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Biomedical subjects

L Engelmann

Publications and source records attributed to L Engelmann.

At least 19 recordsLinked to original sources
PubMed1992

[Antimicrobial chemotherapy of infection in intensive care conditions].

Antimicrobiologic chemotherapy is a cornerstone in the modern concept of treatment of sepsis. It is supported by a number of measures of intensive care. Externally acquired infections followed by sepsis mainly affect immunocompromised patients. They represent the minority. On the other hand, nosocomial infections play a dominant role in intensive care units. Nosocomial pneumonias and infections caused by intravascular plastics or endoprotheses are the most important reasons of sepsis. Initial antimicrobiologic therapy considers both the infectious focus and the specific epidemiology and resistance of microorganisms present in the department: it comprises the drawing of 2 to 3 blood cultures, taking of urinary cultures, tracheal secretion, liquor and wound-swaps for microbiologic examination. A gramstaining of the preparation can be helpful. In case the focus of the sepsis is not known, the first step of treatment consists of a combination of piperacilline or cephalosporins with aminoglycosides. If the septic state does not improve within 48 hours, a glycopeptide should be added against staphylococci (second step). If the combination fails, imipenem/cilastatin and aminoglycosides are administered as the third step. Normally, the result of cultures and resistogram already are available by this time. Today aminoglycosides are preferably given once daily, the serum level is monitored, and the toxicity of aminoglycosides is thus diminished.

Anti-Bacterial Agents↗
PubMed1991

[Delayed hypersensitivity to protamine and immediate hypersensitivity to insulin].

A 63-year-old female, with type II diabetes mellitus, diagnosed in 1967, was started on combination therapy with sulphonylureas and human depot insulin in May 1989, because of inadequate blood sugar control with sulphonylureas alone. Within 3 months she began to develop nodular skin reactions at the site of injection, 12-24 hours after insulin injections. Intradermal testing demonstrated delayed (Gell and Coombs type IV) hypersensitivity to protamine. No specific IgE or IgG antibodies were demonstrable. She was changed to protamine-free human delayed action insulin. After an initial reaction-free period, red urticarial lesions, attributable to immediate (Gell and Coombs type I) hypersensitivity to human insulin, appeared at the injection sites. There were no other complications with continued insulin therapy, and after about 6 weeks no further local reactions were detectable. When an allergic reaction to an insulin preparation is suspected, careful immunological investigation should be performed, to ensure adequate treatment without risk to the patient.

Delayed-Action Preparations↗
PubMed1991

[The determination of left ventricular flow rates using single-probe radiocardiography in the steady-state distribution phase].

A new procedure of extracting data from measurements by single-probe radionuclide ventriculography is presented which reduces the phase differences during summation of single-beat actions and permits the use of a greater number of single actions for summation. Sum curves so determined are better suited for measurements of ejection fractions, compliance and ventricular blood flow rates.

Angina, Unstable↗
PubMed1990

[Multiple trichoepitheliomas].

We report on a 27-year-old male patient suffering from multiple trichoepitheliomas, which first appeared on his face at the age of 15 and later spread to his upper extremities and back. Multiple trichoepitheliomas are benign tumors of the skin appendages with autosomally dominant heredity. Clinically, these lesions have to be differentiated from other adnexal tumors, adenoma sebaceum, as well as basal cell nevus syndrome (Gorlin-Goltz's disease).

Adult↗
PubMed1990

[Retrospective analysis of hip joint development after pericapsular Pemberton ilium osteotomy (modified by Tönnis) in conjunction with intertrochanteric corrective osteotomy].

A review of 45 hips with disorders (congenital dislocation of the hip, subluxation of the hip, hip dysplasia with or without secondary pertheslike changes) treated by pembertons pelvic osteotomy with femur osteotomy is shown. Its a followed-up about two years. Many of them (85%) had satisfactory roentgenographic results and its showed the effectiveness of this procedure. We think the best time for treatment is the age between 2 and 4 years.

Child, Preschool↗
PubMed1990

[L-tryptophan-induced eosinophilia-myalgia syndrome with features of diffuse fasciitis with eosinophilia].

Two female patients developed localized scleroderma on the trunk and the thighs after oral ingestion of L-tryptophan for some years. Both patients reported acute progressive myalgia and weakness of the proximal parts of the extremities. On laboratory evaluation, the leucocyte count was approximately 20,000/mm3, with 38% blood eosinophils in one patient and 53% in the other. The ESR was slightly elevated; electrophoresis and muscle enzymes were normal. Skin and muscle biopsies revealed characteristic features of diffuse fasciitis with eosinophilia. High-dose glucocorticoid therapy resulted in a rapid normalization of the ESR and blood eosinophilia, whereas the scleroderma showed little improvement. The diffuse edema observed in one patient receded within a few days. A correlation between oral ingestion of L-tryptophan and the eosinophilia-myalgia syndrome has been reported recently, and the present case reports must be discussed in the light of this observation. Both patients developed a tryptophan-induced scleroderma-like illness resembling diffuse fasciitis with eosinophilia (Shulman's syndrome).

