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Biomedical subjects

H Braun

Publications and source records attributed to H Braun.

At least 19 recordsLinked to original sources
PubMed1996

Patient controlled analgesia for shock wave lithotripsy: the effect of self-administered alfentanil on pain intensity and drug requirement.

PURPOSE: Second generation lithotriptors offer immersion-free treatment and a decrease in shock wave induced pain. Pain sensations caused by advanced lithotriptors vary widely and have a significant impact on clinical management. We tested patient controlled analgesia during extracorporeal shock wave lithotripsy (ESWL) and quantified analgesic requirements by means of patient controlled analgesia during ESWL of renal stones. MATERIALS AND METHODS: Patients with renal stone disease undergoing ESWL were randomized prospectively to receive an alfentanil infusion titrated by 4 different anesthesiologists not otherwise involved in the study (22 controls) or to self-administer alfentanil via a patient controlled infusion pump (22 patients). As a measure of individual pain sensitivity the detection, pain and tolerance thresholds of electrocutaneous sensitivity were determined in all patients. RESULTS: Alfentanil was used more often in the patient controlled analgesia group than in the control patients (12 versus 8 required the narcotic, respectively, p = 0.226). Patients using patient controlled analgesia needed less drug (0.5 versus 2.15 mg., p = 0.005, median values), tolerated higher discharge voltages and pain intensities, needed significantly fewer shock waves to complete stone fragmentation (1,612 versus 2,105, p = 0.014) and had shorter treatment times (36.9 versus 46.2 minutes, p = 0.069). There was a significant correlation between the duration of shock wave exposure tolerated without analgesia, and pain (p = 0.0009) and tolerance (p = 0.0020) thresholds but not with regard to detection thresholds (p = 0.1400). Male patients showed significantly higher tolerance thresholds to electrocutaneous stimulation (10.2 versus 6.9 mA., p = 0.0238), which corresponded to longer analgesia-free treatment times in male versus female patients (31.7 versus 19.4 minutes, p = 0.0510). CONCLUSIONS: Patient controlled analgesia increases pain tolerance, decreases narcotic requirements, simplifies ESWL as an outpatient procedure and can be used to quantify analgesic requirements during lithotripsy. Pain and tolerance thresholds of electrocutaneous sensitivity are sensitive markers of pain tolerance during lithotripsy, which may be more pronounced in male patients.

Alfentanil↗
PubMed1995

Evolution of seed storage protein genes: legumin genes of Ginkgo biloba.

Legumin-like seed storage proteins have been intensively studied in crop plants. However, little is known about the molecular evolution of these proteins and their genes and it was assumed that they originated from an ancestral gene that already existed at the beginning of angiosperm evolution. We have evidence for the ubiquitous occurrence of homologous proteins in gymnosperms as well. We have characterized the major seed storage globulin from Ginkgo biloba by amino acid sequencing, which reveals clear homology to legumin-like proteins from angiosperms. The Ginkgo legumin is encoded by a gene family; we describe two of its members. The promoter regions contain sequence motifs which are known to function as regulatory elements involved in seed-specific expression of angiosperm legumins, although the tissues concerned are different in gymnosperms and angiosperms. The Ginkgo legumin gene structure is divergent from that of angiosperms and suggests that the evolution of legumin genes implicated loss of introns. From our data and from functional approaches recently described it becomes obvious that the posttranslational processing site of legumin precursors is less conserved than hitherto assumed. Finally, we present a phylogenetic analysis of legumin encoding sequences and discuss their utility as molecular markers for the reconstruction of seed plant evolution.

Amino Acid Sequence↗
PubMed1995

High water intake combined with low sodium intake abolishes the antidiuretic effect of angiotensin II in conscious dogs.

