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Biomedical subjects

K Brandt

Publications and source records attributed to K Brandt.

At least 73 records · Page 4Linked to original sources
PubMed1991

The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip.

Clinical criteria for the classification of patients with hip pain associated with osteoarthritis (OA) were developed through a multicenter study. Data from 201 patients who had experienced hip pain for most days of the prior month were analyzed. The comparison group of patients had other causes of hip pain, such as rheumatoid arthritis or spondylarthropathy. Variables from the medical history, physical examination, laboratory tests, and radiographs were used to develop different sets of criteria to serve different investigative purposes. Multivariate methods included the traditional "number of criteria present" format and "classification tree" techniques. Clinical criteria: A classification tree was developed, without radiographs, for clinical and laboratory criteria or for clinical criteria alone. A patient was classified as having hip OA if pain was present in combination with either 1) hip internal rotation greater than or equal to 15 degrees, pain present on internal rotation of the hip, morning stiffness of the hip for less than or equal to 60 minutes, and age greater than 50 years, or 2) hip internal rotation less than 15 degrees and an erythrocyte sedimentation rate (ESR) less than or equal to 45 mm/hour; if no ESR was obtained, hip flexion less than or equal to 115 degrees was substituted (sensitivity 86%; specificity 75%). Clinical plus radiographic criteria: The traditional format combined pain with at least 2 of the following 3 criteria: osteophytes (femoral or acetabular), joint space narrowing (superior, axial, and/or medial), and ESR less than 20 mm/hour (sensitivity 89%; specificity 91%). The radiographic presence of osteophytes best separated OA patients and controls by the classification tree method (sensitivity 89%; specificity 91%). The "number of criteria present" format yielded criteria and levels of sensitivity and specificity similar to those of the classification tree for the combined clinical and radiographic criteria set. For the clinical criteria set, the classification tree provided much greater specificity. The value of the radiographic presence of an osteophyte in separating patients with OA of the hip from those with hip pain of other causes is emphasized.

Hip Joint↗
PubMed1991

Cardiohemodynamic and serum catecholamine response to surgical removal of impacted mandibular third molars under local anesthesia: a randomized double-blind parallel group and crossover study.

The aim of this study was to differentiate between the extent to which surgical stress and the epinephrine in local anesthetic solutions influence serum catecholamine, cAMP, and potassium levels, and contribute to changes in cardiohemodynamic parameters. One hundred sixty mg of articaine hydrochloride (4.0 mL of a 4% articaine hydrochloride solution) with two different epinephrine doses was injected into outpatients prior to removal of an impacted mandibular third molar in a randomized, double-blind parallel group and crossover design. The results showed that the amount of epinephrine absorbed from the intraoral injection site predominantly determined the serum epinephrine concentration. The anesthetic-induced increase in the serum epinephrine level did not correlate with changes in the cardiohemodynamic parameters under study at any time during the operative procedure. The serum cAMP changes correlated with those of epinephrine, whereas the serum potassium levels remained unchanged. The procedure of tooth extraction was a stressful event when the 1:200,000 epinephrine-containing anesthetic solution was used, showing that the risk of inducing a cardiovascular incident during oral surgery seems to be higher the greater the extent of operation and the lower the epinephrine dose in the anesthetic solution.

Adult↗
PubMed1991

Homeward bound. Broadening student experience with home visits.

1. Because of patients are rapidly discharged after medication stabilization or crisis resolution, tertiary care in the home is emerging as an integral part of current psychiatric care. Students miss a valuable opportunity to participate in psychosocial rehabilitation if the clinical rotation is limited to an inpatient setting. 2. Guiding the client toward mental stabilization is the process of psychiatric care; outcomes are most apparent in the home. 3. Nursing is moving into psychiatric case management and continues to provide home care as a traditional role. Student home visits promote awareness of nursing responsibilities to families beyond the institution.

Education, Nursing, Baccalaureate↗
PubMed1990

The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand.

Clinical criteria for the classification of symptomatic idiopathic (primary) osteoarthritis (OA) of the hands were developed from data collected in a multicenter study. Patients with OA were compared with a group of patients who had hand symptoms from other causes, such as rheumatoid arthritis and the spondylarthropathies. Variables from the medical history, physical examination, laboratory tests, and radiographs were analyzed. All patients had pain, aching, or stiffness in the hands. Patients were classified as having clinical OA if on examination there was hard tissue enlargement involving at least 2 of 10 selected joints, swelling of fewer than 3 metacarpophalangeal joints, and hard tissue enlargement of at least 2 distal interphalangeal (DIP) joints. If the patient had fewer than 2 enlarged DIP joints, then deformity of at least 1 of the 10 selected joints was necessary in order to classify the symptoms as being due to OA. The 10 selected joints were the second and third DIP, the second and third proximal interphalangeal, and the trapeziometacarpal (base of the thumb) joints of both hands. Criteria derived using the "classification tree" method were 92% sensitive and 98% specific. The "traditional format" classification method required that at least 3 of these 4 criteria be present to classify a patient as having OA of the hand. The latter sensitivity was 94% and the specificity was 87%. Radiography was of less value than clinical examination in the classification of symptomatic OA of the hands.

