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Biomedical subjects

A Schnabel

Publications and source records attributed to A Schnabel.

At least 19 recordsLinked to original sources
PubMed2006

Dermal lesions after post mortem petrol-exposure.

The effect of post mortem contact of the skin with petrol was investigated in 18 corpses with exposure times between 10 min and 24 h. The earliest onset of skin changes was observed within 2 h of exposure. They consisted of swelling and wrinkling with detachment of the upper layers of the skin (positive Nikolski's sign). Histologically the lesions appeared as non-vital acantholyses located in the prickle-cell layer with formation of intra-epidermal bullae. An influence of age and sex could be excluded, the earlier onset of lesions at 22 degrees C than at 4 degrees C was not statistically significant. These findings prove that post mortem petrol exposure may lead to dermal lesions.

Adult↗
PubMed2005

Hyperbaric oxygen therapy for acute ischaemic stroke.

BACKGROUND: Most cases of stroke are caused by impairment of blood flow to the brain (ischaemia) which results in a reduction in oxygen available and subsequent cell death. It has been postulated that hyperbaric oxygen therapy (HBOT) may reduce the volume of brain that will die by greatly increasing the oxygen available, and it may further improve outcome by reducing brain swelling. Some centres are using HBOT routinely to treat stroke. OBJECTIVES: To assess the effectiveness and safety of adjunctive HBOT in the treatment of acute ischaemic stroke. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched 9 January 2004), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 3, 2004), MEDLINE (1966 to July 2004), EMBASE (1980 to July 2004), CINAHL (1982 to July 2004), and DORCTHIM (Database of Randomised Controlled Trials in Hyperbaric Medicine) (from inception to 2004). We handsearched journals and conference proceedings, searched reference lists of articles, and contacted researchers in an effort to identify additional published and unpublished studies. SELECTION CRITERIA: We included all randomised controlled trials that compared the effect of adjunctive HBOT with no HBOT (no treatment or sham). DATA COLLECTION AND ANALYSIS: Two authors used standardised forms to extract the data independently. Each trial was assessed for internal validity with differences resolved by discussion. Data were extracted and entered into RevMan 4.2. MAIN RESULTS: Three randomised controlled trials (106 participants) satisfied the inclusion criteria. The methodological quality of the trials varied but was generally high. Data could be pooled for a limited number of clinically important outcomes. There were no significant differences in mortality rate at six months in those receiving HBOT compared to the control group (relative risk 0.61, 95% confidence interval (CI) 0.17 to 2.2, P value 0.45). Two of 15 scale measures of disability and functional indicated an improvement following HBOT, both at one year follow up: the mean Trouillas Disability Scale was lower with HBOT (mean difference (MD) 2.2 points reduction with HBOT, 95% CI 0.15 to 4.3, P value 0.04) and the mean Orgogozo Scale was higher (MD 27.9 points, 95% CI 4.0 to 51.8, P value 0.02). These improvements were not reflected in other trials or functional scales. AUTHORS' CONCLUSIONS: This systematic review has not found evidence to show that HBOT improves clinical outcomes when applied during the acute presentation of ischaemic stroke. While evidence from the three randomised controlled trials is insufficient to provide clear guidelines for practice, clinical benefit does not seem likely. Further research is required to better define the role of HBOT in this condition.

Brain Ischemia↗
PubMed2005

[Pulmonary-renal syndrome].

Pulmonary-renal syndrome is a potentially life-threatening disorder, characterized by diffuse alveolar hemorrhage on the basis of pulmonary capillaritis in conjunction with rapidly progressive glomerulonephritis. Pulmonary-renal syndrome can originate from various systemic autoimmune diseases. ANCA-associated vasculitides account for approximately 60%, Goodpasture's Syndrome for approximately 20% of the cases. Fulminant pulmonary capillaritis can result in acute respiratory failure, more subtle courses are only detected by bronchoalveolar lavage. Renal biopsy displays extracapillary proliferating glomerulonephritis and renal immunohistology facilitates detection of the underlying systemic disease. By accelerating the diagnosis of the specific underlying disease, autoantibody testing fosters rapid initiation of treatment and thereby significantly improved the prognosis of pulmonary-renal syndrome. Intense immunosuppression with cyclophosphamide and glucocorticoids, augmented by plasmapheresis in the event of Goodpastures' syndrome, is the mainstay of therapy. Supportive measures as temporary ventilation and hemodialysis have further reduced mortality.

