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Biomedical subjects

E Gruber

Publications and source records attributed to E Gruber.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Lipid infusion in multiple trauma intensive care patients in the early phase of treatment].

OBJECTIVES: To study the metabolic effects of a high-dose fat infusion application in the early phase of total parenteral nutrition (TPN) after major trauma. DESIGN: Prospective study in male patients after major trauma. SETTING: Intensive care unit of the University Clinic. PATIENTS: 21 male, mechanically ventilated patients after major trauma. INTERVENTIONS: Infusion of Elolipid 20% (Fa. Leopold, Graz, Austria), starting on the 3rd day after ICU admission (0.075 g/kg body weight/h) in 8 h. The dose was increased on the 5th day (0.125 g/kg BW/h) and on the 7th day (0.15 g/kg BW/h). RESULTS: There was a pathologic rise in serum triglycerides on days 3, 5 and 7 during the infusion period. A serious diabetic metabolic state was shown on the 3rd day. No significant changes in urea production rate could be demonstrated after the high-dose fat infusion. CONCLUSIONS: The reason for the decreased fat elimination in patients after major trauma after high-dose fat infusion (8 h) remains unclear (fat clearance or fat oxidation failure). Therefore the fat infusion should be started after normalization of the blood glucose level. Thus the fat infusion should be given continuously over 24 h to avoid serious metabolic complications.

Adolescent↗
PubMed1993

[Doppler ultrasound of the saphenous vein as a bypass. Detection of arteriovenous fistulae].

In 13 patients who underwent a femorodistal revascularisation with an in situ saphena vein graft and who had been operated on by angioscopic technique, intraoperative angiography and postoperative colour-coded Doppler sonography and i.v./i.a. digital subtraction angiography (DSA) were performed to detect arteriovenous fistulas (AV fistulas). In intraoperative completion angiography no AV fistulas were seen. Colour-coded Doppler sonography and DSA studies performed three to five days postoperatively revealed AV fistulas in 8 patients. The fistulas could be exactly located by sonography, and, if confirmed haemodynamically significantly by i.v./i.a. DSA, they were marked on the skin and ligated. In the detection of AV fistulas in in situ saphenous vein grafts operated by angioscopic technique colour-coded doppler sonography and i.v./i.a. DSA showed equivalent results. In the detection of connections of AV fistulas to the deep draining veins the i.v./i.a. DSA was superior.

Aged↗
PubMed1993

[Effects of short-term application of recombinant human growth hormone on urea production rate in patients in the early postoperative phase].

OBJECTIVE: To determine the effect of short-term recombinant human growth hormone (rhGH) administration on urea production rate (UPR), N balance and aminograms. DESIGN: Prospective, double-blind placebo-controlled study. SETTING: Intensive care unit of a University Hospital. PATIENTS: 20 adult patients after major abdominal surgery. INTERVENTIONS: Postoperative substitution of rhGH (Saizen, Serono, Aubonne, CH) in a dose of 0.15 IE/kg BW for 3 days. The serum levels of hGH, insulin-like growth factor-1 (IGF-1), ACTH and cortisol were measured as well as the amino acids in plasma. The degree of catabolism was calculated according to Woolfson's formula, which is based on the UPR, and by calculation of the cumulative N balance. RESULTS: With exception of proline, the plasma amino acids between the groups receiving active substance and total parenteral nutrition (TPN) and those receiving placebo and TPN did not differ significantly. Neither was there a significant difference between the groups for any other parameter measured. The UPR and IGF-1 levels showed only a tendency towards higher values as compared with the placebo group (UPR verum group, values in g/day: 1st measurement, 29.8 +/- 16.7; 2nd measurement, 28.3 +/- 17.7; 3rd measurement, 32.1 +/- 19.1; 4th measurement, 33.1 +/- 21.2. UPR placebo, values in g/day; 1st measurement, 32.6 +/- 23.9; 2nd measurement, 30.8 +/- 17.9; 3rd measurement 41.6 +/- 28.7; 4th measurement, 47.3 +/- 29.5. IGF-1 verum group, values in nmol/l; 1st measurement, 25.7 +/- 19.2; 2nd measurement, 44.8 +/- 23; 3rd measurement, 52.4 +/- 30; 4th measurement, 54.3 +/- 20. IGF-1 placebo, values in nmol/l; 1st measurement: 22.9 +/- 11.7; 2nd measurement, 37.0 +/- 19.4; 3rd measurement, 38.4 +/- 21.4; 4th measurement, 40.0 +/- 23.0). The ACTH-cortisol axis was only slightly depressed in the group receiving active substance. CONCLUSIONS: We conclude that short-term rhGH administration over 3 days is not capable of significantly reducing the UPR in postoperative patients, but we cannot exclude a significant difference between rhGH group and placebo after a longer administration period.

