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Biomedical subjects

J Breuer

Publications and source records attributed to J Breuer.

At least 19 recordsLinked to original sources
PubMed1992

[Hinman syndrome. Pronounced renal failure as a sequela of pseudo-neurogenic disorder of bladder emptying].

The case of an eight year old girl is presented who was seen because of secondary enuresis and recurrent urinary tract infection. Detailed examinations revealed urinary retention and sustained renal insufficiency (Creatinine clearance: 11 ml/min x 1.73 m2) due to a pseudo-neurogenic bladder. After improvement of renal function by continuous bladder drainage, bladder dysfunction was successfully treated by medication (Phenoxybenzamine, Baclofen), conventional physical therapy and biofeedback.

Acute Kidney Injury↗
PubMed1992

[Anomalous origin of the left coronary artery from the pulmonary artery. Variability of clinical aspects, echocardiography and angiography findings].

OBJECTIVES: Analysis of symptoms, diagnostical difficulties and follow-up in infants and children with anomalous origin of the left coronary artery from the pulmonary artery. METHODS: Retrospective study; 12 children between 3 weeks and 2 years old; time period: 1980-1991. RESULTS: Three infants were detected on routine examination because of a new cardiac murmur, the others presented with signs of cardiac failure. Cross sectional echocardiography and color Doppler flow mapping allowed to verify the suspected diagnosis. However, in one infant a false-negative cross sectional echocardiographic result was obtained. In this case nuclear magnetic resonance imaging was able to delineate the exact anatomy. Mean preoperative left ventricular ejection fraction: 33 +/- 4%; percentage of infants below the age of 6 months: 92%; surgery related mortality: 66%; mean follow-up of the remaining 4 patients being in good clinical condition: 2.9 +/- 1 years. CONCLUSIONS: 1. An anomalous origin of the left coronary artery should be included into the differential diagnosis when a new cardiac murmur is detected. 2. Possibility of false-negative echocardiographic results is emphasized. 3. With early symptoms and highly reduced left ventricular function, the mortality is still high.

Angiocardiography↗
PubMed1991

alpha-Peroxyachifolid and other new sensitizing sesquiterpene lactones from yarrow (Achillea millefolium L., Compositae).

Yarrow, Achillea millefolium L., is one of the commonest weeds of the Compositae family. Cases of allergic contact dermatitis have been described since 1899. Although 10 sesquiterpene lactones (SL) and 3 polyines have previously been identified, the sensitizers of yarrow have escaped detection. A reinvestigation of short ether extracts of yarrow revealed the presence of 5 unsaturated hitherto unknown guaianolides of peroxide character. The main SL, identified as a strong sensitizer in guinea pig sensitization experiments, was named alpha-peroxyachifolid. The minor SL also contribute marginally to the sensitizing capacity, while other known yarrow constituents like dehydromatricaria ester and pontica epoxide appear to play no role. A 5-year follow-up (1985-1990) of Compositae-sensitive patients showed that more than 50% reacted when tested with a short ether extract of yarrow. Exacerbation of the patch test sites by irradiation with UV light was never observed.

Animals↗
PubMed1991

[Peroxides as plant constituents. 8. Guaianolide-peroxides from yarrow,Achillea millefolium L., a soluble component causing yarrow dermatitis].

From the ether extract of the blossoms of yarrow, Achillea millefolium L., two guaianolides (1, 2) with a peroxide bridged cyclopentane ring and an alpha-methylene-gamma-butyrolactone structure have been isolated. For these compounds the names alpha-peroxyachifolid (1) and beta-peroxyisoachifolid (2) are proposed. 1 is responsible for the allergic contact dermatitis caused by yarrow.

Anti-Bacterial Agents↗
PubMed1990

[Validity of calculating oxygen saturation at rest and during exercise].

Oxygen saturation calculated with the formulae proposed by Heck, Kelman, Lutz, Marsoner, Severing-haus and Siggaard-Andersen, was compared with oxygen saturation measured photometrically. An analysis of 1350 peripheral venous, mixed venous and arterial blood samples obtained during bicycle ergometry revealed that only the calculations using the Kelman, Siggaard-Andersen and Severing-haus formulae had adequate validity and reliability over a wide measuring range. If, however, the oxygen saturation figures are to be used for further calculations, direct measurement should be given preference to avoid errors (for example, in shunt calculation).

