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Biomedical subjects

R Hoffmann

Publications and source records attributed to R Hoffmann.

At least 361 records · Page 20Linked to original sources
PubMed1991

[Gallbladder morphology after extracorporeal shockwave lithotripsy of gallstones with the MPL-9000].

The effects of extracorporeal spark-gap shockwave lithotripsy (ESWL) on human gallbladder-morphology are barely known. We studied the gallbladders of nine patients cholecystectomized 5 to 166 days after ESWL. Patients were treated one to three times receiving a mean of 1928 +/- 693 shockwaves per treatment, with a total of 3375 +/- 1307 per patient. Control gallbladders were of randomly selected patients after plain cholecystectomy (age and sex-matched). There was no difference in pathomorphology of the two groups. No signs of trauma related damage (hemorrhage, necrosis, ulceration, scar, or hemosiderin deposits) other than from surgical manipulation were found. Predominant pathomorphological changes were signs of chronic cholecystitis due to gallstone disease. In conclusion, spark-gap ESWL did not induce deleterious morphological damage to the gallbladder, although large numbers of shock waves were applied.

Adult↗
PubMed1991

[Bassini or Shouldice operation?].

Between October 1988 and March 1990 a controlled, prospective study was conducted comparing the operative methods of Bassini and Shouldice for hernia repair. On 100 patients (11 female, 89 male) the Shouldice-technique was used, on 55 patients (6 female, 49 male) the Bassini-technique. Most patients were operated under local anesthesia. No significant difference was noted between the two groups regarding the postoperative complication rate (hematoma, wound infection). However, patients had a shorter hospital stay after the Shouldice operation. Six patients (10.9%) had recurrent hernia after the Bassini procedure, one patient (1%) after the Shouldice procedure. An increased risk for recurrent disease was found in patients with the Bassini operation who already had recurrent hernia. Because of the significant shorter hospital stay and the significant lower incidence of recurrent hernia, we abandoned the operative method of Bassini in favour of the Shouldice procedure.

Female↗
PubMed1991

[Rumania January 1990: acute medical deficits and chronic shortage--an evaluation at the site].

Between January 4 and 8, 1990, a medical delegation of the University Hospital Zurich (three surgeons, one OT-nurse) was sent to Bukarest. They escorted a large sending of surgical and pharmacological equipment. The assignment was 1. to evaluate the situation in the hospitals around the Bukarest area; 2. to determine the feasibility and the need of medical emergency support; 3. to assess the usefulness and practicability of medium-term relief. A total of 11 hospitals were visited in Bukarest, Pitesti, Racovita and Schitu-Golesti. It was found that 1. a sufficient number of doctors and medical personnel is available; 2. emergency aid is important regarding pharmaceuticals (local anesthetics, analgetics, insulin), infusions, dressing material, surgical instruments and external fixation equipment; 3. medium-term support is need for the complete medical equipment (syringes, injection and infusion sets, probes, suture material, etc.). Local medical literature and journals are worthless. Doctors long for high-quality medical books and periodicals. We can help!

Developing Countries↗
PubMed1990

[The organization of gallstone lithotripsy using the MPL-9000 at the Zurich University Hospital, successes and failures. Initial results].

At Zurich fragmentation of gallstones is a joint venture between the Visceral Surgery Clinic, the Medical Clinic, Medical Policlinic, Radiodiagnostic Central Institute and Urologic Clinic. Lithotripsy is performed by a team from the Visceral Surgery Clinic with apparatus placed at their disposal by the Urologic Clinic. Indications for lithotripsy include symptomatic cholecystolithiasis, functioning gallbladder, and up to 3 gallstones of at least 10 mm and at most 30 mm diameter. Bile duct stones, acute cholecystitis, coagulopathy, pregnancy, aortic aneurysm and pacemakers are exclusion criteria. Patients spend two days in hospital, lithotripsy is performed without anesthesia, and outpatient follow-up is performed 1, 3, 6 and 12 months afterwards. Our experiences show that lithotripsy is more difficult and more treatments are needed if multiple gallstones are present. We had to perform cholecystectomy in 6 of a total 48 patients, mainly because of therapy resistant biliary pain due to stone fragments. The intraoperative findings did not correspond to the ultrasonic examination before lithotripsy in two of the patients who underwent cholecystectomy. Histologic examination of the six gallbladders in the surgical cases showed no abnormality. After an average treatment duration of 209 days, 9 of 48 patients are stone-free, 15 patients show improvement, in 14 patients no distinct reduction of fragments could yet be shown in recent follow-ups and 4 patients have not yet been reached for follow-up. Of the 230 patients examined lithotripsy was indicated only in 48 (21%) cases.

