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Biomedical subjects

J Hartung

Publications and source records attributed to J Hartung.

At least 37 records · Page 2Linked to original sources
PubMed2002

Fetal pulmonary venous flow pattern is determined by left atrial pressure: report of two cases of left heart hypoplasia, one with patent and the other with closed interatrial communication.

We report two cases of fetal left heart hypoplasia with extremes of size of interatrial communication, i.e. a closed foramen ovale and an atrial septal defect. Doppler examinations of the pulmonary veins showed almost to and fro flow in the fetus with the closed foramen ovale and, in contrast, a normal flow velocity waveform in the fetus with the atrial septal defect, despite mitral atresia. Our observations support the importance of left atrial pressure in the creation of a pulmonary venous flow pattern in the fetus.

Adult↗
PubMed2002

[CO2-stunning of slaughter pigs: effects on EEG, catecholamines and clinical reflexes].

Investigations were carried out on the response of slaughter pigs to CO2 stunning with two different gas concentrations (80 vol%, 90 vol%, 73 s) under practical conditions in a one gondola-dip-lift system. EEG measurements were performed and blood constituents such as catecholamines (adrenaline, nor-adrenaline) and lactate as well as clinical reactions (nasal septum and corneal reflex, heart beats) investigated. Special EEG-electrodes were adapted for the measurement on pigs and a mobile data logger was prepared for the use in the lairage of the slaughter house and in the stunning unit. The CO2 concentrations were measured continuously close to the head of the pigs when transported up and down in the stunning gondola. The results show that the technique is suited to monitor the effects of different CO2 gas concentrations on the EEG of the pigs under practical conditions. There is strong evidence that CO2 concentrations of 80 vol% applied over 70 s as required by law are not sufficient to stun pigs properly. A large part of the animals still showed typical reflexes when leaving the stunning pit. When an atmosphere of 90 vol% CO2 is applied, most animals are already dead before bleeding commences. This may create problems in respect to meat hygiene. The blood analysis revealed very high concentrations of catecholamines after stunning. The values for adrenaline and nor-adrenaline in the sticking blood rose by a factor of about 1000 as compared to the concentrations in blood samples taken in the lairage before stunning. It seems necessary to revise the current legislation on gas stunning and to look in greater detail in the effects of CO2 stunning on the welfare of slaughter pigs.

Abattoirs↗
PubMed2001

A refined method for the meta-analysis of controlled clinical trials with binary outcome.

For the meta-analysis of controlled clinical trials with binary outcome a test statistic for testing an overall treatment effect is proposed, which is based on a refined estimator for the variance of the treatment effect estimator usually used in the random-effects model of meta-analysis. In simulation studies it is shown that the proposed test keeps the prescribed significance level much better than the commonly used tests in the fixed-effects and random-effects model, respectively. Moreover, when using the test it is not necessary to choose between fixed effects and random effects approaches in advance. The proposed method applies in the same way to the analysis of a controlled multi-centre study with binary outcome, including a possible interaction between drugs and centres.

Cisapride↗
PubMed2001

Ultrasonographic and clinical appearance of a 22-week-old fetus with Brachmann-de Lange syndrome.

The diagnosis Brachmann-de Lange or Cornelia-de Lange syndrome is based on the characteristic facial appearance and other malformations. Prenatal ultrasonographic diagnosis has been made occasionally usually confirmed by clinical photographs of third trimester fetuses with distinctly recognizable hair anomalies (synophrys, low anterior and posterior hairlines, and hypertrichosis). However, at 22 weeks of gestation, these highly characteristic signs fail to support the clinical diagnosis. We report on pre- and post-natal findings in a 22-week-old female fetus with Brachmann-de Lange syndrome. The facial Gestalt was already characteristic and the associated upper limb malformations (bilateral monodactyly and ulnar agenesis) supported the diagnosis. The prenatal ultrasound images demonstrated a grossly abnormal facial profile (a protruding and overhanging upper lip and severe retrognathia) highly suggestive of Brachmann-de Lange syndrome. The recurrence risk is estimated &#1%. The recognition of Brachmann-de Lange syndrome in second trimester fetuses is essential for genetic counselling and reassurance of parents contemplating future reproduction.

Adult↗
PubMed2001

On tests of the overall treatment effect in meta-analysis with normally distributed responses.

