Biomedical subjects

M Graw

Publications and source records attributed to M Graw.

At least 37 records · Page 2Linked to original sources

PubMed1997

The kinetics of methanol elimination in alcoholics and the influence of ethanol.

Methanol concentrations were studied during the end phase of ethanol elimination and for about five hours afterwards in 12 alcoholics admitted with alcohol intoxication for acute care. The rate of ethanol elimination (beta 60) ranged from 0.114 g/kg/h to 0.270 g/kg/h (mean 0.178 +/- 0.045 g/kg/h). The methanol concentration was found to remain almost steady as long as ethanol levels were relatively high, and changed only to an extent that could be explained by the combined opposing influences of methanol excretion and endogenous synthesis. There was no significant relationship between the rate of ethanol elimination and the methanol level. The methanol concentration began to decrease when the ethanol concentration had fallen to under 0.2 g/kg. When the ethanol concentration had fallen to base levels, methanol was eliminated at a rate characterized by an elimination constant (kel) of 0.212-0.481 h-1, and a half life of 1.44-3.27 h. There was a positive correlation between the rate of ethanol elimination and the rate of methanol elimination (r = 0.642; p < 0.05).

Adult↗

PubMed1997

Methanol elimination in non-alcoholics: inter- and intraindividual variation.

Five male subjects aged between 25 and 40 years were given methanol at a dose of 10 mg/kg, once orally and once intravenously, while the enzyme systems responsible for methanol oxidation were blocked by ethanol. The study assessed the duration of inhibition of methanol oxidation in relation to the blood ethanol concentration, and the elimination of methanol not influenced by ethanol. Methanol elimination was found to begin at a blood ethanol concentration of 0.04-0.13 g/kg. Elimination constants of 0.406-0.267 h-1 with corresponding half-lives of 1.71-2.60 h were established for methanol not influenced by ethanol. When data from a previous study using an identical protocol for parenteral administration were included, making the total number of subjects nine, the mean elimination constant was found to be 0.298 +/- 0.470 h-1 and the mean half-life 2.37 +/- 0.357 h, distribution being normal. No evidence of any differences in methanol elimination kinetics between alcoholics and non-alcoholics or of a significant influence of the route of administration was found. The extent of intraindividual variation in methanol elimination as indicated by the difference in each subject between the values established, expressed as a percentage of the corresponding mean values, was found to be 3-25%, which is comparable to the magnitude of intraindividual variation in the rate of ethanol elimination.

Administration, Oral↗

PubMed1996

Endogenous methanol: variability in concentration and rate of production. Evidence of a deep compartment?

The endogenous methanol concentration was determined in 72 men aged between 18 and 35 years in the morning after a 12-h period of fasting and abstinence from alcohol. The distribution curve was found to be skewed to the right, the concentrations ranging from '0' (below the detection threshold) to 3.4 mg/kg. The median was 0.1 mg/kg and the mean 0.35 mg/kg. Significant differences were found between three groups defined according to the duration of prior abstinence from alcohol (8 h, 30 h, and 5 days). The highest values were seen after the shortest period of abstinence and the lowest values after the longest period of abstinence. The course followed by the methanol concentration in the presence of blocking of methanol oxidation by orally or parenterally administered ethanol was observed over at least 10 h on two separate occasions in a further 8 subjects aged between 24 and 35 years. At blood ethanol concentrations of more than 0.20 g/kg, the rate of production of methanol, calculated by regression, ranged from 0.09-0.37 mg/kg/h (r = 0.970-0.554, S(y.x) = 0.227-0.565 mg/kg). The rise in methanol concentration at the start of ethanol administration was significantly more rapid than the subsequent rise. It is hypothesised that there may be a so-called deep compartment for methanol that would explain the dependence of the endogenous methanol level on the duration of the preceding period of abstinence from ethanol, and the occurrence of an initial phase of faster rise in methanol concentration associated with the administration of ethanol.

Adolescent↗

PubMed1996

[Changes in the spectrum of alcohol-induced traffic accidents in relation to blood alcohol level].

A retrospective study was undertaken to determine whether the degree of alcohol intoxication has an effect on the driving performance with regards to both the quantity and quality. A total of 625 accidents caused by drivers who were under the influence of alcohol were reviewed. They were divided into three groups according to the blood alcohol concentration (BAC):0.30 - 1.09 g/kg, 1.10 - 1.99 g/kg and > 2.00 g/kg. In order to exclude the influence of factors unrelated to alcohol, the groups were matched for age, sex, location of accident and the light and road conditions. This resulted in a total of 85 accidents in each group. The accidents were classified with reference to the "Register of causes of accidents" used in road accident statistics. The three groups differed significantly in their causes of accidents (p < 0.025), although those due to speeding dominated in each group. In the group with low BAC, the next most common accidents were the ones caused by failure to give way. In the group with medium BAC, rear-end collisions and accidents occurring during low speed manoeuvres were the second most common. In the group with highest BAC, the next most common causes of accidents were the leaving of the correct traffic lane unassociated with speeding.

Accidents, Traffic↗

PubMed1994

Spleen findings in drowning.

