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Risk assessment in Lyme borreliosis. | miology and ecology of the disease in order to assess risk in Lyme borreliosis. | 10666816 | [
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Studies on the pathogenesis and treatment of Lyme arthritis. | Lyme arthritis is one of the most common clinical manifestations of Lyme borreliosis. It is caused by an intraarticular infection with Borrelia (B.) burgdorferi. A small number of bacteria are liable to provoke severe arthritis by inducing mechanisms (including the induction of cytokines and chemokines) that amplify the inflammatory response. The cellular immune response against B. burgdorferi is characterised by a predominant T helper cell type 1 (Th1) pattern that appears to be inadequate to overcome the | 10666814 | [
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Studies on the pathogenesis and treatment of Lyme arthritis. | infection. In most cases; Lyme arthritis may be cured by antibiotic therapy. A brief summary of current recommendations for the treatment of Lyme arthritis in adults and children is given in this article. However; about 10% of Lyme arthritis patients do not respond sufficiently to antibiotic treatment. Two not mutually exclusive pathogenetic concepts of these treatment-resistant cases will be discussed in the present study: persistent infection and infection-induced immunopathology. | 10666814 | [
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Species identification of Borrelia burgdorferi sensu lato from tick and human isolates in Styria (Austria) by PCR-RFLP analysis. | Seventy-one isolates of Borrelia burgdorferi sensu lato (B.b.s.l.) derived from Ixodes ricinus ticks (50 strains) and patients (21 strains) were characterised by PCR-RLFP analysis. In four cases the human isolates were obtained from the cerebrospinal fluid (CSF) of patients with clinical symptoms of neuroborreliosis and in 17 cases from skin biopsies of patients with dermatological manifestation of Lyme borreliosis. Ixodes ricinus isolates originated from 14 localities in three regions (Mur valley; eastern | 10666817 | [
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Species identification of Borrelia burgdorferi sensu lato from tick and human isolates in Styria (Austria) by PCR-RFLP analysis. | and western Styria) in Styria. Thirty six strains of B.b.s.l. were isolated from nymphal ticks; nine strains from female and five strains from male ticks. Species identification of human isolates revealed three B. garinii and one B. afzelii isolates in CSF. In the PCR-RFLP analysis of 17 skin specimens a pattern for B. afzelii was found in ten cases; while six could be identified as B. garinii and one as a mixed infection of B. afzelii and B. garinii. Genetic characterisation of tick isolates resulted in 24 | 10666817 | [
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Species identification of Borrelia burgdorferi sensu lato from tick and human isolates in Styria (Austria) by PCR-RFLP analysis. | strains of B. afzelii (48%); 11 strains of B. garinii (40%) and 5 strains of B. burgdorferi s.st. (10%); one isolate showed a mixed infection of B. afzelii and B. garinii. Our findings indicate that B. afzelii and B. garinii predominate over B. burgdorferi s.str. in Ixodes ricinus ticks from Styria; which is similar to findings in neighbouring countries. This also reflects the occurrence of different pathogenic Borrelia strains in human samples. | 10666817 | [
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Infection of small mammals with Borrelia burgdorferi sensu lato in Slovenia as determined by polymerase chain reaction (PCR). | Thirty-four small mammals collected in the vicinity of Ljubljana were tested for the presence of Borrelia burgdorferi sensu lato by polymerase chain reaction (PCR) of urinary bladder tissues; using universal flagellin primers and species specific rRNA primers. Seventeen small mammals (50%) were found to be positive; and 7 small mammals were infected with two species of B. burgdorferi sensu lato simultaneously. The most commonly found species was B. afzelii (n = 14); followed by B. burgdorferi sensu stricto | 10666818 | [
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Infection of small mammals with Borrelia burgdorferi sensu lato in Slovenia as determined by polymerase chain reaction (PCR). | (n = 7) and B. garinii (n = 3); as determined by species-specific primers. We conclude that PCR is a rapid and reliable method to detect infection with B. burgdorferi sensu lato in small mammals. | 10666818 | [
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Epidemiological aspects of human granulocytic Ehrlichiosis in southern Germany. | Human granulocytic Ehrlichiosis (HGE) is a newly emerging acute febrile illness which is likely transmitted by ticks of the Ixodes ricinus/I. persulcatus complex. First seroepidemiological surveys on the prevalence of HGE antibodies; detection of DNA of granulocytotropic Ehrlichiae in I. ricinus and one case of HGE from Slovenia confirmed by serology and PCR (polymerase chain reaction) suggest that HGE might exist all over Europe. The purpose of the present study was a) to determine the prevalence of antibo | 10666819 | [
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Epidemiological aspects of human granulocytic Ehrlichiosis in southern Germany. | dies against the HGE agent in sera collected from persons at high risk for exposure to I. ricinus with that of a control population and b) to determine the prevalence of granulocytic Ehrlichiae in I. ricinus ticks from Southern Germany. We studied sera from 150 forestry workers and 105 patients with an established diagnosis of Lyme disease as tick-exposed populations. Sera from 103 healthy blood donors without a history of known tick bites served as controls. A significantly higher prevalence of HGE antibod | 10666819 | [
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Epidemiological aspects of human granulocytic Ehrlichiosis in southern Germany. | ies (P < or = 0.01) was present among patients with Lyme borreliosis (12 of 105 were positive; 11.4%) and forestry workers (21 of 150 were positive; 14%) compared to blood donors (2 of 103 were positive; 1.9%). Furthermore; 510 adult and nymphal I. ricinus were investigated by PCR for the presence of granulocytic Ehrlichiae with primers specific for the E. phagocytophila group. In eight (1.6%) of the investigated ticks the expected amplification product was detectable; indicating a low prevalence of infecte | 10666819 | [
