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Biomedical subjects

M Hohmann

Publications and source records attributed to M Hohmann.

At least 19 recordsLinked to original sources
PubMed2001

Osteoporosis in patients with paralysis after spinal cord injury. A cross sectional study in 46 male patients with dual-energy X-ray absorptiometry.

In a cross-sectional study, 46 male patients with paralysis after spinal cord injury (average age 32 years; injuries sustained from 1 to 26 years ago; 33 Frankel A, 13 Frankel B, C, D) were examined clinically and by dual-energy X-ray absorptiometry (DEXA). Their bone mineral density (BMD) values were compared with age-related controls and correlated to clinical parameters. BMD was reduced in the proximal femur (p < 0.05) and the distal forearm (p < 0.05), but not in the lumbar spine. Demineralisation was influenced in the proximal femur (Z-score -2.95) by immobilisation after surgical treatment. Patients suffering from complete lesions had significantly lower BMD in the lumbar spine (-1.47) compared with patients with incomplete lesions (+0.02). BMD was not significantly influenced by the level of the lesion and the ambulatory status. Long-term monitoring showed significant demineralisation in the proximal femur (r = -0.36) and the distal forearm (r = -0.4), but not in the lumbar spine (r = -0.21). By correlating BMD with clinical parameters, it can be deduced that, firstly, immobilisation after surgical treatment should be reduced to a minimum; secondly, that every effort must be expended to prevent turning an incomplete into a complete lesion; and finally, that rehabilitation treatment should be lifelong.

Absorptiometry, Photon↗
PubMed1998

[Gameprost, sulproston and dinoproston for induced abortion in the 15th-24th week of pregnancy].

In a randomized, prospective study at the Dept. of Obstetrics and Gynecology of the University Hospital of Giessen 4 different ways of inducing abortions with prostaglandins were tested between the 15th and 24th week of gestation. The aim of the study was to determine the best approach to inducing abortion in order to minimize the psychological and physical stress to the patient. Subjects randomized to the first two groups got a single cervical installation of either 0.5 mg Dinoprostongel (Prepidil, N = 22) or 0.5 mg Sulprostongel (Nalador, N = 21). Six hours later, i.v. infusion with Sulproston (8.3 micrograms/min) was started and continued until the abortion was complete. Patients randomized to the third and fourth group received either 0.5 mg Dinoprostongel intracervically (N = 15) or 1 mg Gemeprost vaginal suppositories (Cergem, N = 21) every 6 hours until the cervix was 1-2 cm dilated. Subsequently the patients received an i.v. infusion with Sulproston until the abortion was complete. In the first group with intracervical application of Sulproston the total time until abortion was 17.8 h +/- 7.8 h. This was shorter than following a single application of Dinoprostongel (22.5 h +/- 14.7 h). Although there was a five hours difference, the between-group differences were not statistically different because of a wide range in values following Dinoproston treatment. This range could not be explained by the age of the mother, week of gestation or parity. In the group receiving multiple intracervical applications of Dinoproston the time till expulsion was twice as long as that after multiple vaginal suppositories of Gemeprost (33.8 h +/- 13.9 h vs. 15.6 +/- 6.0 h, p < 0.01). The time span until a cervical dilatation of 1-2 cm was 27.0 h +/- 13.7 h in the group with repeated Dinoproston application. This period of time was more than twice the time span seen in the group with repeated Gemeprost application (12.5 h +/- 4.2 h, p < 0.01). On the average four treatments with intracervical Dinoprostongel were required while the average with Gemeprost vaginal suppositories was two to achieve a cervical dilatation of 1-2 cm. Furthermore in 7 of 21 cases treatment with Gemeprost achieved the expulsion of the fetus without Sulproston infusion (11.4 h +/- 5.2 h). Comparing single versus repetitive prostaglandin application we could demonstrate that the duration of Sulproston infusion was cut in half after repeated therapy with Gemeprost. We conclude that repetitive application of Gemeprost vaginal suppositories decreases the time to abortion and subject discomfort tremendously. The application of Gemeprost suppositories provides the easiest and most efficient therapeutic approach for both patients and staff. Furthermore the regiment that provided the best results was also the most cost-effective (range 180,-DM to 317,- DM per case).

