Biomedical subjects

M Bartels

Publications and source records attributed to M Bartels.

At least 19 recordsLinked to original sources

PubMed1998

[Early morphological changes in Crohn disease as further evidence for conservative resection indications].

Clinical studies revealed that the size of the margin of resection and the microscopic findings at the edge of the specimen did not influence the rate of recurrence. Regarding early lesions of Crohn's disease, the aim of the present study was to identify morphological alterations which are able to explain the clinical findings and are in accordance with the operative procedure. In the present study the resection margins of 29 patients with Crohn's disease were investigated using the scanning electron microscope. Seventy-three percent of patients with histopathologically unaffected resection margins in the small bowel and 71% in the large bowel showed early lesions. These consisted of mucosal architectural alterations, epithelial bridge formation and goblet cell hyperplasia and hypertrophy. Curative resection is not possible, independent of the resection margins. The morphological findings underline the correctness of the usual operative procedure, namely limited resections in Crohn's disease.

Crohn Disease↗

PubMed1998

Antibrain antibodies in mental disorder: no evidence for antibodies against synaptic membranes.

Antibody reactivity in serum to synaptic membranes from human was investigated in major depressive disorder (N = 20), paranoid schizophrenia (N = 20), schizoaffective psychosis (N = 20), and in controls (N = 20) using Western and Immunoblots and ELISA technique. None of the patients showed a significant immune response to synaptic membranes. There was a base-line activity in both controls and patients with antibodies directed to a double band of proteins at 66kD. These antibodies may represent natural autoantibodies. The authors conclude from this and other studies that there is at present no proof of antibrain antibodies in mental disorder.

Adult↗

PubMed1998

Coagulatory response after femoral instrumentation after severe trauma in sheep.

OBJECTIVE: Pulmonary complications after intramedullary femoral nailing have been attributed to bone marrow fat embolization and a variety of cascade effects. We investigated whether the coagulatory response after intramedullary femoral nailing in merino sheep is altered after severe trauma. METHODS: Adult merino sheep were submitted to hemorrhagic shock (2 hours, 50 mm Hg) and unilateral lung contusion. After recovery (day 3 of the study), reamed femoral intramedullary nailing (RFN), unreamed femoral intramedullary nailing (UFN), or plate osteosynthesis of the femur (P) was performed. Pulmonary artery pressure, central venous levels of factor V, protein C, antithrombin III, and fibrinogen, were determined. At 1 and 3 days before and after femur instrumentation, pulmonary capillary permeability was assessed on the basis of the comparative albumin content in bronchoalveolar lavage fluid. RESULTS: Group RFN, n=8; group UFN, n=7; group P, n=6. A significant (p < 0.05) postoperative increase in the relative albumin content in terms of the BAL/plasma albumin ratio was measured in group RFN (day 3 preoperatively: 0.38+/-0.05 day 3 postoperatively: 0.53+/-0.06, p < 0.05 (RFN vs. P), which contrasted with group UFN (day 3 preoperatively: 0.44+/-0.09, day 3 postoperatively: 0.46+/-0.09, no significant difference). This evidence of increased pulmonary permeability occurred in association with evidence of increased activation of coagulation factors (data presented as percentage of day 3 preoperative baseline values). The data for fibrinogen (15 min postoperatively) is as follows: group RFN, 74+/-9% (p < 0.05 vs. P); group UFN, 83+/-8% (not significant); group P, 98+/-6%. The data for antithrombin III (15 min. postoperatively) is as follows: group RFN, 72+/-6% (p < 0.05 vs. P); group UFN, 79+/-8% (not significant); group P, 92+/-8% (not significant). CONCLUSION: After severe trauma, an increase of pulmonary permeability after reamed femoral nailing was associated with increased consumption of coagulation factors. After unreamed nailing, a similar trend was apparent, but this was not found to be statistically significant. These data provide support for the theory that after severe trauma, unreamed femoral nailing reduces but does not abolish pulmonary sequelae when compared with reamed femoral nailing.

Adolescent↗

PubMed1998

Transcultural study of schizophrenic delusions. Tokyo versus Vienna and Tübingen (Germany).

