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Biomedical subjects

E Schmidt

Publications and source records attributed to E Schmidt.

At least 235 records · Page 13Linked to original sources

Marrow graft rejection and veno-occlusive disease of the liver in patients with aplastic anemia conditioned with cyclophosphamide and cyclosporine.

Based on studies in multiply transfused dogs showing that cyclosporine (CsA) pregrafting reduced the incidence of rejection, we treated 11 multiply transfused patients with severe aplastic anemia with CsA, 12.5-20 mg/kg/day i.m. on days -6 to -1, and cyclophosphamide, 50 mg/kg/day i.v. on days -5 to -2, followed on day 0 by a marrow graft from an HLA-identical sibling donor. Patients were not given additional infusions of buffy coat cells from their marrow donors. As postgrafting prophylaxis for graft-versus-host disease 10 patients were given CsA, 12.5 mg/kg/day orally, and one patient was given a standard regimen of intermittent methotrexate. Among 10 evaluable patients, 2 rejected their marrow grafts. Eight patients had sustained engraftment. Two of these developed severe veno-occlusive disease of the liver, a complication previously observed only in patients conditioned with total-body irradiation but not in more than 200 patients with aplastic anemia conditioned with cyclophosphamide without the addition of CsA. These data indicate that conditioning of patients with cyclophosphamide and concurrent CsA does not uniformly prevent graft rejection and can result in severe hepatic toxicity.

Adolescent↗

[Infant nutrition with prefabricated foods].

Hygienic problems with industrially prefabricated foods for infants are rare. Industrial prefabrication has considerably increased safety of infant feeding. Problems may result from preparation for feeding. Least complications occur with ready-to-feed formulae which can be filled immediately before feeding. There may however be pitfalls in the technological preparations of these formulae especially through heating procedures. The use of prefabricated Beikost in powdered from or in containers is hygienically safe and guarantees constant nutrient and vitamin content throughout the whole year. Rewarming may be dangerous.

Food Handling↗

Production and certification of secondary enzyme reference materials (ERMs). Part 1: Preparation of the sera and some of their properties.

We produced three batches of a human-serum-based enzyme reference material (ERM) enriched with human aspartate aminotransferase (EC 2.6.1.1), alanine aminotransferase (EC 2.6.1.2), creatine kinase (EC 2.7.3.2), and lactate dehydrogenase (EC 1.1.1.27). The added enzymes were not exhaustively purified; thus the final ERMs contained some enzymes as contaminants, of which only glutamate dehydrogenase activity might interfere. The stability during storage and after reconstitution was good. The commutability of the four enzymes in the three ERM batches was also good, except when German or Scandinavian methods for aminotransferases were involved. The temperature-conversion factors for the ERMs were equivalent to those for patients' sera. Reactivation after reconstitution was complete within 5 min and was independent of the temperature of the reconstitution fluid. We believe that these secondary ERMs will aid in the transfer of accuracy between well-defined reference methods and daily working methods so that clinical enzymology results will become more comparable from laboratory to laboratory.

Alanine Transaminase↗

[Idiopathic intestinal pseudo-obstruction].

The extremely rare case of an idiopathic chronic intestinal pseudo-obstruction is pointed out here. This disease would manifest myomechanically by highly active, uncontrollable, non-propulsive contraction. It is caused by a collapse of smooth muscle control with cholinergic and beta adrenergic receptors being partially blocked, and by lacking reaction to substances which act on smooth muscles.

Adult↗

Some characteristics of antenatal care in 13 European countries.

This study compares the organization of antenatal care in 13 European countries having a fetal and infant mortality rate below 20 per 1000. The countries differ in the number of prenatal visits, the role performed by midwives and the use of home care. It shows that there is no single model of antenatal care among countries having similar fetal and infant mortality.

Ambulatory Care↗

Bacterial profiles of subgingival plaques in periodontitis.

