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Biomedical subjects

B Schöning

Publications and source records attributed to B Schöning.

At least 19 recordsLinked to original sources
PubMed1994

Apple allergy: the IgE-binding potency of apple strains is related to the occurrence of the 18-kDa allergen.

Low-temperature, acetone powder extracts were prepared from mature fruit of 16 apple strains. SDS-PAGE and immunoblot analysis revealed great variation in the relative amounts of the 18-kDa apple allergen in these extracts. EAST (RAST) scores, measured with individual and pool sera from patients allergic to birch pollen and apples, ranged from 0.2 to 4.0 and were related to the relative amount of the 18-kDa protein. These findings were confirmed by ELISA-inhibition assays, dose-related histamine release, semiquantitative evaluation of immunoblots by absorption/reflection densitometry, and skin prick tests with extracts of Golden Delicious, Boskoop, and Jamba apples (corresponding to a high, low, and very low 18-kDa allergen content). Additional open oral challenge tests were performed with two apple-allergic patients and 15 and 16 apple strains. With all methods, the deduced allergenic potency decreased in the following order: Golden Delicious > Boskoop > Jamba. Therefore, we concluded that the IgE-binding potency of apple strains depends on the occurrence of the 18-kDa allergen.

Allergens↗
PubMed1994

Characterization of the 18-kDa apple allergen by two-dimensional immunoblotting and microsequencing.

A low-temperature extract taken from Golden Delicious apples was separated by two-dimensional polyacrylamide gel electrophoresis. By means of two-dimensional immunoblotting with patients' serum containing IgE specific to Bet v I, a rabbit polyclonal antiserum raised against Bet v I, and two Bet v I specific monoclonal antibodies, epitopes cross-reactive to Bet v I were identified on an apple allergen with a molecular mass of 18 kDa and pI 5.5. Furthermore, certain antibody reactivities with 4 isoproteins of a molecular mass of 16 kDa and pIs ranging from 4.9 to 5.5 were observed, which may indicate the presence of Bet v I related epitopes on these proteins. Based on 26 amino acid residues, N-terminal sequencing of the 18-kDa apple allergen revealed 62% sequence identity between Bet v I from birch pollen and the apple allergen. Our results therefore support the view that both proteins express common as well as non-related IgE-reactive epitopes.

Allergens↗
PubMed1988

Prediction of risk for pseudoallergic reactions and histamine release in patients undergoing anaesthesia and surgery: a computer-aided model using independence-Bayes.

A computer-aided model for the prediction of pseudoallergic reactions was developed using prospective data collected from 581 patients in a controlled clinical trial examining pseudoallergic reactions to the plasma substitute Haemaccel (outdated formulation). The multivariate analysis of 22 proposed risk factors was performed using Bayes theorem. This enabled the accurate prediction of 86% of the patients who had a systemic reaction. The clinical use of such system would enable a selection of patients to receive the effective prophylactic measure of pretreatment with H1 plus H2-receptor antagonists.

Anesthesia↗
PubMed1984

[Heart arrest during dextran infusion despite hapten blockade].

In a running clinical prospective study on the incidence of adverse reactions to colloidal polysaccharides (randomised, single blind, n = 300) a bronchospasm followed by cardiac arrest occurred during dextran infusion although the necessary hapten blockage with monovalent dextran-1 had been effected. Resuscitation was successful. Directly after this, surgery was carried out as planned under general anaesthesia. The 69-year-old patient was discharged without noticeable sequelae. For the first time in the literature on dextran the studied sample allows a generalisation: The event occurred with an incidence of about 0.9% (of 116 patients who had received dextran infusion). This incidence corresponds to a confidence interval ranging from 0.02 to 4.96%. If the study would be continued as planned, the upper limit of this interval signals the probability of another case of severe intolerance. The diagnosis "dextran adverse reaction" can be made in this case by clinical symptoms. Since no previous or concomitant medication had been administered as provided in the protocol to confirm the diagnosis as an adverse reaction to dextran by determination of the titer of dextran antibodies prior to infusion is not required and it may be concluded that dextran was the causative agent.

Aged↗
PubMed1982

Prophylaxis of anaphylactoid reactions to a polypeptidal plasma substitute by H1- plus H2-receptor antagonists: synopsis of three randomized controlled trials.

