Biomedical subjects
Publications and source records attributed to S Schmidt.
A mental stimulation programme employed in a woman aged 37 years suffering from Wernicke-Korsakoff's syndrome is described. This resulted in such improvement of her condition that full-time institutionalization could be avoided.
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Serological and clinical data were collected in 348 cases of suspected neonatal alloimmune thrombocytopenia (NAT). Of the 144 mothers who were Zwa-negative, 107 had Zwa antibodies--alone (94); with HLA antibodies (12); or with Bra antibodies (1). Antibodies were detected in 12 of the 204 Zwa-positive mothers as follows: anti-Bra (9), anti-Zwb (1), anti-Baka with HLA antibody (1), and blood group B isoagglutinins (1). The frequency of NAT due to Bra incompatibility (19%) was second to Zwa (78%). Zwa-NAT was clinically the more severe (14% had intracranial haemorrhages) and responded well to either maternal platelet transfusions or intravenous IgG. In Bra-NAT intracranial haemorrhages were not observed and most children recovered without specific therapy.
FMAU (1-[2'-deoxy-2'-fluoro-1-beta-D-arabinofuranosyl]-5-methyluracil) a newly synthesized fluorinated nucleoside, has potent in vitro antiviral and antileukemic activity and is active in murine leukemia lines resistant to cytosine arabinoside. In the initial phase I trial neurotoxicity, characterized by extrapyramidal dysfunction, was found to be the dose-limiting toxic effect, and a dosage of 32 mg/m2/day for 5 days was suggested for phase II studies. We report a second phase I study of FMAU using this schedule. Mild, transient neurologic dysfunction was encountered in patients treated at the starting dose of 4 mg/m2/day x 5 days and became severe and irreversible in two patients who received the highest cumulative doses administered at the 8 mg/m2/day x 5 days level. Both severely affected patients died. Severe neurotoxicity developed and progressed in these patients despite serial neurologic examinations, including detailed neuropsychologic tests implemented in an effort to detect early neurotoxicity. Because of these findings, further study of this drug as an antileukemic agent cannot be recommended. If it is to be used as an antiviral agent, further phase I study at lower doses is advised.
Syngeneic transplantation of cultured and functionally characterized neonatal islets into the spleen of streptozotocin diabetic Lewis rats resulted in long time survival up to 200 d and in plasma glucose levels lower than 9 mmol/L. The daily plasma glucose profile of transplanted rats had shown significantly above that of nondiabetic control rats. Two-hundred d after transplantation, morphologically intact, insulin containing beta-cells were demonstrable in the spleen, thus demonstrating the long-term survival of functioning islet cells. Proliferation of beta-cells was shown in the transplanted islets. In addition, beta-cell clusters were found that derived from pancreatic ductules transplanted together with the isolated islets into the spleen. Mitoses were visible within ductular epithelial cells. The proliferative response of islets after intrasplenic transplantation is probably the result of a long-term stimulation by slightly enhanced plasma glucose values of the transplant acceptors compared to control animals.
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Laser spectrophotometry with near-infrared light is newly available for clinical application. The equipment consists of a near-infrared datacollection unit (NIRDCU) and apersonal computer. Emission of laser light at wavelengths of 775, 805, 845 and 904 nm is provided by the four laserdiodes of the NIRDCU. By analyzing changes of optical density during laser radiation, information is achieved about the intracellular redoxstate and relative changes of blood volume. During measurement with the system on fetal head we were able to get a first impression of the methods potential. While the application of the laser sensors is still cumbersome, signals providing information of the relative changes of hemoglobine concentrations, relative changes of blood volume and cytochrome aa3 seem achievable. Laser spectrophotometric monitors may become save, low cost and portable instruments for the noninvasive assessment of the biochemical and biophysical status in the fetus.
A case of premature beats and paroxysmal supraventricular tachycardia without resulting congestive heart failure was diagnosed in a fetus of 38 weeks of gestation by echocardiography. Transplacental antiarrhythmic therapy was initiated, but a complete cardioversion was not achieved. Due to these arrhythmias adequate fetal heart rate monitoring during labor was not possible. By using continuous transcutaneous measurement of fetal carbon dioxide tension the fetus was delivered spontaneously, having been adequately monitored in spite of the effect on the fetal heart rate of the arrhythmias.
