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Biomedical subjects

S Ulrich

Publications and source records attributed to S Ulrich.

At least 73 records · Page 4Linked to original sources
PubMed1994

Functional analysis of separate topographies of aberrant behavior.

We conducted a functional analysis of distinct topographies of aberrant behavior displayed by 4 clients. We first analyzed the behaviors in an aggregate fashion and then separated the behaviors to formulate hypotheses about the maintaining variables for each behavior. The procedures were used in a two-phase experiment. During Phase 1, two extended functional analyses were completed, one in an inpatient unit and one in a special education classroom. During Phase 2, two brief functional analyses were completed in an outpatient clinic. Results indicated that hypotheses of separate functions for distinct behaviors can be generated using both extended and brief functional analyses when the results are graphed in the aggregate and are separated by response topography. The results also suggest that these methods can improve the accuracy of data interpretation and treatment selection.

Adult↗
PubMed1994

Revisiting an "old" solution to the high costs of maternity care.

This article examines the high costs of maternity care in the United States and proposes an old fashioned solution--the midwife. Particular attention is given to the costs associated with poor birth outcomes, such as prematurity and low-birthweight infants. Literature is reviewed that demonstrates certified nurse-midwives have achieved a reduction in these poor birth outcomes. Projections of cost savings resulting from these better outcomes are also presented.

Cesarean Section↗
PubMed1994

[Relation of Doppler ultrasound to hemostaseologic and hemorheologic parameters in pregnancy-induced hypertension].

During this study we investigated 23 patients with preeclampsia and 23 women with normal pregnancies. The hemorheological, the hemostasiological and the dates of doppler ultrasound were evaluated. High values of D-Dimer as a sign for a rapidly turnover of fibrin, are a poor prognostical symptom for gestational hypertension. There is a close correlation between doppler ultrasound indices and the maternal D-Dimer. Nearly 80% of the new born babies with growth retardation suffered by a high blood viscosity of the umbilical artery. We postulate that the changes of maternal and fetal blood viscosity are very important to estimate the doppler flow velocity by patients with gestational hypertension.

Adult↗
PubMed1994

[The Na+/K+ cotransporter of the erythrocyte membrane in pregnancy-induced hypertension].

In erythrocytes, the extrusion of a cellular sodium level load is accomplished by the Ouabain-sensitive Na+/K+ pump and by the furosemide-sensitive Na+/K+ cotransport, which operates against the passive sodium permeability. An abnormal low rate of net sodium extrusion by the Na+/K+ cotransport was observed in pre-eclamptic patients. At the molecular level the cotransport abnormality seems to be consecutive to a diminished apparent affinity for intracellular Na+. The normal pregnancy is characterized by a strong increase of Na+/K+ cotransport efflux. No difference could be detected between the passive sodium permeability of erythrocytes from normotensive pregnant patients and from normotensive controls. Pre-eclampsia seems to be associated with a low passive sodium and potassium permeability. The abnormalities of cotransport and red cell deformability in patients with pre-eclampsia might be interpreted as an early sign of impaired microcirculation and increased vascular reactivity.

Adolescent↗
PubMed1993

The Na+/K+ co-transport system in erythrocytes from pregnant patients.

In erythrocytes, the extrusion of a cellular sodium level load is accomplished by the Ouabain--sensitive Na+/K+ pump and by the furosemide-sensitive Na+/K(+)--cotransport, which operates against the passive sodium permeability. An abnormal low rate of net sodium extrusion by the Na+/K+ cotransport was observed in pre-eclamptic patients. At the molecular level the cotransport abnormality seems to be the consequence of an apparent diminished affinity for intracellular Na+. Normal pregnancy is characterized by a strong increase of Na+/K+ cotransport efflux. No difference could be detected between the passive sodium permeability of erythrocytes from normotensive pregnant patients and from normotensive non-pregnant controls. Pre-eclampsia seems to be associated with a low passive sodium and potassium permeability. The abnormalities of cotransport and red cell deformability in patients with pre-eclampsia might be interpreted as an early sign of impaired microcirculation and increased vascular reactivity.

