Detection of hepatitis A virus RNA in commercially available factor VIII preparation.
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Drug Contamination↗
Biomedical subjects
J Graff
Publications and source records attributed to J Graff.
Comparison of Bay K 8644, nitrendipine and atropine on spontaneous and pelvic-nerve-induced bladder contractions on rat bladder in vivo.
The effects of the dihydropyridine-type calcium antagonist (nitrendipine) and agonist (Bay K 8644) in comparison to atropine have been studied after intravenous administration on spontaneous and pelvic-nerve-induced contraction of rat urinary bladder. Bay K 8644 increased the basal internal bladder pressure as well as the amplitude of the spontaneous bladder contractions in a dose-dependent manner. In addition, an increase in systemic arterial blood pressure was noted for a period of about 20 min. In the presence of atropine the effects of Bay K 8644 on the urinary bladder were almost completely antagonized. Both nitrendipine and atropine reduced in a dose-dependent manner the amplitude of spontaneous and nerve-induced bladder contraction. The spontaneous and nerve-induced bladder contractions were significantly reduced by atropine or nitrendipine. Only nitrendipine caused a reduction of the spontaneous bladder contraction frequency. The systemic blood pressure was decreased significantly by nitrendipine but not after atropine administration. We suggest that both calcium antagonist and agonist can change the tension of the urinary bladder in vivo. As a side-effect the systemic blood pressure is altered. Atropine can antagonize the effect of BayK 8644 on the urinary bladder and reduces spontaneous and nerve-induced bladder contractions more specifically than nitrendipine.
3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗
Influence of papaverine on rat bladder contractions in vivo.
In an acute rat model (in vivo) spontaneous rhythmic bladder contractions were induced by ligation of the urethra. In addition single bladder contractions were recorded during neurostimulation of the pelvic nerve. Spontaneous and electrically induced bladder contractions were sensitive to papaverine and isoprenaline in vivo. The basal bladder pressure and bladder contraction parameters were reduced more potently by isoprenaline. Blood pressure decreased significantly after isoprenaline injection (0.5-50 micrograms/kg = 4.73 x 10(-6)-4.73 x 10(-4) mol/l) and high concentration of papaverine (5 mg/kg = 2.95 x 10(-2) mol/l). Compared to isoprenaline papaverine was less toxic. These results are different to previous in vitro investigations in rat bladder strips. In vivo papaverine seems to be less effective on nerve-mediated bladder contractions and decreases bladder pressure. Our results indicate that beta-adrenergic receptors play a potent role in the inhibition of spontaneous and pelvic nerve-induced bladder contraction.
Animals↗
An assessment of the flow rate within peritoneal dialysis catheters, using a standardized in vitro technique.
A variety of peritoneal dialysis catheters are used in clinical practice. The catheters are mainly described by their design, French number (circumference in mm) and length. However, this description does not provide information about the catheters inflow and outflow rates. We have therefore, studied flow rates of 18 adult catheters, using a uroflowmeter. Inflow rates were measured with the inflow bag 100 cm and 145 cm above the tip of the catheter, and outflow rates were measured with the flow transducer located 35 cm and 80 cm below the tip of the catheter, imitating situations where patients are sitting in a chair or laying in a bed during fluid exchanges. Ten measurements were made for each catheter at all heights. We found that catheter designs do affect flow rates. Straight catheters had statistic significantly faster inflow and outflow rates compared to curled catheters (p < 0.001). Moreover, curled catheters had statistic significantly faster flow rates than Swan Neck catheters (p < 0.001). The length and internal diameter of the catheter was found to be the determining factor for the differences in flow rates.
Catheterization↗
Interferon-alpha 2b instillation prophylaxis in superficial bladder cancer--a prospective, controlled three-armed trial. Project Group Bochum--Interferon and Superficial Bladder Cancer.
Sixty-seven patients with recurrent pTa G1-G3 to pT1 G1-G3 tumors were randomized into three groups receiving either Intron A at 10 MU/instillation, Intron A at 10 MU and mitomycin C (MMC) at 20 mg/instillation or MMC at 20 mg/instillation. After a mean follow up of 6.2 months no tumor recurrence has been seen in the group receiving combined therapy, whilst four out of 22 in the interferon group and five out of 23 in the MMC group suffered a recurrence. Side effects were slight. These preliminary results suggest that a combination of the two drugs is more effective than either drug alone.
Aged↗
[Decompression sickness].
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Decompression Sickness↗
[Analgesia using oral administration of tilidine naloxone for extracorporeal shockwave lithotripsy. A double blind study].
