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Biomedical subjects

H Wulf

Publications and source records attributed to H Wulf.

At least 145 records · Page 8Linked to original sources
PubMed1990

Postmortem findings after epidural anaesthesia.

Postmortem specimens of 10 patients who had received continuous epidural anaesthesia postoperatively (ranging from 2-21 days) were examined. Slight epidural haemorrhage was observed in six patients and a macroscopically visible haematoma in a thrombocytopenic patient. Nonspecific epidural inflammatory reactions were observed microscopically in all patients. Specimens from seven patients with systemic infection showed signs of epidural infection. No similar pathology was found in a control group without epidural catheters. The aetiology and risk factors of the above findings are discussed, and recommendations given to prevent such sequelae after epidural anaesthesia.

Adult↗
PubMed1990

[Anesthesia and intensive therapy of pregnant women with the HELLP syndrome].

The HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) is a severe complication of pre-eclampsia with high risk for mother and fetus. During the last 40 months 27 parturients met the diagnostic criteria for HELLP syndrome in the University Hospital of Kiel (Tables 1-3). In 24 cases cesarean section was performed. Fetal mortality was 17.2%. In 13 women an uneventful clinical course resulted, all other patients developed complications: renal insufficiency (11 cases), disseminated intravascular coagulation (DIC) (4), intracerebral hemorrhage (1), cerebrovascular ischemia (1), eclamptic convulsions (3), reoperation due to intra- or extra-abdominal hemorrhage (4), severe blood loss ex vagina following spontaneous delivery (1), and liver rupture (1). Despite these severe complications no maternal death was observed. DIC, intrauterine death, and a rapid increase in liver enzymes are considered to be serious prognostic factors that could help to identify high-risk patients. The following recommendations for therapy of parturients suffering from HELLP syndrome are given: epidural anesthesia is not an appropriate method in HELLP syndrome because of the risk of epidural hemorrhage due to thrombopenia. At the present time general anesthesia seems to be the method of choice. Inhalation anesthetics such as halothane, enflurane, or isoflurane should probably be omitted in view of the preexisting hepatopathy. The high risk and the unpredictable postpartum course strongly indicate intensive care for parturients with HELLP syndrome. Antihypertensive, antieclamptic therapy and prophylactic measures to avoid renal insufficiency or hemorrhage (e.g. early substitution of erythrocytes, thrombocytes, and coagulation factors) deserve special attention. Co-operation between obstetrician and anesthesiologist is essential to obtain optimal therapy for these high-risk patients.

Adult↗
PubMed1989

[Fortification of bread with bean flour (Phaseolus vulgaris, L.). I. Flour and bread aspects].

This paper deals with the incorporation of bean flour (Phaseolus vulgaris, var. Tórtola) (BF) made at laboratory scale in bread enrichment, by substituting 2, 4, 6, 8 and 10% wheat flour by bean flour. First, wheat and bean flours blends were prepared to study the farinological properties of these combinations. Then, breads containing bean flour in the above-mentioned proportions were made. At the 6, 8 and 10% levels, a deterioration in farinological properties of the blends, such as water absorption, developing time, weakening and W value were evident. Baking tests showed that no significant changes occurred with respect to water absorption, mixing time, weight and volume of breads, and color and texture of crumb in BF levels of 2, 4 and 6%. However, overall qualities of the breads were significantly impaired at the 8 and 10% levels.

Bread↗
PubMed1989

[Fortification of bread with bean flour (Phaseolus vulgaris). II. Nutritive value of the fortified bread].

The protein value of breads containing bean flour (BF) (Phaseolus vulgaris, cv Tórtola) was tested in rats. BF replaced wheat flour by 2, 4, 6, 8 and 10 per cent. Protein content was 9.3 (N x 5.7) per cent and 24.4 (N x 6.25) per cent for wheat flour and bean flour, respectively. The protein content in the control bread was 11.6%, and increased to 12.6% at the 10% level of substitution. Parameters measured were protein efficiency ratio (PER), net protein ratio (NPR), and apparent and true digestibility of the protein. PER, in the control bread, was 1.44; a slight, non-significant increase occurred up to the 10% level of substitution. The control bread showed a NPR value of 2.78, figure which also remained practically unchanged at the higher levels of replacement. Nevertheless, both apparent and true protein digestibility decreased significantly with increasing levels of substitution of WF by BF (p less than 0.05). In conclusion, substitution of WF by BF in bread did not produce the expected increase in protein quality under our experimental conditions.

