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Biomedical subjects

D Wilke

Publications and source records attributed to D Wilke.

14 recordsLinked to original sources
PubMed2001

Enteral versus parenteral nutrition for acute pancreatitis.

BACKGROUND: Acute pancreatitis creates a catabolic stress state promoting a systemic inflammatory response and nutritional deterioration. Adequate supply of nutrients plays an important role to ensure optimum recovery. Total parenteral nutrition (TPN) has been the standard practice for providing exogenous nutrients to patients with severe acute pancreatitis. However, recent data suggest that enteral nutrition (EN) is feasible. Thus, a comparison of EN and TPN in patients with acute pancreatitis needs to be made. OBJECTIVES: To compare the effect of total parenteral nutrition (TPN) versus enteral nutrition (EN) on mortality, morbidity and length of hospital stay in patient with acute pancreatitis. SEARCH STRATEGY: Trials were identified by computerized searches of The Cochrane Controlled Trials Register, MEDLINE, and EMBASE. Additional studies were identified and included where relevant by searching Scisearch, the bibliographies of review articles and identified trials, and personal files. The search was undertaken in August, 2000. No language restrictions were applied. SELECTION CRITERIA: Randomized clinical trials, in which nutrition support with TPN were compared to EN in patients with acute pancreatitis. DATA COLLECTION AND ANALYSIS: Two reviewers independently abstracted data and assessed trial quality. Information was collected on death, length of hospital stay, systemic infection, local septic complications, and other local complications. MAIN RESULTS: Two trials with a total of 70 participants were included. The relative risk (RR) for death with EN vs TPN was 0.56 (95% CI 0.05 to 5.62). Mean length of hospital stay was reduced with EN (WMD -2.20, 95% CI -3.62 to -0.78). RR for systemic infection with EN vs TPN was 0.61 (95% CI 0.29 to 1.28). In one trial, RR for local septic complications and other local complications with EN vs TPN was 0.56 (95% CI 0.12 to 2.68) and 0.16 (95% CI 0.01 to 2.86) respectively. REVIEWER'S CONCLUSIONS: Although there is a trend towards reductions in the adverse outcomes of acute pancreatitis after administration of EN, clearly there are insufficient data to draw firm conclusions about the effectiveness and safety of EN versus TPN. Further trials are required with sufficient size to account for clinical heterogeneity and to measure all relevant outcomes.

Acute Disease↗
PubMed1999

Chemicals from biotechnology: molecular plant genetics will challenge the chemical and the fermentation industry.

Industrial biotechnology has evolved as a significant manufacturing tool for products like fuel-grade ethanol, organic acids and bulk amino acids, but most items are still speciality products for food and pharmaceutical applications. Current development projects within the chemical industry, including lactic acid and 1,3-propanediol based polymers and plastics, indicate that new biotechnological processes and products may soon approach the market place, clearly targeted at the leading petrochemical bulk outlets. This is flanked by a strategic shift by the major chemical companies in to "life sciences"-pharmaceuticals, agrochemicals and the seed business as well as biotech fine chemicals. The recent tremendous achievements in molecular plant genetics and transgenic crop breeding will boost agrobiotechnology, agriculture and renewable raw materials as compelling projects for chemistry and biotechnology. New plant-based production routes may challenge established chemical and biochemical domains, but at the same time open new horizons to valuable feedstocks, intermediates and end-products.

Biotechnology↗
PubMed1998

The influence of CO2 in a space-like environment: study design.

For the operation of manned spacecraft, the removal of CO2 from the cabin atmosphere, produced by its inhabitants, is essential. This is accomplished by chemical absorption in a gas processing unit, a process which requires energy and consumables. Therefore, in terms of resource management, the CO2-level should be kept as high as possible. Otherwise, considering crew health and performance and also the interference with life science experiments, the CO2 load should be as on Earth, close to zero. In order to obtain more information about the permissible CO2 level for future space missions and also to clarify Space Station design criteria, NASA-ESA-DARA have initiated a ground-based simulation study with two different CO2 levels: 0.7% (first campaign) and 1.2% CO2 (second campaign). For this study the deep diving facility of DLR was used to provide atmospheric control and long-term habitation for the test subjects in studying the effect of increased CO2 on physiological and psychological functions. A number of experiments were implemented, which tested selected effects of raised CO2 on humans. Four male subjects stayed in the chamber for 26 d in each campaign, in order to perform the different tests in repeated trials, with the aim of evaluating possible long-term effects. CO2 was controlled by absorption with soda lime, flushing with fresh air and the addition of CO2, if necessary. Essentially, the CO2 produced by the subjects was used to maintain the level at 0.7 and 1.2%, respectively. Basic control of CO2 was carried out in the soda lime container of the Life Support System. In order to maintain the required level, the amount of gas flowing through the soda lime could be adjusted by a remote controlled bypass. With this set-up it was possible to keep CO2 at an average level between 0.67 and 0.73% in the first campaign and between 1.17 and 1.23% in the second campaign. The results of the experiments support the current CO2 limits for space operations, insofar as values around 1% do not impose any severe restrictions to human habitation for at least several weeks, whereas life sciences experiments especially sensitive to CO2 influences have to be carefully evaluated for possible interferences.

