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Biomedical subjects

R Maier

Publications and source records attributed to R Maier.

At least 19 recordsLinked to original sources
PubMed1992

[Treatment procedure in humeral shaft fractures with primary or secondary radial nerve damage].

We give an account of 28 patients with fractured humerus diaphysis, suffering from primary and seven patients suffering from secondary lesion of the radialis nerve, all treated by operation. In each case the radialis nerve was exposed and the fracture was treated by fixation with compression plates. In case of primary lesions of the radialis nerve, we found intraoperative damages by traction (six times), contusions (seven times), intraneural hämatomas (six times) and for one time perforation of the nerve by bones. The rest of this group (eight times) did not show any pathological finding. Those patients with secondary lesion of the radialis nerve showed damages by traction (three times) and in two cases the nerve was walled up by callus or connective tissue. Two times we could not find any pathological alteration of the nerve. 23 (six) out of 28 (seven) patients with primary (secondary) lesion of the radialis nerve could be followed up. On this occasion we stated complete neurological restitution 20 times (four times) and incomplete restitution three times (two times). The great number of pathological findings, which necessitate operative treatment, the short duration of remission and the high rate of restitution confirm us to leave the way of conservative treatment in cases of primary or secondary lesion of the radialis nerve and the indication of acute operation is given.

Adolescent↗
PubMed1992

Long-term variability of heart rate increases with successful closure of patent ductus arteriosus in preterm infants.

Long-term variability (LTV) of heart rate was calculated continuously by a microprocessor in 25 preterm infants undergoing indomethacin treatment for closure of patent ductus arteriosus (PDA), in 24 preterm infants without signs of PDA, and in 10 neonates treated with prostaglandin E1 for cyanotic heart malformation. In infants with patent ductus arteriosus, LTV was lower than in controls. Following indomethacin, LTV increased most markedly (from 1.5 to 3.2; p less than 0.01) in infants with improved ventilation. The increase was less marked (from 1.8 to 2.5; p less than 0.05) in infants whose degree of respiratory failure did not change. LTV remained largely unchanged in infants who deteriorated. In 9 out of the 10 neonates treated with prostaglandin E1, LTV increased. We conclude that LTV corresponds to brain stem oxygenation and may be a useful tool to monitor treatment of PDA.

Alprostadil↗
PubMed1992

[Evaluation of central speech disorders using objective criteria: a psychophysiologic contribution to the discussion of the neural plasticity hypothesis].

Examinations of aphasic patients by using cognitive tasks were based on the hypothesis that semantically evoked potentials correlate to the processing of information in the different speech processing of information in the different speech processing areas. It was found that patients with Broca aphasia generated synchronization potentials in the Wernicke area in contrast to Wernicke patients. We suppose a correlation between the timing in sensorial speech processing areas and the generation of synchronization potentials.

Aphasia, Broca↗
PubMed1992

[Results after conservatively managed vertebral fractures of the thoracolumbar level with special reference to bony stenosis of the spinal canal].

Seventy-two patients with compression fractures of the lower thoracic and lumbar spine who were treated by the Böhler method from 1972 to 1987 were followed up to compare the clinical signs and the results of conventional radiography and spinal computed tomography. There were 33 men and 39 women with an average age of 44.3 years (23-69 years). Treatment by the Böhler method is indicated for fractures between T12 and L5, which constitute 60% of all vertebral fractures. The main distribution in our patients was T12 (n = 26) and L1 (n = 33). Four patients primarily had neurological symptoms. The mean duration of hospitalization was 16 days (4-54). In our results, back pain is the most frequent complaint. A comparison with the findings on the day of the accident showed that the vertebral deformity decreased in all cases (index: mean accident = 0.64; mean follow-up = 0.82). In the CT scan we found spinal stenosis in up to 30% in 9 patients (12.5%) with no neurological symptoms. Based on these results, the authors recommend the Böhler method in lower thoracic and lumbar compression fractures without neurological symptoms. The main aim of the treatment must be reduction of the vertebral deformity to a minimum in order to maximize the biomechanical integrity of the vertebral column and prevent degenerative changes. The use of computed tomography is recommended even in these fractures because of possible spinal stenosis. CT is accurate, especially in evaluating the nature of facet joint failure.

