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Biomedical subjects

W Kuhn

Publications and source records attributed to W Kuhn.

At least 325 records · Page 18Linked to original sources

Effects of medrogestone and conjugated oestrogens on serum lipid and lipoprotein concentrations.

Twenty patients, aged 30-60 yr, who had undergone bilateral ovariectomy, were treated orally with 5 mg medrogestone (6,17-dimethylpregna-4,6-diene-3,20-dione) and 1.25 mg conjugated oestrogens per day, according to a constant dosage pattern during the cycle (22 + 6 days). The lipids and lipoproteins were determined twice before the start of therapy and 3, 6 and 12 mth thereafter. The lipids were quantified enzymatically and the lipoproteins by quantitative lipoprotein electrophoresis. Whilst cholesterol and triglyceride concentrations showed no detectable change, a slight but significant increase was seen in the high-density alphalipoprotein (HDL) cholesterol concentrations. The low-density beta-lipoprotein (LDL) cholesterol level showed a moderate fall. There was a resultant reduction in the beta/alpha-lipoprotein ratio. Accordingly, the apoprotein A1 concentrations were found to be elevated, while apoprotein B tended to fall to lower levels during therapy. When these changes are measured by the lipid metabolism risk criterion for the occurrence of coronary heart disease applicable to post-menopausal patients, the effects of the above-mentioned combination may be regarded as entirely favourable.

Adult↗

Discontinuation of bee venom immunotherapy in children and adolescents.

Sixty-six patients with a history of systemic allergy reactions to bee stings, positive skin prick test to less than or equal to 100 micrograms/ml bee venom, and positive radioallergosorbent test (RAST) results were given venom immunotherapy. IgE and IgG antibodies to bee venom were measured by RAST and enzyme-linked immunosorbent test (ELISA), respectively. IgE and IgG anti-bee venom levels rose initially, but subsequently fell during immunotherapy. In 31 patients in whom specific IgE fell to low (less than 6% counts bound) or unmeasurable levels, immunotherapy was discontinued, and sting challenge was carried out 1 to 3 years later. All patients tolerated sting challenge well. The specific IgE and IgG antibody levels did not change significantly after treatment was stopped. Our data suggest that hyposensitization treatment can be stopped when specific IgE serum concentrations have fallen to low or unmeasurable levels and specific IgG antibody values are maintained, and that in a considerable number of patients venom immunotherapy has a lasting therapeutic and immunologic effect.

Adolescent↗

Facilitation of cervical dilatation by intracervical application of sulprostone gel prior to hysteroscopy.

In a prospective, randomized study, 10 patients with primary sterility received an intracervical application of 0.1 mg Sulprostone-Tylose gel for cervical priming 12 hours prior to panoramic CO2-hysteroscopy and pelviscopy with chromopertubation. Ten patients who served as controls were not treated with the local prostaglandin. The force required to overcome the cervical canal was measured with a special tonometer for Hegar 3 before application of the gel in the group treated with Sulprostone and was 3-8 mm in both groups of patients immediately preoperatively. Cervical priming led to a significant reduction in the force required to dilate the cervix. After priming with Sulprostone, the cervical canal was freely passable for an average of 6.7 mm. In none of these patients was a force of 7 Newton exceeded for Hegar 8, whereas in the control group a mean force of 8.2 Newton was required to dilate the cervix for Hegar 6. Haemorrhage and epithelial lesions of the cervix caused by the dilatation can largely be avoided, and the risk of uterine damage reduced by local priming of the cervix. The intracervical application of prostaglandin gel is an easy, efficient and gentle method of dilatation for hysteroscopy, particularly in patients with a firmly closed and rigid cervix.

Adult↗

[Cervix priming in induced abortion in the 1st trimester using intracervical administration of sulprostone gel].

In a prospective, randomised study 40 primigravidae were treated intracervically with 0.05 mg or 0.1 mg Sulprostone-Tylose gel in order to soften the cervix prior to first trimester termination of pregnancy. Curettage was performed on the average 7.5 hours after prostaglandin administration. For objective demonstration of the priming effect, the force required for dilatation of the cervical canal was measured in Newtons by a special tonometer before prostaglandin application and before operation. The maximal dilatability with a force of 10 N, the increase in dilatability after local PG application, and the patency of the cervix were measured. The occurrence of PG-induced lower abdominal pain associated with contractions was analysed with regard to the number of episodes at pain, their timing and the required amount of analgesics. A modified visual analogue scale was used to evaluate the subjective pain experience. The abortive effect of 0.1 mg Sulprostone was found to be more efficient than the 0.05 mg dose. There was no statistical significant difference between the two doses, however, for the priming effect detectable with the tonometer. The subjective experience of pain, use of analgesics and the frequency of gastrointestinal side effects were significantly higher with 0.1 mg than with 0.05 mg Sulprostone. The visual analogue scale allows the patient to quantify, at least to some extent, her experience of pain, and enables a differentiated analgetic therapy. Because of its effectiveness and low rate of side effects, the intracervical application of 0.05 mg Sulprostone gel promises to be an advantageous alternative to other methods of cervical priming.

