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Biomedical subjects

B Schulte

Publications and source records attributed to B Schulte.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Sonography of acute appendicitis. A 5-year prospective study of 2074 patients. 2].

High-resolution real-time ultrasound (US) with a 5 MHz transducer has proved to be an important method in the diagnosis of acute appendicitis. In a prospective study we examined 2074 unselected patients with suspected appendicitis to assess the diagnostic and epidemiological value of US. According to the clinical diagnosis females aged 10 to 30 represented the majority of suspected cases. Appendicitis was most often proved in male patients aged 15-30 years. The prevalence of acute appendicitis in childhood is lower (7%) than in elderly patients (33%). US enables the diagnosis of acute appendicitis with a sensitivity of 91%, a specificity of 98% and an overall accuracy of 97%. For differential diagnosis US demonstrates other diseases that mimic acute appendicitis. Thus it is possible to reduce the negative appendectomy rate particularly in children by revealing mesenteric lymphadenitis or terminal ileitis and in young women by directing attention to gynecological diseases.

Acute Disease↗
PubMed1993

[Anaphylactic reaction in streptokinase therapy].

Streptokinase is used worldwide as thrombolytic agent. Indications are deep vein thrombosis, arterial thrombosis and embolism, arteriovenous cannula occlusions, acute coronary artery thrombosis, and acute renal vein thrombosis. The major drawback in comparison with other thrombolytic drugs is its antigenicity. Allergic reactions have been reported but the underlying mechanisms have not yet been fully elucidated. A 58 year-old man with acute myocardial infarction developed an anaphylactic reaction immediately after commencement of streptokinase infusion, although immunological laboratory findings were not affected. The patient had no history of prior exposure to streptokinase, infections with streptococci, or chronic allergic reactions. 2 months after streptokinase therapy increased plasma levels were detected of specific IgG antibodies to streptokinase. The levels of specific IgE antibodies to streptokinase and other anti-streptococcal antibodies were within the normal range. A prick test performed 4 months later with 100 I.U. streptokinase was unremarkable. The problems of such allergic reactions are discussed on the basis of this case report and a review of the literature.

Anaphylaxis↗
PubMed1992

[Radiologic diagnosis of maxillary sinus aspergillosis].

Aspergillosis of the maxillary sinuses shows an increasing incidence in even otherwise healthy patients. Next to inhalation as the mode of infection, a dental root canal filling with an orosinusal fistula can be the cause. As most infections remain initially undetected or underestimated as common sinusitis, early diagnosis must be achieved. Standard X-ray of the paranasal sinuses, conventional tomography as well as CT scans are of major importance. Centrally located hyperdense opacifications are a good criterion and can be best seen in CT. Even when the case has not progressed too much, radical surgery combined with Amphotericin B therapy is still the treatment of choice since the infection may progress rapidly.

Adult↗
PubMed1991

AF-DX 116, a cardioselective muscarinic antagonist in humans: pharmacodynamic and pharmacokinetic properties.

Effects of AF-DX 116, a cardioselective antagonist, on M cholinergic receptors (M-ChR) were studied in healthy volunteers. Occupancy of M-ChR subtypes by drug present in plasma samples (radioreceptor assay) was compared with these effects. After an intravenous dose of AF-DX 116 saturating greater than 90% of cardiac M2-ChR, an increase in heart rate by 25 beats/min was observed. This cardiac receptor occupancy and effect wore off with a parallel time course within 10 hours. No inhibition of salivary flow was observed, coinciding with a lack of M3-ChR blockade in the radioreceptor assay. Beta-adrenergic receptor blockade by propranolol did not affect either of the effects. No indication for active metabolites or stereoselective drug metabolism was found comparing HPLC and receptor assay for drug concentrations in plasma. We conclude that AF-DX 116 may be a useful drug for the treatment of bradycardia. Its lack of troublesome side effects is the result of its selectivity for cardiac M-ChR.

Adult↗
PubMed1991

[Effect of the GnRH analog buserelin on sex hormone serum level in relation to treatment onset and duration].

Changes of serum estradiol, progesterone, LH, FSH, prolactin, testosterone, androstendione, DHEA and DHEAS levels during a GnRH-analogue (buserelin) treatment have been analysed retrospectively taking account of effectiveness of treatment and its relation to the beginning and duration of treatment. 1200 micrograms/day buserelin were administered intranasally from the first day of the menstrual cycle (n = 30) or the 7th hyperthermic day of the cycle (n = 22). The results proved, that the administration of buserelin to sterile women inhibits the ovarian (estradiol, progesterone) and pituitary (LH, FSH) hormone secretion during the first 10-14 days of treatment. The adrenal hormone secretion (DHEA, DHEAS) remained unaffected, whereas the androgens of ovarian origin (testosterone, androstendione) were suppressed during the GnRH analogue treatment. The serum prolactin level increased during the first two weeks of treatment and returned to pretreatment values within the following two weeks. On the basis of the faster suppression of estradiol secretion with buserelin treatment, beginning in the middle of the luteal phase, this therapy is recommended for ovarian suppression.

