Biomedical subjects
A Schramm
Publications and source records attributed to A Schramm.
Effect of yohimbine on renal sympathetic nerve activity and renal norepinephrine spillover in anesthetized rabbits.
The function of presynaptic alpha-2 adrenergic autoinhibition of norepinephrine release was studied in anesthetized rabbits (alfadolone + alfaxalone) with uninterrupted sympathetic impulse traffic. The animals received a tracer infusion of [3H]norepinephrine i.v. Arterial and renal venous concentrations of endogenous norepinephrine and [3H]norepinephrine, the firing rate of the renal sympathetic nerves and renal blood flow were determined. The results were used to calculate the renal fractional [3H]norepinephrine extraction, the renal removal and spillover of norepinephrine, the total body [3H]norepinephrine clearance and total body norepinephrine spillover. Sodium nitroprusside (10-80 micrograms kg-1 min-1 i.v.), which was infused to modulate sympathetic activity through the baroreceptors, caused hypotension and increased the renal sympathetic firing rate and the renal as well as total body norepinephrine spillover. Increases of total body norepinephrine spillover were much higher than increases of renal spillover. Yohimbine (1 mg kg-1 + 0.2 mg kg-1 hr-1 i.v.) caused slight central sympathoexcitation. In addition, it enhanced the renal and total body spillover of norepinephrine at any given firing rate of the renal sympathetic nerves. The distinguishing feature of this study is the measurement of sympathetic firing rate and norepinephrine spillover in one and the same organ, the kidney. The results demonstrate that the alpha-2 adrenergic autoinhibition of norepinephrine release normally operates in the kidney with intact sympathetic impulse traffic. They also suggest its operation in other peripheral sympathetically innervated tissues.
[Medical problems in the care of the elderly].
The number of long-lived persons is increasing dramatically. They have a high need for medical help and make high demands on their doctors, especially because of their extreme physical, psychological and social multimorbidity. It is difficult but important to assess the vital energy and the life expectancy of these persons living near death. The spectrum of vitality ranges from admirably well-preserved persons without any need of help to bedridden sick people wasting away. In this paper, there are discussed specific findings and opportunities of intervention, in particular the problems of admission to hospital and life-lengthening measures.
[Acute methanol poisoning--a review and a case report].
Acute methanol intoxications are infrequent among accidental or suicidal intoxications today. The characteristic findings are illustrated by a review. Mainly, the methanol metabolites formaldehyde and formic acid are of toxicologic importance and cause the dominant central nervous and ocular symptoms. The principal therapeutic procedures include gastric lavage, induced vomiting, titrated correction of acidosis with sodium bicarbonate, administration of ethanol, folic acid and, especially, the secondary detoxication with peritoneal--or better--haemodialysis. The therapeutic measures must be started quickly and carried out consequently to improve the prognosis of methanol intoxication and to decrease the frequency of serious late complications like ophthalmologic and neurologic lesions. Our own medical management is described by a case report treated successfully.
[The significance of internal medicine intensive care within the complex of intensive medicine. Discussion contribution to the structural and professional classification in adult intensive medicine].
The development and establishment of intensive care units for adult patients requires a far-reaching subdivision into surgical and conservatively oriented intensive care for qualitative and quantitative reasons. Insufficiently substantiated claims to monopolization of intensive care techniques that are polemically asserted have to be strongly contradicted. The present paper is concerned with approved structural concepts of intensive care developed by Deutsche Krankenhausgesellschaft and various medical societies. They are supplemented by personal experience in the field of internal intensive care.
[MRT of tumors of the larynx and hypopharynx using Gd-DTPA: clinical value].