Exercise Test↗
PubMed1989

Oxygen saturation calculation procedures: a critical analysis of six equations for the determination of oxygen saturation.

Photometrically measured values of O2-saturation (SO2) were compared with SO2 predictions on the basis of the equations proposed by Heck, Kelman, Lutz, Marsoner, Severinghaus, and Siggaard-Andersen on 1350 occasions. Capillary, venous and mixed venous blood samples from 23 healthy subjects and 30 patients, suffering from cardio-pulmonary diseases were analyzed at rest, during exhaustion, limited exercise and during the recovery phase of ergometric tests. Overall the best agreements with the measured values were found for the equations of Kelman, Severinghaus and Siggaard-Andersen. The results of Heck's, Lutz', and Marsoner's predictions were in reasonable agreement with the measured SO2 only under special physiological conditions. No calculation mode can be performed with constant accuracy and reliability when covering a wide range of acid-base values. If SO2 values are used for further calculations, e.g. for determination of cardiac output, measured values are preferred.

Adult↗
PubMed1989

Excretion of hippuric acid during sodium benzoate therapy in patients with hyperglycinaemia or hyperammonaemia.

In patients with non-ketotic hyperglycinaemia and two patients with urea cycle disorders treated with varying doses of sodium benzoate there was linear correlation between intake of benzoate and excretion of hippurate. Patients with non-ketotic hyperglycinaemia excreted significantly more benzoate in the form of hippurate than patients with urea cycle disorders (74 +/- 7.0 vs 41 +/- 3.6%). The plasma concentration of glycine decreased following benzoate treatment only in the patients with non-ketotic hyperglycinaemia. The observed difference between the two groups in the excretion of hippurate seems to support the concept that glycine availability may be limiting in benzoate therapy for some patients.

Amino Acid Metabolism, Inborn Errors↗
PubMed1989

Experimental ductus arteriosus: the relationships of atrial pressure, dilatation and flow with ANF secretion.

The design of the study was to determine whether an increased blood flow as seen in shunt lesions could serve as a stimulus for the secretion of atrial natriuretic factor (ANF). Since atrial pressure, flow, and dilatation are closely related, an experimental ductus arteriosus model was utilized, in which acute changes of flow are assumed not to dilate the left atrium. In six dogs, a Dacron graft was constructed between the main pulmonary artery and the innominate artery. Constricting and releasing the tape around the graft adjusted the amount of "ductal" shunting. The total pulmonary flow and the shunt flow were measured by electromagnetic-flow transducers around the aortic root and around the graft. Plasma ANF concentration was measured from both cardiac atria. The size of the left atrium was determined from echocardiographic measurements made from a short-axis view. The total pulmonary flow varied between 1.2 and 5.8 1/min. The highest measured ANF was 396 pg/ml, and this was from the left atrium when the pressure was 18 mmHg, the highest left atrial pressure recorded. The highest right atrial pressure (5 mmHg) also correlated with the highest right-atrial level of ANF (366 pg/ml). The right atrial pressure had a significant correlation with plasma ANF concentration (R = 0.43, p less than 0.05). Pulmonary flow and plasma ANF concentration did not correlate; neither did left atrial size and ANF levels in 16 flow states where the size was measured. In the absence of atrial dilatation there was minimal stimulus for ANF secretion. A transient increase of left atrial pressure, without a concomitant significant atrial dilatation, did not serve as a significant stimulus for ANF secretion.

Animals↗
PubMed1989

Cardiac function, substrate utilization, and myocardial energy metabolism studied with 31-P NMR spectroscopy during acute hypoglycemia and hyperketonemia.

