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Biomedical subjects

W Schramm

Publications and source records attributed to W Schramm.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Electronic data processing assisted documentation of tumor after care in an ambulatory setting--a simplification of daily routine].

A data collection system on microcomputer was developed for patients with malignant diseases in ambulant aftercare. At the same time when patient data are collected to be sent to a central medicostatistical plotting station, as it is usual in Austrian hospitals, a file for further aftercare is opened. By data transfer to other software products, statistical data evaluation is possible. Patients can also be called to hospital for different reasons.

Aftercare↗
PubMed1991

[Thrombocyte aggregation and fibrinolysis in healthy probands treated with molsidomine, isosorbide-5-mononitrate and placebo].

Twelve healthy volunteers received either a single oral dose of molsidomine (4 mg), isosorbide-5-mononitrate (ISMN, 20 mg), or placebo in a randomized, double-blind fashion. Blood was drawn prior to, as well as 30 and 60 min after intake of the respective drug. Platelet aggregation and the plasma levels/activity of plasminogen activator (tPA) and its inhibitor (PAI-1) were determined. In contrast to ISMN and placebo, molsidomine provoked a significant reduction in platelet aggregability. No alteration in plasma tPA concentrations was observed independent of whether molsidomine, ISMN, or placebo was applied. However, plasma PAI-1 activity was considerably reduced following molsidomine, but not altered following ISMN or placebo. We conclude that a single oral dose of molsidomine, but not of ISMN inhibits platelet aggregation and increases the fibrinolytic potential in healthy volunteers.

Adult↗
PubMed1991

[Local low dosage thrombolysis with rt-PA. Systemic effects on the fibrinolytic system--data on the assessment of the value and risk of this method].

We investigated 70 patients suffering from peripheral vascular disease for alterations in fibrinolytic parameters before, during and twice after local, low dose thrombolysis with rt-PA (1 - 7.5 mg). Recanalization was achieved in all 10 embolic occlusions and in 87% of 60 thrombotic occlusions. We found no alterations of fibrinogen and plasminogen plasma levels, but significant consumption of antiplasmin 5 min after the end of rt-PA application. Degradation products of fibrinogen and fibrin showed a parallel increase only during the therapy. PAI I concentrations significantly increased until the 2nd day after the therapy. Since we limited the maximum dose of rt-PA to 7.5 mg we never saw systemic bleeding or embolisation in more than 300 cases.

Aged↗
PubMed1991

The influence of preoperative anticoagulation on heparin response during cardiopulmonary bypass.

The effect of preoperative anticoagulant therapy on intraoperative heparin response in patients undergoing cardiac operations was examined in a prospective study. The study included 45 patients with different preoperative anticoagulant treatments: 10 patients received treatment with phenprocoumon (a warfarin analogue) (group M), 12 patients received treatment with intravenous heparin (group Hiv), and 13 patients received treatment with subcutaneous heparin (group Hsc). The control group consisted of 10 patients who did not receive anticoagulant therapy before operation (group C). Preoperative antithrombin III activity was highest in group M (85% +/- 6%) and lowest in group Hiv (70% +/- 15%, p less than 0.05). The activated clotting time, determined 10 minutes after bolus injection of 250 IU (group M) or 375 IU heparin (all other groups), was 529 +/- 109 seconds in group C, greater than 1000 seconds in group M, 483 +/- 99 seconds in group Hsc, and 406 +/- 63 seconds in group Hiv (p less than 0.05). Heparin consumption during cardiopulmonary bypass varied between 4.6 +/- 1.4 IU/kg.min (group Hiv) and 2.6 +/- 0.9 IU/kg.min (group M) (p less than 0.05). Despite this increased heparin consumption, the patients who had received heparin before operation demonstrated increased activation of coagulation at the end of cardiopulmonary bypass (thrombin-antithrombin III complex, 19 +/- 4.1 ng/ml in group M and 61 +/- 7 ng/ml in group Hsc, p less than 0.05; cross-linked fibrin fragments, 257 +/- 92 ng/ml in group M and 875 +/- 152 ng/ml in group Hiv, p less than 0.05). Increased platelet activation was also found in patients with preoperative heparin therapy (beta-thromboglobulin at the end of cardiopulmonary bypass was 585 +/- 88 ng/ml in group M versus 1341 +/- 190 ng/ml in group Hsc, p less than 0.05). Drainage from the chest tube 24 hours after operation was 815 +/- 305 ml in group C, 644 +/- 238 ml in group M, 1133 +/- 503 ml in group Hsc, and 950 +/- 505 ml in group Hiv (p less than 0.05 for group M versus group Hsc). This study suggests that patients who receive heparin therapy before operation face a high risk of insufficient anticoagulation during cardiopulmonary bypass if standard heparin doses are used. Therefore, for patients who receive preoperative heparin therapy, a larger (500 IU/kg) initial bolus of heparin is recommended before cardiopulmonary bypass. On the other hand, patients who undergo preoperative treatment with phenprocoumon receive sufficient anticoagulative effect with a heparin bolus of 250 IU/kg.(ABSTRACT TRUNCATED AT 400 WORDS)

Antithrombin III↗
PubMed1990

[Obstetrical management in dysfibrinogenemia].

