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Biomedical subjects

H Müller

Publications and source records attributed to H Müller.

At least 559 records · Page 31Linked to original sources
PubMed1987

High incidence of stomach cancer in relatives of patients with malignant lymphoproliferative disorders.

Family histories of 189 patients with lymphomas and leukemias and 14 patients with stomach cancer were used in this study. Controls consisted of family histories of 391 patients with other tumors. In the 189 probands with lymphoproliferative disorders stomach cancer accounted for 17.3% of the total cancers in the relatives, whereas in the probands with breast and other types of cancer the corresponding figures were 8.1% and 8.3% as against an incidence of 5.9% of stomach cancers in Basel. In first-degree relatives, the incidence of stomach cancer was higher than expected in the families of probands with malignant lymphoma and stomach cancer. It is suggested that an inherited subclinical disturbance of the immune system is involved in familial association of stomach cancer with malignant lymphoproliferative disorders.

Breast Neoplasms↗
PubMed1987

Role of immunological factors in male infertility. Immunohistochemical and serological evidence.

Immunological deposits in the testis and circulating antibodies to spermatozoa are presented as a possible explanation for infertility in man. Testicular biopsy specimens from infertile patients (N = 52) as well as from fertile controls (N = 6) were analyzed immunohistochemically by using semithin sections. Immunoglobulin deposits were found in the testes of 21 patients. Antibody deposits were observed on the seminiferous tubule wall, on germ cells or in the interstitium. In two cases, the C3 complement component was detected on the tubular wall and in one case on atypical spermatogonia. Deposits of immunoglobulin class G were found most frequently, and were often attached to the seminiferous tubule wall. In addition, the occurrence of circulating antisperm antibodies in the sera of these patients was examined by a recently developed method, the immunobeads binding test. A significant number of patients with normal spermatogenesis had antibodies that exhibited a strong binding reaction to spermatozoa as observed by the immunobeads binding test. It is suggested that at least two different immunological mechanisms may be involved in pathological infertility: an immunoglobulin deposit, induced locally in the testis, in a manner specifically against the germ cells and the seminiferous tubular basement membrane, or in a manner nonspecifically against seminiferous tubular wall, and asystemically induced immunoglobulin production which is directed against spermatozoal antigens.

Autoantibodies↗
PubMed1987

[Comparative clinical studies of the hemodynamic parameters by anesthesia combination with Nalbuphin (Nubain) and Fentanyl].

UNLABELLED: The narcotic agonist-antagonist nalbuphine is reported to act as a strong analgesic with only minor respiratory depressant side-effects. Even in the postoperative period, the pain-relieving properties of analgesic drugs are reported to continue if the respiratory side-effects are being antagonized by administering nalbuphine. It was the aim of this study to investigate the analgesic properties of nalbuphine as compared to those of fentanyl, in suppressing the hemodynamic responses due to endotracheal intubation and skin incision. Furthermore, we are interested in studying postoperative analgesia and respiratory depression after using the two drugs during anesthesia. PATIENTS AND METHODS: Forty-one patients undergoing general surgical procedures were randomly assigned to two groups in a double-blind study. The patients were between 18 and 70 years old and belonged to ASA classes I-III. Patients with chronic obstructive pulmonary disease, cerebral vascular disorders, hepatic or renal failure, or those treated with monoamine oxidase inhibitors and tricyclic antidepressants were excluded from the study, as were patients with a drug dependency. All patients were premedicated with 25-50 mg each promethazine and pethidine. Anesthesia was induced with either 60-70 mg nalbuphine or 0.3-0.35 mg fentanyl, 2 mg alcuronium, 0.01 mg/kg flunitrazepam, and 1-2 mg/kg thiopental. All patients were intubated following 1-2 mg/kg succinylcholine. Five minutes following intubation they received another 30-40 mg nalbuphine or 0.15-0.2 mg fentanyl intravenously. Anesthesia was maintained with N2O:O2 2:1, alcuronium, and either nalbuphine or fentanyl and enflurane up to 1 vol.% or halothane up to 0.5 vol.%. Blood pressure, pulse rate, and arterial blood gases were measured at certain intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Comparative clinical study of nalbuphine and fentanyl. Effects and side effects with special reference to the induction phase].

