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Biomedical subjects

M Hohl

Publications and source records attributed to M Hohl.

At least 19 recordsLinked to original sources
PubMed2006

[Right sided lower abdominal pain two weeks after delivery].

We report the CT imaging findings of a 33 year old patient who presented to the emergency department with increasing right lower abdominal pain and shivering. She delivered a healthy baby two weeks ago after induction in the 39th week of pregnancy due to a large fetus. Two days after delivery, sterilisation was performed. Clinically the primary differential diagnosis was appendicitis. However, computed tomography revealed thrombosis of the right ovarian vein. Consequently, management was altered appropriately with administration of antibiotics as well as a therapeutic dose of low molecular weight heparin.

Abdomen, Acute↗
PubMed2005

Shorter PFA-100-closure times in laparoscopic versus conventional hysterectomy are not caused by increased vasopressin levels.

BACKGROUND/OBJECTIVES: Bleeding problems during laparoscopic surgery are infrequent. We hypothesised that increased abdominal pressure during the application of the pneumoperitoneum would lead to an increased release of endogenous vasopressin which could then contribute to the hemostasis by increasing platelet reactivity, FVIII and von Willebrand-factor. PATIENTS AND METHODS: We compared the vasopressin levels, the platelet function as measured by the PFA-100-test, aPTT and FVIII in 39 consecutive patients who underwent elective hysterectomy (20 with the laparoscopic and 19 with the conventional, "open" method). Blood was sampled the day before surgery and 2, 4 and 72 h after the induction of anaesthesia. RESULTS: After two hours, the PFA-100 closure times with collagen/ADP decreased to lower levels in the laparoscopic group (from 93 +/- 22 to 82 +/- 20, mean +/- SD) and even further down to 65 +/- 13 s (compared to 82 +/- 20 s) (p = 0.024)) four hours after the beginning of surgery. Vasopressin levels and F VIII increased in both groups but there was no significant difference between the groups (21 vs. 17.8 pmol/l for vasopressin, differences of the mean). Bleeding was minimal, with a trend to lower Hb-levels in the laparotomy group. CONCLUSIONS: The procedural difference of laparoscopic vs. open hysterectomy appears to enhance platelet reactivity by other mechanisms than increased vasopressin levels and may contribute to an enhanced hemostatic competence in laparoscopic surgery.

Adult↗
PubMed2005

[Ultrasound-guided fine-needle aspiration of the breast].

PURPOSE: Retrospective analysis of the results of all ultrasound (US)-guided fine needle aspirations (FNA) of the breast performed at our institution between 1988-2002. MATERIALS AND METHODS: The radiologic and pathologic information database was retrospectively searched for all referrals, in whom an US-guided FNA of the breast was performed as further diagnostic work-up of sonographically unclear or suspicious findings. Percutaneous tissue diagnosis was performed under US-guidance using a 20-Gauge-needle. Results were correlated with histology or sonographic and/or mammography follow-up examination, respectively. RESULTS: The total study population consisted of 324 patients (19-92 years). In 20 cases (6.2%), results of FNA were non-diagnostic, a cytologic diagnosis was established in the remaining 304 (93.8%) cases. Cytologically, malignancy was diagnosed in 60 cases; 2 of those were shown to be false positive by subsequent histologic work-up. In 33 of 244 surgery was performed. 9 cases were false negative. No complication was observed. The accuracy was 96.4% with a sensitivity of 86.6% and specificity of 99.2%. CONCLUSION: If a skilled cytopathologist is available, US-guided FNA is a highly accurate and minimal-invasive technique. False negative findings may occur, thus clinical and imaging findings should be taken into account for further therapeutic decision.

Adult↗
PubMed2001

Binding and repair of mismatched DNA mediated by Rhp14, the fission yeast homologue of human XPA.

Rhp14 of Schizosaccharomyces pombe is homologous to human XPA and Saccharomyces cerevisiae Rad14, which act in nucleotide excision repair of DNA damages induced by ultraviolet light and chemical agents. Cells with disrupted rhp14 were highly sensitive to ultraviolet light, and epistasis analysis with swi10 (nucleotide excision repair) and rad2 (Uve1-dependent ultraviolet light damage repair pathway) revealed that Rhp14 is an important component of nucleotide excision repair for ultraviolet light-induced damages. Moreover, defective rhp14 caused instability of a GT repeat, similar to swi10 and synergistically with msh2 and exo1. Recombinant Rhp14 with an N-terminal hexahistidine tag was purified from Escherichia coli. Complementation studies with a rhp14 mutant demonstrated that the tagged Rhp14 is functional in repair of ultraviolet radiation-induced damages and in mitotic mutation avoidance. In bandshift assays, Rhp14 showed a preference to substrates with mismatched and unpaired nucleotides. Similarly, XPA bound more efficiently to C/C, A/C, and T/C mismatches than to homoduplex DNA. Our data show that mismatches and loops in DNA are substrates of nucleotide excision repair. Rhp14 is likely part of the recognition complex but alone is not sufficient for the high discrimination of nucleotide excision repair for modified DNA.