Adult↗
PubMed1990

Mitoxantrone, cytosine arabinoside, and VP-16 in 36 patients with relapsed and refractory acute myeloid leukemia.

Mitoxantrone in combination with VP-16 proved to be effective in refractory and relapsed acute myeloid leukemia (AML), with 42% of patients achieving complete remission (CR). The aim of this study was to assess whether the addition of cytosine arabinoside increased the response rate at a tolerable toxicity. The regimen consisted of mitoxantrone (M) 10 mg/m2 i.v. days 4-8, cytosine arabinoside (A) 100 mg/m2 continuous infusion days 1-8, and etoposide (VP-16) (V) 100-120 mg/m2 i.v. days 4-8 (MAV protocol) for relapsed and refractory AML. Thirty-six patients were treated, with a median age of 51 (20-73) years. For induction therapy one to two MAV cycles and for consolidation therapy two courses were scheduled. Twenty-one (58.3%) patients attained a complete remission (CR), with a median duration of 4.5 (1-12+) months. The median survival of all patients was 5.5 (0.5-15.5+) months. Four patients died in CR from chronic infections or after consolidation therapy with MAV. In evaluable patients, times to greater than 500 granulocytes/microliters and greater than 25,000 platelets/microliters were 23 (7-46) and 23 (6-44) days, respectively. In 54 evaluable MAV courses the following toxicity was observed (WHO grades 3/4): 26%, nausea and vomiting: 9%, hemorrhage; 6%, bilirubinemia; 11%, diarrhea; 22%, mucositis; 6%, local infection; 20%, septicemia; 13%, fever of unknown origin; 2%, cardiac arrhythmia; 7%, congestive heart failure. We conclude that MAV therapy is a highly active antileukemic combination with acceptable toxicity, which is recommended for further clinical trials in untreated AML.

Adult↗
PubMed1990

A monoclonal antibody against human vitamin-D-binding protein for the analysis of genetic variation in the group-specific component system (Gc).

We have developed a murine hybridoma cell line that is stable in secreting a monoclonal antibody (hDBP-1) directed against the group-specific component (Gc) molecule. The hDBP-1 is monospecific for Gc and does not crossreact with human albumin, which has 23% of its amino acid residues identical with vitamin-D-binding protein (DBP). The subclass of the antibody is IgG1 for the heavy chain, the light chain being of the kappa type. Isoelectric focusing discloses four major bands for the hDBP-1 with isoelectric points between pH 6.5 and 7.8. Binding to the antigen at different pH values was determined: there is high affinity in the physiological range and no binding at pH 3.5 and lower. In the presence of high salt concentrations, binding was reduced to about 50% at 1.5 M NaCl. The hDBP-1 recognizes the common human Gc types and the Gc of all apes and old world monkeys. No reaction was observed with the Gc of other mammals such as horses, cattle, rats, rabbits, sheep, goats and pigs. By testing hDBP-1 against 77 of the more than 120 known rare human Gc variants, it could be shown that this monoclonal antibody cannot recognize seven of these rare variants and can only poorly recognize nine. The binding site of hDBP-1 to Gc is not related to the binding site of Gc with G-actin: it recognizes Gc, the binary complex between Gc and G-actin, as well as the ternary complex between Gc, G-actin and DNase I. Competition assays with vitamin D3 and Gc in enzyme-linked immunosorbent assay indicate that the epitope of hDBP-1 on the Gc molecule may be related to the vitamin-D3-binding site.

Animals↗
PubMed1990

Chara buckellii, a Euryhaline Charophyte from an Unusual Saline Environment : III. Time Course of Turgor Regulation.