Adult↗
PubMed1998

Inflammatory breast carcinoma: comparison of survival of those diagnosed clinically, pathologically, or with both features.

There still remains some controversy as to whether or not there is a survival difference in patients with inflammatory breast carcinoma (IBC) with regard to whether they were diagnosed clinically, pathologically, or with both features. We conducted a retrospective chart review of all the patients diagnosed with IBC who were treated at the Nova Scotia Cancer Treatment and Research foundation between the years of 1990 and 1994, inclusive. Fifty-seven patients' charts were reviewed for recurrence or death up until Feb. 16, 1996. The overall survival of the 57 patients was 32 per cent (confidence interval, 16-48%) and 12 per cent (confidence interval, 0-26%) at 3 and 5 years, respectively. The survival times according to presentation (clinical, pathological, or both) at 3 and 5 years were 31 and 10 per cent for the clinically diagnosed group, 56 per cent at 3 years for the pathologically diagnosed group (5-year survival times could not be calculated), and 34 and 20 per cent for the group diagnosed both clinically and pathologically, respectively. Analysis by the log-rank test revealed that there was no significant difference in survival between these three groups. We conclude that there was no statistically significant difference in survival between those patients who presented clinically, pathologically, or with both features.

Adenocarcinoma↗
PubMed1995

Comparison of voice stress reactivity under psychological stress test and simulated Mir docking manoeuvre.

The relation between the results of laboratory tests and results of the interesting professional work is a very difficult one. The same is true for the relation between training and real performance. The pilot controlled MIR-docking manoeuvre is in reality a very seldom but very important one. The training of this manoeuvre is a very special professional work and only for cosmonauts available. But the objective estimation of the performance and the used objective and subjective needs is nevertheless necessary. Even for the subjective "stress"-feelings during task solving it is often impossible to get reliable data without any physiological measurements. The use of electrodes, cables and equipments is hardly limited during real work. Sometimes only the voice is available over more or less quality communication channels. So it is the case during the training and the real pilot controlled MIR-docking manoeuvre. Based on findings in the literature and own experiments analyzing the relation between fundamental voice frequency (F0) and subjective stress feelings we tested the hypothesis that a on-line measurement of F0 can be used for stress evaluation during standardised training sessions of MIR-docking manoeuvres.

Astronauts↗
PubMed1994

Women and alcoholism: how a male-as-norm bias affects research, assessment, and treatment.

A comprehensive discussion of women's alcoholism must include an understanding of how the male-as-norm bias has affected alcoholism research, assessment, and treatment. This bias defines male alcoholism as the standard by which female alcoholism is judged. Although alcoholism and treatment needs are unique in many ways, those differences are often minimized, ignored, or defined as abnormal in a male model of alcoholism. This article summarizes how a male-as-norm bias has affected research on women's alcoholism and shaped perceptions of women's alcoholic behavior and their responses to treatment.

Aftercare↗
PubMed1993

Rational protein engineering and industrial application: structure prediction by homology and rational design of protein-variants with improved 'washing performance'--the alkaline protease from Bacillus alcalophilus.

The successful attempt is presented to engineer an enzyme with respect to its technical application by the use of computer-aided protein design techniques. Based on a modeled 3-D structure a number of mutants of a subtilisin-like protease was designed with the aim to increase its washing performance. The model of the highly alkaline subtilisin protease OPTICLEAN from Bacillus alcalophilus was developed by the process of 'modeling by homology' starting with the structure of subtilisin Carlsberg 1CSE.BRK from the Brookhaven protein databank. Amino acid changes and deletions were performed with the graphic protein design program BRAGI. Force field calculations and molecular dynamic simulations were made with AMBER 3.0. The comparison of the model and the later solved X-ray structure of OPTICLEAN shows a high similarity between the two structures. On the other hand, interesting deviations between the two structures were observed in some external loop regions. The comparison shows that the deviations are due to difficulties in the prediction of correct main chain torsion angles of additional prolines and the selection of correct loops in deletion or insertion regions.