Abortifacient Agents, Nonsteroidal↗
PubMed1997

Neonatal morbidity and mortality associated with maternal haemolysis elevated liver enzymes and low platelets syndrome.

UNLABELLED: To compare the impact of maternal haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, uncomplicated hypertension in pregnancy (HIP), and no hypertension (controls) on neonatal morbidity and mortality, 108 infants were matched with respect to gestational age, date of birth, and gender. The HELLP group infants had more grade 3 and 4 respiratory distress syndromes (36%) than the HIP group (19%) or controls (11%). Cardiovascular instability (arterial hypotension, volume resuscitation) was significantly more common in HELLP neonates (20% and 31%) than in HIP infants (9% and 6%) or controls (3% and 9%). Both, HELLP and HIP infants showed a higher incidence of growth retardation than the controls. After 32 weeks of gestation the incidence of severe neonatal morbidity was not different. CONCLUSION: : Before 32 weeks of gestation both respiratory and cardiovascular morbidity and intra-uterine growth retardation associated with HIP is further aggravated by a maternal HELLP syndrome.

Adult↗
PubMed1996

Age and reproductive status affect basal venous tone in the rat.

OBJECTIVE: Changes in venous tone alter vessel diameter and capacitance of veins. These alterations may be induced by the steroid hormonal milieu. Therefore, our question was whether venous tone differs between estrous cycle, pregnancy and old rats. STUDY DESIGN: Mesenteric veins from young, pregnant and old Sprague-Dawley rats were dissected and cannulated in a venograph system with a continous readout of pressure-dependent lumen diameter. RESULTS: During estrous cycle venous tone was increased in metestrous (P < 0.05), whereas it was decreased in all old rats (P < 0.05). There was higher venous tone in pregnant animals compared to controls (P < 0.05). CONCLUSIONS: Venous tone exhibits marked differences during rat estrous cycle. It is increased during pregnancy and decreased in old rats.

Aging↗
PubMed1996

[Prof. Dr. Richard Völker and the School for Veterinary Medicine Technical Assistants in Hannover].

The first assistant professions in medicine technical field were established in the last third of the 19th century. Basic units primarily were private institutions which aimed to set up training facilities and money-making opportunities for unmarried women of the middle and upper classes. In correlation with the progress in microbiology and X-ray technics from about 1900 in veterinary medicine the demand for technical assistants raised up too. Since 1929 in some institutes and clinics of the Hannover Veterinary School unpaid trainees were instructed. Accordingly to this the "School for the Training of Technical Assistants in Veterinary Institutes" was founded on the initiative and under control of Richard Völker in summer 1937. In this paper a preliminary report is given which deals with the main aspects of the development of the profession, the school's foundation history and the special role of its founder Völker. A doctoral thesis to this subject is submitted to the veterinary authorities.

Animal Technicians↗
PubMed1993

Causal attributions in psychiatric patients.

An instrument for a systematic assessment of attributions that psychiatric patients have about their disorder is presented together with some preliminary results, for example on differences between sex and diagnostic groups. The comparison with a sample of (mostly untreated) students demonstrates that causal attributions in psychiatric patients should be assessed with specifically designed instruments. The presented scale may help to investigate longitudinally the course of causal attributions during treatment.

Adult↗
PubMed1993

[Intrapartum CTG].

Explore the source record for details and available documents.

Acid-Base Equilibrium↗
PubMed1992

Dihydroergotamine causes fetal growth retardation in guinea pigs.