The time course of turgor regulation of the euryhaline giant-celled alga, Chara buckellii, is presented. Isolated intermodal cells were challenged by increasing or decreasing the external osmotic pressure by 150 milliosmoles per kilogram with all ions in the media or by dilution, respectively. Regulation following hypotonic stress was complete within 48 hours whereas regulation following hypertonic stress required between 96 and 144 hours. The change in internal osmotic pressure could be entirely accounted for by changes in vacuolar KCl in response to hypotonic stress, but this ion pair only accounted for 45% of the change in response to hypertonic stress. The membrane potential of C. buckellii is normally hyperpolarized with respect to the equilibrium potential for K(+) (E(K)). The membrane depolarized to a level close to E(K) in response to hypotonic treatment and this was accompanied by a transient increase in membrane conductance. In response to hypertonic stress, the membrane hyperpolarized transiently, then repolarized to a level close to the control. This was accompanied by a temporary decrease in membrane conductance. The data are discussed with respect to the ecological significance of the time course and ion transport mechanisms during turgor regulation.

Journal Article↗
PubMed1990

Organ preservation: experience with University of Wisconsin solution and plans for the future.

Transplantation of organs continues to be a primary therapeutic modality for treatment of end-stage organ disease, and 1-year graft survival rates show increasing improvements for most organs. A number of transplant centers show 1-yr graft survival rates approaching 90% or more for the kidney, liver and pancreas. Rejection continues to be the major cause for loss of organs and there is still a major shortage of organs for transplantation. Additionally, many organs showed delayed graft function (or primary nonfunction) which may be related to either donor factors or preservation factors. The University of Wisconsin solution for organ preservation has increased the safe time of preservation for the liver, kidney, and pancreas and helped to increase the quality and number of organs available for transplantation. However, the long-range goal of organ preservation (unlimited preservation) is still far from being reached. In the past, preservation could accurately be categorized as an art and preservation solutions were developed based upon theoretical rationales about the mechanisms of organ injury at hypothermia and what agents would suppress injury. The utility and success of this approach is exemplified by the developments of Collins solution and the UW solution. However, further developments in methods to increase the quality and duration of preservation of all transplantable organs would appear to be dependent upon defining, systematically, how organs are injured and what can be done to suppress the injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Forecasting↗
PubMed1990

[Enrofloxacin, a new drug for ornamental fish].

The compatibility and efficacy of enrofloxacin (Baytril) a newly developed antibiotic belonging to the quinolones, were tested for five ornamental fish species (Herotilapia multispinosa, Pterophyllum scalare, Symphysodon discus, Brachydanio rerio and Melanochromis johanni). The results prove that enrofloxacin has a high tolerance level for ornamental fishes and high efficacy against important bacterial diseases. 30 micrograms/l water over 5 hours are recommended for the treatment of ornamental fishes.

4-Quinolones↗
PubMed1990

[Problems with definitive abdominal closure using "zipper" and after "left open abdomen"].

There are many problems associated with definitive closure of "left open abdomen" and abdominal zip. If the assumption can be made that after an operation multiple lavages will be necessary, we recommend a transverse laparotomy because there is much less retraction of the abdominal wall than with longitudinal laparotomy. Definitive closure with split-skin is inadequate as the missing elasticity especially with underlying small intestine loops leads to tearing, besides the mechanical properties of a thiersch as replacement for the abdominal wall is bad. Should the intra-abdominal infection have affected the abdominal wall itself, the implantation of an abdominal zip is useless as it tears away in a short time. Primary laparostoma is then the therapy of choice. The earlier definitive closure is planned, the easier this can be done. Prognosis does not depend on the way of temporary closure but on underlying pathology and on the possibility of resolving problems in adequate time.

Abdominal Muscles↗
PubMed1990

[The origin of non-emulsified fat during autotransfusions in elective hip surgery].

