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Biomedical subjects

K Böhme

Publications and source records attributed to K Böhme.

At least 19 recordsLinked to original sources
PubMed1998

Practicability and acceptance of subcutaneous self-administration of the selective serotonin agonist sumatriptan.

To cater to the special situation of much reduced oral bioavailability which occurs in severe migraine attacks with pronounced nausea and vomiting, sumatriptan can also be used in a subcutaneous form that can be self-administered. The aim of this study was to analyze the practicability and acceptance of a method of self-administration ("Glaxo-Pen") for treatment of severe migraine attacks by subcutaneous injection of sumatriptan. The Glaxo-Pen was compared with the conventional autoinjector for subcutaneous administration of sumatriptan. The multicenter study was conducted under practical conditions by 150 office-based physicians in Germany. Patients who commonly suffered from severe migraine attacks were given a careful explanation of how to use the device ("Glaxo-Pen") for self-administration of subcutaneous sumatriptan and were able to practice using it under guidance. They were given a Glaxo-Pen with two sumatriptan refills to take with them for treating their own migraine attacks. The patients used a headache diary to document administration outside the practice session. A total of 376 patients were included in the study. The major findings were that 80% of the patients rated the Glaxo-Pen "very easy" or "easy" to use, and only 6.4% rated it "difficult" or "very difficult." Compared with the conventional autoinjector, the Glaxo-Pen was rated "much better" or "better" by 77.9% of patients. Only 8.5% considered the Glaxo-Pen "worse" or "much worse" than the conventional autoinjector. The figures show that the great majority of patients found it easy to use sumatriptan for treating severe migraine attacks by self-administration under practical conditions. Thus, especially for patients who suffer from severe nausea, vomiting, or diarrhea during migraine attacks, this method of delivery is an easily used means of arresting migraine attacks.

Adult↗
PubMed1998

[Paraspinal opioids and pump systems].

The regional application of opioids close to the spinal cord by using pumps induces a pain reduction comparable to the systemic medication of the WHO analgesic ladder. However, this method does not reduce the side effects of these drugs, e.g. nausea, vomiting, dysfunctional bladder emptying, and obstipation. Problems and complications leading to revision surgery and system explantation, respectively, are of more severe importance. Pump explantation occurs in a frequency of 7.3% and revision surgery in a frequency of 6.2%. Catheters and port systems have to be revised in 15% of all cases. Therefore, the indication for this method has to be considered carefully and includes the following criteria: pain of somatic origin, exclusion of mental diseases and psychogenic causes of pain, causal therapy is exhausted, insufficient effects of peripheral analgesics and co-analgesics, oral or transdermal opioids are insufficient despite dosages resulting in side-effects, pain is sensible to opioids, regional application of opioids has been tested effective before implantation.

Analgesia, Epidural↗
PubMed1997

Renal transplantation from donors aged < 6 years into children yields equal graft survival when compared to older donors.

Several articles have shown inferior renal allograft survival in patients receiving kidneys from young cadaver donors. We therefore assessed the survival and function of the first cadaveric graft from donors aged under 6 years of age, transplanted after 1983. The results were compared with the outcome of children receiving kidneys from older donors. Graft survival and serum creatinine were analyzed retrospectively at various time intervals after first cadaveric transplantation in 35 pediatric recipients of renal transplants grafted between 1983 and 1996 from donors < 6 years of age. Their data were compared with those of 167 pediatric recipients of renal transplants grafted from older donors. The proportion of young donors remained constant throughout the observation period. Mean recipient age was 10.4 years (range 3.2-17.5 years) in the patients grafted from donors < 6 years of age, not much different from the mean age of the donors in the 6+ years group (12.5 years, range 2.3-18.6 years). Five-year patient survival did not differ between the two groups (89 vs. 90%). In 1983-1996, graft survival rate of kidneys from donors aged < 6 years after one year was 77% (donors aged 6+ years=76%), after 2 years 66% (donors aged 6+ years=68%), after 3 years 62% (donors aged 6+ years=66%), and after 5 years 55% (donors aged 6+ years=60%, n.s., Log-rank test). In 1994-1996, 2-year graft survival was 88% (controls 91%, n.s.). In children receiving a cadaveric graft from a donor aged < 6 years, mean serum creatinine fell from 132+/-101 (SD) micromol/l after 3 months to 101+/-66 micromol/l after 12 months, and was 110+/-52 micromol/l after 5 years. This compared with a serum creatinine of 131+/-108 micromol/l after 3 months, 132+/-97 micromol/l after 12 months and 143+/-81 micromol/l after 5 years in children receiving grafts from older donors. When transplanting renal allografts from young donors into children, there was no significant difference in graft survival between donors aged < 6 years and older donors or in graft function. We conclude that good results from young donors can be obtained in a specialized center, and therefore the restriction of kidney selection to donors aged > 6 years may not be justified.

Adolescent↗
PubMed1997

[Quality assurance in roentgen diagnosis. 1996 results and problems from the viewpoint of the Medical Section in accordance with ordinance 16 of the roentgen regulation of the Saxony Regional Medical Group].