A retrospective study of spleen findings in 42 victims of drowning and a comparison group of 42 cases of asphyxiation due to other causes (hanging, ligature strangulation and manual strangulation), that were matched for sex, age, body weight and build, was performed. Significantly smaller spleen weights (P < 0.05), spleen weight:body weight ratios (P < 0.01) and spleen weight:liver weight ratios (P < 0.01) were found in the victims of drowning. The difference in weight was approximately 18%. A significant negative correlation between spleen weight and blood alcohol concentration was found in the study group (r = -0.44; P < 0.01), but not in the control group. The possibility that the findings are due to a stress reaction caused by hypoxia in the presence of cooling and an influence of alcohol on reflex mechanisms is discussed.

Adolescent↗

PubMed1993

[Fatal complications of a colon contrast enema due to erroneous insertion of the infusion catheter in the vagina].

A 68-year-old woman was to have a barium enema of the colon to discover the cause of recurrent cramp-like symptoms in the lower abdomen. At the beginning of the examination the responsible radiologist saw, during a fluoroscopic check, that the contrast medium had not advanced beyond the region of the infusion catheter tip. Believing this to be due to blockage in the catheter he increased the infusion pressure. Suddenly the patient went into treatment-resistant shock and died. The autopsy revealed that the infusion catheter had by mistake been placed into the vagina. This had caused a tear in the vagina with resulting subperitoneal contrast-medium infiltration. Embolization of contrast medium to the lung was demonstrated both histologically and radiologically. The cause of death was the combined effect of the embolism and peritoneally induced vagal shock.

Aged↗

PubMed1993

[Rate of ethanol clearance after oral and parenteral ethanol administration].

A crossover investigation of the ethanol concentration decline after oral and parenteral administration of ethanol respectively was performed with direct intra- and interindividual comparison. No significant differences in relation to the kind of administration were noted. An influence of the circadian rhythm on the rate of decline could be excluded. The low beta 60 values derived (average: 0.111 g/kg/h) can be explained by the long period over which the probands were denied food.

Adult↗

PubMed1992

[Statistical approach to forensic conversion values for alcoholics].

With collaboration of the study groups from Tübingen, Munich and Kiel and consideration of the results of Bonnichsen et al 1968, alcohol elimination curves of 98 alcoholics were subjected to a joint evaluation for determination of the beta 60 values. The average elimination rate was 0.21 g/kg/h (s = 0.05 g/kg/h). By analogy to average beta 60 values and back-conversion factors of nonalcoholics, the limit values for alcoholics were estimated as being between 0.12 g/kg/h (minimum value) and 0.29 g/kg/h (maximum value).

Adult↗

PubMed1991

[Sudden death in Sanarelli-Shwartzman phenomenon with an unusual pathogen].

The classical generalized Sanarelli-Shwartzman phenomenon (SSP) in animal experiments is induced by two conservative endotoxin injections. The experimental animals mostly die within 24 hours in irreversible shock. They show numerous microthrombi with as high fibrin content in the peripheral vessels of many organs (especially the kidneys) in the context of a consumption coagulopathy. In a 49-year-old man who died within one day of a condition associated with high fever, the clinical picture could be defined on the basis of the clinical and morphological findings as a human equivalent of SSP. The detection of a gram-positive bacterium (Diplococcus pneumoniae), which has been described as the causative organism of SSP only in a few exceptional cases, was noteworthy. The special features of the pathophysiology are described.

Death, Sudden↗

PubMed1991

[Epidemiologic studies of the effect of alcohol and drugs on psychophysical performance].

In this new epidemiological investigation, it is first of all observed that the proportion of chemical toxicological investigations instituted by the police in the area served by the Institute of Forensic Medicine, University of Tübingen, has not risen despite increases in the use or abuse of drugs and alcohol consumption although 80 per cent of those concerned are car and motorcycle drivers. On the other hand, is has been noticed in recent years that such investigations are instituted especially when the level of blood alcohol measured does not explain the actual condition of the person concerned. Just under 20 per cent of the affected persons denied consumption of a drug, and more than half admitted the use of a drug. Just under one fifth admitted using two drugs. The remainder used three and four agents. In about half of all cases, the statements were confirmed by the result of the chemical toxicological investigations. In contrast to an investigations of our own, the confirmation of the admissions does not correlate with the rising blood alcohol content. About 63 per cent of the 676 cases investigated had taken analgesics, beta blockers or calcium antagonists, hypnotics or sedatives, gastrointestinal agents and psychoactive agents. The percentage of active agents from the benzodiazepine group, which is subject to the Narcotics Law, is especially great. Finally, the blood and urinary levels of benzodiazepines and individual psychoactive agents measured as well as the pertinent blood and urinary alcohol values were compared with the constellations described in the medical examination and the divergences from the data obtained experimentally are discussed.

Adult↗

PubMed1991

[Alcoholic fermentation in "Schwabischen Most": ethanol and alcoholic congener alcohols].