Adult↗
PubMed1990

[Comparison of 4 procedures in plasmapheresis: studies of modifying the hemostasis potential].

The separation of plasma using the systems "Plasmapur Monitor" (Fa. Organon), "Autopheresis-C" (Fa. Baxter) and "PCS" (Fa. Haemonetics) was compared with the conventional blood bag centrifugation. In 16 apheresis per method, several parameters with the main focus on blood coagulation were examined in addition to other criteria. Compared to conventional centrifugation of blood bags, the plasma separation machines led to an only slight activation of the coagulation system, which seems to be negligible for donors as well as recipients. Furthermore, a decrease of coagulation factors and inhibitors in the collected plasma was most pronounced using bag centrifugation. Beyond this, particularly in apheresis systems with plasma filtration the low number of remaining cells meets the aim to reach a high quality of transfused plasma.

Blood Coagulation Tests↗
PubMed1990

Patients with anti-Vel--immunohematological characterization and transfusion management.

As reported by other authors we can confirm that the frequency of the blood group Vel negative in Lower Saxony is 1:4000. We report on a patient whose serological characteristics (IgM- and IgA-anti-Vel) made the transfusion of Vel positive blood impossible. Since it was not possible to obtain sufficient Vel negative red cell units in time, the patient was convinced to donate blood for autologous transfusions. This should be the procedure of first choice in the transfusion management of such patients.

Blood Group Antigens↗
PubMed1990

T and Tk transformation in hemolytic uremic syndromes.

In two cases of hemolytic uremic syndrome (HUS) the bacterial pathogenesis of the disease could be elucidated by lectin red cell agglutination tests. The possible role of anti-T and anti-Tk antibodies is discussed. Transfusions of fresh plasma had no adverse effects. The fatal outcome in one case was caused by disseminated intravascular coagulation (DIC).

Agglutination Tests↗
PubMed1990

[Decreased vagal tone in hyperkinetic heart syndrome?].

Increasing amounts of atropine (0.03 mg + 0.07 mg + 0.01 mg + 0.25 mg + 0.5 mg + 1.0 mg + 1.5 mg; sigma = 3.5 mg, interval between injections: 30 min) were injected intravenously in a cumulative manner in five patients with hyperkinetic heart syndrome and in seven healthy volunteers. The heart rate increased from 93 to 127 beats per min in patients, and from 63 to 104 beats per min. in controls. The diastolic blood pressure slightly increased in both groups, whereas the systolic blood pressure did not change significantly. The accommodation diminished from 6 to 2 dioptries in patients, and from 8 to 5 dioptries in controls. Salivary flow fell from 1.6 to 0.1 g/min in patients with hyperkinetic heart syndrome, and from 1.3 to 0.1 g/min in control persons, respectively. The maximum occupancy of muscarinic receptors (m2-glandular), as measured in plasma specimens by means of a radioreceptor assay, reached more than 80% in each group. The dose-response-curves of atropine were highly comparable in patients and controls. It is concluded that the effects of atropine are essentially the same in patients with hyperkinetic heart syndrome and in healthy control persons. There is no evidence for a diminished vagal tone in such patients.

Adult↗
PubMed1989

AF-DX 116 discriminates heart from gland M2-cholinoceptors in man.

The M2-cholinoceptor subtype selective antagonist AF-DX 116 was compared with atropine with respect to effects on heart rate and salivary flow in healthy volunteers. These effects were related with in vitro occupancy of M-cholinoceptor subtypes in radioreceptor assays of plasma samples. Radioreceptor assays comprised M1-cholinoceptors in bovine cerebral cortex and M2-cholinoceptors in pig heart and rat salivary gland membranes. 3H-pirenzepine served as a label in the cerebral cortex 3H-N-methyl-scopolamine in the heart and gland preparations. Oral administration of 240 mg AF-DX 116 led to a time dependent increase in heart rate with a maximum effect comparable to atropine 40 micrograms/kg i.v. The effects of both drugs on heart rate were matched by a greater than 80% occupancy of heart M2-cholinoceptors in the radioreceptor assay of plasma samples. In contrast to the complete inhibition of salivary flow after atropine, AF-DX 116 induced an increase of salivation. The effects on salivary flow coincided with a greater than 80% occupancy of glandular M2-cholinoceptors after atropine but no detectable occupancy after AF-DX 116. Occupancy of the M1-subtype amounted to 61.7% after AF-DX 116 and a blockade of inhibitory, presynaptic M1-autoreceptors at missing postsynaptic blockade of glandular M2-cholinoceptors might explain the hypersalivation induced by AF-DX 116.

