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Biomedical subjects

C Schlegel

Publications and source records attributed to C Schlegel.

At least 19 recordsLinked to original sources
PubMed2004

[Cost-of-illness Study for the Treatment of COPD in Germany].

The present cost-of-illness study is focused on the costs of COPD in Germany. In a pre-study, data on 814 randomly selected patients were collected to achieve reliable figures for the distribution of COPD severity grades and the frequencies of exacerbations. The main study was performed on 321 randomly selected patients from the pre-study. Data on resource use were collected in a face-to-face interview with the respective physicians using the patient records as a basis. Costs associated with resource consumption were weighted with the frequencies of COPD severity grades as assessed in the pre-study to determine the costs of COPD. Annual COPD-related costs per patient were 3,027 from the societal perspective. Main cost components were hospitalisations (26 %), medication (23 %) and early retirement (17 %). Annual COPD-related costs from the perspective of the German health insurance system (GKV) were 1,944 euros per patient.

Cost of Illness↗
PubMed2003

Phase II trial of intralesional therapy with interleukin-2 in soft-tissue melanoma metastases.

The objective of the present study was to validate the use of intralesional injection of interleukin-2 (IL-2) in patients with skin and soft-tissue melanoma metastases. A total of 24 patients with AJCC stage III or IV melanoma and single or multiple skin and soft-tissue metastases were included. Interleukin-2 injections were administered intralesionally into the total number of cutaneous and soft-tissue metastases accessible from the skin, 2-3 times weekly, over 1-57 weeks. Single doses varied from 0.6 to 6 x 10(6) IU, depending on lesion size. The clinical response was monitored by sonography and confirmed by histopathology; response evaluation was confined to the intralesionally treated tumours. Complete response (CR) of the treated metastases was achieved in 15 patients (62.5%), the longest remission lasting 38 months to date. In five patients, partial response (PR) was achieved (21%) and in another three patients, progressive disease was observed (one patient not assessable). A total of 245 metastases were treated with CR in 209 (85%), and PR in 21 (6%). The therapy was generally well tolerated; the observed adverse events were mainly of grade 1-2 severity. Immunohistochemical studies showed the tumour cells undergoing apoptosis and revealed a mixed character of the inflammatory infiltrate. The unusual high CR rate in metastatic melanoma of 62.5% and the limited toxicity suggest that treatment of skin and soft-tissue melanoma metastases with intralesional injection of IL-2 may be a safe and effective alternative to conventional therapies. The optimal dosage and duration of this therapy still remain to be defined in larger prospective multicentre trials.

Adult↗
PubMed2002

Localization of functional calcitonin gene-related peptide binding sites in a subpopulation of cultured dorsal root ganglion neurons.

In this study we investigated whether cultured dorsal root ganglion (DRG) neurons from the adult rat express binding sites for calcitonin gene-related peptide (CGRP). These were identified on fixed cells by using CGRP labeled at the N-terminal site with 1.4-nm gold particles. After 1 day in culture, about 20% of small to medium-sized DRG neurons showed CGRP-gold binding. Binding of CGRP-gold was dose-dependently reduced by coadministration of CGRP. The calcium imaging technique in living cells revealed that the bath administration of CGRP evoked an increase of the intracellular calcium in up to 30% of the DRG neurons tested. Both depletion of intracellular calcium stores by thapsigargin or using a calcium-free medium blocked the CGRP-mediated increase of cytosolic calcium in most neurons. Thus intracellular and extracellular sources of calcium are relevant for the CGRP response. Using the whole-cell patch-clamp technique, about 30% of the neurons were found to exhibit an inward current and a depolarization upon administration of CGRP close to the neurons. Immunocytochemical double-labeling techniques showed that most of the CGRP-gold binding sites were expressed in unmyelinated (neurofilament 200-negative) DRG neurons. Most of the neurons with CGRP-gold binding sites also expressed the tyrosine kinase A receptor, and all of them showed CGRP-like immunoreactivity. This study shows, therefore, that a subpopulation of unmyelinated, peptidergic primary afferent neurons express CGRP binding sites that can be activated by CGRP in an excitatory direction. The binding sites may serve as autoreceptors because all of these neurons also synthesize CGRP. The activation of CGRP binding sites may sensitize primary afferent neurons and influence the release of mediators.

