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Biomedical subjects

H Neef

Publications and source records attributed to H Neef.

At least 37 records · Page 2Linked to original sources

Effects of metal ions, thiamine diphosphate analogues and subunit interactions on the reconstitution behaviour of pyruvate decarboxylase from brewer's yeast.

The reconstitution of pyruvate decarboxylase starts with reversible binding of thiamine diphosphate and Mg2(+)-ions to the apoenzyme, followed by a rate-limiting conformational change to the catalytically active holoenzyme. Investigations with diphospho-esters of 4-methyl-5-(2-hydroxyethyl)thiazolium derivatives have shown that the diphosphate residue of thiamine diphosphate is the most important part of the coenzyme responsible for the first reversible binding step. Methylation of the N1'-atom of the pyrimidine ring of thiamine diphosphate or 4'-oxythiamine diphosphate prevents the coenzyme from binding stably to the apoenzyme, so that the methylated coenzyme displays no coenzyme activity. In contrast, thiamine diphosphate analogues with bulky residues on the neighbouring C2'-atom of the pyrimidine ring form active holoenzyme complexes. This result shows the essential role of the N1'-atom of thiamine diphosphate in stable cofactor binding. The cofactor binding rate to the dimeric and tetrameric apoenzymes indicates that the cofactor is located in the contact regions of the subunits in the tetrameric enzyme.

Binding Sites

The role of surgery in diagnosis and treatment of mediastinal malignancies.

Primary mediastinal malignancies should be treated aggressively using a multidisciplinary approach since some are curable. Surgery is indicated in almost all cases of mediastinal masses with the exception of malignant lymphomas. The question of operability must be placed at the beginning of diagnostic measures in a mediastinal mass. Exact decisions about local operability are often only possible after thoracotomy. Long lasting diagnostic maneuvers are therefore to be avoided. Histological assessment of masses in the middle or anterior mediastinum is possible by mediastinoscopy or other methods. Thus in malignant lymphomas or metastases thoracotomy can be avoided. In the other mediastinal spaces exact histology remains unknown until thoracotomy. If exploration shows inoperability, mass reduction is performed to decrease the space-taking process and to provide better chances for radiotherapy and chemotherapy. Primary radiotherapy and/or chemotherapy are indicated in malignant lymphomas and germ cell tumors. After these measures the indication for surgical excision in tumors has to be proved. X-ray screening techniques need to be improved to aid in early detection, higher extirpation rates, and thus better chances for cure. Because the amount of cases in individual departments is low multicenter collaboration will be required to define the optimal combined modality approach.

Adolescent

[Risk assessment of bronchial cancer surgery using quantitative lung perfusion scintigraphy].

28 patients with bronchogenic carcinoma were studied to predict lung function after thoracic resectional surgery, i.e. the functional operability, employing preoperative vital capacity (VC), forced expiratory volume (FEV1) and perfusion lung imaging. The perfusion scan was divided into 12 regions of interest which were semiquantitated to determine the relative distribution of perfusion as a fraction of the total perfusion. The planned reduction of lung parenchyma was expressed as percent of total perfusion, and the expected decrease in VC and FEV1, i.e. the predicted postoperative function of the lung, was calculated. The comparison of the predicted functional lung capacity with the re-estimated lung function (VC and FEF1) 6 months after surgery showed high correlation coefficients for both VC and FEV1. Semiquantitative perfusion scintigraphy of the lung helps to determine the extent of surgery possible in the individual therapy of lung cancer and is especially important in patients with a high operative risk.

Carcinoma, Bronchogenic

[Model and experimental animal studies of the use of hand-controlled catheter-jet-ventilation (CJV) by plastic replacement of the tracheobronchial tree].

Pressure and volume flow measurements were performed on a simple model of the tracheobronchial tree using a catheter-jet-ventilation apparatus. This type of respiration is particularly favourable in tracheo-bronchial surgery, i.e. resections and anastomosing, due to the experience of model as well as animal experiments. Under consideration of the particularities of catheter-jet-ventilation, this type of respiration provides excellent conditions for the surgeon. This is valid for the overview of the site of operation and possible manipulation within this region. This method of respiration is suggested as a reliable tool in the hands of less skilled anaesthetists, too, for its easy handling.

Anastomosis, Surgical

[Evaluation of reflux behavior of esophago-jejunal anastomoses following gastrectomy].

Functional results of 48 gastrectomies are reported. The applied techniques of the construction (jejunoplicatio) are judged for the safety of the anastomosis. 29 patients (60.5%) were examined for the degree of jejunooesophageal reflux after a survival time of 1 year. Antireflux techniques of anastomosis had good functional results measured by manometry and pH-metry.

Anastomosis, Roux-en-Y

[Late results of resection treatment of bronchiectases with special reference to functional studies].

In 83 patients an unilateral pulmonary resection because of bronchiectasis was performed. The indication was unsuccessful medical treatment. Forty seven patients were re-examined clinically and radiologically and with spirometry and ergooxytensiometry 13.2 years (average) after operation. Good functional results were found in 72.1% of the patients. This justifies pulmonary resection for bronchiectasis even in the era of potent antibiotics. We preferred lobectomy because of its low postoperative complication rate and good functional late results. In bilateral bronchiectasis we operated upon the side with the advanced disease.

Adolescent

The effect of thiamine pyrophosphate modification on its coenzyme function in a transketolase-catalyzed reaction.

The coenzyme function of TPP analogues: 4'-NH-methyl-TPP,6'-methyl-TPP and 6'-methyl-4-nor-TPP has been studied in a transketolase-catalyzed reaction. Their dissociation constants have been found with the aid of the circular dichroism method, and coenzyme activity has been determined in a complete transketolase reaction, involving the substrate-donor and the substrate-acceptor, and also at the intermediate stage (by the alpha-carbanionic intermediate oxidation rate). The coenzyme activity values have been found different and largely dependend on the nature of the substrates used. A possibility of TPP functioning by the "two-center mechanism" in a transketolase-catalyzed reaction is discussed.

Kinetics

[Recurrences after surgical treatment of achalasia of the cardia (author's transl)].

We observed 17 cases of so-called recurrences of achalasia of the cardia (10 times after preceding dilatation and 7 times after Heller's operation). For surgical treatment 16 of these patients underwent cardiomyotomy, using the transthoracic approach. In one patient who had cardiomyotomy plus fundoplication at the first operation an oesophago-gastrostomy became necessary. Three quarter of these patients had a satisfactory result when followed up. I case of recurrence the authors recommend to give priority to cardiomyotomy, rather than to dilatation or bougienage.

Deglutition Disorders

[Contact-free temperature measurement in the heart by means of infrared telepyrometry].

The actual temperature of the myocardium requires the surgeon for the assessment of the ischemia time under hypothermic conditions in operations on the heart. The problem of the contact free temperature measurement on heart was solved by means of the infra-red telepyrometer. Preponderant technical aspects of the application in the cardiosurgery were described. On the basis of the physics the function of an infra-red contactlesspyrometer was discussed and the first results of own investigations about the contact free measurement of the epicardial temperature.

Cardiac Surgical Procedures

[The value of the symptom of dysphagia from the surgeon's viewpoint].

Dysphagia is the leading symptom in the most frequent and surgically most important disturbances of the passage of the oesophagus. Possibilities and results of the treatment are analysed on the basis of clinical material from the surgical clinic of Halle university. Nevertheless insufficient results in malignant tumours are opposite to favourable results of the operation in benign diseases (diverticles, achalasia, strictures). Measures for the improvement of the situation of treatment are discussed.

Cachexia