Adult↗
PubMed1989

[Reform of the right of power of attorney, guardianship and assistance--draft of the discussion of a nursing care law].

The Federal Minister of Justice has published a "Bill of a Care and Assistance Law" (Betreuungsgesetz) which has been elaborated by a an independent, interdisciplinary team of experts. The new law which is intended to replace the old law on guardianship and tutelage set into force in 1900 is actually widely discussed among politicians, lawyers, medical doctors and other people who are concerned.

Disability Evaluation↗
PubMed1989

Selective antagonists reveal different functions of M cholinoceptor subtypes in humans.

Effects of atropine and of the subtype selective mAChR antagonists pirenzepine (PZ) and AF-DX 116 were studied in humans. Dose- or time-response curves were established for heart rate and salivary flow. Plasma samples were drawn in parallel with the effect measurements and analysed for drug concentrations. Subtype-selective radioreceptor assays of the samples served to estimate the respective receptor occupancy in vivo. It is shown that low doses of PZ (M1-selective blockade) cause cholinomimetic effects indicated by bradycardia and increase in salivary flow. After high doses of PZ or atropine, tachycardia and inhibition of salivary flow are observed in parallel with occupancy of both the M2 and M3 subtypes. AF-DX 116 induces a tachycardia together with an increased salivary flow in agreement with its selectivity profile (M2 greater than M1 greater than M3). The diagnostic and therapeutic applications of M1- or M2-selective blockade by low dose PZ or AF-DX 116 respectively are discussed.

Humans↗
PubMed1987

Insufficiency of carotid and vertebral flow velocity in cerebrovascular disease: a continuous wave Doppler study.

In patients with cerebrovascular disease, quantitative Continuous Wave Doppler sonograms were made of carotid and vertebral arteries. In transient ischaemic attacks (TIA) all flow velocity insufficiencies were found to be related to stenosis. In stroke, however, a relatively high percentage of insufficiencies proved not to be related to stenosis. A disturbed autoregulation seems the most acceptable explanation.

Aged↗
PubMed1986

Immunogenicity of recombinant hepatitis B vaccine in dialysis patients.

Eighty-eight dialysis patients were vaccinated with recombinant hepatitis B vaccine prepared in yeast. Fourty-nine patients were immunized 3 times (months 0, 1, 6) intragluteally with 40 micrograms hepatitis B surface antigen (HBsAg) per dose. Only 32 of them (65.3%) showed anti-HBs concentrations above 10 IU/l with a geometric mean titer (GMT) of 180.7 IU/l after 3 vaccinations, whereas all of the 16 healthy controls, vaccinated 3 times with a 10-micrograms dose of the same vaccine batch, had specific antibodies higher than 10 IU/l (GMT 897.4 IU/l). Responses of patients were slightly higher than those of dialysis patients vaccinated in an earlier study with plasma-derived vaccine according to the same schedule. Results in 20 patients immunized 6 times intragluteally with 40 micrograms HBsAg/dose in monthly intervals were not better (at month 7, 65% showed anti-HBs concentrations greater than 10 IU/l; GMT = 126.6 IU/l), and 19 patients receiving 6 times 20 micrograms HBsAg monthly showed significantly lower responses (anti-HBs greater than 10 IU/l in 42% of vaccinees, GMT = 89.5 IU/l). The vaccine was tolerated well; side-effects were slight, and no serious adverse reactions were observed. In conclusion, recombinant hepatitis B vaccine is comparable to plasma-derived vaccine also in the case of dialysis patients; a 6-dose schedule does not seem to have much advantage compared to the conventional 3-dose regimen.

Adult↗
PubMed1982

D-penicillamine in Wilson's disease presenting as acute liver failure with hemolysis.

Wilson's disease in a young woman presenting with an acute course is described. The clinical manifestations were fulminant hepatic failure associated with marked intravascular hemolysis. Immediate D-penicillamine and high-dose steroid therapy did not influence the course of the disease. Necropsy revealed an increased hepatic copper content and cirrhosis with extensive necrosis of the liver.

Acute Disease↗