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Biomedical subjects

H Müller

Publications and source records attributed to H Müller.

At least 487 records · Page 27Linked to original sources
PubMed1989

Value of thyroid hormone determination.

Free thyroid hormone assays have broadened the repertoire in thyroid diagnosis. At elevated binding protein levels they provide more reliable information on the metabolic state than do total hormone determinations; yet under estrogen contraception free T4 may yield test specifically falsely too high data. As a rule, there is accordance between free hormone concentrations and the indices, being equivalent in establishing the free thyroid hormone fraction. In this light the Thyroid Section of the German Endocrinologic Society recommended in 1986 to consider determinations of free or total hormone concentrations with calculation of the indices as being of equal value. In borderline situations the TRH test, the hypersensitivity TSH assay as well as checkups establishing the course of development of the disorder are substantiated.

Adolescent↗
PubMed1989

[Temperature-dependent changes in the microcirculation of the dental pulp].

Laser Doppler flowmetry was used to study the changes in the blood flow within the dental pulp as a reaction to thermal stimuli between 17 degrees C and 57 degree C. Temperatures below 31 degrees C resulted in a reduction, temperatures above 43 degrees C in an increase in blood flow. Temperatures higher than 49 degrees C caused irreversible damage to the pulp's microcirculation. Experimental nerve blocks showed that the reactive increase is linked to the afferent rather than the sympathetic innervation of the tooth pulp.

Dental Pulp↗
PubMed1989

A user-oriented protocol for integrating heterogeneous communication systems of medical facilities using ports.

The crucial feature of future communication systems in hospitals will be the heterogeneity between the individual systems. People working in a hospital do not communicate via data objects, but via highly complex functions like preparation of a patient report or diagnosis of patients' symptoms and signs. Essentially such tasks are accomplished by initiating remote functions in various modes of a communication system. The aim of the MEDAS protocol developed by our group is to propose a definition of such a high-level medical protocol and then to implement it. Our user-oriented protocol permits information exchange between heterogeneous systems. Modules and functions are defined. Message passing to and from a processor is realized using ports. The protocol sequence of every communication request is described. The relation of ports to the ISO model is specified. First experiences in a network for a medical school are reported.

Communication↗
PubMed1989

[Herlitz syndrome and "pyloric atresia"].

The aetiological and pathogenic relation between junctional epidermolysis bullosa (Herlitz) and prepyloric and pyloric obstruction in newborns with junctional epidermolysis bullosa is still unknown. There are two different hypotheses; one suggesting two distinct genetically related disorders (namely junctional epidermolysis bullosa and congenital pyloric atresia), the other suggesting an intrauterine mucosal damage in junctional epidermolysis bullosa. We report two infants suffering from junctional epidermolysis bullosa, Herlitz-type, verified by electron microscopy, and from connatal prepyloric and pyloric obstruction. In both cases we could demonstrate proliferative inflammation at the prepyloric antrum and pylorus as the cause of the obstruction but no complete obliteration of the pyloric channel. These findings point to an intrauterine event impacting the mucosa of the gastrointestinal tract in patients with junctional epidermolysis bullosa of the Herlitz-type and don't comply with the hypothesis of two different but genetically related diseases.

Epidermolysis Bullosa↗
PubMed1989

[Differential diagnostic considerations in tumors in childhood in the ear-nose-throat specialty].

198 children with tumours in the head-neck region were treated in the Clinic of ENT of Karl Marx University of Leipzig in the period from 1953 to 1985. 166 benign and 32 malignant tumours were verified histologically. All of the tumours were analyzed in relation to histological classification and distribution of age and sex. Problems of differential diagnosis, early recognition, therapy, and prognosis were demonstrated with examples. An optimal interdisciplinary cooperation between pediatrician, oncologist, cyto-histologist, and otorhinolaryngologist is necessary.

Adolescent↗
PubMed1989

[Hyperthermic reaction in the perioperative phase in 2 children with acute lymphoblastic leukemia of B-cell type].

Acute lymphatic leukemia (ALL) represents one of the most frequent malignancies in childhood. Central venous access ports or partly implanted silicone catheters are usually placed for high-dose chemotherapy in these children. We report two patients aged 7 and 3 years with acute lymphoblastic beta-cell leukemia (B-ALL), a less common subtype of ALL, which presented with hyperthermia (38.4 degrees C and 39 degrees C) during anesthesia with isoflurane for implantation of a central venous catheter. The hyperthermic reactions were accompanied by an increase in expired CO2 and acidosis as well as moderate elevation of heart rate and blood pressure. As in both patients the history and preoperative findings did not reveal signs of infection or other causes of fever, the observed alterations were interpreted as symptoms of malignant hyperthermia triggered either by succinylcholine or isoflurane, which were used in both children. In addition, the hyperthermia responded to administration of dantrolene sodium according to dose recommendations for treatment of malignant hyperthermia. In one of the patients, withdrawal of dantrolene during the initial postoperative hours was followed by a recurrent increase in body temperature, which once again could be suppressed by additional dantrolene infusion. According to the literature, malignant hyperthermia has occasionally been described in children with malignancies such as leukemia or Burkitt's lymphoma. Our observations indicate that children with B-ALL may be especially susceptible to malignant hyperthermia. Close monitoring of body temperature and expiratory CO2 are therefore indicated in these children, and dantrolene therapy should be started immediately in case of increased temperature during anesthesia.

