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Biomedical subjects

H P Graf

Publications and source records attributed to H P Graf.

16 recordsLinked to original sources

Ethics-committee authorization in Germany.

On 9 August 1994 the German legislature revised the German Drug Law (AMG). Included in the revision is a passage requiring, for the first time, that the sponsors and investigators of clinical studies involving human subjects first obtain the approval of an ethics committee before carrying out such studies. According to the legislation, which takes effect on 17 August 1995, approval is to come from 'an independent ethics committee, set up and administered according to state law [emphasis added]' (1). Although it is clear according to the text that the 16 federal states have been empowered to establish ethics committees within their jurisdictions, this does not mean that the state governments are free to transfer exclusive authority in the matter to their respective medical associations, a step that would effectively abolish Germany's private ethics committees. First, the legislation does not rule out the authorization of private ethics committees. Second, as legal scholars attest, the exclusive control of ethics committees by the medical associations would constitute an illegal monopoly. Third, it is arguable that medical-association ethics committees fail to meet the one prior federal requirement, that of independence. There is a great deal of confusion in Germany today about which kinds of ethics committees (public and/or private) the states will sanction before 17 August 1995. In an attempt to sort things out we present a brief explanation of how ther came to be two kinds of ethics committees in Germany, review the legal battle between the two over the issue of authorization, point out how the German legislature, in passing the recent bill, has missed an opportunity to clarify the issue and, finally suggest why the administration of ethics committees by the medical associations may be incompatible with the requirement that ethics committees be independent.

Civil Rights↗

Quantitative radiographic diagnosis of osteo-arthritis of the knee-joint in the C57BL mouse.

Comparative histopathological and radiographic investigations in the C57BL mouse model of spontaneous osteo-arthritis of the knee-joint indicate that there is a relation between quantitative radiographic diagnosis and semiquantitative histopathological diagnosis. Statistical analysis based on a set of quantitative radiographic parameters of the mouse knee-joint shows that the greater part of the radiographic information reflecting the histopathological degree of the osteo-arthritis is contained in the projection areas of the lateral and medial meniscus: progression of the osteo-arthritic process is accompanied with enlargement of the menisci. On the basis of these observations, a radiography score for the osteo-arthritis has been constructed, which consists of a weighted sum of the - suitably transformed - projection areas of the lateral and medial meniscus. In addition to the size of the menisci, the width of the joint space is also a useful quantitative parameter of osteo-arthritis of the mouse knee-joint.

Animals↗

Spontaneous osteo-arthritis of the knee-joint in C57BL mice receiving chronic oral treatment with NSAID's or prednisone.

In a statistically planned study based on quantitative radiography, treatment for 25-26 weeks with the 2 NSAIDs, diclofenac sodium, or indomethacin (both 0.5 and 1.5 mg/kg p.o. daily), or prednisone (6 mg/kg p.o.) had no influence on the progression of spontaneous osteo-arthritis of the knee-joint of the C57BL mouse, by comparison with placebo-treated controls.

Animals↗

[Eye surgery in Sudan].

A seven-week stay in the Sudan in the winter of 1988/89 revealed the ophthalmological problems of this Third World country. As a result of the catastrophic shortage of local doctors, many cases of eye disease have progressed to terminal stages. Of 990 patients examined, 80% were unilaterally or bilaterally blind. The three main causes of blindness were cataract, trachoma, and glaucoma. The most effective treatment for these conditions was surgery. Operable cases were identified by a simple examination method, and a total of 330 operations were performed, of which 63% were for cataract and 21% for trichiasis. Trabeculectomy was performed in 9% of the cases in order to prevent absolute glaucoma. Owing to the many technical, personnel, and specific local problems complicated surgical methods were inappropriate. As in war surgery, the methods applied had to be simple and fast. In order to achieve any success it was necessary to abandon perfectionist western methods and adapt to locally available facilities. In the author's view, a well-prepared assignment of this kind can be a useful experience for any ophthalmologist.

Developing Countries↗

[Secondary implantation of the Omnifit II].

In this paper the author discusses the problems of secondary intraocular lens implantation with the Kelman Omnifit II lens following intracapsular cataract extraction. Indication, surgical technique, and complications are described. In 13 cases unilateral and in three cases bilateral implantations were performed. The results, after an average follow-up period of two years, were good in 18 cases. In one complicated case corneal decompensation occurred after a lens dislocation. The continuing good visual acuity results and low incidence of implant-related intraocular problems in this series suggest that anterior chamber IOLs are a safe and effective means of correcting surgical aphakia.

Aged↗

[Ultrasonic Doppler method for noninvasive determination of fetal blood flow volumes].

