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Biomedical subjects

K Borchert

Publications and source records attributed to K Borchert.

At least 19 recordsLinked to original sources
PubMed2005

Glutamine-enriched total parenteral nutrition in patients with inflammatory bowel disease.

BACKGROUND: Studies in animal models of inflammatory bowel disease (IBD) suggest that supplementation of total parenteral nutrition with glutamine (gln), a conditionally essential amino acid in catabolic conditions, increases gln plasma concentrations, reduces intestinal damage, improves nitrogen balance and may improve the course of the disease. However, human data supporting this assumption are missing. METHODS: A total of 24 consecutive patients with an acute exacerbation of IBD (19 Crohn's disease; five ulcerative colitis) and scheduled for total parenteral nutrition (TPN) (>7 days) were randomised. Parallel to a standardised anti-inflammatory therapy, the patients received either a TPN with 1.5 g/kg body weight of a standard amino acid or an isonitrogenic, isocaloric TPN with 1.2 g/kg body weight of a standard amino acid and 0.3 g/kg L-alanine-L-glutamine. Primary end points were gln plasma concentrations and intestinal permeability assessed by urinary lactulose and D-xylose ratio. RESULTS: Gln plasma levels did not differ significantly in either group throughout the study. Intestinal permeability did not change within 7 days either with or without gln supplementation (Delta-lactulose/xylose ratio: 0.01+/-0.05 (gln+) vs 0.02+/-0.1 (gln-)). The observed changes in inflammatory and nutritional parameters, and also disease activity, length of TPN and hospital stay, were independent of glutamine substitution. Five (41%) patients in the gln+ group and three (25%) patients in the gln- group needed surgical intervention. CONCLUSION: Although limited by the sample size, these results do not support the hypothesis that glutamine substitution has an obvious biochemical or clinical benefit in patients with active IBD scheduled for total parenteral nutrition.

Acute Disease↗
PubMed2001

Evaluation of long-term efficacy and safety of transdermal fentanyl in the treatment of chronic noncancer pain.

The objective of this international, multicenter, open-label trial was to assess the efficacy and safety of up to 12 months of therapy with transdermal therapeutic system (TTS) fentanyl in patients (n = 532) with chronic noncancer pain. The trial was completed by 301 (57%) of the patients. The main outcome measures were pain control assessment, global treatment satisfaction, patient preference for TTS fentanyl, and quality of life. The mean dose of transdermal fentanyl (TDF) increased from 48 to 90 microg/h during a period of 12 months. During treatment, on average 67% of patients within the efficacy analysis group (n = 524) reported very good, good, or moderate pain control. Global satisfaction (very good or good) was also stable at 42%. The majority (86%) of patients reported a preference for TDF over their previous treatment (P < .001, binomial test). Short Form 36 quality-of-life scores improved from baseline for bodily pain. The most frequent treatment-related adverse events were nausea (31%), constipation (19%), and somnolence (18%). With regard to opioid-specific adverse events (respiratory depression [< 1%], adrenal insufficiency [< 1%], drug abuse/dependence [1%], and opioid withdrawal syndrome [3%]), these were extremely rare and, with the exception of opioid withdrawal syndrome, none was considered definitively related to the treatment. Long-term treatment with TDF provided a stable degree of pain control in the majority of patients with moderate to severe chronic noncancer pain. It was preferred by the majority of patients compared with their previous opioid medication. Overall, long-term treatment with TDF was generally well tolerated, particularly in view of the low incidence of potentially serious side effects such as drug abuse/dependence and respiratory depression. However, at present, it is important that patients receiving TDF should still be subject to careful assessment and monitoring.

Journal Article↗
PubMed1998

Evaluation of a novel mononuclear cell isolation procedure for serological HLA typing.

Despite recent advances in DNA-based genotyping, the microcytotoxicity test is still broadly used for the determination of human leukocyte class I antigens in patients as well as organ donors and also for the detection of HLA antibodies. Excellent purity and viability of peripheral blood mononuclear cells (PBMC) are essential for reliable HLA typing results. Background staining and cell loss can contribute to impaired typing results or even cause misinterpretations. A novel isolation procedure using cell preparation tubes (CPT) with prefilled Ficoll was compared with the standard Ficoll gradient. We determined the recovery, purity, and viability of the PBMC after several periods of storage. Finally, the isolated cells were used for HLA class I typing, and background reactivities were scored. By using the CPT method, the recovery of PBMC was significantly higher than recovery with the standard technique (P </= 0.001). Contamination by granulocytes increased considerably during the storage time for the standard protocol, whereas purity remained stable when CPT were used (P </= 0.001). With both methods, lymphocyte viability declined markedly over time. We found significantly more dead cells by using the CPT methods. Due to high background scores, HLA typing was impossible after 48 h. The isolation of PBMC by the CPT method resulted in a higher yield and improved purity compared to those obtained with the standard gradient technique. The decreasing viability after 48 h limits the use of both methods for HLA typing and HLA antibody screening.

Cell Separation↗
PubMed1997

The development of chromatic and achromatic contrast sensitivity in infancy as tested with the sweep VEP.

Swept-contrast visual evoked potential (VEP) techniques were used to measure the development of contrast sensitivity functions (CSFs) for achromatic and red/green isoluminant chromatic gratings. Subjects were infants of 8, 14, 20 and 32 weeks of age, and adults. Stimuli were 20 deg, 0.3-4 cyc/deg sinusoidal gratings, counterphased at 6 Hz and modulated through white. Achromatic and chromatic CSFs for all ages could be fit simultaneously with a double exponential equation of a common, lowpass shape. Both achromatic and chromatic CSFs exhibited developmental shifts in both sensitivity and spatial scale. From 8 weeks to adulthood, sensitivity increased by 0.64 log units for achromatic gratings and by 0.91 log units for chromatic gratings, yielding an 0.27 log unit larger sensitivity change for chromatic than for achromatic stimuli. Spatial scale shifts were closely similar across achromatic and chromatic CSFs, and were consistent with the factor of about four predicted on the basis of changes in foveal receptor packing density and eye size. The question of uniform vs differential loss of sensitivity for chromatic vs achromatic stimuli at fixed spatial frequencies is discussed.

Adult↗
PubMed1977

[On the causes of intra- and post-operative consumption coagulopathies and postoperative thromboembolism].

The determination of the onset of a disseminated intravascular coagulation (DIC) is examined shortly after its intraoperative andpost-operative dissolution with the help of easily performable haematological and physiological clotting tests in 20 patients. In this connection the operation is appreciated as a model even for other processes defined at the beginning, where DIC can be observed. Whereas the aethanol test, the determination of fibrinogen split products (FSP) and the euglobulin lysis time indicate the beginning of DIC more clearly in the form of average values, the aethanol test, partial thromboplastin time and thrombin time have a prognostic value for each patient. As it is too time consuming to determine FSP, the counting of basophilie granulocytes may be used for the diagnosis. In the initial phase of and post-operative DIC will determine the essential share of predisposition to post-operative thromboembolism.

Basophils↗
PubMed1977

[Problems of postoperative respiratory insufficiency (author's transl)].

Postoperatively patients are particularly endangered by the development of respiratory failure. All parts of the gas-exchange between the atmospharic air and the metabolizing cell are to be considered as a unit. The increase of dead-volume-respiration and intrapulmonary shunting is of great importance for the development of arterial hypoxaemia. Early diagnosis of impaired gas-exchange and an adequate treatment are emphasized. CPAP and intermittent mandatory ventilation are therapeutic methods, well approved in clinical practice.

Blood Gas Analysis↗