Bats obtain information about the structure of objects in the outside world from their echolocation signals, an extremely useful method when hunting non-flying prey in densely cluttered habitats, for example. Information about object structure is contained both in the time and in the spectral interference patterns of signals reflected from surfaces at different distances from the bat. I report here an experiment designed to test the extent to which bats use these two types of information. A 'phantom target' is generated by playing back to an echolocating bat signals that mimic the result of reflection from two planes set at different distances. The ability of the bat to discriminate between two such targets is investigated as a function of the separations of the planes. Several of the results do not fit the hypothesis that the bat simply uses time-delay information: the very small time difference that can be discriminated, the fall off in ability to discriminate planes at a particular separation and the symmetry of the discrimination ability measured in the frequency domain. The empirical data can best be fitted by a function based on spectral correlation.
The purpose of this study was to determine the effects of endothelial cell seeding and graft internodal distance upon the performance of 4-mm-ID e-PTFE grafts during acute reduced blood flow conditions. PTFE grafts especially manufactured with three different mean internodal distances (28, 40, and 52 microns) were evaluated. Fifteen dogs (n = 5 for each design of PTFE graft) underwent bilateral carotid artery replacements with 6 cm lengths of 4-mm-ID PTFE grafts. In each dog one graft was seeded with enzymatically derived endothelial cells; the contralateral graft was nonseeded. All grafts were evaluated 5 weeks postoperatively. Dogs with bilaterally patent grafts were subsequently subjected to flow conditions through the graft that were maintained at 30% of the initial flow rates for 4 hr. Following controlled low flows the grafts were excised and assessed for patency, thrombus-free surface area, inner capsule thickness and prostacyclin production. Endothelial cell seeding of these small-diameter e-PTFE vascular grafts improved patency and thrombus-free surface areas in grafts of all pore sizes, with these parameters being greatest in the 40-microns grafts. Inner-capsule healing in these grafts was controlled and related to the pore size. PGI2 production was improved in endothelial cell seeded grafts of all pore sizes. However, neither endothelial cell seeding nor graft pore size affected the performance of these e-PTFE grafts under conditions of reduced blood flows.
In 1893, C. Garrè published an article dealing with the manifestations of acute osteomyelitis. Since then, his name has been associated with diseases such as Garrè's osteomyelitis, chronic sclerosing osteomyelitis, and periostitis ossificans, among others. Scrutiny of a translated version of the original article reveals that Garrè was not responsible for the description of the disease that now bears his name.
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We have been successful in achieving phosphorus NMR in-vivo spectra of the fetal lung in an animal model. We used pregnant guinea-pigs with a gestational age of 45 to 65 days. The spectra were recorded on a Bruker tomograph (BMT 24/30) with a field strength of 2.35 T. The spectra showed a typical pattern. After recording the animals were sacrificed and the lungs were prepared for electron microscopic examinations. In the spectra peaks were found which appeared to be phosphorylcholine and phosphatidylcholine. For one peak it could be observed that the relative signal intensity increased with increasing gestational age as well as with increasing lung maturity. This could not be observed for other peaks. So the lecithin of the surfactant in the tissue of the fetal lung appears to be directly accessible through phosphorus in-vivo NMR spectroscopy. The peaks found appear already before the lamellar bodies are present in the pneumocytes type II.
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Aiming at an improvement of fetal surveillance in high risk cases, a clinical trial was performed to evaluate the potential of fetal tcPco2 monitoring. An electrochemical tcPco2 sensor heated at 44 degrees C was applied in 119 fetuses after abnormal heart rate patterns had occurred. The number of operative deliveries for fetal distress was reduced to 14 cases by means of the biochemical parameters (tcPco2) and fetal blood analysis (FBA). In the majority of cases with pathologic heart rate patterns the tcPco2 values were prepathologic or normal (60%), while in 68% of cases with prepathologic heart rate patterns the tcPco2 level was normal. At all instances an intrauterine complication was indicated by a marked rise of the tcPco2 level. The clinical benefit of using the tcPco2 measurement is the better specificity of detecting fetal distress when compared with the use of cardiotocography alone. Furthermore the tcPco2 technique has the advantage of providing continuous information about one biochemical parameter and of avoiding the necessity of repeated incisions of the scalp, as compared with the technique of fetal blood analysis. In conclusion the use of this non-traumatic technique lends itself to avoid unnecessary operative deliveries in high risk cases.
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