Base Pair Mismatch↗
PubMed2001

Prognostic and predictive significance of ErbB-2 breast tumor levels measured by enzyme immunoassay.

PURPOSE: A retrospective analysis to assess the prognostic and predictive clinical value of breast tumor ErbB-2 receptor expression quantified by enzyme immunoassay (EIA), to compare levels measured by EIA with ErbB-2 status determined by immunohistochemistry (IHC), and to correlate receptor content with levels of phosphorylated (Y1248-P) ErbB-2, a measure of functional tyrosine kinase activity. MATERIALS AND METHODS: EIA quantification of ErbB-2 was performed on membrane extracts from 3,208 well-characterized primary breast cancers. Overall, relapse-free, distant disease-free, and local/regional-free patient survival data were available on 1,123 of these tumors. IHC scoring for ErbB-2 status (HercepTest; DAKO, Glostrup, Denmark) was performed on adjacent sections of 151 cases, and receptor functionality was measured in 230 tumors by an antibody specific for phosphorylated (Y1248-P) ErbB-2. RESULTS: Unlike nonmalignant breast tissues, breast tumors showed increased ErbB-2 levels in a bimodal distribution, with 12% constituting a distinct set of ErbB-2-overexpressing tumors. The intermodal threshold value for ErbB-2 overexpression distinguished tumors with reduced estrogen and progesterone receptor content, high IHC score for ErbB-2, and significantly increased levels of phosphorylated (Y1248-P) ErbB-2 receptor. By multivariate analysis, EIA-determined ErbB-2 overexpression predicted significantly reduced patient survival that was unaffected by tamoxifen or cyclophosphamide, methotrexate, and fluorouracil adjuvant therapy. CONCLUSION: Determination of ErbB-2 receptor expression by EIA offers a clinically valuable alternative to semiquantitative IHC assessment of breast tumor ErbB-2 overexpression and affords the opportunity to evaluate ErbB-2 phosphorylation, which may represent an important predictive parameter of receptor functionality.

Adult↗
PubMed1994

Arthroscopy of meniscal injuries with tibial plateau fractures.

We examined 36 consecutive patients with closed tibial plateau fractures under anaesthesia and by diagnostic and operative arthroscopy before treating them by closed or open reduction and internal fixation. Following the principle of Hohl (1967) (Fig. 1) there were 9 minimally displaced fractures (type I), 6 with local depression (type II), 13 with split depression (type III), 7 with total condylar depression (type IV), and one bicondylar comminuted upper tibial fracture (type V). Seventeen (47%) of knees were found to have associated meniscal injuries which required surgical treatment; five repairs and 12 partial meniscectomies. Neither the type of plateau fracture nor the presence or absence of ligament injury correlated with meniscal tear. There were no intraoperative or postoperative complications from arthroscopy.

Adult↗
PubMed1992

[Pneumocystis carinii pneumonia in HIV-negative immunosuppressed patients].

During a period of 10 years 129 immunosuppressed HIV-negative patients were evaluated for pulmonary complications. A definite diagnosis could be established in 72 cases (56%): Pneumocystis carinii pneumonia (PCP) (25), pulmonary involvement of underlying disease (10), drug toxicity (8), mycobacterioses (6), bacterial pneumonias (5), aspergillosis (5), others (13). The underlying conditions in patients with PCP were: lymphatic neoplasias (11), immunosuppression after solid organ (9) and after bone marrow transplantation (3), cytotoxic therapy for lupus erythematodes (1) and carcinoma (1). In 8 of 9 transplant patients anti-rejection therapy preceded the episode of PCP. Six patients (24%) died from respiratory failure 1 to 25 days after diagnosis of PCP, despite mechanical ventilation in four. Two patients recovered completely after mechanical ventilation for 14 and 30 days respectively. The frequency of PCP has markedly increased during the last few years: 1981-1987: 2 cases (6%), 1988: 4 (14%), 1989: 8 (42%) and 1990: 11 (26%). This can hardly be explained by improved diagnostic sensitivity or an increased number of immunosuppressed patients. Apart from the use of more potent immunosuppressive agents, the increased prevalence of Pneumocystis carinii may play an important role.

