Search PubMed⌕ Search

Biomedical subjects

H Schneider

Publications and source records attributed to H Schneider.

At least 37 records · Page 2Linked to original sources
PubMed2005

[Interventional therapy of acute ST-elevation myocardial infarction in a regional network].

BACKGROUND AND OBJECTIVES: Management of acute ST-elevation myocardial infarction (STEMI) demands rapid and complete reflow to the infarct related artery (IRA). Primary PCI (percutaneous coronary intervention) performed by experienced operators is superior to thrombolytic thrombolytic therapy and reduces mortality, occurrence of non-fatal reinfarction and stroke, but is not available in rural Germany. We established a regional infarction-network using established therapeutic guidelines comprising of 1 interventional center and 7 referring community hospitals without PCI facilities. PATIENTS AND METHODS: We analyzed 322 patients with STEMI treated by PCI within the network; 160 patients were transferred from a community hospital without PCI facilities (transfer group (TG): 63.4 yrs., 71.8% men) and 162 patients were admitted directly to the interventional center (center group (CG): 61.7 yrs., 73.8% men). The interval from onset of symptoms to first medical contact was 205 minutes in TG, and 195 minutes in CG (n.s.); 7.8% of the CG and 7.2% of the TG patients were in cardiogenic shock; 95% of patients completed 12- months of follow-up. RESULTS: In the TG, median transportation time to PCI was 54 minutes. PCI of the infarct-related artery (IRA) was performed in 95.1% of TG patients and in 94.1% of CG patients. In addition, 96% of all patients received a GP IIb/IIIa receptor inhibitor. In case of pre-interventional application of GP IIb/IIIa receptor inhibitor 22.3% of patients revealed TIMI-3 flow of the IRA before PCI. After PCI, normalized flow to the IRAwas documented in 87.5% of CG versus 86.3% of TG. There were no differences between groups with respect to infarct size (TG vs. CG: CK 2482 vs. 2481 U/I; CKMB 302 vs. 264 U/I), mortality (30 days: 5.3 vs. 5.2%, 6 months: 7.3 vs. 7.1%, 12 months: 7.9 vs. 7.8%); NYHA (1.41 vs. 1.43) and left ventricular ejection fraction (0.41 vs. 0.43). CONCLUSIONS: The organization of a regional STEMI-network with logistic alliance of community hospitals and one experienced interventional center ensures timely PCI treatment of patients with STEMI according to present guidelines even in rural areas, and relegates thrombolytic treatment to bail-out scenarios only.

Aged↗
PubMed2005

Systemic aspergillosis with predominant genitourinary manifestations in an immunocompetent man: what we can learn from a disastrous follow-up.

Prostatic aspergillosis is a rare finding with only ten cases reported previously. We report the first case of systemic aspergillosis predominantly presenting with prostatic involvement and, clinically, with urinary retention in an immunocompetent host. Routine transurethral resection was performed due to benign prostatic hyperplasia with subvesical obstruction. Concomitant prostatic aspergillosis was diagnosed without signs of systemic infection. In the clinical follow-up systemic aspergillosis became rapidly progressive requiring complex surgical interventions and long-term antifungal therapy. The current literature is reviewed, and diagnostic and management options are discussed.

Abscess↗
PubMed2005

A comparative study of the effect of three different syncytiotrophoblast micro-particles preparations on endothelial cells.

Pre-eclampsia is a pregnancy-associated multi-system disorder of unknown etiology, characterized by damage to the maternal endothelium. The latter facet has been suggested to be mediated in part by elevated shedding of inflammatory placental syncytiotrophoblast micro-particles (STBM) into the maternal circulation. In this study, we have examined STBM prepared by three different methods: mechanical dissection, in vitro placental explant culture and perfusion of placental cotyledons. All three preparations yielded morphologically similar STBM, as confirmed by scanning electron microscopy, and all contained syncytiotrophoblast-specific proteins as determined by the presence of placental alkaline phosphatase. The functional properties of the three STBM preparations were examined on human umbilical vein endothelial cells (HUVEC), where the mechanically prepared particles were found to inhibit proliferation to the greatest extent. Furthermore, only mechanically prepared STBM lead to the detachment and apoptosis of HUVEC cells. Our study, therefore, suggests that STBM prepared from placental perfusion or in vitro explant culture are biologically different from mechanically prepared ones, and may provide a better approximation of physiologically produced placental micro-particles.

Adult↗
PubMed2005

Factors influencing adenovirus-mediated airway transduction in fetal mice.