1. We studied post-prandial changes in renal function in dogs adapted to either low or high sodium intake with and without concomitant post-prandial infusion of angiotensin II. Six trained dogs were exposed to diets containing either 0.5 or 14.5 mmol Na+ day-1 kg-1 body weight (low or high sodium respectively). They were studied from 20 min before to 4 h after food intake. In half of the experiments a physiological dose of angiotensin II (4 ng min-1 kg-1 body weight) was administered after food intake for four post-prandial hours. The water intake was high and equal on both diets (91 ml day-1 kg-1 body weight). 2. On a high-salt diet post-prandial sodium excretion and urine volume increased considerably above fasting values. This post-prandial increase was attenuated when angiotensin II was infused (post-prandial sodium excretion was 31% +/- 3% of intake without versus 10% +/- 1% with angiotensin II, post-prandial urine volume was 22% +/- 2% without versus 8% +/- 1% with angiotensin II, P < 0.05). Post-prandial increases in glomerular filtration rate and fractional sodium excretion were attenuated during angiotensin II infusion in dogs on a high-salt diet. 3. On a low-salt diet post-prandial sodium excretion remained low with or without angiotensin II infusion, whereas urine volume increased post-prandially, and this increase was greater when angiotensin II was administered (40% +/- 3% versus 34% +/- 2% of intake, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗
PubMed1994

A convenient synthesis of nucleoside monophosphate-N-acetylneuraminic acids (NMP-Neu5Ac).

Reaction of sialyl phosphites 2a,b with acetyl-protected ribonucleoside monophosphates 3C, 3U, 3A and 3G furnished without addition of a catalyst directly the corresponding beta-configurated sialyl ribonucleoside monophosphates 4C, 4U, 4A and 4G, respectively. Treatment of these compounds with sodium methanolate in methanol and sodium hydroxide afforded the disodium salts of CMP-Neu5Ac (1C), UMP-Neu5Ac (1U), AMP-Neu5Ac (1A), and GMP-Neu5Ac (1G).

Cytidine Monophosphate N-Acetylneuraminic Acid↗
PubMed1991

Combined resting-postural tremor of the head with a changing axis.

When essential tremor involves the head, it produces a rhythmic, periodic movement with a certain fixed frequency and a variable amplitude. The axis of the tremor has been described as either horizontal (no-no) or vertical (yes-yes) and is present when the head is in an action or postural position. Seven patients who differ in symptoms are described; one subgroup exhibited a combined resting-postural tremor of the head, sometimes with a changing axis; three patients had only postural head tremor with a changing axis.

Aged↗
PubMed1991

Antihypertensive monotherapy with nitrendipine in general practice.

Efficacy and tolerability of antihypertensive monotherapy with the calcium antagonist nitrendipine were investigated in a 6-month open trial in 495 patients with mild to moderate essential hypertension from 101 practicing internists and general practitioners. Previous antihypertensive therapy (57.4%) was stopped for 1 week and therapy then started with nitrendipine, 20 mg once daily. Sixty-one patients discontinued therapy prematurely because of unwanted effects, mostly characteristic with dihydropyridines (headaches, flushing, and ankle edema), and 23 patients because of insufficient efficacy. In 75% of the remaining 411 patients, the goal blood pressure was achieved by nitrendipine monotherapy (10 mg in 17.6%, 20 mg in 73.3%, and 20 mg b.i.d. in 8%) and diastolic blood pressure was between 90 and 95 mm Hg in another 6%. The reduction in blood pressure did not result in changes of heart rate or weight. Nitrendipine was effective in patients of all age groups but patients older than 60 years of age showed a significantly greater fall in systolic pressure than middle-aged or young patients. At the end of the study, 15 patients still reported side effects. Nitrendipine appears to be well suited for first-line therapy of mild to moderate essential hypertension.

Adult↗
PubMed1989

A mobile traction device for MR and CT imaging.

