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Biomedical subjects

K Hess

Publications and source records attributed to K Hess.

At least 19 recordsLinked to original sources
PubMed1991

The effect of dietary vitamin K on warfarin-induced anticoagulation.

We examined the effect of vitamin-K-rich vegetables, vitamin-K-poor vegetables and phytomenadione on the stability of warfarin-induced anticoagulation. Patients on stable anticoagulant treatment were randomized to either 1 (n = 5), 2 (n = 7) or 7 (n = 13) d with high intake of vitamin-K-rich vegetables (median daily vitamin K intake 1100 micrograms) or high intake of vitamin-K-poor vegetables (daily vitamin K intake 135 micrograms) for 6 d (n = 7), or habitual diet supplemented with 1000 micrograms of phytomenadione daily (n = 5). Nine patients (69%; 95% CI, 39-91%) who consumed vitamin-K-rich vegetables for 7 d reached activities above the therapeutic level. Two (40%; 95% CI, 5-85%) and three patients (43%; 95% CI, 10-86%) who consumed vitamin-K-rich vegetables for 1 and 2 d, respectively, exceeded the upper therapeutic limit. No changes were observed in the vitamin-K-poor group. All patients who received phytomenadione exceeded the upper therapeutic limit. Dietary vitamin K should be regarded as an important environmental factor contributing to unwanted disturbances in warfarin-induced anticoagulation.

Adult↗
PubMed1991

[Narcolepsy and activity monitor].

By means of a wrist accelerometer, motor activity of 14 narcoleptic patients was continuously monitored. The accelerometer registered accelerations exceeding a threshold value of 0.1 gr and stored activity integrated over 3 minutes. After a registration period of 20 days, the data were read out, graphically displayed and compared to the patient's diary. Interruptions of night sleep and some sleep attacks during day correlated closely with the patient's diary. However, sleep attacks of less than about 5 minutes duration were not identified, because they could not be differentiated from normal rest. Except for that, activity monitoring with this accelerometer is a useful and simple method for ambulatory activity recording in narcoleptics.

Circadian Rhythm↗
PubMed1990

Natural history of radiation-induced brachial plexopathy compared with surgically treated patients.

Twelve patients who developed radiation-induced brachial plexopathy (RIBP) after receiving radiation therapy for breast carcinoma (7 patients) or Hodgkin's lymphoma (5 patients) were followed for 12 or more years, with a mean follow-up time of 20 years. Tingling and numbness of the fingers as well as weakness of the hand or arm were the most prominent presenting symptoms of RIBP. Whereas pain in most patients evolved only later in the course, it became a predominant feature in only 2. In 8 of the 12 patients, the plexopathy was surgically treated, either by neurolysis only or by neurolysis plus omental grafting in order to stop progression or paresis and/or pain. In 8 patients, including 6 of the operated group, there was slow and steady progression of RIBP over time, with the final outcome being almost complete paralysis of the arm (2 patients) or severe sensorimotor paresis rendering the hand useless (6 patients). In only 4 patients, including 2 of the non-operated group, was there absence of progression and stabilization of the paresis with only slight functional loss of the affected arm in 3 patients and severe palsy in 1. None of the 12 patients had any clear long-lasting improvement of their sensorimotor impairment. It is concluded from this study that RIBP, irrespective of surgery (neurolysis and/or omentum transplant), left two-thirds of the patients with severe or total paresis of the arm. However, the almost complete relief of severe pain (6 of 8 patients), both immediately and in follow-up patients treated with neurolysis and/or omental transplant, indicates that surgical treatment has a beneficial effect on pain relief.

Adult↗
PubMed1990

Adjusted hypervolemic hemodilution in acute ischemic stroke.

We prospectively randomized 47 patients with acute ischemic stroke of the middle cerebral artery of less than 24 hours' duration to either adjusted hypervolemic hemodilution or control treatment and followed them up for 90 days. Rapid hemodilution to a target hematocrit of 30-35% as monitored with bedside determinations was achieved by using infusions of dextran 40, venesections, and infusions of additional crystalloid solution when necessary. There was no difference in the death rate between the two treatment groups. Of these 47 patients, 37 (19 in the hemodilution group and 18 in the control group) could be followed up for the entire study period of 3 months. The relative improvement in neurologic function from day 1 to days 8, 21, and 90 was significantly better in the hemodilution group than in the control group. In accordance, special tests for fine motor control of the paretic arm disclosed better performance in the hemodilution group. The frequency of patients with severe disability was significantly lower in the hemodilution group on days 8 and 21. Plasma viscosity (measured in 11 patients) was not affected by infusions of dextran 40. Vigorous hypervolemic hemodilution in patients with acute ischemic stroke is well tolerated and improves early neurologic outcome with an effect lasting at least 3 months.