Reduction in pain perception during ESWL due to a technical modification of the lithotriptor was expected and prompted a reassessment of anaesthesia techniques for ESWL. In this study the need for analgesic treatment had to be investigated. After satisfactory preliminary results in a previous pilot study, the value of the oral combination of the anti-anxiety drug dipotassium clorazepate on the evening before ESWL together with the analgesic tilidine-naloxone before treatment was tested in a randomised double-blind study in 120 patients. In case of intolerable pain during the treatment all patients were free to ask for additional intravenous analgesic medication (fentanyl). During ESWL, 28.3% of the tilidine-N group patients and 6.7% of the placebo group were pain-free, whereas intolerable pain was reported by 30% of the tilidine-N group and 56.7% of the placebo group. Therefore, 70% of the tilidine-N group patients were treated without any additional analgesic or sedative medication. The good experience with this oral anaesthesia approach, the lack of significant side effects and a good acceptance by the patients warrant further recommendation of this technique.
Administration, Oral↗
Nature, Volume 205, 1965: Evaluation of chemical diets as nutrition for man-in-space.
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Food, Formulated↗
[Emergency coronary surgery in patients with unstable angina pectoris. Results and place in the total concept of the treatment of this group of patients].
The urgent coronary surgery performed in patients with high risk unstable angina (rest pain greater than 48 h) shows still different results. We found in 57 urgent operated patients the same functional and clinical results as after elective bypass grafting. A higher in hospital mortality after urgent coronary surgery based on a higher number of grafts are occluded in the early postoperative period. The better prognosis concluded that the use of urgent coronary surgery is the therapy of choice in patients with refractory unstable angina pectoris.
Adult↗
Influence of iloprost on eicosanoid generation and lipid levels in experimental myocardial ischemia in dogs.
Anaesthetized mongrel dogs were subjected to occlusion of a coronary artery. The resulting myocardial infarction was observed for three hours. One hour after occlusion, infusion of the stable prostacyclin analogue iloprost or saline was started. In the control group myocardial infarction was associated with an increase of the ratio TXB2/6-keto-PGF1a which was abolished by iloprost treatment. After occlusion in the control group, the atherosclerosis index (TC-HDLC): HDLC was increased, but in the iloprost-treated group it was significantly decreased. The results of this study suggest that the administration of iloprost is able to prevent changes in eicosanoid metabolism and lipoprotein pattern after coronary artery occlusion in dogs.
6-Ketoprostaglandin F1 alpha↗
Critical evaluation of treatment of staghorn calculi by percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy.
The combined use of percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy in patients with staghorn calculi has become an established treatment regimen. We evaluated the results of 90 staghorn calculi-bearing kidneys treated with such combination therapy after a mean follow-up of approximately 2 years. A total of 69 kidneys (76.7 per cent) became free of stones at some point after treatment. However, due to stone recurrence this number decreased to 55 kidneys (61.1 per cent) at the end of follow-up. Patients who had undergone a previous open operation on the stone-bearing kidney showed less favorable results than the over-all group. When our results were compared to reported data on open surgery or percutaneous nephrolithotomy alone even better results may have been obtained by such treatment modalities. However, our data indicate that percutaneous stone debulking combined with further destruction of residual stone fragments by shock wave lithotripsy certainly is less invasive than an open operation and provides an alternative to percutaneous treatment alone, which can yield comparable results.
Adult↗
Lack of effectiveness of lidocaine for sustained, wide QRS complex tachycardia.
Records of 31 episodes of sustained, wide QRS complex tachycardia treated with IV boluses of lidocaine in 20 consecutive patients were reviewed. Most of the episodes were managed in the emergency department. Patient ages ranged from 18 to 91 years (mean +/- SD, 64 +/- 17), and 17 of 20 were men. All but three had coronary artery disease. Although 19 of 20 patients were admitted with a diagnosis of "rule out acute myocardial infarction," only two had this diagnosis confirmed. Seventeen patients had ventricular tachycardia, and three had wide QRS complex supraventricular tachycardia. Patients were given one to three boluses of lidocaine totaling 75 to 400 mg (127 +/- 64 mg). Termination of the tachycardia was temporally related to lidocaine administration in only six of 31 episodes (19%) occurring in five of 20 patients. In three of these five patients, lidocaine was given again for a recurrence of the tachycardia and was ineffective. A similarly low efficacy was seen in 20 episodes initially managed in the hospital compared with 11 episodes initially managed by paramedics. Thus, although lidocaine is widely considered the drug therapy of first choice for sustained wide QRS complex tachycardia, it was not usually effective in our study. Patients presenting to the ED with this rhythm disturbance rarely prove to have acute myocardial infarction. Although this small retrospective study should not be the basis for a change in standard medical practice, the recommendation of lidocaine as initial therapy for such patients should be reexamined.
Adolescent↗
Long-term followup in 1,003 extracorporeal shock wave lithotripsy patients.