Anesthesia, Inhalation↗
PubMed1988

[An atraumatic needle for the puncture of ports and pumps].

Huber-point needles have been found to induce substantial coring during puncture of ports or pumps, which may lead to leakage or obturation of these devices. Therefore, different types of cannulas were tested in order to evaluate their applicability for this purpose. Pencil-point needles led to increased pain during puncture and thus seemed unsuitable. A newly developed port-cannula bent inwards within the length of the bevel ("protected bevel") and proved to be definitely noncoring during electron microscopy. Consequently the force required to introduce this needle was reduced by 50% in comparison with the Huber-type needle. In addition, this cannula allowed up to 3000 punctures of one port without leakage and, thus, correspondingly therefore relevantly increased the durability of this device.

Catheters, Indwelling↗
PubMed1988

[The Huber needle as a special cannula for the puncture of implanted ports and pumps--a mistake in multiple variations].

Huber-point needles, which are thought to be noncoring, are usually recommended for puncture of implanted drug-delivery devices, such as ports and pumps. Nevertheless, we found occlusion by silicone chips deriving from the silicone inlet septum to be a major technical complication. Electron microscopic investigations demonstrated substantial loss of material from the port membrane after repeated puncture with this type of needle. During an in vitro test, multiple puncture with Huber-type cannulas led to a pressure-dependent leakage of a port after only 150 to 750 insertions of a needle. In addition, the forces necessary for puncture or for withdrawal of the needle were increased with Huber-point needles, possibly due to a coring effect. Another disadvantage of the available port needles is the formation of a hook at the tip, which may lead to additional lesion of the port or pump membrane. In our opinion, resterilization of Huber needles, recommended by the manufactures, is not advisable, because it is well known that safe sterilization of small lumina, e.g., the lumen of the needle, is impossible.

Catheterization↗
PubMed1988

Rat amnion membrane matrix as a substratum for regenerating axons from peripheral and central neurons: effects in a silicone chamber model.

An extracellular matrix preparation, the human amnion membrane matrix (hAMM) can serve as a neurite-promoting substratum for cultured peripheral and central neurons, and also as a support for axonal growth in experimentally injured adult brain in vivo. In the present study, we tested similar materials as bridges in a silicone chamber model for the regeneration of sciatic nerve in the adult rat. Since hAMM elicited an inflammatory response, we developed a rat amnion membrane matrix (rAMM), which proved to be an excellent neurite-promoting substratum for cultured ganglionic and spinal cord neurons. The rAMM was coiled and inserted in the 10 mm gap between the two nerve stumps from the silicone chambers. At 16 days after implantation, temporal progress of regeneration was grossly similar as in saline-prefilled control chambers. However, rAMM-prefilled chambers displayed significantly higher number of vessels and a markedly different geometry of the regenerate: an endoneurium, surrounded by a perineurial-like cell layer, was formed outside the largely preserved central portion of the rAMM coil. After longer regeneration times (28 days), a rAMM core was no longer detected, but some rAMM-like materials remained interspersed in the endoneurium. The overall organization of the regenerate and the number of myelinated axons at this time were similar to those of control chambers, although the endoneurial cross-sectional area was larger in the rAMM chambers. One specimen, however, displayed the very patterns for which the experiments were designed, namely an array of numerous, myelinated axons tracing the spiraling spaces between consecutive lamellae of the rAMM coil.

Amnion↗
PubMed1988

Thymine dimer repair in fibroblasts of patients with dysplastic naevus syndrome (DNS).

Dysplastic naevus syndrome (DNS) is frequently observed in association with familial melanoma and xeroderma pigmentosum (XP), but the role of UV-light in the development of DNS has not been elucidated. Previous work has shown that UV-induced unscheduled DNA synthesis is associated with the early loss of antigenicity observed in immunoassays using a monoclonal antibody specific for thymine-thymine dimers. We now show that the rate of loss of antigenicity, which reflects the relative amount of bound antibody, observed during the first 60 min following 10 Jm-2 UVC irradiation is significantly reduced (p = 0.02) in cultures of fibroblasts from 7 out of 8 DNS patients compared with the results from cells of a group of 30 healthy volunteers. This observation suggests an early event in excision repair is altered in the majority of DNS patients.

Adult↗
PubMed1988

Biogenesis of the yeast lysosome (vacuole): biosynthesis and maturation of proteinase yscB.