Aged↗
PubMed1989

[Dietary advice in hypercholesterolemia. Relation of selected dietary factors to total serum cholesterol and high density lipoprotein cholesterol].

Forty patients (14 women and 26 men) with slight to moderate hypercholesterolaemia received dietary advice and were followed-up for 12 weeks, the majority for 26 weeks. After 12 weeks, the total cholesterol had decreased by an average of 12% (from 7.92 to 6.97 mmol/l), the high density lipoprotein (HDL) cholesterol had increased by 5.3% (from 1.14 to 1.20 mmol/l) and thus the ratio of total cholesterol/HDL cholesterol had decreased by 17% (from 7.42 to 6.15). In the 35 patients who were followed-up for 26 weeks, the total cholesterol/HDL cholesterol decreased further (to 22% below the original value). HDL cholesterol was found by univariate regression analysis to be correlated significantly with the dietary content of the patients of fats (negative), polyunsaturated fatty acids (positive), sugar (negative), fibre (positive) and the total value (positive). Employing multivariate analysis with stepwise reduction, fats and fish sandwich spreads were found to be significantly correlated. The ratio of total cholesterol/HDL cholesterol by means of univariate analysis was found to be inversely correlated with the same dietary factors as HDL cholesterol while multivariate analysis revealed the content of polyunsaturated fatty acids, sugar and alcohol intake to be significantly correlated.

Adult↗
PubMed1989

Brain tumors: detection of B-cell stimulatory factor-2/interleukin-6 in the absence of oligoclonal bands of immunoglobulins.

24 patients with neoplasia of the central nervous system (CNS-N) were investigated for the presence of B-cell stimulatory factor-2/interleukin-6 (IL-6) in the cerebrospinal fluid (CSF). Whereas IL-6 was detected in 21 (88%) of these CSF samples, only 6% of CSF from non-inflammatory brain diseases and 12% of the samples from multiple sclerosis patients were positive. IL-6 was found in both primary and secondary CNS-N. The presence of IL-6, a cytokine which activates B-lymphocytes to produce high-rate immunoglobulin (Ig) synthesis, is in contrast to the ineffective intrathecal B-cell activation as suggested by the failure to detect oligoclonal bands of Igs in CNS-N.

Adolescent↗
PubMed1988

[Experimental conditions of a technic of in vitro transcription using placental nuclei].

To examine the expression of human placental lactogen, we investigated transcription in isolated placental nuclei. Using SH-agarose affinity chromatography, we have isolated Hg-RNA synthetized in vitro. These RNA are translated in a wheat germ cell-free system. hPL synthetized in vitro, accounting for 20% of total protein. This system should prove useful for the study of gene expression of hPL.

Female↗
PubMed1986

Stapedius reflex in multiple sclerosis.

The stapedius reflex (StR) was studied in humans by impedance audiometry. Ipsilateral and contralateral reflexes, obtained from 48 multiple sclerosis (MS) patients and 26 controls, were analysed. MS patients showed smaller reflex amplitudes, longer onset latencies and higher contralateral reflex thresholds. Using onset latencies, 33% of all MS patients had at least two abnormal ipsi- and/or contralateral StRs. If the diagnosis was MS of the definite type, this figure was 39%. The StR is therefore a useful tool for detecting a subclinical lesion in the brainstem and can contribute to the early diagnosis of MS.

Acoustic Impedance Tests↗
PubMed1985

Effects of BAY l 5240, a fixed combination of low dose nifedipine and acebutolol on hypertension: comparison with standard dose nifedipine.

116 patients from 4 clinics participated in a double blind study to assess the efficacy of (BAY l 5240), a nifedipine-acebutolol fixed combination (10 mg + 100 mg), as compared to nifedipine 20 mg in essential hypertension. During the 10 week study, the mean recumbent blood pressure decreased 1 to 3 h after treatment from 175.5/105.2 to 148.3/88.0 mmHg in the BAY l 5240 group and from 174.3/102.9 to 150.3/86.5 mmHg in the nifedipine group. The results also showed a comparable decrease in the mean systolic (SBP) and diastolic (DBP) blood pressures before treatment (24 h after last tablet) and after physical exertion before and after either drug given for 4 weeks. Doubling of the dose for 4 additional weeks produced a moderate and similar additional decrease in blood pressure. The results show the possibility of treating essential hypertension with a low dose of a beta-adrenergic blocking agent in combination with 10 mg nifedipine. Both regimens were well tolerated. One patient in the BAY l 5240 group and 2 in the nifedipine group, all treated by the same investigator, were withdrawn from the study because of headache during the nifedipine pre-period.

