Biomedical subjects
Publications and source records attributed to H Pietsch.
In spite of the dramatic development in CT, there was no major breakthrough in the iodinated contrast media development. New agents based on hybrid between MRI and CT compounds may be a new innovative alternative. This new approach may also open new indications such as radiotherapy.
In this study, three dummies were evaluated on the component level and as a whole. Their responses were compared with available volunteer and embalmed Post Mortem Human Subject (PMHS) data obtained under similar test conditions to evaluate their biofidelity. The volunteer and PMHS data, used as comparators in this study, were used previously to establish some of the biofidelity requirements of the Hybrid III. The BioRID II, the Hybrid III, and the RID2 were all subjected to rear impact HYGE sled tests with deltaVs of 17 and 28 km/hr to determine their biofidelity in these conditions. A static pull test, where a load was manually applied to the head of each dummy, was used to evaluate the static strength of their necks in flexion and extension. Finally, pendulum tests were conducted with the Hybrid III and RID2 to evaluate the dynamic characteristics of their necks in flexion and extension. The sled test results indicate that out of the three dummies, the overall flexibility of the Hybrid III is comparable to that of the volunteer anticipating the impact. The overall flexibilities of the BioRID II and the RID2 are greater than those of all the comparators used in this study (the tensed volunteer and the two embalmed PMHSs). The responses of the Hybrid III are closer to those of the tensed volunteer than those of the PMHSs. The responses of the BioRID II and the RID2 are closer to those of the PMHSs than to the tensed volunteer.
This report describes three different investigations undertaken to demonstrate the advantage of fluid alcoholic hand disinfectants. In the first study, the skin compatibility of Sterillium, a liquid alcoholic rub-in hand disinfectant was compared with that of Hibiscrub, a water-based handwashing antiseptic. Using various parameters such as image analysis of removed squames (D-squames), skin roughness or transepidermal water loss, Hibiscrub was found to be significantly inferior to Sterillium. Hibiscrub caused skin irritation in 15 volunteers who could not complete the test. In a second study, the microbicidal efficacy of Sterillium and Hibiscrub was tested in surgical hand disinfection. The microbial reduction by Sterillium was significantly greater than that of Hibiscrub, immediately after application as well as after the surgical procedure. In a third study, certain alcoholic gels were tested according to the EN 1500 'hygienic hand disinfection'. None of the gels tested passed the EN 1500 within 30s. However, Sterillium met the EN 1500 requirement within 30s. We conclude that Sterillium is superior to Hibiscrub in terms of skin tolerance and microbicidal efficacy in surgical hand disinfection. It is also superior to alcoholic gels.
The pathogenic bacterium Helicobacter pylori, which has infected more than one-half of the world's human population, exists in two morphological forms; the viable helical form and the disputed viable-but-not-culturable coccoid form. Infection by the helical form proceeds through the oral-oral route, while that by the coccoid form, if possible at all, is by the faecal-oral and/or the oral-oral route. The present pilot study addresses the question of disinfectant efficacy against both forms of the bacterium.
Ultrasound technologies have a wide range of hospital and dental applications which include cleaning and disinfection of surgical and dental instruments. We measured the germicidal efficacy of sonication, with or without chemical disinfectants, in an ultrasonic bath delivering a frequency of 35 kHz and an intensity of 0.66 W/cm2. Cultures of Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were exposed to ultrasound and to an amine-based disinfectant in non-bactericidal concentrations. Ultrasonication for 60 min alone did not cause a significant killing of the bacteria and yeast. However, we were able to show that sonication can act as a powerful synergistic agent to increase the cidal efficacy of the disinfectant against S. aureus and P. aeruginosa. C. albicans was more resistant to the combination of ultrasound and chemical disinfection. The key role in the action of ultrasound in cleaning of instruments and perhaps in enhanced disinfection is played by cavitation phenomena. The distribution of cavitations in an ultrasonic bath is not homogenous. We found a similar synergistic effect of ultrasound and disinfectant in positions with low cavitation. The synergistic effect was not reduced inside rubber tubes. Before ultrasound can be accepted as an integral part of the cleaning and disinfection process of medical instruments, the influence of intensity and frequency of sonication and the effects of cavitation must be clarified.
