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Biomedical subjects

A Schrey

Publications and source records attributed to A Schrey.

At least 19 recordsLinked to original sources
PubMed2004

[Minimally invasive, safe treatment of the neurogenic bladder with botulinum-A-toxin in children with myelomeningocele].

PURPOSE: The efficacy and durability of botulinum-A toxin in the treatment of detrusor hyperreflexia in myelomeningocele (MMC) children was evaluated prospectively. MATERIALS AND METHODS: A total of 15 children (10 male and 5 female, mean age 5.8 years), all on clean intermittent catheterisation (CIC) due to MMC, were "non responders" to orally and intravesically administered anticholinergic medication. Pretreatment assessment included a videourodynamic evaluation, incontinence scoring and a mercaptoacetyltriglycine-3 renal scan. We injected from 10 U/kg up to a maximum of 360 U botulinum-A toxin at 25-40 sites of the detrusor, sparing the trigone. Follow-up was 24 months. All children had a urodynamic reevaluation with assessment of bladder capacity and incontinence score at 3, 9 and 12 months. RESULTS: Mean bladder reflex volume increased from 72.00 +/- 28.12 ml to 298 +/- 32.45 ml (p < 0.001). The maximal detrusor pressure decreased from 78.76 +/- 23.14 cm H(2)O to 42.76 +/- 24.34 cm H(2)O (p < 0.001). Maximal bladder capacity increased from 136.34 +/- 45.71 ml to 297.02 +/- 87.17 ml (p < 0.001). Detrusor compliance increased from 18.29 +/- 27.19 ml/cm H(2)O to 51.17 +/- 38.17 ml/mmH(2)O (p < 0.001). While 10 patients became completely dry between CIC, the remaining 2 patients improved from score 3 to 1. Results at 9 months were similar to the ones at 3 months. The mean efficacy and durability of the toxin was 10.5 months after the first intravesical injection. CONCLUSIONS: Botulinum-A toxin is a safe alternative in the management of detrusor hyperreflexia in MMC children. Preliminary results are promising concerning urodynamic parameters and continence.

Botulinum Toxins, Type A↗
PubMed2002

Effect of hypothermia on blood-flow responses in pedicled groin flaps in rats.

Cooling is widely used for preserving tissues such as kidneys before transplantation and for preserving extremities before replantation. Hypothermia has also been shown to be effective in the temporary storage of free flaps. However, in the intact living body, cooling can be damaging to tissue and the body system. We used a custom-designed clamping method (after flap elevation, occlusion and release of the flap-feeding artery) and continuous laser Doppler flowmetry to investigate the effects of hypothermia on blood flow and postocclusive reactive hyperaemia in the flaps. The animal model used was the partially elevated epigastric flap of adult Sprague-Dawley rats. In the hypothermia group (n=12), the core temperature and the flap temperature were allowed to fall during anaesthesia. At core temperatures of 34.58 degrees C and 338 degrees C and after rewarming of the rat, the feeding artery was occluded for 30 s and 120 s to observe the changes in blood flow and postocclusive reactive hyperaemia in the flap. In the control group (n=12), the core temperature was maintained at more than 378 degrees C throughout the experiment. To compare the flap blood-flow responses to occlusion of the femoral artery in the hypothermia group and the control group, the postocclusive reactive hyperaemia periods (i.e. blood flow above baseline after clamp release) were analysed. Statistical analysis of the responses showed that the magnitude (P=0.024), duration (P<0.001) and amplitude (i.e. peak flow) (P=0.037) of postocclusive reactive hyperaemia were significantly decreased in the hypothermia group. Our results suggest that hypothermia significantly decreases blood flow and postocclusive reactive hyperaemia in the rat epigastric flap. This may increase the risk of ischaemic flap complications unless rewarming is performed.

Animals↗
PubMed2001

The effect of promontorial bone on laser light transmission in measuring capillary blood flow in vivo.

Use of laser Doppler flowmetry (LDF) to assess cochlear blood flow (CBF) in experimental animals has elucidated the complex mechanisms in CBF regulation. Some attempts have been made to measure CBF in humans, although earlier studies produced confusing data about the physical possibility of LDF penetrating the human tympanic cavity promontory. In this study, we used LDF in an attempt to observe capillary blood flow in vivo through the intact human promontory in order to develop a method for measuring CBF in human patients. Temporal bones from six human cadavers were removed and the promontory overlying the basal turn of the cochlea was drilled off and fixed in 10% formalin. Perpendicular bone thickness was measured at the site of the stria vascularis. Seven young rats were anesthetized and the carotid artery was cannulated for blood pressure recording. Capillary flow was registered with LDF from two sites, the kidney and the plantar area of a hind limb, using a custom-designed probe with 632.8 nm and 780 nm wavelengths. Intravenous epinephrine was used to evoke blood flow changes. The same measurements were repeated through the promontorial bone. The light attenuation induced by the promontorial bone was 79+/-28% for the 632.8 nm wavelength, and 22+/-15 to 65+/-13% for the 780 nm wavelength, depending on the thickness of the bone. The sensitivity in detecting minute changes was 78% and 91-96%, respectively, for the 632.8 nm and 780 nm wavelengths. This study indicates that it is possible to detect minute changes in capillary blood flow through the intact human promontory at the site of the stria vascularis.