The development of a spinal traction device for use in Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) imaging is described. Such a device has arisen from the need to apply continuous traction to patients having suffered acute cervical spine trauma. Previous traction techniques have proven unsuitable for use in the MRI scanner, particularly as they lack stability, are awkward to implement and prove quite cumbersome to manage. Traction may be applied to a patient for periods of time in excess of 1 hour with a minimum of discomfort. Materials are used which have a negligible proton density and a low atomic number, yielding no detectable magnetic resonance and very small x-ray cross sections respectively. Calibrated traction may be applied to patients via tongs or a head harness, the latter rendering the device suitable for general transport of injured patients with traction applied. The device is compact, light and strong and contains no ferrometallic parts. Thus far in excess of 40 patients have been scanned, most in a FONAR beta-3000M .3 Tesla electromagnetic MR imager and some also in a GE 9800 Quickscan CT scanner. No artefact has been demonstrated in any of the images to date for any of the MR pulse sequences or CT kVp. Modifications likely include refinement of the tensioning mechanism, inclusion of x-ray cassette facilities and improvement of aesthetic design.

Equipment Design↗
PubMed1988

Antihypertensive monotherapy with nitrendipine in general practice.

Efficacy and feasibility of antihypertensive monotherapy with the calcium antagonist nitrendipine were investigated in a 6-week open trial in 768 patients with mild to moderate essential hypertension from 191 practicing internists and general practitioners. Previous antihypertensive therapy (n = 501) was withheld for 1 week and therapy then started with nitrendipine 20 mg q.d. If diastolic blood pressure before tablet intake in the morning stayed above 90 mm Hg or fell less than 10 mm Hg, the dose could be doubled to the maximum dose of 20 mg b.i.d. Alternatively, if blood pressure control was good, the dose could be halved to 10 mg q.d. One hundred thirty-four patients discontinued therapy prematurely because of unwanted effects mostly characteristic with dihydropyridines (headaches, flushes, and ankle edema) and mostly within the first 3 weeks. In 72% of the remaining 634 patients, the goal blood pressure was achieved by nitrendipine monotherapy (10 mg q.d. in 8%, 20 mg q.d. in 87%, and 20 mg b.i.d. in 5%) and diastolic blood pressure was between 90 and 95 mm Hg in another 3%. Reductions of blood pressure did not result in changes of heart rate or weight. Nitrendipine was effective in patients of all age groups but patients older than 65 years showed a significantly greater fall of systolic and mean arterial pressure than middle aged or young patients. Nitrendipine's efficacy under conditions of general practice and the high proportion of patients responding to once daily administration appear well suited for first-line therapy of uncomplicated hypertension. The incidence of side effects might have been smaller if therapy had started with a smaller dose.

Aged↗
PubMed1988

Risk factors in the population of the GDR-MONICA Study (1983/84).

The GDR-MONICA project comprises 25 administratively defined areas with a population of nearly two million people aged 25-64. Data from the first random sample survey are reported here. The survey gathered information regarding risk factors, dietary behaviour, physical activity and psychosocial factors from 11,281 persons aged 25-64. The average risk factor levels were high in the population: The mean casual blood pressure was 140/88 mmHg and 138/86 mmHg for men and women respectively. In both sexes the mean total cholesterol level exceeded 6.1 mmol/L, and the mean body mass index (BMI) was just over 26.0. The study population consumed, on average, excessive amounts of energy, fat, alcohol, and sodium, and too few carbohydrates. Preliminary conclusions regarding unfavourable trends in risk factor levels have been drawn by comparing the present data with other recent reliable epidemiological studies.

Adult↗
PubMed1988

Combined SPECT imaging of regional cerebral blood flow (99mTc-hexamethyl-propyleneamine oxime, HMPAO) and blood volume (99mTc-RBC) to assess regional cerebral perfusion reserve in patients with cerebrovascular disease.

