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Biomedical subjects

D Heinrich

Publications and source records attributed to D Heinrich.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1985

Monoclonal antibodies against human platelet membrane glycoproteins IIb-IIIa. II. Different effects on platelet function.

Preincubation of human platelets with two pairs of immunologically identical monoclonal antibodies (mab) directed against epitopes on the membrane glycoprotein IIb-IIIa complex - two of them (Gi3 and Gi5) precipitating glycoproteins IIb-IIIa, and two (Gi4 and Gi6) recognizing glycoprotein IIIa - induced slightly different inhibitory effects on platelet function. Gi3 and Gi5 blocked platelet aggregation and 14C-serotonin release from platelets induced by ADP, collagen, thrombin, arachidonic acid, ionophore A 23187, platelet activating factor and ristocetin (in the presence of divalent ions). Ristocetin-induced platelet agglutination (in the presence of EDTA) was not inhibited by these mab. Gi4 had no effect on platelet aggregation and release. Gi6 had the same effect on platelet function as Gi3 and Gi5, but only when incubated with Zw(a) (PlAl)-positive platelets with the exception that collagen-induced aggregation was not affected. We conclude that the similar, though not identical, effects on platelet function induced by mab against different epitopes on the glycoprotein complex IIb-IIIa indicate an "unspecific" interference with platelet membrane function possibly due to steric hindrance by mab of the fibrinogen receptor or by inhibition of conformational changes in the GP IIb-IIIa complex necessary for exposure of the fibrinogen binding site.

Antibodies, Monoclonal↗
PubMed1985

Permeability studies of the guinea pig placental labyrinth. II. Tracer permeation and freeze-fracture of fetal endothelium.

Permeability of the fetal endothelium within the guinea pig placental labyrinth is studied by means of horseradish peroxidase (HRP) and ionic lanthanum as diffusion tracers. The paracellular transport of HRP is restricted by the occluding junctions of the fetal endothelium. In contrast, ionic lanthanum readily permeates most of the intercellular junctions and rapidly infiltrates the basal lamina. Freeze-fracture replicas reveal zonulae occludentes connecting the fetal endothelial cells. The network of the zonulae occludentes is variable, exhibiting highly complex areas as well as single strand interconnections. A correlation between the permeability studies and freeze-fracture findings is discussed.

Animals↗
PubMed1985

[Complications and side effects of artificial ascites for adhesion prevention].

The side-effects of "artificial ascites" induced with Dextran 60 (Makrodex 6%) as a mean of preventing adhesions were investigated in 47 patients (treatment group: 32 patients; control group: 15 patients) in whom microsurgery had been performed for infertility with adhesiolysis. On the day of surgery and the following four days 300 to 500 ml of Makrodex was instilled via an intraperitoneal catheter (7.5 ml/kg body weight on day of surgery; 5 ml/kg body weight on days 2 to 5). In addition, the patients received, on the day of surgery, single doses of 450 IU of hyaluronidase (Kinetin), 500,000 KIU of aprotinine (Trasylol) and 1 g of hydrocortisone acetate instilled intraperitoneally. In the group treated with Dextran, there was a significantly higher number of patients who felt unwell and had abdominal complaints and dyspnea. In six cases in the Dextran group a vulval edema was seen, and in 2 cases a thigh edema. A significant weight increase and elevation of central venous pressure occurred for the duration of the "artificial ascites" in this group. There were a few cases of bradycardia with frequencies of under 50 beats per minute. On the fifth p.o. day 75% of the patients in the Dextran group had a pleural effusion. Such changes were not observed in the control group. In view of these side-effects and the fact that it is still not proven that Dextran effectively prevents adhesions we no longer carry out this form of adhesion prophylaxis.

Adult↗
PubMed1985

[Thrombosis of a St. Jude Medical valve in malignant lymphoma and extensive blood vessel malformation].

We present a case of thrombosis of a St. Jude Medical valve in mitral position at the time of manifestation of an acute malignant lymphoma. Since valve thrombosis and the onset of acute malignant lymphoma appeared simultaneously, we conclude that the malignant lymphoma may have been the cause of valve thrombosis. In our case report we discuss the genesis and prophylaxis of valve thrombosis during malignant disease.

Heart Valve Prosthesis↗
PubMed1985

[Effects of prostacyclin (PGI2) on tachycardic heart arrhythmias following aortocoronary venous bypass operations].

