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Biomedical subjects

S Engel

Publications and source records attributed to S Engel.

At least 55 records · Page 3Linked to original sources
PubMed1987

Bracing of thoracic and lumbar spine fractures.

A prospective study of the non-operative management of 33 thoracic and lumbar fractures and dislocations was undertaken examining factors such as duration of bed rest and brace prescription. Outcome was assessed using Frankel's grading system and serial radiological examination. Bed rest for 6 to 8 weeks followed by 16 weeks of immobilisation in a thoraco-lumbar orthosis (either a moulded plastazote lined polythene brace or a Taylor brace) resulted in less than 15 degrees kyphus in 85% of patients and less than 20% kyphus in 94%. One patient with a T12/L1 dislocation who had an early decompressive laminectomy showed persistent instability and required internal fixation. One patient with an L1 fracture who initially wore a Hexalite brace developed late instability (at 12 months after injury) and required spinal osteotomy and fusion. Neurological improvement was observed in 50% of patients, and no permanent neurological deterioration occurred. A non-operative regimen of treatment of fractured thoracic and lumbar vertebrae as described is an alternative to prolonged immobilisation in bed, or early operative fusion.

Braces↗
PubMed1986

[Disorders of potency in the male--recent etiologic and diagnostic aspects].

Sexual function is impaired by organic, iatrogenic, or psychic causes. The results of numerous studies recently undertaken revealed that organic, especially vascular causes are more common than thought of before. It may be assumed that sexual dysfunction is caused by arteriosclerosis of the penile arteries alone in about 40% of the patients over 40. In addition, other organic (local, endocrine, neurogenic, a.o.) as well as iatrogenic causes (abdominal or pelvic surgery, side effects of drugs) have been observed. Consequently, the number of cases due to psychic factors is considerably below 50%.

Arterial Occlusive Diseases↗
PubMed1986

Photoinactivation of catalase in vitro and in leaves.

Purified catalase from bovine liver and catalase of isolated intact peroxisomes from rye leaves were inactivated in vitro by irradiation with visible light. During photoinactivation the protein moiety of pure catalase was not cleaved; however, the electrophoretic mobility of the native enzyme was decreased, and a major portion of enzyme-bound heme was dissociated. In a suspension of isolated chloroplasts photoinactivation of pure or peroxisomal catalase was mediated by light absorption in the chloroplasts. Both the direct and the chloroplast-mediated photoinactivation of catalase were affected little by the presence of D2O or superoxide dismutase but were greatly retarded by formate. In isolated peroxisomes substantial photoinactivation of catalase occurred only in the presence of nonphotosynthesizing but not in the presence of photosynthesizing isolated chloroplasts. Substantial and selective photoinactivation of catalase was also observed in vivo when leaf sections from various plant species (rye, pea, sunflower, cucumber, maize) were irradiated with light of high intensity in the presence of the translation inhibitors cycloheximide or 2-(4-methyl-2,6-dinitroanilino)-N-methylpropionamide, while catalase activity was much less or not affected in 3-(3,4-dichlorophenyl)-1,1-dimethylurea-treated or untreated control sections. The extent of photoinactivation of catalase in leaves depended on light intensity and also occurred in red light. The results suggest that photoinactivation of catalase generally occurs in leaves under high light intensity, though it is not apparent under normal physiological conditions because it is compensated for by new synthesis. Apparent photoinactivation of catalase has to be regarded as an early indication of photodamage in leaves and conceivably enhances its progress.

Animals↗
PubMed1986

Antiemetics in children receiving cancer chemotherapy: a double-blind prospective randomized study comparing metoclopramide with chlorpromazine.

This is the first prospective randomized study comparing commonly used antiemetics in children receiving cancer chemotherapy. We compared metoclopramide (MCP) with chlorpromazine (CLP), both administered in conventional doses, in 50 cancer patients aged 6 to 18 years who were receiving emetic chemotherapy. CLP proved significantly better than MCP in reducing both the frequency of vomiting (P less than .05) and the duration of nausea and vomiting (P less than .025). Extrapyramidal reactions (EPRs) were more common in MCP-treated patients. We conclude that, in the standard doses used, CLP is a better overall antiemetic than MCP for children receiving intensive chemotherapy. However, further prospective pediatric studies of antiemetic combinations are needed.

Adolescent↗
PubMed1985

Protective immunization against Treponema pallidum using specific immune complexes--an attempt.

Rabbits were immunized using isolated and dissolved specific immune complexes obtained from patients suffering from early syphilis. After immunization the rabbits were infected intradermally with living Treponema pallidum. Some of them did not develop lesions at the infection sites. In comparison to controls there was a delayed and reduced production of antibodies. The effect of immunization may be induced by a treponemal protein antigen as a constituent of the specific immune complexes.

Adult↗
PubMed1985

[Contribution of urology in the interdisciplinary treatment concept of fertility disordered males].

The most important disturbances of male infertility are described in detail. The varicocele is in 30 to 40% the main cause of subfertility. 106 out of 125 patients are operated because of unability to conceive a child. Postoperatively, the results show a significant improvement of the sperm density, total sperm count, sperm morphology and the initial and late forward progression. 26% of the couples were achieve pregnancies. In obstructive azoospermia microsurgical repair is the preferable method. The obstruction, whether developmental or acquired, is most frequently at the epididymal junction. Vasography is performed intraoperative immediately before the planned reconstruction to demonstrate the block. In only 5 of 12 patients microsurgical repair was possible. The other patients had developmental abnormalities or scarring and long-distant obstruction. The diagnostic and therapeutic procedures in erectile impotence are described, 5 patients are operated by implantation of a penile prosthesis. The most important step in prophylaxis of infertility is the treatment of cryptorchidism. The therapy should be closed at the end of the second year of life. The role of testicular autotransplantation in selected cases is discussed. Because of more recent data suggest that a male factor is present in or contribute to as many as 50 per cent of the infertility problems and the urologist has the best training and expertise to examine and to diagnose disorders of the male reproductive tract, he should be at the forefront of treatment of these problems.