Adult↗
PubMed1990

New tetracyclic guanidine derivatives with H1-antihistaminic properties. Chemistry of epinastine.

A series of new tetracyclic guanidines were synthesized by various methods. Specific binding of the described compounds to histamine-1 and histamine-2 receptors was determined. The compound 3-amino-9,13b-dihydro-1H-dibenz[c,flimidazo[1,5-a]azepine (epinastine, WAL 801, compound IIIa) combines high selectivity with high affinity for the H1 receptor and was selected from the compounds studied for further pharmacological and clinical investigations. Experimentally determined physicochemical parameters (pka-value, partition coefficient) and the hydrogen-bonding ability of epinastine are indications that this compound will not easily cross the blood-brain barrier. This explains the absence of CNS side-effects of epinastine in pharmacological and clinical studies.

Animals↗
PubMed1989

Cytostatic activity in vitro of some new cyclophosphazene oligomers.

Cytostatic activity of newly synthesized aziridinyl substituted cyclophosphazenes was tested in two in vitro systems. First, the compounds were tested by total cell protein inhibition test on human KB tumor cell line. Selected active compounds were tested in a clonogenic assay on murine L1210 leukemia cells. Out of 18 compounds tested, 12 were newly synthesized, 3 were their substrates and 4 were compounds with known cytostatic activity, used as a positive controls. Four of the newly synthesized compounds, designated with symbols: BANF-4Az, BBNF-4Az. T-oFDA-Az and W-10 revealed cytostatic activity for KB cells (ED50 = 3.4-19 micrograms/mL) and were tested in clonogenic assay. One of these compounds, namely T-oFDA-Az was subsequently selected for the further steps of screening for antitumor activity in animal tumor models.

Alkylating Agents↗
PubMed1988

Longitudinal study of electrometric sensitivity of young permanent incisors.

Electrometric sensitivity of permanent maxillary central incisors was studied longitudinally in 34 children at 6-month intervals over 2 1/2 yr (mean age of the children at the beginning of the study: 94.6 months). Root development stages were determined from radiographs obtained at the beginning of the study, after 1 yr, and after 2 1/2 yr. An increase in sensitivity was found over the study period, but large variations were found from child to child and even within the same child. Especially at the first examinations a few children showed very low sensitivity. Statistical analysis showed that examination number, root development and side of the mouth (right or left central incisor) all were statistically significantly related to sensitivity. Statistically significant differences were also found between the individuals.

Child↗
PubMed1986

Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association.

For the purposes of classification, it should be specified whether osteoarthritis (OA) of the knee is of unknown origin (idiopathic, primary) or is related to a known medical condition or event (secondary). Clinical criteria for the classification of idiopathic OA of the knee were developed through a multicenter study group. Comparison diagnoses included rheumatoid arthritis and other painful conditions of the knee, exclusive of referred or para-articular pain. Variables from the medical history, physical examination, laboratory tests, and radiographs were used to develop sets of criteria that serve different investigative purposes. In contrast to prior criteria, these proposed criteria utilize classification trees, or algorithms.

Adult↗
PubMed1986

Chromatographic and immunochemical characterization of neurotensin in cat adrenal gland and its release during splanchnic nerve stimulation.

A subpopulation of norepinephrine-containing cells in the cat adrenal medulla contain neurotensin (NT) immunoreactive material. Using high performance liquid chromatography (HPLC) and radioimmunoassay with region-specific antisera we have demonstrated that electrical stimulation of the splanchnic nerve releases NT and its metabolites NT(1-8) and NT(1-12) from cat adrenal gland into the circulation. Blood samples from anesthetized cats were simultaneously collected from the adrenolumbar vein and femoral artery over a 10-min period prior to and during splanchnic nerve stimulation. Trains of stimuli (15 Hz/10V) were applied at 30-s intervals over 10 min. Plasma samples were extracted, run on HPLC and column fractions assayed with C- und N-terminal directed antisera. During splanchnic nerve stimulation unchanged. Concomitant with the increase in NT was a two- to threefold increase in the levels of NT(1-8) and NT(1-12). The chromatographic profiles of extracted adrenal glands showed a major peak of immunoreactive material with the same retention time as NT (18.6 +/- 3.0 pmol/g weight wet of tissue) as well as a small peaks on NT(1-8) (0.96 +/- 0.18 pmol/g) and NT(1-12) (2.05 +/- 0.1 pmol/g). HPLC analysis of a tryptic digest of the NT-like material gave 1.0 equivalent of NT(1-8) and NT(9-13). These results are consistent with the presence of NT in adrenal tissue and its release and metabolism during stimulation of the splanchnic nerve.

