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Biomedical subjects

K Albrecht

Publications and source records attributed to K Albrecht.

At least 37 records · Page 2Linked to original sources
PubMed2003

Accidental autoerotic deaths between 1978 and 1997. Institute of Legal Medicine, Medical School Hannover.

Between 1978 and 1997 the Institute of Legal Medicine of the Hannover Medical School examined 17 fatal autoerotic deaths. The incidence for the Hannover region was 0.49 cases per million inhabitants per year. The victims included 17 men with an average age of 36.8 years; a peak in the age distribution was seen between 20 and 29 years. Twelve of the men were found by friends or family in a domestic environment, while other situations in which the victims were found included the victim's own car, a hotel room, a canal embankment, a public parking lot as well as the holding cell of the youth detention center. The men were of varying socioeconomic status and held a number of different types of jobs or still attended school. Five of the men were found completely nude, while five were only undressed below the waist. Four men wore women's clothes and two were fully clothed with exposed genitals. Besides women's clothes, other objects found at the scene included various types of sexual aids, including ropes, chains, metal bars, locks, sex magazines, condoms, plastic bags, rubber items, etc. In four cases blood alcohol levels between 0.1 and 2.5 per thousand (urine alcohol levels between 0.2 and 2.5 per thousand ) were found. Toxicologic examination revealed chloroform, ketamine, a propane-butane gas mixture in one case each, and in two cases cocaine and morphine. Causes of death included central paralysis after strangulation (seven cases), asphyxiation (4), subarachnoid hemorrhage (2), intoxication (1), hypothermia (1), left heart failure (1), and drowning (1). The history, findings at scene, and autopsy findings and, in individual cases, other investigations are of utmost importance to accurately reconstruct a fatal autoerotic accident.

Accidents↗
PubMed2002

[Effects of social support on well-being of demented nursing home residents. The Käferberg Visitation Study].

BACKGROUND: Relatives and caregivers of patients with dementia are often insecure about the impact of their efforts. This study examines whether and to what extent social support in the form of regular visits is increasing the well-being of demented aged. PROCEDURE: A field experiment with slightly to seriously demented institutionalized aged persons (MMS 5-25) was carried out to assess the effect of increased social support upon their well-being. Voluntary helpers, who were willing to visit their patients on a regular basis, were recruited by appeals at the senior university and by advertisements. The volunteers were trained to deal with the demented and were looked after regularly. The test subjects were randomly assigned to one of two test groups. The first group was visited regularly for ten weeks, whereas the second group served as a control group. The participants of the experimental group received a visiting card with a photo of the volunteer and the next appointment date to remember their visitors and to increase the effect of predictability. RESULTS: The effect of visits on the well-being of the institutionalized aged persons was significantly positive (F(1,39) = 11.16, p < 0.002). The psychological, physiological and social well-being of the participants was improved. Additionally, visits moderated the pain resulting from physical illness and seemed to decrease the effects of mental decline on their performance. Furthermore, it was most impressive to find that the demented aged really took notice of the visits and seemed to remember them in one way or an other. The study pointed out that demented aged persons are still very sensitive in an emotional respect and that they are still able to give astonishing good and differentiated information about their feelings even in an advanced state of dementia. Even the volunteers gained from their visits, which was shown by their higher well-being after their visits.

Adaptation, Psychological↗
PubMed2002

Autoerotic accident associated with self-applied ketamine.

We present a rare case of an autoerotic accident involving a fatal combination of asphyxia by suffocation and intoxication with self-administered intravenous ketamine. Of note in this case is the fact that the victim was an emergency medical technician. Ketamine causes complete analgesia with superficial unconciousness and amnesia called "dissociative anasthesia". Futhermore low anaesthetic doses of ketamine induce alterations in mood, cognition and body image and the substance is an emerging drug of abuse. We discuss the death scene investigation, findings at autopsy and the toxicological report.

Adult↗
PubMed2001

Pattern of connexin 26 (GJB2) mutations causing sensorineural hearing impairment in Ghana.

