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Biomedical subjects

G Grohmann

Publications and source records attributed to G Grohmann.

15 recordsLinked to original sources

[Microcirculatory changes over the tender points in fibromyalgia patients after acupuncture therapy (measured with laser-Doppler flowmetry)].

Apart from widespread pain which is the main symptom of fibromyalgia, a great variety of functional and vegetative changes occur in the presence of this disease. Such changes include alterations in microcirculation, which may cause pain. A preliminary study demonstrated a reduction in regional blood flow above "tender points" in fibromyalgia patients compared with healthy controls. A consensus statement of the National Institutes of Health (NIH) states that acupuncture is a sufficient adjuvant method to treat patients with fibromyalgia. The aim of the present study was to determine parameters to measure the effectiveness of a specific treatment modality (such as acupuncture) in addition to the patient's subjective assessment of acupuncture treatment. Twenty patients with fibromyalgia according to the ACR and the Müller/Lautenschläger criteria were included in the study. Acupuncture was performed and adapted to individual needs in accordance with a specific protocol. Five representative "tender points" were examined before and after therapy by laser flowmetry, and the data were compared with temperature measurement and dolorimetry. Increased blood flow was registered above all "tender points" after acupuncture. Skin temperature had increased in 10/12 tender points by a mean of 0.45 degree C. The number of "tender points" were reduced from 16.1 to 13.8 after therapy. The pain threshold increased in 10/12 "tender points". These data suggest that acupuncture is a useful method to treat patients with fibromyalgia. Besides normalisation of clinical parameters, the improvement in microcirculation above "tender points" may alleviate pain.

Acupuncture Therapy↗

Hepatitis A in New South Wales, Australia from consumption of oysters: the first reported outbreak.

Between 22 January and 4 April 1997, 467 hepatitis A cases were reported to the New South Wales Health Department, Australia. To identify the cause of the outbreak, we conducted a matched case-control study, and an environmental investigation. Among 66 cases and 66 postcode-matched controls, there was a strong association between illness and consumption of oysters (adjusted odds ratio 42; 95 % confidence interval 5-379). More than two-thirds of cases reported eating oysters, including one third of cases and no controls who reported eating oysters in the Wallis Lake area. A public warning was issued on 14 February, and Wallis Lake oysters were withdrawn from sale. Hepatitis A virus was subsequently identified in oyster samples taken from the lake. Hepatitis A virus poses a special risk to consumers who eat raw oysters because it can survive for long periods in estuaries and cause severe disease.

Adult↗

Abnormal microcirculation and temperature in skin above tender points in patients with fibromyalgia.

OBJECTIVE: Skin temperature and skin blood flow were studied above different tender points in 20 patients with fibromyalgia (FM) and 20 healthy controls. METHODS: Blood flow was measured by laser Doppler flowmetry and skin temperature was measured with an infrared thermometer. RESULTS: In the skin above the five tender points examined in each subject, we found an increased concentration of erythrocytes, decreased erythrocyte velocity and a consequent decrease in the flux of erythrocytes. A decrease in temperature was recorded above four of the five tender points. CONCLUSION: Vasoconstriction occurs in the skin above tender points in FM patients, supporting the hypothesis that FM is related to local hypoxia in the skin above tender points.

Adult↗

The arteriovenous impulse system in total hip arthroplasty.

BACKGROUND: Despite the continuing high incidence of deep vein thrombosis after total hip arthroplasty, currently available mechanical thromboprophylactic systems are not sufficiently utilised in Germany. PATIENTS AND METHODS: Duplex-sonographic measurements of the maximum venous flow velocity (V. femoralis) in 10 healthy individuals performed with a leg orientation synonymous to that during total hip arthroplasty were compared to figures obtained during an out-stretched leg position. Additionally, duplex-sonography was conducted on 9 patients intra-operatively during total hip replacement to complete the study. All investigations were executed both with and without application of the A-V Impulse System (AVIS), a mechanical thromboprophylactic procedure. RESULTS: In contrast to the out-stretched leg position, a decreased venous peak flow velocity during surgery as well as in the operation-identical leg orientation was demonstrated in the absence of AVIS. However, by means of AVIS, a significant increase in the venous peak flow velocity (p < 0.01) was achieved for both situations. Additionally, an increased vessel diameter of the V. femoralis communis was observed in 75% of patients due to the leg orientation stipulated for hip replacement surgery. CONCLUSION: The data suggest that the A-V Impulse System can effectively accelerate the venous reflux-flow during operations involving hip replacements and thus provide an early preventative therapy for deep vein thrombosis after a surgical procedure.

