[Healing of fractures and soft tissues depending on tissue pressure (animal experiment)].
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Biomedical subjects
Publications and source records attributed to T Becker.
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In 16 asthmatic patients and in four subjects suspected of having hypersensitivity pneumonitis, serum levels of CH50, C3, C4, C5 and factor B were measured before, between 10 and 20 min, between 5 and 7 h and, in the latter group, also 24 h after allergen challenges provoking type I bronchial reactions or acute hypersensitivity pneumonitis. There was a significant decrease in one of the complement factors in two patients during the immediate asthmatic phase, but in no patient during the late asthmatic phase and in no patient with hypersensitivity pneumonitis. On the other hand, significant increases of C3, C4, and/or CH50 were seen in five patients during immediate asthmatic reactions, in seven patients during late asthmatic reactions and in all cases with hypersensitivity pneumonitis. However, with respect to the particular complement factors the vast majority of the patients showed no appreciable change. Investigations of C3 split products, which were done in seven patients gave negative results. No correlations existed between the changes in the levels of complement factors to increases of Raw, decreases of DLCO, size of skin test reactions or RAST scores. The cause and pathophysiological role of the non-uniform behaviour of serum complement levels after inhalation challenges is not yet clear; obviously both consumption and formation of complement factors take place during allergen-induced asthmatic reactions and hypersensitivity pneumonitis.
The sera of 65 patients with myasthenia gravis (MG) were analysed for antibodies against the nicotinic acetylcholine receptor (ACh-R) using an immunoprecipitation assay (125I-alpha-bungarotoxin bound to human ACh-R as antigen). In 91% of MG sera elevated antibody titers were found ranging up to 500 times reference values. A control group of 77 patients showing various autoimmunological phenomena had ACh-R antibody concentrations within the reference range. The demonstration of antibodies against ACh-R provides a sensitive and highly specific tool for the diagnosis of MG. In addition, the test is helpful in following patients under treatment with immunosuppressive drugs or plasmapheresis. Antibodies against striated, smooth, or heart muscle (indirect immunofluorescence test) are much less sensitive and nonspecific for the diagnosis of MG.
Immunochemical homogeneous human pepsinogen I-group (PgI) was purified by solid immunoadsorbent and by DEAE-chromatography from gastric mucosa. PgI contained five electrophoretic distinct bands at pH 8.2 but only four bands at pH 5.6. After acid activation human pepsin (PI) was separated from the inhibitory peptide by affinity chromatography using poly-L-lysine. Purified PgI contained 9-16% of the inhibitory peptide. The yield of PI was 64 to 85%. A 65% increase of specific activity was observed. PI demonstrated three bands in agar gel electrophoresis at pH 5.6. The pH range of PI was rather wide, showing two maxima at pH 2.0 and pH 3.0 with hemoglobin as substrate. Irreverisble inactivation of PI was observed at pH 7.0 and at a temperature of 60 degrees C. The Km-value of PI was 0.170 mmol as determined with N-acetyl-L-phenyl-alanyl-L-3,5 diiodotyrosine. The specific activity was 9.6 IU/mg (hemoglobin substrate) and 0.032 IU/mg (dipeptide substrate). Porc pepsinogen (PPg) and its activated pepsin (PP) was used for comparison. PP showed indentical elution patterns in affinity chromatography. In AEE PPg and PP demonstrated both two components at pH 5.6 with different electrophoretic mobilities. The pH optimum of PP was observed at pH 2.0. PP was slightly more sensitive in alkali and heat inactivation than human P. A higher Km-value of PP of 0.082 mmol and higher specific activity as compared to human PI was observed.
Human pepsinogen II (PgII) was purified from human gastric mucosa by immunoadsorbents using anti-PgII antiserum. Contaminating pepsinogen I (PgI) was adsorbed by a subsequent anti-PgI immunoadsorbent. PgII was further purified on DEAE-Sphadex A50. By agar gel enzyme electrophoresis (AEE) at pH 8.2 PgII was separated into five proteolytic bands, demonstrated upon acidification and incubation with hemoglobin. PgII was converted to pepsin II (PII) by acidification at pH 2.0 and was immediately separated from its inhibitory peptide and from other substances by DEAE chromatography. Purified PII showed two bands in AEE at pH 5.6 and was immunochemically identical with PgII. The "gastricsin" and "pepsin" purified from acid gastric juice by classical procedures proved to be identical with PII and pepsin I (PI), respectively. PII showed a broad pH range with one maximum at pH 2.9. PII in contrast to PI did not hydrolize N-acetylphenylalanyl-3,5-diiodotyrosine and proved to be more alkali-stable than PI. A modified nomenclature is proposed for the human pepsinogen system.
