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Biomedical subjects

B Marschall

Publications and source records attributed to B Marschall.

At least 19 recordsLinked to original sources
PubMed2003

["Problem-based learning--inflammation and transplantation": an integrated, subject-centred course in the clinical section of the medical curriculum at the medical school of the University of Muenster].

Conventional medical curricula present information pertinent to chronic inflammatory diseases, infectious diseases and transplantation, via systematic lectures and courses in medical specialties without any integrated approach. The authors report on a 3-week model course that attempts to provide students with an overview of clinical presentation, diagnostics, and therapy of representative disease entities with particular emphasis on the interdisciplinary approach to these problems in hospital practice. In addition to problem-based learning in small groups, the model course comprises interdisciplinary concept lectures, practical demonstrations of specific diagnostic procedures, and bedside teaching. In the meantime, the course "Problem-Based Learning--Inflammation and Transplantation" has been held twice successfully as a mandatory course in the clinical part of the curriculum at the Muenster Medical School.

Autoimmune Diseases↗
PubMed2000

Cadaveric "two-in-one" kidney transplantation from marginal donors: experience of 26 cases after 3 years.

BACKGROUND: Because of the problem of organ shortage, the use of renal transplants from marginal donors has been tested by different procedures. METHODS: In our center 26 recipients (59 +/- 7 years) underwent double renal transplantation from July 1996 to August 1999 using marginal donors (71 +/- 6 years). A special scoring was applied that included donor age, serum creatinine, the grade of glomerulosclerosis, and kidney weights leading to the decision whether single or dual or no kidney transplantation was performed. RESULTS: After an average follow-up of 18 +/- 10 months 22 of 26 (85%) double kidney transplant recipients are alive and have functioning grafts. Three patients died with well-functioning grafts. The actuarial 1-year patient and graft survival rate was 94% (n=18), the 2-year rate 92% (n=12). Two patients lost one graft each without becoming dialysis dependent. The average serum creatinine was 1.6 +/- 0.5 mg/dl after 12 months (n=17) and 1.9 +/- 0.6 mg/dl after 24 months (n=11). Primary nonfunction occurred in 31%, acute rejection within the first 6 months in 14%. Ten patients who received single old grafts according to our score had similar transplant survival rates but worse graft function after 1 year. CONCLUSIONS: Transplant function and survival of patients after dual kidney transplantation indicate that this procedure is reasonable to ameliorate the problem of organ shortage. The most crucial point is to establish a widely accepted standardized scoring for the donors leading to single, dual, or refusal of transplantation.

Aged↗
PubMed1998

Site-directed mutagenesis of boar proacrosin reveals residues involved in binding of zona pellucida glycoproteins.

Proacrosin, the zymogen form of the serine protease beta-acrosin, is thought to function as a secondary binding molecule between mammalian gametes during fertilization (Jansen et al., 1995: Int J Dev Biol 39, 501-510). The interaction involves strong ionic bonds between positively charged amino acids on proacrosin and negatively charged polysulphate groups on zona pellucida glycoproteins. In this investigation, we identified the basic residues on proacrosin that are important for this binding. Site-directed mutagenesis shows that two groups of amino acids comprising His47, Arg50, and Arg51 together with Arg250, Lys252, and Arg253 are crucial because their deletion or replacement severely reduces affinity for zona glycoproteins. Molecular models of proacrosin reveal that these residues are located along one face of the protein on two exposed surface loops that project over and around the catalytic site. These findings support the hypothesis that polysulphate binding sites on proacrosin are formed by a restricted number of basic amino acids on the surface of the protein, presenting a specific orientation that is complementary to negatively charged sulphate groups on zona glycoproteins. Identification and elucidation of the stereochemistry of these charged moieties will aid design of new kinds of nonsteroidal antifertility agents.

Acrosin↗
PubMed1998

[Clinical anatomy as an integrating element in teaching surgical subjects].

