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Biomedical subjects

W Fischer

Publications and source records attributed to W Fischer.

At least 235 records · Page 13Linked to original sources
PubMed1988

[Plating of fresh clavicular fractures. Experience with 60 operations].

In two trauma units 63 patients with 65 fresh fractures of the clavicle were treated by plating, applying strict indications for the selection of the patients for surgery. The straight reconstruction plate 3.5, DCP 2.7 and in very slim clavicles the straight reconstruction plate 2.7 proved to be the most useful implants. With correct indication and good operative technique plating leads nearly always to healing in anatomic position with good functional results. The course of 60 fractures could be analysed. 57 patients with 58 fractures were followed. One polytraumatised woman with bilateral fractures died. Seven complications with negative influence on the result were observed: four pseudarthroses following loosening, bending or breaking of the plate, three refractures after removal of the plate. There was no infection. That means, that technical complications with bad results occurred in about 1/10 of the operations. All seven were multiple fragment fractures in the middle of the clavicular shaft. It therefore seems that complications could be avoided by using a different technique or a different implant.

Adolescent↗
PubMed1987

'Lipoteichoic acid' of Bifidobacterium bifidum subspecies pennsylvanicum DSM 20239. A lipoglycan with monoglycerophosphate side chains.

The lipid macroamphiphile of Bifidobacterium bifidum subsp. pennsylvanicum DSM 20239 was extracted with phenol/water and purified by treatment with nucleases and hydrophobic interaction chromatography. From analytical data, the results of Smith degradation, hydrolysis with HF and methylation studies, the following structure is proposed: (formula; see text) where n and m are approximately 7-10 and 8-15, respectively. The monoglycerophosphate residues have the sn-glycero-1-phosphate configuration; 20-50% of them are substituted with L-alanine in ester linkage. The lipid anchor is most likely a galactosyldiacylglycerol, part of which carries a third fatty acid. This is the first example among gram-positive bacteria of a glycerophosphate-containing lipid macroamphiphile that carries the glycerophosphate residues as monomeric side chains on a lipoglycan. Further, it contains L-alanine in place of the D-alanine found in lipoteichoic acids.

Bifidobacterium↗
PubMed1987

Analysis of the lipoteichoic-acid-like macroamphiphile from Bifidobacterium bifidum subspecies pennsylvanicum by one- and two-dimensional 1H- and 13C-NMR spectroscopy.

The native lipoteichoic-acid-like amphiphile from Bifidobacterium bifidum subspecies pennsylvanicum and its basic glycan moiety, obtained by alkaline hydrolysis, were studied by 1H-, 13C-, and 31P-NMR, DEPT (distorsionless enhancement by polarization transfer), 1H-1H correlation spectroscopy and 13C-1H shift correlation NMR spectroscopy. The results are consistent with the structure elucidated by chemical analysis (Fischer, W., preceding paper in this journal): (formula; see text) and establish the structures of the repeating units independently. In addition to characteristic shifts in the 13C-NMR spectrum, the sites of phosphodiester and alanine ester bonds are also manifest in the 1H-NMR spectrum. Substitution of the glycerophosphate residues can be recognized in the 31P-NMR spectrum also.

Bifidobacterium↗
PubMed1987

[Costs of psychiatric treatment: a comparative approach to 3 categories of patients].

Based on methodology similar to that used in international studies, the calculation of costs was carried out for three cohorts of patients: schizophrenics, other psychotics and non-psychotics, taking into account the parameters of sex, age, professional employment/unemployment. Attention is paid particularly to: the preponderance of indirect costs over direct costs, the much higher level of costs for psychotic patients and amongst these above all of schizophrenics, and significant differences in this last group with regard to sex and age. As far as direct costs are concerned, no substitution of hospital costs by outpatient costs is noted; on the contrary, the cumulative effect of these two constituent parts is marked among the three cohorts no matter what parameters of analysis of data are used.

Adult↗
PubMed1987

Astroglial response in the excitotoxically lesioned neostriatum and its projection areas in the rat.