Adolescent↗
PubMed1992

Blood flow velocity waveforms of the middle cerebral artery and abnormal neurological evaluations in live-born fetuses with absent or reverse end-diastolic flow velocities of the umbilical arteries.

We studied 37 fetuses with absent or reverse end-diastolic flow velocities (AREDFV) of the umbilical arteries with respect to the mode of delivery, fetal acidosis, resistance index of the middle cerebral arteries, and abnormal neurological evaluation at the time of discharge from the department of pediatrics. A control group with normal umbilical artery flow velocity waveforms was matched for gestational age. Fetuses with AREDFV were delivered almost exclusively by cesarean section, in most cases due to fetal distress. Metabolic changes with decreased base excess values were found more often in fetuses with AREDFV, but no difference could be detected with respect to severe fetal acidosis. The number of fetuses with abnormal neurological evaluations during the first 6 months of life was significantly higher in cases with AREDFV than in the control group. More than two thirds of the fetuses with AREDFV showed an abnormal blood flow velocity waveform of the middle cerebral arteries with elevated end-diastolic flow velocities. The combination of extreme premature delivery before 28 weeks of gestation, severe idiopathic respiratory distress syndrome, and a resistance index of the middle cerebral arteries under the 5th percentile seems to be a risk factor for early neurological morbidity in fetuses with AREDFV. Premature delivery of fetuses with AREDFV--as we did during our study in order to prevent intra-uterine death or fetal asphyxia--should therefore be critically regarded in cases under 28 weeks of gestational age and abnormal flow velocity waveforms of the middle cerebral arteries.

Acid-Base Imbalance↗
PubMed1992

Condition at birth of infants with previously absent or reverse umbilical artery end-diastolic flow velocities.

In a case control study we assessed 47 fetuses with absent or reverse end-diastolic flow velocities (AREDFV) of the umbilical artery with respect to the mode of delivery, fetal acidosis, and abnormal neurological evaluations at the time of discharge from the department of pediatrics. We also studied a control group which was matched for gestational age and had normal umbilical artery flow velocity waveforms. Fetuses with AREDFV were delivered almost exclusively by cesarean section which was usually done for fetal distress. The number of fetuses with abnormal neurological signs was significantly increased compared to the control group. Fetuses with AREDFV showed an increased incidence of fetal acidosis. Forty per cent of these fetuses were delivered within one day of the first abnormal flow measurement; Sixty per cent were observed clinically for up to four weeks before delivery.

Blood Flow Velocity↗
PubMed1991

Recurrent abdominal pain due to chronic appendiceal disease.

Recurrent appendicitis and chronic appendicitis are the subjects of much controversy, but long-standing inflammation of the appendix and surrounding tissues has been reported in rare instances. We have described two patients, both with recurrent episodes of abdominal pain, who subsequently were shown to have chronic appendiceal disease. Appendiceal disease should be considered in the differential diagnosis in patients with recurrent abdominal pain.

Abdominal Pain↗
PubMed1987

Effects of low dose enoximone for chronic congestive heart failure.

To examine the short-term hemodynamic and long-term clinical effects of oral enoximone at low doses, 12 patients with severe, chronic congestive heart failure (CHF) were given 1 mg/kg oral enoximone and followed with serial hemodynamic measurements for 24 hours. Control cardiac index was 1.9 +/- 0.5 liters/min/m2 and it increased significantly by 1 hour, with a peak effect at 2 hours to 2.4 +/- 0.4 liters/min/m2 (p less than 0.05). Similarly, wedge pressure, 22 +/- 8 mm Hg at control, decreased to 16 +/- 10 by 1 hour (p less than 0.05). Six of the 12 patients received 1 mg/kg of enoximone on day 1 and 2 mg/kg on day 2. The higher dose of enoximone caused no further improvement in cardiac performance but prolonged the salutary hemodynamic effect. Subsequently, 79 patients (18 in New York Heart Association class III and 61 in class IV) with CHF (ejection fraction 17 +/- 8%) were followed over a 3 year period; the average enoximone dose was 1.7 +/- 0.7 mg/kg 3 times daily. Improvement of at least 1 functional class occurred in 55 patients (70%) at 1 month, 27 patients (34%) at 6 months and 19 (24%) maintained their improvement for over 1 year. Enoximone was discontinued in 20 patients (25%); in 5 (6%) for adverse effects and in 13 patients because of no clinical benefit. Adverse effects occurred in 14 patients (18%); 6% of all patients required discontinuation of drug. Six month survival was 50%, 42% at 1 year and 30% at 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1987

Autoimmunity to pancreatic juice in Crohn's disease. Results of an autoantibody screening in patients with chronic inflammatory bowel disease.