Abortifacient Agents↗

[Solitary neurofibroma of the lumbosacral plexus. Case report].

The article describes a case of a solitary neurofibroma of the plexus lumbosacralis causing pain and incomplete leg paresis. Complete relief was obtained by total extirpation of the tumour, a procedure which must be regarded as the method of choice. Pain and pareses in the lower extremities require differential diagnostic consideration of rare neurogenic tumours of the peripheral nervous system in the regions of the pelvis and plexus lumbosacralis. Neurological examination by a specialist is of significant importance preoperatively to determine the seat of the tumour and to assess the postoperative course.

Female↗

[Changes in serum lipoproteins under hormonal therapy of breast carcinoma and other endocrine-dependent tumors].

The higher the low-density-lipoprotein cholesterol (beta lipoprotein) level, the greater the risk that coronary heart disease will develop, alpha-lipoprotein fractions (high-density-lipoproteins) are considered to be protective factors. Medroxyprogesterone acetate is responsible for characteristic changes of the lipoprotein patterns indicating enhanced coronary risks. Medroxyprogesterone acetate is applied in the therapy of breast, uterus and ovarian cancer. A statistically significant decrease was observed in alpha-lipoproteins whereas beta-lipoproteins increased without statistical significance. A similar reaction can be observed under the combination therapy of aminoglutethimide and medroxyprogesterone acetate, whereas the combination of cortisone and aminoglutethimide has a distinct influence on beta-lipoproteins but the alpha-lipoprotein level remains uninfluenced. According to these data the effect of an adjuvant application of these drugs must be carefully evaluated due to an increase of coronary risks.

Aminoglutethimide↗

Effect of tocainide on the concentrations of norepinephrine dopamine, serotonin and histamine in rat brain and its binding affinity to neuroceptors.

Tocainide (W-36095, Xylotocan) is a derivative of lidocaine which is applied clinically as a cardiac antiarrhythmic. In addition, it diminishes the severity of symptoms in neurological disorders such as myotonia and paramyotonia and in patients with torticollis spasmodicus it brings about a distinct reduction in the tension of the neck muscles. It was investigated whether in reducing the tonus in torticollis spasmodicus tocainide could be acting on the central nervous system. The binding affinity of the substance to the dopamine, serotonin, opiate, GABA and benzodiazepine receptors was measured without finding any significant affinities. In addition, the effect of tocainide on the concentration of the neurotransmitters norepinephrine (noradrenaline), dopamine, serotonin and histamine were investigated in rat brain, and it was found that tocainide induces a significant increase in dopamine and serotonin concentrations. This lead to the conclusion that, in addition to its antiarrhythmic effects, tocainide acts on the central nervous system.

Animals↗

Huntington's disease: biochemical prediction by determination of GABA synthesis of cultured fibroblasts.

GABA synthesis in skin fibroblasts from patients with Huntington's chorea was compared with that in a control group by means of the highly specific 3H-muscimol radioreceptor assay. A significantly increased rate of GABA synthesis was found in the group with Huntington's chorea in an early cell passage. The possible use of this method for early diagnosis of Huntington's chorea is considered.

Cells, Cultured↗

Changes of the clinical presentation of abruptio placentae.

There is an increase of the diagnosis "a.p." during the last years, especially stage 0 + 1. Qualified US monitoring seems to be responsible for this fact. Abruptio placentae is reversible in some cases. Conservative management can be done under intensive care conditions if antenatal treatment is indicated.

Abruptio Placentae↗

[Lipoprotein changes during hormonal treatment of endometriosis with lynestrenol and danazol].

