Is fentanyl appropriate for postoperative epidural PCA?
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Analgesia, Epidural↗
Biomedical subjects
G Friedrich
Publications and source records attributed to G Friedrich.
[Screening for psychogenic factors in functional dysphonia].
Psychosocial influences are now increasingly accepted to be important factors in the etiology of many diseases. The application of these findings is often not possible in clinical routine, especially because there is a lack of practical instruments for the diagnoses of psychogenic disorders. Based on previous investigations determining relevant psychogenic factors causing functional dysphonia, the goal of this study was to develop an easy-to-manage screening sheet for the estimation of psychogenic factors in the etiology of functional dysphonia. With this approach, physicians not trained in psychology are able to prove a suspect psychogenic disorder. Patients are forced to reflect on their disease by completing the sheet and thus may limit resistance to recognizing the true nature of their disturbance. Patients with pathological results can be sent effectively for further investigations and specialized therapy.
Adult↗
[Psychogenic aspects of functional dysphonia].
In order to estimate the significance of the psychogenic factor in the etiology of functional voice disorders on the basis of relevant psychological dimensions we compared patients with functional dysphonia, aphonia and a normal control group by means of an empirical-psychological test procedure. Psychogenic conditions proved to be a major factor in the etiology of aphonia, whereas such an interrelation turned out only partially in patients with functional dysphonia. The conclusion can be that psychogenic aspects are not necessarily of exceeding importance in the etiology of functional dysphonia. If no differentiation is made between the two kinds of voice disorders an overestimation of psychogenic influence might occur.
Adult↗
Side-branch occlusion during percutaneous transluminal coronary angioplasty.
Concentrations of creatine kinase (CK) MB mass and cardiac troponin T were measured in serial peripheral venous blood samples from 21 patients who underwent percutaneous transluminal coronary angioplasty (PTCA). Angiography showed side-branch occlusion during PTCA without clinical signs of myocardial injury in 5 patients. After PTCA, CKMB mass concentrations were substantially higher than normal in all 5 patients with side-branch occlusion, and troponin T concentrations were high in 3. By contrast, only 2 patients and 1 patient, respectively, without side-branch occlusion had slight rises in CKMB and troponin T. Release of the contractile protein troponin T reflects more severe damage to myocytes than simple leakage of CKMB. Therefore, myocardial damage induced by side-branch occlusion can be graded by measurement of troponin T in plasma.
Adult↗
[Complications during directional coronary atherectomy (DCA): catheter fracture between housing assembly and shaft point with subsequent vascular occlusion].
Directional coronary atherectomy of a severe stenosis of the left anterior descending coronary artery was complicated by device fracture between the cylindric housing portion and the distal nose-cone collecting chamber. After successful removal of the DCA device, an early occlusion of the coronary vessel occurred, which could be successfully treated by perfusion balloon catheter.
Adult↗
[Pilot study of dose dependence in glucuronidation of morphine to morphine-3- and morphine-5-glucuronide].
In the capacity of an initial study both, the half-lives of morphine and its metabolites morphine-3-glucuronide and morphine-6-glucuronide as well as the ratio of concentrations in the development of time using two different dosages were determined and shown by comparison. A bolus of 10 mg (10 micrograms) tritium-marked morphine was administered intravenously. Subsequently the half-lives of morphine, morphine-3-glucuronide and morphine-6-glucuronide in serum, saliva and urine were determined. To achieve this, morphine and its glucuronides were separated via HPLC and then quantified by measuring the radioactivity. In addition to the short half-lives of morphine and morphine-glucuronides long half-lives were found in the range of 12.6 to 20 hours in serum and urine. There was no positive evidence for glucuronides in saliva. In urine the morphine/glucuronide ratio showed a linear resp. exponential development dependent of dose.
Adult↗
[Digital x-ray image processing as an aid in forensic medicine].
Radiology plays an important role in the identification of unknown corpses. Positive radiographic identification by comparison with antemortem films is an established technique in this setting. Technical defects together with non-well-preserved films make it sometimes difficult or even impossible to establish a confident comparison. Digital image processing after secondary digitalization of ante- and postmortem films represents an important development and aid in forensic medicine. The application of this method is demonstrated on a single case.
Cadaver↗
Determination of the retinoid (E)-1,2,3,4-tetrahydro-1,1,4,4-tetramethyl-6-(1-methyl-2- phenylethenyl)naphthalene and its phenolic metabolite in human plasma by reversed-phase high-performance liquid chromatography.
