Biomedical subjects

U Schmidt

Publications and source records attributed to U Schmidt.

At least 595 records · Page 33Linked to original sources

PubMedDate not supplied

Intrahepatic absorbable fine mesh packing of hepatic injuries: preliminary clinical report.

A previous report from the authors' institution reported the effectiveness of hepatic packing with absorbable fine mesh (AFMP) for the control of hemorrhage in an animal model with an otherwise lethal hepatic injury. The technique has subsequently been applied to 12 abdominal trauma patients with hemodynamic instability and actively hemorrhaging hepatic injuries. Two patients expired in the operating room owing to uncontrolled hemorrhage from hepatic and associated injuries for a mortality of 16.7%. AFMP was successful in controlling hemorrhage in the remaining 10 patients. Hepatic injuries ranged from grade II to grade V, and all were actively hemorrhaging at the time of exploration. None of the surviving 10 patients experienced early or late recurrent bleeding attributable to the hepatic injuries, and there were no intraabdominal abscesses or late deaths. Liver function studies returned to normal prior to discharge in all surviving patients. Follow-up included serial computed tomographic scans, which demonstrated fibrosis incorporating the mesh packing. Complete resolution of injury and mesh appears to proceed over approximately a 6-month period. AFMP is a safe, effective method for controlling hepatic hemorrhage. It is easy to perform in the operating room, offers an excellent matrix for hemostasis, provides tamponade of bleeding sites, and does not require reoperation for removal of packing material, as is necessary with conventional, nonabsorbable packing techniques.

Absorption↗

PubMedDate not supplied

A controlled study of alexithymia in eating disorders.

The aims of the study were (1) to establish whether alexithymia is present in patients with bulimia nervosa (BN), (2) to compare bulimic patients with restricting anorexics (AN/R), bulimic anorexics (AN/BN), and normal controls with regard to alexithymia, (3) to determine whether in BN patients alexithymia is a state or a trait, and (4) to see whether alexithymia predicts short-term treatment outcome in BN. Study 1 included 173 eating disorder patients (BN: n = 93, AN/R: n = 55, AN/BN: n = 25) who were compared with 95 controls on the Toronto Alexithymia Scale (TAS). Study 2 included 41 BN patients who were assessed prospectively with the TAS before and after a 10-week drug treatment. AN/R patients in study 1 had significantly higher alexithymia scores than BN patients. All three eating disorder groups had significantly higher alexithymia scores than controls. For BN patients in study 2, TAS scores before and after drug treatment were stable, despite significant symptomatic improvement. We conclude the following: (1) eating disorder patients are considerably more alexithymic than normal controls; and (2) in BN, alexithymia may be a trait, unaffected by clinical improvement unless psychological treatment, encouraging the expression of emotions is offered.

Adult↗

PubMedDate not supplied

Successful resuscitation of a child with severe hypothermia after cardiac arrest of 88 minutes.

A 4-year-old boy broke through the ice of a frozen lake and drowned. The boy was extricated from the icy water by a rescue helicopter that was dispatched shortly after the incident. Although the boy was severely hypothermic, no cardiac response could be induced with field resuscitation measures, including intubation, ventilation, suction, and cardiopulmonary resuscitation. On admission, the primary findings included fixed, nonreacting pupils and asystole. The first core temperature measured was 19.8 degrees C (67.6 degrees F). During active, external warming, the first ventricular beats were observed 20 minutes after admission, and changed 10 minutes later to a sinus rhythm. Continuous monitoring included repeated arterial blood gas and electrolyte tests; prophylaxis for cerebral edema was performed with hyperventilation and administration of sodium Brevimytal and dexamethasone. Seventy minutes after admission, hemodynamics stabilized and the boy was transferred to the pediatric intensive care unit (PICU), where active external warming was continued to raise the core temperature at a rate of 1 degree C/hour. Adult respiratory distress syndrome developed, and the boy had to be ventilated in the PICU for 10 days. He was discharged home after another two weeks. He recovered fully. The rapid heat loss with the induction of severe hypothermia (< 20 degrees C; 68 degrees F) was the main reason for survival in this rare event of a patient with cardiac arrest lasting 88 minutes after accidental hypothermia.