Animals↗
PubMed2001

Photoneutron cross sections for unstable neutron-rich oxygen isotopes.

The dipole response of stable and unstable neutron-rich oxygen nuclei of masses A = 17 to A = 22 has been investigated experimentally utilizing electromagnetic excitation in heavy-ion collisions at beam energies about 600 MeV/nucleon. A kinematically complete measurement of the neutron decay channel in inelastic scattering of the secondary beam projectiles from a Pb target was performed. Differential electromagnetic excitation cross sections d sigma/dE were derived up to 30 MeV excitation energy. In contrast to stable nuclei, the deduced dipole strength distribution appears to be strongly fragmented and systematically exhibits a considerable fraction of low-lying strength.

Journal Article↗
PubMed2000

A triplet of differently shaped spin-zero states in the atomic nucleus 186Pb

Understanding the fundamental excitations of many-fermion systems is of significant current interest. In atomic nuclei with even numbers of neutrons and protons, the low-lying excitation spectrum is generally formed by nucleon pair breaking and nuclear vibrations or rotations. However, for certain numbers of protons and neutrons, a subtle rearrangement of only a few nucleons among the orbitals at the Fermi surface can result in a different elementary mode: a macroscopic shape change. The first experimental evidence for this phenomenon came from the observation of shape coexistence in 16O (ref. 4). Other unexpected examples came with the discovery of fission isomers and super-deformed nuclei. Here we find experimentally that the lowest three states in the energy spectrum of the neutron deficient nucleus 186Pb are spherical, oblate and prolate. The states are populated by the alpha-decay of a parent nucleus; to identify them, we combine knowledge of the particular features of this decay with sensitive measurement techniques (a highly efficient velocity filters with strong background reduction, and an extremely selective recoil-alpha-electron coincidence tagging methods). The existence of this apparently unique shape triplet is permitted only by the specific conditions that are met around this particular nucleus.

Journal Article↗
PubMed2000

[Results after shock wave lithotripsy for salivary gland stones].

INTRODUCTION: Extracorporeal shock wave lithotripsy for salivary gland stones was not introduced until 1989 as a new treatment modality. Follow-up studies years after treatment are lacking. METHODS: Follow-up study from February to March 2000 of 71 (91%) of all 78 patients who had extracorporeal shock wave lithotripsy for salivary gland stones at our clinic between March 1996 and November 1998. RESULTS: Over 2 years after treatment (mean 27 months, range 12-48 months), 13 (48%) of 27 patients with parotid stones are free of stones and symptoms and 17 (63%) are free of symptoms. In 44 patients with submandibular stones, 13 (29%) are free of stones and symptoms and 23 (52%) are free of symptoms. For residual symptoms, 9 (20%) patients had submandibulectomy whereas no parotidectomy had to be performed. 5 patients with residual stones after treatment showed increased stone size in sonography, and one patient with a stone-free interval for 3 years had a local recurrence. DISCUSSION: Extracorporeal shock wave lithotripsy is often the treatment of choice for parotid stones and the recommended conservative treatment option for smaller submandibular stones. Limitation to the common, larger submandibular stones diminishes the general value of this modality, which needs to be established in comparison with endoscopic techniques in further studies. Residual stones after treatment may cause new symptoms over time, but only in one case was renewed stone formation observed.

Adolescent↗
PubMed2000

[Infectious aspects of Wegener's granulomatosis].