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Epidemiological aspects of human granulocytic Ehrlichiosis in southern Germany. | d ticks especially when compared with B. burgdorferi. The presented data strongly suggests that the HGE agent or a closely related organism exists in Southern Germany and therefore HGE should be considered in the differential diagnosis of febrile illnesses. However; final evidence can be provided only after isolation of the organism from patients. | 10666819 | [
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[Reducing pain by oral enzyme therapy in rheumatic diseases]. | Proteolytic enzymes have analgesic; effects; besides the wellknown antiinflammatory and edema-reducing properties. These analgesic effects are based on the inhibition of inflammation and in addition to that on direct influences on the nociceptors. All that explains the therapeutical effects of such enzymes in degenerative-rheumatic and soft tissue rheumatic diseases in which inflammatory or immunologic processes are not in the forefront. In recent years a significant reduction of pain in various rheumatic d | 10666820 | [
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[Reducing pain by oral enzyme therapy in rheumatic diseases]. | iseases; concerning these aspects; was shown in several clinical studies. The clinical trial in patients with periarthritis of shoulder showed statistical equivalence of pain reduction; whether they were treated with phlogenzym or diclofenac. Likewise in the trial of patients suffering from painful osteoarthritis of the knee; there was a statistical equivalence of the pain-scores; comparing diclofenac and enzymes. The study of painful vertebral syndromes again resulted in equivalence of the treatment with N | 10666820 | [
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[Reducing pain by oral enzyme therapy in rheumatic diseases]. | SAIDs compared to therapy with enzymes. | 10666820 | [
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[Compression treatment after burns]. | After healing up of the injury wounds; hypertrophic scars and keloids often develop; which are histologically characterised by irregulary arranged collagen fibre bundles and a strong vascularisation. Approximately 20 years ago; the so-called compression clothing; as for example suits; masks; gloves; stockings; were first employed for the prevention and therapy of these complications. These means of compressions are crosswise and lengthwise elastical and consist predominantly of elasthan and viscose. The pre | 10666821 | [
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[Compression treatment after burns]. | ssure acting on the skin lies between 25 and 32 mmHg: thereby the values are above the average capillary pressure of 20 mmHg. The efficiency of the compression clothing after a burn injury is well proved by several studies; and one knows today that; for example in the case of children as from the 5th year of life; the results are better than in the case of adults from the 35th year of life. The compression effected at least during a period of 15 months slows down the blood circulation; reduces the number of | 10666821 | [
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[Compression treatment after burns]. | capillaries and makes the scar become more pale. Furthermore; the orthologically parallel arranged collagen fibres maintain their arrangement due to the compression pressure and do not get irregularily arranged. | 10666821 | [
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[Alzheimer disease--differential diagnosis and modern therapy]. | Alzheimer's disease and other dementias are a multidisciplinary challenge and become more and more important because of the growing life expectancy; and also due to the presence in the media. A. Alzheimer published first 100 years ago the disease named after him as an entity marked by the clinical course and by typical histological findings. The last decades brought remarkable progress in demarcation to other forms of dementias for example by CT or MRI. The cause of Alzheimer's disease has not yet been clea | 10666822 | [
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[Alzheimer disease--differential diagnosis and modern therapy]. | red up. The finding of secondary dementias has great importance since causal therapeutic possibilities exist. In the last years new ideas to etiology in respect to the hypothesis of acetylcholine resulted in new therapeutic promises. A rational treatment of this disease seems now possible. Besides psychological and behavioral signs and symptoms of dementia are of great importance in the care of these patients. | 10666822 | [
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[Therapy of heart failure with ACE inhibitors--"evidence-based medicine" and clinical reality]. | Treatment of patients with chronic heart failure improves symptoms and NYHA functional class in about 50-80% of all patients treated. A 15% reduction can be observed in the need for hospitalisation and a 16-31% reduction in 1-year mortality. 37% risk reduction for progression to symptomatic heart failure can be achieved with ACE-inhibition in asymptomatic patients with systolic left ventricular dysfunction (55). Thus; ACE-inhibition should be part of standard treatment in symptomatic and asymptomatic patien | 10666823 | [
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[Therapy of heart failure with ACE inhibitors--"evidence-based medicine" and clinical reality]. | ts with left ventricular dysfunction. In symptomatic patients with chronic heart failure; combination therapy of an ACE-inhibitor with digitalis and diuretics is state of the art and improves symptoms significantly. The addition of a vasodilatator can be considered in selected cases. Based on recently published data on beta-adrenoreceptor-blockade in the treatment of chronic heart failure; beta-blockers seem to get part of standard therapy of heart failure in the present and near future (2; 44; 50; 60). In | 10666823 | [
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[Therapy of heart failure with ACE inhibitors--"evidence-based medicine" and clinical reality]. | spite of innovations of modern heart failure therapy prognosis is still bad. Survival after diagnosis of severe heart failure (functional class NYHA III and IV) is limited to a mean of 14 month. | 10666823 | [
