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Biomedical subjects

W Rulf

Publications and source records attributed to W Rulf.

6 recordsLinked to original sources

Fees for outpatient operations in Germany: development, evaluation and European comparison.

In Germany, discussions on the fees for statutory sickness insurance for ambulatory surgery has, in the last few years, become almost a symbol of dispute for the German health services. Outpatient surgeons complain about the fact that the fees do not cover their services. They see innovation severely threatened by bureaucracy, profitability by planned economy, rights by reasons of State, aggravated by the 'reform' attempts of the Greens and Socialist coalition Federal Government. On the other hand their opponents complain about the money mindedness of the doctors. Intentional panic or real disaster? The fundamental consideration to clarify this question is based on a comparison of the German statutory medical insurance fees and private fees with our neighbours. In Europe an economic area with similar prices for goods, services and wages, even 'outpatient operations' services with comparable cost rates should be paid for at a corresponding level. Any discrepancies would give cause to look for an explanation by analysing the historic development of fees and the question of a fair comparison between operations and the non-operative services.

Journal Article↗

Testosterone metabolism in human bone.

The conversion of [1,2,6,7-3H]testosterone to [3H]dihydrotestosterone has been assessed in ground sp¿ongiosa of normal and osteoporotic bone. The tissue was obtained from 23 patients, 18 women, 3 men and 2 children who were undergoing orthopedic surgery. The formation of dihydrotestosterone was demonstrated in all samples examined. The half maximum rate of dihydrotestosterone formation occurred at a substrate concentration of 0.3 microM a value similar to that reported for dihydrotestosterone formation in other androgen target organs. Under the standardized conditions utilized in this study the rate of dihydrotestosterone formation did not differ significantly in normal as compared to osteoporotic bone. Furthermore, the conversion of testosterone to androstenedione was also similar in osteoporotic and normal bone. Based on these studies it seems reasonable to conclude that dihydrotestosterone rather than testosterone is the active intracellular androgen in human bone since in other androgen target tissue androgen action is mediated by dihydrotestosterone if 5 alpha-reductase is present.

Adult↗