The biosynthesis and processing of the vacuolar (lysosomal) proteinase yscB was followed in vivo and in vitro. In vitro transcription--translation of the cloned proteinase yscB gene results in a high mol. wt precursor protein (HMr-precursor) of Mr = 73,000. In vivo a precursor of identical mol. wt is found in sec6l mutant cells deficient in translocation of secretory protein precursors into the lumen of the endoplasmic reticulum (ER). In contrast to N-glycosylated intermediate mol. wt forms of proteinase yscB, the HMr-precursor of the enzyme is not N-glycosylated, indicating its appearance outside the ER. sec18 Mutant cells, wild type for translocation of proteins into the ER but blocked in the delivery step of secretory proteins to the Golgi apparatus, accumulate a lower mol. wt precursor (LMr-precursor) of proteinase yscB of Mr = 41,500. Processing of the HMr-precursor of proteinase yscB to the LMr-precursor requires proteolytic cleavage which is independent of the proteinase yscA gene product, a protein known to be involved in the processing event of the LMr-precursor of proteinase yscB to the mature enzyme of Mr = 33,000. A LMr-precursor of proteinase yscB of Mr = 42,000 accumulates in proteinase yscA-deficient mutant cells (allele pep4-3). This form is enzymatically active. Incubation in vitro of the LMr-precursor of proteinase yscB with mature proteinase yscA leads to further activation and to processing of the enzyme yielding the mature 33,000 Mr protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Fungal Proteins↗
PubMed1988

Inhibition of proteases during extracorporeal extremity perfusion experimental and clinical results.

In an experimental and clinical study a significant reduction of the postoperative edema after extracorporeal extremity perfusion under addition of Aprotinin was observed. Together with reduction of edema usually expected complications like pain and peripheral nerve damage could be reduced significantly. Preliminary, yet unpublished data on cytostatic infusion of the pancreas also indicate that intraarterial Aprotinin when given simultaneously may prevent pancreatitis. It is mandatory Aprotinin to be given early enough in sufficiently high dose and there seems to be an advantage when the arterial route is used.

Animals↗
PubMed1988

Implanted pump systems for treatment of spasticity.

In about one third of patients with violent spasticity due to spinal trauma, multiple sclerosis, and diffuse brain injury adequate control with oral antispastic medication cannot be achieved and successful rehabilitation is severely handicapped. In the past these patients were subjected to destructive chemical procedures or extensive surgery. The authors present the results of management of uncontrollable spasticity by means of continuous intrathecal administration of baclofen with a totally implantable gas driven pump system (Infusaid). 30 patients were treated between June 1985 and January. 1987. The main indication was incapacitating spasticity resistant to oral treatment with baclofen and caused by spinal cord injury or lesion (11 patients), multiple sclerosis (11 patients), infantile cerebral palsy (3 patients) and cerebral injury, hypoxia or ischaemia (5 patients). Clinical assessment included spasticity scores, integrated electromyography (Iemg) and motography. Effective control for spasticity with mean reduction of Iemg by 55%, decrease of Ashworth's score from 3 to 0 and improvement of life quality was obtained in all patients with daily dose of 10-800 micrograms of Baclofen. Voluntary resting motoricity was not impaired and there were no untoward central side effects. The excellent effect of intrathecal baclofen in comparison with oral therapy is explained by local, spinal GABAergic inhibitory action of the drug which is delivered directly into spinal subarachnoid space. Dose finding and dose adjustment is performed prior to pump implantation by intermittent injections into a subcutaneous port. The complications of the procedure were minor (catheter displacement, disconnection) and easily correctable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Interactions between nimodipine and general anaesthesia--clinical investigations in 124 patients during neurosurgical operations.

Haemodynamic, respiratory, metabolic and endocrine investigations were performed in a total number of 124 patients, divided into four different groups, during opiate anaesthesia for neurosurgical operations in order to characterize general effects of nimodipine, a calcium channel blocking agent with a preferential cerebrovascular action. These studies led to the following conclusions: Nimodipine is a vasodilator drug with a hypotensive action, which is especially obvious in hypertensive patients and in combination with similarly acting agents, such as sodium nitroprusside or nitroglycerin. This vascular hypotensive effect may be also enhanced by combined cardiodepressive activity if nimodipine is applied together with inhaled anaesthetics, such as halothane or isoflurane. Nimodipine as well as other vasodilator drugs may lead to increased pulmonary shunting in patients with artificial ventilation, which, however, can be reduced by adequate positive end-exspiratory pressure. With high doses the decrease of oxygen extraction and consumption, seen with nimodipine, is accompanied by a moderate rise of lactate. Determination of stress hormones did not reveal analgesia potentiation of nimodipine, as has been assumed in other studies.

Anesthesia, General↗
PubMed1988

[Leiomyosarcoma of the pulmonary artery--report of 2 cases from clinic practice and review of the literature].

Sarcoma of the pulmonary artery is a rare tumor. Only 81 cases are reported in the international literature. Leiomyosarcoma of the pulmonary artery is seen in 17% of these tumors. Most of them are not recognized during life but accidentally found at autopsy. So primary leiomyosarcoma of the pulmonary artery is a very rare tumor. We report about two new clinical cases and give a review of the literature.

Adult↗