Adult↗
PubMed1991

Localization of transforming growth factor-beta 1, -beta 2 and -beta 3 gene expression in bovine mammary gland.

We have studied the expression of transforming growth factor (TGF)-beta 1, -beta 2, and -beta 3 in the non-lactating and lactating bovine mammary gland by in situ hybridization. All three isoforms were expressed in the lobuloalveolar framework of the non-lactating and lactating gland although marked differences were apparent in their spatial distribution. TGF-beta 1 was expressed predominantly by the epithelial cells of the lobules although expression was also observed in the intralobular stroma cells lining the epithelium. In contrast, TGF-beta 2 expression was only observed in the epithelial cells. TGF-beta 3 transcripts were expressed at the highest levels and were observed in almost all cells of the lobule. No TGF-beta signals were found in the interlobular regions of the mammary gland. The possible regulatory functions of these molecules in development of the mammary gland and on differentiation processes in the neonate are discussed.

Animals↗
PubMed1991

Surfactant substitution in ventilated very low birth weight infants: factors related to response types.

We investigated factors than may influence the response to surfactant substitution. Thirty-five very low birth weight infants with respiratory distress syndrome were treated with Curosurf at 3-12 h of age. From the changes in oxygenation, the therapeutic response was categorized as rapid and sustained, rapid with relapse, or poor. Phospholipids and surfactant protein A were quantified in gastric aspirate samples obtained immediately after birth. They showed that 16 infants had accelerated lung maturity, despite clinical and radiologic signs of respiratory distress syndrome. Ten of them had suffered from birth asphyxia or connatal infection. Nevertheless, 12 of these 16 infants responded rapidly to surfactant substitution. Poor response was seen in four infants with connatal infection. Of 19 infants with immature lung profile, 18 showed a rapid initial response to surfactant substitution. Dynamic compliance of the respiratory system or arterial blood pressure before substitution, the ultrastructure of the surfactant preparation, or persistence of the ductus arteriosus did not influence the response type, but fraction of inspired oxygen was higher before surfactant substitution in infants with poor response. Prognosis was related to short-term response: Of 17 infants who showed a rapid and sustained response, none died, whereas eight of 18 infants with relapse after rapid initial response or poor response died (p less than 0.05). We conclude that surfactant substitution may be beneficial not only in babies with primary surfactant deficiency but also in other pulmonary disorders that are common in very low birth weight infants. The type of response may be of prognostic value.

Biological Products↗
PubMed1991

Differential expression of TGF beta 1, beta 2 and beta 3 genes during mouse embryogenesis.

We have examined by Northern analysis and in situ hybridisation the expression of TGF beta 1, beta 2 and beta 3 during mouse embryogenesis. TGF beta 1 is expressed predominantly in the mesodermal components of the embryo e.g. the hematopoietic cells of both fetal liver and the hemopoietic islands of the yolk sac, the mesenchymal tissues of several internal organs and in ossifying bone tissues. The strongest TGF beta 2 signals were found in early facial mesenchyme and in some endodermal and ectodermal epithelial cell layers e.g., lung and cochlea epithelia. TGF beta 3 was strongest in prevertebral tissue, in some mesothelia and in lung epithelia. All three isoforms were expressed in bone tissues but showed distinct patterns of expression both spatially and temporally. In the root sheath of the whisker follicle, TGF beta 1, beta 2 and beta 3 were expressed simultaneously. We discuss the implication of these results in regard to known regulatory elements of the TGF beta genes and their receptors.

Animals↗
PubMed1991

[Hemisphere dominance of cortical speech processing and its dynamics in the course of aphasia therapy. A psychophysiologic contribution to the discussion of the neuronal plasticity hypothesis].