INTRODUCTION: Because of manifestation of Wegener's granulomatosis in the upper respiratory tract the ENT-specialist is often initially involved in diagnosis. Recent research results suppose the chronic nasal carriage of Staphylococcus aureus triggering relapse rate in Wegener's granulomatosis. The adequate therapy of this bacteria as chronic nasal carriage may reduce the number of relapses in patients with Wegener's granulomatosis in remission. PATIENT: An illustrative case report shows the positive effect of prolonged treatment with cotrimoxazole in a 49-year-old male with a second relapse of Wegener's granulomatosis. RESULTS: The prolonged treatment of cotrimoxazole reduced the dose of cyclophosphamid and glucocorticoids which show long-term side effects. DISCUSSION: 15 years ago a positive effect of cotrimoxazole to Wegener's granulomatosis was discussed. Later immunological and clinical studies confirmed this fact. Prolonged treatment with cotrimoxazole seems to reduce the number of relapses in patients with this chronic disease. Corresponding with our case reduction of the systemic therapy with cyclophosphamid and glucocorticoids is possible.

Cyclophosphamide↗
PubMed1999

Dielectric properties of skeletal muscle during ischemia in the frequency range from 50 Hz to 200 MHz.

The complex dielectric properties of canine skeletal muscles were measured at 25 degrees C during ischemia in the frequency range from 50 Hz to 200 MHz. The dielectric spectrum of skeletal muscle shows an alpha-dispersion below 1 kHz and a beta-dispersion with a relaxation frequency of about 100 kHz. The alpha-dispersion disappears between 450 and 500 min of ischemia time, the same time during which mechanical contraction was observed, and was restored later. During ischemia, the beta-dispersion is shifted continuously to higher frequencies; and at frequencies above 50 MHz, a decrease of the real part of the dielectric permittivity was measured. The dielectric loss factor decreases during ischemia at frequencies below 500 kHz, only interrupted by a short increase, coinciding with the disappearance of the alpha-dispersion. The principal processes that happen during ischemia inside the skeletal muscle tissues were studied with the help of a model especially designed to simulate membrane effects on the dielectric spectrum. The disappearance of the alpha-dispersion is explained by an increase of conductivity in the membrane of the sarcoplasmic reticulum. Shifting beta-dispersion to higher frequencies is a result of metabolically produced ions and therefore increasing conductivity of the intracellular medium. Decreasing dielectric permittivity at frequencies above 50 MHz and decreasing dielectric loss factor at low frequencies are caused by the cell edema.

Animals↗
PubMed1997

[Conservative therapy in thoracic outlet syndrome. Literature review and pathogenetic considerations].

Due to the broad clinical presentation and the lack of generally accepted diagnostic criteria, thoracic outlet syndrome (TOS) is a disputed diagnosis. Various surgical techniques have been described and investigated as treatment for TOS, whereas only a few studies have reported the outcome after a conservative approach. Based on the literature, the pathophysiology of TOS and the impact of conservative therapy are discussed. Our personal experience has shown that after early diagnosis and implementation this treatment is a safe and valuable therapeutical option in TOS based on the correction of a postural and functional disturbance of the upper thoracic aperture underlying the pathogenic process. Successful conservative treatment may also be considered as further diagnostic evidence for TOS.

Adult↗
PubMed1997

[Lithotripsy in the conservative treatment of salivary stones].

Otolaryngologists and generalists as well are commonly involved in the evaluation and management of salivary gland stones. Most patients present with a history of recurrent swelling and pain in the gland, associated with eating. Up to date conservative therapy was limited to the treatment of the acute sialadenitis, which may develop as a consequence of the obstruction and often recurs until the function of the salivary gland ceases. Surgical treatment depends on the location of the calculus. Distal stones can be removed trans-orally by dilatation or incision of the duct, whereas those near the hilus and intraglandular stones required excision of the gland, including the disadvantage of a scar and the risk of injury to cranial nerves. Extracorporal shock wave lithotripsy is a new noninvasive method, which allows to destroy intra- and extraglandular salivary stones, mostly without the need of local or general anesthesia. Reported disintegration rates vary from 14% to 85%, depending on site and size of the calculus. About 80% of the patients remain symptomless Lithotripsy of salivary stones is a cost-effective, additional treatment modality to surgery and may be employed on an outpatient basis.

