Biomedical subjects
Publications and source records attributed to M Fuhrmann.
Severe competition for the limited investment capital available and the high acquisition cost of bedside terminal systems require that the full benefit potential they offer be identified and realized. The authors discuss a multiple-phase study process used to: 1) identify the savings potential offered (to cost-justify its acquisition); and 2) assure the savings potential offered was realized.
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Cell marker analysis with monoclonal antibodies (MoAb) as well as differentiation studies with the chemical inducer TPA were used to identify a population of apparently lymphoid cells as monocytic precursor cells in a patient with acute leukemia. The initial manifestation of the disease with mediastinal mass and lymphadenopathy was followed by the appearance of small lymphocyte-like blast cells in bone marrow (BM) and peripheral blood (PB). Although a lymph node biopsy revealed an infiltration with monoblasts, the leukemic cells in BM and PB were not classifiable. However, when the patient relapsed after chemotherapy with large monoblasts and again with morphologically lymphoid blast cells, the latter could be classified by treatment with TPA. After incubation with the inducer (12-48 hr) the cells became positive with the MoAB VIM-D5, showed a strong reaction with alpha-naphthyl-acetate-esterase and developed macrophage like morphology, as well as phagocytic properties. During the terminal phase of the disease, small, lymphocyte-like blast cells predominated. These cells could be classified by a panel of MoABs. They expressed myeloid determinants (VIM-D5, VIM-2, MY 9, VIM-12, VIM-13) but showed no reactivity with MoABs specific for lymphocytic cells.
A 12.1-kilobase PstI fragment from Rhizobium japonicum, which contains homology to both the Klebsiella pneumoniae and the Rhizobium meliloti nifH genes, was cloned into vector pHE3 . The nifH -homologous region was localized on the restriction enzyme cleavage map by Southern blot hybridization experiments. DNA fragments overlapping the R. japonicum nifH gene were subcloned into plasmid vectors to allow the expression of this region in Escherichia coli minicells. The nifH gene product (the polypeptide of the nitrogenase Fe protein) was thus found to have a molecular weight of 33,000. The complete nucleotide sequence of the nifH gene was established, and the amino acid sequence of its gene product was deduced. The reading frame is 882 nucleotides long, corresponding to 294 amino acids which add up to a polypeptide with a molecular weight of 31,525. There was extensive sequence homology with nifH genes or gene products from other nitrogen-fixing bacteria. The transcription initiation site of the R. japonicum nifH gene was found to lie 153 nucleotides upstream from the coding region and was preceded by a characteristic promoter sequence. A potential terminator region was located 13 nucleotides downstream from the coding region.
Various immunological parameters were determined in 46 patients with severe hemophilia A and in 9 patients with severe hemophilia B. All patients were treated over many years with commercial factor VIII or IX concentrates. Patients with severe classic hemophilia had a significantly reduced relative and absolute number of T-helper cells and a significantly increased relative and absolute number of T-suppressor cells. About half of these patients had an inverse T-helper/suppressor cell ratio. Patients with moderate hemophilia A and severe hemophilia B did not show these abnormalities. Hemophiliacs with an inverse ratio had a significantly higher concentration of serum total protein, IgG and IgM. No relationship between the amount of factor VIII concentrate administered, the HLA-type of the patient, the presence or absence of CMV-antibodies, hepatitis markers, thrombocytopenia and abnormal liver function tests to the T-cell abnormalities could be established. Lymphadenopathy was frequently associated with an inverse ratio. Indirect evidence suggests that the alterations of the immune system began in 1979/80.
From 1975 to 1982, the Austrian Poison Information Centre gave medical advice in forty cases of acute melitracenee-flupenthixol poisoning. The case reports were reviewed and analysed in retrospect. 13 patients who either had ingested less than 20 pills (n = 5) or who underwent early gastric lavage (n = 8) showed no symptoms. In 19 patients who had swallowed 20 to 60 (n = 11), 60 to 100 (n = 3) pills respectively, or an unknown dose (n = 5) atropine like symptoms predominated. Five patients developed atropine like and extrapyramidal symptoms. The number of pills taken by these patients ranged from 20 to 60 (n = 4) and in one up to 100. Extrapyramidal reactions were encountered as predominant symptoms in three patients one of which had taken 20, the other 60 and the third an unknown number of pills. Additionally, five patients were unconscious. 21 patients developed ECG changes, 19 of which showing sinus tachycardia. The remaining two patients who had ingested 600 to 1000 mg melitracen atrial premature beats or T-wave inversions were observed. All 40 patients recovered.
A total of 18 cases of Amanita phalloides poisoning was treated by combined chemotherapy during 1980 and 1981. After attempted primary elimination of the toxin all patients received silybin as basic therapy mainly by infusion and, in two instances, silymarin orally. In order to investigate the effect of silybin therapy a retrospective study of the followed-up case records was made. The cases were arbitrarily classified into three groups of severity (light, medium and severe) according to clinical and laboratory findings. A close relationship was found between the severity of the intoxication and the time elapsed before commencement of silybin therapy. The time interval between mushroom intake and the commencement of the silybin administration averaged 71.5 hours in the "severe" group compared with 46 and 33.8 hours, respectively, in the "medium" and "light" groups. The mean silybin dosage was 33 mg/kg body weight/day; the mean duration of silybin therapy was 81.6 hours. With the exception of one fatality in a particularly high dosage suicidal intoxication, all patients survived. Administration of silybin within about 48 hours after mushroom intake seems to be an effective measure to prevent severe liver damage in Amanita phalloides poisoning.