Acute Kidney Injury↗
PubMed2005

Long term biventricular resynchronisation therapy in advanced heart failure: effect on neurohormones.

OBJECTIVE: To assess prospectively the effect of cardiac resynchronisation therapy (CRT) on New York Heart Association (NYHA) functional class, cardiac function, cardiopulmonary exercise performance, and neurohormonal activation during 24 months' follow up. DESIGN: Controlled study. PATIENTS AND RESULTS: 124 patients with severe congestive heart failure (ejection fraction < 35%, NYHA III-IV) and left bundle branch block (QRS duration > 150 ms) were enrolled (control group, n = 59; CRT group, n = 65) and followed up at 1, 3, 12, and 24 months. Compared with the control group, CRT led to significant short and long term improvements in functional NYHA functional class (mean (SEM) 2.1 (0.4) v 2.8 (0.4) at 24 months, p < 0.05), mean ejection fraction (25.7 (4)% v 21.1 (5)% at 24 months, p < 0.05), peak Vo(2) (16.8 (3.9) v 12.6 (3.5) ml/kg x min at 24 months, p < 0.01), and Vo(2) at anaerobic threshold (14.4 (3.7) v 10.8 (3.2) ml/kg x min at 24 months, p < 0.05). In addition, CRT for one and 12 months significantly decreased the plasma concentrations of noradrenaline (norepinephrine) and N-terminal fragment of pro-brain natriuretic peptide, whereas no changes were observed for other neurohormones such as antidiuretic hormone, aldosterone, and endothelin. CONCLUSION: Long term CRT (<or= 24 months) results in significant improvement of NYHA class and cardiopulmonary exercise capacity and a short term decrease in neurohormonal activation.

Bundle-Branch Block↗
PubMed2004

Technique for the direct measurement of DC-like magnetic biosignals demonstrated by the cold reflex of the abdomen.

Very low frequency dc-like signals, such as the cold reflex, could only be measured up to now by moving the subject repeatedly, up to the magnetic detector. PTB's novel magnetically shielded room BMSR 2, together with a low noise 16 channel SQUID magnetometer, allow the recording of dc-like signals without moving the subject; these are direct measurements. The total observed magnetic drifts are limited by 1/f-noise and external disturbances to a value below 6 pT/h. The measurement is continuous in time, therefore provides frequency resolution from dc to several kHz. This allows us to also observe the changing pattern between two different static magnetic states. As an example, the measurement of the cold reflex of the abdomen is shown and discussed. Not only the expected cold reflex, but other periodic and spontaneous signals from the human body can be seen with this method.

Abdomen↗
PubMed2004

Spatial distribution of cardiac magnetic vector fields acquired from 3120 SQUID positions.

An extended measurement of the magnetic vector field of the human heart is presented. It is acquired by sequential recordings, shifting a 16 SQUID vector magnetometer across 195 positions over a healthy subject's thorax. The magnetocardiographic (MCG) signals were synchronized using a simultaneously measured ECG channel. The registration of the field extends over a volume of 1000 mm x 600 mm x 420 mm sampled at 3120 SQUID positions. We present diagrams of the vector amplitude of selected points in 6 planes at increasing distances from the frontal thorax. Each plane contains 76 vector points. Additionally, we measured the vector field at 126 points lateral to the chest. At the edge points of the measurement volume, the absolute value of the magnetic vector signal amplitude exceeds 0.3 pT in all measurement points. The dataset provides an excellent base to study dedicated MCG detection or rejection methods. Examples where rejection of the heart signal is necessary are magnetoencephalography, magnetoneurography and fetal MCG. The knowledge of the spatio-temporal distribution of the magnetic vector field of the heart supports the development and comparison of multi-SQUID systems and will be used to create new MCG interpretation and representation algorithms.

Body Surface Potential Mapping↗
PubMed2004

Discrimination of multiple sources using a SQUID vector magnetometer.

