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Biomedical subjects

S Gräber

Publications and source records attributed to S Gräber.

18 recordsLinked to original sources
PubMed2005

Preparing strategic information management plans for hospitals: a practical guideline SIM plans for hospitals: a guideline.

OBJECTIVES: Systematic information management in hospitals demands for a strategic information management plan (SIM plan). As preparing a SIM plan is a considerable challenge we provide a practical guideline that is directly applicable when a SIM plan is going to be prepared. METHODS: The guideline recommends a detailed structure of a SIM plan and gives advice about its content and the preparation process. It may be used as template, which can be adapted to the individual demands of any hospital. RESULTS: The guideline was used in several hospitals preparing a SIM plan. Experiences showed that the SIM plans could be prepared very efficiently and timely using the guideline, that the proposed SIM plan structure suited well, that the guideline offers enough flexibility to meet the requirements of the individual hospitals and that the specific recommendations of the guideline were very helpful. CONCLUSIONS: Nevertheless, we must strive for a more comprehensive theory of strategic information management planning which -- in the sense of enterprise architecture planning -- represents the intrinsic correlations of the different parts of a SIM plan to a greater extent.

Hospital Information Systems↗
PubMed2005

Enhanced blood coagulation and fibrinolysis in mice lacking histidine-rich glycoprotein (HRG).

Histidine-rich glycoprotein (HRG) is a serum protein belonging to the cystatin superfamily. HRG may play a regulatory role in hemostasis and innate immunity. However, this role is uncertain because of a lack of rigorous testing in an animal model. We generated mice lacking the translation start point of exon 1 of the Hrg gene, effectively resulting in a null mutation (Hrg-/-). The mice were viable and fertile but had no HRG in their blood. Antithrombin activity in the plasma of Hrg-/- mice was higher than in the plasma of heterozygous Hrg+/- or wild-type Hrg+/+ mice. The prothrombin time was shorter in Hrg-/- mice than in Hrg+/- and Hrg+/+ mice. Bleeding time after tail tip amputation in Hrg-/- mice was shorter than in Hrg+/+ mice. The spontaneous fibrinolytic activity in clotted blood of Hrg-/- mice was higher than in Hrg+/+ mice. These findings suggest that HRG plays a role as both an anticoagulant and an antifibrinolytic modifier, and may regulate platelet function in vivo.

Animals↗
PubMed2003

[A population-based survey of critical care].

OBJECTIVES: Results of a population-based survey of critical care in a German state are presented. The indication for critical care was derived using the APACHE-II score,which measures the physiologic state of patients, and the TISS-28 score as a measure for expenditure of critical care. METHODS: During 3 months all adult patients of intensive care units in Saarland, a German state with 1.08 million residents,were included. All kinds of hospitals were involved. Completeness and validity of data are proved. RESULTS: The TISS score was registered daily on 13,391 adult patients with 54,503 days, the APACHE score during admission and discharge of intensive care units only. The correlation between the scoring-systems and indication, kind of care (critical care vs. intermediate care), kind of hospital, and ICD-10 diagnoses is analysed in this paper. CONCLUSIONS: In this study the population-based critical care in a state is analysed the first time. It completes previously published studies,which were performed at the level of hospitals and departments.

APACHE↗
PubMed2001

Strategic information management plans: the basis for systematic information management in hospitals.

Information management in hospitals is a complex task. In order to reduce complexity, we distinguish strategic, tactical, and operational information management. This is essential, because each of these information management levels views hospital information systems from different perspectives, and therefore uses other methods and tools. Since all these management activities deal only in part with computers, but mainly with human beings and their social behavior, we define a hospital information system as a sociotechnical subsystem of a hospital. Without proper strategic planning it would be a matter of chance, if a hospital information system would fulfil the information strategies goals. In order to support strategic planning and to reduce efforts for creating strategic plans, we propose a practicable structure.

Hospital Information Systems↗
PubMed2000

Purpose and structure of strategic plans for information management in hospitals.

Information management in hospitals requires a strategic plan that gives directives for the construction and development of a hospital information system. The paper describes the purpose and a suggested structure for those strategic plans. This structure is a central component for a guideline that may be used for creating and updating strategic plans.

Germany↗
PubMed1999

Phonemic vowel length contrasts in cerebellar disorders.