Intra-amniotic injection of adenovirus allows transduction of the fetal airways following natural fetal breathing movements. This administration method is promising for use in gene therapy for cystic fibrosis and other diseases for which the main target for exogenous gene expression is the lung. Here we have investigated factors that may affect the efficacy of gene transfer to the murine fetal lung. We examined marker compound distribution and transgene expression (from a first-generation adenoviral vector) at different stages of development. This demonstrated that fetal breathing movements at 15-16 days of gestation are of sufficient intensity to carry marker/vector into the fetal lungs. These movements can be significantly stimulated by the combination of intra-amniotic theophylline administration and postoperative exposure of the dam to elevated CO(2) levels. However, the most important factor for efficient and consistent pulmonary transgene delivery is the dose of adenoviral vector used, as both the degree of transduction and the percentage of lungs transduced increases with escalating viral dose.

Adenosine↗
PubMed2005

Posterior sacculation of the uterus in a patient presenting with flank pain at 29 weeks of gestation.

BACKGROUND: Uterine sacculation is a rare complication of pregnancy and may cause substantial peripartal morbidity. CASE: A possible diagnosis of posterior uterine sacculation was raised when a 34-year-old Gravida 1 Para 1 presented with bilateral flank pain at 29 weeks. Sonographic and magnetic resonance imaging findings confirmed the diagnosis and demonstrated bilateral dilated renal pelvises. Bilateral nephrostomas were placed, offering the patient considerable relief. A healthy female newborn was delivered by cesarean at 34 1/7 weeks. Operative findings confirmed the posterior sacculation of the uterus. CONCLUSION: Early diagnosis of sacculation of the uterus is necessary to limit maternal and fetal morbidity and mortality. For a detailed evaluation of the pelvic anatomy, we recommend the use of magnetic resonance imaging in the third trimester.

Adult↗
PubMed2005

Neuroanatomical correlates of voluntary inhibition of accommodation/vergence under monocular open-loop viewing conditions.

The purpose of this work is to identify human neural circuits involved in inhibition of accommodation/vergence by contrasting the cortical functions subservient to negative voluntary accommodation/vergence (NVA) with those evoked by active fixation in darkness (FIX). Five subjects with normal corrected acuity were studied using positron emission tomography and the HO bolus technique. The dominant right eye viewed a laser speckle pattern (633 nm) whose direction and velocity of motion were determined by the refractive state of the eye. The speckle pattern was presented at a distance of 1.8 m (0.55 D). The non-dominant eye was patched. Subjects performed two tasks counterbalanced for order effects: (i) attempted fixation on the remembered target in darkness with the dominant eye open and 'fixating'; and (ii) voluntary reduction of the laser speckle flow during each alternate 20-s epoch when a convex +2.0 D lens was placed in front of the right eye causing the speckle pattern to move downwards at 3 degrees /s. Comparison of the condition of NVA with the condition of FIX indicated widespread occipital activation. Decreases in absolute regional cerebral blood flow occurred in the superior parietal cortex (BA 5), frontal cortex (BA 8 and 10) and within the postcentral/precentral gyrus (BA 1/2/3/4) bilaterally where deactivation clusters eclipsed the presumed neck and shoulder areas. Negative accommodation/vergence appears to be driven by a reduction of parasympathetic tone, and has the effect of shutting down brain regions known to be involved in regulating visual search as well as a centrally controlled eye-head-neck-shoulder motor programme responsible for posturing gaze.

Accommodation, Ocular↗
PubMed2005

Partially hydrolysed guar gum supplemented comminuted chicken diet in persistent diarrhoea: a randomised controlled trial.

BACKGROUND: Partially hydrolysed guar gum (Benefiber) added to a diet is fermented in the colon, producing short chain fatty acids, which improve intestinal function, including colonic salt and water absorption. AIMS: To evaluate the effect of Benefiber supplemented comminuted chicken diet in the treatment of persistent diarrhoea. METHODS: One hundred and sixteen children (aged 5-24 months), presenting to Dhaka Hospital with a history of watery diarrhoea for more than 14 days (persistent diarrhoea), were randomised to receive either: (1) comminuted chicken diet with Benefiber (study diet); or (2) comminuted chicken diet without Benefiber (control diet). The study period was seven days. RESULTS: Of 116 children, 57 received the study diet and 59 received the control diet. Diarrhoea resolved in a greater number of children with the study than with the control diet (46/55 (84%) v 36/58 (62%); odds ratio 3.12, 95% CI 1.19 to 8.4). Survival analysis for the duration of diarrhoea also showed a reduced duration of diarrhoea in children receiving the study diet. There was also a trend in daily stool reduction in children receiving the study diet, significant on days 4-7. CONCLUSION: Results show that Benefiber supplemented comminuted chicken diet enhances recovery of children with persistent diarrhoea, indicating its therapeutic potential.

Animals↗
PubMed2005

Improving the quality of STI care by private general practitioners: a South African case study.