Analysis of Variance↗
PubMed1988

Pharmacokinetics and protein binding of bupivacaine in postoperative epidural analgesia.

We describe a method, which is both specific and rapid, for the measurement of bupivacaine concentrations in plasma using high-performance liquid chromatography. Bupivacaine plasma concentrations, pharmacokinetics and protein binding in the postoperative period were investigated in seven patients (58-77 years old) following hip surgery. Postoperative analgesia was achieved by epidural bolus injections of 25 mg bupivacaine 0.25% every 6 h. Sufficient pain relief without side-effects was obtained. Total (maximum 1.13 micrograms/ml) as well as free (maximum 0.1 microgram/ml) bupivacaine plasma concentrations remained below toxic threshold levels and no cumulation occurred. Increased protein binding in the postoperative period is reported, emphasizing the importance of measuring the free fraction in addition to the total plasma concentration. The free fraction decreased from 5.4% preoperatively to 2.7% in the postoperative period (P less than 0.05). Changes in plasma protein binding of bupivacaine and changes in plasma levels of the acute phase reactant alpha-1-acid glycoprotein were correlated (r = 0.8, P less than 0.05). Difficulties in interpreting the elimination parameters following epidural administration are discussed, leading to the conclusion that the derivation of dosage regimens from kinetic parameters following epidural administration is not warranted.

Aged↗
PubMed1988

[Epidural hematoma following epidural catheter anesthesia in thrombocytopenia].

We report a 21-year-old male patient suffering from acute myeloid leukemia and concomitant thrombocytopenia. Following a diagnostic thoracotomy-which revealed Aspergillus pneumonia-he developed respiratory insufficiency and dyspnea. A thoracic epidural catheter was inserted and epidural morphine treatment led to improved ventilation. No clinical signs of pathological epidural processes were noticed during the treatment. The patient died of Aspergillus sepsis 26 days after catheter insertion. Autopsy revealed bacterial growth in the epidural space with slight infectious tissue reactions as well as an epidural hematoma. No evidence of spinal cord compression was found at autopsy. The development of epidural infection or hematoma seems to be a possible complication of epidural analgesia in patients suffering from impaired defense mechanisms or thrombocytopenia. These risk factors should be taken into account when epidural analgesia is considered. We suggest that the platelet count should be determined beforehand in patients suspected of having thrombocytopenia (e.g. cancer, pre-eclampsia).

Adult↗
PubMed1988

[Successful resuscitation in near-drowning with reference to special complications in recovery from great depth].

A case of near drowning of a 37-year-old female in cold sea water is reported. She was rescued after 30 minutes from a depth of 11 meters and resuscitation was successful. The case is to demonstrate that successful resuscitation is possible in adults even after such a long period of cold water immersion adequate rescue and treatment assumed. But if fast decompression during rescue from great depths occurs, one has to be aware of typical complications (air embolism, barotrauma).

Adult↗
PubMed1986

[Risks in postoperative pain therapy using a peridural catheter in a normal general ward].

In general surgical wards postoperative epidural analgesia was performed in 286 patients consecutively. Epidural catheters were kept in place 8.3 days in the average with a minimum of 24 h and a maximum of 45 d. Bupivacain was applied as a 0.25% solution with an average daily dose of 75-250 mg and single doses of 12.5-50.0 mg. An uncomplicated course was noticed in 250 cases, 19 cases showed haemodynamic, 7 cases neurologic and 10 cases technical complications. Severe decrease of systolic blood pressure more than 30% of the control value was due to postoperative haemorrhage, to anaemia with Hgb-concentration lower than 11 g/dl or to untreated chronical hypertension. On the basis of these observations a list of conditions has been drawn up which should be adhered to when epidural catheters are used for postoperative pain relief in normal wards.

Adolescent↗
PubMed1985

Occupational chronic exposure to organic solvents. XI. Alkylbenzene exposure of varnish workers: effects on hematopoetic system.

Thirty-five spraymen, who were varnishing vehicles with alkyd-, phenol- and polyestervarnishes, which were dissolved in solvent mixtures mainly containing o-, m-, p-xylene and ethylbenzene, have been investigated. The concentrations of these solvents in air were 2.1, 7.9, 2.8 and 4.0 ppm on average. The levels of alkylbenzenes in blood and those of their metabolites in urine have been determined. At two of the six working places the spraymen were additionally exposed to n-butanol, respectively 1,1,1-trichloroethane, and several C9-aromatic hydrocarbons. Some of the lacquers contained lead pigments. Alterations of blood cell counts have been observed under the described conditions of exposure. On average the number of lymphocytes was higher than that of segmented granulocytes. Erythrocytes and hemoglobin level of the spraymen were lower than those of the controls.

