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Biomedical subjects

W Kapp

Publications and source records attributed to W Kapp.

At least 19 recordsLinked to original sources
PubMed2000

Long-term residual musculoskeletal deficits after femoral shaft fractures treated with intramedullary nailing.

BACKGROUND: Locked intramedullary (IM) nailing has been recognized as one of the most reliable methods for treatment of femoral shaft fractures. Although IM nails are routinely used in the treatment of these fractures, the long-term effects of retained IM nails are unknown. METHODS: Seventeen patients with radiographically documented healed fracture of femoral diaphysis after locked IM nailing technique were evaluated at a follow-up of at least 18 months postoperatively. All patients had returned to their preinjury level of function and activity before the study. The bone mineral densities (BMD) of the injured and contralateral femora were measured using dual energy x-ray absorptiometry (DEXA). BMD of symmetrical regions in the femoral neck and medial and lateral femoral cortex of the implanted and contralateral femora were compared. Postinjury muscle function was assessed from measurement of the isometric strength of six separate muscle groups (quadriceps, hamstrings, hip extensors, hip flexors, hip abductors, and hip adductors) in treated and control extremities. RESULTS: The average BMD of the femoral neck region of instrumented femora was 9% less than in contralateral control. Within the medial cortex, BMD of the control femora was an average of 20% greater than in the implanted side. In the lateral cortex, the difference averaged 13%. The isometric dynamometric data demonstrated a statistically significant reduction in the strength of the quadriceps of the instrumented extremities as compared with the contralateral ones. There was no significant difference in the strength of the hamstrings, hip extensors, hip flexors, abductors, or adductors. In the control extremities, the average torque generated by isometric contraction of the quadriceps was 3.45+/-1.35 times greater than by the hamstrings. Torque in extension/flexion and abduction/adduction was also observed. CONCLUSION: Our data suggest that limbs with long-term retained IM nails experience a significant reduction in the femur BMD and quadriceps muscle strength. These findings may not be simply related to the implant, and further study is warranted to determine the causes of these changes.

Adolescent↗
PubMed1994

[Legal aspects (with comparative reference to German Law)].

Considering the improved medico-technical possibilities, the treatment of handicapped newborns has weighty consequences for all interested persons. But 'letting die' these infants can never be a solution for this problem. It is not possible to find a reliable test for an authorized withdrawal of vital treatment. The law has to require that medical treatment is carried out in all cases in which the infant is viable with medical support. In exceptional cases the prosecution of the responsible persons can be relinquished.

Euthanasia, Passive↗
PubMed1992

The history of drugs for the treatment of Parkinson's disease.

In 1817, the English physician, James Parkinson, described the classical symptoms of a disease that was characterized by tremor, rigidity and akinesia. In 1861, the first autopsy of a patient with Parkinson's disease was carried out. Although Ordenstein, a pupil of Charcot, introduced treatment with belladonna in 1867, this later fell into disuse. In 1875, Brissaud determined that the lesion responsible for Parkinson's disease must be locatec the subthalamic regions of the brain. He was also the first to discuss arteriosclerosis-induced forms of Parkinson's disease. In 1919 Tretiakoff discovered cellular damage in the substantia nigra of patients with the encephalitic form of Parkinson's disease. In the 1920s, C. and O. Vogt discovered the basic histological conditions underlying the function of the corpus striatum; later Hassler significantly expanded and completed this work. The following chronology of dates and events is aimed at creating an understanding of the historical aspects of this diseases and consists of milestones in the development of antiparkinsonian treatment.

Antiparkinson Agents↗
PubMed1984

[The action of the benzodiazepine antagonist Ro 15-1788].