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[Methods and results of controlled walking training in patients with peripheral arterial occlusive disease]. | d with a treadmill test at a constant-load of 0.82-1.06 Watt/kg. Improvement in initial/absolute claudication distance (ICD/ACD) ranged from +28% to +213%. The average increase was +150% in ICD; and +200% in ACD. Exercise rehabilitation significantly improved patient's quality-of-life as well. However; the benefit of exercise training however was only moderate (6-32%). Exercise training is a very effective therapeutic measure. However; for further use better guidelines and prospective cost-effectiveness stu | 10666825 | [
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[Methods and results of controlled walking training in patients with peripheral arterial occlusive disease]. | dies including evaluation of rehabilitation programs with regard to improvements in functional capacity; modification of risk factors; long-term compliance; quality-of-life and medical costs incurred are needed. | 10666825 | [
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[Antithrombotic therapy and follow-up of peripheral arterial occlusive disease]. | In patients with arterial occlusive disease the following antithrombotic drugs are used to prevent new arterial thromboses: Unfractionated heparin (UFH) and low molecular weight heparins (LMWH): UFH is frequently used perioperatively in patients with vascular reconstructions and after peripheral percutaneous transluminal angioplasty (PTA). Only one study on the longterm use of a LMWH after operative revascularization has been published; where LMWH led to an increased patency rate in comparison to acetylsali | 10666826 | [
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[Antithrombotic therapy and follow-up of peripheral arterial occlusive disease]. | cylic acid + dipyridamol. Vitamin-K-antagonists were effective in the prevention of new vascular occlusions in studies published in the 1970ies. Platelet function inhibitors (aspirine; ticlopidine and clopidogrel): Aspirine reduced reocclusions after vascular surgery and PTA. Ticlopidine was effective in the Swedish Ticlopidine-Multicenter-Trial in the prevention of ischemic heart disease and also reduced the need for vascular surgery. In the CAPRIE-study clopidogrel reduced myocardial infarctions in patien | 10666826 | [
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[Antithrombotic therapy and follow-up of peripheral arterial occlusive disease]. | ts with peripheral arterial disease in comparison to aspirine. | 10666826 | [
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[Value of vasoactive drugs in conservative therapy of peripheral arterial occlusive disease]. | Based on controlled clinical trials; vasoactive drugs (pentoxyfylline; naftidrofuryl; buflomedil) and prostanoids (alprostadil; iloprost) are used in symptomatic peripheral arterial occlusive disease: In stage II; vasoactive drugs are prescribed in order to improve leg hyperemia in response to muscular work; in complicated stage II (e.g.; non-healing traumatic skin lesions); and in stages III/IV; prostanoids are given in order to increase forefoot skin blood flow. These drugs should only be applied if neith | 10666827 | [
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[Value of vasoactive drugs in conservative therapy of peripheral arterial occlusive disease]. | er angioplasty nor vascular surgery are recommendable; possible; or successful after complete angiological diagnostic. It should be considered that these substances have a rather limited clinical efficacy in both stage II and stages III/IV and therefore attempts should be made to select patients with a reasonable chance to benefit. These drugs are also not suitable for primary or secondary prophylaxis against the progression of vascular lesions. | 10666827 | [
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[Special aspects of therapy of non-atherosclerotic vascular diseases]. | The long term course of thromboangiitis obliterans as well as frequency and extent of major or minor limb amputations depend almost exclusively on the smoking behaviour of the patients. Superficial phlebitis accompanying an acute relapse responds well to high-dose aspirin or NSAIDs. Critical limb ischemia is treated by intra-arterial or intravenous prostaglandins (Alprostadil; Iloprost). Lokal measures for finger; toe; or foot gangrene do not differ from comparable sequelae of atherosclerotic vascular disea | 10666828 | [
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[Special aspects of therapy of non-atherosclerotic vascular diseases]. | se. Revascularisation procedures (angioplasty; surgery) have a high rate of technical failure and are indicated only in rare atypical situations. Corticosteroids are the therapy of choice for both vasculitides of large muscular arteries; i.e. temporal arteritis (M. Horton) and Takayasu arteritis. Combination therapy is restricted to steroid refractory disease; while this is the exception in temporal arteritis; it occurs in up to 50% of patients with Takayasu arteritis. Critical limb ischemia due to giant ce | 10666828 | [
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[Special aspects of therapy of non-atherosclerotic vascular diseases]. | ll arteritis may persist even if the inflammatory activity of the disease is well controlled. Revascularisation procedures in Takayasu arteritis may have good results; as with all other therapeutic measures in this disease; they should be provided by specialized centers. Treatment of Raynaud's phenomenon requires patient evaluation for signs or symptoms of an underlying disease; i.e. some kind of connective tissue disease. Strength and frequency of attacks depend on a number of different factors (triggers) | 10666828 | [
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[Special aspects of therapy of non-atherosclerotic vascular diseases]. | which in a given patient may not be completely understood. Exposition prophylaxis for known triggers and vasodilator drugs are the main therapeutic measures in Raynaud's phenomenon. Careful documentation of disease activity provided; non-classical remedies (behavioural psychotherapy; acupuncture) may be attempted. | 10666828 | [
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[Fibrinolytic, revascularizing therapy of peripheral arterial occlusive disease]. | Thrombo-embolic events are the primary or secondary cause for occlusions of peripheral arteries. The systemically applied fibrinolysis rarely resulted in revascularization. The local application of plasminogen activators leads to better results. Combined with interventionally techniques 70-80% of the acute und subacute occlusions can be opened an the necessity of angio-surgical interventions can be reduced by about 50%. The technical procedure of the local fibrinolysis and the dosages of the applied activat | 10666829 | [