Adolescent↗
PubMed1991

Water Relations of Growing Maize Coleoptiles : Comparison between Mannitol and Polyethylene Glycol 6000 as External Osmotica for Adjusting Turgor Pressure.

Water relations of growing segments of maize (Zea mays L.) coleoptiles were investigated with osmotic methods using either mannitol (MAN) or polyethylene glycol 6000 (PEG) as external osmotica. Segments were incubated in MAN or PEG solutions at 0 to - 15 bar water potential (Psi(o)) and the effects were compared on elongation growth, osmotic shrinkage, cell sap osmolality (OC), and osmotic pressure (pi(i)). The nonpenetrating osmoticum PEG affects pi(i) in agreement with Boyle-Mariotte's law, i.e. the segments behave in principle as ideal osmometers. There is no osmotic adjustment in the Psi(o) range permitting growth (0 to -5 bar) nor in the Psi(o) range inducing osmotic shrinkage (-5 to -10 bar). Promoting growth by auxin (IAA) has no effect on the osmotic behavior of the tissue toward PEG. In contrast to PEG, MAN produces an apparent increase in pi(i) accompanied by anomalous effects on segment elongation and shrinkage leading to a lower value for Psi(o) which establishes a growth rate of zero and to an apparent recovery from osmotic shrinkage after 2 hours of incubation. These effects can be quantitatively attributed to uptake of MAN into the tissue. MAN is taken up into the apoplastic space and the symplast as revealed by a large temperature-dependent component of MAN uptake. It is concluded that MAN, in contrast to PEG, is unsuitable as an extemal osmoticum for the quantitative determination of water relations of growing maize coleoptiles.

Journal Article↗
PubMed1991

Acid- and Enzyme-Mediated Solubilization of Cell-Wall beta-1.3,beta-1.4-d-Glucan in Maize Coleoptiles : Implications for Auxin-Mediated Growth.

The release of soluble carbohydrates from isolated cell wall of maize (Zea mays L.) was investigated in the range of pH 1 to 8.5. The pH profile demonstrated two peaks, a broad peak at pH 6 due to enzymatic breakdown of beta-glucan to monosaccharides (wall autolysis) and a sharp peak at pH 2.5 due to acid-mediated, nonenzymatic liberation of macromolecular beta-glucan from the wall. The pH dependence of acid-induced growth and cell-wall extensibility of coleoptile segments closely agrees with the pH dependence of acid-mediated beta-glucan solubilization in the isolated wall. However, there is no evidence that enzymatic or nonenzymatic beta-glucan solubilization is involved in the mechanism of auxin-mediated growth.

Journal Article↗
PubMed1990

Soft tissue neck injuries--a review.

The current state of knowledge about soft tissue neck injuries has been described. Much progress made in establishing exact mechanisms of injury and in accurate diagnosis and treatment of injury. Certain symptoms and signs soon after injury has been shown to be poor prognostic factors for recovery. Although much progress has been made in many important areas of concern there is much that remains to be learned about soft tissue neck injuries.

Esophagus↗
PubMed1990

Ligament injuries associated with tibial plateau fractures.

Thirty-nine patients with tibial plateau fractures and concomitant ligament injury were evaluated at least one year after injury. Ligamentous injury was determined by stress roentgenograms, plain roentgenograms, operative findings, and Pelle-grini-Stieda's ossification. There were 22 isolated medial collateral, eight lateral collateral, one isolated anterior cruciate, and eight combined ligament injuries. All types of tibial plateau fractures were associated with ligamentous injury, although split compression and local compression were most common. Twenty patients (Group 1) did not have operative repair of the injured ligaments, and 19 patients (Group 2) had primary repair of the injured ligaments. Open reduction and internal fixation of the plateau fracture(s) were performed in 13 patients in Group 1 and 19 patients in Group 2. Follow-up evaluation (100-point scale), including subjective, functional, and anatomic factors, revealed 12 excellent and good, four fair, and three poor results in the 19 patients with ligamentous repair. There were ten excellent and good, two fair, and eight poor results in those without ligament repair. Ten of the 12 patients with 10 degrees or more of instability had poor results. These poor results included five unrepaired medial collateral ligaments, two unrepaired lateral collateral ligaments, and three patients with cruciate ligament injury. This study confirms the view that instability is a major cause of unacceptable results in tibial plateau fractures. Operative repair of medial and lateral collateral ligaments, with appropriate treatment of the bony plateau fracture, may reduce late instability and may improve overall morbidity in these concomitant injuries. Cruciate ligament injury associated with a tibial plateau fracture carries a poor prognosis.

