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Biomedical subjects

D Heinrich

Publications and source records attributed to D Heinrich.

At least 19 recordsLinked to original sources
PubMed1991

Omega-oxidized leukotriene B4 detected in the broncho-alveolar lavage fluid of patients with non-cardiogenic pulmonary edema, but not in those with cardiogenic edema.

Leukotriene (LT) generation has been implicated in the pathogenesis of the acute respiratory distress syndrome, ARDS. In the present study, we analysed broncho-alveolar lavage fluids of patients on mechanical ventilation because of ARDS (17 samples taken from 9 patients) or because of cardiogenic edema (8 samples taken from 6 patients) and of healthy volunteers (10 samples from different donors). LTs were separated as methylated and non-methylated compounds using different HPLC procedures, and were identified by chromatographic mobility, on-line UV-spectrum analysis and post HPLC immunoreactivity. In the lavage samples of the healthy volunteers and the patients with cardiogenic edema, no LTs were detected by these techniques (detection limit congruent to 0.1-0.2 ng/ml lavage fluid). By contrast, in 15 out of 17 samples from patients with ARDS LTB4 or its metabolites 20-OH-LTB4 and 20-COOH-LTB4 were detected. The endproduct of omega-oxidation, 20-COOH-LTB4, represented the quantitatively predominant compound, detected in the range of 0.3-2.6 ng/ml perfusate. We conclude that the chemotactic agent LTB4 may be involved in the amplification of inflammatory events encountered in ARDS, and that the oxidized metabolites of LTB4 are particularly suitable for monitoring lung leukotriene generation under conditions of neutrophil efflux and oxidative stress.

Adult↗
PubMed1990

Virus safe plasma exchange medium containing essential human plasma proteins.

CFFP (Coagulation Factor Free Plasma from Biotest) is manufactured under standardized conditions from pooled human plasma of more than 1000 donors per lot. It is sterilized by beta-PL/UV and has not the risks of FFP to transmit viral diseases. CFFP offers desirable advantages as a plasma exchange solution over albumin and FFP as it avoids serious depletions or deviation of normal plasma constituents.

Blood Proteins↗
PubMed1990

[Pulmonary function parameters of shock lung patients--results of a follow-up study].

In seventeen patients out of a total of 219 survivors who had received long-term ventilation for pulmonary failure, an examination was carried out to clarify the question as to late pulmonary sequelae. The following sequelae were detected: 1. a diffusion disturbance in five cases, 2. load-dependent pulmonary hypertension in four cases, and 3. a considerable reduction in compliance.

Adult↗
PubMed1988

Deposition of terminal C5b-9 complement complexes on erythrocytes and leukocytes during cardiopulmonary bypass.

Hemolysis, leukopenia, a hemostatic deficit, and nonspecific systemic reactions collectively known as the postperfusion syndrome develop in patients who undergo cardiopulmonary bypass. We now report that terminal C5b-9 complement complexes are deposited on erythrocytes and polymorphonuclear neutrophilic leukocytes during cardiopulmonary bypass. Plasma samples taken from 48 unselected patients during and at the end of cardiopulmonary bypass contained raised levels of fluid-phase SC5b-9 complement complexes, indicating that the complement sequence had been activated to completion. Various degrees of overt intravascular hemolysis were observed in all the patients, and lysed erythrocyte membranes were recovered from the blood samples. Immunoassays performed with use of antibodies to C5b-9 neoantigens demonstrated the presence of C5b-9 on red-cell ghosts but not on intact erythrocytes. The appearance of ghosts carrying C5b-9 always coincided with hemolysis. Furthermore, granulocytes isolated from 20 patients during bypass were all found to carry C5b-9 complexes, whereas cells isolated before or 24 hours after surgery carried no C5b-9. The neoantigen-positive material present in detergent extracts of granulocytes sedimented in a broad peak (25 to 40 sedimentation coefficient [S]) in sucrose-density gradients, exactly as did pore-forming C5b-9 complexes. Deposition of C5b-9 on blood cells during cardiopulmonary bypass may be partly responsible for the hemolysis and may augment granulocyte activation by the stimulation of arachidonate metabolism in those cells.