Dihydroergotamine is a vasoactive drug which enhances venous tone, central blood volume and cardiac output but has variable effects on arterial tone. Its effect on the uterine arterial circulation is unstudied and yet dihydroergotamine is widely used to treat postural hypotension in pregnant and nonpregnant women. For this reason we undertook studies to determine if its chronic use had any adverse effect on the placental arterial circulation and fetal growth in an animal model. We administered dihydroergotamine (14 micrograms/kg/day) to pregnant guinea pigs with 2-4 fetuses from day 30-60 of pregnancy. At term under light ketamine anaesthesia, we measured maternal arterial blood pressure and blood flow to myometrium, placenta, skin and skeletal muscle using left ventricular injection and standard sampling techniques. Vascular resistance was calculated from arterial blood pressure and blood flow. When controlled for litter size, both fetal weight and the fetal weight/placental weight ratio were significantly less (P less than 0.001) in the dihydroergotamine group (-21% and -11% respectively). Placental blood flow was decreased by 51% (P less than 0.01) whereas myometrial blood flow, skin blood flow and muscle blood flow were not significantly altered. There was no significant difference in mean arterial blood pressure but placental vascular resistance was increased (+45%, P less than 0.05) while it was unchanged in myometrium and skin and decreased in skeletal muscle (-51%, P less than 0.05). Chronic administration of dihydroergotamine at a clinical dosage level has a constrictive effect on the placental vasculature of guinea pigs with a subsequent adverse effect on flow and fetal growth.

Abnormalities, Drug-Induced↗
PubMed1991

Orthostatic hypotension and birthweight.

This study was designed to test two hypotheses. First, that the changes in arterial blood pressure, induced by a transition from a lying to a standing position, are different in early and late pregnancy. Second, that birthweight is related to the change in mean arterial blood pressure in late pregnancy such that those patients whose pressure fell on standing should have the lightest babies. Fifty-three patients were studied between the 12th to 18th week, and 41 women were between the 34th to 40th week of an accurately dated, clinically normal, singleton pregnancy. Twelve nulliparous females served as controls. Blood pressure and heart rate were measured at rest, then in the standing position and finally at rest again with a Dinamap blood pressure measuring device. The variability in the pressor response to standing was approximately three times and in heart rate response two times greater in early pregnancy and in late pregnancy, when compared to the nonpregnant controls. It should be further noted that only in late pregnancy did the heart rate fall in 10 out of 41 women on standing. A linear relationship was observed in late pregnancy between the change in mean arterial blood pressure and birthweight (r = 0.57, P less than 0.001). This linear relationship was improved to r = 0.86, when only those women (16/41), who either had a rise or fall in systolic blood pressure of more than 5 mm Hg were included. These data indicate that pregnancy increases the variability in the pressor response to standing. Moreover, birthweight was directly related to the magnitude and direction of the pressor response in late pregnancy. Finally, this relationship suggests an additional cause for unexplained cases of intrauterine growth retardation.

Adult↗
PubMed1990

[Maternal cardiovascular adaptation in pregnancy].

Maternal cardiovascular adaptations during pregnancy, such as cardiac output, blood volume, hormones, water and electrolyte balance, arterial blood pressure, vascular resistance, uterine blood flow amongst others ensure the well-being of the mother and of the fetus. Several of these changes are not yet well understood. This report reviews the factual changes in cardiovascular physiology during pregnancy. Methodological experimental problems are identified and their relationship to the interpretation of the data discussed. Open scientific questions are identified and the experimental designs necessary to answer them are discussed. The possible mechanisms which are responsible for these changes are addressed. Special attention is given to arterial blood pressure during pregnancy as the regulated variable. It is shown how cardiovascular parameters are involved in the regulation of blood pressure and the signals, which trigger these changes. The effects of the vasoactive agents, angiotensin II and catecholamines, on the circulation during pregnancy are reviewed. Alterations of baroreceptor function are discussed for this time period. Further investigations should assess venous function during pregnancy to elucidate mechanisms by which such maternal adaptations occur.

Animals↗
PubMed1990

Norepinephrine sensitivity of mesenteric veins in pregnant rats.