Adolescent↗
PubMed1989

The cast brace and tibial plateau fractures.

Three hundred six tibial plateau fractures treated at the authors' institutions and in private practice were analyzed in relation to the use of a cast brace or fracture brace. One hundred forty-one of these patients had had a cast brace or fracture brace as part of their treatment program, either as the primary fracture treatment or after open reduction or traction. The aims of this study were (1) to determine if cast bracing could maintain alignment, fracture position, and range of motion and (2) to compare its results with those of other major long-term studies of similar fractures. There were 85 lateral, 24 medial, and 32 bicondylar fractures. Cast bracing was used for one to 17 weeks, with a mean of eight weeks. Ninety-nine of the 141 patients were followed for at least one year. Eighty-two of the patients maintained alignment with less than 5 degrees of deformity, and fracture position was maintained in 85% of cases, with only 15% having 4-8 mm of loss of position. Medial plateau and subcondylar fractures had an increased incidence of fracture position loss. Ninety-seven percent of patients had greater than 90 degrees of flexion, and 90% had full extension, i.e., less than 5 degrees of contracture. Pain was minimal or absent after heavy exercise in 90% of patients using cast bracing. Arthritic changes on roentgenographic analysis were absent or mild in 93.5% and moderate or severe in 6.5% of patients. Complications, including phlebitis, pulmonary emboli, wound infection, hardware slippage, and skin slough, occurred in nine patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

The significance of early motion in the treatment of tibial plateau fractures.

Although the trend in management of tibial plateau fractures has been toward early motion, the period of immobilization that can be tolerated safely is open to question. In the present study, 160 acute tibial plateau fractures were reviewed in an effort to answer this question. The 112 fractures that were suitable for analysis were divided into undisplaced fractures, displaced fractures treated nonoperatively, and displaced fractures treated operatively. Among these groups, results were compared based on the period after injury that the knee was immobilized. Undisplaced fractures and displaced fractures that were treated nonoperatively regained full knee motion when immobilized up to six weeks. Fractures treated operatively tended to develop knee stiffness with only two weeks of immobilization. Loss of fracture reduction tended to occur in patients who were immobilized for relatively short periods. Immediate knee motion was correlated with prolonged hospitalization. Based on these results, knee mobilization following tibial plateau fractures is determined by the degree of fracture displacement, method of treatment, and quality of aftercare.

Adult↗
PubMed1980

Incidences of fatal postoperative pulmonary embolism after prophylaxis with dextran 70 and low-dose heparin: an international multicentre study.

A total of 4352 patients were admitted to a prospective' randomised multicentre trial comparing the prophylactic efficacy of dextran 70 and low-dose heparin against fatal pulmonary embolism after elective operations for general, orthopaedic, urological, and gynaecological conditions. Out of 3984 patients correctly admitted, 1993 were allocated to receive dextran 70 and 1991 to receive low-dose heparin. Withdrawal of prophylaxis because of bleeding or technical difficulties occurred more often in the heparin group, but allergic reactions were more common in the dextran group. Of the 75 patients who died within 30 days after operation, 38 had been given dextran and 37 low-dose heparin. Necropsy was performed in 33 and 32 of these cases respectively. In six patients in each group pulmonary embolism was the sole or a contributory cause of death. Of these, five patients in the dextran group and two in the heparin group had received a full course of prophylaxis. There was no statistically significant difference between the two treatment groups in the incidence of fatal pulmonary embolism after a full course of prophylaxis.

Aged↗
PubMed1980

[The clinical significance of accelerations in intrapartum fetal heart rate monitoring (author's transl)].

Fetuses failing to exhibit accelerations in antepartum fetal heart rate (FHR) testing are considered to be at risk. However, until now the prognostic value of intrapartum FHR-accelerations is not known. The occurrence or absence of accelerations during the last 30 minutes preceding delivery was compared in 812 intrapartum FHR-records with FHR-score (3), umbilical cord artery pH, one and five minute Apgar score values. When accelerations were absent during the last 30 minutes before delivery, severe neonatal depression was observed in 10 per cent of neonates as compared to 5 per cent when accelerations were present. This difference is statistically significant. If accelerations were observed, no correlation was found between rate of FHR increase, amplitude, or duration of accelerations, and fetal or neonatal state.

Apgar Score↗