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M Roessler

Publications and source records attributed to M Roessler.

11 recordsLinked to original sources
PubMed2005

[New pathways in undergraduate medical education - first experiences with the cross section speciality emergency and intensive care medicine].

OBJECTIVE: On October 1 (st) 2003 Emergency Medicine was recognised for the first time as an independent cross section speciality in the new German "Approbationsordnung fuer Aerzte" (Medical Licensing Regulations). These amendments were made not only to increase the amount of small group teaching sessions but also to encourage a multidisciplinary and rather practical approach to the related topics. This article portrays the realisation of these objectives in form of a multidisciplinary module, as it has been established at University of Göttingen Medical School since the summer semester of 2004. We present the new curriculum, calculate the associated personnel resources and demonstrate the results of the structured evaluation given by the participating students. METHODS: We linked the fields of emergency and intensive care medicine by splitting them up into submodules which the students had to run through according to a set rota. 162 students were allocated to 27 small groups. Every student received a total of 38.5 hours of teaching, with the workshops coming to 46.8 %. The workshops comprised of nine sessions, three in Emergency Medicine, four in Intensive Care Medicine and two at human patient simulators. In addition we scheduled a seminar and an accompanying lecture. The final examination was performed as an Objective Structured Clinical Evaluation (OSCE). RESULTS: The realisation of the new module required a total of 1290 working hours for medical staff and 130 for our student aids. Compared to all other modules of Goettingen University Medical School the module here presented obtained the highest overall evaluation score by the medical students. Lessons with a high amount of practical involvement (i. e. Emergency Medicine and simulator-based workshops) were significantly better evaluated than rather formal teaching techniques, such as the lectures and the seminar. According to the students' self-assessment the simulator-based workshops were seen particularly valuable for the facilitation of knowledge transfer into clinical practice. CONCLUSION: The determined realisation of the new German Medical Licensing Regulations requires considerable time resources. However, its evaluation by the medical students is strikingly positive.

Anesthesiology↗
PubMed2004

[Blunt chest trauma with total rupture of the right main stem bronchus--a case report].

Tracheo-bronchial lesions in blunt chest trauma are rare--the incidence is about 1%--but potentially life-threatening events. Indirect signs such as pneumothorax, pneumomediastinum, subcutaneous emphysema or an insufficient expansion of the lungs after drainage of a pneumothorax are ominous. The fastest and most reliable method to assess the definite diagnosis of tracheo-bronchial lesion is fibre-optic tracheobronchoscopy. Early surgical treatment is mandatory to prevent major pulmonary resection. This case shows that computer tomography might fail to provide the right diagnosis. Independent lung ventilation is an option to protect the bronchial anastomosis during the early postoperative period. Reported here is the case of a young man who sustained a total traumatic rupture of the right main stem bronchus after being thrown from the passenger seat through the windshield of a motor vehicle. When the emergency doctor arrived on the scene, he found the patient with dyspnoea and massive thoracic subcutaneous emphysema. Reduced breath sounds on the left and no breath sounds on the right side led to an immediate placement of two chest tubes and controlled mechanical ventilation. After primary care in a district hospital, the patient was transferred to our university hospital for further treatment of his head injury. On admission, the patient was making breath sounds on both sides and a CT scan showed no clear sign of a tracheo-bronchial lesion. After neurosurgical intervention, the diagnosis of a rupture of the right main stem bronchus was made with delay by fibre-optic bronchoscopy. The patient was intubated with a left-sided double lumen endotracheal tube followed by surgical end-to-end anastomosis of the lesion. The initial postoperative ventilator support consisted of BIPAP-mode ventilation of the left lung, while the right lung was kept open with positive airway pressure. Forty-eight hours later, synchronised independent lung ventilation with two ventilators was established to protect the surgical result. The ventilation was switched to conventional mode a further 48 hours later. Extubation and the remaining ICU stay were uneventful.

Accidents, Traffic↗
PubMed2002

Identification of a salt-induced primary transporter for glycine betaine in the methanogen Methanosarcina mazei Gö1.

