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Biomedical subjects

W Kramer

Publications and source records attributed to W Kramer.

At least 91 records · Page 5Linked to original sources
PubMed1986

[Results of conservative treatment of distal radius fractures].

The results of conservative treatment of fractures of the distal radius in 303 patients over a period of two years are demonstrated. 226 patients could be followed-up. The healing of the fracture was satisfactory in 78%, while the results regarding the various age groups showed considerable differences. Along with the demonstration of the functional and anatomical results in relation to age, sex, and localization the technique of fracture treatment as well as follow-up treatment are discussed.

Adolescent↗
PubMed1986

[First aid and transport in injuries of the spine].

Prognosis of lesions of the spine and spinal cord has greatly improved in recent years. It depends significantly and decisively on early recognition of such lesions and can be improved further by on-target immediate or early measures. Especially after traffic accidents, every unconscious person must be assumed to have suffered an injury of the spine until definite proof to the contrary. Appropriate measures must therefore be taken during rescue and transportation.

Accidents, Traffic↗
PubMed1986

[Long-term intubation following tracheotomy].

Between 1981 and 1983 tracheotomy was performed on 61 patients in the Surgical University Clinic of Tübingen. The dominant factors in indication of tracheotomy was for 49% of patients the persistingly necessary artificial respiration, for 26% a better bronchial toilet and other reasons for 25%. With 40.5% of all cases pneumonia was the most frequent complication encountered with our patients. The most frequent bacteria was Pseudomonas aeruginosa. Because of the decisive advantage constituted by the possibility of unproved bronchial toilet an earlier realisation of tracheotomy is to be recommended.

Bronchitis↗
PubMed1985

Mechanisms of altered myocardial contractility during hemodialysis: importance of changes in the ionized calcium to plasma potassium ratio.

Hemodialysis is associated with alterations in myocardial contractility, but duration and precise determinants responsible for these changes are unknown. We investigated the effect of several variables, established to influence left ventricular (LV) contractility, which normally changed during dialysis: the plasma concentrations of ionized calcium, potassium, bicarbonate, and magnesium and the removal of uremic toxins. The influence of three different isovolemic bicarbonate-dialysis procedures in 16 patients with normal (group 1) and hypertrophied myocardium (group 2) was assessed by echocardiography prior to and up to 44 h following each dialysis. During the first procedure, ionized calcium and potassium concentration decreased, but LV performance remained unchanged in both groups. The second procedure with increased ionized calcium and decreased potassium concentration resulted in an improvement of mean circumferential fiber shortening (VCF from 1.15 to 1.56 circ/s (P less than 0.001) in group 1 and from 1.05 to 1.16 circ/s (P less than 0.05) in group 2. The positive inotropic effect declined gradually up to 12 h (group 1) and 2.5 h (group 2) respectively. In the third procedure when ionized calcium was increased and potassium concentration remained unchanged contractility did not improve. Removal of uremic toxins, decrease in magnesium, and increase in bicarbonate concentrations were comparable during each procedure. These results suggest that the ionized calcium to potassium ratio is the important determinant of dialysis-related augmentation in LV contractility. In LV hypertrophy the expected contractile response is diminished indicating a depressed inotropic state.

Adult↗
PubMed1985

Analysis of the efficacy of the new cardiotonic agent TA-064.

TA-064 is a new cardiotonic agent which is also effective orally, according to investigations conducted in Japan. We analyzed computer-assisted alterations of pressure-volume relationships serially and of indirect myocardial oxygen consumption (MVO2) estimations on line during TA-064 influence in 16 patients with congestive cardiomyopathy: left ventricular function was moderately decreased in seven patients (group A) and drastically decreased in nine (group B). Results showed that TA-064, 8 micrograms/kg/min intravenously, exerted positive inotropic effects in both groups and induced mean maximal delta percentage changes at about 5 minutes of infusion as follows: left ventricular stroke work index +65% and +47%; dP/dtmax +61% and 59%; left ventricular efficiency +62% and 53%; MVO2 +31% and +11% (p less than 0.05). TA-064, 20 mg by mouth induced serum levels (group A = 23.8 +/- 12ng/ml and group B = 26.4 +/- 20 ng/ml) corresponding to the effects with dosages of 1 to 2 ng/kg/min intravenously (p greater than 0.05), thus implying that significant changes in left ventricular function require higher oral dosages. We conclude that TA-064 improves left ventricular function, primarily via a contractility increase, also in group B patients without toxic side effects. On-line indirect MVO2 assessment and analysis of serial pressure-volume relationships helped to provide a more complex definition of the mechanism and efficiency of the cardiotonic agent under study.

Administration, Oral↗
PubMed1985

Progressive cardiac involvement by Fabry's disease despite successful renal allotransplantation.

Enzyme replacement by renal allotransplantation has been suggested as a specific mode of therapy for Fabry's disease. We report a case of Fabry's disease who developed symptoms and signs of heart failure despite successful renal transplantation 14 years ago. Echo- and angiocardiographic features resembled findings in patients with hypertrophic non-obstructive cardiomyopathy. Endomyocardial biopsy specimens demonstrated cardiac manifestation of Fabry's disease.