Dysfibrinogenaemia is an inherited disorder, characterised by a plasmafibrinogen in normal concentration, but of abnormal quality due to impaired release of fibrinopeptides and/or impaired aggregation of fibrinomonomers. The typical abnormalities of the laboratory findings will be demonstrated by presenting the case reports of 4 patients with 5 pregnancies (1 ectopic pregnancy); the importance of clinical exploration is emphasized. Newborn infants must be subjected to careful clinical and biochemical examination, because of factors of Mendelian dominant inheritance.

Adult↗
PubMed1990

[Documentation of the surgical report with graphic statistical data analysis--a simplification of daily routine work].

A data collection system on microcomputer connected with an automatic medical report system for operations, was developed to facilitate both medical report as well as documentation. Linking different commercial software products by use of a Pascal programme, we were able to speed up daily routine work as well as establish efficient graphical statistics of patient data.

Cesarean Section↗
PubMed1990

Influence of high-dose aprotinin treatment on blood loss and coagulation patterns in patients undergoing myocardial revascularization.

Intraoperative administration of the proteinase inhibitor aprotinin causes reduction in blood loss and homologous blood requirement in patients undergoing cardiac surgery. To ascertain the blood-saving effect of aprotinin and to obtain further information about the mode of action, 40 patients undergoing primary myocardial revascularization were randomly assigned to receive either aprotinin or placebo treatment. Aprotinin was given as a bolus of 2 x 10(6) kallikrein inactivator units (KIU) before surgery followed by a continuous infusion of 5 x 10(5) KIU/h during surgery. Additionally, 2 x 10(6) KIU were added to the pump prime. Strict criteria were used to obtain a homogeneous patient selection. Total blood loss was reduced from 1,431 +/- 760 ml in the control group to 738 +/- 411 ml in the aprotinin group (P less than 0.05) and the homologous blood requirement from 838 +/- 963 ml to 163 +/- 308 ml (P less than 0.05). In the control group, 2.3 +/- 2.2 U of homologous blood or blood products were given, and in the aprotinin group, 0.63 +/- 0.96 U were given (P less than 0.05). Twenty-five percent of patients in the control group and 63% in the aprotinin group did not receive banked blood or homologous blood products. The activated clotting time as an indicator of inhibition of the contact phase of coagulation was significantly increased before heparinization in the aprotinin group (141 +/- 13 s vs. 122 +/- 25 s) and remained significantly increased until heparin was neutralized after cardiopulmonary bypass (CPB).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[PC-based computer monitoring in an intensive care unit].

The lack of direct communication with the intensive care patient means the medical staff have to try to achieve a realistic picture of the condition of the patient from numerous pieces of detailed information fitted together something like a jigsaw. The immense amount of data thus gained means an overall interpretation of the many individual data would be hardly imaginable without the use of a computer. PC networks in conjunction with a high-level language provide an ideal basis for building up a background monitoring system that can be used at the bedside. Simple PC-ATs and software developed in house in Turbo-Pascal have enabled us to realize a useful and very economical computer-aided background monitoring system. Any online and offline data important for an operative critical care unit can be collected, documented, displayed and processed in secondary parameters.

Austria↗
PubMed1990

Rapid solid-phase immunoassay for 6-keto prostaglandin F1 alpha on microplates.

We describe, for the measurement of 6-keto prostaglandin F1 alpha in biological media, a solid-phase immunoassay with immobilized antibodies that requires a total processing time of less than 2 h with hands-on time less than 30 min for 40 samples. The method combines the convenience of the microplate format with the sensitivity of radiolabeled prostaglandin derivatives as tracers in a competitive immunoassay. The intra- and interassay variations at 50% displacement of the radiolabeled prostaglandin derivative as tracer were 9.0% and 11.8%, respectively. At 50% displacement of the radiolabeled tracer, the sensitivity is about 20 pg per well. Optimal incubation time is between 60 and 90 min. Nonspecific binding was less than 1% if about 8 pg of tracer (approximately 25,000 counts/min per well) was used. Inhibition curves of samples in different dilutions were parallel to standard curves. The variation of bound radiolabeled prostaglandin derivative within the wells of one microplate (n = 96) was less than 3%. Human plasma samples and medium from tissue culture assayed for 6-keto prostaglandin F1 alpha correlated well with results obtained with a solid-phase assay based on use of magnetic particles (r = 0.99, n = 24 for culture-medium samples; r = 0.99; n = 26 for plasma samples.

6-Ketoprostaglandin F1 alpha↗
PubMed1990

A simple method for estimating association constants between monoclonal antibodies and derivatized or native antigens.

