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Biomedical subjects

M Junge

Publications and source records attributed to M Junge.

14 recordsLinked to original sources
PubMed2005

Post-mortem evaluation of 415 pacemakers: in situ measurements and bench tests.

AIM: The hypothesis was that there is more undetected dysfunction of implanted pacemaker systems than that detected and corrected. This prompted a research project (sponsored by the German Research Foundation) to detect pacemaker abnormalities and evaluate their complications for patients, thus, proving or disproving the hypothesis. METHODS AND RESULTS: Four hundred and fifteen pacemakers of deceased patients were analyzed assessing their functionality by in situ measurements and bench tests including five measurements and one telemetric interrogation. Results were divided into four categories and statistically evaluated. Life-threatening abnormalities were found in 3.8%, potentially life-threatening in 3.7%, probably symptomatic, divided into atrial and ventricular problems, 13.3% and 2.8%, respectively, and premature exhaustion in 1.2%. Three of 179 bipolar ventricular leads and 2 of 131 bipolar atrial leads had insulation defects corresponding to 1.7% and 1.5%, respectively. The bipolar complication rate was 2.8 times higher than unipolar. CONCLUSION: The pacemaker patients investigated, living 4 years with their pacemaker on average, had a post-mortem evaluated complication rate of the category "life-threatening" of 3.8%. This result corresponds to an annual complication rate of 0.94% compared with a rate of only 0.39% in an earlier investigation.

Aged↗
PubMed2003

Cutaneous current marks due to a stun gun injury.

Histological changes of the skin following electrical injury with a stun gun have rarely been described. We report the case of a 61-year-old man who died after having been tortured with a stun gun during a robbery. At autopsy two reddish, dot-like lesions where found on the chest and histological examination revealed electric current-related changes. Only a few reports concerning micromorphological cutaneous changes following stun gun injury have been reported; therefore further investigations concerning the frequency and type of histological findings due to stun gun injuries will be necessary in order to provide sufficient characteristic data for a conclusive interpretation.

Electric Injuries↗
PubMed2001

Death after excessive propofol abuse.

Abuse of the anaesthetic agent propofol (2,6-diisopropylphenol) is rare, but we report a case of a 26-year-old male nurse in which the autopsy showed unspecific signs of intoxication and criminological evidence pointed towards propofol abuse and/or overdose. Intravenously administered propofol is a fast and short-acting narcotic agent, therefore it seemed questionable whether the deceased would have been able to self-administer a lethal overdose before losing consciousness. The blood and brain concentrations corresponded to those found 1-2 min after bolus administration of a narcotic standard dose of 2.5 mg propofol/kg body weight. Extremely high propofol concentrations were found in the urine indicating excessive abuse before death. However, due to the short half-life of propofol, the cumulative effects of repeated injections should not be relevant for toxicity, since this would result in a blood level increase of only 1-2 micrograms/ml. Furthermore, the detection and quantitation of propofol in three different hair segments indicated chronic propofol abuse by the deceased. The results of the investigation suggest that death was not caused by a propofol overdose but by respiratory depression resulting from overly rapid injection.

Adult↗
PubMed2001

Zygmunt Bauman's poisoned gift of morality.

Bauman's attempt to develop a sociological theory of morality turning around fundamental premises of Durkheim's approach fails in the last analysis, since in Bauman's view the 'moral party of two' does not constitute a social situation. It is argued that the necessary condition to think sociologically about morality is the concept of reciprocity and thus one can arrive at a view of morality in postmodernity consistent with Bauman's earlier theory of practice. If Bauman's idea about responsibilty as the core of morality is transformed to the idea of an appeal of history to compassion and is supplemented with the idea of reciprocity as an emerging norm it is possible to outline a sociological theory of moral practice according to postmodern conditions.

Ethics↗
PubMed2001

Antiandrogenic pesticides disrupt sexual characteristics in the adult male guppy Poecilia reticulata.

Environmental contaminants have been identified as endocrine disruptors through their antiandrogenic activity. Thus, as androgen receptor antagonists, the fungicide vinclozolin and the principal DDT metabolite p,p'-DDE have been demonstrated to induce demasculinization in rats. Whether this is also the case in fish remains to be demonstrated. For a period of 30 days, groups of adult male guppies were exposed to vinclozolin, p,p'-DDE, or the therapeutic antiandrogen flutamide (used as positive control) applied to the fodder at concentrations between 0.1 and 100 microg/g fodder. Subsequently, sexual characteristics of relevance to the male reproductive capacity were measured and compared with untreated control fish. All three chemicals caused profound alterations at increasing levels of biological organization, even in these fully matured males. At the cellular level, the three compounds induced a significant reduction in the number of ejaculated sperm cells. At the organ level, the sexually attractive orange-yellow coloration was reduced in area and discolored, and treated fish also had smaller testes. Further, at the organismal level, computer-aided behavior analyses demonstrated a severe disruption in male courtship behavior. We conclude that this demasculinization is consistent with an antiandrogenic action of vinclozolin and p,p'-DDE and is likely to compromise reproductive capability in this fish.

Animals↗
PubMed2000

Recent developments in cornea transplantation (1997-1999).

Between 1997 and 1999 a steady increase in cornea donations was achieved, but the number of transplantations remained stable because many grafts did not pass quality control. Intermediate organ culture of entire bulbi was examined as a possible solution to reduce post-mortem times and increase suitability for transplantation.

Corneal Transplantation↗
PubMed2000

Suicide by insulin injection in combination with beta-blocker application.