The salt adaptation of the methanogenic archaeon Methanosarcina mazei Gö1 was studied at the physiological and molecular levels. The freshwater organism M. mazei Gö1 was able to adapt to salt concentrations up to 1 M, and the addition of the compatible solute glycine betaine to the growth medium facilitated adaptation to higher salt concentrations. Transport studies with cell suspensions revealed a salt-induced glycine betaine uptake activity in M. mazei Gö1, and inhibitor studies argue for a primary transport device. Analysis of the genome of M. mazei Gö1 identified a homolog of known primary glycine betaine transporters. This gene cluster was designated Ota (osmoprotectant transporter A). Its sequence and gene organization are very similar to those of the glycine betaine transporter OpuA of Bacillus subtilis. Northern blot analysis of otaC revealed a salt-dependent transcription of this gene. Ota is the first identified salt-induced transporter for compatible solutes in Archaea.

Amino Acid Sequence↗
PubMed2001

Chloride dependence of glycine betaine transport in Halobacillus halophilus.

Growth of Halobacillus halophilus is strictly chloride-dependent but the physiological basis for the chloride dependence remains to be elucidated. To address the function of Cl(-) in H. halophilus, a physiological study was performed. It was found that uptake of the compatible solute glycine betaine under isoosmotic conditions was stimulated by increasing salt concentrations. Uptake of glycine betaine required both, Na(+) and Cl(-). Cl(-) could be substituted by nitrate and bromide, but not by sulfate. Glycine betaine transport was optimal at around 0.7 M Cl(-). Cells responded to an osmotic upshock by accumulating glycine betaine, but only in the presence of chloride. These studies revealed the first chloride-dependent glycine betaine transporter in a prokaryote.

Betaine↗
PubMed2000

Missing osteoconductive effect of a resorbable PEO/PBT copolymer in human bone defects: a clinically relevant pilot study with contrary results to previous animal studies.

PEO/PBT 70/30 (POLYACTIVE(R) 70/30), a degradable porous copolymer with elastic properties, was found to be osteoconductive in many animal studies. The aim of this study was to determine the osteoconductive effect in a human paired control iliac defect model. In seven patients undergoing anterior spinal interbody fusion surgery, two bicortical iliac defects for autograft harvesting were created. The defect size was identical for both defects measuring about 40 x 15 mm (group I). One defect was filled with the degradable implants, whereas the remaining one was left untreated as a control. The defect site for treatment was chosen randomly. In three further patients, only one defect measuring about 40 x 35 mm was created (group II). All patients were examined clinically and radiologically by spiral-CT after 1, 6, 12, 24, and 52 weeks. Three-dimensional reconstructions as well as CT-volumetric measurements using 1 mm sections were used as evaluation methods. In group I, a two-tailed paired t-test showed that the treated defects had significantly less formation of new bone than the untreated ones (p < 0.05 after 12 weeks, p < 0.01 after 52 weeks). Also, in group II, not much bone ingrowth could be observed. The histological evaluation of one patient in group I revealed no bone within the pores, and a fibrous layer between bone and implant was always present. Therefore, PEO/PBT 70/30 cannot be recommended as a bone substitute for clinical use. Differences in bone regeneration between humans and certain animal species as well as inapplicable defect models in previous animal studies are discussed as possible reasons for the failure.

Animals↗
PubMed2000

Motility and flagellum synthesis in Halobacillus halophilus are chloride dependent.

The motility of Halobacillus halophilus as observed on swarm agar plates was strictly dependent on the chloride concentration. Cl(-) was apparently not used as the coupling ion for flagellar rotation. Cells grown in the absence of chloride were devoid of flagella, but flagellation was restored upon the addition of chloride. These experiments indicate that chloride is involved in synthesis of flagella in H. halophilus.

Bacteriological Techniques↗
PubMed1998

Quantitative and physiological analyses of chloride dependence of growth of halobacillus halophilus

A quantitative analysis of the Cl- dependence of growth of Halobacillus halophilus was performed. Optimal growth rates were obtained at Cl- concentrations of between 0.5 and 2.0 M, and the final yield was also strictly dependent on the Cl- concentration. Br- but not I-, SO42-, NO2-, SO2-, OCN-, SCN-, BO2-, or BrO3- could substitute for Cl-. To analyze the function of chloride, chloride concentration was determined. At low external Cl- (Cle-) concentrations, the growth rate was low and Cl- was excluded from the cytoplasm; increasing the Cle- concentration led to an increase in the growth rate and an energy-dependent uptake of Cl-, thus decreasing the Cle-/internal Cli- gradient from >/=10 at 0.1 M Cle- to a nearly constant value of 2 at Cle- concentrations which allowed optimal growth. Two membrane proteins with apparent molecular masses of 31 and 16 kDa which were identified to be specific for Cl--grown cultures are possible candidates for a chloride uptake system.

Journal Article↗