescens infection or colonization.

Anti-Infective Agents, Local↗
PubMed1997

Medical complications of anorexia nervosa.

Anorexia nervosa is often characterized by progressive deterioration in many different organ systems. Most medical complications are the result of starvation and can be reversed with a well-planned refeeding program. While some of the complications of anorexia nervosa are predictable physiologic adaptations to the self-imposed starvation, many others are potentially life threatening. It is therefore incumbent upon all primary care physicians to become familiar with this disorder, because it is increasing in incidence and is commonly burdened by substantial chronicity and recidivism.

Adolescent↗
PubMed1997

Musculoskeletal involvement in cystic echinococcosis: report of eight cases and review of the literature.

OBJECTIVE: Our purpose was to describe the morphologic appearance of musculoskeletal lesions in patients with cystic echinococcosis shown by CT and MR imaging. CONCLUSION: Patients with musculoskeletal lesions of cystic echinococcosis typically have cystic structures in adjacent soft tissues. These cysts morphologically resemble abscesses, with peripheral uptake of contrast medium and variable signal intensities on T1-weighted MR images. The absence of calcifications or endovesicular daughter cysts does not exclude the diagnosis of cystic echinococcosis.

Adult↗
PubMed1997

Experiences with DCE: the pro7 communication server based on OSF-DCE functionality.

The pro7-communication server is a new approach to manage communication between different applications on different hardware platforms in a hospital environment. The most important features are the use of OSF/DCE for realising remote procedure calls between different platforms, the use of an SQL-92 compatible relational database and the design of a new software development tool (called protocol definition language compiler) for describing the interface of a new application, which is to integrate in a hospital environment.

Computer Communication Networks↗
PubMed1997

[A method for nidus localization in osteoid osteomas].

A method for localization of the nidus of osteoid osteomas using CT-controlled needle placement and subperiosteal marking with methylene blue is demonstrated. Our clinical experience in 13 patients is reported. This method allows proper intraoperative localization of the nidus of osteoid osteomas without problems. Thus, osseous resection can be reduced and additional stabilization by internal fixation or defect filling by bone graft are not necessary.

Adolescent↗
PubMed1996

Predictors of mortality after acute hip fracture.

To identify determinants of mortality after hip fracture, we performed a multicenter, retrospective study of 390 Medicare beneficiaries. Independent predictors of 30-day mortality included a history of congestive heart failure (odds ratio [OR] 32; 95% confidence interval [CI] 5, 192), angina (OR 26; 95% CI 4, 184), or chronic pulmonary disease (OR 11; 95% CI 2, 62). Postoperative use of aspirin was associated with a reduced risk of mortality (OR 0.24; 95% CI 0.08, 0.70). Cardiovascular events were the presumed cause of 63% of in-hospital deaths. Aspirin may have significant potential to reduce mortality in this population and deserves further study.

Aged↗
PubMed1996

Quality assurance by specification and achievement of goals in palliative cancer treatment.

As the goals of palliative cancer treatments have not always been clearly specified, this paper describes how frequently the goals of palliative cancer treatment can be specified according to a given definition and how frequently those specified goals can be achieved. The clinical problems of 171 cancer patients were discussed in the Interdisciplinary Oncologic Conference (IOC) of the Cancer Centre University of Ulm (CCUU) and recommendations concerning further diagnostic treatments and/or therapy were provided. These recommendations had been documented and analysed retrospectively. The goals were classified as either cure or palliation or further investigation. If the goal was palliation, it was investigated whether or not the goal was specified as either alleviation of existing problems or prevention of impending problems. The achievement of the specified goals was assessed. Palliation was the goal of treatment in 119 (71%) of the 168 evaluable recommendations. In 83 of the 119 cases (70%), immediate treatment was recommended. The goal was specified in 57 (69%) of the 83 recommendations and could be realized in 24 of 57 specified cases (42%). Patients in this group survived longer (p < 0.01) than patients in whom the goals could not be achieved. Impending problems could be prevented more often (p = 0.001) in 14 out of 18 cases, while existing problems could be alleviated in only 10 out of 34 cases. It is concluded that specification of the goals of palliation is necessary because it is impossible to decide if a goal of treatment could be achieved or not unless the goal of treatment has been defined (as existing/impending problem). The prevention of impending problems could be investigated in prospectively controlled clinical trials.

Adult↗
PubMed1996

[Communication in hand surgery].

Computer-aided communication provides us with an easy way of exchanging different messages. Personal data (E-Mail) can be transferred as easy as pictures. News-groups would be intended to act as a forum where many people could interact and share information on issues related to the practice and the advancement of hand surgery. This paper explains the technique and the advantage of electronic communication. Using already existing computer-networks will enable us to start communication at once.

Computer Communication Networks↗
PubMed1996

[Primary malignant bone and soft tissue tumors of the pelvis--oncologic and functional outcome].

Surgical treatment of primary malignant bone and soft tissue tumors involving the innominate bone has to be considered an extensive procedure with high incidence of complications. It requires the knowledge of different techniques of resection and reconstruction of bone, joints, soft tissue and intrapelvic organs, as well as a multidisciplinary management. Therefore, it should be limited to specialized centers. The best oncological and functional results can be achieved by continuity resection and pelvic reconstruction in low grade malignant bone tumors [1-3].

Adult↗
PubMed1995

Thermodynamics of Strecker synthesis in hydrothermal systems.