Adrenal Glands↗
PubMed1986

Metabolic fate of [14C]-brotizolam in the rat, dog, monkey and man.

The metabolism of brotizolam (2-bromo-4-(2-chlorophenyl)-9-methyl-6H-thieno [3,2-f]-1,2,4-triazolo[4,3-a]-1,4-diazepine, We 941, Lendormin) was studied in the bile of the rat and in the urine of the dog, rhesus monkey and man using 14C-labeled substance. Concentration, fractionation and purification of the metabolites were performed using thin layer chromatography, column chromatography or high pressure liquid chromatography. Metabolites were structurally characterized by thin layer chromatography, high pressure liquid chromatography, mass spectrometry and nuclear magnetic resonance spectrometry using reference compounds. Hydroxylation at different sites of the brotizolam molecule and subsequent conjugation were the metabolic pathways preferred by far in the species studied. Unchanged brotizolam was excreted in minute amounts only, if at all. In man and monkey We 964 (brotizolam hydroxylated in the methyl group) and We 1061 (brotizolam hydroxylated in the diazepine ring) represented the main metabolites. In the rat, the main metabolites were We 1061 and a brotizolam hydroxylated in the phenyl ring. The main metabolites found in the dog were We 964 and We 1064, an isomeric compound of We 1061. Since We 1061 is irreversibly transformed in an alkaline medium to We 1064, the latter could be formed due to the clean-up processes. Thus, in the dog also We 1061 was probably the metabolite which was actually excreted renally. The proposed structures of minor metabolites are presented.

Animals↗
PubMed1984

[Asymmetrical synthesis of (R)(-) and (S)(+)-etilefrine by enantioselective hydrogenation and the effects of enantiomers in an animal experiment].

The enantiomers of etilefrine (Effortil) were produced by enantioselective hydrogenation. The optical purity was determined by conversion with (+)-[(R)-tetrahydrofurfuryl-(1S)-camphor-10-sulfonate] to N-[(R)-tetrahydrofurfuryl]-etilefrine and subsequent separation of the diastereomers by HPLC. An animal experiment showed that the (R)(-)-enantiomer is more effective.

Animals↗
PubMed1983

[Biotransformation of fentanyl. III. Effect of chronic drug exposure on the distribution, metabolism and excretion in the rat].

In male Wistar rats, tissue distribution and excretion of fentanyl and its metabolites were studied after intravenous of intramuscular injection. Oxidative desalkylation leading to phenylacetic acid and norfentanyl proved to be the main degradation pathway in-vivo, whereas other metabolites, including the pharmacologically still active p-hydroxy(phenethyl)fentanyl were formed only in minor quantities. All compounds could be detected in any tissue under study (brain, lung, liver, kidney, muscle and fat) as well as in the gastric contents, the amount of fentanyl in the latter cumulating to about 2% of the total dose 60 min after injection, compared with about 10% in the fat. In rats chronically treated with ethanol, nicotine, morphine, phenobarbital, promethazine or diazepam, major differences in in-vitro fentanyl metabolism by liver homogenates were observed including both inhibition and induction. Phenobarbital pretreatment also induced extrahepatic biotransformation in kidney, adrenals and intestinal mucosa. On the other hand, tissue concentrations of fentanyl and its metabolites did not clearly reflect the in-vitro changes in metabolic activity. Fentanyl brain levels were found to be lower in the treatment groups but seemed not to correlate with pharmacodynamics, less effects following injection being observed only after ethanol and morphine. The in-vitro metabolic drug interaction proved to be of less importance than changes in diuresis and/or urinary pH when excretion products were analysed. As a conclusion, it is suggested that altered sensitivity of brain tissue rather than changes in bioavailability must explain variations in dose-response relationship which are frequently believed to be seen when fentanyl is used in patients with chronic drug administration.

Animals↗
PubMed1976

The human leukocyte test system. IX. DNA synthesis and mitoses in PHA-stimulated 2-day cultures set up with Eagle's mimimal essential medium (MEM).

In human leukocyte cultures set up with Eagle's MEM and stimulated with Difco's PHA M, DNA synthesis and mitotic indices were analyzed by means of 3(H)-thymidine autoradiography and cell counting from 23 up to 52 h after culture initiation. Considerable amounts of DNA synthesis and mitoses were found in this time span. This resembles the results found with Ham's F-10 medium. However, the DNA synthesis pattern and the distribution of mitotic indices a higher yield of asynchrony in Eagle's MEM as compared with Ham's F-10 cultures. Proportions of first, second, and third mitoses at 72 h culture time were determined with different methods.

Culture Media↗