To demonstrate the efficacy of a premedication with H1- + H2-receptor antagonists against histamine-release responses in anaesthesia and surgery 3 randomized controlled trials were conducted in patients, volunteers and experimental animals (dogs). Cutaneous anaphylactoid reactions following infusion of polygeline (Haemaccel) in orthopedic patients were successfully abolished by premedication with 0.1 mg/kg dimethpyrindene (Fenistil) and 5 mg/kg cimetidine (Tagamet). Chlorpheniramine (Piriton) was also useful, but dimethpyrindene was more effective in the doses recommended and used. Side-effects of the premedication were not observed when the 2 drugs were slowly administered (2 min each). Systemic anaphylactoid reactions following infusion of polygeline were completely prevented in volunteers by the same premedication (0.1 mg/kg dimethpyrindene and 10 mg/kg cimetidine). Life-threatening reactions could not be tested in human subjects, but were elicited in experimental animals (dogs). In this species which resembles man in its sensitivity against histamine, in plasma histamine levels and in response to polygeline life-threatening reactions were prevented or in especially severe cases diminished to such an extent by the premedication with H1- + H2-blockers that this premedication was finally judged to be very effective against histamine-release responses of any grade of severity. To confirm this clinically very important hypothesis more clinical trials in patients at risk for anaphylactoid reactions to drugs are urgently needed.

Adult↗
PubMed1982

[Limitation of heat loss in long-lasting paediatric operations by means of a metal foil--positive correlation between room and body temperature (author's transl)].

A controlled clinical prospective study in 80 children showed the efficiency of an aluminium-coated polyester foil as a protection against heat loss during long-lasting (greater than or equal to 2 h) orthopaedic correcting operations. A pronounced correlation between theatre temperature and the body temperature of the children wrapped in foil could be demonstrated. This method is recommended as a safe and low-cost routine preventive measure for a major part of anaesthetics in paediatric surgery. The foil effect could be completed further by infusion solutions warmed to body temperature and an operation theatre temperature raised to 22-24 degrees C.

Age Factors↗
PubMed1981

[Reducing of unwanted side effects of modified fluid gelatin by promethazine: controlled clinical trial with orthopaedic patints (author's transl)].

In order to determine the undesirable side effects of standard commercially available plasma substitutes, 450 stationary patients covering 5 age groups were randomly allocated to various methods of pre-medication and 3 batches of modified fluid gelatin (Neo-Plasmagel). The incidence of allergoid and anaphylactoid reactions depended on the pre-medication (p less than 0.025). Atosil proved to be an strong histamine blocker: the incidence of reactions between the control and the promethazine group was p less than 0.005. Seen as a whole reactions among females were greater than with males (p less than 0.025). No relationship could be determined statistically between the different batches and the incidence of side-effects. -The prophylactic use of Neo-Plasmagel in orthopaedic patients is therefore dependent on a sufficient blockade of histamine receptors.

Adult↗
PubMed1980

Binding of native and denatured collagen to immunoglobulins and cold insoluble globulin in serum of patients undergoing orthopedic surgery.

Native and denatured 125-I-collagen were reacted with sera from 366 patients undergoing orthopedic surgery. Complexes consisting of native or denatured collagen and immunoglobulins or of denatured collagen and cold insoluble globulin were precipitated with secondary antibodies to either immunoglobulins or CIG. Only approximately 10% of the patients' sera bound more than 5 ng native collagen/10 microliter serum. Binding of denatured collagen to immunoglobulins occurred more frequently and in larger amounts. Binding of denatured collagen to CIG was determined in some of the sera and found to occur in all of them and in substantial amounts. Some of the subjects developed pathergic reactions upon subsequent infusion of a gelatin based plasma substitute. There was no correlation between the severity of such adverse reactions and any of the parameters measured. Therefore, the observed clinical reactions are not likely to be caused by true immunological mechanisms.

Binding Sites, Antibody↗
PubMed1980

Statistical analysis of perioperative and postoperative mortality of patients with prosthetic replacement of the hip joint.

From 1967 to 1975 a total of 1322 hip replacement operations in 1157 patients was carried out in the Orthopaedic Hospital, University of Heidelberg. The mortality rate, as evaluated by modern methods of medical statistics, was 5.7%. The risk of fatality must be one of the main factors influencing the surgeon when considering whether to offer hip replacement to an aged patient.

Adolescent↗
PubMed1980

H1 + H2-receptor antagonists for premedication in anaesthesia and surgery: a critical view based on randomized clinical trials with Haemaccel and various antiallergic drugs.

