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Biomedical subjects

B Seifert

Publications and source records attributed to B Seifert.

At least 19 recordsLinked to original sources
PubMed1995

Seeding with omental cells prevents late neointimal hyperplasia in small-diameter Dacron grafts.

BACKGROUND: The influence of complete endothelialization of a prosthetic graft on development of late neointimal hyperplasia is unknown. This study was designed to investigate the effect of complete coverage with endothelial-like cells on late neointimal hyperplasia in small-diameter Dacron grafts seeded with omental cells in a canine model. METHODS AND RESULTS: Four-mm-ID Dacron grafts were seeded with cells from omentum and implanted in the carotid arteries in 24 mongrel dogs. Each dog received one seeded and one nonseeded graft. The graft patencies were assessed by angiography at 1, 5, 12, 26, and 52 weeks after surgery. The prostheses were explanted at 5, 12, 26, and 52 weeks after surgery and underwent microscopic studies. The actuarial patency rates at 1, 5, 12, 26, and 52 weeks were 100%, 95%, 95%, 95% and 95% for seeded grafts and 100%, 86%, 49%, 40%, and 13% for nonseeded grafts, respectively. The seeded grafts exhibited a uniform endothelial-like luminal monolayer without the development of late neointimal proliferation or anastomotic neointimal hyperplasia. Neointimal tissue thickness increased up to 6 months; no additional progression of the subendothelial tissue thickness was observed, in fact there was an insignificant decrease. CONCLUSIONS: Seeding with omental cells prevents development of late neointimal hyperplasia of small diameter prosthetic vascular grafts in a canine model.

Animals↗
PubMed1995

Validity criteria for exposure assessment methods.

The validity of any exposure assessment is an essential step in risk assessment. Following definitions of the various types of measurement validity, such as content, criterion and construct validity, and study validity, some shortcomings of actual exposure measurements are discussed. Both direct and indirect ways of measuring exposures to air, water and food pollutants are taken into consideration, with special attention being payed to indirect measurements using questionnaires and/or time-activity budgets. It is concluded that it is difficult to measure validity in an absolute way. Rather, a relative evaluation is possible comparing the validity of one result or study to that of another.

Environmental Exposure↗
PubMed1995

The influence of leukocyte filtration during cardiopulmonary bypass on postoperative lung function. A clinical study.

The accumulation of activated leukocytes in the pulmonary circulation plays an important role in the pathogenesis of lung dysfunction associated with cardiopulmonary bypass. Animal studies have demonstrated that the elimination of leukocytes from the circulation reduces postoperative lung injury and improves postoperative pulmonary function. We conducted a prospective randomized clinical study to evaluate whether postoperative lung function could be improved by use of a leukocyte filter during cardiopulmonary bypass. Elective coronary artery bypass grafting was done with a leukocyte-depleting arterial blood filter incorporated in the extracorporeal circuit (14 patients, leukocyte filter group) or without the filter (18 patients, control group). Blood samples collected at intervals before, during, and after operation were used for analysis of blood cell counts, elastase concentrations, and arterial blood gases. The use of the leukocyte filter caused no significant reduction in leukocyte count (p = 0.86). There were no differences in postoperative lung function between the groups, as assessed through (1) oxygenation index (290 for leukocyte filter group compared with 329 for control group, 95% confidence interval, 286 to 372, p = 0.21), (2) pulmonary vascular resistance (p = 0.10), and (3) intubation time (16.6 hours for leukocyte filter group versus 15.7 hours for control group, 95% confidence interval, 12.1 to 19.1 hours, p = 0.72). The levels of neutrophil elastase were significantly higher at the end of cardiopulmonary bypass in the leukocyte filter group (460 microgram/L in leukocyte filter group versus 230 microgram/L in control group, 95% confidence interval, 101 to 359 microgram/L, p = 0.003). We conclude that the clinical use of the present form of leukocyte-depleting filter did not improve any of the postoperative lung function parameters analyzed in this study.

Cardiopulmonary Bypass↗
PubMed1995

Continuous versus bolus thermodilution cardiac output measurements--a comparative study.