In addition to hemodilution and preoperative blood donations, mechanical intraoperative autotransfusion (MAT) is an important method of preventing or minimizing the transfusion of homologous blood in operations with major blood loss. Using cell separators allows most of the problems of MAT to be solved, but the processed red cell concentrates of patients having hip joint replacement contain fat. Due to the high risk of fat embolism during bone surgery, as well as other circulatory problems, it is of interest whether the infusion of up to 15 ml of fat does not expose patients to an even higher risk. This study aimed to research the pathogenesis of fat embolism and possibly support one of the existing theories. METHODS. Semiquantitative oil measurement: in 45 cases with first insertion of hip joint prosthesis and 16 cases with change of prosthesis MAT was used intra- and postoperatively. For comparison, 10 patients with aortic aneurysm repair were checked for fat as well. In these cases MAT was only used intraoperatively. After the red cell concentrate was processed there was a time lag of 10 min to allow better sedimentation of fat. At the end of retransfusion 50 ml of blood were saved. They were then separated into 10-ml plastic tubes, centrifuged, and fat content was measured using a mm-scale. The results were transformed to ml by means of a previously determined calibration. Analogous to hematocrit values, it was thus possible to establish a lipocrit for these patients. In another 16 cases of hip surgery we carried out cholesterol/triglyceride investigations in red cell concentrates, and in 5 cases analysis of the fatty acids by gas chromatography was performed. RESULTS. The lack of an emulsifier causes biochemical analysis of cholesterol-triglyceride levels to be impossible. Therefore, triglycerides and cholesterol in MAT blood were below normal levels although a high quantity of fat could be seen in the blood. No oil was found in any of the patients in the vascular surgical group. There were 61 patients in the orthopedic group; no oil was found in 34.4%, we found 1-2 ml in 16.4%, and in 49.2% there was more than 2 ml of oil. With regard to age, sex, weight, height, and deviation from Broca index no significant difference in lipocrit could be seen. Differences in lipocrit were observed depending on the type of operation (i.e. new insertion/change of hip prosthesis), these were not significant possibly due to the small number of patients undergoing a change of prosthesis. The more MAT blood was transfused, the more significant were the rises in lipocrit level. The rinsing solution itself (1000 ml NaCl 0.9% with heparin 30,000 IU) does not influence the oil concentrations. Gas chromatography revealed that there was more than 40% oleic acid and 20% palmitic acid. Combined with linoleic acid, this comprised 4/5 of the total amount of oil (Table 3)...

Aged↗
PubMed1990

[Organization of gallbladder lithotripsy with the MPL-9000 at the Zurich university hospital. Initial results].

Gallstone shock wave therapy at the University Hospital of Zurich is a joint venture between the Medical Clinic, Medical Policlinic and Surgical Clinic. Patients with symptomatic cholecystolithiasis willing to submit themselves to a long period of treatment, were accepted for ESWL, should no contraindications be present. From October 1988 through May 1989 we treated 48 patients. In approximately two thirds of our patients we were successful with one ESWL alone, in one third 2 sessions and in two patients even 3 sessions were needed. In 42 patients course after therapy was as planned. Six had to be cholecystectomized later on. Best results were achieved in patients with single gallstones. In 2 of 5 cases there was disagreement between the number of gallstones found sonographically and the intraoperative findings. Histologic examination of gallbladders after ESWL showed no pathologic changes.

Adult↗
PubMed1990

Dream recall: imagination, illusion and tough-mindedness.

The failure of dream psychology to delineate clear, consistent and interesting correlates of dream recall presents serious difficulties for the claim that dream recall is functionally significant. The present study examined the relation of six indices of boundary functioning and four measures of life affect to the consistency and frequency of dream recall in 373 young adults. Factor analysis indicated that consistency and frequency of dream recall were unrelated to global measures of boundary functioning, stress, depression, hassles and uplifts. On the assumption that the correlates of dream recall might be specific rather than global, 34 items from our expanded boundary questionnaire having significant zero order correlations with the frequency of dream recall were factor analyzed separately for consistent and inconsistent recallers. The two factors in each analysis were quite similar. Factor one was called the Imagination, factor two, Illusion. Among consistent recallers, dream recall and a group of items called "tough mindedness" loaded on the Imagination factor. For inconsistent recallers similar variables loaded on the Illusion factor. For all subjects, dream recall and tough mindedness were linked whether associated with Imagination or Illusion. The Imagination factor is creative and linked to dream recall for consistent recallers. Their illusion factor is frightening. For inconsistent recallers, the Illusion factor is linked to dreaming and is not frightening, and their Imagination factor is not creative. The stability-instability of dream generation and recall over time apparently results in the association of the dream recall tough-mindedness group of items with either the Imagination or Illusion factors.

Adaptation, Psychological↗