Histamine release by drugs used in anaesthesia and surgery has been often demonstrated in human volunteers, but only occassionally in patients. Three questions arose from these studies. (1) Is the incidence of histamine release high in patients during routine anaesthesia and surgery? (2) Can the clinical effects of histamine release in man be prevented by H1 + H2-receptor antagonists? (3) Are there any side-effects of such a premedication? These problems were investigated in patients and volunteers by randomized controlled clinical trials using only one of the histamine-liberating drugs in man, the plasma substitute Haemaccel. This drug was chosen because it causes a reproducible histamine release in man and because its mechanism of action in man is largely known. (1) Out of 600 orthopaedic patients 30 (5%) showed anaphylactoid reactions following Haemaccel infusion. 26 of these had a histamine release of more than 1 ng histamine/ml plasma. Using predictive values this gives an efficiency of the test by nearly 98%. (2) In volunteers the combination of an H1-plus H2-receptor antagonist (dimethypyrindene and cimetidine) completely prevented the clinical effects of histamine release by Haemaccel (9 allergoid and anaphylactoid reactions in the control group, none in the H1 + H2-group). The incidence of histamine release, however, remained unchanged. (3) The premedication was found to release histamine itself. Cimetidine was effective when given alone but especially in combination with chlorpheniramine (4 events out of 7 applications). The clinical side-effects of these premedication were mild since apparently the free histamine was largely blocked at the receptor sites. It is concluded that premedication with a combination of H1- and H2-receptor antagonists is indicated due to the high incidence of histamine release during anaesthesia and surgery induced by various drugs and treatments. Such premedication is effective but associated with mild side-effects. For this reason more extended clinical trials with dimethpyrindene plus cimetidine in patients are necessary before this premedication can be generally recommended.

Adolescent↗
PubMed1980

Prevention of allergoid (cutaneous anaphylactoid) reactions to polygeline (Haemaccel) in orthopaedic patients by premedication with H1- and H2-receptor antagonists.

"Purified" polygeline (Haemaccel) was examined for its anaphylactoid and allergoid reactions in a controlled clinical trial on a homogenous sample of orthopaedic patients. In two test groups histamine H1- and H2-receptor antagonists were applied, in the control group saline as a placebo premedication. Unexpectedly no anaphylactoid reaction associated with histamine release greater than or equal to 1 ng/ml plasma occurred in the trial. Clinically unimportant allergoid reactions restricted to the skin occurred with a lower frequency (18%) than observed in previous trials. The specific premedication was highly effective in preventing these reactions in the two test groups (p less than 0.0005). Due to the apparent improvement of the product a general premedication with histamine H1- and H2-receptor antagonist seems not to be necessary before polygeline is administered to patients. For reasons of safety, however, it seems to be indicated in patients at risk, such as those with carcinoma, a proven allergic diathesis and in those who have already suffered from an incident to plasma substitutes.

Anaphylaxis↗
PubMed1980

Lack of evidence for immunological reactions to polygelatin.

Gelatin-based plasma substitutes resemble denatured collagen in that sequence dependent antigenic sites of collagen may be preserved in these preparations and cause side reactions of such plasma substitutes. We have measured the binding of 125I-collagen in denatured conformation to antibodies and to cold-insoluble globulin (CIG) in sera of patients undergoing orthopedic surgery. About two thirds of the sera bound significant amounts of denatured collagen to immunoglobulins and to CIG. Yet, there was no correlation in individual patients or in groups of patients between the collagen binding capacity of sera and the occurrence of allergic reactions upon infusions of Haemaccel. Furthermore, antibodies to denatured collagen induced in animals did not cross-react with gelatin-based plasma substitutes. Thus, it is not likely that side reactions after infusion of gelatin-based plasma substitutes are caused by immunological reactions between antigens and performed antibodies.

Antibodies↗
PubMed1980

Incidence and mechanisms of adverse reactions to polypeptides in man and dog.

Adverse reactions (pseudoallergic = anaphylactoid (severe) and allergoid (slight)) to polygeline (Haemaccel) are caused by histamine release. The mechanism by which other polypeptides produce these reactions is unfortunately hitherto unknown. "Purification" of Haemaccel led to a drug which was free from anaphylactoid reactions in a controlled clinical trial. Clinically insignificant allergoid reactions to polygeline (restricted to the skin) could be prevented by premedication with H1 + H2-receptor antagonists.

Anaphylaxis↗