[Handling of an intravascular catheter by nursing personnel].
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Biomedical subjects
Publications and source records attributed to W Kraus.
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In a study designed to evaluate esophageal motor function in muscular dystrophy we examined 13 patients with myotonic dystrophy, 14 patients with "nonmyotonic" muscular dystrophy, and 8 healthy control subjects by manometric and radionuclide transit studies. Patients with myotonic dystrophy exhibited a marked weakness of esophageal contractions and upper esophageal sphincter pressure. Coordination of sphincter relaxation and peristaltic sequences remained unaltered. These changes led to delayed esophageal emptying in all patients with myotonic dystrophy. Although esophageal function was also impaired in the distal esophagus, on histologic studies, morphologic alterations were confined to esophageal striated muscle in a single patient with myotonic dystrophy. In contrast to the marked dysfunction of esophageal motility in patients with myotonia, no such alterations were observed in the "nonmyotonic" form of muscular dystrophy.
120 patients suffering from malignant melanoma were examined by means of 10-Mcs sonographic scanner for the detection of regional lymphatic metastases. Metastases appeared as circumscribed regions of very low echodensity and could readily be separated from benign alterations. Sonography of the regional lymph nodes, therefore, proved to be a useful technique for the follow-up of melanoma patients.
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In alkaptonuria, a recessively inherited disturbance of amino acid metabolism, deposits of oxydation products of homogentisinic acid result in the disease pattern of ochronosis. Due to the enhanced brittleness of the supporting and gliding tissue, ochronotic arthropathy develops at the vertebral column and later at the major joints with typical roentgenological changes especially in the intervertebral space and the intervertebral disk, as well as the adjacent vertebral bodies. The bone scintigram shows enhanced accumulation in the base and tectorial plates as well as in the adjacent sclerosing zones in the spongiosa of the affected vertebral bodies.
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Two membrane associated placental tissue proteins (PP4 and MP1) have been isolated and characterized. Both proteins are found in the soluble as well as solubilized protein fractions of the human placenta and thus appear to be at least partly associated with placental membranes. PP4 has a molecular weight of 35000 and apparently consists of a single peptide chain. It has an electrophoretic mobility in between the alpha 1- and alpha 2-globulins, an isoelectric point of 4.85 and a sedimentation coefficient of 3.3 S. The carbohydrate content of PP4 amounts to 2.4%. MP1 was isolated from placental protein fractions solubilized with Triton X-100. It has a molecular weight of around 18000 and appears to be composed of two identical subunits which are non-covalently linked. MP1 was found to have an electrophoretic mobility in between the alpha 2- and beta 1-globulins, an isoelectric point of 4.75 and a sedimentation coefficient of 6.65 S. MP1 is a glycoprotein which contains 9.6% carbohydrates. Immunochemical methods were used to detect and quantitate PP4 and MP1 in extracts of placentae and other human tissues. MP1 appears to be specific to the placenta, whereas PP4 was found to occur also in certain other human tissues. The diagnostic significance of detection and measurement of these proteins in tissues and body fluids is presently under investigation.
Two widely used in vitro systems of Escherichia coli capable of synthesizing murein were evaluated by using high-pressure liquid chromatography for murein analysis. Comparison of the composition of murein synthesized by either a membrane preparation or ether-treated cells with native murein revealed that both in vitro systems failed to synthesize murein that was identical to murein formed in vivo. Furthermore, neither system attached the lipoprotein to the murein. Ether-treated cells, however, were superior to the membrane preparation in catalyzing the formation of the remarkable A2pm-A2pm cross-linkage. In both systems an atypical transpeptidation reaction was found to take place in which exogenously supplied UDP-N-acetylmuramylpentapeptide was directly linked to the murein without participation of the bactoprenol lipid carrier. The direct transpeptidation yields preferentially trimeric peptide bridges with the UDP-linked muramylpentapeptide serving as the acceptor.
High-resolution real-time sonography enables visualization of the morphology of the cutis and subcutaneous layers. Evaluation of 19 malignant melanomas showed that tumors of a thickness of more than 0.6 mm can be seen sonographically. Malignant melanomas are revealed as nodules with very sparse internal echoes and sharp delineation, situated in the upper cutis. Infiltration of the subcutis can be shown reliably. The sonographically measured values of maximal tumor thickness show a good correlation with those determined postoperatively by histometry (r = 0.95). Regional metastases of melanomas and recurrencies are also revealed as sharply limited lesions with very few internal echoes. They can readily be separated from benign regressive nodules. Out of 237 examinations, the 181 evaluated ones showed a sonography sensitivity of 95% and a specificity of 99%. Therefore, an earlier diagnosis of regional metastases and recurrencies, as well as more precise indication for second operations during melanoma tumor follow-up can be made, and, in future, the decision for primary regional lymphonodectomy may be influenced. High-resolution sonography is thus a diagnostic imaging method which helps to evaluate preoperatively both malignant melanomas and their regional lymphatic areas.
In 96 patients in urological treatment the 10 MHz high resolution B-scan sonography proved to be a valuable complement to inspection, palpation and diaphanoscopy. A distinction between testicular, extratesticular, cystic and solid lesions could be made with great reliability. Masked testicular neoplasia associated with hydroceles testis and epididymitis can be detected earlier with sonography. However, great care must be taken when differentiating benign from malign changes in the testicles and epididymis. Testicular neoplasia, focal orchitis, testicular abscess and chronically inflamed tumours of the epididymis have a similarly lowered echogenicity and a tumour-like picture. Focal areas of increased testicular echogenicity in all cases represented benign calcifications, fibrosis or cicatricial tissue. Operative exploration is obligatory when the dignity of the lesion is unclear.
The volume of 15 autopsied thyroid glands was determined by fluid displacement and compared with their sonographically obtained stereometric volumes. Maximum variation was 8.6%. Thyroid volumes were measured by ultrasound in 100 volunteers between ages 15 and 36. Total mean value was 19.8 ml. with a mean value of 22.1 ml. in the male group and 17.8 ml. in the female group. 20 volunteers had an additional scintigraphic examination. The thyroid volumes estimated by scintiscanning differed up to 85% with the volume measurements from sonography. Sonography scans were obtained from 6 autopsied thyroid glands and compared with the corresponding tissue slices. Tissue structures were reproduced with great accuracy by ultrasound.
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The use of high-resolution ultrasonic instruments with transducer frequencies above 8 MHz makes it possible to visualize malignant melanomas of a thickness of more than 0.7 mm. While the sonolucent structure has not permitted the dignity of a lesion to be judged to date, it is easy to determine the maximal tumor thickness as well as infiltration of the subcutis. Thus "low-risk" and "high-risk" melanomas may be differentiated preoperatively according to these parameters. The results are of great use for the operator to plan the extent of his intervention, as well as to select patients for prophylactic regional lymphonodectomy.