Aged↗

Formation of a carcinogenic aromatic amine from an azo dye by human skin bacteria in vitro.

Azo dyes represent the major class of dyestuffs. They are metabolised to the corresponding amines by liver enzymes and the intestinal microflora following incorporation by both experimental animals and humans. For safety evaluation of the dermal exposure of consumers to azo dyes from wearing coloured textiles, a possible cleavage of azo dyes by the skin microflora should be considered since, in contrast to many dyes, aromatic amines are easily absorbed by the skin. A method for measuring the ability of human skin flora to reduce azo dyes was established. In a standard experiment, 3x10(11) cells of a culture of Staphylococcus aureus were incubated in synthetic sweat (pH 6.8, final volume 20 mL) at 28 degrees C for 24 h with Direct Blue 14 (C.I. 23850, DB 14). The reaction products were extracted and analysed using HPLC. The reduction product o-tolidine (3,3'-dimethylbenzidine, OT) could indeed be detected showing that the strain used was able to metabolise DB 14 to the corresponding aromatic amine. In addition to OT, two further metabolites of DB 14 were detected. Using mass spectrometry they were identified as 3,3'-dimethyl-4-amino-4'-hydroxybiphenyl and 3, 3'-dimethyl-4-aminobiphenyl. The ability to cleave azo dyes seems to be widely distributed among human skin bacteria, as, under these in vitro conditions, bacteria isolated from healthy human skin and human skin bacteria from strain collections also exhibited azo reductase activity. Further studies are in progress in order to include additional azo dyes and coloured textiles. At the moment, the meaning of the results with regard to consumer health cannot be finally assessed.

Benzidines↗

[Retrograde intravenous perfusion as ultima ratio in potential amputation patients with peripheral arterial occlusive disease].

In 21 patients with critical ischemia and/or inflammation of the leg facing possible amputation, retrograde intravenous perfusion (RVP) was used to administer fibrinolytics, vasodilators and antibiotics. Amputation was avoided in 15 patients. In 4 patients, RVP was interrupted due to unsuitable veins for putting in cannulas. After introducing a 3-in-1-Block (Winnie) for analgesia, 7 courses of treatment at least were reached before unbearable pain became a reason for stopping therapy. RVP should, therefore, be considered as the last resort in the treatment of critical ischemia and/or inflammation of the leg of patients facing possible amputation.

Aged↗

Application of PCR to detect Norwalk virus in fecal specimens from outbreaks of gastroenteritis.

Norwalk virus (NV) and other small round-structured viruses (SRSVs) are frequent causes of gastroenteritis outbreaks. The recent cloning and sequencing of the NV genome has made it possible to detect NV and Norwalk-related viruses from fecal specimens by reverse transcription (RT)-PCR. We applied this technique to the examination of a total of 139 fecal specimens from 19 outbreaks characterized by NV serology, including 56 samples from 7 NV outbreaks, 36 from 6 Norwalk-related virus outbreaks, and 47 from 6 outbreaks with SRSVs visualized by electron microscopy that were serologically unrelated to NV. Three primer pairs were evaluated: two pairs in the polymerase region of NV and one pair near the 3' end of the genome. When one set of primers (primer pair 51-3) from the polymerase region was used, 40% of all samples were positive by RT-PCR and specimens from the NV outbreaks were more likely to be positive (64%) than those from outbreaks associated with Norwalk-related viruses (44%) or SRSVs (8%). To determine the relationship of the outbreak strains to NV, we compared the sequences of a 145-base portion of the polymerase gene from 10 specimens obtained from five different outbreaks characterized as NV by serology. No two outbreak strains had the same sequence in this 145-base portion of the polymerase gene, and the identities of the nucleotide and amino acid sequences of these products compared with the sequences of the corresponding region of NV ranged from 62 to 79% and 69 to 90%, respectively. Because of sequence diversity in the polymerase region, the successful application of RT-PCR to investigations of outbreaks of suspected NV-associated gastroenteritis will depend on the use of either multiple primer pairs or primers made against regions of the genome that are more conserved.

Amino Acid Sequence↗

An outbreak of Norwalk-like gastroenteritis associated with contaminated drinking water at a caravan park.