Abdomen↗
PubMed1992

[Results of selective proximal vagotomy after 13 years].

This study reports the long-term results of 216 patients after highly selective vagotomy (HSV) for duodenal ulcers operated from 1970 through 1978 with a mean follow-up of 12.8 years (8.3-15). 26 patients developed symptomatic ulcer recurrences (12%) within 4 to 135 months following surgery, the cumulative recurrence rate (Kaplan-Meier) at 13 years was 20.3%. Acidity analyses showed a postoperative mean reduction of basal acid output (BAO) and maximal acid output (MAO) values of 80.7% and 74.8% respectively with no differences according to recurrences. The risk of recurrence was similar for duodenal (22/194) and pyloric ulcers (4/22) and no differences were found with respect to sex, additional drainage procedure, smoking habits, acute or elective operation and first or recurrent ulcers. Risk was slightly higher for complicated ulcers (p less than or equal to 0.07), but without reaching statistical significance. 78.5% of patients showed (very) good results (Visick I or II), only 6% were Visick III. HSV is therefore regarded as a valuable therapeutic measure for the treatment of duodenal ulcer independent of patient compliance.

Adolescent↗
PubMed1992

Elastase-type enzymes and their relation to blood lipids in atherosclerotic patients.

Serum elastase-type activity, elastase inhibitory capacity and their relation to lipids were examined in 140 male patients with ischemic vascular disease (coronary, cerebral, peripheral) and in 60 control subjects. In a further 24 patients with acute myocardial infarction elastase activity, inhibitory capacity and lipids during the course of the illness have also been investigated. Serum elastase-type activity was found to be significantly lower and inhibitory capacity significantly higher in the groups of patients than in the controls. HDL- and HDL2-cholesterol as well as apo A concentration showed significant negative correlation with elastase inhibitory capacity both in atherosclerotic and in control subjects. During the course of myocardial infarction a significant elevation of serum elastase-type activity could be observed at the end of the first week; serum triglyceride levels increased, HDL- and HDL2-concentrations decreased significantly in the first 3 weeks, than gradually approached the initial values. In the patients with an elevation of serum elastase-like activity by more than 30% in the first week, there was a significantly higher elevation of serum GOT and LDH1 and a greater occurrence of transmural (Q) infarction than in those with a smaller variation of elastase-like activity.

Adult↗
PubMed1992

Effect of fluoride on aluminum-induced bone disease in rats with renal failure.

Aluminum (Al) accumulation in renal failure is an etiological factor in the pathogenesis of low turnover bone disease. Aluminum-induced impairment of mineralization has been related to a reduced extent of active bone-forming surface. The present study investigated the effect of fluoride, a potent stimulator of osteoblast number, on the toxicity of aluminum in rats with renal failure (Nx). Following a large parenteral aluminum load (3.2 mg/kg x day) over a period of nine weeks, bone histomorphometry of vertebral cancellous bone revealed a severe low-turnover osteodystrophy as evidenced by a fall in osteoblastic osteoid surfaces and mineral apposition rates. Concurrent administration of fluoride [20 mg/liter (F20) or 40 mg/liter (F40) supplied with the drinking water] resulted in a significant increase in the number of osteoblasts (Nx+Al+F40 vs. Nx+Al, 33.75 +/- 2.83 vs. 1.81 +/- 0.43 mm-1, P less than 0.001) together with an overall reduced deposition of aluminum in bone (469.3 +/- 24.6 vs. 592.2 +/- 28.3 micrograms/g, P less than 0.01). However, there was an increase in the fraction of osteoid surface exhibiting stainable aluminum at the bone-osteoid interface (70.7 +/- 7.1 vs. 44.3 +/- 6.0%, P less than 0.005). Fluoride-exposed rats accumulated a significantly larger osteoid volume, suggesting an exacerbation of the osteomalacic lesion, and furthermore, dynamic histomorphometric parameters remained depressed. These results indicate that fluoride has a distinct effect on the pattern of aluminum deposition in bone. In addition, fluoride antagonizes the aluminum-induced reduction in osteoblast number but provides no amelioration of the impaired mineralization in aluminum-intoxicated rats. Thus, in this model a decrease in the extent of osteoblast surface does not account for the development of aluminum-related bone disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗
PubMed1991

Lithotripsy of gallstones by means of a quality-switched giant-pulse neodymium:yttrium-aluminum-garnet laser. Basic in vitro studies using a highly flexible fiber system.