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1. Various weather factors were examined which were operative during the occurence of lung embolism in 915 patients of the Surgical Clinic of the University of Jena for a period of 50 years (1917 to 1966). 2. No relationship could be found between the incidence of pulmonary embolism and temperature (maximal and minimal values, or temperature differences) or with atmospheric pressure. 3. The incidence of pulmonary embolism is significantly higher at days with high rainfall (above 10 mm/m2) and high average humidity (8-10 Torr) values. 4. Thromboembolic complications are less frequent at average values for air humidity (6-7 Torr), at days with a relative air humidity of 70% and with lower rainfall.
The diagnosis in the field of surgery of the old age is to be standarized if you suppose that not all illnesses or consequences of accidents are the real problem, but the old age which is accompanied by multi-illnesses. So it must be examined in how far it is possible to realise the great existing risk. Besides most of the operations of the old age belong to the urgent surgery and care connected with a great risk. A standardized diagnosis must think of the individual factors and must recognize--because of the little time--the most important signs of the heart circulation-, the lung-and the kidney-function. This must be united with the results of the diagnosis of the organes to a pre- and postoperative therapeutic programme.
Objects of surgery of the higher age are accident injuries, malignant tumors, thoracial and gastrointestinal emergency conditions as well as disorders of the central and peripheral circulation of blood. The aim of surgery of the old age is the complete recovery of the old men and the integration in his familiar surroundings. In many cases this aim can be realized only to a certain degree on account of the polymorbidity of the higher age. For men older than 50 years the risk of operation is continuously increasing. In the 10th decennium the value of postoperative letality is reaching almost 30%. The reason is not in first line the basic disease or the accident, but the complication for intervention is in most cases an absolute one, because cases of emergency are predominant. The consequence of surgery with high risk is the prophylaxis, that means: all pathologic, already in younger years existing states, which are generally treated by operation, ought to be operated early, in order to prevent complicationsin the higher age. In tumor surgery, which is characterized by a high delay rate, looking for tracks of cancer and early diagnosis are the ways to diminish the burden of the older men.
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In the 50 year period between 1917 and 1966, 915 patients, 0.44% of the total surgical patients at the Surgical Clinic of the University of Jena, died from pulmonary embolism. In 20% of the cases autopsy failed to disclose any thrombus. Among 714 fatal cases of postoperative lung embolism, 43% occurred after abdominal surgery, 18% after surgery on the extremities, and 14% followed urogenital operations. Peak incidence of lung embolism fell on the day of operation and on the 6th, 7th, and 13th postoperative day. Patients at risk of embolism can be identified beforehand. The incidence of pre- and postroperative pulmonary embolism can be reduced to a great extent by specific preventive measures carried out prior to, during, and after surgical intervention. Prevention, diagnosis, and present day treatment of pulmonary embolism are discussed.
During the 50 year period from 1917 to 1966, 210078 patients were treated in the Surgical Clinic of the University of Jena. Autopsies were carried out on 10083 of the patients which had dies in the Clinic. The average incidence rate of lung embolism was 0.44%, the range of values lying between 0.04% (1917) and 1.02% (1965). In periods of famine or distress, lung embolism reached its lowest point, whereas in periods of relative prosperity a high peak was reached. On the whole, the incidence of pulmonary embolism seem to be the increased age of the patients population and the higher frequency of associated heart and circulatory diseases, obesity, and accidents, as well as the extended indications for surgery in the aged.
By means of chemotherapy it is not possible to heal the lymph osarcoma but to obtain remissions lasting up to 5 years in about 20% of the cases. The mode of therapy is discussed with regard to the generalized lymphosarcomatosis.
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The effectiveness of truncal vagotomy to prevent stress ulcers was examined in rats. Truncal vagotomy protects safely from stress ulcer caused by immobilization. This protection continues for a longer postoperative period. After vagotomy, even repeated immobilizations cause no ulcer. There are no different results after truncal vagotomy with or without drainage operation.
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