This study was designed to test the hypothesis that during the course of pregnancy there is a decrease in the venous response to adrenergic stimulation that is characterized by a decrease in venoconstriction to both exogenous norepinephrine (NE) and to transmural electric stimulation of endogenous sympathetic nerves. Capacitance-size mesenteric veins were removed from nonpregnant and early- (7/8 day) and late-pregnant (18/19 and 20/21 day) Sprague-Dawley rats and studied in vitro under pressurized conditions. Lumen diameter was measured continuously by a video-electronic method. There was a marked increase in the sensitivity of the veins to exogenous NE stimulation at the end of pregnancy, which was most dramatic at a transmural pressure of 6 compared with 2 mmHg. The increase in exogenous NE sensitivity was associated with a progressive decline in the response to transmural nerve stimulation during pregnancy. Cocaine, an inhibitor of neuronal uptake, resulted in a greater potentiation of the response to transmural nerve stimulation in the pregnant rats compared to controls, suggesting an increased reuptake mechanism during pregnancy. Additional studies in the pseudopregnant, lactating, and nonlactating rat suggested that the conceptus was necessary for the alterations in neural response but not for the increase in exogenous NE sensitivity. In conclusion there is a dramatic change in venous function during pregnancy in the rat that is characterized by a difference between endogenous and exogenous NE sensitivity. The fact that transmural pressure can profoundly affect exogenous NE sensitivity suggests that pregnancy-induced changes in venous volume could contribute to changes in venous reactivity.

Animals↗
PubMed1989

Etilefrine and amezinium reduce uterine blood flow of pregnant guinea pigs.

Etilefrine and Amezinium are used during pregnancy to prevent hypotension and fetal growth retardation. The effect of these drugs on uterine blood flow (UBF), uterine vascular resistance (UVR) and fetal growth are, however, unknown. 31 guinea pigs were injected daily with Etilefrine (3 X 0.14 mg/kg) and Amezinium (0.14 mg/kg) from day 30 to day 60. Uterine blood flow was measured with radioactive-labeled microspheres. Uterine vascular resistance was calculated from arterial blood pressure and uterine blood flow. 10 guinea pigs treated with 0.9% sodium chloride served as controls. As a response to Etilefrine and Amezinium, UBF fell by 68 and 48%, respectively, accompanied by an increase in UVR. The fetal weight decreased only slightly. It is concluded that long-term application of anti-hypotensive drugs may be hazardous to uterine blood flow and fetal growth.

Animals↗
PubMed1989

[Maternal and neonatal bupivacaine plasma levels in peridural anesthesia for relief of labor pain].

Peripheral venous blood samples were drawn for bupivacaine analyses (gas chromatography) from 24 patients under epidural anaesthesia, used to reduce pain caused by contractions. The specimens were taken 10, 20, 30 and up to 45 minutes following a first injection of 11 to 13 ml bupivacaine 0.25%, before, 15 as well as 30 minutes after each repetitive dose and at childbirth. Immediately after cord clamping, blood sampling in the neonate was performed to evaluate bupivacaine concentrations in the umbilical artery and vein. Additionally, apgar scores and blood gas parameters were checked and compared with those of neonates, born without analgesic treatment of their mothers. Using bupivacaine 0.25% (average 12 ml) for epidural anaesthesia, the peak plasma levels (mean = 0.2 micrograms/ml) were found 10 minutes after application of the analgesic dose. In one patient a maximum bupivacaine plasma concentration (0.47 micrograms/ml) was determined 15 minutes after the second repetitive dose of 5 ml bupivacaine 0.25%. Apgar scores and results of blood gas analyses demonstrated no significant difference between neonates born spontaneously under regional anaesthesia or without any analgesic treatment of their mothers, respectively. Using bupivacaine 0.25% in epidural anaesthesia for pain relief in labour, we found maternal and neonatal plasma concentrations of the local anaesthetic drug far below the accepted threshold level which might produce systemic toxic reactions.

Adolescent↗