The concentrations of ethanol and congener alcohols in "Schwäbischer Most" were determined (1) at various stages throughout the fermentation process in two different types of "Most", and (2) after completed fermentation in eleven different types. The fermentation process was finished after about five weeks with a final ethanol concentration of 35-54 g/l. According to the congener alcohols the different specimens of "Most" could be classified as beverages like wine. However, the concentrations were found to vary so widely that the analysis of the beverage in question is to be recommended whenever an expert opinion is given. Our studies suggest that the alcohol concentrations do not change significantly, when the fermentation process has been finished.

Ethanol↗

PubMed1990

[Sudden death of natural internal cause: endocarditis ulceropolyposa].

There is an increasing tendency amongst the general population towards rejection of conventional medical therapeutic measures, particularly certain types of medication such as antibiotics. Alternative modes of treatment, often undertaken independently by the patient, are favoured. Because of this, diseases that have become less frequent have acquired new significance as the cause of sudden unexpected death. This problem is illustrated with the case of a 20-year-old woman who died as a result of inadequate treatment of subacute bacterial endocarditis (endocarditis ulceropolyposa).

Adult↗

PubMed1990

[Cough syncope as a cause of traffic accident].

The rare tussive syncope syndrome, which can lead to a road traffic accident, occurs almost solely in the male aged 40 years and over with a pyknic to athletic physique, who suffer from obstructive respiratory tract disease and/or pulmonary emphysema. Frequently there is a correlation between the illness and alcohol and tobacco consumption. Loss of consciousness lasting only a few seconds occurs a few seconds after a coughing attack leaving behind a short loss of memory. Tussive syncope can be a solitary event, but can also occur up to thirty times a day. In foro, characteristically the link between a heavy coughing and loss of consciousness as well as the type of person make diagnosis easier. The suitability of the subject to hold a driving licence should be judged carefully and on individual criteria.

Accidents, Traffic↗

PubMed1989

[Sonography for intracorporeal drug smuggling].

To evaluate the place of ultrasonography in the detection of intracorporeal drug packets (body-packs) ten volunteers were examined by ultrasound after having swallowed four body-packs each. Diagnostic criteria had first been established by ultrasound imaging of body-packs in a water bath. The body-packs contained finger-stalls, 1.5-1.8 cm in diameter, filled with hard-pressed glucose. The criterion for identification in the water-bath was shown to be a sickle-shaped echo with a dorsal echo deficit. This sign identified 23 of the 40 body-packs in eight of the ten subjects. Within the first three hours of ingestion 22 body-packs were demonstrated in eight of the subjects; after 17 hours nine body-packs were identified in the stomach of four subjects. In only one subject was it possible to identify (two) body-packs in the region of the small-large intestine. In practice, intracorporeal drug smugglers will almost always have the body-packs in the stomach at the time of likely examination. Extensive ultrasound screening of suspected smugglers is, therefore, recommended.

Crime↗

PubMed1989

[Fatalities in drug dependent patients: suicide or accident?].

The investigation is based on the evaluation of 87 fatalities arising from drug addiction in autopsy material at the Institute for Forensic Medicine, Tübingen. When considered individually there were 76 cases of intoxication, 10 deaths due to external forces and one death due to natural internal causes as a result of drug abuse. The investigation was mainly concerned with the differentiation between suicide or accidental death in the intoxication group. Amongst the total of 76 cases we found 12 to be indisputable or probable suicides and 44 to be indisputable or probable accidents. The remaining 20 could not be classified with sufficient certainty. With the exception of the existence of a farewell letter there were no single meaningful differentiation criteria. There are indications which in themselves are not strong pointers but which, when considered together, allow a cautious interpretation. Finally the question is discussed as to how far the character changes typical in drug addiction can be explained by a latent suicidal tendency with quoad vitam fatalistic indifference.

Accidents↗

PubMed1989

[Body-packing: detection of incorporated drug packets using ultrasound technics].

According to the Federal Criminal Office the number of undetected cases of intracorporal drug smuggling is startlingly high. To enable the investigating authorities to carry out searches of suspicious persons in the airport, a safe, comparatively cheap and simple procedure is required. Using nine volunteers the detection of swallowed packets is demonstrated by means of ultrasound techniques. The advantages and disadvantages of this method, as well as the value of the radiological pictorial methods (conventional X-rax check, digital radiography, 2-spectrum-radiography and X-ray computer tomography) which we have already tested, are presented.

Adult↗

PubMed1989

[Factors influencing ethanol determination in urine using the TDx system].

The quantification of ethanol in urine samples and the susceptibility to trouble by Abbott Radiative Energy Attenuation (REA) was evaluated and compared with results by gas-chromatography (GC) and by ADH-technique. REA technique shows good reproducibility and specificity, but concerning accuracy Abbott's REA gives always lower results comparing those obtained by GC and ADH.

Alcoholic Intoxication↗

PubMed1986

Simulation of physiological ureteral peristalsis.

Occlusive ureteral peristalsis is simulated in an enlarged technical model of the ureter with a lobe-shaped lumen. The local pressure pulse is measured with catheters of different caliber and the influence of the catheters size and position on the uromanometrogram (UMG) is examined. The measurements are compared with UMGs at pathologically changed conditions (stagnation, residual urine depot etc.) and suggestions are given concerning size and shape of catheters to be used for urodynamic measurements.

Humans↗