For the meta-analysis of controlled clinical trials or epidemiological studies, in which the responses are at least approximately normally distributed, a refined test for the hypothesis of no overall treatment effect is proposed. The test statistic is based on a direct estimation function for the variance of the overall treatment effect estimator. As outcome measures, the absolute and the standardized difference between means are considered. In simulation studies it is shown that the proposed test keeps the prescribed significance level very well in contrast to the commonly used tests in the fixed effects and random effects model, respectively, which can become very liberal. Furthermore, just for using the proposed test it is not necessary to choose between the fixed effects and the random effects approach in advance.

Amlodipine↗
PubMed2001

Cardioselective K(ATP) channel blockers derived from a new series of m-anisamidoethylbenzenesulfonylthioureas.

Sulfonylthioureas exhibiting cardioselective blockade of ATP-sensitive potassium channels (K(ATP) channels) were discovered by stepwise structural variations of the antidiabetic sulfonylurea glibenclamide. As screening assays, reversal of rilmakalim-induced shortening of the cardiac action potential in guinea pig papillary muscles was used to probe for activity on cardiac K(ATP) channels as the target, and membrane depolarization in CHO cells stably transfected with hSUR1/hKir6.2 was used to probe for unwanted side effects on pancreatic K(ATP) channels. Changing glibenclamide's para-arrangement of substituents in the central aromatic ring to a meta-pattern associated with size reduction of the substituent at the terminal nitrogen atom of the sulfonylurea moiety was found to achieve cardioselectivity. An additional change from a sulfonylurea moiety to a sulfonylthiourea moiety along with an appropriate substituent in the ortho-position of the central aromatic system was a successful strategy to further improve potency on the cardiac K(ATP) channel. Among this series of sulfonylthioureas HMR1883, 1-[5-[2-(5-chloro-o-anisamido)ethyl]-2-methoxyphenyl]sulfonyl-3-methylthiourea, and its sodium salt HMR1098 were selected for development and represent a completely new therapeutic approach toward the prevention of life-threatening arrhythmias and sudden cardiac death in patients with coronary heart disease.

ATP-Binding Cassette Transporters↗
PubMed2001

Reliability of prenatal sonographic lung biometry in the diagnosis of pulmonary hypoplasia.

OBJECTIVE: The purpose of the present study was to assess the value of biometric lung measurements for the diagnosis of severe fetal pulmonary hypoplasia by investigating whether a significant correlation between two-dimensional lung biometry measurements and autopsy findings could be established. METHODS: This was a prospective study carried out between 1995 and 1997. Nomograms for normal fetuses of the anterior-posterior and transverse inner thoracic diameters, which describe the growth and shape of the lung, were used as a basis for diagnosis of pulmonary hypoplasia in fetuses at high risk of developing the condition (the fetuses had bilateral renal agenesis or multicystic kidneys; chronic PROM <25 gestational weeks or hydrothorax). Pregnancy was terminated by abortion or intrauterine death in 29/43 high-risk fetuses and autopsies were performed. Only the 29 fetuses for which there were autopsy findings were included in the study. RESULTS: The best plane for diagnosing pulmonary hypoplasia was the four-chamber view. The diagnostic accuracy for this view as expressed by the sensitivity was 57% for the anterior-posterior diameter and 44% for the transverse diameter; as expressed by the specificity it was 42% for the anterior-posterior diameter and 50% for the transverse diameter. The results for the four-chamber view for the various high-risk conditions were as follows: for fetuses with chronic PROM we obtained sensitivities of 75% and 50% (anterior-posterior and transverse dimensions, respectively) and specificities of 80% and 60% (anterior-posterior and transverse dimensions, respectively). The sensitivities of lung biometry in fetuses with hydrothorax were 1% and 80% for the two diameters, but there was a low specificity. In fetuses with bilateral renal agenesis or multicystic kidneys we obtained sensitivities of 36% and 30% (anterior-posterior and transverse dimensions, respectively) and a specificity of 50% (anterior-posterior dimension). CONCLUSIONS: The present results show that two-dimensional lung biometry is not a suitable method for antenatal detection of pulmonary hypoplasia. However, in individual cases with high risk for pulmonary hypoplasia, lung biometry might prove to be an additional diagnostic parameter.

Autopsy↗
PubMed2001

A self-designing rule for clinical trials with arbitrary response variables.

