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Biomedical subjects

T Muller

Publications and source records attributed to T Muller.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Immigration, income distribution, and social welfare].

"This paper explores the consequences of immigration for aggregate income and income distribution. On the one hand, immigration generally increases the residents' aggregate income, on the other hand, it makes income distribution more unequal if immigrants bring little capital with them. These two effects can be analyzed jointly using a measure of social welfare. In general, the arrival of immigrants owning little capital lowers social welfare of residents and immigration of capital-rich persons increases it." (SUMMARY IN ENG AND GER)

Demography↗
PubMed1994

A treatment protocol for mandible fractures.

Mandibular fracture management has evolved over several decades, and controversies exist over ideal approaches for individual fractures. Treatment choices include closed versus open techniques, reduction methods and repair, and decision concerning intermaxillary fixation. Both the patient and the fracture characteristics have an impact on these choices. Patient factors include age, mandibular bone quality, dentition, patient reliability, and associated injuries. Fracture characteristics include favorability versus unfavorability, single versus multiple, location, and infection. This study was undertaken to develop and evaluate a management algorithm to determine the best treatment of mandible fractures. Sixty-seven patients were managed at the Grady Memorial Hospital otolaryngology service. Ages ranged from 3 to 68 years and included 55 male patients and 12 female patients. Forty-three patients had multiple fractures, while 24 had single fractures. Sixty-four patients were successfully managed and had normal function on follow-up examination. Eleven patients (16.4%) had complications. These included three infections, one malunion, two malocclusions, and five marginal nerve pareses. Multiple fractures did not have a higher incidence of complication. This protocol allows an orderly approach to the successful outcome of mandibular fractures.

Adolescent↗
PubMed1992

Magnum system for routine coronary angioplasty: a randomized study.

The Magnum system, initially designed for coronary angioplasty (PTCA) of chronic total occlusion, consists of a balloon catheter and a solid steel 0.021 inch (0.53 mm) steerable and removable wire with a soft and moldable distal portion, tipped with a 1 mm olive. To evaluate its performance in routine PTCA, 200 unselected consecutive patients were randomized to two equal groups, i.e., group Magnum (100 patients, 115 vessels) and group Standard (100 patients, 118 vessels) including 18 and 21 patients with chronic total occlusions, respectively. Randomization was performed by the sealed envelope system in the catheterization laboratory and crossover of system was imposed if it was not possible to place a balloon correctly within 20 min of fluoroscopy time. There were no significant differences between groups concerning clinical and angiographic baseline characteristics, size of initial balloons (3.0 +/- 0.3 mm in both groups), fluoroscopy time to cross the lesion with the wire (Magnum: 4 +/- 5, Standard: 5 +/- 6 min), total fluoroscopy time (Magnum: 11 +/- 9, Standard: 12 +/- 12 min), and need for crossover (Magnum: 10%, Standard: 16%). Success rates per lesion were comparable with 90% in group Magnum and 84% in group Standard, as were the complications with one inhospital death in group Standard, occurring three weeks after PTCA and stent implantation. There was no emergency operation. Six patients per group had myocardial infarction of whom two in group Magnum and one in group Standard developed a Q-wave. The following variables were significantly in favor of the Magnum system compared with the Standard system: success rate in nontotal lesions (97% versus 90%) crossover success in total occlusions (0 vs. 33%), fluoroscopy time to cross the lesion with the balloon once the wire was in place (1 +/- 2 vs. 2 +/- 4 min), and use of a single versus 1.2 +/- 0.5 wires per lesion. The only advantage of the Standard systems was the more common use of 7 French guiding catheters (Magnum: 40%, Standard: 53%, p = 0.09). The Magnum system compares favorably with standard systems for routine PTCA. The robust design of the Magnum wire does not impair ease of placement and safety but saves material and facilitates balloon advancement across the lesion.

Aged↗
PubMed1992

Mammary-derived growth inhibitor in lactation and involution.

Presence of mammary-derived growth inhibitor (MDGI) in mammary tissue of lactating and involuted cows was investigated. Eighteen lactating, non-pregnant high-producing Holstein cows were randomly assigned to 3 experimental groups of 6 cows each. Cows of the first group were slaughtered while in lactation. Cows of the second group were slaughtered at 2-3 d, and the others at 4-8 d following sudden cessation of milking. Cessation of milking occurred at approximately 300 d in lactation. Western blot analysis revealed the presence of MDGI in the cytosolic and microsomal fractions of mammary tissue homogenates. High levels of MDGI were detected in mammary tissue obtained from lactating non-pregnant cows. A dramatic reduction in MDGI was observed in early involution (2-3 or 4-8 d following cessation of milking). These data suggest that a relationship exists between MDGI levels and the physiological status of the gland. Lack of MDGI may play a role during the processes of mammary involution and development prior to parturition.