Submarine hydrothermal systems on the early Earth may have been the sites from which life emerged. The potential for Strecker synthesis to produce biomolecules (amino and hydroxy acids) from starting compounds (ketones, aldehydes, HCN and ammonia) in such environments is evaluated quantitatively using thermodynamic data and parameters for the revised Helgeson-Kirkham-Flowers (HKF) equation of state. Although there is an overwhelming thermodynamic drive to form biomolecules by the Strecker synthesis at hydrothermal conditions, the availability and concentration of starting compounds limit the efficiency and productivity of Strecker reactions. Mechanisms for concentrating reactant compounds could help overcome this problem, but other mechanisms for production of biomolecules may have been required to produce the required compounds on the early Earth. Geochemical constraints imposed by hydrothermal systems provide important clues for determining the potential of these and other systems as sites for the emergence of life.

Aldehydes↗
PubMed1995

[Diagnosis and spontaneous course of non-traumatic localized myositis ossificans].

Non-traumatic localized myositis ossificans is a rare variant of pseudotumoral muscular ossification. In the early stage it may be misdiagnosed as soft tissue sarcoma or some kind of osteosarcoma. Myositis ossificans itself does not always require therapy; when diagnosed on the basis of the typical features revealed by meticulous non-invasive investigation, biopsy is not mandatory for confirmation of the diagnosis. The diagnostic procedures needed - radiography, ultrasound, MRI, and isotope bone scan - are discussed with reference to three clinical case reports.

Adult↗
PubMed1995

Diagnosis of pyogenic abscesses by ultrasound.

Pyogenic infections are common in tropical countries and draining pus is one of the most frequent surgical operations all over the developing world. While superficial abscesses are easily detectable by clinical means the diagnosis of deeper abscesses in muscles, joints, parenchymatous organs and body cavities is frequently difficult or even impossible. In those situations B-mode ultrasound represents a valuable diagnostic tool. Furthermore, diagnosis may be confirmed or defined by ultrasound guided needle aspiration and ultrasound-guided drainage. Those measures may save surgical interventions and cost. Based on our experience with more than 3820 ultrasound examinations in 2746 patients of Northern Zaire sonographic characteristics of pyogenic abscesses are defined. Clinical examples of pyogenic affections with the corresponding ultrasound morphology are presented.

Abdomen, Acute↗
PubMed1994

Community-acquired bacteremias from tunneled central intravenous lines: results from studies of a single vendor.

Tunneled central intravenous catheters are a common method for rendering prolonged outpatient intravenous therapy. Their safety, however, has not been well studied. We conducted a retrospective evaluation of bacteremias associated with tunneled central intravenous catheters managed by a single home health care vendor during a 1-year period. All catheters were inserted in the operating room under sterile conditions. To calculate total line days, the dates of catheter insertion and removal were obtained from either the hospital operating room or the home health care agency. Catheter care was conducted according to written protocols. Total line days were calculated. Community-acquired bacteremia (defined as bacteremia occurring more than 6 days after the patients' discharge from the hospital) was determined from records available in the infection control department. Sixty-eight patients received intravenous therapy from the vendor during the 1-year study period. Total line days were 5548 (median 52 days/patient). Eleven episodes of bacteremia occurred in five patients, providing an incidence density rate of 2.0 infections/1000 catheter days. The most frequent bacteria encountered were Staphylococcus epidermidis (five), Klebsiella pneumoniae (two), and Acinetobacter calcoaceticus var anitratus (two). Median time to bacteremia was 103 days. Two patients, both younger than 4 years, accounted for seven of the infections; both had short-bowel syndrome. On the basis of historical comparisons, outpatient intravenous therapy appears to be associated with a lower risk of bacteremia than in-hospital therapy. These data can provide quality improvement information and may be a means for comparing home infusion therapy vendors.

Acinetobacter Infections↗
PubMed1994

Lens refilling and endocapsular polymerization of an injectable intraocular lens: in vitro and in vivo study of potential risks and benefits.

Endocapsular cataract removal and injection of a liquid artificial lens has several advantages, including restitution of accommodation, small corneoscleral incision, a more physiological position of the intraocular lens, and a reduced rate of secondary opacification. Our technique consists of bimanual phacofragmentation followed by injection of a fluid monomeric material that can be polymerized inside the capsular bag by short light exposure. Our study assessed the potential risks of the technique (e.g., heat damage to ocular tissue, light damage to the retina) and investigated the technique in vivo. We performed in vitro experiments on porcine cadaver eyes and an in vivo study on 15 rabbits. After a clinical follow-up of at least 12 weeks, the eyes were investigated histopathologically. During the polymerization process, the highest temperature measured at the posterior lens capsule was 45.1 degrees Celsius for a few seconds. The measured irradiance (0.065 watts per cm2) and the risk of photochemical damage to the retina during 20 seconds of polymerization were comparable to that caused by 1.5 minutes of standard coaxial illumination with the operating microscope. In vivo there were no serious inflammatory reactions except in four cases in which there had been intraoperative problems. The rate of secondary opacification appeared less than in conventional intraocular lens implantation in rabbits, especially when the capsule refilled completely. Retinal damage could not be detected histopathologically. In conclusion, refilling techniques may be successful once appropriate refilling materials become available.

Animals↗
PubMed1994

[The value of ultrasound for correction of clinical diagnostic errors in soft tissue tumors].

In doubtful clinical diagnosis, ultrasound investigation may represent a workable diagnostic means in revealing the nature of soft tissue alterations, as will be demonstrated by 6 clinical examples; in all cases a wrong clinical diagnosis delayed the necessary therapy and possibly deteriorated the prognosis of disease. In these patients correction of the clinical diagnosis was of decisive importance for consecutive diagnostics and therapy.

Adult↗