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C Ernst

Publications and source records attributed to C Ernst.

At least 19 recordsLinked to original sources
PubMed1996

[Tibial pseudoarthrosis. Treatment using the Ilizarov technique].

In the period from the 1.1.1991 to the 31.5.1993 17 patients with a tibial pseudoarthrosis were treated by the Ilizarov method. The mean age was 35 years (13-88 years). Mean time from fracture to operation for pseudoarthrosis was 14.6 months (3-39 months). There were two hypertrophic, 14 atrophic and one defect pseudoarthrosis. Six of the pseudoarthroses were infected. After stable external fixation the treatment was compression over the pseudoarthrosis in four cases and alternating distraction and compression in eight cases. In five cases the treatment was supplemented by bone transport for the defects between 15 and 50 mm. Mean time of treatment with the external fixator was 5.2 months (2-11.5 months). The overall treatment time was 9.8 months (3-19 months). At the follow-up 14 pseudoarthroses were fully consolidated, one patient was still using an orthosis, and three patients were in need of reoperation with bone transplantation. During the period of fixation thirteen patients were hospitalized for short periods, and some of them several times. The treatments were for correction of the distraction, replacement of fixation of pintrack infection or treatment of pain. The Ilizarov method of treatment of pseudoarthrosis show a good stimulation of healing, but experience with the fixator system and aggressive treatment of various minor complications are essential for a successful outcome.

Adolescent↗
PubMed1995

[Bone lengthening of the extremities using the Ilizarov method].

We describe the indications and the results in 18 bone lengthenings carried out on 14 patients in our department during the period January 1991 to September 1993. Seven patients had limb length inequality, five patients had dysplasia or aplasia, one patient had Turner's syndrome and one patient had suffered traumatic amputation of all the fingers of one hand. The mean lengthenings achieved were: femur 4.9 cm; tibia 5.6 cm; fibula 1.5 cm; humerus 7.5 cm; ulna 3.5 cm; radius 1.9 cm; and metacarpals 1.6 cm. There were 14 cases of pin-problems which needed surgery. Nine cases of infection around the pin holes were treated with antibiotics only. We had five cases with severe pain due to distraction. We had two cases of fracture after removal of the external fixation. Both fractures healed without further problems, but in one case there was three cm loss of the achieved lengthening. Our conclusion is that the Ilizarov method for bone lengthening is a demanding procedure. Because of the many--often minor--complications the patients must be seen frequently, as one must be prepared for "aggressive" treatment of the problems.

Arm↗
PubMed1995

Development of a continuous system for the degradation of a cyanuric acid by absorbed Pseudomonas sp. NRRL B-12228.

Cyanuric acid in high concentrations (15.5 mM) was degraded completely by Pseudomonas sp. NRRL B-12228 independently of glucose concentration. In the batch fermentations there was a relation between the glucose concentration, on the one hand, and the liberation of ammonia or production of protein, on the other. The greater the supply of carbon, the more biomass was produced, and fewer NH4+ ions were released. Continuous fermentations using adsorbed cells could be performed to degrade cyanuric acid. In spite of different glucose feeding there was only a negligible difference in residues of s-triazine. In a one-step continuous system with dilution rates between 0.021 h-1 and 0.035 h-1, even a ratio of 0.65 between glucose and cyanuric acid was not sufficient to degrade the cyanuric acid supplied (320-540 mumol l-1 h-1) completely. When a continuous two-step system was applied with dilution rates between 0.035 h-1 and 0.056 h-1, the consumption of carbon source could be minimized while s-triazine degradation up to 860 mumol l-1 h-1 was complete. In this way the ratio between glucose and cyanuric acid could be increased to 0.25 (molar C:N ratio = 0.33:1). Thereby the process was made considerably more economic.

Adsorption↗
PubMed1995

Utilization of chlorinated s-triazines by a new strain of Klebsiella pneumoniae.

A bacterium utilizing 2-chloro-4,6-diamino-s-triazine (CAAT) as sole nitrogen source was isolated under a N2-free atmosphere and identified as Klebsiella pneumoniae. Concomitant to CAAT degradation the protein content increased and chloride was released into the medium. Under air and a N2-atmosphere no reduction of CAAT degradation resulted, though this strain is able to fix molecular nitrogen, but the decomposition accelerated under anaerobic conditions. The degradation rate increased continuously with increasing CAAT concentration. A continuous CAAT degradation without CAAT accumulation was possible up to a influx rate of 4.8 mumol.l-1h-1 (dilution rate = 0.007 h-1). K. pneumoniae A2 was also able to utilize deethylsimazine (CEAT) and deethylatrazine (CIAT) as nitrogen source. Both under aerobic and anaerobic conditions CEAT could be degraded faster than CIAT. The degradation sequence of mixed s-triazines was cyanuric acid < CAAT < CEAT < CIAT, which was reflected by the degradation times of single compounds. Complete degradation was assumed for all investigated s-triazine derivatives.