The benzodiazepine-receptors are close by the GABA-receptors. They are found in all areas of the brain, especially in the area of the cortex. The imidazo-benzodiazepine Ro 15-1788 has a high affinity to the receptor without showing any biological activity. The antagonist Ro 15-1788 cancels the sleeping effect, which was produced by benzodiazepines, within 30-60 s. Deep phases of sleep after 4 mg per 70 kg body weight lormetazepam, a dose which was not in clinical use up to now as well as the sleeping effect of 2 mg flunitrazepam per 70 kg body weight and 10-11 mg midazolam per 70 kg body weight are safely antagonized without adverse reactions. According to pharmacodynamic researches by means of EEG and psychometry the half-life period of the antagonist is shorter (1-2 h) than that of the agonist. The clinical application of the antagonist Ro 15-1788 (in patients) is at hand. The control of benzodiazepine-N2O/O2-anaesthesia seems to be guaranteed with the introduction of the antagonist for clinical use.

Anesthesia↗
PubMed1983

Comparative clinical studies with midazolam, oxazepam and placebo.

The efficacy and safety of midazolam compared with oxazepam and placebo were investigated in 50 hospital patients (19 males, 31 females; age range 21 to 74 years) in a double-blind parallel group study. On the first 2 nights (selection phase), patients received only placebo. On the next 5 nights, they received either 15 mg midazolam, 15 mg oxazepam or placebo. They received no medication on the last 2 nights and were kept under observation (withdrawal phase). Compared with placebo, both benzodiazepines shortened sleep onset latency, reduced the number of awakenings and improved sleep quality. All 3 compounds were well tolerated with only few, mild side-effects (headache, nausea) in the 2 verum groups. Psychometric performance was not impaired on the morning following drug administration. The overall patients' assessments showed 80% satisfaction with midazolam, 66% with oxazepam and 10% with placebo. Midazolam and oxazepam yielded similar results, although midazolam induced sleep more rapidly and was rated more favourably by the patients. Midazolam, in a dose of 15 mg, is thus an effective, fast-acting, well-tolerated hypnotic without residual effects and is suitable for the treatment of insomnia of mild to moderate degree. Oxazepam in a dose of 15 mg is also well suited for the treatment of sleep disorders, particularly if a rapid onset of action is not required.

Adult↗
PubMed1983

Comparative study of midazolam and vesparax in moderate or severe insomnia in female surgical patients.

A double-blind study was conducted in 60 female patients with moderate or severe insomnia, hospitalized for gynaecological surgery. After an initial 2-day placebo selection phase, 30 subjects received 15 mg midazolam and the remaining 30 received 1 tablet Vesparax (= 50 mg hydroxyzine, 150 mg secobarbital, 50 mg brallobarbital) for 5 nights. This verum phase was immediately followed by a 2-day placebo withdrawal phase in order to study the occurrence of rebound phenomena. Both verum compounds were effective in hastening sleep onset, increasing sleep duration, and improving sleep quality, without causing residual effects on the following day. There was no difference in effect between the two agents. Neither active drug caused rebound effects on withdrawal.

Adult↗
PubMed1983

Midazolam and anaesthesia.

By virtue of its physico-chemical properties and its rapid biotransformation, midazolam is an important addition in certain areas in anaesthesia. Of particular importance are its good local tissue tolerance after intramuscular injection, the absence of venous irritation, and the rapid start of metabolism with good control of action. Midazolam is suitable for both oral and intramuscular administration as premedication in anaesthesia. The compound can also be used for the induction of anaesthesia in combination with analgesics.

Administration, Oral↗
PubMed1981

[Pharmacological and toxicological aspects of benzodiazepine compounds (author's transl)].

The fact that the benzodiazepines, like the neuroleptic drugs, combine with receptors makes the duration of their combination with the receptors and differences in their affinity to them a matter of great importance. Correlation between the blood levels of the drugs and the duration of their effects obtains only within certain dose limits. Barbiturates inhibit the effect of excitatory mechanisms whereas benzodiazepines enhance the effect of physiological inhibitory mechanisms. The shape of the dose response curve is greatly influenced by the so-called ceiling phenomenon. A new compound of the benzodiazepine family has been developed which holds out hope of better control on account of its pharmacological and pharmacokinetic properties. As it is water-soluble local tolerance is also likely to be improved.

Animals↗