Apraxia of speech and Broca's aphasia both affect voice onset time (VOT) whereas phonemic vowel length distinctions seem to be preserved. Assuming a close cooperation of anterior perisylvian language zones and the cerebellum with respect to speech timing, a similar profile of segment durations must be expected in ataxic dysarthria. In order to test this hypothesis, patients with cerebellar atrophy or cerebellar ischemia were asked to produce sentence utterances including either one of the German lexial items "Rate" (/ra:t(h)e/, 'installment'), "Ratte" (/rat(h)e/, 'rat'), "Gram" (/gra:m/, 'grief'), "Gramm" (/gram/, 'gramm'), "Taten" (/t(h)atn/, 'actions'), or "Daten" (/datn/, 'data'). At the acoustic signal, the duration of the target vowels /a/ and /a:/ as well as the VOT of the word-initial alveolar stops /d/ and /t/ were determined. In addition, a master tape comprising the target words from patients and controls in randomized order was played to three listeners for perceptual evaluation. In accordance with a previous study, first, the cerebellar subjects presented with a reduced categorical separation of the VOT of voiced and unvoiced stop consonants. Second, vowel length distinctions were only compromised in case of the minimal pair "Gram"/"Gramm." In contrast to "Rate"/"Ratte", production of the former lexical items requires coordination of several orofacial structures. Disruption of vowel length contrasts would, thus, depend upon the complexity of the underlying articulatory pattern.

Adult↗
PubMed1999

Cerebellar contributions to the perception of temporal cues within the speech and nonspeech domain.

A previous study (Ackermann, Gräber, Hertrich, & Daum, 1997) reported impaired phoneme identification in cerebellar disorders, provided that categorization depended on temporal cues. In order to further clarify the underlying mechanism of the observed deficit, the present study performed a discrimination and identification task in cerebellar patients using two-tone sequences of variable pause length. Cerebellar dysfunctions were found to compromise the discrimination of time intervals extending in duration from 10 to 150 ms, a range covering the length of acoustic speech segments. In contrast, categorization of the same stimuli as a "short" or "long pause" turned out to be unimpaired. These findings, along with the data of the previous investigation, indicate, first, that the cerebellum participates in the perceptual processing of speech and nonspeech stimuli and, second, that this organ might act as a back-up mechanism, extending the storage capacities of the "auditory analyzer" extracting temporal cues from acoustic signals.

Adult↗
PubMed1999

Cognitive deficits in spinocerebellar ataxia 2.

This is one of the first studies assessing the pattern of cognitive impairment in spinocerebellar ataxia 2 (SCA2). Cognitive function was studied in 17 patients with genetically confirmed SCA2 and 15 age- and IQ- matched controls using a neuropsychological test battery comprising tests for IQ, attention, verbal and visuospatial memory, as well as executive functions. Twenty-five percent of the SCA2 subjects showed evidence of dementia. Even in non-demented SCA2 subjects, there was evidence of verbal memory and executive dysfunction. Tests of visuospatial memory and attention were not significantly impaired in the non-demented group compared with controls. There was no relationship between test performance and motor disability, repeat length or age of onset, while disease duration was shown to be inversely correlated with two tests reflecting the progression of cognitive deficits during the course of the disease. Intellectual impairment should therefore not be interpreted as a secondary effect of progressive motor disability, but represents an important and independent part of the SCA2 phenotype.

Adult↗
PubMed1999

[Value of German Hospital Diagnosis Statistics in epidemiology-- an analysis with subarachnoid hemorrhage as an example].

Due to the Hospital Statistics Regulations of the 10th April 1990, the German Hospital Diagnosis Statistics were introduced in 1993 with the intention to serve as a database of health care decisions. This purpose requires a high-quality collection of epidemiologically relevant data. From 1993 to 1996 we analysed the datasets obtainable for subarachnoid haemorrhage which is coded with ICD 430. A subset concerning the data of 1996 and the Saarland region was compared to the data of the Saarland medical school at Homburg/Saar. Cases treated in the neurosurgical department were critically reviewed. About 20% of the cases coded with ICD 430 showed no subarachnoid haemorrhage. On the other hand, again about 20% of subarachnoid haemorrhage cases were not coded with ICD 430. The statistics comprise duplicates due to transfers between hospitals. The calculation of incidence is not possible because new bleeding cases cannot be outlined. In the present form the German Hospital Diagnosis Statistics are not suitable as a reliable base of health care decisions. This is partly caused by the inadequacy of the ICD-classification but, also, by the criteria for collecting data. We propose several modifications which can improve data quality in order to meet the intended requirements.