The "Arztliche Stelle gemäss RöV" was established in Saxony in 1992. Structure and results of quality assurance in radiological diagnostics are described briefly. Quality checks delivered acceptable results for the majority of X-ray devices. Typical errors are shown and explained by using some X-ray pictures.

Germany↗
PubMed1995

Primary structure of the long and short splice variants of mouse collagen XII and their tissue-specific expression during embryonic development.

Type XII collagen, a member of the FACIT group of extracellular matrix proteins, consists of molecules that are trimers of alpha 1(XII) chains. The three chains in each molecule form a cross-shaped structure with a central globule from which a triple-helical tail and three finger-like regions (containing von Willebrand factor A-like regions (containing von Willebrand factor A-like domains and fibronectin type III repeats) extend. cDNA cloning/sequencing of chicken alpha 1(XII) collagen and protein studies with mouse, bovine, and human material suggest that the alpha 1(XII) collagen gene gives rise to two molecular variants, differing in the length of the finger-like regions, by alternative splicing of the primary transcript. To provide a basis for studies of the function of the two variants in an organism that can be genetically manipulated, we have isolated and sequenced mouse cDNAs encoding both splice variants. The sequence provides the first complete nucleotide and amino acid sequence of mammalian type XII collagen. From these cDNAs we have generated digoxigenin-labeled RNA probes for in situ hybridization of developing mouse embryos to find out whether the splicing mechanism responsible for generation of the two forms is developmentally regulated. The results, combined with Northern blot and RT-PCR analysis of RNA from embryos at various developmental stages, demonstrate that the long form of collagen XII, XIIA, is the predominant form at early stages (ED7 and 11); at later stages of development (ED15 and 17) the short form, XIIB, becomes the major form. As the short form becomes the major product, the long splice variant continues to be expressed in several tissues, even after birth. An exception is dermis, which is positive for the long form up to embryonic day 15, but negative at day 18, when only the short form RNA can be detected.

Alternative Splicing↗
PubMed1995

Terminal differentiation of chondrocytes in culture is a spontaneous process and is arrested by transforming growth factor-beta 2 and basic fibroblast growth factor in synergy.

At Day 17 of in ovo development, chondrocyte hypertrophy including synthesis of collagen X takes place in a limited region within the cranial part of chick embryo sternum. Here we analyze in suspension culture the differences in response to single growth factors of chondrocytes derived from the cranial part versus cells derived from the caudal part. Cells from either part were cultured separately without serum in the presence of insulin-like growth factor-1, transforming growth factor beta 2, basic fibroblast growth factor, or thyroid hormones. In culture, chondrocytes derived from the cranial part of sterna from 14- to 18-day-old chicken embryos become hypertrophic and initiated the synthesis of collagen X and alkaline phosphatase. These processes were enhanced by anabolic diffusible signals, such as those contained in fetal bovine serum, insulin-like growth factor-1, or thyroxine. Cells derived from the caudal part lack this capacity and, instead, prevented hypertrophy of cranial cells in cocultures, presumably by secreting diffusible signals. As candidate molecules, we have identified transforming growth factor beta 2 and basic fibroblast growth factor, which both were released by chondrocytes. Synergistic action of transforming growth factor beta 2 and basic fibroblast growth factor was required to suppress insulin-like growth factor-1-stimulated maturation of cranial chondrocytes in culture.

Alkaline Phosphatase↗
PubMed1993

Autocrine or paracrine transforming growth factor-beta modulates the phenotype of chick embryo sternal chondrocytes in serum-free agarose culture.

Sternal chondrocytes of 17-day-old chick embryos in serum-free agarose culture secrete transforming growth factor-beta. Media conditioned by such cells prevent serum-induced chondrocyte hypertrophy and cause a phenotypic modulation in serum-free culture which is similar to that observed for chondrocytes in monolayer culture. The modulated cells lose the round shape of differentiated chondrocytes and increasingly with time resemble tendon fibroblasts embedded into agarose. In addition, they produce less matrix macromolecules which include collagen I rather than cartilage collagens II, IX, X, and XI. All of these effects are abolished upon addition to the conditioned media of a monoclonal antibody against recombinant human transforming growth factor-beta 2. The same factor caused effects closely similar to those elicited by conditioned media. Therefore, the phenotypic modulation in adhesion-dependent cultures of chondrocytes in vitro does not directly result from cell-matrix interactions but can be produced also in suspension culture under the direction of appropriate diffusible stimuli that include transforming growth factor-beta. In addition, the results support the concept of transforming growth factor-beta as a multifunctional cytokine acting differently on cells of the same developmental origin depending on their stage of differentiation.

Animals↗
PubMed1993

[The premedication of PTA. A double-blind and randomized comparison of midazolam/tramadol versus placebo/tramadol].

