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Biomedical subjects

B Gerber

Publications and source records attributed to B Gerber.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Experiences with 2 different techniques of breast reduction-plasty].

About 58 patients with reduction mammoplasty is reported. 27 women were operated after the technique of Beller and Wagner, 31 women after the technique of Bostwick. The average weight of reduced breast tissue was about 800 g per side in both techniques. The results are reported and critically discussed. The authors prefer the method of Bostwick because of the possibility of more individuality and variability in breast surgery.

Adult↗
PubMed1995

[Transfusion incidence and indications for homologous blood sparing measures in single stage breast carcinoma operations].

Under a ruling by the Bundesgerichtshof from December 17, 1991 (AZ VI ZR 40/91), the surgeon is obliged to inform a patient about the risks of a possible blood transfusion if the transfusion frequency is 5% or more. Between January 1989 and December 1994, 273 patients with primary breast cancer at the stages pT1-3, N1-2, M0 underwent one-time modified radical mastectomy (n = 164) or a breast conserving operation (n = 109) in our hospital. The number of blood transfusions, pre- and postoperative haemoglobin, age, tumour size, lymph node involvement, kind and duration of the operation and the postoperative course were analysed. In all, 44 of the 273 patients (16.1%) received an homologous blood transfusion perioperatively. The annual transfusion rates were 39.4% (1989), 44.8% (1990), 12.2% (1991), 16.6% (1992) and 3.1% (1993), falling to 2.2% in 1994. The mean pre- and postoperative haemoglobin concentrations did not differ significantly (p > 0.05) over the years: 13.4 +/- 1.0 g/dl and 12.0 +/- 1.1 g/dl in 1989 and 13.7 +/- 1.2 g/dl and 11.8 +/- 1.2 g/dl in 1994. Patients who received transfusions had preoperative anaemia (p < 0.021), bigger tumours (p < 0.0005) and mastectomy operations significantly more frequently than patients not given transfusions. There were no correlations between transfusions and age, lymph node involvement and kind and duration of operation. We conclude that, cognizant of a transfusion frequency of 2.2% in our hospital in one-time breast cancer operations, only patients with anaemia or large tumours require blood transfusions, for which autologous blood donations or normovolaemic haemodilution are the choices. The patients' attention is to be drawn to these. In cases of normal preoperative haemoglobin and small tumours, the physician should inform the patient that experience has shown that in all probability a blood transfusion will not be necessary and so a preoperative autologous blood donation or normovolaemic haemodilution can be dispensed with.

Adult↗
PubMed1994

Recombinant human leukemia inhibitory factor is mitogenic for human bone-derived osteoblast-like cells.

Recombinant human leukemia inhibitory factor (rhLIF) is mitogenic for human bone-derived osteoblast-like cells in vitro. [3H]-thymidine incorporation into DNA was stimulated dose-dependently in a prostaglandin E2-independent manner. rhLIF exerted no effect on either the basal or 1,25(OH)2D3-induced synthesis of osteocalcin or alkaline phosphatase (AP) activity. Following treatment with rhLIF, radiolabelled cell nuclei were co-localized with AP, indicating that the mitogenic effect of rhLIF occurs on cells of the osteogenic lineage. Local generation of LIF at the human bone surface may therefore serve as a potential autocrine/paracrine mitogen for progenitor cells of the osteoblastic lineage and so could correlate with the known bone forming properties of LIF.

Alkaline Phosphatase↗
PubMed1994

[Diagnosis of urinary tract infections in puerperium].