Mutations of the connexin 26 gene (GJB2) were studied in 365 apparently unrelated individuals with profound nonsyndromic, sensorineural hearing impairment from Ghana, West Africa. Among 121 mutated chromosomes found, 110 carried the previously described R143W mutation. A total of 6 novel mutations: L79P, V178A, R184Q, A197S, I203K, and L214P, were identified, whereby I203K was based on a dinucleotide exchange and R184Q appeared to be dominant. The GJB2 variants found in Ghana tend to comprise less nonsense and frameshift mutations and more mutations located in the C-terminal half of the molecule than the variants found in other parts of the world.

Adolescent↗
PubMed2000

[Clinical manifestations of CHARGE association in the area of the mouth, jaw and face].

Clinical experience of 11 patients with CHARGE association is reviewed. The study comprised six girls and five boys. All presented with congenital heart disease. Eight had bilateral choanal atresia. Coloboma affecting either one or both eyes was detected in nine children. Nine patients suffered abnormal pinnae or deafness. In addition to major abnormalities, further anomalies of the orofacial region and the upper airways occurred in all patients. All children exhibited velopharyngeal incoordination and swallowing problems often resulting in recurrent aspiration pneumonia. Three patients had cleft lip and palate. Both micrognathia and high-arched palate were present in two patients. Facial palsy was observed in six patients. Optimal management requires a multidisciplinary approach with active coordination and cooperation between the appropriate specialties. The anatomical repair of bilateral choanal atresia should be performed as early as possible. In our experience, the transpalatal approach is far more satisfactory than the transnasal. It gives the surgeon the opportunity of direct access and anatomical repair. After the child has grown stronger, a long-term management is desirable including developmental and feeding training.

Abnormalities, Multiple↗
PubMed1999

[Treatment of intraarticular calcaneal fractures in adults. A treatment algorithm].

Significant progress has been made in terms of the management of calcaneal fractures. This is reflected in the marked decrease in complication rates associated with the current intervention of these potentially devastating injuries. The treatment priorities that, in the authors opinion, are key to achieve best results in a displaced calcaneal fracture are anatomic reconstruction of the entire calcaneus: articular surfaces, height, alignment, and length, with a function directed postoperative management. The value of these priorities are confirmed by the authors longterm follow-up results as presented here. To reemphasize, conservative treatment should be considered only in cases of extraarticular fractures, minor displaced intraarticular fractures in nonambulatory patients, and in cases where there is a clear contraindication for surgery. Regarding the technical requirements for an anatomic reconstruction, the os calcis fracture should be categorized as a procedure for experts. In two-part fractures, according to the Sanders classification, an anatomical reduction is obtainable in more than 80%-90% of cases. However, in consideration of the articular cartilage damage, a 70% rate of good to excellent clinical results seems realistic. In three-part fractures, anatomic reduction is attainable in about 60% of cases with a 70% rate of good results. These two subgroups comprise about 90% of all calcaneus fractures. It is the authors recent experience to optimize the extended lateral approach using posteromedial and anterolateral windows, so that an anatomic reduction in more than 60% of Sanders Type III os calcis fractures can be achieved. Further scientific work in this area of trauma orthopedics would benefit most from a general consensus on a fracture classification system and on a clinical scoring system, with 5 year follow-up studies using these treatment methods and evaluation systems.

Adult↗
PubMed1998

Management of calcaneal fractures in adults. Conservative versus operative treatment.