A rapid, sensitive and specific high-performance liquid chromatographic assay was developed for the determination in plasma of (E)-1,2,3,4-tetrahydro-1,1,4,4-tetramethyl-6-(1-methyl-2- phenylethenyl)naphthalene (1) and its phenolic metabolite (E)-4-[2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)-2- methylethenyl]-phenol (2). An extraction procedure using protein precipitation and liquid-liquid extraction was combined with a simple column-switching technique. To minimize sample consumption, the assay was adapted to a sample volume of 200 microliters, which was sufficient for more than 90% of all determinations. The quantification limit was 100 ng/ml for 1 and 2, whereas the detection limits were 20 and 30 ng/ml, respectively. The recoveries for 1 and 2 were 91 and 94%, respectively, using ultraviolet detection at 280 nm. The assay was used to quantify both compounds in human plasma samples.
Chromatography, High Pressure Liquid↗
Phospholipase A2 inhibition by alkylbenzoylacrylic acids.
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Acrylates↗
Allergen-induced bronchospasm in passively sensitized guinea pigs: influence of new substances in comparison to reference compounds.
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Acrylates↗
Bacteremia following operative endoscopy of the upper gastrointestinal tract.
The rate of bactaeremia following surgical endoscopy of the upper gastrointestinal tract is reported with up to 50% depending on the therapeutic measure performed. In a prospective study we examined 160 patients treated by surgical endoscopy of the upper digestive tract. The rate of bactaeremia showed a significant difference with 12.5% after diagnostic and 28.96% after surgical endoscopy. Our results recommend a single shot antibiotic prophylaxis depending on the endoscopic measure performed and the patient's individual risk.
Anti-Bacterial Agents↗
[Prospective randomized study on the comparative effect between 10% HES 200/0.5 and 6% HES 200/0.5 in patients with hearing loss].
Two good comparable groups of patients (group 1 treated with 10% HES 200/0.5 + Naftidrofuryl; and group 2 treated with 6% HES 200/0.5 + Naftidrofuryl) with sudden hearing loss were compared with respect to their hearing recovery, hemorheological parameters and intravasal detectable HES fraction. The results showed an overall improvement of the hemorheological features. No difference between the two groups could be found wether in the hearing improvement nor the investigated parameters. We therefore conclude, that HES 6% is a good alternative to HES 10% for hemodilution therapy in cochleo-vestibular disorders.
Adult↗
Promoter traps in embryonic stem cells: a genetic screen to identify and mutate developmental genes in mice.
A general strategy for selecting insertion mutations in mice has been devised. Constructs lacking a promoter and including a beta-galactosidase gene, or a reporter gene encoding a protein with both beta-galactosidase and neomycin phosphotransferase activity, were designed so that activation of the reporter gene depends on its insertion within an active transcription unit. Such insertion events create a mutation in the tagged gene and allow its expression to be followed by beta-galactosidase activity. Introduction of promoter trap constructs into embryonic stem (ES) cells by electroporation or retroviral infection has led to the derivation of transgenic lines that show a variety of beta-galactosidase expression patterns. Intercrossing of heterozygotes from 24 strains that express beta-galactosidase identified 9 strains in which homozygosity leads to an embryonic lethality. Because no overt phenotype was detected in the remaining strains, these results suggest that a substantial proportion of mammalian genes identified by this approach are not essential for development.
Animals↗
Promoter interactions in retrovirus vectors introduced into fibroblasts and embryonic stem cells.
The activity of the Moloney murine leukemia virus promoter is restricted in mouse embryonic stem cells. Gene expression with retrovirus vectors can be achieved in these cells if internal promoters are used. To address the possible influence of the viral enhancer sequences on expression from the internal promoter, we have constructed high-titer, self-inactivating retrovirus vectors which delete viral regulatory sequences upon integration in the host genome. We show that deleting most of the viral enhancer sequences has no significant effect on viral titer. This enhancer deletion leads to either an increase or a decrease in the amount of RNA transcribed from the internal promoter, but no consistent change can be found with any type of vector. The same changes in expression from the internal promoter observed in embryonic stem cells are also observed in 3T3 fibroblast cells, in which the viral promoter is active. These results indicate that viral regulatory elements influence expression from an internal promoter independently of expression from the virus promoter.