In a previous study concerning balanced anesthesia we realized that the adrenergic sympathetic reaction caused by intubation could not be suppressed by nalbuphine-HCl (NAL), a new narcotic agonist-antagonist in the same way as by fentanyl (FE). The aim of the study was to investigate whether the observed autonomic reaction could be overcome by: (a) varying the interval between injection of NAL and intubation or (b) increasing the induction-dose of NAL. MATERIALS and METHODS. After receiving institutional approval and the patients' written informed consent, a two-part randomized trial arrangement was made using two groups of 10 surgical patients each. During the first part the induction-dose of NAL was 1.5 mg/kg BW and that of FE was 0.005 mg/kg BW. Midazolam 0.15 mg/kg BW was the induction hypnotic. Orotracheal intubation was performed 15 min after NAL and 10 min after FE injection. During the second part, the NAL dosage was 2.5 mg/kg BW and intubation was carried out 10 min after opiate injection. Induction conditions in the FE group were unchanged. RESULTS. NAL causes adrenergic sympathetic hemodynamic and autonomic reactions immediately after injection (Figs. 1a + b, 2a + b). The rate-pressure product increase during intubation is significantly higher after NAL than after FE administration and cannot be suppressed by increasing the dosage or increasing the injection-intubation interval. In contrast, the postoperative period is characterized by long-lasting analgesia (114 min vs 82 min in the FE group) and sedation, especially after administration of 2.5 mg/kg BW NAL. CONCLUSION. These results may be explained by the agonist-antagonist activity of NAL at the opiate receptor sites.

Adult↗
PubMed1987

[Use of family therapy knowledge in gerontopsychiatry as a part of comprehensive treatment].

The geronto-psychiatric departments of the Klinik Schlössli are run on the principles of milieu therapy. The family therapeutic approach brought additional points of emphasis: the patient, although committed to a hospital, still belongs to a family; the hospitalized patient too is a member of the society. As a consequence of this approach, the family interview is used to serve the wellbeing of the entire family. Patient as well as relatives are prepared for the hospitalization, guilt feelings are dealt with, family problems worked through, new life phases for patient and relatives are planned. Possibilities for strengthening the family's relation with patient as well as institution are discussed, practical help initiated to relieve special pressures; even marital problems of the old couple are addressed. The hospital has developed definite admission procedures: After an initial visit by family members in the hospital, the patient is visited by collaborators of the institution. Following this or immediately after admission, a family interview takes place. Additional meetings with the family or part of it follow if indicated.

Aged↗
PubMed1987

[Inpatient final weight data and long-term prognosis of anorexia nervosa].

In a study of 36 patients with anorexia nervosa (age at onset: 14.5 +/- 1.9 years), an attempt was made to predict longterm outcome (follow-up interval: 7.8 +/- 3.77 years) from weight changes during inpatient treatment (duration of treatment: 156 +/- 76 days). Several statistical methods appropriate for use with longitudinal data were applied. The long-term course could be predicted correctly for 96% of the patients with a good or intermediate outcome (prognostic criteria of Morgan and Russel) and for 89% of those with a poor outcome. The most important factors predictive of a good outcome were relatively long time to stabilization of weight (greater than 47 days), a stabilized weight of at least 64% of ideal weight, low age at onset (less than 13 years) and a high variability in weight during inpatient treatment as compared with patients who had a poor prognosis.

Adult↗
PubMed1987

Immunohistochemical studies of lymph nodes from LAS and AIDS patients.

Lymph nodes from eight LAS and six AIDS patients were studied by routine histology, immunohistochemistry, and ultraimmunohistochemistry. LAS lymph nodes show a peculiar follicular hyperplasia with a characteristic increase of proliferating dendritic and interdigitating reticulum cells. In AIDS, these cells are reduced and the expression of proliferation-associated antigens is diminished. The immunohistochemical analysis of dendritic and interdigitating reticulum cells and of proliferation-associated antigens in lymph nodes thus allows a clear distinction between LAS and AIDS and may have important prognostic implications.

AIDS-Related Complex↗
PubMed1987

[Is Chestnut Lodge salt in the wound of psychoanalytic contributions to the treatment of schizophrenia?].

