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Biomedical subjects

E Schuster

Publications and source records attributed to E Schuster.

At least 19 recordsLinked to original sources
PubMed1992

A decrease in plasminogen activator inhibitor-1 activity after successful percutaneous transluminal coronary angioplasty is associated with a significantly reduced risk for coronary restenosis.

To determine a possible relation of changes in plasma levels of plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (t-PA) to the development of coronary restenosis after successful coronary angioplasty (PTCA), we followed 104 patients with a low grade residual stenosis after PTCA (less than 30%) for a period of 12 months. PAI-1 plasma levels (functional activity) and t-PA antigen were determined 1 day before PTCA and 3 days, 3 months and 6 months thereafter. Thirty-four patients (32.69%) developed angiographically proven coronary restenosis (group A) within a time range of 4-48 weeks (median 12.5 weeks) after PTCA while the remaining patients (group B) had neither clinical signs nor angiographic evidence of restenosis after 6 months. No significant differences could be demonstrated in t-PA antigen or PAI-1 activity (plasma levels between the two groups of patients the day before PTCA). During the whole observation period t-PA plasma levels were not significantly different between the two groups; however, PAI-1 plasma levels were significantly higher at 3 months and 6 months after PTCA in patients of group A (p less than 0.005). When the pattern of PAI-1 plasma levels over time (increase or decrease between two consecutive time points of blood collection) was used to discriminate between the two study groups only 3.5-18% of patients with a decrease in PAI-1 developed coronary restenosis within the following observation period in contrast to 25-58% of patients with an increase in PAI-1 plasma levels (p less than 0.05 to p less than 0.0005).

Aged↗
PubMed1992

Influence of age on outcome of mechanically ventilated patients in an intensive care unit.

OBJECTIVE: To assess the influence of age on the outcome of patients receiving prolonged mechanical ventilation. DESIGN: Retrospective study. SETTING: Intensive care unit. PATIENTS: A total of 1,141 patients in our ICU during a 32-month period. A total of 536 patients required mechanical ventilation. After exclusion of 171 patients ventilated for less than 24 hrs after surgery, 365 patients were investigated. MEASUREMENTS AND MAIN RESULTS: Two hundred sixty-six (73%) patients were aged less than 70 yrs; 99 (27%) patients were greater than or equal to 70 yrs. There was no significant difference in mortality rate between the younger and the older age groups. There was no significant influence of other important factors, such as severity of illness, duration of mechanical ventilation, or length of ICU stay. The only factor showing a significant influence on patient outcome was the reason for mechanical ventilation. There were more survivors in the group being ventilated because of ventilatory insufficiency than in the group with oxygenation impairment (57.8% vs. 23.9%, p less than .001). CONCLUSION: An influence of age on the outcome of mechanically ventilated patients in the ICU could not be ascertained in this study.

Adolescent↗
PubMed1992

Growth after radiotherapy and chemotherapy in children with leukemia or lymphoma.

The effect of radio- and chemotherapy on auxological parameters was investigated in 30 children treated for acute lymphatic leukemia (ALL) or non-Hodgkins lymphoma (NHL). Growth velocity was decreased during the first year of treatment. Catch-up growth was insufficient during the following years. Thus, the whole group experienced a loss of height of 0.49 +/- 1.1 SD at 6.8 +/- 2.6 years after diagnosis. Height and growth velocity were not different between children who received 18 or 24 Gy cranial irradiation; however, growth velocity was significantly lower in children who were treated for more than 2 years or who had the more intensive chemotherapeutic protocol. Evaluation of the growth hormone (GH) response to pharmacological stimulation revealed reduced GH peaks in 47% of the patients, but there was no correlation of GH peak with growth or treatment parameters. In conclusion, the impairment of growth in children after treatment for ALL or NHL might be related to the intensity and duration of chemotherapy.

Analysis of Variance↗
PubMed1992

[Acute diarrheal diseases. Treatment with carrot-rice viscous solution is more effective than ORS solution].

