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Biomedical subjects

M Edelmann

Publications and source records attributed to M Edelmann.

At least 19 recordsLinked to original sources
PubMed2005

Cell cycle effects of radiation on human bronchial epithelium and lung carcinoma cells in monolayer cultures and a three-dimensional co-culture system.

The aim of this study was to investigate whether the three-dimensional structure of the bronchial tissue and the contact of non-malignant with malignant cells influence the effectiveness of radiotherapy. Monolayer cultures of cells of the human bronchial epithelial cell line BEAS 2B, monolayer co-cultures of BEAS 2B cells and cells of the GFP-transfected lung carcinoma cell line EPLC 32M1, organ cultures of human bronchial epithelium, and organ co-cultures with EPLC 32M1 cells were irradiated with 10 Gy, and the DNA content was analyzed using flow cytometry. In non-malignant epithelial cells, BEAS 2B monolayer cultures without tumor cells were highly radiosensitive. However, contact with tumor cells in monolayer co-cultures markedly reduced radiosensitivity. Non-malignant cells in three-dimensional organ cultures and organ co-cultures with tumor cells showed moderate radiosensitivity. In EPLC 32M1 tumor cells, proliferation was increased without irradiation when the cells were in contact with epithelial cells in both organ and monolayer co-cultures. Radiosensitivity was higher in organ co-cultures than in monolayer cultures and monolayer co-cultures. These data indicate that organ co-cultures in combination with flow cytometry allow investigation of the effects of radiation in an in vivo-like environment and that both the spatial organization and the interaction of non-malignant and tumor cells are crucial for the effectiveness of radiotherapy.

Bronchi↗
PubMed2004

5-Aminolevulinic acid-induced fluorescence in bronchial tumours: dependency on the patterns of tumour invasion.

5-ALA-induced protoporphyrin IX (PPIX) fluorescence kinetics was quantified by fluorescence microscopy in three-dimensional organ co-cultures of human bronchial epithelium, which were infiltrated by four different lung tumour cell lines (EPLC-M31, LCLC-103H, NCI-H125 and NCI-H841). Corresponding fluorescence measurements were performed in monolayer cultures of these tumour cell lines and BEAS-2B cells as a model for normal bronchial epithelium by flow cytometry. Significant differences of fluorescence intensities (FI) between the tumours were detected in organ co-cultures as well as in single cell measurements. Relative FI values in organ co-cultures (FI(EPLC-32M1)>FI(LCLC-H103)>FI(NCI-H125)>FI(NCI-H841)) did not correspond to the measurements in single cells (FI(LCLC-H103)>FI(NCI-H125)>FI(NCI-H841)>FI(EPLC-32M1)). Histology of organ co-cultures revealed different patterns of invasion and tumour cell densities depending on the tumour type. After correction of FI in the co-cultures to tumour cell density the correlation coefficient for fluorescence values between both models increased considerably. Thus, additionally to distinctive features of 5-ALA metabolism, patterns of tumour invasion may be a factor determining 5-ALA-induced fluorescence. Considering these results, a pronounced heterogeneity of 5-ALA-induced fluorescence might be expected in different bronchial tumours in vivo. This could interfere with the diagnostic reliability of 5-ALA-induced fluorescence for early tumour detection.

Aminolevulinic Acid↗
PubMed2001

[Hernia repair--which technique? Help in making the decision].

Operation of the inguinal hernia is the most common operation in general surgery. Many criteria influence the kind of operation the surgeon will perform. Detailed anatomic knowledge of the inguinal region, standardised tactical and technical performance of the operation team, careful preparation and a minimum of blood loss reduce complications to low levels. These items are the same for all operation methods. The Shouldice procedure has been the golden standard for many years, nowadays (1998) in America in more than 80% of operations a mesh is implanted in the abdominal wall. A Cochran review of EBM showed advantages for mesh repair compared to nonmesh repair. Patient oriented decision making in choosing a method for inguinal hernia repair should be the new standard of modern general surgery.

Evidence-Based Medicine↗
PubMed1999

Whiplash injury.

Explore the source record for details and available documents.

Adolescent↗
PubMed1997

[Ambulatory laparoscopic cholecystectomy].

A total of 140 patients underwent outpatient laparoscopic cholecystectomy in an outpatient clinic. Evaluation and follow-up of the patients were done prospectively. Population and preoperative data were comparable to published studies of patients operated on in hospitals. There were no serious intra- or postoperative complications. Postoperatively, patients needed less pain medication, were less tired and returned to work earlier than patients after clinical laparoscopic cholecystectomies. Outpatient laparoscopic cholecystectomy offers a good alternative to patients with moderate operative risks (ASA 1-3). It could reduce costs in the German health system and would be therefore highly cost effective.