Child, Preschool↗

PubMedDate not supplied

Influence of antibiotics on posttransfusion platelet increment.

BACKGROUND: Fever has been identified as a major cause of platelet refractoriness. However, it is regularly attended by the administration of antibiotics, and thus it cannot be determined whether fever, the administration of antibiotics, or both are responsible for the reduced platelet increment. The present study was undertaken to discern the effect of body temperature and antibiotics on transfusion success. STUDY DESIGN AND METHODS: Single-donor platelet transfusions (n = 400) were monitored retrospectively. Besides other influencing factors (e.g., spleen size, number of previous transfusions, diagnosis, bone marrow transplantation), body temperature and the administration of antibiotics were documented from the patients' records. To distinguish the effects of fever and antibiotics, a general mixed model of variance was used for analysis. RESULTS: Besides the well-known factors of splenomegaly, hepatomegaly, bone marrow transplantation, and pretransfusion storage time, both body temperature and antibiotics independently reduced the corrected count increment. Among the various antibiotics, amphotericin B, ciprofloxacin, and vancomycin had the greatest influence. CONCLUSION: The administration of antibiotics has a negative effect on the corrected count increment, independent of the presence of fever. Besides amphotericin B, which has previously been shown to influence the corrected count increment, vancomycin and ciprofloxacin reduce it significantly. Because these antibiotics are widely used in patients with bone marrow failure, these observations should be proven by further prospective in vivo and in vitro studies.

Adolescent↗

PubMedDate not supplied

[Histological findings of the femoral quadriceps muscle in varus and valgus gonarthrosis].

A pronounced valgization or varization of the lower extremity leads to changes in skeletal muscle which are histologically and morphometrically demonstrable in biopsies of Mm. vastus lateralis et medialis of patients with chronically anomalous stressing of the knee joint. During chronic over-stressing, increased thickness in type I and type II muscle fibers can be observed in both Mm. vastus medialis and lateralis, whereas type II fibers demonstrate a greater variability and there is a greater occurrence in type I fibers. Our investigations show that a chronic anomalous stressing influences both the size and energy metabolism of a skeletal muscle cell in a manner which can be interpreted as a functional adaptation.

Aged↗

PubMedDate not supplied

Clinical evaluation of intravenous trimethoprim-sulfamethoxazole for serious infections.

The efficacy and safety of intravenous trimethoprim-sulfamethoxazole (TMP-SMZ) were evaluated in 22 adults with serious infections caused by gram-negative bacteria. These infections included pneumonia, meningitis, pyelonephritis, deep-seated abscesses, and endocarditis. Of the 19 patients who could be evaluated, 12 (63%) were cured, and four (21%) showed definite improvement; three patients (16%) failed to respond to treatment. The only serious side effect occurred in a patient who had an acute reaction after his first dose. Mild adverse reactions were relatively common: three patients (13.6%) developed skin rashes, in one case with bronchospasm and eosinophilia. Mild transient decline of renal function was observed in five patients (22.7%) and decline of hepatic function in seven patients (31.8%); these abnormalities were not necessarily attributable to the drug. Although side effects were more common than previous reports indicate, intravenous TMP-SMZ was effective in the treatment of life-threatening infections unresponsive to other antibiotics.

Adult↗

PubMedDate not supplied

Outbreak of systemic aspergillosis in a neonatal intensive care unit.

Small pre-term neonates are susceptible to cutaneous aspergillosis because of their immature immune system and because of the vulnerability of their skin. In addition, the common therapy with broad-spectrum antibiotic drugs and corticoids creates a favourable milieu for fungal superinfections. We present four pre-term neonates who succumbed to cutaneous aspergillosis that subsequently developed into a systemic infection. The source of the infection proved to be contaminated latex finger stalls. Three of the four patients died. The poor prognosis for systemic aspergillosis can only be improved by an early therapy with amphotericin B, possibly in liposomal form.

Aspergillosis↗

PubMedDate not supplied

Influence of titanium coating on the biocompatibility of a heavyweight polypropylene mesh. An animal experimental model.