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[Fibrinolytic, revascularizing therapy of peripheral arterial occlusive disease]. | ors are presently not standardized. Therefore the results of 13 reports between the years 1995-1998 including 4 prospective studies are not comparable. According to the present experiences; acute und subacute incomplete ischemia syndromes are to be seen as indication for local lysis. Especially for patients whose constitution is not optimal for surgery; local fibrinolysis is an alternative to surgical revascularization. Further studies are necessary to optimize the therapy. | 10666829 | [
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[Possibilities and limits of interventional therapy in chronic peripheral arterial occlusive disease]. | In the therapy of the chronic peripheral vascular occlusion; angioplasty is rarely used to treat the infra-renal aortic stenosis; whereas the stenosis and the short occlusion of the iliac artery is a classical indication. Primarily; stenoses and occlusions of the iliac artery should be treated with balloon angioplasty exclusively. Only secondarily; when the result of angioplasty was insufficient; e.g. remaining stenosis or dissection; stent implantation is appropriate. Angioplasty is most frequently applied | 10666830 | [
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[Possibilities and limits of interventional therapy in chronic peripheral arterial occlusive disease]. | in the obliteration of the femoro-popliteal artery. It can be stated that early- and long-term results are the better; the shorter the occlusion is. Stent implantation in the femoro-popliteal artery should be avoided because of poor results. Only with the intention of limb salvage; when there is no opportunity for surgical treatment; a stent implantation should be considered. In case of recurrent stenoses after stent implantation; angioplasty can be reapplied with great success. The indication for any vasc | 10666830 | [
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[Possibilities and limits of interventional therapy in chronic peripheral arterial occlusive disease]. | ular intervention should be a decision of both; the interventional radiologist and the vascular surgeon; because both kinds of treatment are palliative and not causal. It is the task of the angiologist to do clinical diagnostics and the after-treatment. Quality monitoring is indispensable. It consists of documentation of pre-angioplasty diagnostics and should be able to prove the correct indication for the intervention. The result of the intervention should also be documented by angiography and functional t | 10666830 | [
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[Possibilities and limits of interventional therapy in chronic peripheral arterial occlusive disease]. | ests. Regular control of the patient after the intervention is necessary for the early recognition of recurrent stenoses. | 10666830 | [
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[Current status of vascular surgery]. | German vascular surgery compares favourably to international standards. Reconstruction of the complete vascular systems are carried out by experts in specialized centres. Sophisticated techniques are applied to the open and intravascular procedures of small and large vessels. Prosthesis grafts and vein autografts are often used with the help of atraumatic surgical equipment. The external quality control by the German Society of Vascular Surgery and the introduction of continuous medical education in vascula | 10666831 | [
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[Current status of vascular surgery]. | r surgery help to maintain this high quality standard. There is a lack of vascular operation; a prerequisite for the development of further independent centres. | 10666831 | [
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[Cardiovascular risk in arterial vascular surgery reconstruction]. | Perioperative cardiac complications can limit the outcome after major vascular surgery where the underlying severe coronary artery disease is considered to be the main source. We describe the results of a prospective study including 201 patients undergoing elective vascular surgery. After looking at the encouraging low complication rate (mortality 0.99%; non-fatal myocardial infarction 2.98%; cardiac complications 9.95%) we would recommend the discussed diagnostic strategy. Specialized and expensive cardiac | 10666832 | [
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[Cardiovascular risk in arterial vascular surgery reconstruction]. | testing should be reserved for a few cases. | 10666832 | [
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[Promoting quality and quality circles from the viewpoint of established physicians--representative Bremen and Saxony-Anhalt results]. | To study the attitudes of ambulatory care physicians towards quality improvement; the intentions to join quality circles (QCs; peer review groups) and the expectations directed towards them.Survey with a five-page questionnaire posted to all ambulatory care physicians in the German states of Saxony-Anhalt (n = 3139) and Bremen (n = 1131).Response rates were 61.8% in Saxony-Anhalt and 41.7% in Bremen. 2412 questionnaires were available in this largest survey on that topic in Germany. Necessity of quality imp | 10666833 | [
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[Promoting quality and quality circles from the viewpoint of established physicians--representative Bremen and Saxony-Anhalt results]. | rovement (QI) in ambulatory care was approved by the majority of the respondents (1.7 on a 5-point Lickert scale). Concerns existed about a rise in control and the risk of abuse of QI measures. 56.4% in Saxony-Anhalt and 52.3% in Bremen had the intention to join a QC. Motives and impediments of participation in QCs were investigated by content analysis. A causal dominance analysis was performed to identify the key elements for the decision to participate. The main benefits of QC-participation were expected | 10666833 | [
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[Promoting quality and quality circles from the viewpoint of established physicians--representative Bremen and Saxony-Anhalt results]. | as assistance in daily practice and exchange of experiences. The major obstacles were professional and private duties; fear of control and inefficiency.Policies that could be adequate to rise motivations and tackle on widespread fears should be purposely adapted to the needs and expectations of the physicians. | 10666833 | [