OBJECTIVE: To compare the methods for continuous and bolus thermodilution cardiac output measurements. DESIGN: In vivo and in vitro experimental studies. SETTING: Surgical research division in a university hospital. SUBJECTS: Eight calves and flow bench model. INTERVENTIONS: Data were collected in vivo from eight calves instrumented with pulmonary artery catheters, which allowed both continuous and bolus thermodilution measurements. The pulmonary artery catheter was placed through the external jugular vein. All in vitro measurements were performed using a flow bench model. MEASUREMENTS AND MAIN RESULTS: A total of 232 bolus and continuous thermodilution measurements were analysed in vivo to determine the degree of agreement between the two methods. The absolute measurement bias was 0.14 L/min with 95% confidence limits ranging from -0.83 to 1.15 L/min. In vitro analysis of 576 measurements at six different temperature points (range 31 degrees to 41 degrees C), using clinically relevant flows (2 to 9 L/min), showed overestimation of flow values using continuous and bolus thermodilution methods. However, the continuous method showed better accuracy by a lower degree of overestimation. Systematic error was 9.7 +/- 8.4 (SD) % for continuous and 11.1 +/- 6.3% for the bolus method (p < .001). This effect was especially evident at lower flow rates. The influence of various temperatures on the accuracy and reproducibility of both methods of measurement was statistically significant but not clinically relevant. The infusion of lactated Ringer's lactate solution (infusion rates 100 to 1000 mL/hr) affects both methods at a low flow rate of 2 L/min, without causing a significant effect on continuous measurement at a higher flow rate (4 L/min). Shunting of 50% of circulating volume to the distal part of the thermal filament of the pulmonary catheter impaired the accuracy of continuous measurement without affecting results from bolus measurements (systematic error -26.8 +/- 8.2% for continuous and -5.2 +/- 4.1% for bolus thermodilution). CONCLUSIONS: Continuous thermodilution cardiac output measurement provided higher accuracy and greater resistance to thermal noise than standard bolus measurements. The correct placement of the catheter is essential for precise measurements.

Analysis of Variance↗
PubMed1995

Immobilization of heparin on polylactide for application to degradable biomaterials in contact with blood.

The poly-(D, L-lactide) RESOMER R208 (Boehringer-Ingelheim, Germany) was modified with heparin to improve the blood contacting properties of the material. The immobilization of herapin was carried out by covalent binding with glutaraldehyde as the coupling agent. The reaction conditions, such as temperature and time, were varied to optimize the binding of heparin. The efficiency of the immobilization was monitored with respect to the total amount of coupled herapin with a toluidine blue assay and the anticoagulant activity of immobilized heparin with a factor Xa assay. The hemocompatibility of the modified polylactide was estimated after blood-material contact by the activation of platelets measured with an enzyme immuno assay for GMP140. Immobilization at ambient temperature and a reaction time of 2 h resulted in maximal heparin binding, high anticoagulant activity, and low thrombogenicity. Since the remaining unsaturated aldehyde groups of the coupling agent may cause a low hemocompatibility of the material, washing of the heparinized polylactide was carried out with ethanol. However, it was shown that washing diminished the anticoagulant activity of heparin and increased the thrombogenicity. The prolonged storage of heparinized polylactide in phosphate buffered saline for 8 days demonstrated that small quantities of heparin were released but the hemocompatibility was further improved, indicated by an increasing anticoagulant potential and a decrease in platelet activation with incubation time. A comparison of polylactide, heparinized polylactide, polypropylene, and Pellethane with respect to platelet activation by GMP140 assay and scanning electron microscopy, revealed that the heparinization of polylactide substantially improved the hemocompatibility of RESOMER R208, making the material comparable to Pellethane.

Anticoagulants↗
PubMed1995

Muscle strength assessment in polymyositis and dermatomyositis evaluation of the reliability and clinical use of a new, quantitative, easily applicable method.

OBJECTIVE: To evaluate the feasibility and the reliability of a quantitative method of maximal isometric strength measurement for the assessment of patients with myositis in clinical practice and research. METHODS: Three observers independently examined the strength of 13 muscle groups of 7 patients with stable polymyositis and dermatomyositis (PM/DM) using a handheld pull-gauge. Reliability was assessed following a balanced random 3-way cross classification with interactions and using the analysis of variance method. Serial followup strength data for 2 patients were compared to change in creatinine kinase (CK) levels. RESULTS: All measurements could be performed without causing pain to the patients. One single test including 13 muscle groups was done in 7 min or less. Both intra and interobserver correlations were strong and significant for all muscle groups. The intraobserver reliability ranged from 0.88 for elbow extensors to 0.98 for knee extensors and cervical spine flexors. The interobserver reliability ranged from 0.81 for elbow flexors to 0.98 for knee extensors and cervical spine flexors. The followup of 2 cases yielded moderate to strong correlations of serial strength measurements with CK levels. CONCLUSION: Serial measurement of isometric muscle strength with a handheld pull-gauge is a feasible, inexpensive, time efficient and reliable method and may provide additional quantitative information in the clinical assessment of patients with myositis.

Adult↗
PubMed1994

Assisted circulation without systemic heparinization.