Atrazine↗
PubMed1995

Depression in old age. Is there a real decrease in prevalence? A review.

The discrepancy between the constancy or increase of the prevalence of depressive symptoms and dysphoria in old age on one hand, and the decrease in the prevalence of the DSM-III diagnoses of major depression and dysthymia on the other, is discussed in light of the most frequent explanatory hypotheses such as memory defects, interpretation of depressive as somatic symptoms, higher risk of institutionalization as well as higher mortality of depressives and a mitigated course of depression in old age. We conclude that higher mortality, mitigation and the rarity of true late-onset depression are arguments for a real decline in prevalence, which occurs in accordance with the decline in all psychiatric disorders that are connected with emotional upheavals and substance ingestion. On the other hand, the connection of depressive states with somatic illness is strengthened, and according to preliminary validation studies, clinically relevant depressive states not reaching the threshold of DSM-III diagnoses may be typical for the depressive psychopathology of old age.

Adolescent↗
PubMed1994

[Violence-related cases in the emergency ward. A 5-year follow-up of registrations made in 1981 and 1986 at the Esbjerg emergency department].

During six-month periods in 1981, 1986 and 1991 a prospective registration was made of all injuries caused by violence treated in the casualty ward of Esbjerg Hospital. The numbers of such contacts during these periods were 236 in 1981, 379 in 1986 and 509 in 1991. There were no differences between the three periods with respect to the following parameters: age, sex, civil status, place, types of lesions, need for further treatment and influence of alcohol. The total incidence rate rose between 1986 and 1991 from eight to nine per 1000 (not significant). The only significant increase was among females aged 15-19, where the incidence rose from 2.0 per 1000 in 1986 to 11.3 in 1991. Fourteen percent of the injured required hospitalization, occupying 1216 hospital bed days during the 1991 period.

Adolescent↗
PubMed1994

Premorbid personality traits of men who develop unipolar or bipolar disorders.

In 1972, all Swiss males in the Canton of Zurich who reported for a compulsory medical examination for selection for military service were given the Freiburg Personality Inventory. This was repeated in half the sample on three subsequent occasions. From 1983 to 1988, an effort was made to identify all male psychiatric cases. There were 99 unipolars and 26 bipolars. The unipolars who had their age of onset after the personality testing displayed elevated scores on a constellation of symptoms labelled autonomic lability which consisted of items that correlated highly with neuroticism. The trait endured even when it was retested at age 36 years. The bipolars did not differ from the controls in any respect on any occasion.

Adult↗
PubMed1993

[Intraoperative autotransfusion. Reinfusion of erythrocytes in total hip arthroplasty reduces the need for blood from banks].

We have tested a cell-saver system, which collects, washes, concentrates and filtrates red blood cells before autotransfusion. The study consisted of 35 consecutive patients who had a total hip arthroplasty (THA), 18 using the cell-saver and 17 not using it. There was no significant difference in the peroperative bleeding, or in the total blood loss. The median blood loss was 1950 ml (925-6337 ml) in the cell-saver group and 2350 ml (1260-4440 ml) in the control group. The need for homologous transfusion was significantly higher in the control group compared to the cell-saver group, median 500 vs 250 ml of sag-M blood. This difference is of the same magnitude as the amount of autotransfused red blood cells suspended in saline water, median 398 ml. In the cell-saver group nine patients did not need any homologous transfusions at all, whereas in the control group only one did not need any transfusion.

Adult↗
PubMed1993

The Zurich Study. XVII. Sexual abuse in childhood. Frequency and relevance for adult morbidity data of a longitudinal epidemiological study.

In the course of a 10-year longitudinal investigation of young Swiss adults, childhood sexual abuse was assessed at the age of 30 years. It was reported by 11.5% of women and by 3.5% of men; 56% of the females had been abused by relatives (none of the males), 20% by fathers. Abuse cases tended to be more depressed and anxious; they reported more suicide attempts and more sexual problems than controls and also slightly more psychiatric symptoms and neuroticism. Childhood familial risk factors were more frequent for abuse cases than for controls. Depression at adult age was more strongly connected with early familial risk factors than with early sexual abuse.