OBJECTIVES: Evaluation of an intervention to improve quality of sexually transmitted infections (STI) care among 64 private general practitioners (GPs) working in two urban districts in Gauteng Province, South Africa. METHODS: We implemented a multifaceted intervention, the core of which were four interactive continuing medical education seminars. Changes in STI treatment practices were evaluated through record reviews before and after the continuing medical education intervention in 17 randomly selected practices in the intervention districts and in nine randomly selected practices from a reference GP group (n = 34). RESULTS: There were statistically significant improvements in the quality of drug treatment for urethral discharge but not pelvic inflammatory disease among both intervention and reference GPs. CONCLUSIONS: Improvements in STI quality were possibly the result of a background secular trend rather than the intervention itself. Further research is needed on financial and other incentives to improved quality of STI care in the private sector environment.

Family Practice↗
PubMed2005

Effect of mandibular position on upper airway collapsibility and resistance.

It has been proposed that advancement of the mandible is a useful method for decreasing upper airway collapsibility. We carried out this study to test the hypothesis that mandibular advancement induces changes in upper airway patency during midazolam sedation. To explore its effect, we examined upper airway pressure-flow relationships in each of 4 conditions of mouth position in normal, healthy subjects (n = 9). In the neutral position, Pcrit (i.e., critical closing pressure, an index of upper airway collapsibility) was -4.2 cm H(2)O, and upstream resistance (Rua) was 21.2 cm H(2)O/L/sec. In the centric occlusal position, Pcrit was -7.1 cm H(2)O, and Rua was 16.6 cm H(2)O/L/sec. In the incisor position, Pcrit was significantly reduced to -10.7 cm H(2)O, and Rua was significantly reduced to 14.0 cm H(2)O/L/sec. Mandibular advancement significantly decreased Pcrit to -13.3 cm H(2)O, but did not significantly influence Rua (22.1 cm H(2)O/L/sec). We conclude that the mandibular incisors' position improved airway patency and decreased resistance during midazolam sedation.

Adult↗
PubMed2005

Sexually transmitted infections -- factors associated with quality of care among private general practitioners.

OBJECTIVES: To study the factors associated with quality of sexually transmitted infection (STI) care among private general practitioners in Gauteng. METHODS: We analysed 1 194 records of patients attending 26 randomly selected GP practices in the first 3 months of 2000 and 2002, for 3 STI syndromes, namely urethral discharge, pelvic inflammatory disease and genital ulcers. We assessed adherence to nationally accepted STI treatment guidelines and analysed the influence of patient and practice-level variables on effectiveness of STI drug regimens and trends over time. RESULTS: After controlling for syndrome mix, district and time period, appropriate drug treatment for STIs was significantly associated with the client having medical aid (p < 0.001), recent graduation as a medical practitioner (p < 0.001) and male GP gender (p = 0.007). Between 2000 and 2002, STI care improved for clients with medical aids but for not cash clients. CONCLUSIONS: There was variation in the quality of prescribing for STIs among GPs and positive trends in this prescribing. There is a need for interventions that address the financial incentives that may hamper quality of STI care for cash clients.

Family Practice↗
PubMed2004

[Guideline-conforming interventional treatment of acute ST-segment elevation myocardial infarction in rural areas using network collaboration].

BACKGROUND AND OBJECTIVES: Therapy of acute myocardial infarction demands rapid and complete myocardial reperfusion. Primary percutaneous coronary intervention (PCI) performed is superior to thrombolytic therapy in reducing mortality, non-fatal reinfarction and stroke, but is not available in rural Germany. PATIENTS AND METHODS: : From 8/2001 to 12/2002 322 patients with STEMI were treated by PCI with standardized therapeutic guidelines within a regional infarction-network comprising one interventional centre and 7 community hospitals without PCI facilities. 160 patients were relocated (transferred) from a community hospital without PCI facilities (transfer group, 63.4 yrs., 71.8 % men); 162 patients were admitted directly to the interventional centre (centre group, 61.7 yrs., 73.8 % men). The interval from onset of symptoms to first medical contact was 205 minutes in the transfer group, and 195 minutes in the centre group. 7.8 % of the centre group and 7.2 % of the transfer group patients were in cardiogenic shock. 95 % of patients have completed a 6-month's follow-up. RESULTS: In the transfer group median transportation time to PCI was 54 minutes. PCI of the infarct-related artery (IRA) was performed in 95.1 % of transferred patients after transfer and in 94.1 % of patients with direct admission. In addition 96 % of all patients received a GP IIb/IIIa receptor inhibitor. In case of pre-interventional application of the GP IIb/IIIa receptor inhibitor 22.3 % of patients revealed normal (TIMI-3) flow of the IRA before PCI, compared to 14.9 % TIMI-3 flow with 5000 IE Heparin/500 mg aspirin alone (p < 0.05). After PCI normalized flow in the IRA was documented in 87.5 % after direct admission and 86.3 % after transfer. No differences between groups were shown with respect to infarct size (transfer vs. centre: CK 2482 vs. 2481 U/I; CKMB 302 vs. 264 U/I), mortality (30 days: 5.3 vs. 5.2 %, 6 months: 7.3 vs. 7.1 %); NYHA (1.41 vs. 1.43) and left ventricular ejection fraction (0.41 vs. 0.43). CONCLUSIONS: The organization of a regional infarction-network with logistic alliance of community hospitals with one experienced interventional centre ensures timely PCI for patients with STEMI according to present guidelines even in rural areas.