Databases, Factual↗
PubMed1997

Categorical speech perception in cerebellar disorders.

Keele and Ivry (1991) considered the cerebellum an "internal clock" responsible for temporal computations both in the motor and in the perceptual domain. These authors, therefore, expected that the processing of durational parameters of the perceived acoustic speech signal such as voice onset time (VOT) depends upon the cerebellum as well. However, a preliminary investigation of Ivry and Gopal (1992) revealed unimpaired phoneme-boundary effects in cerebellar patients along a continuum of monosyllabic stimuli with systematically varied VOT (/ba/-/pa/). Since the energy of the aspiration noise provides additional cues for the discrimination of voiced and voiceless stops, the present study used a series of disyllabic stimuli differing in a purely durational parameter. Both controls and patients with unilateral cerebellar lesion identified the endpoints of this continuum in nearly all instances as the counterparts of a minimal pair (Boten, /bo:tn/, "messengers" versus Boden, /bo:dn/, "floor"). Subjects with bilateral pathology of the cerebellum, in contrast, did not show a comparable phoneme-boundary effect. Our data corroborate the hypothesis of the cerebellum as an internal clock and implicate a role of this structure in speech perception.

Adult↗
PubMed1997

Binding of non-native protein to Hsp25 during heat shock creates a reservoir of folding intermediates for reactivation.

Small heat shock proteins (sHsps) are a conserved and ubiquitous protein family. Their ability to convey thermoresistance suggests their participation in protecting the native conformation of proteins. However, the underlying functional principles of their protective properties and their role in concert with other chaperone families remain enigmatic. Here, we analysed the influence of Hsp25 on the inactivation and subsequent aggregation of a model protein, citrate synthase (CS), under heat shock conditions in vitro. We show that stable binding of several non-native CS molecules to one Hsp25 oligomer leads to an accumulation of CS unfolding intermediates, which are protected from irreversible aggregation. Furthermore, a number of different proteins which bind to Hsp25 can be isolated from heat-shocked extracts of cells. Under permissive folding conditions, CS can be released from Hsp25 and, in cooperation with Hsp70, an ATP-dependent chaperone, the native state can be restored. Taken together, our findings allow us to integrate sHsps functionally in the cellular chaperone system operating under heat shock conditions. The task of sHsps in this context is to efficiently trap a large number of unfolding proteins in a folding-competent state and thus create a reservoir of non-native proteins for an extended period of time, allowing refolding after restoration of physiological conditions in cooperation with other chaperones.

Animals↗
PubMed1996

Memory dysfunction of the frontal type in normal ageing.

In this study healthy subjects divided into five consecutive age groups (20-60 years of age) completed a series of memory tasks which had previously been shown to reveal impairments in patients with frontal lobe lesions. Significant age differences were found for free recall, retention rates for material which required effortful encoding, memory for temporal order and prospective memory. In the tests addressing these memory functions, subjects of more than 60 years of age performed more poorly than the youngest group, and they also showed evidence of false recognition (increased false alarm rates and confabulatory responses). The general pattern suggests that inefficient frontal functioning might contribute to age-related memory problems.

Adult↗
PubMed1995

Electrophoretic transfer of protein-pigment complexes from non-denaturing gels to electron microscopy grids.

Different fractions of a mixture of protein-pigment complexes have been separated from one another by non-denaturing gel electrophoresis. These complexes were prepared for observation by inserting electron microscope grids directly into the focused bands of the pigment-protein complexes and resuming electrophoresis for a brief time, so that the complexes were deposited onto the grids. It was found that complexes deposited from each band exhibited distinctly different appearances. It was also found that the exact conditions of electrophoretic deposition onto the grids affected the appearance of the complexes. The protein-pigment complexes were characterized additionally by spectroscopy and denaturing gel electrophoresis.

Chlorophyll↗
PubMed1980

[The influence of the stapes prosthesis on the long-term results of stapedectomy (author's transl)].

In comparing two groups of patients following stapedectomies, significantly better long-term results were obtained by using the Robinson steel piston prosthesis (n = 85) as opposed to the wire prosthesis (n = 74). By so doing, the impairment of sound transmission was reduced and the Carhart depression counterbalanced. This improvement is thought to result from the increased mass and stability of the steel prosthesis as well as from its more correct anatomical positioning.

Bone Conduction↗