Adult↗
PubMed1985

Heavy-ion effects on mammalian cells: inactivation measurements with different cell lines.

In track segment experiments, the inactivation of different mammalian cells by heavy charged particles between helium and uranium in the energy range between 1 and 1000 MeV/u has been measured at the heavy ion accelerator Unilac, Darmstadt, the Tandem Van de Graaf, Heidelberg, and the Bevalac, Berkeley. The inactivation cross sections calculated from the final slope of the dose-effect curves are given as a function of the particle energy and the linear energy transfer.

Animals↗
PubMed1984

HZE effects on mammalian cells.

In track segment experiments cell survival and chromosome aberrations of mammalian cells have been measured for various heavy ion beams between helium and uranium in the energy range between 0.5 and 960 MeV/u, corresponding to a velocity range of 0.03 to 0.87 C, and an LET spectrum from 10 to 15 000 keV/micrometers. At low LET, the cross section (sigma) for cell killing increases with increasing LET and shows a common curve for all ions regardless of the atomic number. This indicates that in this region the track structure of the different ions is of only a minor influence, and it is rather the total energy transfer, which is important for cell killing. At higher LET values, deviations from a common sigma-LET curve can be observed which indicate a saturation effect. The saturation of the lighter ions occurs at lower LET values than for the heavier ions. These findings are also confirmed by the chromosome data, where the efficiency for the induction of chromosomal aberrations for high LET particles depends on the track structure and is nearly independent of LET. In the heavier beams (Z > or = 10) individual particles cause multiple chromosome breaks in mitotic cells.

Animals↗
PubMed1982

[Enrichment of bread with soy flour].

A series of laboratory studies was conducted to test the effect of the inclusion of soy flour in bread at the levels of 2, 4, 6, 8, 10 and 12%. The farinographic tests showed that several changes occurred with the incorporation of soy flour to the wheat flour, such as an increase in water absorption and weakening of the dough, and a decrease in the dough developing time. The mixing time remained unchanged up to the level of 8% substitution. Higher levels produced an increasing stickiness of the dough that made its handling more difficult. Soy-containing breads were slightly darker than wheat bread with a score of 71 points (scale 100) for the 12% level of substitution. The texture became coarser with increasing substitution of soy flour. Starting with the level of 4% of soy flour a volume decrease was observed, but this was corrected by the addition of 0.5% sodium stearoyl-2-lactylate (SSL). At the levels of 10 and 12% of soy flour, SSL was not effective in preventing the reduction of volume. The chemical composition of bread showed a regular increase in its protein content from 13.4, to 18% in the bread containing 12% soy flour. The protein efficiency ratio of bread improved from 1.17 for the wheat bread, to 2.13 for the bread containing 6% soy flour (casein, 2.54). Our results confirm the observation made by other workers in that the inclusion of soy flour in bread improves both the protein concentration and quality of this basic food.

Bread↗
PubMed1982

[Chemical and nutritional evaluation of triticale (Secale sp.) cultivated in Chile].

Six varieties of triticale and two varieties of wheat flours were analyzed for their proximal composition. The protein content of triticale flours ranged from 7.2 to 11.0%, and that of wheat flours, was 10.8 and 10.9%, respectively. The biological quality of Tca 8-74, measured as PER in Wistar rats, was 1.14, while that of commercial wheat flour was 0.85 (P less than 0.05). Amino acid supplementation of triticale flour with 0.2% L-lysine or 0.4% DL-threonine did not improve the biological quality of the protein. Supplementation with both amino acids, however, significantly improved both weight gain and PER. The value for the latter was 2.59 as compared to 2.62 for the standard casein diet. A panification assay was carried out using triticale, wheat and triticale: wheat blends in the following proportions: 1:0; 3:1; 1:1; 1:3; 0:1, and all of the breads were tested for their PER in rats. The PER for wheat bread and triticale bread was 1.05 and 1.25, respectively. None of the breads made from the wheat and triticale blends improved its protein quality beyond that of the wheat or triticale breads. The results of this study indicate that triticale has a better protein quality than wheat; furthermore, it may be used either alone or mixed with wheat in panification without affecting its protein value.

Amino Acids, Essential↗