The Lipoprotein profile of 24 patients with endometriosis was determined before, during and after the treatment with the two steroid hormones Lynestrenol (10 mg/day) and Danazol (600-800 mg/day). The total cholesterol triglycerides, beta-, prebeta-, and Alphalipo -protein bound to cholesterol were determined. Both hormones cause a marked lowering of the Alpha-Lp-cholesterin. In addition, the beta-LP-cholesterin was elevated and the beta-alpha-LP-ratio was elevated. In the dosage used by us, Lynestrenol showed less effect on the Lipoprotein profile. Danazol caused changed in the beta- and alpha-lipoprotein pattern of highly pathological atherogenic types. The total cholesterol was not influenced. Since women in the fertile age group will suffer a higher risk of arteriosclerosis from an elevation of the beta-LP-cholesterin, the treatment with Danazol calls for a sophisticated monitoring of the lipid metabolism and care in the indication for long term treatment with Danazol or with Lynestrenol.

Adult↗

Urinary excretion, osmolarity and electrolytes after bolus-injection of fenoterol in female rabbits.

The effects of bolus injections of 1.0-80.0 micrograms/kg body weight fenoterol on urinary excretion, osmolarity and electrolytes were studied in unanesthetized, water-loaded rabbits. In animals infused initially with isotonic solution over 2 h with 60 ml/h and thereafter over 10 h with 45 ml/h, urine excretion was 538 ml/12 h, sodium excretion was 65.4 mmol/12 h, and potassium excretion was 4.8 mmol/12 h. In animals injected with 5.0-80.0 micrograms/kg body weight fenoterol, a strong antidiuresis occurred, lasting for 2 (10.0 micrograms/kg) to 4 h (80.0 micrograms/kg). Due to the strong antidiuresis, urinary osmolarity was significantly elevated for 2 (10.0 micrograms/kg) to 3 h (80.0 micrograms/kg). The changes of sodium excretion after fenoterol injection were very similar to those of urine excretion. Maximum reduction of sodium excretion was found after injection of 10.0-80.0 micrograms/kg body weight fenoterol, the effect lasting for 1 h (10.0 micrograms/kg) to 4 h (80.0 micrograms/kg). Potassium excretion was significantly reduced after injection of 5.0-80.0 micrograms/kg body weight fenoterol. In contrast to all the other parameters measured, potassium excretion remained significantly reduced until the end of the infusion period in animals treated with 10.0-80.0 micrograms/kg body weight fenoterol and was not dose dependent. Our data presented in this work extend earlier findings in the rabbit in that bolus injection of fenoterol also results in a drastic decrease of urine and electrolyte excretion. The results are discussed with special reference for the management of acute fetal distress with betamimetics and to the development of pulmonary edema that has been shown to occur under therapy with betamimetics on both female rabbits and humans.

Animals↗

[Efficacy of oral and parenteral hyposensitization with pollen extracts].

Hyposensitization was undertaken in 26 children, aged 4-15 years, with proven sensitivity to grass and wheat pollen, in some orally (ten), in others parenterally (16), for two years before the start of the season. The administered cumulative dose with oral hyposensitization was 1,750,000 PNU (protein nitrogen units), corresponding to 3,500,000 NU (Noon units), and on parenteral sensitization 1,550 PNU, corresponding to 3,100 NU. A symptoms score was registered daily during the pollen season. It showed fewer symptoms in those with parenteral hyposensitization, although subjective assessment of the success of treatment did not indicate any difference between the two groups. Oral hyposensitization produced a higher IgE and a lower IgG immune response. Systemic side-effects were noted in half of those after oral but none after parenteral hyposensitization. Measured by side-effects, the cumulative dose and expense, the effectiveness of oral hyposensitization is inferior to parenteral administration.

Administration, Oral↗

The interactions of 1-alkyl-4,4-diphenylpiperidines with opiate receptors.

1-Alkyl-4,4-diphenylpiperidines inhibit the binding of mu- and delta-opiate receptor agonists to crude synaptosomal membranes of rat brain. Opiate receptor affinity is dependent on the nature of the 1-alkyl substitution. In displacing [3H]etorphine, [3H]dihydromorphine and [3H][D-Ala2,D-Leu5] enkephalin, the 1-methyl-derivative was most effective (IC50 [3H]etorphine = 9 microM, IC50 [3H]dihydromorphine = 0.71 microM, IC50 [3H][D-Ala2,D-Leu5]enkephalin = 2.1 microM). 1-t-Butyl-4,4-diphenylpiperidine and its 1-isopropyl analogue, used as antiparkinsonism drugs, exhibit distinctly lower inhibiting concentration values (50% inhibition, IC50 values).

Animals↗