In a catamnestic follow-up study of 226 patients treated psychotherapeutically in Chestnut Lodge on an inpatient basis, two-thirds of the schizophrenics and one-third of the patients with affective disorder presented with an unfavourable course. Since the schizophrenics had a chronic type of schizophrenia, this result agrees largely with the general course of schizophrenia. Although it is a disappointing result, it does away with both myths and distorted stories told about Chestnut Lodge. Social considerations as well as those based on institution analysis and on family therapy led to the thesis that the external reality of life of the schizophrenic patient is involved in deciding his possibilities of development even if the therapeutic approach is based on intrapsychic factors. The institutional nature of Chestnut Lodge, involving care and exclusion, was an obstacle to fulfilling Chestnut Lodge's claim that the conditions for an experimental trial in psychotherapy of schizophrenia (which aims at uncovering and understanding the patient's disturbed subjectiveness) are fulfilled only by a type of social psychiatry that allows the patient to solve the task of mastering his life in an adequate manner.

Affective Disorders, Psychotic↗
PubMed1987

[The effect of ion pair formation on the pharmacokinetic properties of drugs. 1. The effect of alpha-methylpalmitic acid on the pharmacokinetics of quinine in rabbits].

The transport of quinine through artificial lipid membranes is significantly increased by use of alpha-methylpalmitinic acid (alpha-MPS). Using rabbits it could be shown that the alpha-MPS causes a significant increase of the mean resistance time (MRT) of quinine. Besides the alpha-MPS causes an increases Cmax and a shorter tmax of the quinine blood levels.

Animals↗
PubMed1987

[ENT medical aspects in bronchial asthma in childhood].

At the examination of 55 children from a regular care group suffering from asthma bronchiale by an ENT-specialist, in two third of them pathological findings demanding treatment were found. Since the majority of the findings remained clinically silent, the need of co-operation of ENT-specialist and pediatrician is obvious. According to our results, one single examination as it is usually done routinely at the onset of the disease is not sufficient.

Adolescent↗
PubMed1987

Biochemical monitoring of the lung during and after extracorporeal circulation.

The activity of NAG, lysozyme and PMN-elastase has been investigated in the superior vena caval and left atrium blood collected from patients who underwent open heart surgery. The effect of various types of respiration on the enzyme release has been also documented. Concentration gradients between v. cava sup. and left atrium has been used as an index for pulmonary damage post operatively. We found a time dependent increase of all enzymes during extracorporeal circulation. However, only the release of NAG and lysozyme is characteristic for pulmonary damage. We observed significant higher enzyme release from the lung after Apnea ventilation compared with the PEEP and low frequency ventilation group. Also significant higher NAG and lysozyme activity was found in patients who needed longer respiration post-operatively. PMN-elastase seems to be not suitable for diagnosis of post perfusion lung because the main amount of elastase released by mechanical destroy of the granulocytes.

Acetylglucosaminidase↗
PubMed1987

[Opinion of mothers on continuous peridural obstetrical anesthesia].

The general opinion on epidural anesthesia in obstetrics may be adversely affected by recent public controversies about the mother's situation during childbirth in hospital, which nowadays is often considered to be a highly technological, impersonal, or "unnatural" procedure. This assumption led us to conduct an inquiry on maternal assessment of obstetric epidural anesthesia and its relation to the clinical and social history. The study included 113 parturients, who received epidural anesthesia (on-demand epidural injections of bupivacaine 0.25%) for vaginal delivery. Mothers were asked to answer certain questions about this regimen (e.g. analgetic efficacy; difficulties in deciding on this method; recommendations to other parturients; opinion of the role of epidural anesthesia in obstetrics; choice of analgesic regimen for future childbirth) 1 day after delivery and 2 months later. Additional social and historical factors (e.g. education; profession; family status; preceding pregnancy, childbirth or abortion; complications during pregnancy or childbirth; duration of parturition) were used to reveal relevant statistical correlations. Sixty-five percent of the patients considered pain relief by epidural anesthesia as "good" or even "very good" during the first inquiry immediately after childbirth. Women who had undergone prior interruptions of pregnancy were less satisfied, probably because of their rather ambiguous attitude towards motherhood. With regard to the choice of analgesic regimen for future childbirth (50% of the patients had made a definite decision to have epidural anesthesia under this condition), those women were especially reserved who had suffered from complications during pregnancy and disapproved of it in the future.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1987

Histogenesis of Kaposi's sarcoma associated with AIDS: a histologic, immunohistochemical and enzyme histochemical study.