We evaluated 1,003 patients treated with extracorporeal shock wave lithotripsy after a mean followup of 19.1 months (range 12 to 26 months). Followup excretory urograms were normal in 97 per cent of the patients. Two-thirds of the patients reported further discharge of residual fragments, mainly during the first 3 months. Rehospitalization was necessary in 57 patients. Over-all, the rate free of stones after followup was 72.2 per cent and it was not different for primary and recurrent stone patients. Rates free of stones were influenced mainly by the primary stone location and the number of stones in a renal unit. Patients with lower caliceal stones had a rate without calculi of only 57.8 per cent. Almost identical results were obtained for stones other than in the lower calix, when fragments were found in the lower calix at the time the patient was discharged from the hospital. The pre-treatment stone volume, as determined by measuring the stone area in square millimeters, did not influence the final rates free of stones for calculi up to 400 mm.2, that is 2.4 cm. of a sphere. Only calculi larger than 400 mm.2 showed an inverse relationship to the final rate free of stones. Multiple stones yielded a success rate of 64 per cent, with 90 per cent of the patients having regrowth of residual fragments. Serious complications during followup were not encountered.
Adolescent↗
Extracorporeal shock wave lithotripsy for ureteral stones: a retrospective analysis of 417 cases.
We treated 417 patients with upper ureteral stones with extracorporeal shock wave lithotripsy. All patients with obstructing stones underwent retrograde manipulation, which was successful in 57 per cent. Management of obstructing stones in situ (215 patients) with and without decompression of the collecting system required additional treatments in 13 per cent and ancillary procedures in 25 per cent. Nonocclusive ureteral stones were not manipulated. Treatment of these stones in situ slightly increased the need for postoperative ancillary procedures, compared to successful repositioning into the kidney (5.9 versus 3 per cent). Secondary treatments, however, were necessary as often as with occlusive stones. The main reason for failure of extracorporeal shock wave lithotripsy was the lack of fluid around an impacted stone. An energy absorptive effect of muscle tissue for stones projecting on the psoas muscle could not be demonstrated. The best and most consistent results were obtained when the stone was manipulated successfully into the renal collecting system.
Female↗
New generator for low pressure lithotripsy with the Dornier HM3: preliminary experience of 2 centers.
The technical innovation of a low pressure generator with a standard ellipsoid installed into the Dornier HM3 lithotriptor leads to a decrease in pressure at the second focus by 30 per cent. The preliminary experience with 273 patients treated at 2 centers is presented. The success rate in terms of stone disintegration was similar compared to the old generator (96 versus 97 per cent). However, the rate of secondary treatments increased from 8 to 15.5 per cent, respectively. Owing to the lower peak pressures at the second focus, an additional 700 impulses per session were necessary. The method of anesthesia was changed to a combination of an anxiolytic and analgesic drug in the majority of the patients. Treatment was judged as free of pain or with easily tolerable pain in 93 and 88 per cent of the patients, respectively.
Anesthesia, Epidural↗
Heterotopic pregnancy after in vitro fertilization and ovulatory drugs.
We report two cases of heterotopic pregnancy in women who were previously infertile. One of these patients conceived with the aid of ovulation stimulatory drugs, and the other from in vitro fertilization. In each case an ultrasound of the pelvis revealed a viable intrauterine pregnancy (twins in one case). Both patients presented in hypovolemic shock and required exploratory laparotomy. At the time of surgery a ruptured ectopic pregnancy with accompanying hemoperitoneum was found in each. Simultaneous ectopic and intrauterine pregnancy, though rare, should be suspected in patients who conceive with the aid of ovulatory drugs or in vitro fertilization.
Abortion, Spontaneous↗
Influence of drugs on the TXA2/PGI2 balance and on the atherogenic index in myocardial ischemia in dogs.
The effect of drugs on eicosanoid production and on the development of atherogenic index was investigated in canine myocardial ischemia. Iloprost, verapamil, the trapidil derivative AR 12463 or 0.9% NaCl solution were administered 60 min after coronary artery ligation in anaesthetized dogs. Both iloprost and AR 12463 reduced the thromboxane A2/prostacyclin (TXA2/PGI2) ratio in coronary sinus plasma in comparison to controls. The atherogenic index was significantly decreased in the iloprost as well as in the AR 12463-treated group in comparison to the control group. Verapamil had no influence on the investigated parameters.
Animals↗
Influence of verapamil and its combination with glucose-insulin-potassium-infusion on acute myocardial ischemia in dogs.
The influence of verapamil (V) and of V combined with glucose-insulin-potassium (VG) on ischemic injured myocardium was investigated in dogs after ligation of the left anterior descending coronary artery. Three hours after coronary artery ligation with VG application during the last two hours the left ventricular end diastolic pressure (LVEDP) and the pressure rate product were decreased in contrast to the behaviour after V infusion. Contents of ATP and creatine phosphate were preserved in equal extent by V and VG, but the lowest content in inorganic phosphate was found in ischemic and nonischemic left ventricular tissue after VG application. Thus, VG seems to enable the tissue to save more effective energy rich phosphates and to contribute to the economization of cardiac work by reduction of preload.
Adenosine Triphosphate↗