Schizophrenic delusions of 324 inpatients in Tokyo, 101 in Vienna, and 150 in Tübingen (Germany) were compared according to the same classifications. Among the three areas, about 80% of the patients had equally 'negative' delusions (injury and/or belittlement), and about one-fourth had 'positive' delusions of grandeur. Transcultural influences were found in the detailed contents of the 'negative' delusions; specific and direct themes of persecutory delusion, i.e., delusions of poisoning, and religious themes of guilt/sin were conspicuous in Europe, while amorphous delusions of reference such as 'being slandered' were predominant in Japan. The latter may derive from the group-oriented self in Japanese 'shame culture'.

Adult↗

PubMed1998

[Diagnostic and therapeutic strategies in hepatocellular adenoma].

While liver hemangioma and focal nodular hyperplasia are not considered an indication for surgery in asymptomatic patients resection has been recommended for hepatocellular adenoma because of the risk of rupture and malignant transformation. Problems arise from differential diagnosis and the appropriate surgical radicality including the indication for liver transplantation. This retrospective analysis deals with 58 patients who underwent surgery for hepatocellular adenoma: resection of different extension: n = 54, liver transplantation n = 4. In 39.6% of the patients the tumor was an incidental finding. In 62.0% of the character of the lesion was unclear prior to surgery. Tumor rupture and bleeding occurred in 17.2%, malignant transformation in 6.9%. Surgical morbidity was 27.6%, mortality 5.2% with the transplant patients alive for 1.5, 7, 9 and 10 years. Two and five years after resection 2 patients developed hepatocellular carcinoma in the liver remnant. The results confirm the indication for surgery in hepatocellular adenoma. Diagnostic approach for solid liver tumors without serum increase of tumor markers should rule out FNH and hemangioma. In all other patients surgery should be considered whenever possible with the radicality of malignant disease. Liver transplantation can be discussed even in asymptomatic patients with multiple adenoma.

Adenoma, Liver Cell↗

PubMed1997

Therapeutic options in Charles Bonnet syndrome.

The term 'Charles Bonnet syndrome' refers to visual pseudohallucinations occurring especially in elderly people with reduced visual acuity. Despite numerous case reports, few successful methods of treatment have been described. Therapies with classical neuroleptics, antidepressants or benzodiazepines have generally been found to be unpromising. Only with carbamazepine treatment has improvement been observed in a few cases. In the three cases reported here, we successfully treated the condition with the atypical neuroleptic melperone.

Aged↗

PubMed1997

Antioxidative vitamins in prevention of ischemia/reperfusion injury.

Involvement of oxygen free radicals in ischemia-/reperfusion injury is based on measurement of increased products of lipid peroxidation after organ ischemia and restoration of blood flow during surgical operations and reperfusion of organ transplants. In cardiology inverse epidemiological correlations between plasma vitamin E levels and mortality due to ischemic heart disease, as well as beneficial effects of vitamin E on experimentally induced oxidative damage to the heart support the hypothesis, that vitamin E might have a protective role against myocardial ischemia-/reperfusion injury. In abdominal surgery efficiency of free radical scavengers has been intensively studied on animal models of hepatic ischemia and reperfusion. Examination of free radical scavengers and adenosine metabolites in liver tissue during hepatic ischemia revealed that vitamin E and glutathione levels as well as hepatic adenosine triphosphate levels are decreased during hepatic ischemia and reperfusion. The beneficial effects of alpha-tocopherol on hepatic viability and survival rate after ischemia and reperfusion demonstrated in these studies will be of great importance concerning further studies in organ preservation. In clinical kidney transplantation prevention of lipid peroxidation and improvement in kidney viability and function was demonstrated after infusion of a multivitamin cocktail in a prospective randomised study.

Antioxidants↗

PubMed1996

Confirmation of reduced temporal limbic structure volume on magnetic resonance imaging in male patients with schizophrenia.