Urinary tract infections (UTI) are the most frequent nosocomial infections of women during puerperium. Since, in these women, diagnostic accuracy is affected by lochial secretion, suprapubic urinary bladder puncture (SPB) is recommended. Between December 1989 and January 1993, we subjected 903 women to suprapubic urinary bladder puncture (SpBP) at the 4th or 5th day after delivery. A urine culture of SpBP was done in all cases. Semiquantitative leukocyte counts (n = 891) and nitrite test (n = 830) were done on mid-stream urine (MSU). Side by side with microbiological investigation for urinary tract pathogens via SpPB, MSU was performed in 246 cases immediately after SpPB had been carried out. Leukocyte counts were also estimated in SpBP urine samples. In 370 (41.1%) of 903 SpBP, one or more microorganisms were cultivated. Only 36 (4.0%) of 903 women showed UTI symptoms. Microorganisms were detectable via SpBP in only 26 (72.7%) of these 36 symptomatic patients. Vaginal-operative or secondary caesarean section are related to an increased UTI rate (p < 0.001). UTI were also significantly (p < 0.0001) more frequent in women subjected to catheterisation sub partu (54.5%) compared to no catheterism (24.4%). No significant differences between the number of leukocytes in MSU sediment and the SpBP findings were seen. Semiquantitative leukocyte counts in SpBP offered a significantly (p < 0.001) increased number of leukocytes in cases with microorganism detection in SpBP irrespective of MSU findings. These results justify the designation of uterine tract infection also in the absence of complaints as "infection" and not common "bacteriuria".(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteria↗
PubMed1994

[Changes in surgical treatment of cystic teratoma--620 cases].

Among 3492 patients with ovarian tumors subjected to operation between 1/1957 and 3/1994 at the Department of Obstetrics and Gynaecology at the University of Rostock 620 (17.8%) cases of teratomas were found. Histology findings, age, tumor size, bilaterality and malignity of these 620 cases were analyzed. The histologic differentiation yielded 604 (17.3%) mature teratomas (dermoid cysts), 15 monodermale and 1 immature teratoma. Division of total period in the time before and after 1990-since then we have got the possibility of laparoscopic operation-reveals that presumably by increasing use of ultrasound a decrease in mean age at time of diagnosis from 40.2 +/- 20 to 30.7 +/- 12 as well as in tumor size (9 +/- 4 resp. 4 +/- 2 cm) has been achieved. A secondary malignant transformation of epithelial component has been found in 0.5% (3/604) and bilaterality in 11% of the cases. With regard to general rules of laparoscopic operations the intact dermoid cyst enucleation is recommended in premenopausal and extirpation in postmenopausal women. For opening, reduction of volume, and removal of the dermoid cyst from the abdominal cavity, an endo-bag or endo-catch respectively should be used.

Adolescent↗
PubMed1994

[Puerperal and non-puerperal mastitis].

Report about 82 women with inflammatory breast diseases, who were hospitalized during january 1988 and december 1993. 37 women had a puerperal mastitis, 39 women a non-puerperal mastitis and 6 had perimamillary abscesses. In 35 (42.7%) of the 82 patients abscesses occurred. The different etiology and bacteriology as well as resulting treatment guidelines are discussed. In the treatment of puerperal mastitis, staphylococcus effective penicillins keep the first place. The therapy of non-puerperal mastitis consists in prolactin inhibiting drugs and broad spectrum antibiotics. In abscesses and fistulas surgical treatment is necessary, the same in recurrences. If the process is suspicious for breast cancer diagnostic excision is to perform.

Abscess↗
PubMed1994

Plasma clozapine concentrations predict clinical response in treatment-resistant schizophrenia.

Steady-state blood clozapine concentrations in 58 schizophrenic patients varied more than 45-fold (40-1911 ng/mL) after fixed-dose treatment (400 mg/day). Discriminant function analysis determined that a blood clozapine concentration of 420 ng/mL optimally distinguished responders from nonresponders. After 4 weeks of treatment, only 8% of those patients with a blood clozapine concentration < 420 ng/mL responded compared with 60% of those who had a blood clozapine concentration > 420 ng/mL. When plasma concentrations were increased above 420 ng/mL (by a double-blind random assignment procedure), nonresponders increased their response rate to 73% if their plasma concentrations at Week 12 exceeded 420 ng/mL compared with a response rate of 29% if their Week 12 levels remained below 420 ng/mL (chi 2 = 4.2, p < .04).