Significant progress had been made in the management of calcaneal fractures. This is reflected in the marked decrease in complication rates associated with the current intervention of these potentially devastating injuries. The treatment priorities that are key to achieve best results in a displaced calcaneal fracture are an anatomic reconstruction of the entire calcaneus including articular surfaces, height, alignment, and length, with a function directed postoperative management. The value of these priorities is confirmed by long term followup results. Conservative treatment should be considered only in cases of extraarticular fractures, in cases of minor displaced intraarticular fractures in patients who are nonambulatory, and in cases where there is a clear contraindication for surgery. An anatomic reconstruction of an os calcis fracture is difficult to obtain. In two-part fractures, according to the classification described by Sanders et al, an anatomic reduction is obtainable in more than 80% of cases. However, if the articular cartilage damage that is typically present is considered, a 70% rate of good to excellent clinical results is more realistic. In three-part fractures, anatomic reduction is attainable in approximately 60% of cases with a 70% rate of good results. These two subgroups comprise approximately 90% of all calcaneal fractures. It has been put into practice recently to optimize the extended lateral approach using posteromedial and anterolateral windows, so that an anatomic reduction can be achieved in more than 60% of os calcis fractures considered as Type III according to the classification described by Sanders et al. Additional scientific work in this area of trauma orthopaedics would benefit most from a general consensus on a fracture classification system and on a clinical scoring system, with 5-year followup studies using these treatment methods and evaluation systems.

Algorithms↗
PubMed1998

Conformance with the preferred practice pattern for diabetic eye care.

OBJECTIVE: To investigate conformance with a practice guideline in the eye care of patients with diabetes. METHODS: The care of 210 patients with diabetes seen in a multispecialty eye care setting was compared with the recommendations of the American Academy of Ophthalmology's Preferred Practice Pattern. Criteria measured included appropriate classification of stage of disease, follow-up intervals based on stage of disease, and initiation of appropriate laser treatment. RESULTS: The 210 patients whose charts were reviewed showed high levels of conformance with recommended care patterns. All patients were appropriately classified. From 91-100% of patients were seen within the recommended time intervals and received laser treatment when indicated. CONCLUSION: The American Academy of Ophthalmology's Preferred Practice Pattern can be easily operationalized into review criteria. Application of these review criteria to one multispecialty eye care setting shows evidence of high rates of conformance with recommended care.

Diabetic Retinopathy↗
PubMed1998

Using a computer-based patient record for quality management in surgery.

Our first generation hospital information system is in routine use since 1989. The patient data are used for multiple clinical purposes: operation scheduling, reminder for patient care, case retrieval for research and education, and so on. The computer-based patient record was complemented by a flexible PC-based query and report facility for quality management. A regular export of patient data from the host is translated into a relational database model and assessed via the standard of Open Database Connectivity (ODBC) by a statistical analysis tool. Herewith, descriptive and analytical statistics become available to support the clinical departments in patient care. Concerning the migration of first generation systems to modern architectures the presented approach has to be compared with strategies of replacement and capsulation. A decision on the strategy applied should take into account local resources and opportunities.

Computer Systems↗
PubMed1998

Prevention of deep venous thrombosis associated with superficial thrombophlebitis of the leg by early saphenous vein ligation.

BACKGROUND: Thrombophlebitis of the superficial veins of the leg used to be regarded as a mild and uncomplicated disease, particularly in German speaking countries. PATIENTS AND METHODS: In a retrospective clinical study from 6/91 until 12/96 we followed the progress of all patients (n = 398) with thrombophlebitis of the vena saphena magna or parva. Parameters of interest were: the incidence of concomitant deep vein thrombosis and subsequent pulmonary embolism. All patients underwent colour duplex scanning, most of them repeatedly. In cases of proven ascending superficial thrombosis, or involvement of the saphenofemoral junction, proximal saphenous vein ligation was performed (n = 56, 49 vena saphena magna and 7 vena saphena parva). Among these groups, there were 10 patients with malignant disease (18%), ten with a history of thrombosis (18%), another five comprised diabetes, recent major surgery and organ transplantation. RESULTS: In 56 operations we found free-floating thrombi 6x (11%), 19x the sapheno-femoral junction was involved (33%), 24x the saphenous vein close to the junction (43%). Three patients develop deep vein thrombosis, despite surgery (0.75% of all and 5% of the operated cases). 2 patients suffered from (non-lethal) pulmonary embolism (0.5% and 3.5%, respectively). One embolism occurred before vein ligation. Perioperative morbidity amounted to 8.5% (superficial wound infection, hematoma). CONCLUSION: Venous ligation is probably effective in reducing the rate of fatal pulmonary embolism.