Examinations of aphasic patients by using cognitive tasks were based on the hypothesis that semantically evoked potentials correlate to the processing of information in the cortical areas of Broca and Wernicke. Some of the examined right-handed patients with ischemic lesions of the left hemisphere produced characteristic potentials in the right temporal lobe, and not in the dominant left lobe as was expected. These case histories suggest that in these patients speech processing moved into the subdominant hemisphere as a result of compensation after cerebral damage by using the faculty of neuroplasticity. Furthermore an extended classification of aphasias is presented, illustrated by a three-parameter model.

Aged↗
PubMed1991

[The significance of nerve damage in upper arm fractures].

Lesions of the nerves are a relatively frequent complication after humeral shaft fractures, the nerve most commonly affected being the radial nerve. In the case of proximal fractures of the humerus, particularly dislocation fractures and luxated fractures, lesion of the axillary nerve and irritation of the plexus, are most frequent. In distal humeral fractures the ulnar nerve is most frequently first place and shows a serious complication. The therapy of the fracture must differ in most of these cases from conventional procedure. We believe that primary paresis of the radial nerve is a relative indication for surgery and secondary paresis of the radial nerve, an absolute indication for operation. When we find a subcapital humeral shaft fracture with rare paresis of the nervus axillaris we wait with an operation, but if remission does not occur within approximately 8 weeks a revision should be done. Fracture luxations with irritation of the plexus are an acute indication for operation, because repositioning or displacement of the head fragment can afford relief.

Adult↗
PubMed1990

[Prevention of thromboembolism in para-articular femoral fractures of the hip--results of a prospective randomized study of heparin-DHE and ASS-DHE].

The effectiveness of prophylaxis of thromboembolism either by acetyl-salicylic-acid (ASA) 0.5 g + dihydroergotamin (DHE) 2.5 mg three times a day or by Heparin 5000 IU + 0.5 mg DHE (HDHE) three times a day was compared in 404 patients, elder than 55 years, with fractures close by the hip joint. Effectiveness was proved daily clinical controls, perfusion scintigraphy on the day after admission, the fourth postoperative day and the day before discharge and by autopsy of the died patients. Clinical manifest thrombosis were seen on the operated legs in the HDHE-group in 7.6% of the patients, in ASA-DHE-group in 15.6%, on the not operated leg under prophylaxis by HDHE in 3.8%, by ASA-DHE in 4.1% of the patients. Increased postoperative bleeding could be found under HDHE in 16.1% of the patients, under ASA-DHE in 9.3% of the patients, wound haematoma in 9.5% under HDHE and in 5.7% of the patients of the ASA-DHE-group. Superficial wound infections occurred under HDHE in 8.1%, under ASA-DHE in 5.7% of the patients, deep infections under HDHE in 0.5% and under ASA-DHE in 1.6% of the patients. Gastrointestinal bleeding under HDHE in 0.5% of the cases and under ASA-DHE in 3.1% of the cases. Prophylaxis had to be discharged in 7.6% of the patients of the HDHE-group and of 19.7% of the ASA-DHE-group. Pathologic perfusion scars should be found in 54.0% of the patients of the HDHE-group and in 54.9% of the ASA-DHE-group. Pulmonal perfusion became worse despite of prophylaxis by HDHE in 15.6% of the cases and despite prophylaxis with ASA-DHE in 17.6%. Pulmonal perfusion became better under HDHE in 11.9% and under ASA-DHE in 12.4% of the cases. The mortality was 9.7%. Fatal thromboembolism occurred under HDHE in three patients (1.4%) and under ASA-DHE in three patients too (1.6%), after subcapital fractures in 0.5%, after pertrochanteric fractures in 2.1% and after subtrochanteric fractures in 6.25% of the patients without any significant difference between the two groups of prophylaxis. Fatal gastrointestinal bleeding had to be remarked in 1.0% of the patients of the HDHE-group and in 2.1% of the ASA-DHE-group, fatal infections in 0.5% of the patients of the HDHE-group and in 1.6% of the ASA-DHE-group. Fatal cardinal infarction could be seen under HDHE in 1.9% of the patients, under ASA-DHE no fatal cardial infarction occurred.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1990

Lecithin/sphingomyelin ratio from tracheal aspirates and compliance of the respiratory system in infants with bronchopulmonary dysplasia.

