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Biomedical subjects

F Bachmann

Publications and source records attributed to F Bachmann.

At least 109 records · Page 6Linked to original sources
PubMed1983

Adjusted versus fixed-dose subcutaneous heparin in the prevention of deep-vein thrombosis after total hip replacement.

Venous thromboembolism after total hip replacement continues to be a serious problem. We conducted a study to determine whether adjustment of the dose of subcutaneous heparin to yield partial thromboplastin times in the high-normal range results in a greater reduction of postoperative deep-vein thrombosis than fixed doses of heparin. Seventy-nine patients undergoing elective hip arthroplasty were randomly divided into two groups two days before surgery. Group 1 (41 patients) received a fixed dose of 3500 IU of heparin subcutaneously ever eight hours; 16 of the 41 (39 per cent) had deep-vein thrombosis diagnosed by venography. Group 2 (38 patients) was started on the same dose, which was then adjusted to keep the activated partial thromboplastin time between 31.5 and 36 seconds. From the day of operation to the eighth postoperative day these patients needed progressively more heparin to maintain the activated partial thromboplastin time in the prescribed range. Only 5 of the 38 (13 per cent) had deep-vein thrombosis (P less than 0.01), and the number of thrombi in proximal veins was also lower in this group (P = 0.003). The number of units of blood transfused, the frequency of postoperative wound hematomas, and the drop in hemoglobin levels were identical in the two groups. Adjusted low-dose heparin prophylaxis appears to be a safe and efficacious method to reduce the frequency of deep-vein thrombosis in patients undergoing total hip replacement.

Aged↗
PubMed1983

[Poor fibrinolytic response to venous occlusion: defect of endothelial cells or plasma interference?].

To better characterize the plasminogen activators (v-PA) before and after venous occlusion, the euglobulins obtained from the plasma of 24 volunteers have been separated on SDS-PAGE and revealed zymographically. All the subjects with an excellent fibrinolytic response on fibrin plates (greater than 1.3 TAU/ml) exhibited activity of 68 kdaltons, which corresponds to free v-PA. The poor responders on fibrin plates (less than or equal to 0.3 TAU/ml) only showed increase of a lysis zone at 110 kdaltons, corresponding to a complex of v-PA and a fast-acting inhibitor. Hence poor fibrinolytic activity on fibrin plates after venous occlusion could be due to high plasma concentration of this inhibitor and not necessarily to defective production or release of v-PA.

Endothelium↗
PubMed1983

[Incidence of intramural digestive system hematoma in anticoagulation. Epidemiologic study and clinical aspects of 59 cases observed in Switzerland (1970-1975)].

Intramural hematoma of the small intestine is a relatively rare but serious complication of oral anticoagulant therapy. On the basis of a retrospective epidemiological survey the authors estimate its incidence at 1 case per 20 000 admissions to medical and surgical services or 1 case per 2500 anticoagulated patients per year. The classical trial of clinical symptoms comprises abdominal pain, small bowel obstruction and multiple hemorrhagic symptoms (hematuria, hematomas, ecchymoses, hematemesis and melaena). The most important etiologic factors appear to be overanticoagulation with vitamin K antagonists (the thromboplastin time is prolonged in over 70% of cases) or correct oral anticoagulation associated with additional impairment of hemostasis due to the administration of drugs inhibiting platelet function. Radiologic examination of the gastrointestinal tract reveals that the jejunum and the ileum are sites of predilection for intramural intestinal hematoma. The treatment of choice is conservative; surgery should be reserved for cases in which the diagnosis is doubtful and for patients who exhibit signs of bowel necrosis or peritonitis.

Adult↗
PubMed1982

Influence of detergents on the measurement of the fibrinolytic activity of plasminogen activators.

The influence of detergents on the apparent activity of tissue plasminogen activator and of urokinase was investigated. The nonionic detergents Tween 80 and Triton X-100 and the zwitterionic detergent Zwittergent 314 caused a marked increase in the apparent activity of tissue plasminogen activator and, to a lesser degree, of urokinase in the fibrin plate assay, particularly at higher activator concentrations. The detergents did not enhance the plasma clot lysis in the presence of urokinase or tissue plasminogen activator. The anionic detergent sodium dodecyl sulfate had a small inhibitory action on the fibrin plate activity of urokinase and strongly inhibited the fibrin plate activity of tissue plasminogen activator. A systematic study into the mechanism of the stimulatory action of nonionic and zwitterionic detergents is presented.