Adult↗
PubMed1994

[Postmenopausal hemorrhage and endometrial cancer in tamoxifen therapy].

Report about 8 patients with endometrial pathology during tamoxifen therapy: 1 endometrial cancer, 1 adenomyosis uteri and 6 endometrial polyps. The knowledge about effects of tamoxifen on endometrium and possibilities of prevention are discussed. Sonographic screening of patients during tamoxifen therapy and if need by endometrial biopsy is necessary especially if tamoxifen is given longer than 2 years. No more than 30 mg should given in adjuvant therapy.

Aged↗
PubMed1993

Functional significance of the A-current.

This work considers the response to simulated synaptic inputs of an excitable membrane model. The model is essentially of the Hodgkin-Huxley type, but contains an A-current in addition to sodium and delayed-rectifier potassium channels. The results were compared with previous simulations in which the stimulus was an injected current. These two types of stimuli give somewhat different results because synaptic stimuli directly change the membrane resistance, whereas injected current does not. The results of synaptic stimulation were similar to injected current in that very low frequencies of action potentials were elicited only where the stimulus was slightly above threshold. For most of the range of synaptic inputs that produced oscillatory behavior, the A-current had little effect on oscillation frequency. With synaptic stimuli as with injected current, the model membrane's spiking behavior does not begin immediately when an excitatory stimulus is imposed on a quiescent state. The delay before spiking is closely related to the inactivation time of the A-current. The synaptic results were different from the injected current results in that when substantial inhibition was present, the ability to produce very-low-frequency spiking was absent, even just above the excitatory threshold. The higher the degree of inhibition, the narrower the range of spike frequencies that could be elicited by excitation. At very high inhibition, no degree of excitation could elicit spiking.

Action Potentials↗
PubMed1993

Glycosylation of acute phase proteins and interleukins following hip arthroplasty. Inflammation parameters studied in 10 patients.

We analyzed changes in glycosylation and serum concentrations of alpha 1-acid glycoprotein (AGP), antichymotrypsin (AC), interleukin-6 (IL-6), soluble interleukin-2 receptor (sIL-2R) and C-reactive protein (CRP) following hip arthroplasty. Glycosylation of AGP and AC showed an increased reactivity to concanavalin A between postoperative Day 2 and Day 5 and Day 10, respectively. Serum levels of AGP and AC increased at the earliest on Day 5. The AC levels returned to baseline by Day 10. AGP, however, exhibited increased values beyond Day 14. CRP levels were elevated at Day 2 and remained increased beyond Day 14. sIL2R showed increased values at Days 5, 10 and 14. IL-6 was the first parameter to increase, and it returned to baseline in less than 5 days.

Acute-Phase Proteins↗
PubMed1993

[Granular cell tumor of the breast].

Report about a 46 year old women with granular cell tumor of the breast. Clinical features, mammography and sonography has appearances highly suspicious for breast cancer. Tumorectomy and axillary lymphonodectomy were performed. Estrogen and progesterone receptor both were histochemically and biochemically negative. Estradiol and prolactin levels in serum were normal. Cathepsin D in cytosol was slightly elevated, DNA-flow-cytometry revealed no signs of malignancy. Evident was the high content of protein S100 in cytosol of tumor cells.

Adipose Tissue↗
PubMed1992

[Treatment of acute salpingitis with tetracycline/metronidazole with or without additional balneotherapy, Augmentin or ciprofloxacin/metronidazole: a second-look laparoscopy study].

110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Possible dual effect of synapses that are putatively purely excitatory or purely inhibitory: bases in stability theory and implications for neural network behavior.