For many biomagnetic applications the discrimination between simultaneously active sources is required. To evaluate the performance of a given SQUID system in this respect, the angle between the signal vectors of different sources is used. If the angle reaches large values, discrimination between the multiple sources is possible. We tested this approach with the first module of a new vector magnetometer system consisting of 19 identical modules. Two examples of measurements illustrate the differentiation of multiple sources, i.e. the fetal and the mother's heart signal, and alpha rhythm and heart signal in MEG recordings. This first module of a vector magnetometer system containing 16 SQUIDs is operated at PTB in the new Berlin Magnetically Shielded Room (BMSR 2) The spatial configuration of the 16 integrated SQUID magnetometers of the module is such that all three vector components of the magnetic field can be calculated in three measurement planes at 1.5 cm, 5 cm, and 10.5 cm above the Dewar bottom, respectively. The SQUID magnetometer channels have a typical white noise level of less than 2.3 fT/square root of Hz1/2 at 1 kHz.

Electromagnetic Fields↗
PubMed2004

A sensor configuration for a 304 SQUID vector magnetometer.

A novel SQUID vector magnetometer system is introduced which has been specially designed for the use inside the strongly magnetically shielded room BMSR-2 of PTB. The system is housed in a dewar with a flat bottom and an inner diameter of Ø 250 mm. The SQUIDs are arranged so that in addition to the usually measured Z-component of the field the horizontal magnetic fields are measured too. A total of 304 DC-SQUID magnetometers are divided up into 19 identical modules. The 16 low-Tc SQUIDs of each module are located in such a way that an estimation of the magnetic field in all three dimensions is possible at three points inside the module. The 57 SQUIDs of the lowest Z plane of all modules form a hexagonal grid with a base length of 29 mm. The design criteria and the physical principle behind the complex SQUID arrangement are explained.

Electromagnetic Fields↗
PubMed2004

[Value of inpatient care in rheumatoid arthritis-an evidence based report].

Our aim was to analyze the existing body of evidence about inpatient care of patients suffering from rheumatoid arthritis (RA). The report was induced by the executive board of the German Society of Rheumatology which assigned the "Oliver-Sangha committee" to dissect and point out the tasks of inpatient care during the next few years. A systemic search of the literature was performed covering the years 1966 to 2001. A total of 16 studies were selected and thoroughly appraised in a systematic way. Four randomized controlled trials addressing the question could be identified. All of them included only patients in a clinical condition allowing outpatient care as well. Two studies indicate some advantage of inpatient care in comparison to outpatient treatment. Two studies, both equivalence studies from design, reveal that RA patients do not generally experience additional benefit from hospitalization. Consideration of two additional cohort studies demonstrates the increased need of inpatient care in RA patients. None of the studies was derived from the German health care system. Emergency cases were not the subject of any of these trials. General statements about the value of inpatient care of RA patients can not be drawn from the analyzed studies. The committee makes suggestions for future investigations that may help to answer this important question considering the special circumstances of the German health care system.

Ambulatory Care↗
PubMed2003

Correlation between HRCT findings, pulmonary function tests and bronchoalveolar lavage cytology in interstitial lung disease associated with rheumatoid arthritis.

A prospective study correlating high-resolution computed tomography (HRCT), lung function tests (PFT) and bronchoalveolar lavage (BAL) cytology in patients with interstitial lung disease (ILD) associated with rheumatoid arthritis (RA). Fifty-three RA patients with suspected ILD (19 men, 34 women) underwent 71 HRCT (14 of 53 with sequential HRCT, mean follow-up 24.3 months). The HRCT evaluation by two observers on consensus included a semi-quantitative characterisation of lesion pattern and profusion on representative anatomical levels. Fifty-two HRCT were followed by PFT and BAL. Agreement or discordance of HRCT-, PFT- and BAL findings were analysed with Pearson's correlation, kappa score and McNemar's test. Tobacco-fume exposure was estimated in pack years. Smoking/non-smoking groups were compared with Student's t test. In 49 of 53 patients, HRCT was suggestive of ILD associated with RA (66 of 71 HRCT). Reticular lesions were found in 40 of 53 patients, in 15 of 40 presenting as mixed pattern with ground-glass opacities (GGO). Pure reticular patterns predominated in patients with long duration of ILD (p>0.01). Pure GGO were not observed. Lesion profusion was highly variable and correlated moderately negative with diffusion capacity (mean 88.2% (SD +/- 20.9%); r=-0.54; p<0.001) and very weak with vital capacity and FEV1 (mean values 92.2% (SD +/- 18.3%); r=-0.27; p<0.05 and 89.8% (SD +/- 17.5%); r=-0.31; p<0.01). In patients with GGO, BAL differentials tended towards neutrophilia (kappa=0.39; p=0.04; McNemar test p>0.2), but not towards lymphocytosis (kappa=0.10; p=0.23; McNemar test p>0.2). Differences in smoking history were not significant (p>0.1). The HRCT appears most appropriate for the detection and follow-up of ILD associated with RA. The PFT and BAL correlate only partially with lesion profusion or grading on HRCT, but they contribute valuable information about dynamic lung function and differential diagnoses (pneumonia, medication side effects).