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[Aspects of external quality assurance in anesthesiology--experiences in Hamburg]. | In 1994; external quality assurance in anaesthesia according to the German Society of Anaesthesiology and Intensive Care (DGAI) was obligatory introduced in Hamburg. Since 1992 in a pilot project and since 1994 compulsory nearly 500;000 anaesthesias were documented by 39 institutions with a standard data set issued by the DGAI and transferred to the project office of the Association for Quality Assurance (EQS) Hamburg. Comparative statistics of these data were produced at the project office. In the controll | 10666834 | [
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[Aspects of external quality assurance in anesthesiology--experiences in Hamburg]. | ing committee and in meetings of the project participants the contents; policy and results of the project were critically analyzed and adjustments initiated whenever necessary. With an incidence of 14.1% of all anaesthesias with special occurrences (AVB); the results are in the same range compared to most other studies. To evaluate the concept of documentation the predictory power of single and combined risk assessments for the incidence of particular AVBs in elective anaesthesias were compared to the predi | 10666834 | [
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[Aspects of external quality assurance in anesthesiology--experiences in Hamburg]. | ctory power of ASA-Classification in order to reduce the parameters that had to be collected. This should lead to a positive influence on the quality of documentation. Besides one exception; no superior prediction power for AVB incidence could be demonstrated for any special risk assessment as compared with the ASA-classification. This is also true for the AVBs which are associated with high lethality. Thus; the documentation of risk factors in the core data set as predictors can be abandoned without major | 10666834 | [
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[Aspects of external quality assurance in anesthesiology--experiences in Hamburg]. | loss of information. The participants consider the project to be a useful support for internal improvement projects. Besides the reduction of the amount of data in quality assurance to get a core of particularly meaningful parameters the classification of the surgical procedure by the ICPM- or OPS 301-Code should be integrated into the core data set of the DGAI. It would lead to an increase in acceptance of the method and thus to an increase in the validity of its results and valuations. | 10666834 | [
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[The "Hersbruck Model". Application and integration of the DIN EN ISO 9001 quality norms with criteria of the European Foundation for Quality Management in a clinic]. | The german health system has dramatically changed and still continues to do so. Modified aspects concerning economy; customer orientation; competition; quality assurance and quality management seem to be increasingly important. Appropriate response to this challenge demands a relevant adjustment of a quality "philosophy" within a hospital. The "Hersbruck Model" has proven to be a suitable approach: on the basis of a quality management system--established and certified according to DIN EN ISO 9001--it implem | 10666835 | [
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[The "Hersbruck Model". Application and integration of the DIN EN ISO 9001 quality norms with criteria of the European Foundation for Quality Management in a clinic]. | ents all components of the model of the European Foundation for Quality Management. The modern quality tools as Total Quality Management and continuous quality improvement allow a permanent increase of customer/patient satisfaction. | 10666835 | [
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13C-methacetin breath test: isotope-selective nondispersive infrared spectrometry in comparison to isotope ratio mass spectrometry in volunteers and patients with liver cirrhosis. | The 13C-methacetin breath test (MBT) has been proposed for the noninvasive evaluation of the hepatic mixed function oxidase activity. Up to now; stable isotope analysis of carbon dioxide of the MBT has been carried out with isotope ratio mass spectrometry (IRMS). The aim of the present study was to test a recently developed isotope-selective nondispersive infrared spectrometer (NDIRS) in comparison to IRMS in healthy volunteers and patients with liver cirrhosis. Ten healthy volunteers (range 22 to 76 years) | 10666836 | [
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] |
13C-methacetin breath test: isotope-selective nondispersive infrared spectrometry in comparison to isotope ratio mass spectrometry in volunteers and patients with liver cirrhosis. | and ten patients with histologically proven liver cirrhosis (range 47 to 71 years; Child Pugh score A = 5; B = 3; C = 2) were studied. After an overnight fast each subject received 2 mg/kg BW of 13C-methacetin dissolved in 100 ml of tea. Breath samples were obtained before substrate administration and after 5; 10; 15; 20; 30; 40; 50; 60; 80; 100; 120; 150; 180 min. The 13C/12C-ratio was analyzed in each breath sample both by NDIRS (IRIS; Wagner Analysen Technik; Worpswede; Germany) and CF-IRMS (ABCA; Europ | 10666836 | [
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] |
13C-methacetin breath test: isotope-selective nondispersive infrared spectrometry in comparison to isotope ratio mass spectrometry in volunteers and patients with liver cirrhosis. | a Scientific; Crewe; UK). Results were expressed as delta over baseline (DOB [/1000]) and as cumulative percentage doses of 13C recovered (cPDR [%]) at each time interval. Correlations between IRMS and NDIRS were tested by linear regression correlation. For measuring agreement an Altman-Bland-plot was performed. Applying correlation analysis a linear correlation was found (DOB: y = 1.068 +/- 0.0012.x + 2.088 +/- 0.2126; r = 0.98; p < 0.0001; cPDR: y = 1.148 +/- 0.0109.x + 0.569 +/- 0.172; r = 0.99; p < 0.00 | 10666836 | [
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13C-methacetin breath test: isotope-selective nondispersive infrared spectrometry in comparison to isotope ratio mass spectrometry in volunteers and patients with liver cirrhosis. | 01). For DOB the mean difference (d) was 2.9/1000 and the standard deviation (SD) of the difference was 2.7/1000. The limits of agreement (d +/- SD) were -2.5/1000 and 8.3/1000. The comparison of DOB- and cPDR-values by NDIRS and IRMS shows a high linear correlation. However; the distance of the limits of agreement is wide. Consequently; the validity of the MBT could be influenced which could make MBT by NDIRS unprecise for exact evaluation of hepatocellular dysfunction. Further studies are necessary to det | 10666836 | [