In infants and children, the treatment of acute diarrhoea with glucose-based electrolyte solutions results in rehydration but does not reduce the severity and duration of diarrhoea. In german-speaking countries, rice- and carrot-based solutions have a long tradition in the treatment of diarrhoea and may also reduce stool output and the duration of diarrhoea. Therefore, we evaluated the efficacy and safety of a carrot-rice-based rehydration solution (Na 57 mmol/L, n = 70) and two conventional glucose-based solutions with high or low sodium concentrations (Na 90 mmol/L, n = 48 or Na 55 mmol/L, n = 60) in a prospective study. The study subjects were Pakistani boys and girls between 3 and 48 months of age with mild or moderate dehydration. We measured duration of diarrhoea, fecal and urine output, fluid intake and serum electrolytes. The duration of diarrhoea was significantly lower (p less than 0.05) in the group receiving the carrot-rice based rehydration solution (59.5 +/- 30.9 h) than in the groups receiving the high-Na (75.5 +/- 30.5) and low-Na (74.8 +/- 32.5) glucose-electrolyte solutions. The mean fecal output (p less than 0.01) and fluid intake (p less than 0.001) were also significantly lower in the infants and children receiving the carrot-rice-based rehydration solution. No major electrolyte imbalances were observed in the three groups. We conclude that the carrot-rice-based rehydration solution was safe and more effective than two conventional glucose-electrolyte solutions in the rehydration of infants and children with acute diarrhoea.

Dehydration↗
PubMed1992

[Long-term follow-up of Crohn disease].

184 patients diagnosed with Crohn's disease were observed for an average of 5 years and evaluated for clinical pattern and course of disease. The male/female ratio was almost equal (90 m. vs. 94 f.). The peak of disease manifestation was between years 18-32. Familial clustering of inflammatory bowel disease was observed in 2.2%. The pattern of anatomic involvement was ileocolic in 53%, colon in 24%, small bowel in 20% and other locations in 3%. 34% of patients were afflicted with at least one extraintestinal manifestation, 34% developed fistulae. Fistula formation was seen more often in colon involvement than small bowel involvement (69% vs. 32%). 48% of the patients were operated at least once. 3 patients died during the observation period, 2 of them with sepsis. Evolution of carcinoma was not observed. Some of our results are in accordance with the literature, some distinct observations (e.g. low familial clustering) underline the theory of a multifactorial pathogenesis in Crohn's disease.

Abscess↗
PubMed1991

Interactions between infections, malnutrition and iron nutritional status in Pakistani infants. A longitudinal study.

The interactions between infections, malnutrition and poor iron nutritional status in infants at weaning ages are poorly defined. Therefore, four groups of infants from an area with a high incidence of malnutrition (Lahore, Pakistan) were enrolled in a prospective, randomized nutritional intervention study. Between 122 and 365 days of age, the infants from one community received either a milk cereal without iron fortification (n = 29), a milk cereal fortified with ferrous fumarate (7.5 mg/100 g; n = 30), or a milk cereal fortified with ferric-pyrophosphate (7.5 mg/100 g; n = 27). Forty-four infants from a neighbouring community did not receive a nutritional supplement and served as the control group. Calculated mean daily energy- and protein intake with the cereals was between 259-287 kcal, and 9.6-10.6 g at 12 months of age, respectively. Mean daily iron intake with the fortified cereals was between 4.1-5.1 mg at corresponding age. Nutritional supplementation resulted in significantly lower incidence of malnutrition and higher weight gain. Incidence of acute diarrhoea was significantly (p less than 0.05) lower in the supplemented groups. The infants fed the iron-fortified milk cereals had significantly higher hemoglobin (mean 10.4 vs. 9.8 g.dl-1) and serum ferritin (mean 13.3 vs. 8.5 ng.ml-1) values than the infants fed the non-fortified milk cereals. However, no differences in the incidence of infections were found between the supplemented groups. It is concluded that poor nutritional intake between 122 and 365 days of age substantially contributed to the high incidence of diarrhoea and malnutrition in Pakistani infants.

Analysis of Variance↗
PubMed1990

High total and free 1,25-dihydroxyvitamin D concentrations in serum of premature infants.