Adult↗
PubMed1998

Protein disorder and the evolution of molecular recognition: theory, predictions and observations.

Observations going back more than 20 years show that regions in proteins with disordered backbones can play roles in their binding to other molecules; typically, the disordered regions become ordered upon complex formation. Thought-experiments with Schulz Diagrams, which are defined herein, suggest that disorder-to-order transitions are required for natural selection to operate separately on affinity and specificity. Separation of affinity and specificity may be essential for fine-tuning the molecular interaction networks that comprise the living state. For low affinity, high specificity interactions, our analysis suggests that natural selection would parse the amino acids conferring flexibility in the unbound state from those conferring specificity in the bound state. For high affinity, low specificity or for high affinity, multiple specificity interactions, our analysis suggests that the disorder-to-order transitions enable alternative packing interactions between side chains to accommodate the different binding targets. Disorder-to-order transitions upon binding also have significant kinetic implications as well, by having complex effects on both on- and off-rates. Current data are insufficient to decide on these proposals, but sequence and structure analysis on two examples support further investigations of the role of disorder-to-order transitions upon binding.

Algorithms↗
PubMed1998

[Adenovirus infections in psittacines].

Diagnostic investigations were carried out in a fatal disease of several African Grey Parrots (Psittacus erithacus) and Cape Parrots (Poicephalus robustus) in a large breeding plant. Electron microscopically examination of liver and intestine, the organs with the most prominent pathomorphological changes, regularly revealed adenoviruses. Necrotizing hepatitis and catarrhal to haemorrhagic enteritis dominated on histopathological examination. Numerous basophilic intranuclear inclusion bodies in hepatocytes and enterocytes and their ultrastructural characteristics underline the etiological role of the detected adenoviruses. Adenoviruses were isolated from livers of three different birds and once from the intestine. Serologically the isolates were classified as fowl adenovirus serotype 4 (FAV4). Restriction enzyme analysis of two isolates showed the identity with the FAV4 reference strain KR5.

Adenoviridae Infections↗
PubMed1997

Exogenous caldesmon promotes relaxation of guinea-pig skinned taenia coli smooth muscles: inhibition of cooperative reattachment of latch bridges?

In smooth muscle, the state of prolonged contraction (latch state) is associated with very slow energy turnover and cycling of crossbridges that are dephosphorylated. A similar state may be reproduced in skinned fibres when the calcium-induced contraction is terminated by calcium removal with ethylenebis(oxonitrilo)tetraacetate (EGTA) and, during the slow relaxation that follows, force is maintained by dephosphorylated crossbridges that cycle slowly or not at all and may cooperatively reattach after detachment (Khromov et al. 1995, Biophys J 69:2611-2622). In guinea-pig skinned taenia coli that has been pretreated by prolonged incubation with caldesmon (5 microM), the rate of relaxation is approximately 1.6 times greater than in untreated controls, with half-times of relaxation being 1.3 and 2.1 min, respectively. In contrast, preloading the fibres with calponin does not accelerate relaxation. Preloading the fibres with caldesmon also accelerates the relaxation of skinned fibres from the state of rigor contraction when the latter is terminated by immersion into an ATP-containing relaxing solution or, in the presence of inorganic phosphate (Pi), also by flash-photolytic release of ATP from caged-ATP. Even in the latter case, relaxation is comparatively slow, possibly because of cooperative reattachment of dephosphorylated crossbridges which delays net crossbridge detachment and hence relaxation. We propose that by inhibition of cooperative reattachment caldesmon accelerates relaxation, even in the presence of Pi, and that the latch-like state of skinned fibres is supported by dephosphorylated cooperatively attaching crossbridges and may be regulated by the activity of caldesmon in the smooth muscle cell.

Adenosine Triphosphate↗
PubMed1996

Quaternion contact ribbons: a new tool for visualizing intra- and intermolecular interactions in proteins.