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13C-methacetin breath test: isotope-selective nondispersive infrared spectrometry in comparison to isotope ratio mass spectrometry in volunteers and patients with liver cirrhosis. | ermine sensitivity and specifity of the MBT with NDIRS in larger study populations. | 10666836 | [
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Evaluation of an enzyme immunoassay for detecting Helicobacter pylori antigens in human stool samples. | So far; the detection of Helicobacter pylori (Hp) infection by stool analysis appeared to be almost impossible. With the Premier Platinum HpSA EIA a new enzyme immunoassay was developed for diagnosis of Hp infection; using polyclonal antibodies against Hp antigens in human stool. We evaluated this new test in its diagnostic accuracy in comparison to established reference methods.From 54 consecutive patients (29 male; 25 female; age: 19 to 85 years) undergoing routine upper gastrointestinal endoscopy antral | 10666837 | [
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Evaluation of an enzyme immunoassay for detecting Helicobacter pylori antigens in human stool samples. | and corpus biopsies were taken for histology and Helicobacter urease test (HUT). Endoscopy; 13C-urea breath test (13C-UBT); serology; and stool probes sampling were performed within two days. Stool samples were aliquoted after reception and stored frozen (-20 degrees C) until tested. The Premier Platinum HpSA test (Meridian; Connecticut; Ohio; USA) was performed according to the manufactures protocol. Patients were considered to be infected with Hp if two of the four reference tests were positive.28 of the | 10666837 | [
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Evaluation of an enzyme immunoassay for detecting Helicobacter pylori antigens in human stool samples. | 54 patients were Hp-infected. Only one of these was found to be false-negative by the HpSA EIA. Two false-positive results were obtained in the noninfected group (sensitivity 96.4%; specificity 92.3%).In this group of patients investigated; the novel HpSA Enzyme Immunoassay (EIA) proved to be highly accurate for diagnosis of Hp infection. Collection and testing of stool are noninvasive and easy to perform; therefore this test will become an important tool for diagnosing Hp infection in clinical practice. | 10666837 | [
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[A new papillotome for cannulation, pre-cut or conventional papillotomy]. | A new papillotome was designed to overcome certain drawbacks of the needle-knife; that is most commonly used for precut sphincterotomies. The intention was to develop an instrument at least as good as the needle-knife or the Erlangen-type precut papillotome for precut procedures. In addition; it had to be suitable for direct cannulation of the biliary or pancreatic duct.According to a prospective protocol 54 patients in whom a papillotomy was indicated were examined with the new instrument. The protocol all | 10666838 | [
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[A new papillotome for cannulation, pre-cut or conventional papillotomy]. | owed three futile attempts to cannulate or two inadvertant cannulations of the pancreatic duct with a standard cannula and hydrophilic guide wire before a precut was performed. The new baby-papillotome has a diameter of only 1 mm and a short 10 mm cutting wire. Similar to a guide wire it is introduced via a 6F- or 7F-introducer catheter.Cannulation of the desired duct (the bile duct in 48 patients; the pancreatic duct in five patients; Billroth II anatomy in three patients) was successful within one session | 10666838 | [
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[A new papillotome for cannulation, pre-cut or conventional papillotomy]. | in 98% (53/54). In one patient; the bile duct was successfully cannulated in a second session using the baby-papillotome; resulting in an overall success rate of 100%. Primary cannulation using the new papillotome without precut was obtained in 24% (13/54). Complications were mild pancreatitis in one patient and nonsignificant bleeding in three (immediate endoscopic hemostasis in all; no transfusions; no drop of hematocrit). There were no serious complications.The new baby-papillotome is suitable for precu | 10666838 | [
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[A new papillotome for cannulation, pre-cut or conventional papillotomy]. | t as well as for primary cannulation. In this first series; the desired duct was cannulated in 98% within the first session with a low complication rate. Further studies of the new instrument seem desirable. | 10666838 | [
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[Prevalence of cholecystolithiasis in South Germany--an ultrasound study of 2,498 persons of a rural population]. | Gallbladder stones represent one of the most common reason for morbidity in western industrial nations. There remains a paucity of exact information regarding the prevalence and risk factors for this disease entity in Germany. As part of a whole-community survey focusing on the prevalence of echinococcosis multilocularis conducted in a population in southwestern Germany (response rate: 66.6%); 2;560 subjects underwent an upper abdominal ultrasound examination at which the presence of gallbladder stones was | 10666839 | [
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[Prevalence of cholecystolithiasis in South Germany--an ultrasound study of 2,498 persons of a rural population]. | ascertained. In each case; upper abdominal sonography was performed following completion of a standardized interview. In 62 subjects; the gallbladder could not be adequately visualized due to an insufficient fasting period; the remaining 2;498 subjects (1;326 females; age 38.9 +/- 19.9 years; 1;172 males; age 37.7 +/- 18.8 years) were included in the study collective. Gallbladder stones (sonographically visualized gallbladder stones or history of cholecystectomy for cholecystolithiasis) were found in 196 pa | 10666839 | [
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[Prevalence of cholecystolithiasis in South Germany--an ultrasound study of 2,498 persons of a rural population]. | may be the low average age of study participants; almost 50% of whom were less than 35 years. Besides age; subjects' gender; BMI and positive family history were identified as significant risk factors. | 10666839 | [
