Biomedical subjects
Publications and source records attributed to M Speck.
A PCR identification of methicillin-resistant Staphylococcus aureus (MRSA), obviating the need for subculture on agar media, was investigated. The combination of MRSA detection by mecA femB PCR with prior enrichment in selective broth was tested for 439 swabs. PCR identified 36 MRSA-positive samples, in concordance with conventional methods.
There are different applications in the field of optical diagnostics in which the theories explaining the light transport in tissue do not lead to simple solutions for complicate geometric conditions. In these cases the Monte Carlo method provides a powerful tool to solve this problem statistically. In order to simulate the light transport in the nasal region a model was created which includes the structure depending on the swelling of the mucous membrane as well as the Monte Carlo model. Using this model it is possible to evaluate the measured values qualitatively. However, due to the long distance between light source and detector the statistical error becomes a major problem for reliable statements.
We report the technical details and clinical results of twelve patients who had deep infections of implants in the hip joint and were treated by two-stage revision, using a gentamicin-loaded, hand-moulded cement spacer inserted for the period between resection and reimplantation arthroplasty. During management with the spacer, usually for 4 months, patients were almost free of pain and mobile with good leg control, spending 2/3 of the treatment period at home. Six of twelve spacers failed locally due to dislocation [5] or cement fracture [1], and more than two further episodes of surgery were required in 3 patients. Problems with dislocation of the spacer were significantly higher when the head to neck offset was lacking (P < 0.05) or when anchorage in the femoral shaft was poor. Nevertheless, infection after reimplantation arthroplasty did not occur by the time of follow-up (2.2 years). Based on these data, we consider that the use of the cement spacer is a promising approach to the treatment of complicated infections of the hip joint.
The operative treatment of dislocated fractures of the proximal humerus has been evolving in recent years. Replacement using endoprostheses often results in only moderate functional outcome, and with the high risk of aseptic necrosis with ORIF, new methods of minimally invasive stabilisation have been developed. These methods reduce the opening of the fracture site to a minimum and thereby limit the risk of iatrogenic damage to local vascularity and the rotator cuff. This study reviewed 18 patients operated on with minimal osteosynthesis for dislocated four-part fractures of the proximal humerus from March 1991 to October 1994. Only tension band wiring with resorbable cords from woven polydioxanone was applied. After an average follow-up of 26 months (20-37 months), 72% (n = 13) of the four-part fractures were rated as good and very good results according to the Neer Score. In 16.7%, a complete head necrosis occurred, requiring a prosthetic replacement. Two patients with partial necrosis (11.1%) had a good functional outcome. With regard to these results, we recommend head-preserving tension band wiring with resorbable cords and preservation of the articular surface. At the present time the procedure seems comparable with prosthetic replacement in respect of shoulder function.
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Ribosomal RNA gene dosage was determined for 20 marine heterotrophic bacteria using short probes (< 600 bp) from the Escherichia coli 16S rRNA gene and Southern blot analysis. All Bacterial strains had between 4 and 10 copies of the 16S rRNA genes in their genomes. This report presents important preliminary data for developing quantitative molecular methods to address population dynamics of marine based of 16S rRNA sequences.
Dislocated compound fractures of the proximal humerus are often difficult to treat. The choice of treatment influences the final functional result. From 1984-1991 108 patients with dislocated compound fractures of the proximal humerus were operated with a T-plate osteosynthesis, retrospectively examined and classified according to the Neer-Classification. At an average follow up time of 5 years 72 patients had a clinical and radiological examination. 68% of these patients with 3-fragment fractures and 80% with 4-fragment fractures showed a modest to unsatisfactory result caused by fracture biology, imprecise fracture reduction or poor surgical procedure. Incorrect position of T-plates and inadequate material were distinguishable. The T-plate which was widely used in the late eighties for internal fixation has to be considered a failure for these particular types of fractures and should be limited for Collum chirurgicum fractures.
The AO-Classification of patellar fractures, introduced 1979 is based on difficult radiomorphologic criteria. It has never been widely accepted. The suggested classification should allow a clear therapeutic concept. The prognostic value will be analysed in a further study.
Between 1982 and 1990 seven cases of bladder cancer were detected in a group of 49 workers who were synthesising chlordimeform from 4-chloro-o-toluidine. Latency periods ranged from 15 to 23 years. The incidence of bladder tumours in this group was significantly higher than that of the cancer registers of the former GDR, Saarland, and Denmark by factors of 89.7, 53.8, and 35.0 respectively. This provides further evidence that monocyclic aromatic amines such as 4-chloro-o-toluidine may be carcinogenic in humans.
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The 24 h urinary excretion of 6beta-hydroxycortisol and D-glucaric acid, the plasma half lives and total clearances of aminopyrine, and serum gamma-glutamyl-transpeptidase activity have been measured in nineteen healthy male volunteers. The study was done double blind and was conducted as a test of induction of microsomal drug metabolizing enzymes during and after daily doses of 6 mg clemastine, 300 mg phenobarbital or a placebo. The urinary excretion of 6beta-hydroxycortisol and D-glucaric acid was significantly increased in the phenobarbital group, the standard for induction. No changes were observed after treatment with clemastine or placebo. Phenobarbital also reduced the half life of aminopyrine, but it was not affected by clemastine or placebo. Gamma-glutamyl-transpeptidase activity increased only in the phenobarbital group. The elimination constant k2 of aminopyrine and the excretion of glucaric acid in the pre-medication period were correlated (p less than 0.05) The results indicate that the tests were of diagnostic value in determination of microsomal enzyme induction by phenobarbital. Failure to observe similar changes after treatment with clemastine imply failure of induction of this activity under the experimental conditions.
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