The anatomical distribution of the astrocytic glial reactions, following ibotenic acid-induced neuronal degeneration of the neostriatum in the rat, has been studied immunohistochemically using an antibody directed against the astrocytic marker, glial fibrillary acidic protein. The acute astroglial response to the excitotoxic lesion, determined 7 days post lesion, was compared with a sham-operated group and a chronic group that had received the excitotoxic lesion 6 months prior to histological evaluation. Total doses of 16-20 micrograms ibotenic acid injected unilaterally into the head of the neostriatum caused not only a marked neuronal cell loss but was also accompanied by a large increase in the number and size (about 5 times) of glial fibrillary acidic protein-stained astrocytes throughout the neostriatum by 7 days after lesion. Reactive astrocytes were also observed in the major neostriatal projection areas, the globus pallidus and the substantia nigra pars reticulata, at 7 days post lesion, although no neuronal cell loss could be detected in these regions using regular Cresyl Violet staining. Previous studies of lesions identical to the ones used here have shown that globus pallidus and substantia nigra are deafferented as a result of the neostriatal neuronal degeneration. The reactive astrocytes in the striatal projection areas had a 3-5 times larger size than control astrocytes from the same anatomical region. In animals that received a larger dose of ibotenic acid into the neostriatum (25 micrograms), neuronal cell loss was also observed in the neocortex and reactive glial fibrillary acidic-stained astrocytes were found in the entire neocortex of the injected hemisphere. In the chronic group, 6 months after the excitotoxic lesion, the astroglial response was clearly diminished or absent in the major neostriatal projection areas, but was still present within the lesioned neostriatum. The results suggest that focal neuronal destruction can result in widespread astrocytic glial reactions which follow the anatomical connectivity of the lesioned area. This may have implications for the understanding of the multifocal distribution of glial reactions seen in patients with striatal degeneration as a result of Huntington's disease.

Animals↗
PubMed1987

Investigation of the gastrointestinal transit and in vivo drug release of isosorbide-5-nitrate pellets.

An oral formulation of controlled-release isosorbide-5-nitrate pellets has been used to investigate the location of pellets in the gastrointestinal (GI) tract and, in parallel, to measure the drug absorption from these locations. Using the method of gamma scintigraphy the transit times and spreading of pellets in the GI tract have been determined. The method of numeric deconvolution was applied to calculate the drug input into the systemic circulation. The results indicate that a well-absorbed substance such as isosorbide-5-nitrate is absorbed from the stomach and small intestinal in a manner that is controlled by the properties of the pellets. Drug absorption is reduced in the colon. The average transit time from mouth to colon is 6 to 8 hr, which represents the maximum acceptable time for drug release for this oral controlled-release preparation. Taking into account these relations an isosorbide-5-nitrate pellet formulation with a bioavailability of 84% has been developed that maintained the minimal therapeutic plasma level for more than 16 hr after application.

Delayed-Action Preparations↗
PubMed1987

[Colposuspension at the lateral abdominal wall using fascia strips--an adaptable elevation of the bladder neck in urinary incontinence].

Modifications of classical vesico-urethral suspension, according to Marshall-Marchetti-Krantz, are in widespread use among numerous operations for urinary incontinence, on account of their mild direct effect on both the urethra and bladder neck region. However, dysuria and dyspareunia may be quite frequent consequences later on because of retrosymphysial adhesions and rigid fixation of the vagina. We have, therefore, adopted an approach by which the advantages of mobile sling suspension are combined with indirect elevation of the urethrovesical junction, in that the vagina is fixed to strips obtained from the aponeurosis of the abdominal wall or from lyophilised dura mater. Fascial origin and dura anchorage in the abdominal wall are conducive to achieving a pronounced ventrocranial pull, and involvement of the rectus musculature in bridle action was found to add to the elevation effect in stress situations. A detailed account is given of the surgical technique. The method is contra-indicated or at least not fully sufficient only in cases of severe pelvic floor insufficiency or descensus of the vagina. Twenty-eight women have undergone this operation, within one year, with 20 of them (71 per cent) being relieved from complaints and five (18 per cent) substantively improved. Stress quotient and transmission factor are favourably affected, in terms of urodynamics, while ventral urethrovesical fixation is improved, in terms of radiography. Postoperative uroflow parameters have stayed normal. Problems of co-habitation did not occur. The small number of cases and lack of long-time results, therefore, cannot prevent the authors from recommending the technique for verification by re-use.

Abdominal Muscles↗
PubMed1987

[Obstetrical urogenital fistulas then and now].

An analysis was made of the aetiology and localisation of 83 obstetric urogenital fistulae, in 15-year intervals, which had been treated at the Gynecological Hospital of Charité over the past 45 years, with the view to finding out, if obstetrics continues to play a causative role in fistulation. With overall figures having stayed nearly constant (31, 25 and 27 fistulae), an increase has been primarily recordable from causes relating to caesarean section and from fistula localisations in the vesico-uterine region. Obstetric causes accounted for 10 per cent and gynaecological causes for 90 per cent of 808 urogenital fistulae throughout the entire period under review. Hence, at least surgical obstetrics should not even today be underestimated as a cause of fistulation. These findings have given rise to considerations of strategy and to conclusions regarding prophylaxis against fistulation with particular reference to caesarean section.