We investigated the relationship between serum total and free 1,25-dihydroxyvitamin D (1,25-OH2D) and the biochemical regulation of 1,25-OH2D production in premature infants. We measured 1,25-OH2D, vitamin D binding protein and related biochemical parameters and calculated the free 1,25-OH2D index in serum of 17 premature infants (birthweight 810-1700 g; gestational age 31-36 weeks) on two different occasions defined by body weight (Study A: 1,750-1,850 g, Study B: 2,100-2,200 g). Dietary calcium (Ca) intake was 1,5 or 2,6 mmol/kg/d, phosphorus (P) intake 1,7 mmol/kg/d and vitamin D intake 1,000 IU/d. Biochemical results were similar in infants with different Ca intakes and all were within reference ranges. Concentrations of vitamin D binding protein (Study A 0.15 +/- 0.03 g/l, Study B 0.14 +/- 0.03 g/l; means +/- SD) were lower, concentrations of 1,25 (OH)2D (Study A 180 +/- 67 pmol/l, Study B 216 +/- 53 pmol/l) were higher, and consequently the free 1,25-OH2D index (Study A 6.6 +/- 2.7, Study B 8.8 +/- 2.6) was 4 to 6 times higher than in previously studied term infants. 1,25-OH2D and the free 1,25-OH2D index increased significantly with age and were not correlated with serum P or parathyroid hormone. The data indicate that in premature infants with normal biochemical parameters of Ca and P metabolism elevated concentrations of 1,25-OH2D signify an increased fraction of free 1,25-OH2D and that increased production of 1,25-OH2D is not due to hypophosphatemia or hyperparathyroidism.

Calcitriol↗
PubMed1989

Relationship between neopterin and granulocyte elastase plasma levels and the severity of multiple organ failure.

In a series of 56 patients (24 uncomplicated postoperative and 32 septic patients), neopterin and elastase alpha 1 protease inhibitor complex (E-alpha 1 PI) plasma levels were measured daily. The clinical course of each patient was evaluated with the Multiple Organ Failure (MOF) score according to Goris. Neopterin could differentiate between septic and nonseptic patients (p less than .001), and E-alpha 1 PI between septic nonsurvivors and nonseptic patients only (p less than .01). In septic patients, acute pulmonary insufficiency was indicated by elevated E-alpha 1 PI values (greater than or equal to 400 micrograms/L) 1 day before mechanical ventilation was performed with a sensitivity of 81% and a specificity of 82%. Defining a patient with MOF whose score was greater than or equal to 5 as a high-risk septic patient, a comparison neopterin greater than or equal to 40 nmol/L and E-alpha 1 PI greater than or equal to 400 micrograms/L, measured 1 day before the evaluation of an MOF score of greater than or equal to 5 yielded a sensitivity of 91% and a specificity of 99% when patients fulfilled both criteria. We conclude that neopterin and E-alpha 1 PI might be useful parameters for the diagnosis of septicemia and monitoring of the clinical course in septic patients. Moreover, they might indicate the possible central role of macrophage and PMN activation in the development of MOF.

Adult↗
PubMed1989

Melatonin secretion in Turner's syndrome: lack of effect of oestrogen administration.

Melatonin secretion was investigated in 13 girls with Turner's syndrome before and after long-term oestrogen administration. Oestrogen treatment resulted in an increase in the serum levels of the hormone and a decrease in blood progesterone concentration. No change, however, was observed in the melatonin secretion pattern (in terms of peak values, time of peak level and total melatonin secretion) after oestrogen therapy. A distinct circadian rhythm in serum melatonin was evident in all subjects with peak occurring around 0200 h and concentration similar to those of normal subjects.

Adolescent↗
PubMed1988

Circadian fluctuations of plasminogen activator inhibitor and tissue plasminogen activator levels in plasma of patients with unstable coronary artery disease and acute myocardial infarction.