A structural deficit in the temporal lobes has been implicated in the pathogenesis of schizophrenia. A prospective magnetic resonance imaging (MRI) study was carried out in 20 young male patients with schizophrenia and 20 age-matched healthy male volunteers. Volumetric measurements were performed in all slices with temporal lobe cross-sections from the temporal pole to the tip of the Sylvian fissure. Volumetric assessment included the temporal lobe as a whole, hippocampal formation and amygdala complex, temporal horn and cella media of the lateral ventricle, the third ventricle, and hemispheric volume in all slices that showed temporolimbic structures. Brain structural deficit in the patients was most conspicuous in the posterior portion of the hippocampal formation. Significant effects of diagnosis were also found for the total temporal lobe and the third ventricle. Multiple regression analysis revealed posterior hippocampal volume to be significantly determined by diagnosis, but not by age or by temporal lobe or hemispheric volume. Significant correlations of morphologic and clinical parameters were restricted to negative correlations of temporal lobe volume with the global rating and sum score of the Scale for the Assessment of Negative Symptoms. The study confirms subtle temporolimbic deficit reported in previous MRI studies in patients with schizophrenia.

Adult↗

PubMed1996

Abnormal topography of EEG microstates in Gilles de la Tourette syndrome.

Quantitative analysis of scalp EEGs was performed on 13 patients with Gilles de la Tourette syndrome (GTS) and 25 matched controls. The analysis method was adaptive segmentation, which describes the topography and sequence of brain electric fields in continuous EEG. The GTS patients showed an abnormal increase in fields with a right-frontal/left-posterior configuration. The GTS patient's EEGs did not differ from normal controls in the average duration of the brain electric microstates, field stability and EEG carrier frequency. To find out whether the abnormal activity is similar to movement-related activity a simple and a complex motor task were performed. Both tasks led to distinct changes of brain electric activity, but not to an increase in right-frontal-/left-posterior-oriented patterns. Motor-related activity was contrasted with two auditory tasks. We conclude that GTS patient's EEG show abnormal topographic patterns of brain electric activity. Unlike other psychiatric disorders, the temporal descriptors of the EEG aspects are unaffected. The abnormal EEG patterns in GTS patients are not similar to those elicited by simple or complex movements; thus, the presence of abnormally facilitated, near-threshold motor activity in GTS patients seems not a likely explanation.

Adult↗

PubMed1996

Squamous cell carcinoma of the liver originating from a solitary non-parasitic cyst case report and review of the literature.

Squamous cell carcinoma of the liver arising from a non-parasitic cyst is a rare entity of a primary liver tumor with an unfavourable prognosis. We report a case of a patient with a cyst in the right lobe leading to upper abdominal symptoms and respiratory discomfort. Malignancy was not suspected from the clinical findings or repeated cytological examination of the cyst fluid. However, the blood stained brown color of the cyst fluid was unusual. Cyst recurrence after six attempts of conservative treatment with sonography guided drainage over a period for more than one year led to laparotomy with cyst unroofing. Because frozen section from the cyst wall revealed the unexpected finding of squamous cell carcinoma right hemihepatectomy was performed during the same operation. The patient is alive more than four years after surgery without cyst or tumor recurrence. The difficulties in establishing diagnosis are confirmed by the review of other reports. In the diagnosis and treatment of symptomatic non-parasitic liver cysts possible malignancy has to be considered. In case of proven carcinoma radical surgery with partial hepatectomy should be performed.

Aged↗

PubMed1996

Experience with color-coded duplex sonography after combined kidney/pancreas transplantation--preliminary results.

The value of color-coded duplex sonography in the assessment of combined kidney and pancreatic transplantations (KTX/PTX) was studied in 9 patients. In normal graft function the median resistive index (RI) was 0.69 (range 0.60-0.80) for the kidney and 0.61 (range 0.55-0.70) for the pancreas. Ten episodes of graft dysfunction (kidney n = 4; pancreas n = 6) were observed. During renal rejection and hemolytic uremic syndrome the RI was above 0.80. In pancreatic rejection the RI exceeded 0.80 while all other causes of pancreatic dysfunction were not associated with changes in the RI. Color-coded duplex sonography may prove to be a reliable noninvasive diagnostic method in the evaluation of the posttransplant course after combined KTX/PTX, in particular in the diagnosis of pancreatic rejection.

Diabetes Mellitus, Type 1↗

PubMed1995

Do schizophrenics not differentiate between perception and imagination? an EEG study using dimensional analysis.

