Showing papers by "Charité published in 1988"

Changed composition of high-density lipoprotein subclasses HDL2 and HDL3 after renal transplantation.

Abstract: The concentrations of cholesterol in the high density lipoprotein (HDL) fraction and the HDL2 and HDL3 subclasses were compared in 333 male renal transplant recipients, 36 male patients on maintenance hemodialysis, and 43 healthy men. The subclasses were separated by a precipitation method using polyethylene glycol 6000 and dextran sulphate. In hemodialyzed patients, total HDL cholesterol and both subclasses were reduced. In renal transplant recipients, both total HDL cholesterol and HDL2 were normal, whereas HDL3 remained reduced, analogous to hemodialyzed patients. It can be concluded that a successful renal transplantation has a beneficial effect on HDL metabolism and thus on the development of atherosclerosis.

Epidemiological study on the hepatotoxicity of occupational toluene exposure

Abstract: In a cross-sectional study of 181 male workers of a rotogravure printing plant, most of whom were exposed to toluene levels well above the GDR threshold limit values, 55 subjects revealed pathological liver screening values (activities of serum aspartate aminotransferase, alanine aminotransferase, gamma glutamyltransferase; liver size). The differential diagnostic examination showed in 51 out of these 55 subjects an association with competing factors such as alcohol abuse (78%) and overweight (40%), to a slight extent disorders of fat and carbohydrate metabolism and of the gallbladder. Drug intake did not play any role. The variance and regression analyses of the biochemical data have shown that alcohol significantly and considerably increases the activities of all three enzymes tested. Bodyweight had a similar, but less pronounced, significant effect. On the other hand, in subjects with a higher alcohol intake the activities of liver enzymes in highly toluene exposed subgroups were significantly and clearly lower than among slightly toluene exposed workers.

Dialysis-related beta 2 microglobulin-amyloid arthropathy. Improvement of clinical symptoms after a switch of dialysis membranes.

Abstract: Amyloidosis containing β2 microglobulin (β2m) and joint pains are frequent complications of long-term hemodialysis. In a prospective study the authors planned to act on dialysis arthropathies (DA) by improving β2m depuration: for 8 patients suffering from DA we replaced usual cuprophane membranes (CU) by high permeability polyacrylonitrile membranes (PAN). DA was diagnosed on the presence of severe disabling arthralgias in the absence of any other obvious etiology, and on the presence of at least 3 among 6 criteria. The efficacy of the switch of DM was assessed on 6 criteria including the patient's own evaluation at the end of the study and a joint pain severity index. Clinical evaluation and β2m measurement were carried out at the start of the trial and after a mean duration of dialysis on PAN of 6 months. An improvement in joint symptomatology and a decrease of joint severity index were noted in the 8 cases. Our results suggest that the change of DM has a favorable influence on DA. This improvement could result either from a better β2m depuration or from a better biocompatibility of PAN than the CU previously used.

Movements of the lumbar spine. A biomechanical study

Abstract: The lumbar spine presents movements of flexion-extension, lateral inflexions and rotations, which are, in fact, the result of movements within each mobile spinal segment. These mobile segments present six levels of freedom corresponding to translation and rotation movements in the three spacial planes. Lumbar mobility decreases markedly with age. Muscles not only participate in the movement itself, but also in its control and in maintaining spinal stability. Their action also depends on the effect of gravity. The authors report various studies concerning spinal stresses during varied movements and positions. Flexion of the trunk is the most stressing; walking, rotations and lateral inflexions increase only moderately the intradiscal pressure. All of the these results concur with the classic ergonomic notions.

Induction of bilirubin-eliminating processes by methylphenobarbital in mature newborn babies.

Abstract: In order to find a drug for the prevention of metabolic hyperbilirubinemia of the newborn, which has less sedative effects than phenobarbital (PB) the effect of methylphenobarbital (MPB) on the plasma bilirubin concentration of newborns was studied in a double blind trial. MPB (3 x 10 mg/kg on the first day) reduced the plasma bilirubin level in mature newborns on day four by 33% in comparison to those on placebo. The results justify further investigations in premature babies, who frequently suffer from disturbances which may facilitate the development of bilirubin encephalopathy.

Complementary Laser Application in Gynaecology

Abstract: Partially the application of CO2 laser surgical method is of a complementary character, ie, the application of CO2 laser surgery forms an essential part of the operation process or the spectrum of surgical methods of the type of operation respectively The reason for the essential nature has to be seen in the special effect of the CO2 laser beam on certain tissue The complementary character, however, consists in the limitation of the CO2 laser surgical effect as far as the whole complex of methods used in a certain type of operation is concerned The complementarity of the CO2 laser surgical method consists in its alternating effect with the electro-micro-surgical, micro-surgical and macro-surgical method

ESWL — Ende der Steinzeit?

Abstract: Die Erfahrungen mit uber 6000 Steinbehandlungen an der Urologischen Universitatsklinik Mainz in den Jahren 1968 bis 1987 zeigen einen deutlichen Wandel auf, der sicherlich Allgemeingultigkeit hat. In der Zeit von 1968 bis 1983 wurden 2468 nicht abgangsfahige Steine durch Operation und in der Zeit von 1976 bis 1983 durch perkutane Eingriffe entfernt, wobei diese letzt genannte Technik bis zum Ende des Jahres 1983 in etwa 50% der Falle zur Anwendung kam. Mit Etablierung eines Stoswellen-Lithotriptors Ende 1983 fand eine weitere radikale Anderung des Therapiekonzeptes statt. Zum einen konnten in der vergleichsweise kurzen Zeit von Januar 1984 bis Juni 1987 4033 Behandlungen wegen nichtabgangsfahiger Steine vorgenommen werden, wobei diese hohe Zahl praktisch ausschlieslich auf die Anwendung der Stoswellen-Lithotripsie zuruckzufuhren ist. Hinsichtlich der Indikation fur die einzelnen derzeit zur Verfugung stehenden Behandlungsverfahren ergaben sich im ersten Halbjahr 1987 folgende Daten: Fast man alle Steine zusammen, dann werden derzeit 87% der Steine durch Stoswelle behandelt, 9% durch endourologische Masnahmen und nur 4% durch Operation. Ein noch hoherer Anteil von Stoswellen-Behandlungen wird bei separater Betrachtung der Nierenbekken — und Kelchsteine deutlich, die in 92% der Falle einer Stoswellen-Lithotripsie unterzogen wurden und nur zu 6 bzw. 2% durch perkutane Techniken, bzw. Operation entfernt wurden. Auch fur die Harnleitersteine lassen sich ahnliche Zahlen nachweisen.

Tag der Praxis

Abstract: Die Antwort auf die Frage, ob eine Antibiotikaprophylaxe oder -therapie in der Chirurgie sinnvoll ist oder nicht, richtet sich nach Art und Ort des Eingriffes und nach der vermuteten Infektionsrate. Letztere hangt jedoch wiederum von den individuellen Gegebenheiten einer Klinik und den Operateuren ab. Nach einer Standardklassifizierung werden chirurgische Wunden im Hinblick auf das zu erwartende postoperative Infektionsrisiko in 4 Kategorien eingeteilt, und zwar in sauber, sauber-kontaminiert, kontaminiert und schmutzig. Der Begriff „saubere“ Wunden gibt es lediglich in der gezielten, also elektiven Chirurgie, d. h. es liegt keine Entzundung vor und die Sterilitat wahrend des Eingriffes wurde nicht durchbrochen. Die bei derartigen Masnahmen zu erwartende Infektionsrate liegt unter 5%.