The need for improvements in materials and equipment for extracorporeal circulation has been obvious for years. Among the surfaces with biologically active compounds, those with heparin binding have been found sufficiently thromboresistant and particularly suitable for different types of artificial perfusion. Partial left heart bypass (LHBP) was performed in 10 anesthetized, acutely instrumented, and open-chested mongrel dogs (weight 23 to 50 kg) with a servo-controlled roller pump. The pump flow was maintained at 50 mL/kg/min for 6 hours. Heparin surface-coated equipment was used without additional heparin. For LHBP with a standard circuit, the total amount of heparin during the study period was (mean +/- SD) 487 +/- 124 IU/kg. The right atrial, pulmonary artery, and left ventricular end-diastolic pressures, cardiac output, left ventricular output, right and left ventricular stroke work, pulmonary gas exchange, and acid-base balance changed similarly with both systems. Blood loss (204 +/- 78 v 1,240 +/- 586 mL, P < 0.0005), volume substitution requirements (647 +/- 48 v 1,860 +/- 764 mL, P < 0.0025), and oxygen extraction ratio (mean 25.4 to 32.0 v 25.4 to 56.4%, P < 0.025) were significantly lower, and mean aortic pressure (mean 65 to 69 v 62 to 38 mmHg, P < 0.025) and hemoglobin concentration (mean 9.1 to 8.1 v 9.4 to 3.9 g/dL, P < 0.05) were significantly higher during 6 hours of LHBP without systemic heparinization. Low but stable oxygen delivery was provided with heparin-coated LHBP, whereas it showed a descending trend (mean 14.0 to 10.8 v 13.4 to 5.5 mL/kg/min, P < 0.1) with the standard circuit.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Determination of kidney function in patients with ovarian cancer treated with chemotherapy: calculation versus measurement of creatine clearance].

In patients with ovarian cancer receiving chemotherapy we compared the creatinine clearance measured in the usual way with the calculation of the creatinine clearance according to the formulas of Jelliffe and Cockroft. Regression analysis only showed a moderate correlation, whereas the analysis of the data by ROC curves allows the use of these formulas as screening tests with acceptable values of sensitivity and false-positive rate. Therefore, in the majority of these patients, collecting urine over 24 h before starting chemotherapy is no longer necessary.

Adult↗
PubMed1992

Intratracheal N-acetylcysteine use in infants with chronic lung disease.

To evaluate the effect of intratracheal administration of N-acetylcysteine (Mucomyst) on the clinical status, pulmonary function and gas exchange in premature infants with chronic lung disease, we conducted a randomized, placebo-controlled, crossover trial. Ten mechanically ventilated infants (gestational age 27 +/- 1 week; postnatal age 22 +/- 6 days) with clinical and radiological evidence of chronic lung disease and increased airway secretion were enrolled in the study. Each infant received tracheal administration of 5% N-acetylcysteine for one week and saline placebo every 4 h for another week. N-acetylcysteine was associated with a 59 +/- 26% increase in total airway resistance by the third day of treatment (p less than 0.01). A two-fold increase in airway resistance associated with an increased frequency of bradycardia and cyanosis spells was seen in two of the infants following three days of N-acetylcysteine administration, with a rapid improvement in their condition when subsequently switched to saline. Overall, N-acetylcysteine administration had no effect on the variables measured. We conclude that intratracheal administration of N-acetylcysteine to liquefy airway mucus neither improves the clinical condition nor hastens recovery in premature infants with chronic lung disease and its administration may lead to increased total airway resistance and cyanotic spells. The present data do not support the use of N-acetylcysteine as a mucolytic agent in premature infants with chronic lung disease.

Acetylcysteine↗
PubMed1991

Development of the rabbit retina. IV. Tissue tensility and elasticity in dependence on topographic specializations.

A method is introduced for the quantification of specific compliance and the elasticity of small pieces of living retinal tissue. These pieces are fixed at their margins by means of tissue glue, and loaded with a small iron spherule the bending force of which can be gradually enhanced by the action of an electromagnet. Retinal bending caused by such calibrated forces is measured by a horizontal light microscope, and used for estimations of specific compliance and elasticity of the tissue. Three different particular regions of the rabbit retina--periphery, visual streak, and (prospective) medullary rays--were tested at several post-natal developmental stages. From very early stages on (day 2 p.p.) up to adulthood the peripheral retina was found to be significantly more tensile than the two other central regions. This can be shown to depend greatly on the thickness of the tissue which is lower in the retinal periphery. During early post-natal development, all retinal regions except the (prospective) medullary rays become thinner. The tensility of the tissue increases, with the exception of the medullary rays which reduce their compliance strongly. In the adult retina, however, the tensility of all retinal regions is reduced as compared with the neonatal tissue. This seems to be caused by a constant gradual increase of the elasticity of the retina during development which, in turn, may be caused by several developmental parameters, e.g. the formation of synapses, the outgrowth of glial side branches ensheathing neighbouring neuronal cells, or a reduction in extracellular clefts. It is proposed that these differences in tensility between different retinal regions, may be the cause for differential retinal expansion driven by the intraocular pressure. Thus, simple mechanical features of the tissue may contribute to the formation of important topographic specializations of the retina, e.g. the visual streak as the site of highest visual acuity.