The quality-switched neodymium:yttrium-aluminum-garnet laser represents a new instrument for athermal fragmentation of gallstones by transformation of optical energy into mechanical energy in the form of shock waves via local plasma formation. A highly flexible 300-micron fiber transmission system was used in basic investigations to determine the influence of varying pulse repetition rates (5-30 Hz) and pulse energies (15 and 20 mJ) on shock wave intensity and stone fragmentation in vitro for 105 biliary calculi of known size and chemical composition. After performance of 1200 shock wave pressure measurements using polyvinylidenefluoride hydrophones, stone fragmentation was analyzed by determination of fragment removal rates (volume of fragments removed per fragmentation time), ablation rates (mean volume removed per laser pulse), and median fragment sizes for each laser setting. With the quality-switched neodymium:yttrium-aluminum-garnet laser system, all concrements could be reliably disintegrated into small fragments (median diameter, 0.7-1.7 mm). Compared with pure cholesterol stones, a significantly higher fragment removal rate was achieved in cholesterol stones containing 30% calcium phosphate (P = 0.039), in cholesterol stones containing 20% pigment (P = 0.015), and in pure pigment stones (P = 0.007). Fragment removal rates, local shock wave pressures, and median grain sizes were significantly higher at a pulse energy of 20 mJ than with 15 mJ. Shock wave pressures showed a distinct dependence on pulse repetition rates at 20 mJ, yet not at 15 mJ. Because there is no evident hazard of thermal damage to tissue using the quality-switched neodymium:yttrium-aluminum-garnet laser, it appears to be a promising device for nonsurgical biliary stone therapy.

Aluminum↗
PubMed1991

The Acuvue disposable contact lens as a therapeutic bandage lens.

The Bio-Cor collagen shield (Bausch and Lomb, Rochester, NY) is thought to speed corneal epithelial healing and is available in dissolution rates of 12, 24, and 72 hours to suit the needs of the patient. It often is recommended over soft hydrophilic therapeutic lenses for short-term use, such as postoperatively and after corneal abrasions, in which cases the lens should dissolve within the specified period of time. I found these lenses to be unreliable in their dissolution rates. I presented four cases of corneal epithelial breakdown in which the collagen lenses were tried but were not successful. All cases did well with a hydrophilic soft lens, namely the Acuvue disposable lens, used for therapeutic purposes. The advantage of using a disposable lens rather than a standard therapeutic soft lens is its lower cost. Disposable lenses are cheaper than both regular soft lenses and collagen shields. It makes good economic sense to try these as a therapeutic lens of first choice when one is needed.

Adult↗
PubMed1991

[Acetylsalicylic acid after iliac-femoro-popliteal interventions?].

To determine whether acetyl salicylic acid (ASA) in a daily dose of 1500 mg versus untreated controls is effective in patients with peripheral arterial disease a prospective randomized but not placebo-controlled one single centre trial was undertaken. Patients were assigned to one of two groups by means of multi-dimensional contingency tables whereas the risk factors age, sex, height, body weight, diabetic metabolic state, hypertension, history of myocardial infarction, smoking habits and preoperative clinical status according to the Fontaine classification where found in the state of balance. 298 patients with arterial occlusions in the iliaco-femoro-popliteal level were recruited during 1971-1974, the primary end points were probability of patency and probability of survival. In regard as well as to the probability of patency (p less than 0.56 Breslow, p less than 0.66 Mantel) as to the probability of survival (p less than 0.10 Breslow, p less than 0.70 Mantel) no statistical significant difference was detected. In conclusion ASA, in the doses administered here, was unable to improve patency or prolong patient survival, an outcome, which is at variance with results obtained by others.

Arterial Occlusive Diseases↗
PubMed1990

Interaction between fibronectin, proteoglycans and lipoproteins.