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[Long-term collagenous sprue--remission with a gluten-free diet]. | We report on a 56-year-old caucasian female; 154 cm; 38 kg; who was admitted to the hospital in extremely poor; cachectic condition with pretibial edemas; ascites and pleural effusion with a history of severe watery diarrhea up to 15 times daily. The patient's history with permanent meteorism; recurrent episodes of watery diarrhea and dystrophy dates back to her early childhood. Multiple biopsies from the distal part of the duodenum showed a complete atrophy of villi with an extensive subepithelial layer of | 10666840 | [
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[Long-term collagenous sprue--remission with a gluten-free diet]. | collagenous fibers. No antigliadin or antiendomysial antibodies could be detected. Under a strictly gluten-free diet; the patient's symptoms quickly improved. During the follow-up of one year; no recurrence of diarrhea and meteorism has been seen. The patient showed a continuous improvement of her general condition and nutritional state with a weight gain to 50 kg. Repeated control biopsies still revealed a pronounced villous atrophy. However; no subepithelial collagenous fibers were detectable. A diagnosi | 10666840 | [
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[Long-term collagenous sprue--remission with a gluten-free diet]. | s fitting to the patient's clinical symptoms of severe malabsorption; would be the rare "collagenous sprue"; which is considered to be gluten-insensitive. However; the patient's good response to a gluten-free diet raises the possibility; that the collagenous layer represents a manifestation of more severe forms of common celiac disease. In this case; it would not be necessary to regard collagenous sprue as a distinct entity. | 10666840 | [
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Autologous blood donation for surgery in inflammatory bowel disease--a report of six cases. | Surgery in inflammatory bowel disease (IBD) is frequently associated with need for perioperative blood transfusions carrying the potential risk of infection. Autologous blood donation is often limited by IBD-associated anemia which is reversible by intravenous iron and erythropoietin. We therefore tested the feasibility of autologous blood donation in IBD.Six patients (five Crohn's disease; one ulcerative colitis) with indication for elective bowel resection were treated after informed consent was obtained. | 10666841 | [
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Autologous blood donation for surgery in inflammatory bowel disease--a report of six cases. | Two to four blood donations were scheduled during four weeks prior to surgery. Once a week 350-450 ml of blood were collected from patients with a hemoglobin level above 11.0 g/dl. After each donation 200 mg of iron saccharate diluted in 0.9% saline were given to all patients intravenously as substitute for donation-related iron loss. Patients with preexisting anemia or C-reactive protein above 2.0 mg/dl received concomitant erythropoietin.The scheduled number of packed red cells was donated successfully b | 10666841 | [
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Autologous blood donation for surgery in inflammatory bowel disease--a report of six cases. | y four patients. Due to low hemoglobin levels two patients donated one unit less than intended. Four patients received autologous blood transfusions intra- or postoperatively. No patient needed homologous blood. No serious adverse events were observed during blood donations; perioperatively; and during the one year follow-up period.Preoperative autologous blood donation is save and feasible in IBD patients with elective bowel resection. | 10666841 | [
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[Treatment of multilocular hepatocellular carcinoma (HCC) of 4.5 cm and 3.5 cm diameter using percutaneous ethanol injection in a patient with advanced liver cirrhosis]. | Treatment of hepatocellular carcinoma (HCC) with percutaneous ethanol injection (PEI) is established for tumors up to 3 cm. We report on treatment of a multilocular HCC with a maximum size of 4.5 cm.In a 76-year-old woman with a liver cirrhosis (Child C) due to chronic hepatitis C HCC with two nodules (diameter 3.5 cm and 4.5 cm) was diagnosed. Because of the patient's reduced general state of health and the advanced cirrhosis surgical treatment and chemoembolization were declined. The two nodules were trea | 10666842 | [
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[Treatment of multilocular hepatocellular carcinoma (HCC) of 4.5 cm and 3.5 cm diameter using percutaneous ethanol injection in a patient with advanced liver cirrhosis]. | ted in ten settings during 15 weeks under ultrasound guidance with 85 ml of 96% ethanol. There were no severe side effects. The patient's general condition improved and serum alpha-fetoprotein concentration decreased from 21;126 to 800 micrograms/l. Seven months after the diagnosis of the HCC she was admitted to another hospital due to a cerebral hemorrhage. A few days later she died because of a pneumonia. In spite of detailed micro- and macroscopically investigation no tumor was found during the autopsy. | 10666842 | [
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[Treatment of multilocular hepatocellular carcinoma (HCC) of 4.5 cm and 3.5 cm diameter using percutaneous ethanol injection in a patient with advanced liver cirrhosis]. | This case report shows that HCC up to a diameter of 4.5 cm can be effectively treated by PEI. This treatment modality is cheap and well-tolerated even in patients suffering from advanced cirrhosis. | 10666842 | [
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[Hereditary hemochromatosis--new developments after discovery of the HFE gene]. | Hereditary hemochromatosis (HH) is an autosomal recessive disorder of iron metabolism; resulting in an increased iron deposition and multiorgan failure. Recently a candidate gene of HH; termed HFE; has been identified on chromosome 6; coding for a protein homologous to major histocompatibility complex (MHC) class I molecules. Two mutations of the hemochromatosis gene leading to an exchange of cysteine to tyrosine at aminoacid 282 and histidine to asparagine at aminoacid 63; are retained responsible for the | 10666843 | [
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] |
