Biomedical subjects
E Ernst
Publications and source records attributed to E Ernst.
Regional variations in plasma fibrinogen levels.
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Air travel, DVTs and pulmonary embolism.
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[Lumbago: rest or movement?].
Today, its epidemic frequency makes back pain a major problem. Bed rest continues to be a common form of treatment. However, it also leads to a number of effects that must be considered negative in this situation. In contrast, physical exercise may, in principle, have a positive effect on a variety of functional systems. Controlled clinical studies show that bedrest, in particular if longer than two days, is of no advantage. Thus, these patients should be less often confined to bed, but, should instead be encouraged to take sensible physical exercise and accept more responsibility for their own health. A change in attitudes would appear desirable on the part both of the physician and the patient.
Ultrastructural localization of silver in rat testis and organ distribution of radioactive silver in the rat.
The deposition of silver after a single intravenous injection (2 micrograms Ag g-1 body weight) was studied in the testes of Wistar rats 24 h and 1 and 2 weeks after dosing with radiolabelled 110AgNo3 (2 micrograms Ag and 1.2 kBq g-1 body weight). Also, the temporal accumulation of silver during the experimental period was monitored in the blood, testes, epididymides, kidney, liver and brain. The subcellular distribution of silver within the testes was demonstrated by using the histochemical technique of autometallography. Silver was cleared rapidly from the blood. After an initial rise, concentrations in organs remained almost stable throughout the experimental period. Silver was especially abundant in interstitial macrophages and in the basement membrane. Deposits of silver were found in all cell types of spermatogenesis and in the lysosomes of the Sertoli cells.
Tumour necrosis factor alpha and interleukin-2 in plasma from rheumatoid arthritis patients in relation to disease activity.
Tumour necrosis factor alpha (TNF alpha) and interleukin-2 (IL-2) are potential immunological mediators of pathogenetic changes in rheumatoid arthritis. We measured the concentrations of TNF alpha and IL-2 in plasma from 2 groups of patients suffering from rheumatoid arthritis (RA). One group had high and one had low disease activity. In addition, in connection with steroid treatment in the high disease activity group, TNF alpha was significantly increased in plasma from RA patients with high disease activity compared with those of low disease activity (p = 0.0009). Furthermore, TNF alpha decreased significantly in relation to steroid medication, parallel to clinical improvement (p = 0.016). All IL-2 concentration measurements were within the estimated normal range. The increased TNF alpha plasma levels in patients with rheumatoid arthritis with high disease activity, might result from activated white mononuclear cells in the inflamed joints. This might, in part, support the theory that TNF alpha is a possible mediator of pathogenetic changes known to occur in rheumatoid arthritis.
Ultrastructural demonstration of mercury in Sertoli and Leydig cells of the rat following methyl mercuric chloride or mercuric chloride treatment.
The autometallographic silver enhancement technique has been used to demonstrate the ultrastructural localization of mercury in the testes of adult rats. Administration of mercuric chloride or methyl mercuric chloride in the drinking water (20 mg/L for 12 weeks) resulted in intracellular accumulations of mercury in the interstitial Leydig cells as well as in the Sertoli cells of the seminiferous tubules.
In vitro exposure of human spermatozoa to mercuric chloride--a histochemical study.
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[The ultrasonic diagnosis of an ulnar nerve lesion in the sulcus area].
The diagnostic accuracy of ultrasound in ulnar nerve irritation syndrome was evaluated. 7 patients were examined and compared to a control group of 5 healthy persons. We correlated pathological changes with clinical signs and symptoms, nerve conduction velocity and with the operation report. Ultrasound yielded no false negative or false positive results and is therefore a valuable method for the evaluation of the ulnar nerve irritation syndrome especially in cases of vague localisation of the nerve lesion.
Association between plasma viscosity and blood pressure. Results from the MONICA-project Augsburg.
The relationship between determinants of blood viscosity and blood pressure (BP) variables was studied in a large sample of a population aged 25 to 64 years. Plasma viscosity, hemoglobin, and total serum protein were examined. Systolic and diastolic BP and the prevalence of hypertension showed a crude positive association with plasma viscosity levels in both sexes. Age, body mass index, and total serum protein appeared to have a confounding effect on this relationship, whereas hemoglobin, smoking behavior, and alcohol consumption did not. A crude positive association was also found between total serum protein levels and the prevalence of hypertension in men and women; however, since total serum protein was treated as a covariable, no further analyses were carried out. In contrast to findings reported in the literature, hemoglobin levels were not correlated with BP variables in either sex. After adjusting for all confounders, a significant main effect of plasma viscosity still was found. However, the magnitude of the effect was not as large as for body mass index, a well-established risk variable for hypertension. These results indicate that BP is positively associated with plasma viscosity. Whether increased plasma viscosity in hypertension constitutes a primary or a secondary phenomenon remains to be answered. Since plasma viscosity is significantly associated with hypertension but any BP variable, increased levels of plasma proteins (particularly fibrinogen as the main determinant of plasma viscosity) may represent the cause for elevated plasma viscosity. This might contribute to persistently increased resistance to blood flow on the microcirculatory level in arterial hypertension.
n-3 fatty acids and acute-phase proteins.