The sera of 59 patients with Crohn's disease (CD) and of 46 patients with ulcerative colitis (UC) were tested for autoantibodies (Aab) by indirect immunofluorescence with modern histochemical techniques using 19 different human tissues as antigenic substrates. Control collectives consisted of 19 patients with coeliac disease and of 100 healthy subjects. It was possible to demonstrate a specific marker for CD: Aab against exocrine pancreas (Pab) were present in 39% of the CD sera (UC 4%, coeliac disease 0%, healthy controls 3%). High Pab titres were only detectable in CD sera (29%). The CD-related autoantigen was demonstrated to be a component of normal pancreatic juice. Pab in CD were fundamentally different from those sometimes occurring in chronic and acute pancreatitis. It is suggested that CD is caused by autoimmune reactions against a component of pancreatic juice. Pab in CD correspond to Aab against intestinal goblet cells (Gab), which occurred exclusively in UC (28%). Pab and Gab, but obviously none of the other Aab investigated in this study, are of diagnostic value in chronic inflammatory bowel disease.

Adult↗
PubMed1986

Comparison of acute hemodynamic response to dobutamine and intravenous MDL 17,043 (enoximone) in severe congestive heart failure secondary to ischemic cardiomyopathy or idiopathic dilated cardiomyopathy.

The acute hemodynamic response to intravenous dobutamine administration was compared with intravenous MDL 17,043 administration in 8 patients with severe, chronic congestive heart failure. Simultaneous radionuclide angiography was performed with gated equilibrium blood pool imaging to derive left ventricular volumes and ejection fraction during serial hemodynamic measurements. Six patients had an optimal dobutamine dose of 10 micrograms/kg/min; 2 others were compared at a dose of 7.5 micrograms/kg/min; comparisons with MDL 17,043 were after a 1.5-mg/kg bolus dose in all 8 patients. Dobutamine and MDL 17,043 caused significant and similar increases in cardiac index and stroke volume index. Dobutamine significantly increased heart rate and MDL 17,043 did not. MDL 17,043 significantly decreased pulmonary artery wedge, mean pulmonary artery and right atrial pressures; dobutamine did not. Dobutamine increased end-diastolic volume in 4 patients, with little concomitant decrease in wedge pressure; MDL 17,043 caused no change or a decrease in left ventricular end-diastolic volume in 5 patients, but consistently decreased wedge pressure in all. Thus, the left ventricular pressure-volume curve was displaced downward to a more favorable position after MDL 17,043 but not after dobutamine. In patients with chronic congestive heart failure, acute myocardial performance was more optimally influenced by MDL 17,043 than dobutamine administration.

Adult↗
PubMed1986

Simultaneous measurement of epinephrine-induced platelet aggregation in 14 plasma samples.

A method is described for the simultaneous measurement of epinephrine-induced platelet aggregation in 14 different plasma samples in 15 min. It is based upon discontinuous registration of platelet aggregation and computer evaluation of the data. The samples are placed in holders mounted over magnetic stirring bars in a 37 degrees C water bath and the extinction is measured by removing the samples one after the other, placing them in a Braun Universal Aggregometer and returning them to their holders in the water bath. The time required to reach 37% of maximal aggregation was chosen as the evaluation criterion. It sufficed for the determination of aggregation sensitivity. This method for the first time permits measurement of a complete titration curve rapidly and under identical conditions and can be used to show the influence of a wide range of aggregation inducers and the concurrent effects of inducers plus various blocking agents. A correlation between aggregation sensitivity and alpha 2-receptor binding capacity in platelets, measured by competitive radioactive binding, was established in samples from 10 healthy volunteers. One group exhibited high aggregation sensitivity coupled with high alpha 2-binding capacity and the other showed low sensitivity with low binding capacity.

