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Biomedical subjects

C H Mielke

Publications and source records attributed to C H Mielke.

At least 19 recordsLinked to original sources
PubMed1989

Surgical treatment of adolescent idiopathic scoliosis. A comparative analysis.

Three hundred and fifty-two patients had a one-stage posterior spinal arthrodesis between 1960 and 1984 using one of four types of instrumentation: a Harrington distraction rod, Harrington distraction and compression rods, Harrington distraction and compression rods with a device for transverse traction, and a Harrington distraction rod with sublaminar wires. All of the patients were female (age-range, eleven to nineteen years), and all had idiopathic scoliosis with a single right or double thoracic curve. The minimum length of follow-up was two years. No significant difference was found among the four groups relative to the amount of correction that was obtained at operation or maintained two years after operation. An average of 13.5 per cent of correction was lost during follow-up in the patients who were treated with postoperative immobilization, and an average of 27 per cent was lost in the patients who were treated with sublaminar wires without immobilization. The use of a straight Harrington rod reduced normal thoracic kyphosis, the addition of a compression rod corrected hyperkyphosis, and the use of a rod with sublaminar wires corrected thoracic hypokyphosis or thoracic lordosis.

Adolescent↗
PubMed1983

Influence of aspirin on platelets and the bleeding time.

Aspirin influences the bleeding time, presumably through the inhibition of prostaglandin biosynthesis and the resultant platelet secretion reaction. This can be measured by prolongation of the bleeding time and changes in platelet function results. Despite these changes, bleeding is rarely a problem in patients who have normal hemostatic mechanisms. To investigate this, we have studied the technical variables associated with the determination of the bleeding time. Both venostasis and direction of the incision play a major role in the bleeding time prolongation induced by aspirin. When a bleeding time determination is performed with vertical incision without venostasis, there is almost no detectable prolongation of the bleeding time. These studies support our previous observations that aspirin has a mild influence on primary hemostasis.

Animals↗
PubMed1982

Therapeutic leukapheresis in hairy cell leukemia.

Therapeutic leukapheresis was performed on three patients, and plasmapheresis on two patients with far-advanced hairy cell leukemia. Two of the three patients who were treated with leukapheresis had many hairy cells in their peripheral blood, while the other had relatively few. In each patient, dramatic clinical and hematologic improvements were observed that have sustained for more than 23, 10, and 26 months, respectively. Plasmapheresis of similar intensity failed to show any appreciable therapeutic effects on two other patients with similar clinical and hematologic findings. We believe that the favorable therapeutic effects of leukapheresis are due to the removal of factors capable of inhibiting normal hematopoiesis. This factor(s) is present in the cells that were removed by leukapheresis. The exact nature of this factor(s) or the cells that produce this factor(s) remains to be identified.

Adult↗
PubMed1982

Aspirin prolongation of the template bleeding time: influence of venostasis and direction of incision.

The template bleeding time is a measure of platelet participation in primary hemostasis. Aspirin alters platelet function through interference with prostaglandin biosynthesis. In many individuals, aspirin will consistently prolong the bleeding time. Despite this observation, normal individuals rarely develop a bleeding disorder. This prompted us to investigate the influence of technical variables on the prolongation of the bleeding time by aspirin. Both direction of incision and venostasis influenced the prolongation of the bleeding time by aspirin. A horizontal incision with venostasis produced the most pronounced prolongation, while a vertical incision without venostasis didn't prolong the bleeding time despite the characteristic changes in platelet aggregation and release. These studies suggest that the influence of aspirin on the template bleeding time is dependent on technical variables and is minimal in the normal subject.

Adult↗
PubMed1981

Comparative effects of aspirin and acetaminophen on hemostasis.

The influences of aspirin and of acetaminophen on hemostasis were studied in normal healthy volunteers and in patients with either severe hemophilia A or hemophilia B. Acetaminophen did not alter the template bleeding time or the results of tests of platelet function in either group. Aspirin did prolong the template bleeding time and impaired platelet aggregation; these changes were most pronounced in patients with either form of hemophilia, and some (7/19) required plasma component therapy. Neither drug influenced the coagulation proteins or the fibrinolytic mechanism, as measured. The influences of a single dose (ranging from 975 to 1,950 mg) of acetaminophen and of a single dose (ranging from 325 to 2,925 mg) of aspirin were similar to those observed in persons receiving multiple doses. Acetaminophen is preferred in patients in whom a hemostatic influence is undesirable. However, either aspirin or acetaminophen can be used in normal healthy subjects.

Acetaminophen↗
PubMed1979

Heparin bleeding due to qualitative platelet dysfunction.

On two separate occasions, a 26-year-old white woman bled from arterial puncture wounds while receiving heparin for thromboembolic disease. Bleeding time was prolonged after heparin administration at the time that she was ill and bled, and when she was re-challenged 2 years later. Heparin may produce bleeding as a result of a qualitative platelet dysfunction.

Adult↗
PubMed1978

Altered factor VIII complexes in patients with acute respiratory insufficiency.

Acute respiratory failure is an often-fatal syndrome of multiple etiologies in which altered factor VIII may be a marker of endothelial disease. 12 women with overwhelming viral pneumonia were studied with serial factor VIII antigen, procoagulant activity, and von Willebrand's factor assays. Antigen levels were elevated (range: 86--1644%) out of proportion to procoagulant activity (range: 35--521% by a one-stage assay), and factor VIII antigen to activity ratios were as high as 16:1. Von Willebrand's factor was normal but correlated best with procoagulant activity. All patients had abnormal antigen patterns on crossed immunoelectrophoresis, with increases in protein of both fast and slow mobility. These changes in factor VIII correlated with the patient's clinical courses.

Acute Disease↗