INTRODUCTION: In light of the fact that, to date, no information is available about titanium relative to its application in prosthetic material employed for hernial repair, the aim of the present work was to evaluate the fundamental possibilities of titanium-coated polypropylene meshes. MATERIALS AND METHODS: In experiments with animals, two groups, each containing 11 pigs, received either a heavyweight polypropylene mesh (Atrium) or an identical but titanium-coated mesh (titanium-coated Atrium) implanted into the left groin using the totally endoscopic extraperitoneal patchplasty technique. RESULTS: A significant difference in the shrinkage behavior between conventional Atrium and titanium-coated Atrium was found (14.9 vs. 8.8%, p < 0.05). Furthermore, the partial volume of the inflammatory infiltrate also proved to be smaller with the titanium-coated mesh (14.9 vs. 12.4%). In addition, Ki-67 expression was lower in the group implanted with titanium-coated mesh (21.0 vs. 15.0%). No difference was observed with regard to the apoptosis index (7.6 vs. 6.5). CONCLUSIONS: Heavyweight titanium-coated polypropylene meshes induce a less pronounced foreign body reaction in comparison with identical meshes with no titanium coating, which, since the amount of material implanted is identical, must be attributed solely to the titanium coating.

Animals↗

PubMedDate not supplied

Effects of prostacyclin substitution on systemic procoagulant turnover and cardiorespiratory variables in experimental hypercoagulability.

Endotoxin infusion (lipopolysaccharide from Escherichia coli 120 micrograms kg-1 i.v.) was titrated to produce hypercoagulability in rabbits and the effects of prostacyclin (PGI2) treatment (continuous infusion of 6 ng kg-1 min-1 i.v.) on coagulation variables, cardiorespiratory variables, and fibrin deposition in the microcirculation of vital organs were studied. PGI2 infusion did not influence the concentration of soluble fibrin, thrombelastographic variables, or systemic platelet aggregability. Fibrin deposition in the microcirculation of the liver and the lungs was reduced to 50% of that observed in untreated animals (p < 0.01). The antiplatelet properties of PGI2 were unable to reduce experimental endotoxin-induced systemic procoagulant turnover but improved organ perfusion during the initial phase of disseminated intravascular coagulation.

Animals↗

PubMedDate not supplied

CD30 differential staining is useful in classifying lymphomas intermediate between Hodgkin's disease and anaplastic large cell (Ki1) lymphoma.

AIMS AND BACKGROUND: The authors analyzed the BerH2 reactivity patterns of the tumor cells in 23 Hodgkin's lymphomas (HD), in 13 CD30+ anaplastic large cell (Ki1) lymphomas (ALCL), in two HD with transition to secondary CD30+ ALCL, and in six additional lymphomas intermediate between HD and ALCL. METHODS: Paraffin blocks of formalin-fixed biopsies were immunostained. Immunostaining was modified by pronase digestion and by microwave assistance. RESULTS: Hodgkin-Reed-Sternberg (HRS) cells of all 23 Hodgkin's lymphomas were reactive for BerH2, but the reactivity patterns differed: after pronase digestion, HRS cells of 17/23 Hodgkin's lymphomas showed exclusively or at least predominantly cytoplasmic BerH2 reactivity, whereas only four Hodgkin's lymphomas presented with prominent membrane-bound positivity. Microwave processing in 16/23 Hodgkin's lymphomas induced membrane-bound BerH2 positivity in the HRS cells; a minority of five cases retained the distinct cytoplasmic pattern. In contrast, 10/13 ALCLs were characterized by membranous reactions, independent of whether pronase or microwave pretreatment had been applied. The CD30+ ALCLs secondary to HD also showed a tendency towards membranous positivity more than did the antecedent Hodgkin's lymphomas. In the HD/ALCL borderline group, 3/6 cases revealed cytoplasmic BerH2 patterns after pronase digestion and thus were more closely related to HD, whereas 2/6 cases reacted with membranous positivity as did the genuine ALCLs of our series. CONCLUSIONS: We conclude from these findings that the above modifications in CD30 immunostaining can be helpful in the characterization of lymphomas that constitute a continuous histomorphological as well as phenotypical spectrum between HD and ALCL.

Adult↗

PubMedDate not supplied

Variability of differentiation patterns in xenotransplanted spindle cell sarcomas: a histomorphological, immunohistochemical, and ultrastructural study.