Amino Acid Sequence↗
PubMed1992

MUSC information system ARIADNE: a consistent tool for support of experiment planning, execution and scientific evaluation of microgravity-experiments.

One of the main tasks of DLR-MUSC (Microgravity User Support Center) is to accompany an experiment's complete life-cycle, thus supporting the investigators. This task starts with the preparation of experiments, continues with their execution and finally leads to the evaluation of the respective measurement results. A computer-based information system facilitates these tasks. Considerable effort has been taken in order to make a detailed as well as modular design--as a result the system can now be applied for any mission. ARIADNE mainly supports three phases, all using the same consistent database. 1. The first phase of experiment preparation is supported by--the acquisition and maintenance of general and basic data by user entries into the database, and the support of the integration of partially similar experiment proposals into a timeline as planned which is composed by activities. 2. The support during experiment execution consists of--real-time data acquisition and control (i.e. on-line database generation and display after processing) including experiment monitoring, enabling of fast replanning. 3. The support ARIADNE provides for experiment evaluation includes--the selection of series of measurements belonging to the specified experiment (parts), further processing and evaluation of the collected data, which must partly be done in real-time and partly post-mission and, creation of back-up's of the processing results. The ARIADNE database consists of a relational ORACLE-part (for numerical and character data), a bibliographic part, a program-library, and a realtime-part (BAPAS). The open design of ARIADNE allows interfaces to stored special data (such as graphics, images, archives) as well as several interfaces to other systems, such as CUIS, MARS-MDB, EXPRES, etc.

Aerospace Medicine↗
PubMed1975

Regulation of the pyruvate kinase from Alcaligenes eutrophus H 16 in vitro and in vivo.

The biosynthesis of the enzyme pyruvate kinase (E.C. 2.7.1.40) of Alcaligenes eutrophus (Hydrogenomonas eutropha) H 16 was influenced by the carbon and energy source. After growth on gluconate the specific enzyme activity was high while acetate grown cells exhibited lower activities (340 and 55 mumoles/min-g protein, respectively). The pyruvate kinase from autotrophically grown cells was purified 110-fold. The enzyme was characterized by homotropic cooperative interactions with the substrate phosphoenolpyruvate, the activators AMP, ribose 5-phosphate, glucose-6-phosphate and the inhibitor ortho-phosphate. In addition to phosphate ATP caused inhibition but in this case nonsigmoidal kinetics was obtained. The half maximal substrate saturation constant S0.5 for phosphoenolpyruvate in the absence of any effectors was 0.12 mM, in the presence of 1 mM ribose-5-phosphate 0.07 mM, and with 9 mM phosphate 0.67 mM. The corresponding Hill values were 0.96, 1.1 and 2.75. The ADP saturation curve was hyperbolic even in the presence of the effectors, the Km value was 0.14 mM ADP. When the known intracellular metabolite concentrations in A. eutrophus H 16 were compared with the regulatory sensitivity of the enzyme, it appeared that under the conditions in vivo the inhibition by ATP was more important than the regulation by the allosteric effectors.

Acetates↗
PubMedDate not supplied

Telemedicine for the International Space Station.

The medical care for the integrated crew of the International Space Station (ISS) will require close co-operation between the partner agencies in the areas of selection, medical surveillance, countermeasures, and handling of acute medical problems. Based on a commonly accepted policy of shared care and responsibilities medical guidelines, procedures, and standards for medical data and communication need to be harmonised under the responsibility of the Multilateral Medical Operations Panel (MMOP). A supporting telemedical network connecting the partners on an organisational and technical level will facilitate the harmonisation process and provide new tools for effective co-operation between medical professionals. Earth bound projects with similar application areas can profit from and contribute to this development and need to be considered for efficient implementation and exploitation.

Aerospace Medicine↗
PubMedDate not supplied

Follow-up testing and notification of anti-HIV Western blot atypical (indeterminant) donors.

We conducted anti-HIV testing on follow-up samples obtained at a mean interval of 20 weeks from 150 blood donors who had previously tested anti-HIV ELISA positive and Western blot atypical. Of 93 donors who demonstrated reactivity to HIV core protein p24, 4 progressed to positive Western blots. Most of the remaining donors showed a persistent p24 reactivity on Western blot and had no risk factors for HIV infection. Immunofluorescence testing of the initial sample from 93 donors could not definitively separate seroconverters from those with persistent p24 reactivity. Of 57 donors with p18 reactivity, none were positive on follow-up anti-HIV testing. Our findings suggest policies and strategies for notifying donors of atypical anti-HIV Western blot results.

Blood Donors↗