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Biomedical subjects

B Gehring

Publications and source records attributed to B Gehring.

7 recordsLinked to original sources
PubMed1999

A detailed analysis of changes in serum C-reactive protein levels in neonates treated for bacterial infection.

UNLABELLED: A prospective study was undertaken to characterize the rate of increase, time of peak values and rates of decrease in serum concentrations of C-reactive protein (CRP) in a group of infants treated for neonatal bacterial infection. A total of 176 consecutively admitted neonates with birth weight > 1500 g and without mechanical ventilation or central lines in situ, who received antibiotic therapy for suspected bacterial infection, were enrolled. The changes in serum CRP concentration in 60 of 63 infants who had CRP values above 20 mg/l 24-48 h after the beginning of treatment were analysed in detail. Initial increase rates in serum CRP levels of up to 4.5 mg/l per h were documented peak were reached at a mean of 19.5 h after antibiotic therapy had been initiated, but in some patients an increase in serum CRP levels occurred up to 40-48 h after the beginning of treatment. The mean serum half-life of CRP in infected neonates was 21 h (range 11.2-38 h). CONCLUSION: In neonates with bacterial infection (defined by a combination of clinical signs and increased C-reactive protein and immature-total quotient values) no differences in the overall pattern nor in any of the particular phases of the C-reactive protein response curves could be observed between neonates with positive (n = 13) or negative blood cultures (n = 47).

Anti-Bacterial Agents↗
PubMed1999

Perinatal hypophosphatasia: diagnosis and detection of heterozygote carriers within the family.

We report on two families in which one or two children had a severe disorder of skeletal development detected by prenatal ultrasonography. The children died postnatally and showed typical radiological and biochemical findings of perinatal hypophosphatasia. Biochemical analysis revealed a low activity of alkaline phosphatase (AP) and a high value of pyridoxal-5-phosphate (PLP), one of its natural substrates. The screening for mutations of the tissue nonspecific alkaline phosphatase (TNSALP) gene showed homozygosity for a point mutation (G 317 --> D) in the two affected children of the first family. The affected child of the second family was homozygous for a nonsense mutation (R 411 --> X). Family screening revealed that the determination of AP and PLP is helpful for detection of heterozygotes. However, heterozygote children had values of AP in the lower normal range during phases of rapid growth. The determination of PLP proved to be more sensitive in these cases. It should be kept in mind that during the last trimester of gestation there is an increase in maternal AP activity and a normalization of PLP due to placental AP, which is not affected. Therefore, in the course of a prenatal diagnosis in an index case, paternal blood should be analyzed in parallel. For detailed genetic counseling and early prenatal diagnosis in following pregnancies, the possibility of mutation analysis should be used.

Alkaline Phosphatase↗
PubMed1996

Expression of epileptiform activity induced by a penicillin focus within the posterior thalamus in the awake rat.

Investigations were performed to study the epileptiform activity, induced by a local injection of penicillin (PCN) into the posterior thalamus (pTh) of the awake rat, and to compare it with the epilepsy induced in the same animals 2 weeks later by an injection of PCN into the motor cortex (MC). Using EEG recordings, 1) the distribution of focal cortical activity, and 2) the severity of the epileptiform activity (frequency of focal activity, occurrence and duration of generalized episodes) were analyzed. The focal activity of pTh rats was characterized by two types of potentials: (a) sharp potentials with a spike-like shape that developed during the first hour after PCN injection only in the visual cortex, but in the transition area between the motor and sensory cortex during the last period of epileptiform activity; and (2) large potentials with a wave- or spike-wave-like shape that had their center of focal expression in the transition zone between the motor and sensory cortex. MC rats exhibited only a spike-like potential with or without short-lasting afterdischarges in the homotopic areas of the MC of both hemispheres. During periods with large potentials only, the number of generalized episodes was significantly reduced with respect to those periods with sharp potentials. When the epileptiform activity changed from large to sharp potentials, the interictal frequency increased significantly. It is postulated (a) and a pTh focus activates the lateral and/or the reticular thalamic areas, which, due to their high intrinsic potential for synchronization, cause a self-sustained interictal activity of the large potential type; and (b) that the wave of the large potentials is involved in an anticonvulsive mechanism that reduces the extent of ictal as well as interictal activity.