During the 1989 Christmas holiday period, a large outbreak of gastroenteritis occurred among persons staying at a caravan park in southern New South Wales. Review of local hospital records found that 77 per cent of patients presenting with infective diarrhoea between 29 December and 3 January had stayed at the caravan park. In a retrospective cohort study we compared rates of illness among caravan park patrons exposed to different water sources. Stools were tested for pathogens and convalescent sera for viral antibodies. Rain and reticulated river water sampled from the caravan park were tested for bacteria and viruses. Of 351 persons interviewed at the caravan park, 305 (87 per cent) reported an illness characterised by diarrhoea, vomiting and abdominal pain. Of 196 persons who used reticulated river water for drinking or ablutions, 175 (89 per cent) became ill compared with 47 of 72 persons (65 per cent) who did not use this water (relative risk 1.4, 95 per cent confidence interval 1.2 to 1.6). The outbreak was probably caused by a 27-28 nm small round structured virus found in the stool from one ill person. High levels of faecal coliforms in the reticulated river water and enterovirus in sediment samples suggest that the outbreak was caused by sewage contaminating the reticulated river water through a break in the pipe directly over the underground water tanks. To prevent such outbreaks, poor water and sewerage system layouts should be avoided and nonpotable water should be clearly labelled. Where feasible, all camping-ground water should stem from town supplies.

Abdominal Pain↗

Outbreak of human calicivirus gastroenteritis in a day-care center in Sydney, Australia.

Between January and March 1988, an outbreak of gastroenteritis occurred among children and staff at a day-care center in Sydney, New South Wales, Australia. Over an 11-week period, 53 persons had 101 episodes of gastroenteritis; some patients had 5 separate episodes. The principal etiologic agent in the outbreak, human calicivirus (HCV), was detected by electron microscopy in 32% of fecal specimens from children and staff members with symptoms but in only 8% of asymptomatic individuals (P less than 0.01). HCV was confirmed by both an enzyme immunoassay and solid-phase immune electron microscopy. HCV infection was a particular problem in infants, who had the highest age-specific attack rates, had the greatest symptomatic/asymptomatic infection ratio, and were most likely to have a second symptomatic episode. The mode of transmission of this virus was not identified, and extensive efforts to control the 11-week outbreak had little effect. Prolonged excretion of HCV by some symptomatic patients and high rates of asymptomatic infection may have contributed to the extended duration of the outbreak. HCV may be a common cause of gastroenteritis in children that is under-recognized because of insensitive methods of detection.

Australia↗

[Local low-dose streptokinase therapy of shunt thrombosis in chronic hemodialysis patients].

In two patients undergoing haemodialysis on account of a thrombosis of the saphena transplant a local thrombolytic treatment with 50,000 units Awelysin was performed 2--3 times a day. In the two cases after 4 or 5 days a recanalisation developed, in one patient, however, a new thrombosis developed. As prerequisite for the success a sufficiently high shunt flow before the thrombosis is regarded. The exact coagulation-physiological control in the transposition phase from heparin to oral anticoagulants is particularly important.

Adult↗

In vivo and in vitro inhibition of 3-methylcholanthrene-induced aryl hydrocarbon hydroxylase activity in rat liver by actinomycin D and 7,8-benzoflavone.

Using the very well investigated and sensitive microsomal monooxynogenase aryl hydrocarbon hydrolase (AHH), we investigated the dose-response relations between an inducer, 3-methylcholanthrene (3-MC), and an inhibitor of transcription, actinomycin D (ACT D), in 10 days old rats. An optimum pretreatment schedule proved to be a single dose of 1 to 40 mg/kg 3-MC ip combined with two administrations of 200 to 600 microgram/kg ACT D within 16 hr. With increasing doses of ACT D the inhibition of 3-MC-mediated AHH induction increased up to 88%. With 7,8-benzoflavone (ANF) as a relatively specific in vitro inhibitor of the cytochrome P-448 species no distinct influence on the constitutive AHH activity could be observed up to the 30th days of age. In 60 and 200 days old rats the inhibition reached a significant level of about 50%. After 3-MC induction a nearly uniform ANF-mediated inhibition by about 50% of the hepactic AHH activity was observed: in older animals the percentage became slightly higher. The investigation appears to confirm the change in cytochrome pattern,--especially as for the participation of cytochrome P-448,--according to the age and induction stimulus by 3-MC.

Age Factors↗