Adult↗
PubMed1993

The Zurich Study: XXI. Sexual dysfunctions and disturbances in young adults. Data of a longitudinal epidemiological study.

In a cohort of young Swiss adults, sexual disturbances and dysfunctions were assessed by interview four times between ages 20 and 30 years. Over 10 years almost every second female and every third male subject reported disturbances. In females at age 30 years, the prevalence of orgasmic difficulties and of dyspareunia corresponded to non-clinical samples of other studies. Also, in accordance with the literature, impaired interest was much more prevalent in females. In males and females, sexual disturbances were to some extent associated with anxiety and depression; in addition, in women, they were also associated with social phobia and eating disorders. With regard to neuroticism, negative affect and reports of an unsatisfactory childhood, subjects with temporary disturbances resembled more strongly those with chronic problems than controls. Compared with the controls, women's sexual disturbances were more chronic and more strongly associated with minor psychiatric symptoms and personality deviance; this finding was less pronounced in men.

Adult↗
PubMed1993

Current concepts of the classification of affective disorders.

The introduction of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), which uses a descriptive approach to operational definitions of psychiatric diagnostic groups, is an important step forward. Still the present classification systems of DSM or the International Classification of Diseases (ICD) are preliminary. A systematic descriptive approach based on data collection as a foundation for diagnostic definitions is strongly recommended. Data-based definitions have a good change of surviving later changes of diagnostic fashion. Treatment studies will be more valuable when the course of a disorder is included in its definition. The diagnosis of depression has to include operationalized subthreshold syndromes, such as minor depression and recurrent brief depression. In the face of the elementary importance of the distinction between uni- and bipolar disorders, a development of the definition of hypomania is proposed. Based on this definition, bipolar disorders are more prevalent in the normal population than is commonly assumed. Most diagnostic subgroups of depression are artificial. They are not diagnostic entities, but subtypes of the same spectrum disorder. During his/her lifetime, a patient may therefore receive two or more diagnoses, but still suffer from a single disorder. Dual diagnoses, such as double depression and combined depression, define more severely affected patients with major depression, characterized by higher suicide attempt rates. Thus the differentiation of subgroups is more than an academic exercise but has a practical use.

Bipolar Disorder↗
PubMed1992

The Zurich Study. XII. Sex differences in depression. Evidence from longitudinal epidemiological data.

A prospective study of depressive syndromes and diagnoses was performed among a young adult Swiss population with three interviews over 7 years. Different definitions of depressive states were used: on the one hand, depressive syndromes including mood disturbances of any severity, on the other, well-defined diagnoses of depression. Women were consistently overrepresented among subjects with depressive syndromes of some length and among those with DSM-III major depressive disorder. Both sexes appeared equally affected by brief recurrent depressions with work impairment. Between the ages of 20 and 30 years, men as a group in contradistinction to women showed depressive syndromes with decreasing frequency, whereas, for diagnoses, the sex rates remained quite constant. For identical syndromes, women at each interview reported a greater number of symptoms. DSM-III-R symptoms of melancholia were not reported more often by women than by men. When syndromes or diagnoses were controlled, women and men suffered to an equal rate from subjective impairment at work. Women's syndromes were more recurrent. Among women, a diagnosis of depression was more often associated with disturbances of appetite and with phobias than among men. The importance of differential recall for sex differences in prevalence is discussed. Sex differences may have different weight and different causes with regard to depressive syndromes and to a diagnosis of depression.

Adult↗
PubMed1992

The Zurich Study: XV. Suicide attempts in a cohort from age 20 to 30.

The life-time prevalence of suicide attempts in a Swiss population, interviewed four times between the ages of 20 and 30 years, was 3.8% (females 5.4%, males 2.1%). One fifth of the 30-year-olds reported persistent suicidal ideation. In comparison with controls, attempters reported a more disturbed childhood, and subjects with multiple attempts reported more sexual abuse. Over 10 years attempters persistently showed more negative affectivity, more feelings of helplessness and lower self-esteem. At age 30 they were higher on the scales neuroticism, masculinity and aggressivity in a personality test. Over ten years, a higher than expected comorbidity appeared of suicide attempts with depressive and anxiety disorders, with substance abuse, and with sociopathic features.

Adult↗