Aging↗
PubMed1991

Clinical and physiological responses to prolonged nasogastric administration of doxapram for apnea of prematurity.

We hypothesized that enteral doxapram would effectively treat apnea of prematurity without the appearance of major side effects. Of 16 infants, 10 (BW 1,520 +/- 102 g) received doxapram alone and 6 (BW 1,020 +/- 35 g) received doxapram plus theophylline. Apneas decreased from 16.7 +/- 1.9 to 2.1 +/- 0.6 in infants receiving doxapram alone, and from 38.2 +/- 4.4 to 7.9 +/- 2.2 apneas/24 h in those receiving doxapram plus theophylline. This was associated with an increase in alveolar ventilation, a shift of the ventilatory response to CO2 to the left, and no change in the immediate ventilatory response to 100% oxygen. Side effects included premature teeth buds corresponding to the lower central incisors, prevalence of occult blood in stool and necrotizing enterocolitis. The findings suggest that doxapram effectively controls apnea when given enterally, but should be used cautiously because of potentially harmful side effects.

Apnea↗
PubMed1990

[Determination of prolactin concentration in endometrium in the histologically normal secretory phase and in delayed transformation].

Endometrial biopsies of 92 infertile women were histologically investigated. In 46 cases the endometrium was in-phase. We found tissue prolactin by RIA examination of the endometrium on day 15 of the menstrual cycle and later. A plateau of the prolactin tissue concentration was seen between the 20th and 26th day of the cycle. A marked increase of the hormone concentration is seen at the end of the luteal phase. The endometrial prolactin tissue content was characterized by a large individual variation. A luteal phase defect was observed in 40 cases. There was a later rise of tissue prolactin concentration decreasing in contrast to the normal luteal phase at the end of the cycle. The difference was statistically significant at day 20, 26 and 28 of the menstrual cycle. Six biopsies were not included in the study. The estimation of endometrial prolactin in the late luteal phase appears to be an additional diagnostic test in case of a luteal phase-defective endometrium.

Biopsy↗
PubMed1990

[Introduction and results in the endoscopic treatment of extrauterine pregnancy].

After having applied endoscopic treatment of ectopic pregnancy for one year we herein report on 50 patients who were treated either by laparoscopy (in 20 cases) or laparotomy (in 30 cases). Conservative endoscopic surgery was performed in 12 cases (9 salpingotomy, 2 endoscopic restoration, 1 partial resection of the ovary) while conservative surgical methods by laparotomy were applied in 13 cases (8 milk out, 3 milk out with fimbrioplasty, 1 salpingotomy, 1 partial resection of the ovary). Partial endoscopic salpingectomy was necessary in 8 cases. Out of the women with laparotomy management 4 underwent an adnexectomy and 13 a salpingectomy. After laparoscopic treatment of ectopic pregnancy two patients developed an intrauterine pregnancy and in one case an ectopic pregnancy was observed again. In the laparotomy-group no intrauterine or ectopic pregnancy recurred in the period under review. There was no complication after laparoscopic management of ectopic pregnancy. However a temperature above 38 degrees C occurred in 5 cases after laparotomy caused by local inflammation or by post-operative infiltration. After endoscopic salpingostomy patency of the fallopian tubes was proofed by hysterosalpingography in 6 cases, and all tubes were found to be patent. Endoscopic management of ectopic pregnancy is recommended due to low post-operative morbidity rates and short time of hospitalization.

Fallopian Tube Patency Tests↗
PubMed1989

[Quantitative assessment of heliotherapy in psoriasis vulgaris in high altitude climate].

At the Davos Clinic for Dermatology and Allergy (Alexanderhausklinik), patients suffering from psoriasis were treated with natural UV irradiation over 6 weeks in 1987: the average doses applied amounted to 1.042 J/cm2 UVB (= 41.7 sunburn units (SU] and 41.511 J/cm2 UVA. These doses were far below those of artificial UV sources usually required in the treatment of psoriasis. The doses were also far below those which statistically increase the incidence of non-melanotic skin cancer.

Altitude↗