The electroencephalograms (EEGs) of 18 chronic schizophrenic patients and 16 controls were compared during three experimental conditions: simple mental arithmetic, the perception of a moving double pendulum, and the imagination of it. An elevated dimensional complexity of the EEG of schizophrenic patients during perception as compared to normals and a failure to increase dimensional complexity during mental imagery was found. No differences were found during mental arithmetic. It is concluded that the brains of schizophrenics operate during perception in a functional state that is characterised by increased and apparently unnecessary complexity.

Adult↗

PubMed1995

[What is the role of nutrition in ulcerative colitis? A contribution to the current status of diet therapy in treatment of inflammatory bowel diseases].

Nutritional therapy for ulcerative colitis (UC) is controversial. Studies are usually designed to investigate total parenteral (TPN) or total enteral nutrition (TEN), and before these can be compared it is necessary to differentiate between the different therapeutic aims. The aims of artificial nutritional support in patients with UC are the readjustment of the nutritional status, possible remission of disease activity, and decrease in the incidence of surgical intervention or postoperative complication. Owing to the heterogeneity of the results published so far, it is still difficult to compare studies. Nevertheless, they indicate that the extent and severity of the colitis and the patient selection are of paramount importance in the implementation of nutritional therapy. Positive effects of TPN reported from non-controlled studies were not confirmed by controlled trials. Moreover, TPN was no more effective than an oral diet. Regarding remission rates or operative interventions needed, TPN had more side effects than and no defined advantages over TEN. TEN seems to be useful for certain patients. In some patients with UC, it seems to be accompanied by fewer postoperative complications. However, a definitive conclusion on the effects of TEN or TPN is not yet possible. In this context, certain fatty acids may have an important role in the treatment of UC. In prospective, randomized and controlled studies omega-3 fatty acids were found to be therapeutically useful. A reduction of the steroid doses needed is particularly important. Another therapeutic approach in distal UC is seen in the rectal administration of short chain fatty acids.

Colitis, Ulcerative↗

PubMed1995

Detection of psychoactive drugs using 19F MR spectroscopy.

In vivo 19F resonance spectroscopy measurements of trifluorinated neuroleptics (fluphenazine and trifluoperazine) and later trifluorinated antidepressants (fluoxetine and fluvoxamine) began with animal experiments in 1983. Using rats which have been treated with high oral doses of fluphenazine over a period of three weeks in the beginning of these experiments the measurement time was very long (up to 10 h). The application of better techniques using surface coils led to marked improvement of the signal noise ratio and measurement times in animal experiments could be reduced to minutes. These results encouraged us and other groups to perform experiments in humans to detect and try to estimate brain levels of trifluorinated neuroleptics and antidepressants. The present data of several research groups demonstrate that 19F MR spectroscopy has the potential of becoming a valuable tool for monitoring drug levels at the site of action. The extension of the animal studies to humans might facilitate a better treatment of schizophrenic and depressive patients.

Animals↗

PubMed1995

Scanning electron-microscopic lesions in Crohn's disease: relevance for the interpretation of postoperative recurrence.

BACKGROUND/AIMS: Endoscopic postoperative recurrence often occurs a few months after surgical therapy for Crohn's disease, even if the resection margins were macroscopically free of disease. Why the disease primarily recurs at the anastomotic site is not known. This study investigated resection margins in Crohn's disease in an attempt to clarify whether early lesions are relevant to the interpretation of postoperative recurrence. METHODS: Specimens of surgically resected bowel from 29 patients with Crohn's disease and tissue from 11 controls were studied with a scanning electron microscope. RESULTS: In Crohn's disease, a triad of early lesions occurring in both histopathologically unaffected and affected mucosa was revealed; the triad consisted of mucosal architectural alterations, epithelial bridge formation, and goblet-cell hyperplasia or hypertrophy or both. Seventy-three percent of patients showed early alterations within histopathologically unaffected margins in the small bowel, and 71% had such alterations in the large bowel. CONCLUSIONS: The findings provide further evidence for the concept of diffuse involvement of the whole gastrointestinal tract by the disease process. The endoscopic recurrence rate in the first year after the operative procedure is almost identical to the number of early lesions present during surgery. The term "postoperatively recurrent disease" should be used only if relevant clinical parameters change.

Crohn Disease↗

PubMed1994

Early morphological changes in Crohn's disease. Transmission electron-microscopic findings and their interpretation: an overview.