Acebutolol↗
PubMed1985

Rotational testing in patients with bilateral peripheral vestibular disease.

We performed quantitative low and high frequency rotational testing in 17 patients with bilateral peripheral vestibular deficits. A characteristic pattern of decreased gain and increased phase lead at low frequencies of sinusoidal stimulation and decreased time constant to impulsive stimulation was observed in most patients. The results of caloric testing correlated with the results of low frequency rotational testing but not with the results of high frequency testing. Only 2 patients complained of oscillopsia at the time of testing and both of these had decreased vestibulo-ocular reflex gain at low and high frequencies of sinusoidal rotation.

Adult↗
PubMed1979

Acute ischaemic neuropathy in the rabbit.

Ligation of either the common and internal iliac or the internal and external iliac arteries produced ischaemic lesions of the sciatic nerve and its branches, as well as direct muscle damage, in 5 out of 6 rabbits. In one animal, ligation of the aorta and of the internal iliac artery on one side produced a similar mixture of nerve and muscle damage on the side of the double ligation. Ligation of the femoral artery alone in 3 animals failed to produce significant changes. In the 6 affected animals there was paralysis of the hind leg on the side of the iliac ligations, with loss of tendon reflexes. Appreciation of pinprick over the foot and lower leg also appeared to be impaired. Complete ischaemic necrosis with irreversible damage to both neural and connective tissue elements did not occur in the main nerve trunks, but was present in some of the intramuscular nerve bundles as part of generalized coagulative necrosis of the most severely affected muscles. The characteristic pathological changes in the nerve fibres of the main nerve trunks were Wallerin degeneration and paranodal demyelination, the former being more extensive than the latter. In the animals with double iliac ligations, the upper level of ischaemic nerve damage was in the thigh, the tibial portion of the sciatic nerve being more commonly affected than the peroneal. Nerve and muscle damage tended to occur at different levels in the limb, but there was no example of clinical paresis due to neural damage without any ischaemic muscle changes being present. In two of the 3 animals in which the plantar muscles were examined, these muscles appeared to escape direct damage in spite of ischaemic lesions in the more proximal parts of the limb.

Acute Disease↗
PubMed1979

Stapedius reflex in multiple sclerosis.

An analysis was carried out of recordings of the crossed stapedial reflex response in a series of normal subjects and 30 patients with multiple sclerosis. Parameters measured included latency, contraction time, amplitude, and relaxation time. Criteria derived from the normal group and applied to the multiple sclerosis group showed clear evidence of abnormality in 10 patients. This can be attributed to lesions in the pathways of the second and third order neurones in the trapezoid body and superior olivary complex. Present evidence suggests that further refinements in the measurement technique might significantly increase the detection rate of abnormalities in multiple sclerosis.

Adolescent↗
PubMed1979

Angiographic results in interstitial, vascular and glomerular kidney diseases.

In earlier stages of parenchymal kidney diseases different changes are to be seen in angiography. No single sign appeared to be pathognomonic for glomerular nephritis, vascular disease or interstitial nephropathy. But the disproportionate frequency of some angiographic features assumed discriminatory value. Morphometry of the renal arteriograms discriminated statistically significant interstitial, vascular and glomerular diseases. The correct angiographical diagnosis was made in 76%.

Angiography↗
PubMed1978

Clinical and theoretical aspects of head movement dependent oscillopsia (HMDO). A review.

Head movement-dependent oscillopsia (HMDO) with peripheral vestibular, brainstem and cerebellar lesions is reviewed. The differentiation of this kind of oscillopsia is based mainly on clinical grounds. HMDO with bilateral abolition of caloric responses, and in the absence of disease of the central nervous system, is due to bilateral vestibular disease. HMDO in patients with internuclear ophthalmoplegia and other brainstem signs is probably due to a lesion of VOR pathways in or near the medial longitudinal fasciculus. The occurrence of HMDO with ataxia of gait and cerebellar eye movement disorders (rebound nystagmus, flutter-like oscillations), in the absence of brainstem lesions (medial longitudinal fasciculus), is clinical evidence for HMDO due to a cerebellar lesion. An attempt is made to associate the different kinds of oscillopsia with current knowledge of the vestibulo-ocular reflexes.

Animals↗