Adult↗
PubMed1997

[Sprain of the cervical spine: early functional vs. immobilization treatment].

Neck sprains are very common injuries often treated with immobilisation of different duration. The treatment with collars was tested against physiotherapy in a prospective randomised trial. Endpoints were defined as state of health, pain and costs. Ninety-seven patients with whiplash injuries were splitted by randomisation into two groups. One group was treated with a certain scheme of physiotherapy. Another group was treated with collar immobilisation for 3 weeks. Concerning symptoms at the time of admittance, age and sex distribution the groups were comparable. Fifty healthy persons with the same age and sex distribution served as a control group. Regarding to physical state of health and pain, which were examined by valid questionnaires, significant advantages of physiotherapy after two weeks were found. After 12 weeks the physical state of health corresponds to that of the control group. No influence on psychical state of health was seen. Physiotherapy for treatment of neck sprain is highly recommended. It has clear advantages over the treatment with collars with regard to state of health and pain, and it seems to be economically favourable.

Adult↗
PubMed1997

[Effectiveness and economics of private practice established surgeons, exemplified by ambulatory laparoscopic cholecystectomy in 1994 and 1996].

Ambulatory laparoscopic cholecystectomy is a safe procedure providing high patient satisfaction if performed by an experienced surgeon. These are the results of a prospective documentation of 150 outpatients to undergo laparoscopic cholecystectomy between 1994 and 1996. Patients returned to work early (mean 13.2 days off). No patient had to be admitted to hospital following ambulatory operation. All patients declared that they would have the operation performed in the same way a second time if necessary at all. Looking at the money earned for the ambulatory operation compared to the costs, there is a deficit of nearly DM 800 with each performance. Despite the good results and the great satisfaction on the part of the patients, outpatient laparoscopic cholecystectomy will not be widely performed until and unless the surgeons costs are at least covered.

Absenteeism↗
PubMed1996

Hyperinsulinism and cerebral microangiopathy.

BACKGROUND AND PURPOSE: High insulin levels are a recognized risk factor for atherosclerosis. Microvascular endothelium is more susceptible to metabolic and mitogenic effects of insulin than large-vessel endothelium. Besides their atherogenic effect, high insulin levels impair fibrinolysis by enhancing plasminogen activator inhibitor-1. We undertook this study to evaluate the hypothesis that elevated serum insulin and C-peptide levels are related to cerebral small-vessel disease rather than large-vessel pathology. METHODS: One hundred ninety-four consecutive patients presenting with symptomatic cerebrovascular disease were assigned to three subgroups that were differentiated by clinical presentations, brain imaging studies, and extracranial as well as transcranial vascular ultrasound findings: (1) patients with lacunes (n = 20), (2) patients with subcortical arteriosclerotic encephalopathy (n = 35), and (3) patients with strokes due to large-vessel disease (n = 99). Patients who had suffered a cryptogenic (n = 9) or cardioembolic (n = 16) stroke or who showed characteristics of the microangiopathy and macroangiopathy groups (n = 15) were not further evaluated. Thirty patients without manifestations of cerebrovascular disease were also examined. Fasting blood glucose, insulin, and C-peptide levels were determined in all subjects. RESULTS: There were no significant differences in age or sex among the three groups and control patients. Insulin levels were significantly higher in the lacunar group compared with the subcortical arteriosclerotic encephalopathy group, the macroangiopathy group, and the control patients (median [interquartile range]: 103.8 [198.6], 72.0 [103.2], 66.0 [57.0], and 52.2 [57.0] pmol/L, respectively; all P < .05, Mann-Whitney test). There was a statistically significant difference in insulin concentrations between the microangiopathy group (subcortical arteriosclerotic encephalopathy and lacunes) and the macroangiopathy and control groups (81.0 [110.4], 66.0 [57.0], and 55.2 [57.0] pmol/L, respectively; all P < .05, Mann-Whitney). The same was true for the distribution of C-peptide levels and to a minor extent blood glucose values, but these differences failed to reach statistical significance. CONCLUSIONS: Elevated insulin levels potentially represent a pathogenetic factor in the development of cerebral small-vessel disease, predominantly in patients presenting with lacunes. Whether this is due solely to atherosclerotic changes of the small penetrating arteries or whether changes in hemorheology are operative as well remains to be evaluated.

Aged↗
PubMed1994

A comparison of long term results of the standard Whipple procedure and the pylorus preserving pancreatoduodenectomy.