Eosinophilia↗
PubMed1990

[The status of discography in determining indications for therapy of intervertebral disk-induced diseases].

During a 6-year period from 1983 to 1989 we performed lumbal discography in 403 disc levels on 144 patients. We used the discography to determine the therapeutic way in patients with chronic back pain. In the greater half it was possible to define the symptomatic level exactly. About 90% the discography was very helpful to get a diagnosis or to plan the therapy. The reproduction of pain with discography is helpful in the assessment of abnormal disc levels. Even today in view of CT and MRI.

Humans↗
PubMed1990

[Pathogenesis of HIV-associated Kaposi sarcoma--the Koebner phenomenon as a possible pathogenetic mechanism].

The pathogenesis of the HIV associated Kaposi's sarcoma is still unclear, but it appears to be a multifactorial process. Different investigations have shown, that cytokines and growth factors influence the development of KS. Several cases with tumor manifestation after irritation of the skin are demonstrated. Therefore a mechanism of development comparable with the Koebner Phenomenon can be postulated.

Adult↗
PubMed1989

[Development and status of intensive care medicine in internal medicine at the Karl Marx University in Leipzig].

Issuing from the accomplishments of Köhler for the development of the intensive medicine in internal medicine-in 1964 he performed the first long-term respiration at the then Medical Clinic of the Karl Marx University, in 1969 he institutionalized the young subdiscipline at the clinic, in 1978 he founded the department for intensive medicine and is at work by his decisions concerning the development of young scientists, by the handbook "Intensive Medicine. Internal Medicine and Adjacent Subjects" as well as a member of the presidium of the GDR Society for Internal Medicine for the development of the internal intensive medicine-a description of the development of the department, its achievements and problems is given. The promotion of the intensive medicine by Köhler results, as we think, also from the comprehension that it has the duty to perform a function integrating the subdisciplines, which the modern internal medicine oriented to organs and systems threatens to lose, which, however, makes its self-apprehension, which the patient wishes and the teaching is demanding. From this and from the charge for a highly specialized care of patients who life-threateningly fell ill with internal diseases as well as from the duty to create a scientific forerunning results the stringent necessity of the development of the non-operative, in reality internal intensive medicine in the clinics for internal medicine of the county hospitals and university institutions as well as the greater identification of the internist with the subdiscipline in the district hospitals dealing with multidisciplinary intensive medicine.

Germany, East↗
PubMed1989

[Development and status of nitrate therapy in East Germany].

Nitrates are available in the GDR as: Nitrangin liquidum (0.1 mg glycerol trinitrate/gt.) and Nitrangin isis in 0.3 and 0.8 mg capsules for preventing anginal attacks; Trinitrosan (glycerol trinitrate) for intravenous therapy of ischemic conditions and acute left heart failure; Pentalong 50 (50 mg pentaerythrityl tetranitrate, PETN) for long-term oral therapy. PETN was introduced in 1977 as Pentalong (20 mg), and in a sustained-release form as Pentalong longo (40 mg PETN/dragée: 20 mg in a coated core and 20 mg in capsule form). Patients taking Pentalong longo repeatedly reported undissolved coated pills in their feces due to the varying solubility rates of the coating. It was primarily intended that the coating ensure the sustained release of PETN from the core. Although tests confirmed that 90% of the pill did not release the PETN after 180 min in the "in vitro gastric juice" and of these 90%, another 94% had not released the PETN after 30 min in the "in vitro intestinal juice", it could not be determined what percentage of pill cores did later dissolve and release the PETN during passage through the intestines. Clinical tests on pill cores with eight coatings also revealed no predictable breakdown and release of the core contents. This was not the case with pill cores with five layers of coating, used henceforth for obtaining a sustained release effect with Pentalong longo. However, clinical examinations suggested to abandon sustained release formulations because of the high interindividual release of PETN in the gastrointestinal tract from coated dragées and the drug-inherent sustained action of PETN. The corresponding clinical experiments are the subject of this report.

Angina Pectoris↗
PubMed1989

The influence of mechanical loading on the knee-joint. Animal-experimental examinations.

A physiological maximal loading of the knee-joint of sheep is simulated by a 4-hour peak overloading of 24.5 N and a frequency of 42 impulses per minute. The reactions of articular cartilage, synovia and periarticular muscular tissue to the load were examined histologically, histochemically and biochemically. 20 hours after the loading we could observe a leucocytic influx into the joint and a metabolic hyperactivity in the examined tissue. The changes found during this acute phase are reversible as 180 days after peak overloading the parameters detected to be changed had returned to normal again.

Animals↗
PubMed1985

[Gonadal and adrenocortical hormone changes in myocardial infarct].

On a male group of patients investigations of the behaviour of the testosterone, LH, cortisol and ACTH serum concentrations in the hospital phase of the acute myocardial infarction were carried out. Apart from an early activation of the adreno-cortico-pituitary axis a decrease of the testosterone concentrations at consistent LH levels was observed. On healthy test persons in the ACTH and hydrocortisone tolerance test possible interactions between adrenocortical and gonadal hormone system were controlled.

Adrenocorticotropic Hormone↗