Three leiomyosarcomas, 3 nerve sheath sarcomas, 1 rhabdomyosarcoma, and 1 sarcoma not otherwise classifiable with 17 of their xenografts, grown on nude mice, were analyzed to assess the degree of concordance between histomorphology, immunohistochemistry, and ultrastructure in spindle cell sarcoma xenograft differentiation. Histomorphology was inconclusive or misleading in 4/8 sarcoma strains and immunohistochemistry in 4/8 originals and in 10/17 xenografts, although specific patterns had been identified ultrastructurally. Electron microscopy was superior to immunohistochemistry and histomorphology in spindle cell sarcoma differential diagnosis. A further purpose of this study was to clarify whether spindle cell sarcoma xenografts retain the morphological characteristics of their primaries. Histomorphological features of the primaries were preserved over all passages, whereas the immunohistochemical marker profiles as well as the ultrastructural phenotypes changed in 14/17 xenografts and in 8/17 xenografts, respectively. Moreover, unusual bidirectional or tridirectional patterns of differentiation were identified ultrastructurally with leiomyomatous as well as Schwann cells occurring side by side and with MFH-like areas in 5/17 xenotransplants. These findings suggest genetic instability of tumor cells and may be important in the consideration of mesenchymal differentiation pathways.

Animals↗

PubMedDate not supplied

[Reconstrudive significance of stretch mark tears of the skin].

Stretchmark-like tears of the inguinal region are commonly referred to as typical lesions in pedestrian accidents when the victim is run over by a motorcar. These lesions can also be observed when a pedestrian is hit by a vehicle while being in an upright position. Stretchmark-like tears are due to hyperextension or excessive abduction of the hip joint. Characteristic morphological features are variable numbers of equally superficial and parallel tears of the skin following the skin's cleavage lines. Drivers of two-wheeled vehicles may exhibit inguinal stretchmark-like tears when they hit an obstacle with their bent knee, suffering excessive abduction of the hip joint. Finally, stretchmark-like tears are described in victims of collisions with railed vehicles, of aircraft crashes and--very rarely--in severely injured car passengers.

Accidents, Traffic↗

PubMedDate not supplied

Overexpression of deletion-mutant epidermal growth factor receptor is associated with altered genotoxic stress-provoked p53 mRNA induction in a human glioblastoma cell line.

A distinct 801-bp deletion mutation of the epidermal growth factor receptor (EGFR) gene is frequently present in primary glioblastoma multiforme (GBM), confers enhanced tumorigenicity in vivo and is prognostic of a shorter interval to clinical relapse. This study sought to investigate whether overexpression of deletion-mutant (delta) EGFR affects genotoxic stress-provoked mRNA inductions of p53 and murine double minute 2 (MDM2), two other genes strongly involved in the pathogenesis of GBM. In a set of human wild-type (wt) p53 GBM cell lines (U-87MG and U-87MG.delta EGFR) that exclusively differ in EGFR expression (endogenous wt EGFR expression and exogenous delta EGFR overexpression, respectively), ultraviolet (UV) light irradiation-mediated EGFR, p53 and MDM2 genotoxic stress-provoked mRNA inductions were assessed by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) and densitometry of electrophoretically separated and stained RT-PCR products. Although baseline (at 0 J/m2) p53 mRNA expression in U-87MG.delta EGFR was 42-fold reduced, maximum p53 induction (at 8 J/m2) amounted to 130% compared to U-87MG. Thus, ultimate UV light-mediated p53 mRNA induction was 131.5-fold in U-87MG.delta EGFR and 2.8-fold in U-87MG. In contrast, neither wt/delta EGFR nor MDM2 mRNA expressions were significantly inducible, and MDM2 mRNA profiles were essentially the same among U-87MG and U-87MG.delta EGFR. These data suggest that in human GBM overexpression of delta EGFR is associated with differential genotoxic stress-provoked p53 mRNA induction whereas MDM2 mRNA expression is apparently not directly affected by EGFR status.

ErbB Receptors↗

PubMedDate not supplied

[Death caused by accidental hanging in the hand strap loop of a garage door].

The authors report on a 10-year-old boy who accidentally hanged himself in the hand strap of a garage door. The door was an electric overhead door of an underground garage. The accident was reconstructed at the scene using a dummy. The strap of the door was long enough to be slipped over the head easily. In view of this background it seems advisable to consider whether the current safety regulations on the operation of electric doors should be changed accordingly.