Diagnostic Imaging↗
PubMed1997

Escher-Hirt syndrome.

A mother and her two daughters are reported with bilateral conductive deafness due to incudo-stapedial abnormalities, and microtia with thickened ear lobes. This pattern of abnormal findings, transmitted with an autosomal dominant mode of inheritance, is characteristic of the Escher-Hirt syndrome. One of the daughters died from an additional cardiac malformation (VSD). Anomalies of the middle ear were demonstrated in the surviving patients by computed tomography. Differential diagnosis with other genetic syndromes associated with deafness, and possible therapeutic approaches are discussed.

Adult↗
PubMed1990

Morphological adaptations of human skeletal muscle to chronic hypoxia.

Muscle structural changes during typical mountaineering expeditions to the Himalayas were assessed by taking muscle biopsies from 14 mountaineers before and after their sojourn at high altitude (greater than 5000 m for over 8 weeks). M. vastus lateralis samples were analyzed morphometrically from electron micrographs. A significant reduction (-10%) of muscle cross-sectional area was found on CT scans of the thigh. Morphologically this loss in muscle mass appeared as a decrease in muscle fiber size mainly due to a loss of myofibrillar proteins. A loss of muscle oxidative capacity was also evident, as indicated by a decrease in the volume of muscle mitochondria (-25%). In contrast, the capillary network was mostly spared from catabolism. It is therefore concluded that oxygen availability to muscle mitochondria after prolonged high-altitude exposure in humans is improved due to an unchanged capillary network, supplying a reduced muscle oxidative capacity.

Acclimatization↗
PubMed1982

The antenatal use of ambroxol (bromhexine metabolite VIII) to prevent hyaline membrane disease: a controlled double-blind study.

A prospective double-blind clinical trial was carried out to determine whether ambroxol (bromhexine metabolite VIII) treatment (1000 mg/day for a period of 5 days) reduces the risk of hyaline membrane disease (HMD) in potentially premature infants. Amniocentesis was performed before the first and 24 h after the last application of ambroxol or placebo to assess the development of the total phospholipid phosphorus content, the L/S ratio, the P/S ratio, and the properties of the surface tension of the amniotic fluid after ambroxol or placebo. There were 246 infants born to 224 mothers. Of the 116 infants with less than or equal to 36 completed weeks' gestation, 56 were in the ambroxol and 60 in the placebo group. No differences between groups occurred in risk factors for HMD (diabetes, asphyxia, male sex, cesarean section). Statistically significant differences in favor of the infants in the ambroxol group were found in the HMD incidence: 23.2% in the ambroxol group compared with 41.7% in the placebo group (p less than 0.05). There was no reduction of the HMD incidence in the less than or equal to 32-week gestational age category in the ambroxol group compared with the placebo group inspite of the fact that all the examined parameters for determining lung maturity reflected a stimulatory effect of ambroxol compared with the results of the placebo group, particularly before the 33rd week of gestation. Prolonged rupture of the membranes played no protective role against HMD.

Ambroxol↗
PubMed1981

[Course and prognosis of pregnancy, delivery and childbirth in patients with congenital heart defects].

On the conditions of an optimal therapy and with reference to certain contraindications the prognosis of patients with congenital heart diseases and their children scarcely differs from that of the normal population during gestation. The rate of decompensation in pregnancy was 4.1%, with 3.9% the rate of gestosis was significantly below that of the other patients. The perinatal mortality of the children of patients with congenital vitium cordis os 2.23%, the rate of newborn of 11.2% and the proportion of hypotrophic children of 8.38% were also not increased compared with the totality. By changed diagnostic and therapeutic conditions the relation of the congenital to the acquired vitia cordis has much altered in favour of the congenital ones. With a high proportion of women who underwent an operation of the heart among our patients the results shows that, apart from the already generally accepted absolute contraindications for a pregnancy, the prognosis for patients with stenoses of the outlet is clearly worse than that of the patients with other congenital heart diseases.

Female↗