Autoantibodies↗
PubMed1988

"Haemostasis time", a modified bleeding time test and its comparison with the Duke and Ivy/template bleeding times. II. Application in bleeding disorders.

"Haemostasis time" (HT), the occlusion time of a Butterfly 25 short cannula inserted into the cubital vein, is a bleeding time modification comparable to the skin bleeding times according to Duke and Ivy/Mielke. It also measures platelet function and is not influenced more than the latter tests by clotting factors. In HT, subendothelium is replaced by a standard artificial surface. The technique was investigated in patients with haemophilia A and B, von Willebrand's disease (vWD), and defects of factors VII and XI. HT was prolonged in 9/16 patients with haemophilia A/B, but did not correlate with the factor VIII:C/IX:C values. However, it reflected the different bleeding tendencies in those patients as represented by early or late onset of bleeding symptoms and occurrence of spontaneous haemarthroses. Of the vWD patients, not classified by multimeric analysis, 15/31 had prolonged Simplate II bleeding times, 14/31 prolonged HTs. Only 20/31 patients had corresponding normal or prolonged bleeding times with both techniques. HT correlated significantly with the Duke bleeding time (p = 0.011), ristocetin cofactor activity (p = 0.003) and von Willebrand factor antigen (p = 0.022), while no correlations were found between these parameters and the Simplate II method. Statistical evaluation shows, that in vWD, HT can replace the less precise Duke bleeding time but not the non-related Ivy/Simplate techniques.

Adolescent↗
PubMed1988

Effects of unfractionated and fractionated heparin on platelet function.

Heparin-induced alterations of platelet function have repeatedly been reported over the last 30 years. The development of low-molecular-weight (LMW) heparin fractions prompted us to compare the effect of unfractionated (UF) heparin and LMW heparin on platelet function. Heparin was applied intravenously to healthy volunteers in a dose of 100 U (antifactor Xa)/kg body weight. Sequential evaluation of platelet function ex vivo confirmed that UF heparin may activate platelets in vivo. Studying the ADP-induced fibrinogen binding to platelets in vivo, we were able to show that the effect of heparin on platelets is antibody- and antithrombin-III-independent. LMW heparin fractions in general exhibit a reduced platelet activating activity although there are differences between the LMW heparin fractions available. The stimulating effect of LMW heparin on platelets disappears below a mean molecular weight of 3,000 daltons.

Blood Platelets↗
PubMed1988

Alterations of antithrombin III after acute myocardial infarction.

The antithrombin III (AT III) activity and the AT III concentration were investigated in 62 consecutive patients with acute myocardial infarction (AMI). To identify the reactant pattern of AT III in postaggressive situations, we also determined labile and acute phase proteins. Firstly, 29 patients were nourished orally and then 33 patients were fed by i.v. hyperalimentation (additional caloric intake of approximately 1,000 cal). AT III activities and concentrations as well as prealbumin and retinol-binding protein decreased concomittantly and significantly whereas haptoglobin, C-reactive protein and fibrinogen increased significantly after AMI. The changes cannot be interpreted as being alterations of the haematocrit. The alterations of AT III correlated significantly with the changes of labile proteins but not with the acute phase reactant proteins. The AT III decrease in the postinfarctional phase may promote a prethrombotic state. In In addition it can be concluded from our results that AT III reacts as (nutritive-dependent) labile protein, which is lowered in postaggressive situation and does not increase as an acute phase reactant. This is in accordance with results from recent animal experiments.

Antithrombin III↗
PubMed1987

Immunohistochemical and biological evidence for a neuromodulator function of neuropeptide Y in the human oviduct.