Animals↗
PubMed1992

Mammary-derived growth inhibitor protein and messenger ribonucleic acid concentrations in different physiological states of the gland.

Expression of mammary-derived growth inhibitor in tissue from lactating and involuting bovine mammary glands was investigated. Seventeen lactating, pregnant (220 to 272 d in gestation) cows were divided in two groups of 8 and 9 cows each. Cows of the first group were slaughtered while in lactation. Cows of the second group (9 involuting cows) were slaughtered at 13 to 52 d following sudden cessation of milking. High concentrations of mammary-derived growth inhibitor (.63% of the total protein) were detected in mammary tissue of lactating cows. Mammary-derived growth inhibitor (less than .10% of the total protein) was dramatically reduced during most of the involution period (13 to 45 d following cessation of milking). Mammary-derived growth inhibitor was again detected (.28% of the total protein) during the last stage of the involution (46 to 53 d after cessation of milking), which coincided with colostrum formation. When steady state concentrations of mammary-derived growth inhibitor mRNA were examined, the results obtained mirrored those obtained at the protein concentration. These data suggest that regulation of mammary-derived growth inhibitor occurs via modulation of the steady state concentration of its mRNA. Furthermore, there is a strong correlation between mammary-derived growth inhibitor expression and lactation in dairy cows.

Animals↗
PubMed1991

Coronary balloon angioplasty through diagnostic 6 French catheters.

We investigated the use of ultralow profile balloon catheters (Scimed ACE, USCI Probe, Cordis, Orion) for coronary angioplasty through 6 French diagnostic catheters (Schneider, Cordis). Contrast injection was assisted with a Hercules pump (Cordis) in all cases. During 21 procedures, angioplasty of 27 lesions in 20 selected patients was attempted (1.3 lesion/procedure). Twelve lesions were in the right, 10 in the left anterior descending, and 5 in the left circumflex coronary artery. Balloon size varied between 2.5 and 3.5 mm. Twenty lesions could be successfully dilated (74%) through the 6 French catheter and 7 lesions required an exchange to a 7 French angioplasty guiding catheter. For 5 cases, another balloon was also necessary to complete the procedure. The final overall success rate was 100% per patient and per lesion and there were no major complications. Despite the small internal catheter lumen (1.22 mm) coronary visualization was adequate, and mechanical support was good. Failures of 6 French catheters were attributed to insufficient torque control and excessive friction when the balloon crossed the tapered end of the diagnostic catheter. Coronary angioplasty through a diagnostic 6 French catheter is feasible and may represent a reasonable alternative for simple cases that are done during the same session as the diagnostic angiography. Once available, 6 French high flow angioplasty guiding catheters without a tapered tip should improve success while retaining the advantage of a small femoral puncture site.

Angiography↗
PubMed1991

Electrophysiologic evaluation and outcome of patients with syncope of unknown origin.

Electrophysiologic studies were performed in 134 patients (87 males, mean age 59 years) with unexplained syncope. Seventy-one patients had organic heart disease (ischaemic in 50). Electrophysiologic studies revealed conduction abnormalities and tachyarrhythmias that could account for syncope in 40 patients (30%). Thirty-seven (93%) of these patients received pacing or antiarrhythmic therapy compared with 23 (24%) of the remaining 94 patients who had a negative study and received empiric therapy (P less than 0.0001). Risk of having an abnormal electrophysiologic study was greater in patients with underlying heart disease (P less than 0.05). During a mean follow-up of 22 +/- 17 months, 26 patients (19%) either had recurrent syncope (22 patients) or died (four patients) suddenly. Men had a higher incidence of recurrent syncope than women (26% vs 6%, P less than 0.005). Other clinical characteristics, electrophysiologic findings, final diagnosis and therapy at discharge were not predictive of outcome. We conclude that (1) 19% of patients investigated for syncope will have a recurrent event, (2) female gender may be an independent predictor of favourable outcome.

Adolescent↗
PubMed1991

On-site screening for urinary Hg concentrations and correlation with glomerular and renal tubular function.

At the American Dental Association 1985 and 1986 Annual Sessions, an on-site screening for mercury was conducted as part of the Health Screening Program (HSP) to identify dentists having elevated urinary mercury concentrations. The data generated from this study were used to examine the relationship between elevated urinary mercury exposure and kidney dysfunction. Kidney dysfunction was assessed by measurement of serum and urine beta 2 microglobulin concentrations, serum creatinine, and creatinine clearance. The mean values found for urinary mercury were 5.8 micrograms Hg/L and 7.6 micrograms Hg/L for 1985 and 1986, respectively. Urinary mercury concentrations for this population were found to fall within the range of not detected to 115 micrograms Hg/L. Of the total number of participants assayed in 1985 and 1986, roughly 10 percent of the sample exhibited elevated mercury concentrations above 20 micrograms Hg/L. An analysis of the clinical markers indicated no clear relationship between elevated urinary mercury concentrations and kidney dysfunction. In addition to mercury testing, all dentists who participated in the 1985 and 1986 HSP were issued a questionnaire soliciting information as to their professional exposure. Those participants who were identified as having elevated urinary mercury concentrations in the 1985 HSP were issued a followup questionnaire that addressed psychological and neuropsychological symptoms. From these questionnaires three significant relationships were found. These relationships were associated with mercury/amalgam handling and skin contact, the number of amalgams placed by the dentist, and the number of hours of practice per week. The reported absence of a clear relationship between urinary mercury concentrations and potential kidney dysfunction is in agreement with other findings at the mercury concentrations tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1991

[Immediate results and mid-term follow-up after percutaneous mitral valve replacement].