We describe a simple method for estimating the association constant between an antibody and an antigen, based on a theoretical treatment of experimental dose-response data. We used this method to calculate the association constants of an anti-progesterone monoclonal antibody for native progesterone and for progesterone 11 alpha-hemisuccinate. These association constants provide a quantitative measure of the bridging-group recognition by the antibody.

Antibodies, Monoclonal↗
PubMed1990

Determination of free progesterone in an ultrafiltrate of saliva collected in situ.

We have investigated the utility of an ultrafiltrate of saliva for measuring progesterone as an indicator of luteal function during the menstrual cycle of women. A filtrate of saliva is collected in the mouth by means of an osmotic pump that accumulates medium containing only molecules less than 12,000 Da. We analyzed the nonextracted ultrafiltrate by a solid-phase immunoassay for progesterone and monitored the mid-luteal surge of lutropin in urine with a liquid-phase radioimmunoassay. Progesterone concentrations in the ultrafiltrate are significantly lower during the follicular phase and increase after the release of lutropin. The concentration of progesterone in the ultrafiltrate correlates closely with total progesterone in matched blood samples (r = 0.84, cycle 1; and r = 0.89, cycle 2). Likewise, we found a good correlation between the results in whole saliva and in the ultrafiltrate (r = 0.95). The described method of obtaining a pre-processed specimen noninvasively simplifies the self-collection of samples by patients (including collection at home); excludes potential interference from microorganisms, desquamated cells, and salivary components; and simplifies the processing of the biological fluid in the laboratory.

Adult↗
PubMed1989

Absence of anti-human immunodeficiency virus types 1 and 2 seroconversion after the treatment of hemophilia A or von Willebrand's disease with pasteurized factor VIII concentrate.

Patients with hemophilia A or von Willebrand's disease who are treated with concentrated preparations of human factor VIII made from unscreened pooled plasma are at substantial risk of contracting human immunodeficiency virus (HIV) infection. The purpose of this study was to investigate whether by treating such patients with a pasteurized factor VIII concentrate that had been heated in aqueous solution at 60 degrees C for 10 hours, HIV infection could be avoided. Eleven hemophilia centers in the Federal Republic of Germany and two in Austria identified 155 eligible patients who had been treated exclusively with pasteurized factor VIII concentrate and had not received any other blood products. Between February 1979 and December 1986 they received a total of 15,916,260 IU of pasteurized factor VIII. The United States was the source of 80 percent of the plasma from which the concentrate was made. By September 1988, these 155 patients had been screened for antibody to HIV type 1 (anti-HIV-1) with a total of 657 tests; all were negative. Sixty-seven patients were also tested once for antibody to HIV type 2 (anti-HIV-2); all these tests were negative as well. It appears that pasteurization effectively inactivates HIV, even in plasma that is likely to be highly contaminated with the virus.

Austria↗
PubMed1989

Increasing cesarean section rates in very low-birth weight infants. Effect on outcome.

Examination of a linked birth and death certificate file from Missouri revealed a remarkable increase in the use of cesarean section for very low-birth weight infants (500 to 1499 g) from 24% to 44% in the years 1980 to 1984. In the same years the rate for 1500- to 2499-g infants went from 21% to 26% and the rate for 2500- to 7000-g infants went from 14% to 18%. We studied first-day death rates in very low-birth weight infants as an indicator of potential benefit from this increase in cesarean sections. During the 5-year period first-day deaths averaged 10% and 22% in the cesarean and vaginal birth groups, respectively. This difference was explained almost entirely by deaths in the 500- to 740-g birth weight group, where the death rates were 33% and 59%, respectively. Although this difference remained statistically significant after adjustment for gestational age and other factors that differed between the groups, it was nullified by an excess of deaths in the succeeding 6 days of life. Overall, the odds of death in the first week in these infants weighing 500 to 749 g was 0.85 (95% confidence interval, 0.52 to 1.39) in the cesarean vs vaginal deliveries. We conclude that there is little evidence that the use of cesarean section for the delivery of very low-birth weight infants, independent of maternal or fetal compromise, improves overall survival. We were unable to find reasons to justify the sharp increase in the use of cesarean sections for these small infants.

Cesarean Section↗
PubMed1989

Prevalence of antibodies to hepatitis C virus (HCV) in haemophiliacs.

The prevalence of 1) hepatitis C virus (HCV), an agent likely to be responsible for parenterally transmitted hepatitis non-A, non-B, 2) hepatitis B virus (HBV) and 3) human immunodeficiency virus (HIV) infection was studied in 211 patients with clotting disorders (78% of the patients had residual factor activities of less than or equal to 2%). Of these patients 71% were positive for HBV markers and 44% for HIV markers. Using a new ELISA technique, 80% were anti-HCV-positive. The prevalence of anti-HCV was greater in patients with more severe clotting disorders and was related to the total amount of replacement therapy received; the prevalence was less in older patients. Seroconversion after a single exposure to dry heat-treated factor concentrates was documented in 3 patients 3-4 months after exposure.

Factor VIII↗