In 53 patients with cerebrovascular disease (CVD), regional cerebral blood flow (CBF) and blood volume (CBV) were imaged by SPECT within one session. Slice division (CBF: CBV) yielded distribution of regional cerebral perfusion reserve (CPR). Semiquantitative evaluation was obtained from manually set ROIs by interhemispherical ratios (for CBF, CBV and CPR), using 2 SD from a normal group (n = 10) as a threshold. Sensitivities were 59% for CBF, 94% for CBV and 83% for CPR. Combined sensitivity was 98%. Establishing three constellations for CBF, CBV and CPR, regionally normal CBFs but quantitatively increased CBVs (+69%) and decreased CPRs (-31%) were found in relatively early stages of CVD. Very advanced cases showed decreased CBFs (-65%), CBVs (-40%), CPRs (-49%) and a surrounding penumbra. In 87% (46/53 patients), such rheologically postulated constellations could be demonstrated. We conclude that combined CBF and CBV SPECT, assisted by CPR images, is a promising tool to detect CVD and to assess its individual regional severity.

Aged↗
PubMed1987

Differential scanning calorimetry studies of rabbit cardiac sarcolemma.

Thermal transitions were measured by differential scanning calorimetry for rabbit cardiac sarcolemma in 3-(N-morpholino)propanesulfonic acid buffer at pH 7.5, in glycerol-buffer and dimethyl sulfoxide - buffer mixtures, after heat denaturation, and after enzymatic degradation of the proteins. Specific solvent effects on the protein transitions were observed. Glycerol stabilized some of the four protein transitions, while dimethyl sulfoxide destabilized all protein transitions. The thermal transitions in the lower temperature range were studied for both the membranes and the lipid extracted from the membranes. A very small endotherm was observed for both the lipid extracted from the sarcolemma and the intact membrane (0.1-0.2 cal/g; 1 cal = 4.1868 J). A larger endotherm was observed in both the glycerol-buffer and dimethyl sulfoxide - buffer mixtures. Major perturbation of the protein by enzymatic degradation (papain or trypsin digestion), by heat denaturation, or by reaction with excess N-ethylmaleimide all produced larger endotherms near 20 degrees C. The very small magnitude of the endotherm near 20 degrees C suggests that it is not a typical gel - liquid crystalline transition of the bilayer. However, the occurrence of an endotherm in the extracted lipid suggests that some reorientation of lipid is involved.

Adenosine Triphosphatases↗
PubMed1985

Subacute toxicity of 1,1,1-trichloroethane, noise, and their combination in rats.

The metabolism of the xenobiotics 1,1,1-trichloroethane (TCE) or 1,1,2-trichloro-1,2,2-trifluoroethane and endogeneous substrates may be changed under physiological stress situations. We studied long-term effects on rats exposed to TCE, noise pollution, and their combination. The experiments were performed in a special set-up where four parallel groups of rats were simultaneously exposed to defined conditions the chemical vapor; the noise pollution of 90 dB; their combination; and a control group without any exposure. The vapor of TCE was applied at a concentration of 200 ppm/8 hr or of 2000 ppm/12 hr for 84 days each. The experiments were performed with TCE from two different commercial sources. One of those TCE preparations caused effects at the high dosage level in terms of enhanced levels of the relation of liver to body weight; liver microsomal protein content; liver microsomal monooxygenase activity; and 3,4-dihydroxyphenylglycol excretion in urine. Eight other physiological and biochemical parameters were not changed.

Animals↗
PubMed1985

[Mechanical stress of newborn infants caused by incubator transport].

Newborn babies transported in an incubator are obviously exposed to considerable mechanical vibrations. We measured these vibrations with the aim to improve these conditions. The vibrations measured on transportation by R.T.W. ambulance (Daimler-Benz 508 with an "anti-vibration platform") are almost tolerable; however on the K.T.W. ambulance (Volkswagen Type 2) the registered vertical accelerations were much greater and gave an unacceptable level of gravitational forces. Small constructive corrections to the stretcher and the connection between stretcher and incubator lead to a marked decrease in peak acceleration and the value of effective acceleration. We also found that it is of great importance to drive smoothly and that the vibrations are more pronounced with hasty driving. The influence of these vibrations as a possible co-factor in the pathogenesis of intracranial haemorrhage is discussed.

Acceleration↗