In this report over 400 subgingival plaque samples taken from over 110 patients were examined microscopically and culturally for 30 bacterial parameters. The patients could be placed into six disease categories based upon clinical criteria. The bacterial profile of each clinical category was generally distinctive of that category. Periodontal patients who had been successfully treated and maintained had plaques that were populated by significantly higher proportions of Streptococcus sanguis, Actinomyces viscosus, A. odontolyticus and S. mutans and significantly lower proportions of B. gingivalis and spirochetes compared to the five untreated disease categories. The spirochetes were the overwhelming microbial type in the plaques of adult periodontitis (AP) patients, averaging about 45% of the microscopic count. The bacteriological results could not distinguish between ADA Type III and IV periodontitis, suggesting that the same type of infection was occurring in an active site in any AP patient. The patients designated as early onset periodontitis (EOP) differed from the other patients by their relative youth and by their significantly higher proportions of Bacteroides gingivalis and/or B. intermedius. Two types of EOP were recognized in which the most diseased variant was characterized by having an average of 49% spirochetes in the plaque. Four localized juvenile periodontitis (LJP) patients were notable in not having detectable A. actinomycetemcomitans. The data indicate that the various types of periodontitis, with the possible exception of LJP are specific anaerobic infections involving spirochetes and to a lesser extent B. gingivalis and B. intermedius.

Actinomyces↗

[Not Available].

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Disease↗

[Diagnostic and prognostic significance of massively increased serum glutamate dehydrogenase activity].

In a retrospective analysis of case reports of 115 patients with glutamate-dehydrogenase (GLDH) activity in serum of more than 100 U/l in 1979-1981, the most common causes of this increase were: acute right heart failure (28 patients), protracted septic-toxic circulatory failure (20), obstructive jaundice (18) and severe respiratory insufficiency (16), i. e. diseases causing perfusion or excretion disorders in the liver. The ratio of GLDH activity to transaminase activity provided a reliable separation of acute viral hepatitis, but not of different forms of perfusion disorders. The correlation between GLDH activity and death rate, especially in acute right-heart failure, is of prognostic value.

Cholestasis↗

Regression of androgen-related hepatic tumors in patients with Fanconi's anemia following marrow transplantation.

Two patients with Fanconi's anemia treated for 5 years with oxymetholone developed hepatic function abnormalities in association with hepatic tumors demonstrated by isotope liver-spleen scan or abdominal echogram. The lesions resolved over a period of 26 months after allogeneic marrow transplantation, and the patients are alive and well 3 and 4 years following transplantation. The course of these patients indicates that marrow transplantation for Fanconi's anemia allows the withdrawal of androgens and subsequent regression of androgen-related hepatic tumors in patients who might otherwise have a fatal outcome.

Adolescent↗

Stereoselective first-pass metabolism of highly cleared drugs: studies of the bioavailability of L- and D-verapamil examined with a stable isotope technique.

The pharmacokinetics of dextro(+)- and levo(-)-verapamil were studied in five healthy volunteers following oral administration of pseudoracemic verapamil containing equal amounts of unlabelled (-)- and dideuterated (+)-isomer. (+)-verapamil exhibited approximately five times greater Cmax (+): 240 +/- 81.1 ng/ml, (-): 46.1 +/- 15.7 ng/ml, P less than 0.0001) and AUC than (-)-verapamil. The apparent oral clearance (CLo) for (+)-verapamil was significantly smaller than that for (-)-verapamil (+): 1.72 +/- 0.57 l/min, (-): 7.46 +/- 2.16 l/min, P less than 0.001). The bioavailability of (+)-verapamil (50%) was 2.5 times greater than that of (-)-verapamil (20%), P less than 0.005). Thus following oral administration verapamil exhibited a stereoselective first-pass metabolism. Neither tmax nor the elimination t1/2,z were different between the isomers. The elimination of t1/2,z for each verapamil isomer obtained following oral administration (+): 4.03 h, (-): 5.38 h) were similar to those previously obtained following intravenous administration (+): 4.15 h, (-): 5.38 h, respectively. Whereas the (+)- to (-)-verapamil plasma concentration ratio following oral administration was 4.92 +/- 0.48, the ratio following i.v. administration was approximately 2. (-)-verapamil has been demonstrated to possess 8 to 10 times more potent negative dromotropic effect on AV conduction than (+)-verapamil. Therefore, following oral administration the same concentration of plasma verapamil consisting of a two to three times smaller proportion of the more potent (-)-isomer appeared to be less potent than that following i.v. administration with regard to the negative dromotropic effects on the AV conduction.

Adult↗