A prospective, randomised and double blind comparative study of Midazolam/Tramadol or placebo/Tramadol for premedication before PTA was carried out on 40 patients (12 female and 28 male, average age 66.1 +/- 12). The anxiolytic, analgesic and general findings were quantified by means of a visual analogue score. Pre- and peri-interventional blood gas, blood pressure and pulse rates were determined. The complications of the two schemes were compared. 19 patients received Midazolam/Tramadol and 21 placebo/Tramadol. Patient anxiety was reduced significantly from 25.8 +/- 25 to 4.3 +/- 6 by premedication. Significant increase in the pain score during PTA was observed only in the placebo group (4.3 +/- 12.6 to 27.4 +/- 20.9). There was no difference in the incidence of complications and respiratory depression due to the Midazolam/Tramadol combination was not observed.

Aged↗
PubMed1993

Cord blood erythropoietin in relation to different markers of fetal hypoxia.

OBJECTIVE: To investigate the relationship between erythropoietin concentration in umbilical venous blood and clinical signs of fetal hypoxia. METHODS: We measured erythropoietin concentrations in umbilical venous blood from 200 consecutively born neonates using an enzyme-linked immunosorbent assay (ELISA) with two monoclonal antibodies. Results were available within 6 hours. Inter-assay variation was 8.5% and the mean intra-assay variation was 14.2%. RESULTS: Using a multiple regression analysis, we found that the erythropoietin concentration correlated significantly (P < .01) with fetal growth retardation and umbilical acidosis but not with gestational age, meconium-stained amniotic fluid (AF), abnormal fetal heart rate (FHR) pattern, or Apgar score at 5 minutes. Median erythropoietin concentrations were 25.1 mU/mL in infants with no risk factors or complications during pregnancy and delivery (n = 19), 25.8 mU/mL after complicated pregnancy (n = 95), 50.6 mU/mL with meconium-stained AF (n = 12), 44.7 mU/mL with abnormal FHR pattern (n = 40), 47.8 mU/mL with both stained AF and abnormal FHR pattern (n = 10), and 72.6 mU/mL with umbilical acidosis (n = 24). The median erythropoietin concentration increased significantly with decreasing pH and with increasing base deficit in umbilical arterial blood. The erythropoietin concentration in umbilical venous blood (cutoff value 50 mU/mL) discriminated between infants with no clinical signs of fetal hypoxia and those with umbilical acidosis with a sensitivity of 75% and a specificity of 90%. CONCLUSIONS: Elevated erythropoietin concentrations in umbilical venous blood indicate prolonged fetal hypoxia. The ELISA technique might be a useful tool for determining the exact time course of erythropoietin concentrations in fetal hypoxia.

Acidosis↗
PubMed1992

Induction of proliferation or hypertrophy of chondrocytes in serum-free culture: the role of insulin-like growth factor-I, insulin, or thyroxine.

In bone forming cartilage in vivo, cells undergo terminal differentiation, whereas most of the cells in normal articular cartilage do not. Chondrocyte hypertrophy can be induced also in vitro by diffusible signals. We have identified growth factors or hormones acting individually on 17-d chick embryo sternal chondrocytes cultured in agarose gels under strictly serum-free conditions. Insulin-like growth factor I or insulin triggered the first steps of chondrocyte maturation, i.e., cell proliferation and increased matrix deposition while the chondrocytic phenotype was maintained. However, cells did not progress to the hypertrophic stage. Proliferation and stimulated collagen production was preceded by a lag period, indicating that synthesis of other components was required before cells became responsive to insulin-like growth factor I or insulin. Very small amounts of FBS exerted effects similar to those of insulin-like growth factor I or insulin. However, FBS could act directly and elicited hypertrophy when constituting greater than 1% of the culture media. Basic FGF has been claimed to be the most potent chondrocyte mitogen, but had negligible effects under serum-free conditions. The same is true for PDGF, a major serum-mitogen. Under the direction of thyroxine, cells did not proliferate but became typical hypertrophic chondrocytes, extensively synthesizing collagen X and alkaline phosphatase.

Animals↗
PubMed1989

[Short term effects of carbon disulfide on the intracardial irritation development and transmission in the rat].

Studies were conducted into effects of acute and subacute CS2 application on intracardiac irritability and conduction in rat. Aconitine-induced arrhythmia and the coronary occlusion method were used as pathophysiological models. Under physiological conditions, short-time exposure to CS2 caused deceleration of intracardiac impulse conduction, while under pathophysiological conditions, modified arrhythmia or reduced survival rate was the result.

Animals↗
PubMed1988

[Concept in the treatment of pain in patients with cancers].

Pain in cancer patients is shown to arise in different ways, demanding a flexible approach to treatment. The following procedures can be selected from, depending on the origin of the pain. (1) Systemic analgesia with peripheral or central analgesic agents combined with psychotropic preparation; (2) administration of opioids through peridural or intrathecal catheters (for pain responsive to opioids, but side effects considerable); (3) neurolyses, e.g. epigastric tumors, recurrence of rectal carcinoma; (4) cordotomy, e.g. unilateral pain in plexus infiltration; (5) operations (endoprostheses, bridging osteosynthesis in the case of bone metastases with or without fractures); (6) radiotherapy (strontium in the case of multiple bone metastases of some tumors). Other treatment methods, e.g. administration of karsil or cortisone, as adjuvant therapy require further investigation.

Analgesics↗