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Biomedical subjects

T Steinbach

Publications and source records attributed to T Steinbach.

At least 19 recordsLinked to original sources
PubMed2004

[Performance and costs of outpatient clinics of university hospitals for medical care, teaching, research activities].

BACKGROUND: Outpatient clinics of university hospitals (Hochschulambulanzen) play a significant role in the German health care system. Universities have in contrast to other hospitals the right to implement an outpatient clinic, but the health care services they can render are restricted to clinical research and teaching activities. The university outpatient clinic study evaluates the intensity of medical care, teaching, research activities, and the related costs. METHOD AND DATABASE: 6 university hospitals with 51 outpatient departments in Germany were included. The prospective documentation of consultations was restricted to 800 visits per department. A total of 26,312 consultations with approximately 40,000 diagnoses and 150,000 services were documented. Furthermore, data concerning costs, teaching activities and research facilities were documented. RESULTS: Clinical treatment without any correlation to research or teaching activities amounted to about 81 % of the working time in the outpatient department (research 11 %; teaching 8 %). The primary task of the university outpatient clinics takes up less than 20 % of the working time. The physicians documented that the disease of every fourth visit was in accordance with their main field of research. 6.9 % of the visits were asked to take part in clinical trials, of these 1.25 % were included for the first time, 3.7 % were already included. 6.5 % of the visits were addressed to participate in specific teaching activities. The average total costs per case added up to 149 Euro. No outpatient clinic could cover the total per case costs with the lump sum payments. On the average 31 % of these costs were covered by lump sum payments (without cases concerning research and teaching). CONCLUSION: Treatment in outpatient departments of university clinics is far beyond research and teaching activities required by law. However, the ability of outpatient departments of universities to provide excellent outpatient services should have a more dominant role in the health care system. Therefore access to care should be deregulated for the patients and reimbursement schemes should be adjusted to adjust for the present losses.

Biomedical Research↗
PubMed1991

Symptoms of prosopagnosia in intoxicated subjects.

Two experiments were made to test whether a blood ethanol concentration of about 1 g ethanol per kg blood influences the ability to recognize faces which were shown 24 hours earlier. 18 subjects who saw the faces for the first time when sober and whose task it was to recognize the faces when under the influence of alcohol, recognized the faces significantly less frequently than controls. The controls saw the faces for the first time when sober and their task was to recognize the faces later when also in a sober state. When 20 sober subjects had to recognize faces which they had seen 24 hours earlier under the influence of alcohol, they recognized the faces significantly less frequently than controls. 18 subjects to whom visual forms were shown when under the influence of alcohol and who had to recognize these forms 24 hours later when sober again performed like subjects who had to recognize faces under identical experimental conditions. Subjects who saw the forms, however, in a sober state and who had to recognize these forms when intoxicated performed significantly better than subjects who had to recognize faces under identical experimental conditions. In additional experiments, it was shown that alcohol did not influence ability to compare simultaneously presented faces. Intoxicated subjects' reduced abilities to recognize faces is regarded as a symptom of prosopagnosia since it cannot be explained by a reduced ability to recognize forms or to compare faces.

Adult↗
PubMed1991

Effect of sulfur dioxide inhalation on the respiratory tract of the rat.

In order to study the initial effect of SO2 exposure by electron microscopy, Wistar rats were subjected to the gas for 8 hours at a concentration of 800 ppm. A gradient of decreasing damage was observed in the tracheobronchial tree in peripheral direction. The trachea epithelium showed the most severe lesions represented by groups of detached cells, necrotic cells and disappearance of cilia and goblet cells. The entire apical surface was composed of short protrusions. A complementary ultracytochemical chromatin labelling method could demonstrate a gradient with a decreasing labelling rate of epithelial cells towards the peripheral airways. The cytochemical findings may indicate an increased mitotic and metabolic activity of epithelial cells surviving in a region of marked morphological damage as a response to high SO2 concentration. This nuclear activity seems to decrease in peripheral parts of the respiratory tract along the gradient of decreasing morphological damage.

Animals↗
PubMed1989

[Biomechanical analysis of movement using stroboscopy].

In cases when violence has occurred in some form and its associated forces are subject to expert evaluation. For a mathematical assessment of the intensity of the acting forces there is often a lack of confident basis data, which is why an experimental study is necessary. A simple testing arrangement with a photocamera and flashlight in stroboscopic mode provides a convincing pictorial representation of movement and velocity. The method is described with some examples of applications by experts.

Biomechanical Phenomena↗
PubMed1988

For whom the bells knell.