For testing both one-sided and two-sided hypotheses concerning several treatment arms in group sequentially performed clinical trials with arbitrary outcome variables, a general method is considered that allows one to completely self-design a study. All information available prior to a stage is used for estimating the sample size and the weight for the next step. In "using up" the variance, the test statistic is built in a bounded finite but random number of stages to test just once the rejection of the null hypothesis. Control Clin Trials 2001;22:111-116

Clinical Trials as Topic↗
PubMed2001

Application of three-dimensional power Doppler ultrasound in prenatal diagnosis.

OBJECTIVE: To assess the fetal cardiovascular system using three-dimensional power Doppler ultrasound (3D-PDU) in normal and abnormal conditions during the second half of gestation. SUBJECTS: Forty-five normal fetuses and 87 selected pregnancies with different abnormalities involving the vascular system were examined. METHODS: The following regions of interest were assessed: placental, umbilical, abdominal, renal, pulmonary and intracranial vessels together with the heart and great arteries. Equipment used was a commercially available HDI-3000 and 5000 ultrasound system with integrated 3D-Color Power Angio software. Data acquisition was performed by the free-hand technique. Images were reconstructed online. In pathological cases, a maximum of three attempts of 3D reconstruction was allowed to obtain the information needed. RESULTS: Satisfactory visualization of the fetal vascular system using 3D-PDU could be achieved in normal pregnancies. The main difficulty during the learning curve was the optimization of the power Doppler image prior to 3D data acquisition. Despite good visualization conditions, the reconstruction of satisfactory images was only possible in 56 out of the 87 (64%) pregnancies with abnormal vascular anatomy. These were abnormalities of placenta and umbilical vessels (n = 26), intra-abdominal and intrathoracic anomalies (n = 12), renal malformations (n = 9), central nervous system (n = 4) and cardiac defects (n = 5). The main reasons for the lack of information were fetal position and movements, overlapping with signals from neighboring vessels as well as technical limitations of the online system. Details and figures of the potential field of interest in prenatal diagnosis are presented.

Cardiovascular System↗
PubMed2001

Treatment of non-ulcer dyspepsia: a meta-analysis of placebo-controlled prospective studies.

BACKGROUND: Dyspeptic symptoms are commonly reported complaints in clinical practice and are mostly the result of functional disorders. Empirical treatment with histamine H2-receptor blockers or gastroprokinetics for 2-4 weeks has frequently been proposed as first line management of these patients. The clinical trials which support the use of these agents, show a high variation in clinical success rate and benefit of these treatments. METHODS: The available clinical trials were evaluated, pooled where appropriate and subjected to a meta-analysis with the principal goal to provide valid treatment recommendations for patients with non-ulcer dyspepsia. In the present meta-analysis 19 studies on gastroprokinetics (cisapride, domperidone) and 10 studies on histamine H2-receptor antagonists (cimetidine, ranitidine) were included. RESULTS: Based on these studies, a total of 1540 patients were evaluated for histamine H2-receptor antagonists (verum n = 786, placebo n = 754) and 1235 patients for gastroprokinetics (verum n = 616, placebo n = 619). The probability for treatment success compared to placebo was 0.2026 (0.1261; 0.2791) for histamine H2-receptor antagonists and 0.4029 (0.3042; 0.5069) for gastroprokinetics. CONCLUSIONS: Based on these data both treatments are significantly more effective than placebo in the symptomatic treatment of non-ulcer dyspepsia, with gastroprokinetics (cisapride, domperidone) being more effective than histamine H2-receptor antagonists (cimetidine, ranitidine).

Cimetidine↗
PubMed2001

A case in point.

Explore the source record for details and available documents.

Body Temperature↗
PubMed2001

Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis.

