Biomedical subjects
Publications and source records attributed to M Flügel.
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Human serum contains an enzyme which hydrolyses Paraoxon (E-600, an organic ester of phosphoric acid) by splitting of p-nitrophenol. This enzyme is very specific and shows a statistically significant polymorphism: I.e. in a normal population there are three groups with high, middle and low enzyme activity. The results presented in this paper confirm this polymorphism by showing a differing kinetic behaviour of the enzyme in the three groups. Paraoxon, methyl-paraoxon and chlor-methyl-paraoxon are most likely hydrolysed by the same enzyme and in the same way. On the other hand hydrolysation of n-propyl-paraoxon seems to be dependent on a different enzyme. A kompetitive inhibition of paraoxon-hydrolysation is exerted by S-substituted analogues of paraoxon. Paraoxon-hydrolysation is not influenzed by the addition of singly or doubly desalcylized derivatives of Paraoxon or compounds in which the nitro group is not in the p-position.
The incidence of gout has increased in recent years. For effective treatment an interdisciplinary approach is necessary. Medical therapy can be effectively supported by surgical removal of the tophi. This way normalisation of the uric-acid-pool can be achieved more quickly without additional harmful effects on the kidneys. Especially in the area of the hand surgical extirpation of the tophi can be gratifying, though it may be a difficult task. Severe restrictions in function of the hand can be corrected. This is demonstrated by the case of a 56 year old patient.
A case of neurilemmoma in bone localized in the proximal phalanx of the right thumb is described. There are less than 40 cases of this typoe of tumor to be found in the literature. The majority of them were localized in the jaw and maxillary bones. The tumor usually grows slowly, histories of up to 20 years duration being described. Clinical symptoms are not characteristic. X-ray examination shows cystic bone defects. The origin of the neurilemmoma in bone is believed to be cells of SCHWANN of the paravasal nerves, which accompany the nutrient artery. Microscopically two types of cells can be distinguished in the tumor. The neurilemmoma in bone is probably always benign. The therapy of choice is local excision of the tumor.
At the surgical hospital of the University of Erlangen/Nürnberg a magnetic closure system was developed for colostomies and ileostomies, which can give continence. Since November 1974 113 magnetic systems have been implanted. We have good results in 31% of the patients, less good results in 16%, and bad results in 53%. The authors demonstrate faults in the indication for the operation and faults in the surgical technique which lead to bad results. Avoiding these faults continence in 70% of patients can be achieved. In no case was the magnetic closure system the reason for bad results.
Between 1967 and 1976, 269 tumors of the hand were treated. Among the 56 epithelial tumors the malignant ones played the dominant role whereas they are seldom found in those of soft tissue and osseous skeleton. From the tumors of the hand the "tumorlike lesions" have to be separed according to the recommendations of the World Health Organisation in 1969. In the epithelium the most frequent ones are the verruca vulgaris, the verruca plana, the atheroma, the molluscum contagiosum and the mucoid epithelial cyst. In the soft tissues most common are ganglion, traumatic neuroma, nodular tenosynovitis, giant cell tumor of synovium, hygroma, foreign body granuloma and other inflammatory or metabolic alterations, as for example on the basis of degenerative arthritis or primary chronic polyarthritis. Dupuytren's contracture and keloid are also considered "tumorlike lesions" within the frame of fibromatosis. The osseous skeleton is included in the so-called solitary bone cysts.
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Nodular tenosynovitis occurs in a localized and in a diffuse form. The histologie finding are rather variable. According to electron microscopic studies nodular tenosynovitis originates in the synovial membrane. Mainly there are two types of cells to be found in the tumor: Type A, similar to macrophages - type B, similar to fibroblasts. The localized form of nodular tenosynovitis has a higher incidence in woman and occurs predominantly in the hand. The clinical symptoms are not characteristic and usually not very pronounced. More than one tumor in a single patient and also bone erosions caused by nodular tenosynovitis are rare occurrences. A case of a patient with multilocular occurrence of tenosynovitis is described here.