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Biomedical subjects

J Fuhrmann

Publications and source records attributed to J Fuhrmann.

15 recordsLinked to original sources
PubMed2000

[Reproducibility of a German scale for assessing the need for inpatient treatment in surgery].

During the past years, the assessment of the appropriateness of hospital utilization has become increasingly important in the German health care system. Previous evaluations by regional review organizations in several states demonstrated the need for a standardized, reliable, and valid instrument to evaluate the appropriateness of inpatient care. Objective of the study is to test the reliability of a German adaptation of the "Appropriateness Evaluation Protocol" (AEP). Among all 2672 admissions from the department of surgery of a regional medical center during one calendar year, 54 patients were randomly selected to evaluate the inter-rater reliability and 51 patients to test intra-rater reliability. Overall agreement, specific agreement and Kappa statistics were estimated for every hospital admissions and all consecutive hospital days. The German AEP showed an inter-rater agreement of 74% (62-86%) for hospital admissions (Kappa = 0.44) and 84% (79%-88%) for all hospital days (K = 0.55). Intra-rater reliability was 88% (79%-97%) for hospital admissions (K = 0.60) and 88% (85%-92%) for all hospital days (K = 0.70). The observed agreement is independent of length of hospital stay and proportion of appropriate days. A standardized instrument with known metric properties is essential for quality management in hospitals to prepare for an increasingly consolidating health care market in Germany. The German AEP is a reliable instrument, which will allow to identify inefficiencies in the management of surgical inpatients.

Adult↗
PubMed1999

Genome duplications and other features in 12 Mb of DNA sequence from human chromosome 16p and 16q.

Several publicly funded large-scale sequencing efforts have been initiated with the goal of completing the first reference human genome sequence by the year 2005. Here we present the results of analysis of 11.8 Mb of genomic sequence from chromosome 16. The apparent gene density varies throughout the region, but the number of genes predicted (84) suggests that this is a gene-poor region. This result may also suggest that the total number of human genes is likely to be at the lower end of published estimates. One of the most interesting aspects of this region of the genome is the presence of highly homologous, recently duplicated tracts of sequence distributed throughout the p-arm. Such duplications have implications for mapping and gene analysis as well as the predisposition to recurrent chromosomal structural rearrangements associated with genetic disease.

Animals↗
PubMed1997

[Is ambulatory surgery at a maximum care clinic justified?].

It is politically desirable to promote ambulatory surgery in private practice or in hospitals as a means to reduce costs. In contrast to this, one has to deal with unsatisfactory net profits. Even if a hospital is primarily running at a loss, ambulatory surgery should be performed. Offering the service of ambulatory surgery can improve the recruitment of patients and may help to compete with other hospitals.

Ambulatory Surgical Procedures↗
PubMed1996

[Therapeutic concepts and long-term outcome in thyroid gland carcinoma].

UNLABELLED: Data of all (n = 131) patients carrying thyroid carcinoma and operated on between January 1st, 1979, and September 30th, 1994 in our center were analyzed retrospectively. Patient's files were reviewed concerning histological diagnosis, TNM-classification, operation procedure and complications. Follow-up data were obtained in all cases from local cancer registry as well as from personal records. Statistical analysis was performed using PCS-software (TopSoft, Hannover). RESULTS: Follow-up data from 3-191 months (mean: 50.4 mo.) postoperatively were obtained from 72 patients with papillary thyroid carcinoma (PTC) including 27 cases of occult papillary thyroid carcinoma (oPTC, < 1.5 cm), 30 patients with follicular thyroid carcinoma (FTC), 10 patients with medullary thyroid carcinoma (MTC) and 19 patients carrying anaplastic tumor (ATC). In case of oPTC 51.8% of the patients received total thyroidectomy or lobectomy and contralateral near-total resection. In PTC, both procedures were performed in 68.9% combined with neck dissection in 31%. Radioiodine treatment was given to 59.7%. Treatment of FTC consisted mainly of thyroidectomy (60%) followed by radioiodine therapy (76.7%). In patients with MTC preference was given to thyroidectomy and bilateral neck dissection, more recently completed by mediastinal lymph node dissection. 90% of the patients with ATC were inoperable. No patient received chemotherapy pre- or postoperatively, respectively. Five-and 10-year survival of patients with PTC (oPTC) was 91.6% (93.7%) and 80.2% (93.7%), respectively. Corresponding data for FTC were 70.5% and 50.3%, and 71.6 % and 47.9%, for MTC respectively. ATC showed 10.3% 3-year survival. CONCLUSIONS: Despite therapy of choice was not performed in all patients, our long-term results generally confirm those reported by others. Despite of this, limited radical therapy should be restricted to oPTC in our opinion. In case of MTC presenting rising or elevated tumor markers postoperatively, early mediastinal lymph node dissection should be considered.

Adenocarcinoma, Follicular↗
PubMed1995

The minimal gene complement of Mycoplasma genitalium.