The standard Whipple procedure involves intestinal disturbances, such as dumping, diarrhea, dyspeptic complaints and the occurrence of ulcers of the anastomoses. A postoperative weight loss was observed ranging between 10 and 40 kilograms. Only a few patients were able to compensate after several months. It was thought that preservation of the intact stomach would prevent the complications arising from a loss of gastric reservoir function and thus the malnutrition could be improved postoperatively. Between 1985 and March 1992, we performed the pylorus-preserving Whipple procedure and treated a group of 43 patients with this method. In the same period, 15 patients were operated upon with the standard Whipple procedure. The present evaluation of the accumulated patient data, including extensive functional studies, led to the following results comparing the pylorus preserving Whipple procedure with the standard Whipple procedure. First, the capacity for food uptake and the development of body weight postoperatively is significantly better. Second, gastric or jejunal ulcers were not observed. Third, there were no clinical signs of digestive disorders, such as different forms of dumping. Nutrition and digestion were not impeded by the preserved opening mechanism of the pylorus. Fourth, the postoperative exocrine function was only slightly decreased. Fifth, glucose metabolism postoperatively was influenced only slightly by preservation of the pylorus. In taking the results of all the examinations into consideration, it can be said that the restricted organ loss in the Whipple procedure with pylorus preservation leaves the secretory and functional capacity of the upper part of the gastrointestinal tract almost unchanged.

Adult↗
PubMed1992

[Acute pain in surgery: the significance of a neglected problem].

Acute pain represents a significant problem in surgical patients. However, the management of acute pain in Germany is unsatisfactory, mostly because surgeons are not interested in the pain of their patients, and anesthesiologists do not give pain treatment on surgical wards. The aim of this article is therefore to point out the significance of the problem of "acute pain" for surgeons. Basic knowledge of the production, perception and projection of pain as well as the special aspects of acute versus chronic pain is mandatory. Every surgeon should know about the predictors of postoperative pain, including the surgical and anesthesiological factors and patient characteristics. Efficient management of acute pain requires knowledge of the clinical significance of pain and the different methods for assessment. It is not sufficient to know the methods and advantages of appropriate management of acute pain; one must also understand the dangers. Problems caused by the treatment of pain should be recognized from a clinical point of view. Surgeons must take a greater interest in the problem of "pain", which should lead to the establishment of new concepts in the management of acute pain in surgical patients.

Analgesia↗
PubMed1991

[Arthroscopic meniscus suture].

Up to the late 1970s meniscectomy was a common procedure in case of meniscus tear. After operative technique was improved with arthroscopy and the meniscus was accepted as an important structure in the knee joint, different techniques of arthroscopic meniscus repair were demonstrated. Thirty-two patients were reexamined 2-4 years after arthroscopic meniscal repair by means of a technique developed in Cologne. Traumatic capsular lesions healed well even in case of persisting instability to the knee joint.

Arthroscopy↗
PubMed1989

[Prevention of stress-induced hemorrhage of the upper gastrointestinal tract in neurosurgical intensive care patients. A controlled, randomized double-blind study with ranitidine alone and in combination with pirenzepine].

During a controlled, randomized, double blind study, 30 patients of a neurosurgical intensive care unit were treated with ranitidin and placebo (group 1) or ranitidin and pirenzepin (group 2). No significant difference in the effectivity of both methods was established, presumably due to the small number of cases. The pH values of group 2 lay in the median above 3.5, whereby the difference only became statistically significant after a seven-day period of therapy. In how far the increase of the pH value represents the only factor of a stress ulcer prophylaxis requires further investigation, particularly in connection with pulmonary risks caused by this.

Brain Injuries↗
PubMed1989

[Continued education from the viewpoint of the young surgeon].

Acquired operation skills suffer due to the gap filling gathering of surgical experiences in the operating room. The up to date passing on of information to surgical housemen can be improved by replacing it in part by training programs. The proposed dynamic program of an operation syllabus helps to achieve a better surgical education of housemen. Research programs should be installed as a part of surgical training. Due to the extend of their surgical duties and extra lectures housemen need a new syllabus regulation that meets the requirements stated above.

Attitude of Health Personnel↗
PubMed1987

Treatment of abdominothoracic actinomycosis with imipenem.

The probably successful treatment of a 42 year old diabetic patient suffering from relapsing abdominothoracic actinomycosis with imipenem is reported. Several earlier attempts to cure the patient by combination of surgical procedures (including cysto-jejunostomy and pancreatic tail resection) in combination with four or six week courses of intravenously administered penicillin G had failed.

Abdomen↗