Different conceptions to revise the licensing regulations for physicians (Approbationsordnung für Arzte) aim to interlock preclinical and clinical subjects. Therefore a more practice-oriented anatomy has to be taught in basic and postgraduate medical education. At the Westfalian Wilhelms University of Münster we established an interdisciplinary anatomical education, executed by clinical lecturers in cooperation with the educational staff of the Department of Anatomy. The intergral element is the comprehensive constitution of clinical anatomy: clinical practitioners of different specialties together with anatomists give lessons in applied anatomy accompanying the dissection course. Clinically experienced lecturers of anatomy guide senior medical students in practical courses, refreshing their anatomical knowledge using particular prosections. These courses correlate with the topics of the distinct clinical tutorials. Conjointly clinical practitioners and anatomists plan, and perform meetings in postgraduate medical education.

Anatomy↗
PubMed1998

[Results of double kidney transplantation from elderly donors].

From July 1996 to November 1997 13 patients underwent "two-in-one"-kidney transplantation from marginal donors. Up to now all renal grafts show a stable function measuring an average creatinin of 1.73 mg/dl after an average follow up of 8.2 month. To take the decision between "one-in-one" or "two-in-two" transplantation in marginal donors we developed a specific score. This score needs more evaluation because of the still small amount of patients undergoing double-kidney-transplantation.

Age Factors↗
PubMed1997

Follow-up study among model and pattern makers in a German automobile company. Results of a second follow-up.

An historical follow-up study of 528 model makers in a German automobile company found an unusual pattern of mortality among these workers that included an increased risk of total cancer and tumors of the stomach, genitourinary organs, and the brain (Becker et al, 1992). Because of small numbers of cases and problems with the validity of causes of death, we carried out a second follow-up using data from the official mortality statistics and extending the observation period by five years. The new results did not confirm the previous observations of an increased risk of total cancer, cancer of the genitourinary organs, and tumors of the brain but confirmed indications of an increased risk of stomach cancer and suggested for the first time that there may be an increased risk of cancer of the intestine. Though the small numbers of cases did not allow statistical confirmation of these findings, they are consistent with the results of other studies recently conducted in the United States and published in this journal.

Automobiles↗
PubMed1996

Changes in local cerebral blood flow by neuroactivation and vasoactivation in patients with impaired cognitive function.

Imaging of local cerebral blood flow (lCBF) may serve as an important supplementary tool in the aetiological assessment of dementias. In early or preclinical disease, however, there are less characteristic changes in lCBF. In the present study it was investigated whether vasoactivation or neuroactivation may produce more pronounced local lCBF deficits. Local CBF was investigated by using technetium-99m hexamethylpropylene amine oxime and single-photon emission tomography (SPET) in 80 patients (50 with mild cognitive impairment and 30 with dementia of Alzheimer type (DAT), all without evidence of cerebrovascular disease) at rest (baseline) and during activation. In 31 studies patients underwent vasomotor activation with acetazolamide, while 62 studies were performed under cognitive challenge (neuroactivation by labyrinth task). Cortical activity relative to that of cerebellum increased significantly in a right temporal region and tended to increase in other cortical regions upon vasoactivation. In contrast, neuroactivation reduced cortical activity relative to that of cerebellum in several left and right temporal and in left parietal regions. Visual classification of SPET images of patients with probable DAT by three observers resulted in a reduction of the number of definitely abnormal patterns from 9/12 to 4/12 by vasoactivation and an increase from 10/18 to 15/18 by neuroactivation. Correspondingly, abnormal ratings in patients with mild cognitive dysfunction were reduced from 7/19 to 5/19 by vasoactivation and were increased from 12/21 to 18/21 by neuroactivation. In conclusion, vasoactivation does not enhance local relative perfusion deficits in patients with cognitive impairment of non-vascular aetiology, whereas neuroactivation by labyrinth task produces more pronounced local flow differences and enhances abnormal patterns in lCBF imaging.

Acetazolamide↗
PubMed1992

Chlamydia trachomatis infections in a Greenlandic district.

During the period 1.XI.1985-20.III.1986 all patients attending the venereal disease (VD) in Maniitsoq Sukkertoppen, Greenland were examined for gonorrhoea according to general routines in Greenland supplemented with procedures for identification of chlamydia trachomatis (CT) infections including culture on McCoysells and identification by FITC-labelled monoclonale antibodies, both performed by Statens Seruminstitute in Copenhagen. 261 patients were examined. Prevalence of gonorrhoea was 0.33 and of CT infections 0.34. Two thirds of female CT infections were found in ages below 20 years and practically all cases below 25. In males two thirds were younger than 25 years, and it was noticed that gonorrhoea was more prevalence than CT infections. Diagnostic problems arose in 1/3 of cases with mixed infections. Identification techniques for CT infections are difficult to perform in Greenland, so other diagnostic tests are needed. Finally it is recommendable to introduce a standard treatment in Greenland, covering gonorrhea as well as CT infections.