Animals↗
PubMed1982

The amidolytic activity of the SK-plasminogen complex is enhanced by a potentiator which is generated in the presence of vascular plasminogen activator--role of fibrin degradation products.

In the presence of an excess of streptokinase (SK) the amidolytic activity of the plasminogen-SK complex on chromogenic substrates is 12% lower in serum than in the corresponding plasma. However, in subjects in whom venous stasis lead to a shortening of the euglobulin lysis time to less than 60 min (high responders), the amidolytic activity of the plasminogen-SK complex in serum was 60% higher than in the corresponding plasma. Attempts to find alterations of the plasminogen molecule itself which would account for the enhanced activity in high responder serum were negative. No free plasmin was present and the plasminogens isolated from plasma and serum before and after venous stasis had the same amidolytic activity as gluplasminogen in the presence of an excess of SK. N-terminal analysis of these four plasminogens revealed in each instance glutamic acid. The enhancement of the amidolytic activity of the SK-plasminogen complex in serum of high responders (potentiator activity) could be reproduced by adding purified tissue plasminogen activator (TA) to native blood before clotting, but not if TA was added to plasma or to prestasis serum. Removal of fibrin degradation products from poststasis serum resulted in the disappearance of potentiator activity. These experiments suggest that fibrin degradation products, generated during clotting in the presence of vascular or tissular plasminogen activator act as a potentiator of the amidolytic activity of the plasminogen SK-complex.

Amides↗
PubMed1982

[Rationalization of urine analysis while maintaining diagnostic accuracy (author's transl)].

Screening 720 morning urinary samples for WBC, RBC and protein by test-strip, the number of subsequent microscopic examinations of urinary sediment was reduced to about half, without missing any significant number of clinically significant findings (4.4%). On the other hand, a large number (21.3%) of cases with obviously false-negative sediment findings were revealed. These were largely due to lysis of WBC and RBC, as well as poorly standardized methods of examining urinary sediment. But they could also have been due to differences in subjective criteria employed by the technicians. Our results indicate that using test-strips for screening, clinical routine examination can be rationalized, taking about half the time needed for sediment examination, with more potentially significant findings being discovered than missed.

Clinical Laboratory Techniques↗
PubMed1982

Partial myeloperoxidase deficiency.

Neutrophil myeloperoxidase (MPO) activity was analyzed by a semi-quantitative cytochemical method in 268 subjects divided into several groups. 17 subjects with significantly reduced MPO activity were found: 11 of 23 in the preleukemia group, 2/14 AMLs, 1/20 myeloproliferative syndrome, 1/7 carcinoma with bone marrow metastases, 1/33 diabetes mellitus and 1/50 normals. Only in the preleukemia group, was MPO significantly reduced in comparison to the normal group (p less than 0.005). The high frequency of acquired MPO deficiency in preleukemia represents a useful criterium for this diagnosis. Furthermore, in these patients, as well as in the other subjects studied, no apparent correlation between MPO level and infection could be demonstrated.

Candidiasis, Chronic Mucocutaneous↗
PubMed1982

Lasting Hb F reactivation and Hb A2 reduction induced by the treatment of Hodgkin's disease in a woman heterozygous for beta-thalassemia and the Swiss type of the heterocellular hereditary persistence of Hb F.

A remarkable augmentation of Hb F and a reduction of Hb A2 were observed in a Sicilian woman during and after a course of treatment for Hodgkin's disease. An inverse correlation between the proportion of Hb F and Hb A2 was found over an 8-year period, as well as in populations of red blood cells fractionated by density gradient. She exhibited two genetic defects, the Swiss type of heterocellular hereditary persistence of fetal hemoglobin and a beta-thalassemia trait, which were confirmed by the study of the hemoglobin synthesis and by a family study. The lasting reactivation of Hb F synthesis is attributable to the interaction of several acquired and inherited factors.

Adult↗
PubMed1982

Isolation from human plasma of a plasminogen activator identical to urinary high molecular weight urokinase.

Two different plasmatic plasminogen activators (PA) can be demonstrated after sodium dodecyl sulfate polyacrylamide gel electrophoresis of plasma freshly collected from resting volunteers, followed by transfer of the gels onto plasminogen-rich fibrin-agarose plates. These two PA are also present in plasmas deficient in coagulation Factor XI, Factor XII, prekallikrein, or high molecular weight-kininogen. The slower-moving PA has an apparent 85,000 Mr and is immunologically unrelated to urokinase (UK). The faster moving PA was isolated by immunoadsorption of plasma on anti-UK IgG coupled to Sepharose 4B and appears to be identical to urinary high molecular weight-UK.