By means of the peroxidase-antiperoxidase technique the existence of neuropeptide Y-immunoreactivity (NPY-IR) in nerve fibers of the normal human uterine tube was established. NPY-IR fibers are found to supply vascular and non-vascular smooth muscles of the uterine tube. In both systems the density of NPY-IR nerves is markedly high. The NPY-IR nerves exhibit a predominance for the arterial portion of the oviductal vasculature in the serosal, the muscle and the mucosal layer. Furthermore in the mucosal layer, some NPY-IR fibers occur in contact with the surface epithelium. In-vitro experiments with helical strips of the human uterine tube reveal no significant effects of NPY alone of the different parameters (resting tension, frequency and amplitude of spontaneous contractions) of mechanical activity while it seems to act in combination with acetylcholine. Thus, the distinct innervation patterns of the NPY-IR nerve fibers as well as the results obtained by bioassay may suggest a neuromodulator function of this neuropeptide in the human uterine tube. In this respect, NPY may play an important role in the transport of the eggs through the tube.

Arteries↗
PubMed1987

[Significance of the examination position in urodynamic assessment of female urinary incontinence].

The present paper describes a test center which permits urodynamics tests with the patient in various positions, such as lithotomy position (A), supine position with outstretched legs (B) and, by continuously raising the patient, upright position (C). The results of a comparative investigation show the influence of these different examination positions on urodynamic parameters, in particular the functional length of the urethra and maximum urethra closing pressure at rest. Urodynamic tests on 40 patients with urinary incontinence showed that there is a significant increase in the functional length of the urethra when the patient is in lithotomy position (A) as compared to lying with outstretched legs (B), and that it is once again significantly reduced when the patient is raised to upright position. Maximum urethra closing pressure at rest drops significantly when the patient is repositioned from lithotomy (A) to supine (B) position, and once again rises significantly when she is raised to the upright (C) as compared to the supine (B) position. In the light of the changes described, which cause major changes in the form of the urethra pressure profile, it makes sense to perform urodynamic measurements in at least two different positions. The authors recommend the supine position with outstretched legs (B), as it appears more physiological than the lithotomy position (A), and measurement in the upright position (C). The importance of positioning with regard to the diagnostic information value in determining the cause of urinary incontinence is discussed.

Adult↗
PubMed1987

Virus safety of beta-propiolactone treated plasma preparations. Clinical experiences.

Sterilization of human plasma with beta-propiolactone and UV-irradiation (cold sterilization) has been shown to be effective for a number of common pathogenic viruses. We have published data on the hepatitis safety of cold sterilized factor IX concentrates (PPSB) in healthy volunteers. This study has now been extended to include 6 virgin hemophilia B patients, who have been treated with cold sterilized PPSB for a period of up to 5 years. None of these volunteers or patients exhibited clinical symptoms or laboratory data indicating the transmission of either viral hepatitis (B or NANB) or acquired immunodeficiency syndrome (AIDS). Hyperimmunoglobulin (HIg) preparations from cold sterilized plasma, offering protection against hepatitis B and NANB are also safe regarding HTLV-III virus transmission, even though these preparations may contain HTLV-III antibody titers up to 1:1000.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Posttransfusion purpura. A survey of 13 cases.

Thirteen cases of posttransfusion purpura (PTP) which were diagnosed in Germany and Austria from 1977-1985 are described. All patients were women with a mean age of 58.6 years (range, 36-77 years). All but one had been pregnant and received blood transfusions 2 to 12 days prior to the onset of PTP. The thrombocytopenic purpura was always severe with a nadir of platelet counts below 10 X 10(9)/l and lasted between 3 and 60 days. All patients recovered from PTP. Optimal therapy consisted of administration of high-dose IgG. Twelve of the 13 patients had developed platelet-specific Zwa antibodies (eight of them together with HLA antibodies), in one Zwa positive individual only HLA antibodies were detectable. Five of six HLA-DR typed patients carried DR3 which is considered an immunogenetic risk factor in PTP. Clinical awareness of this rare, but serious iatrogenic transfusion complication is prerequisite for prompt diagnosis and improved therapy.