A decrease in the fibrinolytic potential, mainly due to an elevation of plasminogen activator inhibitor (PAI), has been described in patients with stable coronary artery disease and a previous myocardial infarction. We investigated plasma levels of PAI and tissue plasminogen activator (t-PA) and their possible circadian variations in patients with unstable coronary artery disease (CAD). Sixty-three patients were studied for at least 2 consecutive days during their stay at the coronary care unit (CCU). Diurnal plasma fluctuations in PAI and t-PA and onset of further myocardial ischemic episodes were monitored. As controls we used 22 age-matched patients submitted to the clinic because of non cardiac chest pain or valvular disease who revealed no evidence of CAD. PAI levels were significantly elevated in patients with unstable CAD (p less than 0.0001) but were not influenced by the extent of underlying CAD, history of previous myocardial infarction, known risk factors for CAD, or by extent of myocardial damage. The circadian variation of PAI levels with peak values between midnight and 6 A.M. found in controls was still present in patients but at a higher level. Preservation of circadian pattern in PAI plasma levels despite myocardial ischemic attacks indicates that elevation of PAI is rather not caused by a reactive phenomenon. On the other hand, elevated PAI levels and episodes of severe myocardial ischemia exhibiting a median time of onset at 10 A.M. seem to be closely related.

Aged↗
PubMed1988

Response of the seminiferous epithelium to scattered radiation in seminoma patients.

Semen and blood samples were obtained, at 3-month intervals over 12 to 28 months, from patients who underwent subdiaphragmal radiation after orchidectomy for seminoma testis. Before radiotherapy a mean (+/- SE) semen volume of 4.7 +/- 0.5 ml, a mean sperm count of 44.4 +/- 13.5 x 10(6)/ml, a mean percentage of motile cells of 20.3 +/- 5.2, a mean percentage of morphologically normal spermatozoa of 13.4 +/- 5.4, a mean percentage of swollen sperm of 39.6 +/- 7.4, and a mean serum follicle-stimulating hormone (FSH) value of 8.3 +/- 1.2 mIU/ml was found. The mean testicular dose from scatter was 62 +/- 5 cGy (range, 34 to 95 cGy). Sperm counts between 0 and 2.75 x 10(6)/ml were seen at 6.8 +/- 0.6 months and recovery to values greater than 2.25 x 10(6)/ml at 11.8 +/- 0.8 months after the start of radiation. Peak FSH values of 19.2 +/- 1.6 mIU/ml were obtained at 6.7 +/- 0.9 months after the start of irradiation. After recovery mean semen volume was 3.9 +/- 0.4 ml, mean sperm count 34.6 +/- 5.6 x 10(6)/ml, the mean percentage of motile cells 42.5 +/- 6.0, the mean percentage of swollen sperm 58.7 +/- 6.8, and the mean percentage of spermatozoa with normal morphology 23.4 +/- 5.1. Only motility was significantly different (P less than 0.01) from pretreatment values. The elevation of FSH values with time after start of radiotherapy reflected the toxicity to spermatogenesis but no correlation was found between peak FSH levels and scattered radiation dose. Also, neither the time from start of radiotherapy to sperm count nadir or recovery nor the time to peak FSH levels was significantly correlated with radiation dose.

Adult↗
PubMed1988

[Preventive use of vitamin D and fluoride in Austria].

The implementation of the recommended daily vitamin D and fluoride supplements for infants in Austria has been investigated during a nationwide infant nutrition survey (n = 1069). 93.9% of the infants received daily vitamin D supplements, whereas only 38% received fluroide. Rejection of fluoride supplemtation was most common among mothers aged between 30 and 45 years and mothers with university education. In Carinthia, Vorarlberg and Styria only 2 out of 10 infants received fluoride supplements. It seems necessary to reconsider the recommendations for fluoride supplementation in Austria.

Adult↗
PubMed1988

Local texture analysis: an approach to differentiating liver tissue objectively.

The usefulness of local textural analysis in identifying diseases of the liver has been evaluated. In comparing two areas texturally, a random distribution of one or several textural parameters indicates identical tissue, whereas a distinct clustering can be used to discriminate between different tissues. Using this procedure, various diseases of the liver were differentiated accurately whereas different images of the same state of the liver were classified as similar with high accuracy. The consistent results with different patients, sections, sample locations and scanner parameter settings demonstrate that these factors have no impact on the characteristics of the resulting pattern used for discrimination and therefore for the final diagnosis. The overall diagnostic accuracy of this method seems better than conventional sonographic evaluation of parenchymal liver disease and at least competitive with other computerized methods described. The most important result clinically seems to be the high accuracy in differentiating between hepatitis and normal liver, which cannot be achieved by conventional ultrasonography.

Adult↗
PubMed1988

Texture analysis--a new method of differentiating prostatic carcinoma from prostatic hypertrophy.

