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Biomedical subjects

H Walther

Publications and source records attributed to H Walther.

At least 19 recordsLinked to original sources

[Complicated aneurysm of the splenic artery].

For 2 1/2 years after sustaining blunt trauma to the abdomen a 51-year-old woman had experienced episodes of pain, recently with throbbing, in the left upper quadrant. A smooth, circumscribed, painless tumour filling the left upper and mid-abdomen was palpable under the left costal margin. Ultrasound revealed a 12 x 11 cm space-occupying mass with cystic-fluid components, at first interpreted as a blood-containing pseudocyst. Computed tomography demonstrated a connection with the splenic artery. Digital subtraction angiography established the diagnosis of an aneurysm of the splenic artery arising immediately beyond its origin from the coeliac trunk. Splenectomy and resection of the aneurysm were performed. Total removal of the aneurysm was not undertaken because the dorsal aspect of the aneurysm wall was very thick and fused with the retroperitoneum. The postoperative course was unremarkable. The genesis of splenic aneurysm often remains unexplained. Its occurrence after blunt abdominal trauma is exceedingly rare.

Abdominal Injuries

[Visual evoked potentials in Alzheimer's and Parkinson disease].

Harding et al. suggested at first that an increase of P2 latency in flash VEP without an increase of P2 latency in pattern reversal VEP may be a diagnostic marker of Alzheimer's disease. Up to now there is no convincing evidence for this hypothesis. The purpose of the present study was to examine this hypotheses in an extended group of patients with Alzheimer's disease (n = 36). In addition, a group of patients with Parkinson's disease (n = 8) without dementia syndrome and a group of healthy elderly controls (n = 46) was investigated in order to determine the sensitivity and specificity of these VEP parameters. The results confirmed significant group differences between patients with Alzheimer's disease and healthy controls concerning the increase of Flash P2 latency and unchanged latency of P2 in the pattern reversal VEP. No significant correlations were found between duration of illness and mental test scores. The group differences of P2 latency in the flash VEP for patients with Parkinson's disease and healthy controls were also significant. Therefore, the increase of flash P2 latency in VEP does not seem to be specific for Alzheimer's disease nor for dementia syndrome. The pathological mechanism causing the flash P2 latency increase in a remarkable number of neuropsychiatric patients should be elucidated in further experimental investigations.

Aged

[Side effects of nifedipine in healthy probands within the scope of a discontinued bioavailability study].

In a prematurely discontinued bioavailability study of 40 mg nifidepine retard dragees, it was shown in four subjects that cardiovascular side effects may occur at nifedipine levels equal to or higher than some 80 ng/ml serum. These cases were suggestive of a relationship between the areas under the concentration vs. time curves in the range of side effects, AUC (tC80), and the so-called side effects scores which were derived from the number and the duration of undesirable side effects.

Adult

[Time course of inhibition of caffeine elimination in response to the oral depot contraceptive agent Deposiston. Hormonal contraceptives and caffeine elimination].

In the course of six months, the influence of the oral depot contraceptive, Deposiston (3 mg ethinylestradiol sulphonate and 10 mg norethisterone acetate per menstrual cycle) on the pharmacokinetics of caffeine as a model substance was studied in seven women in intraindividual comparison. The first examination began prior to administration of Deposition. The women were subjected to little challenge as saliva was used as the measuring compartment. Deposiston was found markedly delay the elimination half-life life of caffeine (p less than 0.05): t1/2 prior to therapy 4.9 +/- 2.6 h and, after as little as 2 mg ethinylestradiol sulphonate 8.0 +/- 3.5 h. In contrast to the effect observed for preparations containing less estrogen, these longer half-lives persisted throughout the trial. As expected, the AUC values were slightly elevated during this period, whereas clearance values were reduced.

Adult

[Serum level determination in patients with acute myocardial infarction under diphenylhydantoin therapy].

For the therapy of disturbances of the cardiac rhythm with phenytoin 3 different dosage regimes are examined, in which cases an oral application of phenytoin proves as not suitable. Only by a stepped infusion with following oral treatment a rapid saturation and therapeutically effective serum levels are achieved which are decisive for the effectiveness of the therapeutic measures.

Administration, Oral

Interindividual differences of protein binding in man.

Using equilibrium dialysis protein unbound fractions of phenytoin (390 patients) and phenobarbital (220 patients) revealed serum protein bindings of 8 to 40 per cent and 25 to 80 per cent, respectively. For the purpose of therapy service, this pronounced interindividual variability required in the case of a great number of patients the determination of the extent of protein binding so as to exactly evaluate therapeutical failures or occurrence of undesirable effects.

Blood Proteins

[Studies on the separation and photometric determination of antiepileptics (author's transl)].

Well-known methods for the photometric determination of antiepileptics in body fluids were tested from the aspect of their utilization in a pharmacokinetic therapy service of clinical pharmacology. In the framework of a comparative synopsis of methods, specifications are given for the determination of phenytoin, phenobarbital, methylphenobarbital, and carbamazepine.

Anticonvulsants

Effectiveness of analgesics evaluated with the tourniquet technique.

The analgesic effectiveness of acetylsalicyclic acid, noramidopyrinium methane sulfonate sodium, pentazocin and codeine phosphate was studied in 19 healthy male and female subjects between 25 and 65 years of age by means of two variants of the tourniquet technique. Compared with placebo, no differences in effectiveness were found using a double-blind approach; primarily because of the low reliability of the method.

Adolescent

[Optimizing the therapeutic process in long-term antiepileptic therapy through the determination of drug levels in patients].

Serum levels of phenytoin, phenobarbital, carbamazepine, and ethosuximide were determined in about 2,000 subjects treated on an outpatient and inpatient basis, respectively. Therapeutical serum level ranges were obtained in about 50 percent of the patients. In the other patients, the values determined were either too low or too high. These studies, in addition to enabling the drug-taking behavior of patients to be objectified, made possible "blood-level-oriented dosage" and allowed differential approaches to be adopted in the control of undesirable effects. Blood level determinations permit the therapeutical procedure to be improved and made more reliable especially in "problem cases". A pharmacokinetic therapy service has proved useful for long-time antiepileptic therapy.

Anticonvulsants

Dosage monitoring through measurement of serum level--a task of clinical pharmacology.

Dosage monitoring or "pharmacokinetic therapy service", respectively, covers blood level governed therapy schedule or blood level controlled dosage for certain types of therapy. It is also advantageous in applying drugs of a small therapeutic range or in "risk" patients such as children, old men and patients suffering from elimination disturbances. With the blood level data known, physicians can follow an optimum therapy schedule. The principle of this service is detailed using therapy with antiepileptics as an example. Through substantiation is given.

Adult