BACKGROUND: There are already many effective topical therapies available for use in the treatment of chronic plaque psoriasis. Unfortunately, these treatments are often associated with a rather significant risk of undesirable effects. OBJECTIVE AND METHODS: In this randomized, prospective clinical trial, the effects of the vitamin D(3) analog calcipotriol were evaluated against those of a recently developed vitamin B(12) cream containing avocado oil in an intraindividual right/left-side comparison. The trial population consisted of 13 patients, 10 men and 3 women, with chronic plaque psoriasis. The observation period was 12 weeks; the effects of therapy were assessed on the basis of a PASI score adapted to the right/left-side comparison technique, the subjective evaluations of the investigator and patients and the results of 20-MHz sonography. RESULTS: There was a more rapid development of beneficial effects with the use of calcipotriol in the initial 8 weeks, although differences in effects were significant only at the time point of therapy week 8 (p < 0.05). After 12 weeks, neither the PASI score nor 20-MHz sonography showed significant differences between the two treatments. While the efficacy of the calcipotriol preparation reached a maximum in the first 4 weeks and then began to subside, the effects of the vitamin B(12) cream containing avocado oil remained at a constant level over the whole observation period. This would indicate that the vitamin B(12) preparation containing avocado oil may be suitable for use in long-term therapy, a hypothesis further supported by the fact that the investigator and the patients assessed the tolerability of the vitamin B(12) cream containing avocado oil as significantly better in comparison with that of calcipotriol. CONCLUSION: The results of this clinical trial provide evidence that the recently developed vitamin B(12) cream containing avocado oil has considerable potential as a well-tolerated, long-term topical therapy of psoriasis.

Adult↗
PubMed2001

[Enriched cage systems for laying hens--legal minimum conditions and starting points for their scientific evaluation].

Recent developments in the European and national legislation regarding minimum standards for the keeping of laying hens will be causing changed conditions for egg production in the medium term. Enriched cages shall allow hens to better fulfill their needs than traditional battery cages. More space for the stretching of wings and legs, perches for resting, littered areas for scratching, pecking and dustbathing and nests for egg-laying behaviour shall allow layers to perform more of their normal behaviour patterns. However, regarding the sustainability of these systems there are different views and still a great lack of scientific data and practical experience. An overview is given on the development of European and national animal welfare legislation concerning laying hens, minimum requirements for enriched cages and the available evidence about animal behaviour, performance and health in these systems. Furthermore, a current project at the School of Veterinary Medicine Hannover on the animal welfare assessment of enriched cages, specifically on the Aviplus cage system, which was one of the first systems on the market and is in accordance with EU-directive, is introduced.

Animal Welfare↗
PubMed2001

[A proposal for calculating the dustlike particle emissions from livestock buildings].

Particles emitted from livestock buildings are supposed to cause health implications in nearby residents. This increasingly causes conflicts between farmers and neighbours. At the same time the national emission control regulations are tightened and focus also on the environmental impact of particulate emissions. In front of this background a calculation model is presented by which the emitted masses of PM10 and PM2.5 from animal houses can be estimated. The model may help to establish emission inventories for particulates in rural areas with livestock production and can become a valuable instrument of the emission control act. The validity of the proposed model depends largely on the quality and amount of the input data. The more valid data are available the more precise the model can work. Therefore it will be necessary to improve the data sets on emission amounts for PM10 and PM2.5. In spite of these limitations it appears that a first and reliable estimation of particulate emission amounts from animal buildings can be given by the proposed model calculation.

Air Pollutants↗
PubMed2000

Prenatal diagnosis of intrahepatic communications of the umbilical vein with atypical arteries (A-V fistulae) in two cases of trisomy 21 using color Doppler ultrasound.

We report on two cases of the prenatal diagnosis of arterio-venous communication between the intra-abdominal umbilical vein and atypical arteries. The diagnosis was made by color and spectral Doppler and 'color power angiography'. Both cases presented with hydrops fetalis, one at 14 and the other at 31 weeks of gestation. In the first case, color Doppler demonstrated an atypical arterial vessel connecting the umbilical vein with the aorta; the ductus venosus was patent. Echocardiography showed a so-called atrioventricular canal. In the second case, a complex intrahepatic vascular malformation was found. Color Doppler demonstrated communications between the umbilical vein and the hepatic artery and an atypical artery; the ductus venosus was patent. In the latter case polyhydramnios, duodenal atresia and macroglossia were additionally detected. In both cases, fetal karyotyping revealed trisomy 21. The first case resulted in a missed abortion, the second in a stillbirth. All findings were confirmed on autopsy. Of interest is that both fetuses were affected with trisomy 21. The increasing use of color Doppler in prenatal diagnosis, especially in hemodynamically compromised fetuses, will help to determine the actual incidence of complex vascular malformations of the umbilical vein and to elucidate the impact of such malformations on fetal outcome.

Adult↗