Accidents, Home↗

PubMedDate not supplied

[Extent of burn lesions--an analysis of 68 burned cadavers].

The burned bodies (n = 68) autopsied at the Freiburg Institute of Forensic Medicine in the years 1996-2001 (until the end of February) were examined with regard to the extent of consumption by the fire using the classifications suggested by Eckert et al., Maxeiner, Glassman and Crow, and Gerling et al. Further classification parameters were exposure of the body cavities and amputation of extremities as a result of the fire. Most cases were accidental deaths (approximately 75%). The fires occurred mainly in buildings (57%) or vehicles (34%); in 6 cases the burning took place in the open air. In most cases the degree of consumption by the fire was slight to moderate. Only 15% of the burned bodies showed extensive destruction with severe loss of soft tissue and shrinking or amputation of the extremities. In one case the soft tissue was completely destroyed with fragmentation of the calcined skeletal remains. In bodies recovered from house fired the extent of consumption by the fire was usually less pronounced than in bodies retrieved from burned-out vehicles.

Adolescent↗

PubMedDate not supplied

[Mandibular fracture caused by absolute close-range gunshot with a blank cartridge fright weapon].

Bony injuries caused by starter's pistols were repeatedly observed in the form of fractures of the temporal squama and other thin osseous lamellae; in experiments rib fractures could also be produced. In the presented case a contact shot from a blank cartridge pistol caused a fracture of the lower jaw (transverse fracture with a bone fragment split off in reg. 46). The friend of the 17-year-old victim had fired a shot to the right mandibular region during an argument. In the depth of the gunshot entrance wound, which communicated with the oral cavity, intense soot deposits were found as signs of the contact shot.

Adolescent↗

PubMedDate not supplied

LOH analyses in the region of the putative tumour suppressor gene C13 on chromosome 13q13.

BACKGROUND: In previous studies we isolated a new cDNA fragment named C13 which is down-regulated in malignant prostate tissues. The corresponding gene is localized on chromosome 13q13 between the known tumour suppressor genes (TSG) BRCA-2 and RB-1. MATERIALS AND METHODS: Loss of heterozygosity (LOH) analyses were carried out in the region of C13 in order to investigate the importance of the new putative TSG for prostate cancer development. Using semiquantitative LOH analysis, we screened 21 prostate carcinoma patients of different tumour stages (pT2-pT4) for 14 microsatellite markers in the region of C13 (13q13) and in the flanking BRCA-2 and the RB-1 loci. RESULTS: For 18 (86%) patients LOH or allelic imbalances were found. We identified three to nine alterations in affected tumours per marker. An overall genetic alteration frequency per patient of 38% (86 of 225 informative cases) could be calculated. One important finding regarding the overall frequency of determined microsatellite instability is that the LOH/AI rate of 47% for the seven C13-associated markers was higher than for the four markers of the RB-1 locus (39%) and for the three BRCA-2 markers (25%). Surprisingly, defining LOH critical regions (LCR) for the investigated marker panel, eight of the ten affected LCR cases showed chromosomal imbalances simultaneously for the RB-1 and the C13 LOH markers. CONCLUSIONS: The high LOH rate for eight different microsatellite markers in and around the putative TSG locus C13 on chromosome 13q13 further supports an involvement of C13 in prostate tumourigenesis.

Aged↗

PubMedDate not supplied

Trochanteric fractures treated with the Pugh nail: a study of 270 cases.

We report a series of 270 intertrochanteric fractures of the femur which were treated with the Pugh nail in our department. We used it as a standard treatment of intertrochanteric fractures and lateral fractures of the femoral neck. The Pugh nail method is characterized by a simple technique, a low rate of complications, and early ambulation and weight-bearing, which is important for the mostly aged patients (average age: 81 years). 81% of the patients could be ambulized with weight-bearing within two weeks after operation. 79% of them were able to walk by themselves at discharge from hospital. The rate of complications was 17% without urinary infections. Mortality was 16%. Complications and mortality did not depend on the type of fracture but on the age of the patients and on concomitant diseases.

Aged↗