Aging↗
PubMed1986

Mortality of workers employed in the manufacture of chlordane: an update.

A prospective mortality study was conducted of the 800 employees who worked 3 months or more during the period January 1946 through June 1985, in the only plant in the US where the termiticide chlordane has been produced. The study covers the entire period of chlordane production to date and includes 7,347 person-years of employment at the chlordane plant and 21,585.5 person-years of follow-up since commencement of employment. All but three former employees considered to be alive at the end of the study period were either contacted directly or were identified as alive by a variety of reliable sources. Death certificates were obtained for 161 of the 181 decedents and reliable causes of death were reported for an additional 11 cases. Overall death rate was slightly less than expected but not to the level of statistical significance. Production workers with higher pesticide blood levels had lower standardized mortality ratios for cancer than nonproduction employees, and there appears to be an inverse relationship of cancer mortality to length of employment. An unexplained excess of cerebrovascular deaths was observed, offset by a lesser degree of cardiovascular deaths.

Adult↗
PubMed1985

A cohort study of employees of a manufacturing plant using trichlorethylene.

A prospective study was conducted of 2,646 employees who worked three months or more during the period January, 1957, through July, 1983, in a manufacturing plant that used trichlorethylene as a degreasing agent throughout the study period. Ninety-eight percent of the study cohort were traced; they accounted for 16,388 person-years of employment and 38,052 person-years of follow-up. Mortality experience was found to be generally more favorable than that of the comparable segment of the U.S. population over the same period of time. For the white male cohort there were fewer deaths than expected from heart disease, cancer, and trauma (standard mortality rate for all causes = 0.79, p less than .01). Reports by current and former employees of health problems requiring medical treatment showed that there were only one third as many persons with heart disease or hypertension as were reported in a comparable reference population studied over the past five years.

Adult↗
PubMed1985

Monoclonal antibody-defined human pancreatic cancer-associated antigens.

Three pancreatic cancer-associated antigens were characterized by use of monoclonal antibodies in immunobinding studies with various cellular and soluble target antigens, in immunoprecipitation, and in immunoperoxidase staining. C54-0 represents a tumor-associated Mr 122,000 antigen, which appears to be widely distributed on various epithelial tumors and to a lower extent on normal tissue. C1-N3 antigen exhibited a more restricted distribution, reacting with pancreatic and various gastrointestinal tract tumors as well as with chronically inflamed pancreatic tissue. The most specific antigen expression was observed for C1-P83 antigen, found on all exocrine tumors of the pancreas, but not on normal or chronically inflamed pancreatic tissue.

Animals↗
PubMed1984

[Autoantibodies against the exocrine pancreas and against intestinal goblet cells in the diagnosis of Crohn's disease and ulcerative colitis].

It was demonstrated by indirect immunofluorescence that Crohn's disease and ulcerative colitis are serologically distinct. In 59 patients with Crohn's disease, confirmed by endoscopy and histology, 23 (39%) had serum autoantibodies against exocrine pancreas; in 17 (29%) the titre was 1 : 100 or higher. In 46 patients with confirmed ulcerative colitis pancreas antibodies were demonstrated only twice, in 100 healthy control subjects only 3 times, with titres less than 1 : 100. Pancreas antibodies do not occur in high concentrations in pancreatitis; titres higher than 1 : 100 therefore suggest Crohn's disease. The pancreas antibodies of patients with Crohn's disease were predominantly immunoglobulins IgA and IgG, twice they were IgD and once IgM, never IgE. In 6 patients the pancreas antibodies fixed complement. Autoantibodies against intestinal goblet cells were found only in patients with ulcerative colitis (13 of 46 = 28%). The titres range was from 1 : 10 to 1 : 1000. The goblet-cell antibodies consisted only of IgA and IgG, never reacting with complement. These results indicate that determining pancreas and goblet-cell antibodies alone will make it possible to diagnose either Crohn's disease or ulcerative colitis in more than a quarter of patients with chronic inflammatory intestinal disease.

Adolescent↗