Biopsy↗
PubMed1985

Dialysis-induced cardiac arrhythmias: fact or fiction? Importance of preexisting cardiac disease in the induction of arrhythmias during renal replacement therapy.

Frequency and grade of premature ventricular depolarizations were assessed in 10 patients on maintenance renal replacement therapy. All medication was withdrawn prior to the study. Each patient was treated sequentially by 8 different methods [acetate and bicarbonate hemodialysis (HD), hemofiltration, hemodiafiltration, ultrafiltration, use of 5 different membranes]. Despite marked changes in serum electrolyte concentrations there was no difference in frequency or grade of premature ventricular beats between the periods before, during, and after renal replacement therapy. Comparison of the 8 methods tested revealed no superiority of 1 method during the observation period of 192 h for each patient. In a second group of 8 patients with confirmed coronary artery disease, acetate HD had no effect on grade and frequency of ventricular arrhythmias, although arrhythmias occurred more often (p less than 0.05) and were more dangerous. We therefore conclude that the incidence of ventricular arrhythmias is primarily dependant on the presence of preexisting coronary artery disease and that HD or related methods do not increase the risk of ventricular ectopies in patients without digitalis medication.

Adult↗
PubMed1985

[Acute post-traumatic cholecystitis. Caused by or following polytrauma?].

Traumatic acute cholecystitis is of secondary importance beside many other complications in the polytraumatised patient, since it is rarely diagnosed--possibly too rarely. Difficulties often arise because of a multitude of injuries, which are often life-threatening and which must be given top priority (3). Men are chiefly involved (4). In most cases, the condition is preceded by shock, but not necessarily by gallstones (10, 11). First pointers in literature were given by Mennenga (8). As early as 1939 he pointed out that blunt abdominal trauma may produce tears in the gallbladder and bile duct regions. Marre (7) described acute signs in the upper abdomen due to rupture of the bile duct. Genesis of post-traumatic acute cholecystitis is still unclarified. Apart from rupture or perforation of the gallbladder or bile ducts, it is mainly shock (4, 9, 12) which is considered to be an important causative factor.

Abdominal Injuries↗
PubMed1984

The gapped duplex DNA approach to oligonucleotide-directed mutation construction.

A simple and efficient method is described to introduce structurally pre-determined mutations into recombinant genomes of filamentous phage M13. The method rests on gapped duplex DNA (gdDNA) molecules of the phage M13 genome as the key intermediate. In this gdDNA, the (+) and the (shorter) (-) strand carry different genetic markers in such a way, that a rigorous selection can be applied for phage carrying the markers of the (-) strand. For introduction of the mutation, a synthetic oligonucleotide with partial homology to a target site within the single stranded DNA region is annealed to the gdDNA. The oligonucleotide subsequently becomes part of the (-) strand by enzymatic DNA gap filling and sealing. This physical linkage is preserved at the genetic level after transfection of a recipient E.coli strain deficient in DNA mismatch correction, so that the synthetic marker can be selected from the phage progeny independent from its potential phenotype. It is demonstrated that by this method mutants can be constructed with marker yields in excess of 70%.

Coliphages↗
PubMed1984

Different base/base mismatches are corrected with different efficiencies by the methyl-directed DNA mismatch-repair system of E. coli.

The efficiency of methyl-directed DNA mismatch-repair of E. coli acting in vivo on heteroduplex genomes of phage M13 was found to be strongly dependent on the nature of the base/base mismatch to be corrected. Three efficiency classes were characterized:high (T/G, C/A and G/G); intermediate (A/A); and low (G/A, A/G, T/T, C/C, C/T and T/C). Methyl-directed DNA mismatch repair was lost completely for any type of mismatch in strains carrying either mutL or mutS mutations. Data obtained with a mutH mutant suggest that this locus is involved in methyl-dependent DNA strand discrimination. A functional correlation is suggested between the differential repair efficiencies and the frequencies of the corresponding replication errors.

Base Composition↗
PubMed1984

Identity of hepatic membrane transport systems for bile salts, phalloidin, and antamanide by photoaffinity labeling.

Phalloidin, a bicyclic heptapeptide, and antamanide, a monocyclic decapeptide from the poisonous mushroom Amanita phalloides, interact with bile-salt-binding polypeptides of the hepatocyte membrane, as demonstrated by photoaffinity labeling using the photolabile bile salt derivative 7,7,-azo-3 alpha, 12 alpha-dihydroxy-5 beta-cholan-24-oic acid, either unconjugated or taurine conjugated. With the photolabile derivatives of phalloidin, N-delta-(4-[(1-azi-2,2,2-trifluoroethyl) benzoyl]-beta-alanyl)-delta-aminophalloin, (N epsilon-[4-(1-azi-2,2,2-trifluoroethyl)benzoyl]lys6)-anta manide, the same membrane polypeptides with apparent MrS of 54,000 and 48,000 were labeled as with the photolabile derivatives of unconjugated and conjugated bile salts. The presence of bile salts decreased markedly the extent of labeling of these phalloidin- and antamanide-binding polypeptides. These results indicate that hepatic uptake systems for bile salts, phallotoxins, and the cycloamanide antamanide are identical, thus explaining the organotropism of phallotoxins.

Affinity Labels↗