The acute effects of intravenous injection of cimetidine and pirenzepine on plasma iPTH and CT were studied in seven patients on chronic haemodialysis and seven healthy controls. As expected, the resting iPTH and CT levels were significantly higher in patients on RDT than in the healthy subjects. Both drugs decreased to a similar extent the increased plasma iPTH in the patients, but neither was able entirely to normalize the elevated level. The CT concentration in the patients on haemodialysis was significantly decreased by cimetidine but was only moderately reduced by pirenzepine. As neither drug was able to normalize the elevated PTH level in patients on chronic dialysis, it can be assumed that neither used alone would improve signs and symptoms of secondary hyperparathyroidism.
In contrast to Klebsiella pneumoniae or fast-growing Rhizobium species, such as R. meliloti, where the nitrogenase structural genes are clustered in one operon (nifHDK), in slow-growing Rhizobium japonicum 110, nifH and nifDK are on separate operons.
1 A total of 18 cases of Amanita phalloides intoxication was treated by combined chemotherapy during 1980 and 1981. After attempted primary elimination of the toxin all patients received silibinin as basic therapy mainly by infusion and in two instances orally. 2 In order to evaluate the effect of silibinin therapy a retrospective study of the followed-up case records was made. The cases were arbitrarily classified into three groups according to the severity of liver damage (light, medium and severe). 3 There was found a close relationship between the severity of liver injury and the delay between mushroom ingestion and the onset of silibinin therapy. With the exception of one fatality in a particularly high dosage suicidal intoxication, all patients survived. 4 Administration of silibrinin even up to 48 h after mushroom ingestion appears to be an effective measure to prevent severe liver damage in Amanita phalloides poisoning. Contrarily, the onset of general supportive treatment together with penicillin therapy which was throughout several hours before silibinin administration did not correlate with the severity of liver damage.
Over the past 8 years the Poison Information Centre of Vienna was confronted 24 times with acute chlorproxithene (CPTX) poisoning. In adults doses of 2 g and more caused severe intoxication, but serious toxic manifestations were observed already at low dosage in children (after the ingestion of less than 5 mg/kg body weight). In one case unexpected death due to cardiac failure occurred as long as 49 hours after CPTX intake. The favorable outcome in one patient treated with gut, as well as gastric lavage indicates that this therapeutic strategy may be of value in the management of CPTX intoxication.
Long-term administration of cimetidine, a histamine2 receptor antagonist, has been reported to normalize elevated parathyroid hormone (PTH) concentrations in patients with secondary [1] and primary hyperparathyroidism [2] and even to improve the clinical symptoms. We have compared the effect of cimetidine and pirenzepine on PTH and calcitonin (CT) plasma levels in a short-term trial on patients with secondary hyperparathyroidism. After cimetidine a significant effect on PTH was seen within 30 min lasting 30 min and after pirenzepine, within 60 min and lasting 60 min. The effect on CT was only significant after cimetidine.
The organization of treatment for patients with malignant intraocular tumors is described with reference to the oncology department of an eye clinic specializing in tumor problems. Since eye tumors are seldom encountered in day-to-day ophthalmological practice, and the costs of diagnosis and treatment are so high, centralized treatment facilities are advocated.
Accidental ingestion by children of NaF tablets for caries prophylaxis is a frequent event. However, our own experience from the Poison Information Centre in Vienna and reports from other centers show that these accidents usually do not present a serious risk. The mechanism of fluoride toxicity and symptoms of poisoning are briefly reviewed. The case of a boy who died after ingesting 16 mg fluoride/kg, but whose cause of death is not certain beyond doubt, is discussed.
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The purpose of this study is to quantify some of the parameters needed to perform near-field modelling of sites in the Kara Sea that were impacted by the disposal of radioactive waste. The parameters of interest are: the distribution coefficients (Kd) for several important radionuclides, the mineralogy of the sediment, and the relationship of Kd to liquid-to-solid ratio. Sediment from the Kara Sea (location: 73 degrees 00'N, 58 degrees 00'E) was sampled from a depth of 287 m on August 23/24, 1992. Analysis of the material included mineralogy, grain size and total organic carbon (TOC). Uptake kinetics were determined for 85Sr, 137Cs, 241Am, 99Tc, 1251, 232U and 210Pb and distribution coefficients (Kd) were determined for these radionuclides using batch type experiments. Sorption isotherms, developed for 137Cs, 85Sr and 99Tc, were linear in each case. Increasing the liquid-to-solid ratio strongly increased uptake of 137Cs and moderately increased uptake of 99Tc. Analysis for anthropogenic radionuclides indicated the presence only of 239/240Pu in the sediment with the highest activity (at the top section of the core) being 0.420 Bq kg(-1). Other anthropogenic radionuclides were below detection limits.
As hospital length of stay has decreased and patient acuity has increased, the nurse is confronted daily with the challenge of managing time between patient care and documentation. Documentation of care has consistently been a time-consuming and frustrating part of nursing practice. The nursing shortage has only compounded this problem. St. Joseph's Hospital has creatively begun to facilitate documentation by developing a Nursing Automated Documentation System (NADS) in collaboration with CliniCom, Inc. of Boulder, Colorado. This article documents the development and implementation of the system.