A 72-year-old widowed woman known to have an organic brain syndrome was hospitalised owing to gangrene of her lower limbs. The gangrene had been caused by an adduction contracture of her hip resulting in pressure on the medial surface of her left leg. In addition she had pressure sores over both trochanters and the sacrum. The smell of putrefication could be sensed from a distance and on examination large white worms could be seen slithering in the decomposing tissue. The patient was pyrexial, oblivious of her surroundings, and without pain. Surgery--limb amputations--would not restore the patient to a cognitive state nor improve here quality of life, but abstinence posed an inherent threat of sepsis, and revulsion to the attendants. The sacral pressure sore was so large that surgical closure was impossible. The question of surgical intervention is discussed.

Aged↗
PubMed1988

Update on the use of orthotics in hemophilia.

The availability of concentrated coagulation factor has dramatically changed the effects of hemophilia on the musculoskeletal system. Limb angular deformities, on the whole, can be prevented by intensive medical and surgical care, but hemarthroses result in constantly changing joint circumferences and ranges of movement. Orthoses provide little protection against hemarthrosis and the unstable configurations contraindicate the use of rigid orthotic devices. Modern treatment protocols call for early and adequate factor replacement and physiotherapy. As an adjuvant to this form of therapy, anatomically constructed elastic joint supports and/or transcutaneous electric nerve stimulation (TENS) have been used.

Braces↗
PubMed1987

Changes of euchromatin/heterochromatin ratios in cell nuclei of the aortic adventitia in diabetic rats.

The main objective of this study was to determine quantitatively euchromatin/heterochromatin (EU/HET) ratios of cell nuclei in the adventitia of 2 weeks streptozotocin induced diabetic rats combined with acridine orange (AO) ultracytochemistry. Specimens of the aorta above and below the orificium of the a. renalis were treated with AO and then prepared for electron microscopy. Images of 295 nuclei randomly selected from 180 ultrathin sections were analysed by a computer assisted image analyser method. The findings that surface areas of euchromatin portions and those of total nuclei are dependent variables (correlation coefficients 0.93-0.99), however, the EU/HET ratios and total surface areas are independent variables are essential prerequisites for an efficient application of this method. Determinations of EU/HET ratios revealed that populations of AO labeled cell nuclei consistently have higher ratios (2.17-3.38) than nuclei not labeled by AO (1.26-2.12). On the basis of 2583 nuclei counted AO positive cell nuclei were found to increase from 12% in control to 23% in diabetic rats. Changing EU/HET ratios are interpreted in terms of differential RNA synthetic activity enhanced in the early diabetic state. For these cells AO serves as a specific nuclear marker.

Acridine Orange↗
PubMed1982

[An economical microprocessor system for use with a Quantimet 720 image analyser ].

Development and amplification of a Quantimet 720 image analyser are reported in combination with a microprocessing unit. The system controlling the measuring procedure with telecommunication for evaluation in a large computer is presented in detail. The new cost-saving units supplementing the analyser render possible: i) reduction of measuring times, ii) reduction of possible errors of measurement, and iii) optimal rational evaluation of data in a large computer system.

Autoanalysis↗
PubMed1981

[Two stage Syme amputation].

In 1843 James Syme described the amputation which bears his name. It is done in two stages and can be accomplished in the presence of wounds and infections or gangrene of the feet. The operation is of great value especially in the elderly. Patients with a Syme stump can be fitted with a strong, light, plastic prosthesis, they develop an excellent gait and the entire body weight can be borne without pain. The advantages of the Syme amputation are that the knee joint is retained and the long lever allows an almost normal gait with an energy cost only 10% above normal. The stump has a large interface for proprioceptive feed-back and the prosthesis is easy to put on.

Amputation, Surgical↗
PubMed1980

Alteration of chromatin in early experimental arteriosclerosis.

Our approach serves several purposes: To demonstrate the response of aortic cell nuclei to a changing environment (e.g. hypercholesterolemia, experimental diabetes, drug treatment), to apply the acridine orange (AO) ultracytochemical method, and to determine the euchromatin/heterochromatin (EU/HET) ratio by morphometric procedures as suitable criteria, and to emphasize the differential nuclear activity of adventitial cells. Hypercholesterolemia in rabbits results in an increase of AO positive nuclei in the adventitia. Additional treatment with tinofedrine, a new cerebral vasodilator drug, reveals an even higher number of AO positive nuclei in adventitial and also in endothelial and plaque cells. In streptozotocin induced diabetes in rats the increased number of AO positive cells coincides with an elevated EU/HET ratio.

Animals↗