Adolescent↗
PubMed1992

Follow-up study among model and pattern makers in an automobile company in the Federal Republic of Germany.

The follow-up of a cohort of 528 model makers and a control group of 2273 tool makers shows an unusual pattern of mortality in the model makers' cohort. In contrast to the usual ranking, malignant neoplasms are the most frequent group of cause of death followed by diseases of the cardiovascular system. The rate ratio (RR) for malignant tumors is significantly increased among model makers compared with tool makers RR = 1.8, (95% confidence level [CL] = 1.3-2.7). The sites affected by excess cancer were stomach, the genitourinary organs, and the brain. In contrast to other studies, no tumors of the large intestine have been observed. Furthermore, there is a remarkable underrepresentation of tumors of the respiratory organs. Because these results are based on a rather small number of cases, further follow-up of the cohort is warranted to draw more profound conclusions.

Adolescent↗
PubMed1991

[The value of daily allowance certificates for sociomedical treatment].

In the Tarup district of Odense, an investigation was carried out concerning certificates in connection with maintenance allowances during a period olf two months. A total of 148 maintenance allowance certificates were collected consecutively for one month. Correspondingly, 81 certificates concerning 44 cases which were the subjects of sociomedical analysis were collected during the subsequent month, Four fifths of the certificates were written by the general practitioners. About half of the certificates were only of limited value for analysis of the cases, while one fifth supplied constructive supplementary information. Women in the age group 40-49 years were overrepresented and conditions in the locomotor system predominated (30-50%). These were followed by mental problems and disturbances with 14% and 11%, respectively. Great differences were found between the durations of sick-leave as assessed in the certificates and the factual durations. As assessment of the duration of sick-leave is important for the course of the maintenance allowance, an alteration in the certificate forms is proposed so that maintenance allowance cases are easier to classify.

Adult↗
PubMed1989

[Referral of non-traumatic emergencies treated during after-office hours, the Sukkertopp, in 1985].

All of the emergencies of non-traumatic nature in the Sukkertop/Maniitsoq medical district in Greenland were registered during the year 1985. A total of 601 patients in which the sexes were equally represented were registered. Two thirds of these sought medical advice during the weekends, mainly between 10.00 and 17.00 hours. On weekdays, these patients came between 16.00 and 20.00 hours. The clientele involved was young and 1/4 were under the age of two years. 2.5% of these were admitted and 15% were followed up in the outpatient department. One fourth of the patients were given advice only and these consultations were interpreted as unnecessary. The disease pattern was distributed over 73 diagnoses and these could be summarized in 18 main groups. More than half of the consultations involved common, slightly infectious diseases and these were the reason for a two humped seasonal variation. It was considered that a number of the consultations occurred because of defective knowledge about health and these indicate a need for improved health information. Other conditions such as alterations in the structure of the health system, establishment of district health nursing and employment of the knowledge about variation in the pattern of consultations may lead to improved function in the health system.

Emergency Service, Hospital↗
PubMed1989

[Stress and strain analysis in monitoring functions in a fully automated production plant].

The introduction of new technologies in the automobile industry produces a substantial structural change. This change may lead to a decrease in physical work with a contrary increase in mental and emotional stress at monitoring and controlling tasks. A summarizing analysis of the stress was made by means of the "Arbeitswissenschaftliches Erhebungsverfahren zur Tätigkeitsanalyse (AET)" and for characteristic working conditions the energy expenditure during work was measured. As indicators of strain, the heart rate was registered continuously with portable magnetic tape recorders and additionally the urinary excretion of adrenaline and noradrenaline was analyzed. During and after the implementation of new technologies a shift from physical to mental and/or emotional stress could be observed, but the remaining components of physical load are not to be disregarded and the changing strain patterns have to be analyzed carefully during the transitional stages of the implementation process.

Automation↗