In a prospective double-blind study of 40 male patients requiring aorto-coronary bypass surgery, a dose of 8 ng/kg/min of PGI2 was infused throughout extracorporeal circulation (ECC) (control group: glycine buffer). Between the two treatment groups there was no difference in preoperative hemodynamic parameters, number of preoperative infarctions, or number of implantated aorto-coronary vein grafts. Before, during and up to one day after ECC, extensive hemodynamic and hemostaseologic examinations were performed repeatedly (a total of twelve times in each patient). During ECC and due to inhibition of platelet function, platelet counts were significantly higher in the PGI2-treated group without clinical evidence for an increased bleeding tendency. Systemic blood pressure, heart rate and perfusion pressure did not differ significantly in the two treatment groups (with the exception of one control 60 minutes after onset of ECC). Peri- and postoperative function of the kidneys and lung also demonstrated similar results in both treatment groups. The platelet preserving effect of PGI2 correlated with a significant decrease of severe arrhythmias (tachyarrhythmias before termination of extracorporeal circulation) and a reduction in mechanical reperfusion. It is suggested that PGI2 exerts its beneficial effect on the myocardium by inhibiting platelet aggregation and/or by an antiarrhythmic effect on the myocardium. Whether the antiarrhythmic effect of PGI2 on the myocardium is indirect (reduction of microcirculatory disorders produced by inhibition of platelet aggregation) or direct (electrical stabilization of the myocardial cell membrane), is the subject of further investigations.

Carbon Dioxide↗
PubMed1984

[Antithrombin III changes following myocardial infarct].

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 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↗
PubMed1984

[Treatment of intestinal atony following gynecologic operations. Study on the effectiveness and tolerance of ceruletide].

The efficacy and tolerability of Ceruletide and Neostigmin were compared in patients with postoperative intestinal atonia after extensive gynecological surgical operations. Patients treated with Ceruletide (n = 30, dosage of Ceruletide 2 ng/kg/min. i.v.) showed earlier defecation than the Neostigmin-group (n = 30, dosage of neostigmin 3 x 0,5 mg/die). The frequency of side effects was comparable in both groups, patients treated with Ceruletide suffered mainly from gastrointestinal symptoms (nausea) whereas patients treated with Neostigmin complained of disorders of circulation. Ceruletide is faster effective than Neostigmin, the tolerability of both drugs is equivalent.

Blood Pressure↗
PubMed1984

Distribution of NT-IR perikarya in the brain of the guinea pig with special reference to cardiovascular centers in the medulla oblongata.

The occurrence and distribution of neurotensin-immunoreactive (NT-IR) perikarya was studied in the central nervous system of the guinea pig using a newly raised antibody (KN 1). Numerous NT-IR perikarya were found in the nuclei amygdaloidei, nuclei septi interventriculare, hypothalamus, nucleus parafascicularis thalami, substantia grisea centralis mesencephali, ventral medulla oblongata, nucleus solitarius and spinal cord. The distribution of NT-IR perikarya was similar to that previously described in the rat and monkey. In the gyrus cinguli, hippocampus and nucleus olfactorius, though, no NT-IR neurons were detected in this investigation. Additional immunoreactive perikarya, however, were observed in areas of the ventral medulla oblongata, namely in the nucleus paragigantocellularis, nucleus retrofacialis and nucleus raphe obscurus. The relevance of the NT-IR perikarya within the ventral medulla oblongata is discussed with respect to other neuropeptides, which are found in this area, and to cardiovascular regulation.

Animals↗
PubMed1984

Systemic short-term fibrinolysis with high-dose streptokinase in acute myocardial infarction: time course of biochemical parameters.

The course of plasma catalytic activities of total creatine kinase, creatine kinase isoenzyme MB, total, cytoplasmatic and mitochondrial aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase, glutamate dehydrogenase and concentrations of myoglobin, urea, acidic alpha 1-glycoprotein and creatinine were followed in 33 patients suffering from acute myocardial infarction. All patients were randomized in a double-blind, prospective study. One group (18 patients) was infused with streptokinase 1.5 X 10(6) units/90 minutes; the control group received routine continuous i.v. heparin treatment (1000 units/h). Ten hours after completion of the study protocol, treatment of both groups of patients was continued with heparin, 1000 units/h and Aspisol, 1 g/day2). Streptokinase treatment induced earlier wash-out and therefore earlier peak levels of several enzymes: total creatine kinase (11 hours), creatine kinase isoenzyme MB (6 hours), total and cytoplasmatic aspartate aminotransferase (6 hours) and lactate dehydrogenase (9 hours). Total creatine kinase peak catalytic activity and myoglobin peak concentration were higher in the group receiving thrombolytic therapy. A significantly different course of catalytic activity between both treatment groups was found for total creatine kinase and creatine kinase isoenzyme MB, total and cytosolic aspartate aminotransferase, lactate dehydrogenase and alpha-hydroxybutyrate dehydrogenase. The course of mitochondrial aspartate aminotransferase catalytic activity was different only 12 hours after the beginning of treatment. The shift of several catalytic activities to an earlier peak level in plasma may indicate reperfusion of ischaemic myocardium due to thrombolytic therapy.

Adult↗