Animals↗
Direct correlation of parvalbumin levels with myosin isoforms and succinate dehydrogenase activity on frozen sections of rodent muscle.
Parvalbumin (PV) is a soluble Ca++ binding protein which is particularly concentrated in fast muscles of rodents. We have developed a new protocol to fix frozen sections of muscle by formaldehyde vapor, which enabled us to immunochemically stain serial frozen sections for PV. Fiber types were defined on the basis of myosin ATPase stability, and of isomyosins identified by a variety of antibodies because ATPase stability alone yielded ambiguous results in the mouse. Slow Type I fibers in mouse and rat were devoid of PV and had intermediate to high SDH levels. Fast fiber subtypes IIA, IIB, and IIX-like were defined in the mouse on the basis of the similarity of their myosin heavy chain immunoreactivity to these types in the rat. The soleus muscle was usually PV negative, but a small population of strongly PV-positive IIX-like fibers was present in the mouse. In mouse fast muscle, small diameter IIA fibers were PV negative with high SDH activity. In both mouse and rat, PV reactivities of IIB and IIX fibers were higher than those of IIA and I, whereas SDH levels of IIA, IIX, and I fibers were higher than those of IIB. Thus, PV content correlated with the type of myosin ATPase but not with SDH levels. The method described for immunocytochemistry of PV may be applicable to other highly soluble proteins.
Animals↗
[Elimination half life of the opiate etorphine].
In the capacity of an initial study both, the pharmacocinetics as well as the metabolism of etorphine were investigated. In a self-trial a bolus of 8 micrograms tritium-marked etorphine as administered intravenously and subsequently the half-lives in serum and urine were determined. To achieve this, etorphine and etorphineclucuronide were separated via HPLC and then quantified by measuring the radioactivity. The development of the concentrations was devided into 3 phases. Within the first phase half-lives of etorphine and etorphineglucuronide were found in the range of 0.3-1 hour in serum and, likewise, in urine. During the second phase the estimated half-life of etorphineglucuronide was 160-260 hours in serum as well as in urine. Within the last phase half-lives in urine were 47 hours for etorphine and 41 hours for etorphineglucuronide while the calculation of the half-lives in serum was not sufficiently feasible.
Adult↗
[Pilot study of the metabolism of codeine to morphine and a possible modification by benzodiazepines].
After administration of high-dose codeine we found that in two cases 20-40% of the total morphine-equivalents in the 24-hour urine sample were free morphine. After another 24 hours the proportion of free morphine was up to 70% and after roughly 96 hours even went up to 96%. Although 10% of the administered codeine was eliminated as morphine. In contrast to the values reported in literature we found that even with codeine/morphine ratios greater than 0.5 and morphine concentrations of up to 2000 ng/ml urine one cannot naturally conclude that morphine/diamorphine has been consumed. The short half-life of codeine in serum was 2-4 hours, the final half-life was 9-11 hours. In urine we found a short half-life of 1-6 hours as well as a long half-life of 7-12 hours. When diazepam was administered simultaneously with codeine the expected half-life in serum was up to 1.5 times and in urine 2.5 times. The codeine/morphine ratios were hardly affected so far as evidence goes which they give of preceding drug-intake.
Biotransformation↗
[Urine checks as a supportive measure with drug abuse patients to supplement current therapy models].
Urine samples of 120 heroin-addicted probands who had to take part in urinanalysis tests were analysed during a 26 months' period. Up to 7 substances (morphine/diamorphie, codeine, cocain, LSD, cannabinoides, barbiturates and amphetamines) were tested. The results were compared to the results of a group of 177 cannabies-smokers. The purpose of this study was to find out in how far urinanalysis tests can change drug-consuming behaviour. More than 80% of the cannabis-smokers showed evidently a decrease of THC-positive urine samples at the end of the investigation period. Only about 13% had positive samples during the whole period. 12 out of 120 heroin-addicted probands (= 10%) had morphine-positive urine samples at the beginning of investigations. For 104 out of 1423 tested samples (46 probands) an unmistakable distinction between morphine/diamorphine- or codeine-intake was not possible because the concentrations found were too low. About 20% of the samples indicated a shift to a substitutional used drug like codeine. Further more a slightly significant increase of cannabis-intake was to be observed.
Follow-Up Studies↗