Cesarean Section↗
PubMed1986

[Ordering laboratory tests: their quantity and causes of variations among physicians].

To establish whether some physicians contribute more than others to the alarming increase in laboratory related expenditure, 317 consecutive medical files established by 10 residents of an outpatient clinic were analyzed. The expense incurred in establishing a diagnosis varied, according to the physicians involved, by a factor of 4.9 for back pain and 2.6 for acute respiratory illness. The difference is even more striking when the various types of investigation are analyzed (blood count, ESR, X-rays). It is therefore possible to group physicians according to their individual tendency to order tests. This classification is not related to age, sex, former professional experience or sub-specialty in internal medicine. There is a significant correlation (Spearman's test) between this classification and the approach to medicine, as evidenced by analysis of the content of an interview on medical practice. These interviews were conducted double blind, recorded and transcribed to determine psychological traits. Physicians who order a large number of tests are characterized by a high index of uncertainty, as evidenced by the large number of hesitant expressions and a tendency to cut the interview short, showing off to compensate for lack of self-assurance, depersonalized reference to patients, few references to the interviewer, difficulty in establishing a true dialogue. These characteristics can be considered to form a coherent entity which shows that even the material aspects of medical practice are strongly influenced by the physician-patient relationship.

Attitude of Health Personnel↗
PubMed1986

Beneficial effects of exercising at moderate altitude on red cell oxygen transport and on exercise performance.

The effect of a ascent to moderate altitude (2,300 m) and altitude training on the O2-transport properties of Hb and their possible consequences on tissue oxygenation during exercise were studied on six control and six training subjects. A rapid increase in P-50 values (+2.4 mm Hg, 0.32 kPa) was measured within one day after ascent. At the end of the stay at altitude (13th day) P-50 values were higher in subjects performing training than in controls. At altitude a slow but constant increase in 2,3-DPG, pyruvate kinase activity and reticulocyte count was found, which was more pronounced in training subjects as compared to controls. Ascent to altitude resulted in a decreased maximal performance capacity (-9%), but both groups recovered during the stay. In training subjects maximal exercise performance was increased after descent. Exercise at altitude was performed at a lower heart rate (controls: -10/min; training: -18/min) and at a lower lactate concentration (-4 mmol/l). These data indicate a positive effect of adaptation to altitude on exercise performance. Training itself shifts the ODC to the right and adds this effect to the effects of passive altitude adaptation on the O2-binding properties of hemoglobin.

Acclimatization↗
PubMed1986

Hypotensive and antiplatelet actions of motapizone depend on dose and time after ingestion.

Single doses of motapizone 1 to 10 mg were given to 12 healthy subjects. Before and up to 8 h after each dose the blood pressure and heart rate were measured, as well as thrombocyte aggregation "ex vivo" with collagen, ADP and adrenaline. Motapizone produced a dose-dependent reduction in diastolic blood pressure and an increase in heart rate. These effects were demonstrated with individual variations after 1 to 3 mg and as a rule they were very marked after more than 6 mg. With the highest dose (mean 7.7 +/- 2.3 mg) the diastolic pressure fell by an average of 23% 1 h after medication as compared to with the baseline values. At the same time there was marked inhibition of thrombocyte aggregation, which also became apparent after about 3 mg and increased in proportion to the dose. The inhibition of aggregation peaked after 2 h and had disappeared within 8 h. The inhibition of ADP-induced aggregation was particularly marked.

Adult↗
PubMed1986

Inhibition of thrombocyte aggregation by oral motapizone and other drugs.

Ten healthy subjects took single oral doses of placebo, 8.8 +/- 1.8 mg motapizone, 40 +/- 13 mg captopril, 25 mg dihydralazine, 20 mg nifedipine and 4.5 +/- 1.1 mg prazosin in random order, and, as the last preparation 500 mg acetylsalicylic acid. Thrombocyte aggregation induced "ex-vivo" with collagen, ADP and adrenaline was measured before and after 60 min. Immediately before each dose, the "threshold concentration" of each agent was determined in each subject, i.e. the concentration producing about 90% of maximal aggregation. After the preparation had been taken, aggregation was induced with 1-, 2- and 4-times the threshold concentration. Both motapizone and also acetylsalicylic acid caused marked inhibition of aggregation at up to 4-times the threshold concentration; the dose ratio was about 1:50. Motapizone produced greater inhibition of the aggregation induced by ADP and acetylsalicylic acid than of that due to collagen. The inhibitory actions after captopril, dihydralazine, nifedipine and prazosin were weak and did not significantly differ from placebo.

Adult↗