Protein side chain interactions between residues separated by at least one loop or turn or break in the amino acid sequence are called 'nonlocal contacts' in this manuscript, and contiguous sets of such interactions located between segments of secondary structure are called 'contact zones.' A new interactive program, the quaternion contact ribbon tool, has been developed to help protein chemists identify, straighten if twisted, and display contact zones between two neighboring segments of helix.

Binding Sites↗
PubMed1995

Presence and persistence of HPV infection and p53 mutation in cancer of the cervix uteri and the vulva.

We studied 51 cervical carcinomas, among them 25 squamous-cell carcinomas (SCC) and 26 cervical adenocarcinomas (AdCa), and 40 vulvar SCC for the presence of HPV and mutant p53. HPV was detected by PCR, and p53 alterations by temperature-gradient gel electrophoresis/direct sequencing and immunohistochemistry. HPV, mostly type 16/18, was found in 80.4% of the cervical tumors (92.0% of the SCC and 69.2% of the AdCa), but in only 27.5% of vulvar carcinomas. In contrast, p53 mutations were found in 7.8% and 52.5% of cervical and vulvar tumors respectively. Mutant p53 occurred in pre-invasive vulvar lesions, indicating that this oncogenic factor is involved early in carcinogenesis. Further analysis of recurrent/metastatic lesions of 9 cervical and 14 vulvar tumors also showed remarkable differences: in cervical cancer, HPV was persistent, and p53 mutations absent, whereas in vulvar tumors, HPV was mostly absent or not persistent, and the p53 mutation rate was very high (78.6%). These observations suggest that HPV persistence is an important event for the evolution and maintenance of cervical cancer, whereas for vulvar cancers p53 mutation and not HPV activity is a central oncogenic event.

Adenocarcinoma↗
PubMed1995

Primary gastric non-Hodgkin's lymphoma: a clinicopathological study of 41 patients.

Pathological findings in 41 patients (male/female ratio: 1.3/1) with primary localized gastric non-Hodgkin's lymphoma (NHL) were retrospectively studied and correlated with survival. The median observation period after diagnosis was 32 (0-189) months. Nineteen patients were low-grade NHL, all but one B-cell lymphomas of the mucosa-associated lymphoid tissue (MALT) type. Twenty-two patients had primary (n = 7) or secondary (n = 15) high-grade lymphomas; Musshoff stage IE was found in 29 and IIE in 12 cases. The median age at diagnosis was 61 years (range, 26-88 years), and proliferation, measured by the number of mitosis and Ki-67 antigen positivity (MIB-1), was high or moderately high in 24 cases and low in 17 cases. Follicular lymphatic hyperplasia could be found in 25 of 34 evaluable cases, more often in low-grade than in high-grade NHL. Most of the patients were treated by resective surgery and additional ratio- or chemotherapy. Thirteen patients (31%) died (median survival: 10 months), 5 of them within 3 months after surgery owing to postoperative complications. Survival was superior, though not statistically significant, in low-grade lymphomas. Our retrospective analysis of heterogeneously treated gastric lymphomas reveals that gastric lymphomas, especially of the low-grade MALT type, often remain a localized disease with a good long-term prognosis. Our study confirms previous reports indicating that lymphomas of the MALT type represent a specific clinicopathological entity.

Adult↗
PubMed1994

QMHC interview: Karl Albrecht. Interview by Marie E. Sinioris.

For over a decade, Karl Albrecht has helped health care and other organizations focus on creating superior value for customers. In his books Service America! and The Only Thing That Matters, he developed a model of organizational improvement called Total Quality Service that is tailored to service organizations. One of the principles underlying this model is that service industries are fundamentally different from manufacturing industries. Thus, the approach to quality improvement in services should not be based on a manufacturing mentality. QMHC interviewed Karl Albrecht to catch up with his latest thinking on value creation, leadership, and innovation in health care and elsewhere.

Consumer Behavior↗