[Hereditary hemochromatosis--new developments after discovery of the HFE gene]. | development of hereditary hemochromatosis. The Cys282Tyr-mutation disrupts a disulfid bond and thus abrogates binding of the mutant HFE-protein to beta 2-microglobulin and its presentation on the cell surface. The His63Asp-mutation seems to play a role in pH-regulated dissociation of the transferrin receptor/transferrin complex in the lysosome. Mutations of the HFE-protein alter the affinity of the transferrin receptor for its ligand transferrin and may thus cause an intracellular accumulation of iron. Know | 10666843 | [
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[Hereditary hemochromatosis--new developments after discovery of the HFE gene]. | ledge of the responsible gene allows a molecular diagnosis of HH. The new genetic marker can be used for screening and confirmation of HH reducing the need for confirmatory liver biopsies. Compared to standard screening parameters like ferritin and transferrin saturation genetic testing will allow the diagnosis of HH in an early; asymptomatic state before iron accumulation has occurred. As a normal life expectancy of patients with HH can be achieved if iron reduction is initiated early; genetic testing may | 10666843 | [
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[Hereditary hemochromatosis--new developments after discovery of the HFE gene]. | thus be of great benefit for patients with HH. | 10666843 | [
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[Gene therapy of pancreatic carcinoma]. | nan | 10666844 | [
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[Incidence and prognosis of collagenous and lymphocytic colitis]. | nan | 10666845 | [
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[Identification of CD81 protein as HCV receptor--relevance for pathogenesis and cell tropism?]. | nan | 10666846 | [
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[Evidence-based evaluation of the back school. Wide distribution with minimal effectiveness?]. | nan | 10666847 | [
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[Tissue engineering of bone tissue]. | nan | 10666848 | [
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[Orthopedics and geriatrics]. | nan | 10666850 | [
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[Diagnosis and therapy of spinal stenosis in the elderly]. | nosis the cervical myelopathy occasionally combined with radiculopathy. The first therapeutic step should be the conservative therapy in nearly all cases; the only exception is a severe cervical myelopathy where an operation is indicated. In case of persistent or progressive symptoms under a sufficient conservative therapy; operative therapy is indicated. The different possible therapy decisions will be based on flow-charts.Whereas in lumbar spinal stenosis the indication for operative therapy should be con | 10666852 | [
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[Diagnosis and therapy of spinal stenosis in the elderly]. | sidered with reservation; in cervical spinal stenosis with myelopathy operative therapy should be considered at an early stage. | 10666852 | [
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[Incidence of joint-specific risk factors in patients with advanced cox- and gonarthroses in the Ulm Osteoarthrosis Study]. | To determine the prevalence of joint specific risk factors in patients with different patterns of advanced hip and knee osteoarthritis (OA).We performed a cross-sectional multicenter study in four orthopaedic hospitals in the southwest of Germany. A detailed medical history (date and nature of trauma; conservative and surgical treatment of congenital or acquired joint disorders known as secondary causes of OA) and radiographic evaluation (sequelae of hip dysplasia; slipped capital femoral epiphysis or other | 10666851 | [
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[Incidence of joint-specific risk factors in patients with advanced cox- and gonarthroses in the Ulm Osteoarthrosis Study]. | malformations) was obtained in 809 patients with advanced hip (n = 420) or knee (n = 389) osteoarthritis; which required unilateral total joint replacement. According to the presence or absence of joint specific risk factors; patients were classified as having secondary or primary (idiopathic) OA.In 41.7% (25.5%) of patients with hip OA and 33.4% (11.1%) of patients with knee OA some predisposing abnormality of the operated (or contralateral) joint could be observed. In hip OA the underlying pathological c | 10666851 | [
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[Incidence of joint-specific risk factors in patients with advanced cox- and gonarthroses in the Ulm Osteoarthrosis Study]. | onditions were mainly hip dysplasia (25.0% in the operated joint and 14.8% in the non-operated joint) and slipped capital femoral epiphysis (7.1% and 14.8%); while knee OA was most often associated with a history of severe trauma (28.6% and 8.3%)While there is a lack of comparable investigations in patients with advanced knee OA; the presented data is somewhat contradictory to earlier reports of the prevalence of identified underlying risk factors in patients with hip OA. The reported differences; however; | 10666851 | [
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[Incidence of joint-specific risk factors in patients with advanced cox- and gonarthroses in the Ulm Osteoarthrosis Study]. | might be attributed to different methodological approaches and could also resemble recent changes in the multifactorial ethiopathologic concept of OA. | 10666851 | [
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[Epidemiology of accidental falls in the elderly]. | There is a lack of epidemiological data on falls and fall-related injuries for the aged population in Germany. The purpose of the article is to present the available data focusing on the incidence of the fracture types that carry the highest risk for mortality; hospitalization and persisting disabilities.The paper reports on a 10% representative sample that was drawn by the Federal Bureau of Statistics. A medline search for 1980-1998 was performed to identify relevant articles. The OECD database was used fo | 10666853 | [
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[Epidemiology of accidental falls in the elderly]. | r mortality rates after injurious falls. If no sufficient data were published for Germany; incidence rates of demographic comparable European regions are reported.The number of fractures of the lower extremity (ICD 820-829) followed by hospitalization was 139;000 in 1996 for elderly (65+ years). Fractures of the upper extremities (ICD 810-819) requiring hospitalisation were reported for 65;000 persons aged 65+ years and head trauma (ICD 850-851) followed by hospitalization in this age group for 29;000 perso | 10666853 | [
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