Twenty-one cases (25 biopsies including 9 frozen biopsies) of Kaposi's sarcoma associated with the acquired immune deficiency syndrome (AIDS) were examined immunohistochemically, lectin-histochemically, and enzyme histochemically to ascertain the histogenesis of the lesion. The Kaposi's sarcomas were histologically subtyped according to a modified Schmid's classification (granulation tissue-like-, angiosarcoma-like- and spindle cell type). In almost all lesions, many atypical vasoforming cells and at least some spindle cells without definite evidence of vasoformation by conventional microscopy were positive for factor VIII-related antigen, BMA 120 (a new monoclonal antibody to an endothelial cell-specific antigen), Ulex europaeus I (UEA-I), alkaline phosphatase and ATPase. Linear reaction products for BMA 120 and UEA-I, suggesting the luminal surface of immature vascular channels, were sometimes recognized in the positive spindle cells. Electron micrographs confirmed endothelial characteristics, such as irregular and fragmented but distinct basal lamina and numerous pinocytotic vesicles, in both the UEA-I- and ATPase-positive spindle cells. Among spindle cells negative for the endothelial markers, there were many macrophages as a stromal reaction to tumor tissue, identified by monoclonal antibodies to macrophages (KiM 6, 7, 8 and EBM 11), acid phosphatase and alpha-naphthyl acetate esterase. The results of the immuno- and enzyme histochemical investigations did not correlate with the different histologic types of Kaposi's sarcoma. However, our results strongly suggest that tumor cells of Kaposi's sarcoma are derived from vascular endothelial cells rather than lymphatic endothelium.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Effect of the calcium antagonist nimodipine on hemodynamics, gas exchange and endocrine parameters in opiate anesthesia].

During opiate anesthesia (standardized dosage of fentanyl) for operation of cerebral aneurysms after subarachnoid hemorrhage, different hemodynamic, respiratory, metabolic, and endocrine parameters were determined before (1 in Fig. 1-4), after (6), and during consecutive stages of induced hypotension (systolic blood pressure 100 mmHg (2), 90 mmHg (3), 80 mmHg (4, 5) during an interval of 20 min), comparing two groups with different vasodilating drugs. In the first group (nimo/NNP in Figs. 2-4) a constant infusion of nimodipine was applied (1.2 micrograms/kg b.w. X min-1), while sodium nitroprusside (NNP) was added in small amounts as necessary to achieve the respective values of systolic blood pressure. In the second group (NNP in Figs. 2-4) induced hypotension was done with NNP alone (maximal dosage: 8 micrograms/kg X min-1). Each group consisted of 11 patients. Additional nimodipine (in the first group), a calcium antagonist commonly recommended for preventing vasospasm and consequent neurologic deficits after subarachnoid hemorrhage, not only reduced the need for NNP, a vasodilating drug with potential toxicity, by 70%-80% as compared to the second group (Table 1). In addition, the cardiovascular situation was more stable in patients with nimodipine infusion: rapid variations of blood pressure and heart rate as well as tachyphylaxis and rebound, typical for NNP-induced hypotension, were avoided. Nevertheless, comparing the hemodynamic data at fixed stages of hypotension, there were only minor differences between both groups (Fig. 2). Reduction of blood pressure was due to a decrease in vascular resistance and was accompanied by an increase in cardiac output.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed1986

Autoimmune phenomena and cytogenetic findings in a patient with carcinoma (seminoma) in situ.

Routine examination of a testis biopsy from a patient with oligospermia and a large varicocele in his left testicle and who was childless for over 2 years showed carcinoma in situ (CIS) with atypic spermatogonia in his right testicle. Immunohistochemical investigations of this tissue revealed large intracellular deposits of immunoglobulin G (IgG) restricted to the atypical cells. By blot-immunobinding test of the patient's serum, circulating antibodies against a molecule with an approximate molecular weight of 60 kD were found. Such antibodies were not found in a total of over 500 infertile patients and fertile controls examined. This molecule was extracted from pooled normal human sperms by trypsin digestion and eluted out of a sodium dodecyl-sulphate polyacrylamide gel (SDS-PAGE). This elute is currently used for raising monoclonal antibodies. An analysis of the direct chromosome preparations from the testis biopsy showed both numerical and structural chromosomal aberrations. This might indicate that the atypical cells have already been transformed and hence could be considered as malignant.

Adult↗