Percutaneous mitral valvuloplasty (PMV) was performed by the anterograde transseptal approach (double balloon technique) in 154 patients with symptomatic mitral stenosis. The mean age of the patients was high (53 +/- 14 years), 87% were women, 68% were in functional Classes III or IV of the NYHA and 37 (24%) had previously undergone surgical commissurotomy. The echocardiographic score was 8.5 +/- 1.6. PMV could not be completed because of a technical failure or a complication in 14 cases (9%). In the other patients, PMV increased mitral surface area from 1.0 +/- 0.3 to 2.0 +/- 0.8 cm2 (p less than 0.0001). A haemodynamic success (greater than or equal to 25% increase in mitral surface area and final area greater than or equal to 1.5 cm2) was obtained in 104 patients (75%). The predicting factors of success were echocardiographic score (8.1 +/- 1.4 versus 9.4 +/- 1.7; p less than 0.0001) and cardiac output (4.0 +/- 1.1 versus 3.0 +/- 1.0/l/min; p less than 0.0001). The duration of the procedure, the technical failure rate and the frequency of cardiac perforation were influenced by the learning curve. The degree of mitral regurgitation increased after PMV in 34% of cases, usually by one grade and without clinical or haemodynamic consequences. Acute mitral regurgitation was a rare (3%) and impredictable complication. An interatrial shunt was demonstrated in 80% of cases after PMV but the Qp/Qs ratio rarely exceeded 1.5 (11%). This shunt disappeared or decreased in the majority of cases during follow-up. The clinical result was an improvement of at least one functional Class in 83% of cases at 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Photomaniac behavior and schizophrenia].

Two patients with a chronic residual schizophrenic disorder, according to DSM-III-R, showed a marked resistance to intensive light, manifested through a lack of intolerance and pain when looking at the Sun directly. Light suppresses melatonin secretion in humans, and the melatonin rhythm reflects the subject's light/darkness exposition. A photomaniac character of such a behavior (or phenomena that could favor it) recalls its opposite--the photophobic behavior as described in some cases of depression, and could cause a different profile of exposition to the light. Knowing about such phenomena--such though they lack every explanation for the time being--could be useful--from a methodology point of view, as well as heuristically valuable--during the study of photosensitive neuroendocrine processes in patients who evidence such phenomena.

Humans↗
PubMed1985

The role of serum tumour markers to aid the selection of lung cancer patients for surgery and the assessment of prognosis.

We have measured the following ten serum proteins in a sample of 290 patients presenting with possible lung cancer: carcinoembryonic antigen (CEA), alpha 1-acid glycoprotein (AGP), C-reactive protein (CRP), ferritin (FER), prealbumin (PAB), third component of complement (C3), immunoglobin E (IgE), alpha 2-pregnancy-associated glycoprotein (PAG), beta 2-microglobulin (beta 2-m) and retinol binding protein (RBP). It is found that, with the exception of PAG, C3 and IgE, there are significant differences between protein concentrations in the subsequently diagnosed cancer and non-cancer patients. However, protein concentrations in the cancer patients who were suitable for surgery do not differ significantly from the concentrations in inoperable patients. The prognostic significance of the proteins in the inoperable and operable cancer patients is also envisaged. In the operable group C3 appears to be useful, whilst AGP and RBP are prognostic indicators in the inoperable group.

Blood Proteins↗
PubMed1984

An international collaborative study of laboratory methods for assessing abrasivity to dentin.

An International Collaborative Study was conducted in which one surface profile and two radiotracer methods for assessing abrasivity of dentifrices on human dentin were compared. The study consisted of two phases: an open phase in which participating laboratories used the method they routinely practiced; and a controlled phase in which an expert team for each method performed the abrasion tests using all three methods. Four test pastes of known abrasivity were evaluated by each method. Similar abrasivity values for the test pastes were obtained with the radiotracer methods, whereas the surface profile method produced significantly different values. The precision levels of the radiotracer methods were similar, and both were superior to those obtained by the surface profile method. The time needed to perform the tests by the ADA radiotracer method was significantly less than that needed by the other methods. These findings suggest that the ADA radiotracer method will be useful in assessing abrasivity of dentifrices.

Calcium Carbonate↗