In 55 infants with respiratory distress syndrome the dynamic compliance of the respiratory system (CRS) was measured by pneumotachography during the course of the disease. Lecithin/sphingomyelin ratio (L/S) was evaluated at birth and every 10th day. Thirteen infants who developed bronchopulmonary dysplasia (BPD) had lower L/S ratios at birth than those infants without BPD (mean = 1.0 versus 3.5, p less than 0.01). During the course of disease, L/S ratios were variable and increased in all infants independently of outcome. In the first days of life CRS was low (0.30 ml/cm H2O/kg) in all infants independently of outcome. In infants with BPD who survived, CRS was significantly higher from the 30th day on than in infants who died from the disease (0.35 versus 0.23 ml/cm H2O/kg). Together with an decrease in oxygen supply at this time (less than 70%) the CRS is a reliable predictor of survival in cases of BPD.

Bronchopulmonary Dysplasia↗
PubMed1990

Epimerization of erythromycin derivatives.

Dirithromycin (3) isomerizes upon dissolution in different solvents. From X-ray analysis of V-T 108, an analogue of dirithromycin, and comparative 1H and 13C NMR, and MS data, the isomer of dirithromycin was confirmed to be the C-16-(S)-epimer. The ratio of the two epimers at equilibrium conditions was approximately 8:2 (R/S) in methanol at room temperature.

Anti-Bacterial Agents↗
PubMed1990

[Tendon injuries of the knee joint extensor mechanism].

Diagnosis, aetiology and therapy of injuries to the extensor mechanism of the knee joint are presented. 22 cases of ruptures and discisions of the lig. patellae or the quadriceps tendon could be reexamined. All cases but one, with operation within the first week after injury, suturing with absorbable or non absorbable material, immobilisation for 6 weeks and following physical therapy, had a good functional result. No rerupture occurred. In one case a limitation of the range of movement had to be seen afer an open discision of the lig. patellae. After transposition of the tuberositas tibiae, discission of the scares and functional therapy a good result could also be achieved.

Female↗
PubMed1990

[The surgical treatment of humeral shaft fractures].

This is a study of 84 patients with upper arm fractures who were treated by plate osteosynthesis. The indication was mandatory in 9 patients with open fractures, 23 patients with primary radial nerve palsy on admission, 5 patients with radial nerve palsy after the initial treatment, 22 patients with pseudarthrosis and 7 patients who were polytraumatised. The operation was also indicated in 15 patients, because of the form of the fracture, in 3 patients with brachial plexus lesion, in 3 patients because it involved both upper arms and in 3 patients with segmental fractures. The 4.5 DCP was used in all these cases. All the cases of pseudarthrosis progressed to achieve bony union after the operation. There was no incidence of postoperative pseudarthrosis. We did encounter two cases (2.4%) of radial nerve palsy that required exploration. All the preoperative primary and secondary cases of radial nerve palsy recovered postoperatively. After an average follow-up period of 2.4 years (1-10 years) 90% of the patients could be classified as having very good or good results.

Adolescent↗
PubMed1990

Assessment of topical non-steroidal anti-inflammatory drugs in animal models.

Four commercial gel preparations of topical anti-inflammatory agents have been assessed in six animal models commonly used to determine the biological activity of non-steroidal anti-inflammatory agents for systemic administration. Only UV-induced erythema of the skin, adjuvant induced arthritis and the measurement of vascular permeability proved suitable for differentiation of the potency of the four topical agents. Carrageenin-induced paw oedema, the cotton pellet test and the assessment of the pain threshold according to Randall and Selitto were of little value. The effects of the gel preparation of diclofenac (CAS 15307-86-5) diethylammonium (Voltaren Emulgel) were comparable to two preparations containing 1% and 5% active ingredient, respectively. Gel 4 showed low overall activity. The experiments demonstrated that some of the models used for the assessment of anti-inflammatory agent for systemic administration proved suitable for the testing of topical preparations and that percutaneous absorption was insufficient to elicit anti-inflammatory effect in the animals at sites remote from the site of application.

Administration, Topical↗