Angioplasty, Balloon, Coronary↗
PubMed2004

Interleukin-6: a cytokine to forget.

It is known that proinflammatory cytokines such as interleukin-6 (IL-6) are expressed in the central nervous system (CNS) during disease conditions and affect several brain functions including memory and learning. In contrast to these effects observed during pathological conditions, here we describe a physiological function of IL-6 in the "healthy" brain in synaptic plasticity and memory consolidation. During long-term potentiation (LTP) in vitro and in freely moving rats, IL-6 gene expression in the hippocampus was substantially increased. This increase was long lasting, specific to potentiation, and was prevented by inhibition of N-methyl-D-aspartate receptors with (+/-)-2-amino-5-phosphonopentanoic acid (AP-5). Blockade of endogenous IL-6 by application of a neutralizing anti-IL-6 antibody 90 min after tetanus caused a remarkable prolongation of LTP. Consistently, blockade of endogenous IL-6, 90 min after hippocampus-dependent spatial alternation learning resulted in a significant improvement of long-term memory. In view of the suggested role of LTP in memory formation, these data implicate IL-6 in the mechanisms controlling the kinetics and amount of information storage.

Animals↗
PubMed2004

Intracellular delivery of carbohydrates into mammalian cells through swelling-activated pathways.

Volume changes of human T-lymphocytes (Jurkat line) exposed to hypotonic carbohydrate-substituted solutions of different composition and osmolality were studied by videomicroscopy. In 200 mOsm media the cells first swelled within 1-2 min and then underwent regulatory volume decrease (RVD) to their original isotonic volume within 10-15 min. RVD also occurred in strongly hypotonic 100 mOsm solutions of di- and trisaccharides (trehalose, sucrose, raffinose). In contrast to oligosaccharide media, 100 mOsm solutions of monomeric carbohydrates (glucose, galactose, inositol and sorbitol) inhibited RVD. The complex volumetric data were analyzed with a membrane transport model that allowed the estimation of the hydraulic conductivity and volume-dependent solute permeabilities. We found that under slightly hypotonic stress (200 mOsm) the cell membrane was impermeable to all carbohydrates studied here. Upon osmolality decrease to 100 mOsm, the membrane permeability to monomeric carbohydrates increased dramatically (apparently due to channel activation caused by extensive cell swelling), whereas oligosaccharide permeability remained very poor. The size-selectivity of the swelling-activated sugar permeation was confirmed by direct chromatographic measurements of intracellular sugars. The results of this study are of interest for biotechnology, where sugars and related compounds are increasingly being used as potential cryo- and lyoprotective agents for preservation of rare and valuable mammalian cells and tissues.

Biological Transport↗
PubMed2004

Infrared spectra of X-.CO(2).Ar cluster anions (X=Cl,Br,I).

Ion-molecule clusters of the heavier halide anions X-.CO(2) (X=Cl-,Br-,I-) with CO2 have been studied by gas phase infrared photodissociation spectroscopy, using Ar evaporation from the complexes X-.CO2.Ar upon infrared excitation. We observe that the asymmetric stretch vibrational mode of the CO(2) molecule is red-shifted from the frequency of free CO2, with the red-shift increasing toward the lighter halide ions. A similar trend is repeated in the region of the Fermi resonance of the combination bands of the asymmetric stretch vibration with two quanta of the bending vibration and the symmetric stretch vibration. We discuss our findings in the framework of ab initio and density functional theory calculations.

Journal Article↗
PubMed2004

[Symptoms or complaints in the aging male--which questionnaires are available?].

Age associated hypoandrogenism and related changes in sexual function, as well as multiple physical complaints, and affective and cognitive changes have all been described in the aging male. In addition to decreased testosterone levels, clinical symptoms are required in order to perform substitution therapy. The assessment of symptoms and complaints in the aging male is discussed based on scientific test criteria. Commonly used questionnaires have the advantages of economy and independence from the investigator. In order to cover the broad range of age associated changes, numerous standardized and reliable procedures are available. However, these have usually not been developed specifically in order to assess androgen dependent changes. Preliminary, specific "aging male" questionnaires do not correlate reliably with the levels of testosterone. Thus there is a need for research and development in order to identify and assess androgen dependent complaints.

Age Factors↗