The effect of purified human plasma fibronectin on LDL-GAG and LDL-PG complex formation was studied. Fibronectin added to LDL or to GAG or even to preformed LDL-GAG-Ca2+ complexes could inhibit complex formation and dissociated preformed complexes. Similar results were obtained with total serum instead of purified LDL: 1.2 mg fibronectin added to 1.0 mg LDL-cholesterol completely inhibited insoluble complex formation in the presence of Ca2+ between LDL and GAGs or LDL and PGs purified from aorta, whatever the order of mixing of the macromolecules. When fibronectin was added to preformed PG-LDL complexes however dissociation was less complete than with preformed LDL-GAG complexes (60% dissociation instead of 100% at similar concentration ratios). It appears therefore that the protein and GAG portions of PGs may not interact at the same sites of LDL and competition by fibronectin would be more efficient at the GAG binding site. Fibronectin could also dissociate LDL-heparin complexes formed on heparin-Sepharose affinity columns. As PG-LDL complexes were isolated from atherosclerotic plaques and fibronectin was also shown to increase in plaque area and exhibit opsonic-like functions, the above findings may well have physiopathological significance.

Binding Sites↗
PubMed1989

Factor, present in plasma, inhibiting the interaction of low density lipoprotein with arterial proteoglycan.

The complex formation of LDL with arterial proteoglycan or glycosaminoglycan was quantitated as precipitation of LDL-cholesterol after incubation in a low ionic strength buffer containing CaCl2 and MgCl2. It was found that human plasma or serum contains a factor which inhibits this complex formation. Upon density gradient centrifugation this factor was found at d greater than 1.24 g/ml. It could be further purified from the d greater than 1.24 g/ml fraction by affinity chromatography on heparin-Sepharose and hydrophobic interaction chromatography on phenyl-Sepharose. The content of inhibitory activity was found to vary over a 4-fold range in sera of apparently healthy persons.

Calcium Chloride↗
PubMed1987

Cognitive development and adolescent contraception: integrating theory and practice.

The cognitive skills that develop during adolescence are crucial to successful contraceptive practice because most birth control methods require at least a minimal ability to plan for, acquire, and utilize them at the appropriate time. Consequently, we must understand the special developmental setting in which adolescent sexual growth and experimentation occurs in order to have an impact on their contraceptive use. To provide optimal service to adolescents, the developmental and medical aspects should be taken into account in order to determine the best choice for each patient. This article demonstrates how mental health and medical providers can work together to better serve the adolescent population.

Adolescent↗
PubMed1985

The influence of bisacodyl and deacetylbisacodyl on mucus secretion, mucus synthesis and electrolyte movements in the rat colon in vivo.

The effect of the diphenolic laxatives bisacodyl and deacetylbisacodyl on mucus secretion and fluid, sodium and potassium net transport was studied in rat colon perfused in vivo. Mucus output in the effluent was determined as total protein-bound hexose. Deacetylbisacodyl was more potent than the parent compound and was used to investigate dose-response relationships. At a low concentration (0.1 mg/dl), mucus and potassium secretion were stimulated whereas sodium and fluid absorption were inhibited, or converted to secretion, only at higher concentrations (0.5-3.0 mg/dl). All effects were dose-dependent and reversible within 1 h. With longer lasting perfusion of deacetylbisacodyl, mucus appeared in two peaks, one initial peak and another after 4 h. The late peak contained newly synthetized glycoproteins as indicated by the incorporation of intravenously injected [14C]galactose. It is concluded that stimulation of mucus secretion and synthesis contributes to the laxative action of bisacodyl. The effects of low versus high concentrations suggests that part of the potassium secretion is due to mucus release.

Animals↗
PubMed1985

The interaction of human plasma low density lipoproteins with glycosamino-glycans: influence of the chemical composition.

Human plasma of 5 normolipemic individuals was incubated for 24 hr at 37 C in the presence or in the absence of lecithin:cholesterol acyltransferase (LCAT)-inhibitors. Plasma stored at 4 C served as a control. The low density lipoprotein (LDL) fractions of the samples were isolated and investigated with respect to changes in chemical composition and complexing activity with glycosamino glycans (GAG). Incubation of plasma in the presence of LCAT inhibitors caused a significant increase of LDL triglycerides at the expense of cholesteryl esters. Incubation with active LCAT not only changed the core but also the surface constituents (decrease in phospholipids and in free cholesterol). The amount of GAG bound per mg of LDL was not uniformly changed in samples incubated after LCAT inhibition. LDL isolated from plasma incubated in the presence of LCAT, on the other hand, showed a significant reduction in GAG binding. The ratio of free cholesterol:GAG in the complex was most significantly reduced in LCAT-modified LDL. There was in addition a highly significant correlation between the LDL:GAG ratio in the complex and the free cholesterol and phospholipid content of the LDL samples. It is concluded that alterations in surface lipid constituents of LDL strongly affect their interaction with sulfated polysaccharides, an effect which may be relevant also in vivo for the interaction of LDL with cell surfaces and intercellular matrices.

Female↗