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An 11 year old boy with recurrent meningitis/sepsis (once without positive bacterial culture, once with demonstration of Neisseria meningitidis in blood) was evaluated for suspected immunodeficiency. Absent activity of both the classical and alternative pathway of complement suggested a defect of the membrane attack complex. Immunochemical and functional analyses together with family studies revealed a homozygous defect of the seventh component of complement in the boy. This is the first description of C7 deficiency in a German family.
According to the new German 'Betreuungsgesetz' (BtG) legislation concerning care for the mentally and or physically disabled, instituting a "case of care" requires an expert opinion on the patient's mental and physical impairments as well as on the question as to what degree the patient lacks the ability to manage his or her own affairs. The respect for the personal autonomy has to be weighed against the need to take action for the patient's benefit. The concept of 'neglect' ('Verwahrlosung') plays an important role in judging a patient's situation. Criteria for the use of this term are derived from a study carried out by the author, and lead to a questionnaire designed for preparatory investigations. As to the question of who should act as an expert in BtG cases, the author argues that the public health offices qualify best for this task.
Kallmann's syndrome is generally assessed by history and subjective tests of olfactory function. In this study three patients suffering from Kallmann's syndrome were investigated with more objective techniques, including the recording of chemosensory evoked potentials (CSEPs). After testing olfactory function by means of a simple odor identification test, anosmia was confirmed in only one patient, since the other two patients were able to distinguish between several odorants. However, investigations in which CSEPs were employed indicated that all three patients had complete loss of their olfaction as well as hypersensitivity of the trigeminal nerve. These findings prove the usefulness of CSEPs in clinical investigations of the sense of smell.
Bacterial meningitides occurred in two members of a Yugoslavian family. In one case meningitis remained a singular event, Neisseria meningitidis being identified in the CSF. The second patient developed five episodes of recurrent purulent meningitis associated with petechiae and in one instance also with arthritis of the left knee but no causative germ was found. In both patients the Western blot technique revealed a defect of the beta-subunit of the eighth component of complement that was completely eliminated by purified C8. This proved that the C8 defect was isolated and that no other component was deficient.
We describe an 11-year-old girl suffering from recurrent meningitis with a complete absence of the seventh component of complement (C7). Diagnosis was established by haemolytic titration and western blotting. The patient's serum lacked the 85 kDa C7 chain. Haemolytic activity of serum was reconstituted with either pooled normal human serum or with purified C7. The relatives (parents and one sister) had half-normal levels of both immunochemically and functionally determined C7, indicating a heterozygous state for C7 deficiency.
The C8 alpha-gamma subunit of the eighth component of complement was analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and immunoblotting in sera from 68 normal individuals, 12 C8 beta-deficient patients (from seven unrelated families), and 10 of the parents of the latter. Three different forms of the C8 alpha-gamma subunit were observed: 34/68 normal individuals were found to have a C8 alpha-gamma triple band (termed C8 alpha-gamma 1, C8 alpha-gamma 2, C8 alpha-gamma 3 variants), 23/68 the C8 alpha-gamma 2 and C8 alpha-gamma 3 variants, and 11/68 the C8 alpha-gamma 1 and C8 alpha-gamma 3 variants. In contrast, all C8 beta-deficient patients had detectable C8 alpha-gamma 2 and C8 alpha-gamma 3 variants but lacked the C8 alpha-gamma 1 variant in addition to the C8 beta subunit. Three out of ten parents of the C8 beta-deficient patients were found to have the C8 alpha-gamma triple band, whereas 7/10, like their children, had the C8 alpha-gamma 2 and C8 alpha-gamma 3 variants only. We conclude that there is a linkage between the C8 alpha-gamma pattern and C8 beta deficiency. These data may support earlier findings that in humans the genes encoding for C8 alpha-gamma and C8 beta are closely linked on chromosome 1.
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Temperature measurements are reported effected by aid of thermocouples enclosed in tubules in TEP-implantations of the hip. Two techniques were employed: the first using as acrylic bone cement Palacos or Sulfix-6 without concomitant cooling, the second Palacos after precooling of the femur with crushed ice/water mixtures. The first method yielded, at the acrylic bone cement/bone interface, temperatures above the coagulation point of the protein (56 degrees C). The novel technique of implantation is described, i.e. the cooling of the bone with ice-water prior to the cement implantation. This technique provides a means of restricting the average temperature at the aforesaid interface to 45 degrees C.