Whether severe hypoglycemia alone or in combination with hyperketonemia might cause deterioration of cardiac function has been controversial. Therefore, the influence of acute hypoglycemia (mean 33 mg/dL) with and without hyperketonemia (mean 1.3 and 3.3 mM) on cardiac function, substrate utilization, and myocardial high energy phosphate levels was studied in 10 mongrel dogs. After 45 min of hypoglycemia, mean aortic pressure, total peripheral resistance, and myocardial oxygen consumption had increased significantly, but other hemodynamic parameters and regional myocardial function had not changed. Additional infusion of 3-hydroxybutyrate did not affect hemodynamic variables significantly. During both metabolic interventions in vivo phosphorus-31 nuclear magnetic resonance spectroscopy showed stable levels of myocardial phosphocreatinine, ATP, as well as the phosphocreatinine/ATP (3.0-3.2) ratio. Biochemical measurements revealed that hyperketonemia led to significant alterations in arterial concentrations and arteriocoronary venous differences of selected citric acid cycle intermediates, thus confirming previous reports which suggested a blockade of the 2-oxoglutarate-dehydrogenase reaction induced by ketone body oxidation. However, despite this blockade, the energy supply to the heart was not impaired as shown by normal nuclear magnetic resonance spectroscopy and cardiac performance. It is speculated, that the blockade might be due to an enhanced NADH/NAD ratio.

Adenosine Triphosphate↗
PubMed1989

Comparison of three methods for the determination of serum alpha-1-antitrypsin in patients with pulmonary diseases.

In patients with pulmonary diseases, serum alpha 1-antitrypsin (AAT) was measured by three methods: radial immunodiffusion (RID), trypsin inhibitory capacity assay (TIC) and by rate nephelometry with the immunosystem (NIA) in a total of 369 subjects (sarcoidosis, n = 35; asthma, n = 41; chronic obstructive bronchitis, n = 62; bronchogenic carcinoma, n = 93; pneumonia, n = 24; tuberculosis, n = 43; fibrosis, n = 22; healthy controls, n = 49). Considering all patients, AAT was found to be significantly elevated (p less than 0.01-0.001) in all methods (RID: 3.3 +/- 1.0 g/l; TIC: 2.7 +/- 0.4 g/l; NIA: 2.1 +/- 0.8 g/l) compared to healthy controls (RID: 2.1 +/- 0.3 g/l; TIC: 2.1 +/- 0.4 g/l; NIA: 1.2 +/- 0.3 g/l). The lowest mean values were found by means of the NIA method. The best correlation coefficient (R) was evaluated between the TIC and the NIA method (R = 0.96) in healthy controls, but the best correlated methods were the RID and the NIA (R = 0.93) in patients with pulmonary disease.

Adult↗
PubMed1989

[Aneurysm of the vein of Galen as a possible cause of congestive heart failure: a report of 5 new cases].

We report on five newborns with an arterio-venous malformation of the vein of Galen. All newborns were cyanotic and in congestive heart failure without any evidence of congenital heart disease. Congestive heart failure in these cases was mainly due to an almost two-fold increase in cardiac output of approximately 8 l/min/m2 (normal: 4.5 l/min/m2). According to previous reports, mortality is very high in patients with this malformation when becoming symptomatic during infancy, and therapy by surgery or embolization is only successful in 10-30%. While three of our patients died shortly after diagnosis because of untreatable heart failure, the other two were operated on either by subtotal ligation of the draining vein or by ligation of 4 arterial feeders. In the first case secondary thrombosis of the aneurysm occurred and cardiac failure subsided. In the second case a large shunt remained and a balloon-embolization was performed successfully. However, in both patients severe neurologic defects occurred, the severity of which remains to be assessed later since the post-operative observation period is only 2 and 5 months, respectively.

Cerebral Angiography↗
PubMed1988

High-performance liquid chromatographic measurement of selected blood citric acid cycle intermediates.

We describe a high-performance liquid chromatographic (HPLC) method for analysis of the intermediates of the citric acid cycle. Using two Aminex HPX-87H columns in series at 36 degrees C, the early eluting compounds cis-aconitate, oxaloacetate, alpha-ketoglutarate and citrate-isocitrate can be resolved. Acetonitrile is used for extraction of citric acid cycle intermediates from blood as interfering ultraviolet absorbing peaks are present with perchloric acid or trichloroacetic acid extraction. Acetonitrile extraction is compared with perchloric acid extraction of citric acid cycle intermediates from plasma. Low recovery of some organic acids from blood seems not to be due to enzymatic degradation. Storage of acetonitrile extracts in liquid nitrogen led to a small but significant decrease in pyruvate levels in human blood. However, significant changes in other organic acids were not seen. HPLC methodology allows study of the citric acid cycle in tissue samples as well as blood and promises to facilitate the investigation of human disorders of energy metabolism.

Acetonitriles↗