A 68-year-old non-diabetic physician with a known psychiatric history was found dead in his home. The death scene investigation revealed three used insulin syringes on the coffee table next to the body. The autopsy and the consecutive chemical-toxicological investigation revealed that the deceased committed suicide by injecting an overdose of insulin in combination with a high therapeutic oral bolus application of a beta-blocker (Metoprolol). A surprising morphological finding was a terminal pulmonary thromboembolism in the right pulmonary artery.

Adrenergic beta-Antagonists↗
PubMed1995

[The effect of propofol on vomiting after strabismus surgery in children].

Strabismus surgery in children is associated with a high incidence of postoperative nausea and vomiting (PONV). METHODS. Ninety ASA class I and II children aged 6 to 16 years and scheduled for strabismus surgery were randomly assigned to one of the following groups: Group 1 (n=30):thiopentone 4-6 mg/kg i.v., halothane 0.8-1.5%, N2O--O2 2:1, no opioids, droperidol 75 micrograms/kg i.v.; Group 2 (n=30):propofol 2-3 mg/kg i.v., propofol 6-9 mg/kg.h, alfentanil 30 micrgrams/kg.h, N2O-O2 2:1, no antiemetics; Group 3 (n=30):similar to group 2, but ventilation with air and O2 2:1. All patients were mechanically ventilated during anaesthesia and gastric contents were aspirated. Recovery scores were calculated for 2 h, emetic scores for 24 h postoperatively.

Adolescent↗
PubMed1994

[Multiple sclerosis. Clinical topodiagnosis in comparison with cerebral MRI findings].

Clinicotopographic correlations were performed in a larger group of patients with multiple sclerosis (n = 121). In the assessment of two raters working independently from one another, 73% of all clinical brainstem findings (n = 74) could be traced back to demyelination plaques in the supposed localization as visualized by MRI. The clinical topodiagnostic was especially in accordance with MRI findings concerning internuclear ophthalmoplegia (85%) and abducens palsy (79%). Cerebellar dysfunctions (n = 60) correlated with morphological findings in 87%. More than half of all patients with cerebellar and brainstem symptoms exhibited a periventricular demyelination around the 4th ventricle which was associated with the clinical topodiagnostic. Unequivocal MRI correlations could be hardly found for clinical findings of low topodiagnostical value (symptoms of the long motor and sensory pathways). The clinical status as expressed by Kurtzke's EDSS reflects the extent of cerebral demyelination as seen by MRI only in a larger patient group.

Adolescent↗
PubMed1978

Adaptation to extrauterine existence: cardiac and respiratory rates during the first 72 hours.

In 29 asymptomatic underweight newborns, 10 true preterms and 19 small-forgestational age (SGA), recordings of respiratory and cardiac rates were performed during the first 72 hours of life. The results may be summarized as follows: 1. Respiratory rates (RR) are slightly elevated during the first day of life. 2. The respiratory-to-cardiac ratio (RR/CR) is very constant throughout the first three days. 3. Low-Apgar infants initially have an elevated RR. 4. True preterm infants have higher cardiac rates (CR) than SGA infants. Not all of the phenomena observed can be totally explained on the basis of existing knowledge.

Adaptation, Physiological↗
PubMed1977

Metabolic rate and O2 consumption in newborns during different states of vigilance.

In 135 asymptomatic newborn infants, 1--53 days of age, body weight 1,820--4,120 g, indirect calometry was performed. According to the state of wakefulness the infants showed during the testing procedure, they were divided into four groups of vigilance (V1--V4). Metabolic rate and oxygen consumption showed similar results between groups V1, V2 and V3 (deep sleep; REM sleep; wakefulness with no muscular activity). V4 infants (with muscular activity) had a higher metabolic rate and O2 consumption. Correlation between metabolic rate and body surface area is similar in V2 and V3 but shows a steeper slope in the V1 group. It is speculated that central regulatory mechanisms may account for this difference.

Basal Metabolism↗
PubMed1976

Acid-base parameters and alveolar-arterial oxygen tension gradients in healthy neonatal and postneonatal infants.

In a randomly selected group of asymptomatic neonatal and postneonatal infants, acid-base parameters and oxygen tension measurements in arterial blood (radial artery) were carried out during air and oxygen breathing. Acid-base results showed a mild, partially compensated metabolic acidosis, indicating adequate pulmonary function. Arterial oxygen tension was in the normal range for this age group. Calculated alveolar oxygen tension levels demonstrated alveolar-arterial gradients of about 30 mm Hg during air breathing and 320 mm Hg during O2 breathing. Volumes of R-L shunts calculated from these gradients, were in the order of magnitude commonly found at this age, i.e., about 20% of right cardiac output. No differences were discernible between infants of appropriate weight for gestational age and small-for-date infants.

Acid-Base Equilibrium↗
PubMed1975

Transcutaneous determination of arterial oxygen tension.

Arterial oxygen tension measurements were performed simultaneously using two different techniques: (1) the conventional method of analyzing a blood sample obtained from the radial artery by means of a Clark electrode and (2) a new method of transcutaneous oxygen tension recording using a newly developed surface electrode containing a built-in heating device to ensure optimal cutaneous perfusion at the site of measurement. Two groups of newborn infants were used as subjects: (1) 70 clinically healthy babies who were tested during normoxia and hyperoxia (breathing 80% to 100% oxygen) and (2) 20 sick preterm and term infants receiving inspired oxygen concentrations of between 21% and 100% during the measurement. Our results indicate a satisfactory accuracy for the transcutaneous oxygen tension measurements in normoxia and hyperoxia (percentage coefficient of variation, 15.9% and 24.1%, respectively). In hypoxia agreement between the two methods varies depending on the degree of circulatory derangement. Overall correlation coefficients were greater than 0.85 in each group.

Blood Gas Analysis↗