[Multidimensional contingency table analysis on the effect of antimicrobial chemotherapy on bacterial growth in microbiological study material].
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Biomedical subjects
Publications and source records attributed to S Schulz.
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Active area-covering action to prevent possible complications by early selection of potentially endangered women from among the entire female population of the area concerned, which should, desirably, be under fullest possible medical observation, this has come to be a major characteristic of modern obstetric medicine in the "most developed countries". Appropriate methods have to be devised for high-continuity optimisation of all organisational facilities herefore required. In this paper, methodical approaches are submitted for discussion, as a result of a comprehensive long-term analysis of patients in a big hospital. "Criteria of optimum" are covered in this first communication. Regional weight class rates, weight-class-standardised mortality and early morbidity (5' Apgar score) are proposed as criteria of universal applicability.
In medical attention to patients, achievement and risk are in close correlation. Coherent definition of the term of "risk", therefore, is a primary demand which must be met for systematic optimisation of systems for perinatal care. The definition introduced in this paper will enable critical appraisal of undifferentiated risk control, calculation of an upper limit value of theoretical effectiveness, and assessment of effectiveness in terms of health policy. It is also an uninvolved approach to reduction of characteristics. The suggestions made are backed up by a large bulk of results.
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The cell proliferation of pre-implanted mouse embryos was investigated after development in vivo and in vitro. The studies were started at the pronuclear stage, 2 h post conception (p.c.) and continued until the hatching of blastocysts, 120-144 h p.c. The number of cell nuclei, the DNA content of each nucleus, the mitotic index and the labelling index were determined. From these data it was possible to calculate the length of the cell generation cycle and its various phases. With the exception of the first cell cycle the S-phase was constant. The G1- as well as the G2-phase varied in length during the different cell cycles. From 31-72 h p.c. the increase in cell number was exponential. After cultivation in vitro this increase was smaller than in vivo. At later periods the proliferation rate decreased with proceeding development. In late blastocysts most of the cells were in the G1-phase. The development of the embryos was somewhat faster in vivo than in vitro. But in principle conditions were comparable.
The morbidity of life-threatening inflammatory diseases is determined from examinations of 3,314 inpatients with pyogenic soft-part infections in the maxillocervico-facial region. Abnormally severe and life-threatening disease pictures must be expected in about 5 and 15 per cent of the cases, with the lethality being in the order of 0.2 per cent. The etiological factors responsible for the development of abnormal forms of disease, which were determined from a review of the relevant literature, were confirmed by the results obtained for the patients examined in this investigation. Errors in diagnosis and therapy account for a high percentage of the medical failures reported. Retrospectively, numerous clinical pictures have become modified due obviously to the increasing use in dental practice of antibiotic substances.
Of 162.338 patients who between 1969 and 1978 received treatment at the Clinic of Stomatology, University of Halle-an-der-Saale, 9.069 (or 5.6 percent) were treated on an outpatient basis after having been diagnosed as having actinomycosis, osteomyelitis, lymphadenitis, difficult dentition, and nonspecific pyogenic soft-part infections (abscesses or infiltrates). A retrospective analysis by electronic data processing of case histories provided valuable information about morbidity, disposition, cause, localization, and the tendency for dental surgeons to refer certain cases to specialty clinics. There are pathognomonic differences in indexical systems for the different clinical pictures. Cases of osteomyelitis and soft-part infection with suspected actinomycosis were found to increase in correlation with the proportion of antimicrobially pretreated patients. About 60 percent of all patients receiving treatment at this Clinic were not referred thereto by dentists. Of the documents presented by patients referred to the Clinic of Stomatology by other dental surgeons, some 42.5 percent were filled out incompletely.
Between 1968 and 1978 a total of 38 mandibular resections were performed, at the Halle University Hospital of Stomatology, on lower jaws with continuity defects. In 9 cases, restoration was possible by means of ilial crest autografts. In 25 cases, use was made of various "temporary implants". Preoperatively cast vitallium implants proved successful. Freeze-dried homografts have the disadvantage of lacking the capability of being formed into the desired shape. The experience gathered thus far is reported, showing that the use of prosthetic and orthopedic methods of functional aftertreatment continues to be justified.
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Using Schulte's diagnostic and therapeutic system of treating the pain-dysfunction syndrome, 165 patients were included in a program of myogymnastic self-treatment. The results obtained on reexamination of 96 patients confirmed the correlations observed by Schulte between the principal symptoms (painful side and lateral deviation of the lower jaw) and numerous causal factors. The diagnostic schemes used to search for causal factors may thus be regarded as having proved successful. They allow functional temporomandibular complaints to be classed in groups of diseases by taking into account the principal symptoms alone, namely, painful side and deviation of the lower jaw upon opening the mouth.
In 1975, a total of 165 patients with myoarthropathies were treated by myotherapy. Through the use of a program of step-by-step therapy, which included myogymnastic selftreatment in addition to psychotherpay and repair of teeth, 77.6 percent of 96 reexamined patients were made free from complaints. Fuller utilization of the possibilities of causal therapy would certainly have allowed a higher rate of success to be achieved using the simplified program of exercises described in this paper. Experimental evidence could be presented in support of the assumption that parodontal damage may be caused to uncorrected sites of abnormal occlusion in the course of myogymnastic therapy.
The etiology and therapy of abnormal causes of pyogenic soft-part infections in the maxillofacial and cervical regions are discussed by reference to five case reports. Such clinical pictures usually result from a misinterpretation by the initially attending physician and consequent errors in treatment, from the indolence of patients, and from complicating conditions which are due especially to the particular disease agents involved, with one factor generally affecting the other. Today, even most serious disease pictures can be seen ruled to surgical and antibiotic treatment. In cases of doubt, tracheotomy should be performed before surgical cuts into abscesses are made especially where extensive suppuration involves the floor of the mouth, the parapharyngeal space, and the cervicovascular space.
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Medical and social aspects relating to human reproduction has been the heading of a research subject in the context of sociogynaecology. An account is given in this paper of medicosociological studies and survey approaches with regard to induced-termination patients, puerperae and a control population, with emphasis being laid on identifying attitudes, motivations, and general views on having children. -- Methodical aspects are reported and assessed together with preliminary results obtained from a GDR-representative sub-study into 2,776 induced-termination patients. Priorities issues included the social situation of the interviewees, their attitudes towards having a child and to induced termination of pregnancy, reasons given for termination decisions, as well as views on contraception and family planning.
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Results of macroscopic examinations of placentae, which were obtained under routine clinical conditions for a total of 615 underweight neonates, were checked for their capability of a respiratory distress syndrome, and perinatal mortality. Evidence was obtained for a (partially statistically significant) trend showing that, within individual gestatory age groups and for equal weights of babies, premature infants born in the period up to and including the thirty-fifth week of gestation and having relatively low placental weights premature babies born during the thirty-sixth week of pregnancy, and hypotrophic babies born at term and showing a relatively heigh weight of the placenta are particularly exposed to a number of dangers in the further postnatal course of life. The clinical importance of these results to attending neonatologists is pointed out. Other conditions. such as the form of attachment of the umbilical cord of the nature of allantochorial vasculature, were not found to be closely related to the parameters studied in this investigation.