Adult↗
PubMed1986

Early detection of amatoxins in human mushroom poisoning.

Amatoxins were detected radioimmunologically as early as 90-120 min after ingestion in the gastric fluid and urine of a 15-year-old boy who tried to commit suicide by ingestion of wild mushrooms. This early detection of amatoxins in the urine is proof of rapid absorption from the intestinal tract and subsequent excretion by the kidneys in man.

Adolescent↗
PubMed1986

Peptidergic innervation of the human and guinea pig uterus.

The peptidergic innervation of the human and guinea pig uterus was studied using immunohistochemical methods. Antibodies against several peptides were applied for the PAP-technique to stain peptidergic nerves specifically. These are located in the adventitia of large uterine vessels in the myometrium and smaller vessels of the myometrium and endometrium. A differential distribution of the individual peptides was observed for VIP-IR (vasoactive intestinal polypeptide immunoreactivity), NPY-IR (neuropeptide Y), SP-IR (substance P), SOM-IR (somatostatin) and NT-IR (neurotensin) nerve fibers. Specific functional implications for these neuropeptides can be derived from their histochemical location.

Animals↗
PubMed1986

[Light and electron microscopy changes in the endometrium caused by the administration of a norgestimate-containing oral contraceptive (Cilest)].

Endometrium morphology has been analysed by means of light microscopy, scanning and transmission microscopy in patients before and during treatment with a norgestimate containing low dose combined pill (Cilest). Endometrium biopsies were taken after 1 (N = 3), 2 (N = 3), 3 (N = 7), 5 (N = 1) and 6 (N = 4) OC cycles. Light microscopy of the endometrium obtained during the OC-free pretreatment cycles shows a regular secretory transformed endometrium. During the first OC cycles of Cilest treatment slight growth retardation of endometrial glands was observed. Endometrium after 3 to 6 OC cycles showed an increasing delay of the growth of endometrial glands in terms of an abortive secretion. Morphometric studies revealed a retardation of the development of endometrial glands and an "arrest of secretion". The degree of proliferation varied slightly; a general delay between the date of the menstrual cycle and endometrial dating was evident. Using scanning electron microscopy the endometrium presented mostly a regular surface corresponding to the midcycle or a late proliferative phase up to the early secretory phase. Infiltrative dysplasia or inflammatory changes as well as local proliferations could not be detected. In transmission electron microscopy with semi-thin and ultrathin slices, stroma, structure of glands and surface appeared to be normal. Furthermore, no time delay between the endometrium and the day of menstrual cycle was observed. During treatment with a norgestimate containing low dose combined pill, only slight changes of the endometrium in terms of a growth retardation of endometrial glands were seen in the first 6 treatment cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

Contraceptives, Oral, Combined↗
PubMed1986

Complications of intraperitoneal dextran application for prevention of adhesions.

In 47 patients (dextran group: 32 patients, control group: 15 patients) undergoing laparotomy for microsurgical detachment of adhesions and tuboplasty, the complications of a repeated postoperative intraperitoneal instillation of 6% dextran 60 (5 days) were monitored. In the dextran treated group, abdominal pain and dyspnea occurred significantly more frequently than in the control group. In 6 cases, we observed an edema of the vulva and in two cases an edema of the thigh. During the intraperitoneal irrigation with dextran, a significant increase of body weight and central venous pressure occurred. Bradycardia was observed between the 3rd and 6th postoperative days. Blood pressure remained unchanged. 75% of the patients in the dextran group had pleural effusions containing dextran on the 5th postoperative day. We think that the uncertain desired effects of dextran in the prevention of adhesions do not outweigh the certain and substantial undesired side effects.

Adult↗