Fetal blood flow volume and unteroplacental flow profiles can be measured with a linear real time scanner in conjunction with a pulsed Doppler system. It was the aim of this study to simulate the blood flow volume under varying experimental conditions by using an in-vitro model, and to examine and compare pulsed Doppler equipments. Defined flow rates between 200 and 1200 ml/min were pumped via a tygon tube placed in a liquid bath. The sample volume was kept constant, the depths of the tube were varied. Processing of the Doppler signals was done by spectrum analysis. There was a good correlation between true and ultrasonically measured flow rates (r = 0.96-1). However, particularly low flow rates resulted in an overestimation of blood flow when using high-pass filtering for avoiding Doppler signals arising from the vessel wall. These errors probably not only depend on the flow profiles, but also on the measuring techniques involved with the individual instruments. The effect of high-pass filtering must be taken into account when interpreting the results, particularly in the case of low-flow rates.

Blood Flow Velocity↗

[Influence of the "aliasing" effect and the filter on the quantitative determination of the mean flow rate and flow volume per unit of time using the pulsed Doppler ultrasound method].

By the pulsed doppler ultra sound the blood flow volume will be measured by a discrete time signal. The consequences which are obtained for fourier's transformation are deduced and specially the problem "aliasing" for the quantitative measurement of the flow volume per time is discussed. The influence of the different filters on the quantification of the blood flow volume per time can be demonstrated by in-vitro measurements compared with the pulsed doppler combination of Kranzbühler (pulsed Doppler combination 8105, linear 8130) and the pulsed Doppler combination of Toshiba (pulsed Doppler combination SAL 50).

Blood Flow Velocity↗

[Hepatitis B infection: studies on endemic disease in the closed ward of a psychiatric hospital].

Following the occurrence of 3 cases of icteric hepatitis in the period August 1980 to January 1981 in a closed male ward for mentally retarded patients in a psychiatric institution, the present study was undertaken to determine the type, investigate the source and reconstruct the sequence of viral infection, and to make recommendations for its containment. For this purpose, serologic markers for HAV and HBV (including anti HBcIgM) were determined and serum transaminase (AST) measured in March 1981 in all 24 patients (mean age 40) and in the 39 members of the medical, nursing and housekeeping staff (mean age 39). Subsequently, HAV and HBV serologies were repeated after 6 and 9 months respectively. The propositus (B.F.) and the two subsequent cases with overt hepatitis (F.P. and K.E.) showed the serologic constellation of positive HBs, HBe and anti HBcIgM, together with elevated AST levels (600, 800 and 200 I.U. respectively) at the time of clinical illness, consistent with an acute HBV infection. Since 7 (18%) among the staff members were immune to HBV (positive anti HBs and anti HBc) and the remainder sero-negative; the remaining 6, however, showed evidence of active viral replication (S. P. and K. E.), viral infection (F. P. and J. L.) or incomplete immune response (B.F. and G.H.). During the 9 months' follow-up their serologic status did not change, with the exception of 2 (F.P. and B.F.), in whom HBs disappeared. The incidence of anti HAV in patients was 42% and in the staff 44%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Asthenopia in clinical practice: a comparative study of complaints, clinical findings and results of therapy in asthenopic patients (author's transl)].

A study was carried out by seven ophthalmologists practising in the Berne region on 473 patients complaining of eye strain. Medical histories were taken by questionnaire, refraction was done and phoria measured, followed by therapy in accordance with the physician's opinion. In 380 cases, glasses were prescribed, including prismatic glasses for 14 patients. In 123 cases, local medical therapy was instituted. The statistica evaluation of pre-treatment findings and results of therapy, was carried out using a computer. The principial complaints before treatment were eyestrain and visual disturbances, followed by conjunctival irritation and headache. Women complained more about headaches, men more about visual disturbances. A majority of the patients with visual disturbances needed minus lenses, while for the treatment of headaches mostly plus lenses were needed. In patients with conjunctival irritation local medical treatment resulted in additional relief of symptoms. Cylindric correction had only a minor influence on the result of therapy. Heterophoric patients did not have more complaints than orthophoric ones, and results with spectacles without prisms were the same as in orthophoric patients.

Adolescent↗

Quantitative analysis of intracerebral recordings in epilepsia partialis continua.

A 14-year-old female with epilepsia partialis continua was explored stereo-electroencephalographically (SEEG). SEEG, EEG and EMG were recorded synchronously on a 32-channel machine and stored on magnetic tape for off-line analysis. The beginning of the myoclonus was used as trigger for the analysis of the intracerebral activity, which was analysed by averaging. Thereby the generating potentials of the jerks became evident. They had different maxima and latencies relative to the facial and hand muscles: that for m. orbicularis oculi was located in the precentral gyrus, the beginning of its positive deflection was 17 msec earlier than the muscle action potential; that for the thenar muscles had a latency of 24 msec, appeared at first in the premotor cortex and with a slight delay, but with greater amplitude in the corona radiata and capsula interna. Stimulation of the lateral area 4 elicited myoclonus which corresponded to the spontaneous one in distribution and latency. Stimulation of the thalamic VL nucleus had no effect. During deep sleep the frequency of the myoclonus was diminished. REM sleep was preceded and followed by a definite increase of jerking. The pattern, topography and latency of the generating potentials in waking and sleeping were very similar. In this way quantitative evidence of the neocortical origin of Epc is given and therefore a precise delineation of the epileptogenic focus.

Adolescent↗