Constriction, Pathologic↗
PubMed1984

Conversion reaction presenting as acute spinal cord injury.

A conversion reaction, presenting as an acute spinal-cord injury, was diagnosed in 9.8% of new patients admitted to a spinal injury unit during the period from November 1982 to November 1983. There were eight men and one woman (mean age, 23 +/- 8 years). A history of previous episodes of conversion reaction was common in this group. Some patients had evidence of previous vertebral damage. Diagnosis of this condition is difficult, even for those who are familiar with patterns of spinal-cord injuries. All patients were walking independently and had no sensory deficits at the time of discharge from hospital.

Acute Disease↗
PubMed1984

Regional and global left ventricular function during intra-aortic balloon counterpulsation in patients with acute myocardial infarction shock.

We evaluated the improvement in hemodynamic and left ventricular (LV) function in 15 patients with acute myocardial infarction and cardiogenic shock, who were treated with intraaortic balloon counterpulsation (IABP). They were studied by flow-directed right heart catheterization and nuclear angiography. IABP decreased LV end-diastolic volume from 134 to 114 ml and LV end-systolic volume from 100 to 72 ml. LV stroke volume increased from 34 to 42 ml and cardiac output from 3.0 to 3.6 L/min. Global LV ejection fraction increased from 27.6% to 36.1%, and this was due to improvement in regional ejection fraction in ischemic areas. Pulmonary capillary wedge pressure and pulmonary blood volume decreased. Right ventricular ejection fraction also increased significantly. IABP improved LV function in acute myocardial infarction.

Adult↗
PubMed1984

Odontoid fractures, systemic disease and conservative care.

Patients admitted to the Prince Henry Hospital Spinal Unit between January 1982 and January 1983 with a diagnosis of fracture of the odontoid process of the axis were reviewed. There were nine patients representing 20% of all new cervical fractures. The mean age was 64.5 +/- 19.3 years. Alcoholism, brain damage following head injury, osteo-arthritis, cervical spondylosis, rheumatoid arthritis and osteoporosis may be complicating factors in the management of odontoid fractures. A fracture of the odontoid in an elderly patient with a history of minimal trauma suggests osteoporosis. Early mobilization in a custom-moulded orthosis with frequent radiological monitoring prevents the complications of prolonged bed rest.

Aged↗
PubMed1984

[Results of ligature of the upper testicular vein in idiopathic varicocele and subfertility].

The results of a total of 102 varicocele operations, 83 of which were performed because of subfertility and a desire to have children, are presented. In 3% of the cases a recidive operation was necessary because of persistent varicocele. 55 patients with limited fertility were subsequently examined for volume, density and form of sperm, total motility and propulsive motility. Whereas the volume of sperm and the total motility remained unchanged, the density and form of sperm and the propulsive motility had improved significantly 9 months after the operation. Among the men followed up the conception rate was 20%.

Adult↗
PubMed1983

Detection of ostium secundum atrial septal defects by transoesophageal cross-sectional echocardiography.

Transoesophageal cross-sectional echocardiography has special advantages when investigating the interatrial septum which is imaged perpendicularly without echo dropouts from an oesophageal transducer position. The technique was successfully used in 19 out of 20 patients (95%) with an ostium secundum atrial septal defect and in 30 control subjects. In all of the latter the interatrial septum was visualised as a continuous echo structure separating the atria, whereas a distinct discontinuity representing the septal defect was apparent in all patients with atrial septal defect. Echocardiographic measurement of the defect size correlated well with surgical findings in 11 patients who underwent open heart surgery in the course of this study. In a comparative transthoracic examination, adequate recordings were obtained in 18 of the 20 patients and in 26 of the 30 control subjects. Direct subcostal visualisation of the defect was reliable in 10 of 18 patients. Peripheral venous contrast studies were also performed with the transoesophageal as well as the transthoracic technique. Echo contrast remained confined to the right heart in the control subjects. Left sided contrast appearance diagnostic of an interatrial communication was shown in the patients using the transoesophageal technique (100% sensitivity), with an additional right atrial negative contrast apparent in seven patients. The transthoracic approach, on the other hand, showed left sided echo contrast in 14 of 18 patients and an additional negative contrast effect in two of the 14. It is concluded that transoesophageal is superior to transthoracic cross-sectional echocardiography as a highly sensitive method for the detection and evaluation of ostium secundum atrial septal defects.

Adolescent↗
PubMed1982

Transoesophageal cross-sectional echocardiography with a phased array transducer system. Technique and initial clinical results.

Cardiac imaging by transthoracic two dimensional echocardiography is impaired in patients with chronic lung disease, those with obesity, and those with abnormal chest wall configuration. In order to overcome these limitations, a miniature phased array ultrasound transducer fitted to the tip of a commercially available gastroscope was developed. Transducer position and orientation can be adjusted completely by external control of vertical displacement inside the oesophagus, rotation, and angulation. Introduction and operation of the transducer gastroscope system are usually well tolerated by the patients, since no mechanical vibrations are generated and there is no need for an oil bag to secure oesophageal wall contact. Cardiac images of high quality are obtained even from structures and regions that are poorly or not at all imaged from external transducer positions.

Adult↗