The complete nucleotide sequence (580,070 base pairs) of the Mycoplasma genitalium genome, the smallest known genome of any free-living organism, has been determined by whole-genome random sequencing and assembly. A total of only 470 predicted coding regions were identified that include genes required for DNA replication, transcription and translation, DNA repair, cellular transport, and energy metabolism. Comparison of this genome to that of Haemophilus influenzae suggests that differences in genome content are reflected as profound differences in physiology and metabolic capacity between these two organisms.

Antigenic Variation↗
PubMed1990

Symbiotic effectiveness of indigenous soybean bradyrhizobia as related to serological, morphological, rhizobitoxine, and hydrogenase phenotypes.

A Collection of 360 isolates of Bradyrhizobium japonicum was developed from soybean (Glycine max [L.] Merrill) nodules taken from 18 locations in Delaware. The isolates were characterized serologically with an enzyme-linked immunosorbent assay, morphologically by colony type on yeast extract-mannitol agar, and for production of rhizobitoxine symptoms with soybean plants. These analyses revealed 12 and 3 groups based on serology and morphology, respectively. The more common identifiable isolates were in serogroups 94, 6, 122, and 76. Nearly 33% of the isolates were rated nonreactive with all of the antisera tested. Overall, 18% of the isolates produced rhizobitoxine symptoms, and these were associated with five known serogroups (31, 46, 76, 94, and 130) and the nonreactive grouping, but with only one colony type. A subsample of 92 isolates was rated for N(2)-fixing ability in the greenhouse and for hydrogenase phenotype in the laboratory. The nitrogen content of plant shoots was strongly and comparably related to both the serological and morphological groupings. Rhizobitoxine and hydrogenase phenotypes were relatively poor predictors of symbiotic effectiveness. Among the serologically reactive isolates, those in serogroups 38-115, 122, and 110 fixed the most N(2), whereas one colony type (that containing isolates producing rhizobitoxine) was clearly inferior to the remaining two morphological groupings. Isolates displaying hydrogenase activity (approximately 15% of the isolates tested) correlated with three serologically reactive groupings (serogroups 110 and 122 and a 122/123 cross-reactive group) and two colony types, none of which coincided with groupings containing bradyrhizobia rated positive for rhizobitoxine production.

Journal Article↗
PubMed1990

[Bone stress. A hitherto neglected factor in hip endoprosthesis design].

Growing interest in hip endoprostheses is giving rise to new ideas on form and materials, although it is not precisely known what forces the proximal femur is subject to. To find out more about these forces, we made computerized analyses of the stresses on some different types of prostheses in an artificial standardized femur. The E-module amounts to about 14,000 N/mm. Following measurements in tension-optic trials, we inserted Student gages (EA-13-060LZ-120) at 16 points around the proximal femur; these transmitted the pressure, tensile and torsion stresses to a multipoint measuring instrument (UPM 60) and on-line to a computer. The quality of implantation was monitored by X-ray. With loads varying from 0 to 1.5 kN in 250-N steps we made five readings to reproduce the measurements, without having any material failure. To ensure an absolutely reproducible outcome we used an artificial standardized femur (KNF by Mecron), which without prostheses shows the typical and well-known (Pauwels, Perren) pressure tensions medially and tensile stresses laterally, without crossing the zero line. A distinctly reduced stress profile was seen for pressure and tensile stresses with the ribbed system prosthesis, which might be due to the anchor and collar. Nevertheless, the torsion tensions should be noted. As expected, the shaft systems without anchor and collar show a lesser degree of stiffness. The Mecroblock MR system produces preponderantly pressure stresses, while the CLS (Spotorno) prosthesis sets up more torsion tensions in different directions.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗
PubMed1985

Simplified Enzyme-Linked Immunosorbent Assay for Routine Identification of Rhizobium japonicum Antigens.

A simple, reliable, and flexible modification of the indirect enzyme-linked immunosorbent assay was developed for the identification of Rhizobium japonicum antigens from cultures and nodules. The procedure emphasizes efficient use of time and reagents, adaptability to variously equipped laboratories, and maintenance of sensitivity levels that are adequate for ecological studies.

Journal Article↗
PubMed1979

Patient response to variations in denture technique. Part II: five-year cephalometric evaluation.

This study was designed to determine if differences in rates of residual alveolar bone loss could be found in patients wearing dentures made by a complex technique and a standard technique. Cephalometric radiographs were made for each of 64 patients at initial placement of the dentures and for all active patients at five yearly recall visits. These radiographs were measured to determine rates of mandibular bone loss, maxillary bone loss, loss of total face height, rotation of the mandible, and migration of the denture bases over the 5-year period. At the end of the study no statistically significant differences between the two groups of patients could be found. Examination of all participants in this study revealed rates of bone loss that were very similar to those reported by other investigators.

Alveolar Process↗