Animals↗
PubMed1994

Ultrastructural localization of factor XIIIa.

Thin sections of dermatofibromas, of a basal cell epithelioma, a patch stage lesion of Kaposi's sarcoma, a case of angiolymphoid hyperplasia with eosinophilia, and one case of malignant mastocytosis were incubated with antibody to factor XIIIa (FXIIIa). Regardless whether the tissue had been embedded in Lowicryl K4M, Epon, or Araldite, labeling was found in dermal dendrocytes, mast cells, and endothelial cells. In dermal dendrocytes, the reaction product was seen in dilated cisternae of the rough endoplasmic reticulum as well as free within the cytoplasm. In endothelial cells, FXIIIa was localized within Weibel Palade bodies, free within the cytoplasm, and in villous projections into the vasucular lumen. In mast cells, the reaction was found in mast cell granules exclusively. Mast cells, dermal dendrocytes, and endothelial cells have in common that all three express FXIIIa, belong to the microvascular unit, and are increased in number during angiogenesis and in fibrovascular processes. It thus seems that these cells are functionally related.

Endothelium↗
PubMed1984

Influence of length of aortic occlusion with cold potassium cardioplegia on early and late mortality in cardiac valve replacement.

This study determines if prolonged aortic crossclamp time (ACC) with the use of cold potassium cardioplegia during elective cardiac valve replacement contributed to the risk of operative mortality in 225 patients. In Group I (143 patients), the ACC was less than 120 minutes (mean 86) and in Group II (82 patients), it was greater than 120 minutes (mean 146). The preoperative variables showed that Group II contained more severely ill patients who were undergoing more complex operations than in Group I. The operative mortality rate was 7% in Group I and 10% in Group II (p = not significant). Postoperative inotropic support was required in 13% of Group I and 30% of Group II patients (p less than 0.005). Operative mortality in patients in New York Heart Association (NYHA) functional class I and II was 0 and in patients in classes III and IV it was 13% (p less than 0.00008). Five percent of patients in NYHA classes I and II and 32% in classes III and IV required inotropic support (p less than 0.000005). The actuarial survival at 60 months was 88 +/- 3% for Group I and 77 +/- 7% for Group II (NS). For the NYHA class I and II patients, however, it was significantly better (98 +/- 2%) than class III and IV patients (75 +/- 5%) (p less than 0.0001). Analysis by logistic equation revealed that the NYHA functional classes III and IV were significant incremental risk factors for probability of in-hospital mortality (p less than 0.0001) but not the ACC time (p greater than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Improved cardiovascular hemodynamics with atrioventricular sequential pacing compared with ventricular demand pacing.

To determine the advantages of atrioventricular (AV) sequential pacing over ventricular demand pacing, paired cardiovascular hemodynamic studies were performed in each pacing mode at a constant heart rate. The paired studies included determination of ejection fraction (EF) by echocardiography and gated blood pool radionuclide scanning, and of cardiac output (CO) by the indicator-dilution method. There was no significant difference in EF with either pacing mode. Determined by echocardiography, EF with AV sequential pacing was 57% compared with 56% with ventricular demand pacing; by the gated blood pool method, EF with AV sequential pacing was 58% compared with 57% in the ventricular mode. Significant improvement with AV sequential pacing was seen in CO (4.75 L/min from 3.75 L/min; p less than 0.01); stroke volume (58 ml from 48 ml; p less than 0.02); arteriovenous oxygen content difference (4.9 vol% from 5.6 vol%; p less than 0.01); total peripheral resistance (1,724 dynes sec cm-5 from 2,025 dynes sec cm-5; p less than 0.01); and cardiac contractility, as reflected by mixing time (6.9 seconds from 8.0 seconds; p less than 0.02). No significant changes were noted in mean arterial or atrial pressure or in systemic oxygen consumption. In a second group of 6 patients, similar paired studies were done in AV sequential pacing modes before and after therapeutic reduction of total peripheral resistance. A significant increase in CO (43%) was observed following reduction in total peripheral resistance. We conclude that AV sequential pacing improves CO more effectively than ventricular demand pacing. Cardiac output can be further enhanced in patients with congestive heart failure by pretreatment with agents to reduce total peripheral resistance.

Adult↗