Aged↗
PubMed2003

[Pulmonary renal syndrome].

Pulmonary-renal syndrome is a potentially life-threatening disorder, characterised by diffuse alveolar hemorrhage on the basis of pulmonary capillaritis in association with rapidly progressive glomerulonephritis. It can originate from various systemic autoimmune diseases. ANCA-associated vasculitides account for approximately 60% and Goodpasture's syndrome for approximately 20% of the cases. Fulminant pulmonary capillaritis can result in acute respiratory failure with the more subtle forms only being detectable by bronchoalveolar lavage. Kidney biopsy displays extracapillary proliferating glomerulonephritis and renal immunohistology facilitates detection of the underlying systemic disease. By accelerating the diagnosis of the specific underlying disease, auto-antibody testing fosters rapid initiation of treatment and thereby strongly improves the prognosis of pulmonary-renal syndrome. Intense immunosuppression with cyclophosphamide and glucocorticoids, augmented by plasmapheresis in the event of Goodpastures's syndrome, is the mainstay of therapy. Supportive measures such as temporary ventilation and hemodialysis have further reduced mortality.

Anti-Glomerular Basement Membrane Disease↗
PubMed2003

Complete nucleotide sequence of an isolate of the nepovirus raspberry ringspot virus from grapevine.

The complete nucleotide sequence of the RNAs 1 and 2 of the nepovirus Raspberry ringspot virus cherry isolate (RpRSV-ch) from grapevine was determined. The RNA 1 is 7935 nucleotides (nt) long excluding the poly(A) tail, and contains one long open reading frame (ORF) encoding a polypeptide of 2367 amino acids. This ORF is preceeded by a 136nt 5' non-coding region, and followed by a 695nt 3' non-coding region. Conserved amino acid motifs, characteristic of the viral protease cofactor, the NTP-binding protein, proteinase and polymerase, were found in the sequence of the RNA 1-encoded polyprotein. The RNA 2 is 3915nt long excluding the poly(A) tail, and contains one long ORF encoding a polypeptide of 1106 amino acids. This ORF is preceeded by a 203nt 5' non-coding region, and followed by a 390nt 3' non-coding region. When compared to the corresponding sequences of other nepoviruses, a maximum level of 34% identity was found between the RNA 1-encoded polypetides of RpRSV-ch and other nepoviruses. For the RNA 2-encoded polypeptide, 88% identity was found between RpRSV-ch and RpRSV-S, a Scottish isolate of RpRSV from raspberry, and a maximum 29% identity between RpRSV-ch and other nepoviruses.

3' Untranslated Regions↗
PubMed2003

[Radiology of the primary systemic vasculitides].

Determination of disease extension and disease activity are in the foreground of diagnostic imaging in vasculitides. There are several radiologic modalities available each having specific indications. Magnetic resonance imaging (MRI) readily depicts granulomas and mucosal inflammations in the paranasal sinuses, nasal cavity and orbits. Computed tomography detects osseous lesions of the skull. Due to its superb sensitivity MRI is an established screening modality for CNS vasculitides, although there are limitations with regard to specificity. In spite of its limited accuracy in most institutions angiography is still required for radiological confirmation of CNS vasculitis. Perfusion and diffusion MR-imaging may combine the advantages of "conventional" MRI and angiography. By now the method is not fully validated for vasculitides, however. Vascular disease in Takayasu's arteritis and in giant cell arteritis involving predominantly large and medium sized vessels is readily diagnosed by non invasive magnetic resonance angiography. Percutaneous transluminal angioplasty has proven to be an effective and save therapeutic modality for the cure of vascular stenoses and occlusions. Plain film radiography in two planes is the established modality for pulmonary imaging. In pulmonary vasculitides a more thorough analysis of lung disease is provided by high resolution computed tomography. Diagnostic imaging does substantially assist in the interdisciplinary management of patients suffering from vasculitides.

Adolescent↗