Recent ultrastructural investigations revealed early epithelial lesions in Crohn's disease, while a specific morphological pattern was not identifiable. An increase in plasma cells, lymphocytes, macrophages, mast cells, eosinophilic and neutrophilic granulocytes, as well as focal edema and inflammation of tissue structures was seen in the lamina propria, submucosa and deeper layers. The results are consistent with the frequent discussion about a pathogenetically significant defect of the mucosal 'barrier function', which consists of mechanical, cellular, humoral, immunological and nonimmunological mechanisms, including different histotopographically defined lines of defense of the epithelium and lamina propria. An intact epithelial layer plays an important role as the first line of defense. It is evident that components of the epithelial barrier (absorptive cells, goblet cells, Paneth cells, M cells) show ultrastructural signs of alteration or injury, while the primary agent or event remains unknown. Another pathomechanism would be a preexisting defect in intestinal 'barrier function'. Such a defect would result in an increased uptake of, or an inadequate immune reaction to, ubiquitously occurring antigens/agents (with genetic predisposition). However, no primary defect of epithelial or inflammatory cells has been definitely identified so far. Direct toxic damage of tissue secondarily introducing the inflammatory changes is also possible. Although the morphological alterations in Crohn's disease are not yet clearly understood and exactly interpreted, transmission electron microscopy has been helpful in defining early lesions and has led to further knowledge about the pathogenesis of this disease.

Crohn Disease↗

PubMed1993

Comparison of schizophrenic delusions between Japan and Germany.

The content of schizophrenic delusions of 150 German patients in the Psychiatrische Universitätsklinik Tübingen and those of 324 Japanese patients (ICD-9:295) were compared according to the classification of Huber and Gross. The comparison revealed significantly higher frequencies of delusions of poisoning (18 vs. 8%; p < 0.01) and jealousy (6 vs. 1.9%; p < 0.05) in the German cases, but there was no significant difference in the incidence of comprehensive injury delusions. There was also no significant difference in the incidence of comprehensive grandeur delusions. However, comprehensive belittlement delusions were more frequent in the German group (24 vs. 13.3%; p < 0.01). Among the delusions of this type, the themes of guilt/sin (15.3 vs. 4.9%; p < 0.001), particularly those related to religion, were more frequent in the German group. Although religious delusions were more frequent in the German group (21.3 vs. 6.8%; p < 0.001), the difference regarding the incidence of 'delusions of world destruction' was not statistically significant. Among the persecution/injury delusions, themes of direct persecution from others (Verfolgungswahn) were conspicuous in the German group, whereas delusions of reference (Beziehungswahn) related to harassment, such as 'being slandered by others' or 'being known', were common in the Japanese group. Namely, the difference in the content of these persecution/injury delusions may derive from the different types of self in the two countries: the individually oriented self in Germany and the group-oriented self in Japan. Delusions of guilt/sin in the German group may reflect the characteristics of sin in Christianity.

Adult↗

PubMed1993

[Animal experiment studies of ultrastructural changes in the lamina propria of the ileum caused by dietary fats and comparison with cytopathology in Crohn disease].

Experimental investigations have shown alterations of the ileal mucosal surface after specific fat diets resembling early changes in Crohn's disease. An animal experiment in pigs has been conducted. After creation of an anisoperistaltic segment these were fed either a specific fat diet containing chemically processed, partially hydrogenated fats or a low fat control diet over a period of 3 months. Defined areas of the ileal lamina propria were examined by transmission electron microscopy with the underlying question to what extent ultrastructural alterations could be compared to Crohn's disease. In comparison to the control group these areas were characterized by a dense infiltration of "inflammatory" cells like lymphocytes, histiocytes, macrophages and plasma cells indicating a hyperplasia and activation of lympho-plasmocytotic cells. Additionally, a focal prominent infiltration of mast cells with degranulation was observed as well as a dilatation of axons with depletion of axonal organelles in half of the animals after fat-feeding. Compared to patients with Crohn's disease the results show obvious similarities. It is concluded, that chemically processed fats could cause direct stimulation of immunologically-specific and non-specific cells in the lamina propria mucosae or directly injure the intestinal mucosa with secondary infiltration of inflammatory cells into the lamina propria.

Animals↗