The aim of this study was to determine the effects of n-3 fatty acids on acute-phase proteins and response. Healthy male volunteers were submitted to standard bicycle ergometry once without supplementation and a second time after 3-weeks supplementation with highly purified n-3 fatty acids (1.75 g eicosapentaenoic acid and 1.05 g docosahexaenoic acid per day). Acute-phase proteins (immunoglobulin M, complement C4, haptoglobin, C-reactive protein, alpha 2-macroglobulin, coerulopasmin, fibrinogen, alpha 1-glycoprotein) were measured before, immediately after, 24 and 72 h after exercise. There were significantly lower values of immunoglobulin M (pre-exercise and at 72 h) and alpha 2-macroglobulin (pre-exercise) when cross-sectionally comparing the baseline data with and without n-3 supplementation. Longitudinal comparisons show that the ergometric test induced a discrete acute-phase reaction, which is evident with and without n-3 fatty acids. Yet the kinetics of the response seem to be altered by n-3 supplementation. The relative increase of most acute-phase proteins is numerically larger and the rise persists longer, which is particularly evident for fibrinogen and alpha 1-glycoprotein. The findings suggest that n-3 fatty acids lower acute-phase proteins at baseline and alter the pattern of change following acute exercise.
Impaired blood rheology: a risk factor after stroke?
The hypothesis that blood rheology is of prognostic value in stroke patients was tested in a prospective study. A total of 523 patients in the rehabilitation phase of stroke (outside the acute phase reaction after stroke) were tested for blood, serum and plasma viscosity, haematocrit, fibrinogen, red cell aggregation and deformability, ESR, white cell count, cholesterol and triglycerides. Endpoints were defined as a second stroke (lethal or not) within 2 years after the initial examination. Patients suffering such endpoints exhibit elevated blood viscosity, red cell aggregation, plasma and serum viscosity, fibrinogen and cholesterol levels, compared to patients without endpoints. It is concluded that rheological factors are associated with the prognosis after a first stroke.
Effects of felodipine ER and hydrochlorothiazide on blood rheology in essential hypertension--a randomized, double-blind, crossover study.
The haemorheological effects of felodipine extended release (ER), a new dihydropyridine calcium antagonist, were compared with hydrochlorothiazide (HCTZ) in 28 mild to moderate hypertensives (18 men and 10 women, aged 30-70 years) in a randomized, double-blind, crossover trial. Antihypertensive drugs were gradually discontinued. Felodipine Er, 10 mg, was given once daily for 2 weeks, and after another wash-out period of 1 week, patients were switched to 25 mg HCTZ, once daily, and vice versa. Whole blood viscosity (BV) at three different shear stresses, haematocrit (Hct), plasma viscosity (PV), red blood cell (RBC) aggregation, RBC deformability, and fibrinogen were measured under standardized conditions 2.5 h after medication, and after 2 week of treatment (24 h post-dosing). Felodipine ER improved BV acutely, but not during treatment over a 2-week period. By contrast, HCTZ did not affect BV, but decreased RBC deformability 2.5 h after medication intake. After 2 weeks of treatment, the negative effect on RBC deformability had increased slightly. Furthermore, fibrinogen and PV were significantly elevated at this stage. In summary, felodipine ER did not improve blood rheology over a 2-week treatment period in this study. HCTZ exhibited marginal but significant negative effects on fibrinogen, PV and indices of RBC deformability, but not on RBC aggregation.
Effect of organic and inorganic mercury on human sperm motility.
The effects of mercuric chloride and methyl mercuric chloride on the motility of human spermatozoa in vitro were investigated. Organic as well as inorganic mercury compounds decreased the percentage of motile spermatozoa. After 15 min. incubation with 40 microM mercuric chloride a significant decrease in sperm motility was observed. Less than 5% of spermatozoa were motile after 30 min. of exposure to 20 microM methyl mercuric chloride. These effects could not be attenuated by addition of 5 microM sodium selenite. The ultrastructural localization of mercury was demonstrated by autometallography. Silver-enhanced mercury deposits could be demonstrated only in spermatozoa exposed to inorganic mercury. In these cells mercury grains were most abundant in membranes of midpiece and tail.
Blood rheology in lupus erythematosus.
Blood rheology is one of the determinants of perfusion and might therefore have an impact on the thromboembolic complications of lupus erythematosus. This study aimed at defining the flow properties of blood in patients with various types of lupus erythematosus. Results for 51 patients were compared with those for 20 controls matched for sex. The patients were divided into subgroups--chronic discoid, subacute cutaneous, and systemic lupus erythematosus--according to their clinical or laboratory characteristics. Blood and plasma viscosity, packed cell volume, red cell aggregation, and red cell deformability were used as parameters of blood rheology. Blood and plasma viscosity and red cell aggregation were significantly different in patients compared with controls, indicating reduced blood fluidity in lupus erythematosus. There were no marked sex differences. The rheological effects were greater in those with systemic lupus erythematosus than in those with chronic discoid or subacute cutaneous lupus erythematosus. The presence of a positive antinuclear antibody titre or methods of treatment (systemic steroids or retinoids) had no apparent effect on the parameters tested. It is suggested that a complex haemorheological deficit exists in lupus patients.
Can rheologic variables be of prognostic relevance in arteriosclerotic diseases?
The hypothesis that blood rheology is of prognostic value in patients with arteriosclerotic diseases was tested in a prospective study of 843 patients at a rehabilitation clinic. They were tested for blood serum and plasma viscosity, hematocrit, fibrinogen, red cell aggregation and deformability, erythrocyte sedimentation rate, white cell count, cholesterol, and triglycerides. End points were defined as a second stroke or myocardial infarction or cardiovascular death within two years of the initial examination. Patients suffering such end points as compared with matched pairs (n = 74; matching criteria: identical manifestation of arteriosclerosis, identical sex and similar age and risk factors) had significantly higher native blood viscosity (p = 0.002), red cell aggregation (p = 0.01), serum viscosity (p = 0.01), fibrinogen (p = 0.02), and cholesterol (p = 0.01). It is concluded that rheologic factors are associated with the prognosis in patients with arteriosclerotic diseases.