Thirty one patients with tumours of the larynx and hypo-pharynx were studied by MRI, both with and without the para-magnetic contrast medium, GD-DTPA. The results were compared with pre-operative laryngoscopy and the final pathological tumour classification. The most accurate results were obtained by comparing T1-weighted sequences before and after the use of GD-DTPA. Because of the relatively rapid mode of examination and the specific enhancement, the method proved ideal for evaluating tumours of the larynx and hypo-pharynx. MRI is a valuable diagnostic technique for staging and treatment planning of patient with tumours of the larynx and hypo-pharynx.
[Electrical impedance and time of death in the animal model].
To study passive electric parameters of the rat skeletal muscles in relation to the time of death, investigations were carried out using the impulse distortion method of Pliquett. This measuring method enables the evaluation of the electric rectangular impulse distorted by the biological tissues, which contains any essential information on the passive electric properties of the object to be measured. The passive electric parameters change in the studied time interval up to 79 h post mortem in a characteristic fashion. The linear correlation of the evaluated impulse parameters at the time of death is closest (r = 0.75) between 0.5-8.5 h post mortem, the scatter of single values in late postmortal periods is in part considerable. A further development of the measuring technique and standardization of the measuring method let the passive electric parameters appear to be appropriate magnitudes for estimating the time of death.
[Laser light-induced cytotoxicity of cultivated squamous cell cancer cells of the head and neck following photosensitization].
Photodynamic therapy, which involves the action of light-activated dyes on biological tissues, has been attempted to treat tumors. In order to achieve effective tumor cell destruction in head and neck cancer, the direct photodynamic effects on in vitro cultured squamous carcinoma cell lines were analyzed. Without light no tumor cell killing was observed after photosensitization up to 6 hrs with dihematoporphyrinester/-ether (DHE) concentrations of 5 micrograms/ml. With longer incubation times and higher light irradiation dosages, however, an increasing cytotoxicity could be observed. Optimal intervals for photosensitization were 48 hours. Squamous cell carcinoma lines of the head and neck from different locations did not differ in their photodynamic behaviour with respect to photodynamic treatment. With the results presented, it will be appropriate to complete in vivo studies to inspire photodynamic tumor cell destruction in the treatment of head and neck cancer as a new approach besides the classical therapeutic modalities.
[Progressive systemic sclerosis].
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[Progressive systemic sclerosis - long-term treatment with azathioprin (author's transl)].
The study presents the results of an Azathioprin long-term therapy in 19 of 60 patients with progressive systemic sclerosis (PSS). Average treatment was 47 months (6 to 114 months). The patients received 2-2,5 Azathioprin/kg bodyweight daily. In 16 cases no further progression of PSS was noted. One patient showed minor deterioration. In particular no further deterioration in the lung and kidney manifestations were found. Two patients died. A female patient showed signs of osteomyelofibrosis after being treated for 70 months. She died 3,5 years after Azathioprin had been discontinued. The second patient died of right heart failure after recurrent pulmonary emboli. On the whole treatment with Azathioprin over a long period of time seems in most cases to hold the progression of the disease. The unfavourable prognosis can therefore be much improved.
Anatomy and physiology of the kidney.
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[Osteosynthesis by selfcompressive plates (author's transl)].
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[Mitochondrial antibodies induced by drug administration in patients with and without pseudo LE syndrome (author's transl)].
The pseudo LE syndrome was first described in 1972. It is a severe, sometimes fatal condition, in which high titres of mitochondrial antibodies are a constant feature. In the vast majority of cases detected, Venopyronum in dragée form (containing phenopyrazone, horse-chestnut extract, and cardiac glycosides from various plants), had been taken prior to onset of the clinical symptoms. It is probably commoner, that following intake of the drug mitochondrial antibodies appear without clinical manifestations. In both situations, disposition, dose and duration of treatment are important factors. There is reasonable ground to believe that not just a single component, but rather the combination of various substances in the preparation is responsible for the induction of an autoimmune process. At the present time it appears that an idiopathic form, without drug contact, also exists.
[Contribution to the treatment of chronic osteomyelitis by long-term intra-arterial infusion (author's transl)].
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