Adult↗
PubMed2001

[Value of ultrasound in microlithiasis of the testis in andrological patients].

PURPOSE: The objective of this retrospective study is to show the importance of sonography in andrological patients with testicular microlithiasis (TM). PATIENTS AND METHODS: 1314 male patients were seen to our andrological clinic in the course of one year. The age range of these patients was 25 to 39 years (mean age 32 years). All patients underwent testicular sonography as well as a sperm-analysis. RESULTS: 284 patients showed normozoospermia without any evidence of TM. Of the remaining 1030 patients with a pathological spermiogram, 8 were shown to display more than 10 echogenic foci per transducer field in both tests. 1 patient suffering from an already palpable testicular tumor only showed, unilateral, unifocal calcification. Another patient who had suffered from a maldescensus testicle in his early childhood discharged only one unifocal calcification. Tumor markers including AFP and beta-HCG were normal in 9 patients, but elevated in 1 patient suffering from a testicular tumor (AFP: 73 kU/l; beta-HCG: 10.6 U/l). The hormonal status was normal in 6 patients and pathological 4 patients with the diagnosis of OAT-syndrome. CONCLUSION: TM is a rare condition even in andrological patients. Nevertheless, a thorough scrotal sonography is mandatory in order to rule out testicular malignancy.

Adult↗
PubMed2001

Changes in blood flow in the partially elevated epigastric pedicled flap in response to occlusion of the femoral artery in rats.

In this study, the authors used a custom-designed clamping method and laser Doppler flowmetry to investigate the short-term autoregulatory patterns of blood flow (BF) in partially elevated pedicled epigastric flaps in rats (n=11). The femoral artery was clamped for 30, 60, 120 and 180 sec directly after flap elevation and 40 to 80 min after flap elevation. Changes during and after clamping indicate the functioning of autoregulatory factors in the vessels of the epigastric partially elevated flap. The longer the clamp ischemia is in a flap, the greater (p < 0.0001) is the need for a compensatory increase in BF and for a longer time (p < 0.0001) in the flap after clamp release. They compared the responses of BF directly after flap elevation with those 40 to 80 min after flap elevation. The results suggest a significant increase in the autoregulatory capacity of the pedicled partially elevated flap in measurements performed 40 to 80 min after flap elevation (p = 0.043). They conclude that the novel clamping method seems to be reliable when studying the short-term autoregulatory patterns of the epigastric partially elevated pedicled flap.

Animals↗
PubMed2000

Changes in blood flow in the epigastric free flap after microsurgical artery anastomoses in rats.

A number of clinical disorders of free vascularized flap are presumed to reflect insufficient blood flow (BF) or an inadequate range of vascular responsiveness. We compared the changes in BF in a pedicled and free epigastric flap, directly after and 90 min after performing microsurgical artery anastomoses. We used the clamping method and laser Doppler flowmetry in six Sprague-Dawley rats. The BF response curves shortly after re-anastomosing of the artery differ markedly from those in a pedicled flap model and curves registered 90 min after performing the anastomosis. We conclude that the clamping method is reliable and reproducible when studying the short-term autoregulatory BF patterns of epigastric pedicled and free flaps.

Anastomosis, Surgical↗
PubMed1990

[Prostaglandin E1 injection in erectile dysfunction. Current diagnostic and therapeutic possibilities].

In erectile dysfunction formerly, for both diagnostic and therapeutic purposes, intracavernous injections of papaverine and the combination papaverine/phentolamine were employed. In recent years, promising results have been reported with prostaglandin E1. In a multicenter study, 10 to 20 micrograms prostaglandin E1 were administered for testing corpus cavernosum function. One hundred and fifteen out of 187 patients self-injected themselves with prostaglandin E1 at an average dose of about 13 micrograms. While priapism occurred in 5 to 10% of the patients injecting papaverine or papaverine/phentolamine, and fibrosis and tunica induration in 10 to 57% patients on long-term treatment, the risk of priapism was low in prostaglandin E1. Subsequently, induration and penile deviation were reported in 2 patients each. In this multicenter study, a subjective efficacy of more than 90% was observed, thus confirming similar results with prostaglandin E1 found in other studies. The present results show that prostaglandin E1 can be considered the drug of first choice for intracavernous injection treatment of erectile dysfunction.

Alprostadil↗
PubMed1981

[Ambulant treatment of hypertension with cardiotensin (author's transl)].

A fixed combination preparation consisting of a betablocker and diuretics was tested in 25 outpatients suffering from essential hypertension grades I and II (WHO). The raised blood pressures of the placebo phase fell highly significantly to normal values in th course of the 8 weeks' treatment. The ergometric load testing under standardized conditions showed a significant reduction of blood pressure increase, a significant rise in load capacity, and a decrease in the pressure rate product. Apart from the increase in serum acid in one case, no clinically relevant changes in the laboratory values were observed. Tolerance was good. The side effects mentioned by 10 patients were mild and did not influence the course of treatment. Patient compliance, measured twice in th course of the trial by means of urine fluorescence, was very high (95%).

Adult↗