Depolarization of an excitable membrane has a dual effect; excitatory in that it causes rapid opening of calcium and/or sodium channels but inhibitory in that it also causes those channels to inactivate. We considered whether apparently paradoxical or dual behavior might be exhibited by excitatory and inhibitory synaptic inputs. We used the classic Hodgkin-Huxley model for voltage-gated channels plus leakage channels of appropriate selectivity for ligand-gated postsynaptic channels. We summarize a model cell's behavior by calculating elicited firing frequency as a function of reversal potential and conductance of summed synaptic inputs, using stability theory and direct simulations. Dual behavior is elicited in the model with reasonable densities of ligand-gated channels. Thus a particular synaptic input to a neuron may be either excitatory or inhibitory depending on simultaneous activity of other synaptic inputs to the cell. This input-output map may give rise to biologically realistic and rich behaviors as an element of computed neural networks, and still be computationally tractable.

Animals↗
PubMed1991

[Late metastasis of a breast carcinoma to the uterine corpus and cervix].

In a 55-years-old woman 11 years after radical operation of a left-sided breast cancer a late metastasis in the uterine corpus was diagnosed and treated by subtotal hysterectomy. In the further course a carcinoma developed in the opposite breast, which may be most probably a second primary breast cancer. However a contralateral metastasis of the earlier treated breast cancer cannot certainly be excluded. Finally, a metastasis of the left sided-breast cancer was diagnosed in the uterine cervix. This case shows, that gynaecological bleedings also may be caused by atypical metastasis of a breast cancer.

Breast Neoplasms↗
PubMed1991

[Image analytic DNA cytometry--a possibility for assessment of prognosis after resection of ductal pancreatic cancers?].

In this study we analysed DNA-ploidy as a potential prognostic parameter in ductal pancreatic carcinoma. Paraffin embedded histological material, obtained by resection from 34 patients with a ductal pancreatic carcinoma, was selected for analysis. Tumor areas within the paraffin embedded material were identified by HE-stained reference sections. One 50 microns section was dewaxed, rehydrated and mechanically and enzymatically prepared to form a suspension of 10000 cells/ml. One milliliter of the suspension, which contained bare nuclei with small rests of cytoplasma, was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen SITS technique, which allows for the quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single-cell cytophotometry. In contrast to using flow cytometry, only the tumor cells were measured by image-cytometry. Overlapping nuclei, dirt and other artifacts as well as inflammatory cells were efficiently eliminated. With DNA image-cytometry, we could differentiate between hypotriploid, triploid, hypertriploid and tetraploid tumors. The DNA-content provided the strongest influence on prognosis in the multivariate analysis.

Carcinoma, Intraductal, Noninfiltrating↗
PubMed1991

The decision to execute a durable power of attorney for health care and preferences regarding the utilization of life-sustaining treatments in nursing home residents.

One hundred three nursing home residents were interviewed regarding their preferences for the choice of an agent for health-care decision making while being offered the opportunity to execute a Durable Power of Attorney for health care. They also completed a questionnaire that tapped their preferences regarding the use of four types of life-support treatment under three hypothetical levels of future cognitive functioning. Factors that might influence these preferences, such as previous experiences with life-sustaining treatments, religious beliefs, and personal values, were also examined. Participants tended to choose their son or daughter as their agent for future health-care decision making. They had clear and consistent patterns of preferences regarding the utilization of life-sustaining treatment. Generally, participants opted not to be treated, although there was variability among participants. They were even less inclined to opt for treatment as their perceived level of future cognitive functioning declined, or when the life-sustaining treatment involved permanent rather than temporary procedures.

Aged↗
PubMed1989

[Endometrial findings in long-term treatment with synthetic sex steroids in Turner syndrome].

In 9 patients with Turner's syndrome (karyotype 45/X0) aged from 23 to 50 years (average age 34 years) a curettage was performed. In these women there has been a treatment with mestranol 80 micrograms or ethinylestradiol 50 micrograms and chlormadinome acetate 2 mg as a sequential therapy in a cyclic manner for 5 to 22 years. Additionally in 3 patients a biopsy from the uterine cervix was performed because of abnormal colposcopic findings. Only in one patient an atrophic endometrium was found, whereas in the other patients the endometrium showed a weak proliferation or a slight secretion. Ectasia of the endometrial glands was observed in 4 patients. A hyperplastic endometrium wasn't found in any patient.

Adult↗