Endopeptidases↗
PubMed1982

[Urological diseases during pregnancy].

Pyelonephritis and urinary calculi are the most frequent urological complications during pregnancy. They are followed by injuries of the urinary system during birth or in connection with multiple traumas in traffic accidents. Kidney transplantation or permanent urinary diversion (Ileum- or Colon-Conduit) are not an absolute obstacle for pregnancies when closely followed. Problematic for mother and child is the coincidence of pregnancy and malignant tumours. In that case good cooperation among the different specialities is necessary. This study provides a concept for the diagnostic and therapeutic procedures. Knowledge of adequate methods of examination and modern techniques and a timely treatment meeting the demands of the situation prevent complications and sequelae of the pregnancy.

Female↗
PubMed1980

[Fenclofenac in the treatment of rheumatoid arthritis (author's transl)].

The effectiveness of fenclofenac in the treatment of rheumatoid arthritis was compared in a crossover double-blind study of 30 patients with that of indometacin over a period of two weeks. The therapeutic effectiveness of fenclofenac, at a daily dose of 900 mg, was comparable to that of indometacin, at a daily dose of 100 mg. Side effects were less common with fenclofenac than indometacin, especially with respect to gastro-intestinal ones. On questioning more patients preferred fenclofenac, and its use is therefore recommended for patients with actual or potential gastro-intestinal problems.

Arthritis, Rheumatoid↗
PubMed1980

Prevention of venous thromboembolism after total knee replacement by high-dose aspirin or intermittent calf and thigh compression.

A prospective study of patients undergoing total knee replacement was carried out by using a combination of 125I-fibrinogen scanning and phlebography, and showed a high incidence of venous thromboembolic disease (TE). Ventilation-perfusion lung scanning was performed to detect pulmonary emboli in most patients. High doses of aspirin and an intermittent low-pressure pneumatic compression device (IPCD) were effective, even in women, in preventing TE. Low doses of aspirin and placebo were equally ineffective in preventing TE. Lung-scan abnormalities compatible with pulmonary emboli were found in six out of 10 patients with isolated calf-vein thrombi. Conventional tests of platelet function did not predict the development of TE. No significant differences were found between the patients receiving low and high doses of aspirin with respect to the mean template bleeding time or platelet aggregation in response to adenosine diphosphate, collagen, and epinephrine, although these variables were significantly abnormal in the two groups receiving aspirin compared with those treated with placebo and the IPCD. Thus high doses of aspirin and a new low-pressure IPCD were effective in preventing venous TE in patients (predominantly women) undergoing total knee replacement.

Adult↗
PubMed1980

[Sarcomas of the uterus: morphological criteria and clinical course (author's transl)].

Sixty-nine cases of uterine sarcoma were reviewed histologically withhh respect to their grade of malignancy. Mitotic activity is the most important criterion of malignancy. A histological grading was performed on the basis of mitotic counts per high power field. Clinical follow-up showed that except for the local extension of the tumor, the prognosis of sarcomas depends greatly on mitotic activity. There is a good correlation in the lower stages I and II between number of mitoses and survival rate. The 5 year survival rate of patients with grades I or II is 77% compared to 41% for grades III and IV. Vascular invasion is not evident in distant metastases in our material. Adjuvant chemotherapy is recommended in clinical stages II-IV and in histological grades III and IV.

Female↗
PubMed1979

[Acquired von Willebrand's syndrome associated with malignant lymphoma].

The sudden development of multiple bleeding episodes in a 63-year-old patient with malignant lymphoma was shown to be due to the presence of an acquired von Willebrand syndrome, characterized by a prolonged bleeding time and low levels of the factors VIII: C, VIIR:Ag and VIII:Rcof. Crossed immunoelectrophoresis demonstrated diminution of the factor VIII portion with least anodic mobility. Mixing experiments of the patient's and normal plasma revealed a weak (T/2: 4.5 hours) inhibitory activity against the factors VIII:C, VIIIR:Ag and VIII:Rcof. After infusion of 800 units of cryoprecipitate there was rapid destruction (T/2: less than 1 hour) of infused factors VIII: C and VIIIR:Ag and no correction of the bleeding time. Chemotherapy resulted in disappearance of the lymphoma and the hemostatic defect, and its discontinuation in their reappearance. The weak inhibitory activity of the patient's plasma does not fully account for the factor VIII levels observed and other pathophysiological mechanisms, such as adsorption of factor VIII to the malignant lymphocytes, must be considered.

Antigens↗