This study compares the results of a new computer assisted evaluation program of sonographic images of the prostate with the histological examination of the operative specimen. This computer program is based on the fact that the human eye is not capable of distinguishing picture distribution points which differ in higher than second order statistics. The sensitivity of the method was 89%, the specificity 86% and the diagnostic accuracy 88%. The results are discussed by comparing them to results of transrectal sonography and digital palpation as reported in the literature.

Evaluation Studies as Topic↗
PubMed1988

Reliability of estimation of maximum performance capacity on the basis of submaximum ergometric stress tests in children 10-14 years old.

Thirty-three 10-year-old boys repeatedly performed six symptom-limited, spiroergometric exercise tests according to the vita maxima method over an observation period of 4 years. Submaximum and maximum performance parameters were assessed and their correlation was calculated. The correlation of the heart rate at 1, 2 and 3 watts/kg body weight with the values of maximum performance capacity (wattmax and VO2max) and with the body-weight-related, relative maximum values was statistically significant. The correlation factors for the relative values were about twice as high (r = 0.55) as the absolute values (r = 0.27). The heart rate at 1, 2 and 3 watts/kg therefore was more characteristic of the relative values, which represent the state of training, and less for the absolute performance capacity, which depends to a great extent on body weight. However, the statistically significant correlation factors were too low to estimate reliably the state of training in an individual case. The correlation of physical working capacity at an HR of 170/min (PWC 170) with the maximum ergometric Watt performance was r = 0.80 and therefore appears to be sufficient to estimate the maximum performance capacity in children. This is however only valid for children over the age of 11.

Body Weight↗
PubMed1988

Iron intake and iron nutritional status of infants fed iron-fortified beikost with meat.

We compared iron intake and iron nutritional status of two groups of healthy term infants who received meat-containing baby foods fortified with ferrous sulphate (2 mg Fe/100 g). One group received an Fe-fortified formula (1.6 mg Fe/100 kcal) and the other a nonfortified formula. Fe intake of the group fed the nonfortified formula was significantly lower (p less than 0.0001). These infants received Fe mainly from fortification Fe with beikost (75-86%) and less than 10% met the recommended intake of 1 mg.kg-1.d-1; whereas 80-85% of the infants fed the Fe-fortified formula did. Hb, Hct, FEP, and ferritin were similar in both groups with the exception of lower ferritin values at age 365 d (p less than 0.05) in the group fed the nonfortified formula. No infant had hemoglobin less than 100 g/L. We conclude that regular consumption of commercially prepared Fe-fortified beikost with meat prevents most healthy term infants from Fe deficiency even if Fe intake is substantially below the recommended intake.

Breast Feeding↗
PubMed1988

The effect of sotalol on exercise-induced ventricular arrhythmias.

Sotalol is a non-selective beta-adrenergic blocking agent with class III antiarrhythmic properties. Our study was intended to assess the efficacy of sotalol on exercise-inducible arrhythmias by oral administration to out patients. Thirty patients with exercise-inducible arrhythmias (80% coronary artery disease, 20% congestive cardiomyopathy) were studied after two baseline bicycle ergometric stress tests performed in upright position. Twenty-five patients (including nine crossover cases of the lower dose protocol) were given sotalol in a daily dose of 320 mg (group 1) and 14 patients in a dose of 160 mg (group 2). After 2 and 8 weeks, respectively, group 1 showed a mean reduction of the total number of inducible ventricular premature beats (VPBs) of 50% (P = 0.0042) and 61% (P = 0.0107), respectively and a significantly improved Lown score (P = 0.0002 and 0.0006, respectively). A significant antiarrhythmic response was not demonstrable for group-2 patients. Because of inefficacy, nine patients were changed from group 2 to group 1. Reduction of arrhythmias on the higher dose was significant (P = 0.0147) in this group. There was the same significant reduction of the heart rate pressure product with the low and high dosage indicating that the beta-blocker effect is achieved with the lower dosage. We conclude that sotalol is a powerful drug for reducing the number and complexity of ventricular arrhythmias in a dose of 320 mg daily. As the beta-blocking effect in both groups was the same, we assume that the reduction of arrhythmias is mainly due to class III action.

Adolescent↗