PubMed Health⌕ Search

Biomedical subjects

M Schürmann

Publications and source records attributed to M Schürmann.

At least 19 recordsLinked to original sources
PubMed2002

Effectiveness of twice-weekly pyrimethamine-sulfadoxine as primary prophylaxis of Pneumocystis carinii pneumonia and toxoplasmic encephalitis in patients with advanced HIV infection.

The safety and efficacy of a fixed 25 mg pyrimethamine-500 mg sulfadoxine combination supplemented with 15 mg folinic acid twice a week as primary prophylaxis of Pneumocystis carinii pneumonia (PCP) and toxoplasmic encephalitis was evaluated in 106 patients infected with the human immunodeficiency virus. All patients had a CD4+ T-lymphocyte count of less than 100 cells/microl at study entry. Efficacy in this single-arm open-label prospective study was analyzed on an as-treated basis. No patient received highly active antiretroviral treatment, including protease inhibitors or non-nucleoside reverse transcriptase inhibitors, while on study medication. PCP developed in four patients, one of whom had been noncompliant. No PCP episode occurred in the first year. Probabilities of freedom from PCP were 0.97 (95%CI, 0.92-1) after 24 months and 0.93 (95%CI, 0.84-1) after 36 months. Of 74 (69.8%) patients positive for anti-toxoplasma IgG antibodies, one noncompliant patient developed toxoplasmic encephalitis after 24 months. Allergic reactions were observed in 18 (17%) patients and resulted in permanent discontinuation in 7 (6.6%) patients. One (0.9%) patient who had continued prophylaxis despite progressive hypersensitivity reactions developed a serious adverse reaction (Stevens-Johnson syndrome). The median survival of study participants was 29 months, with relentless progression of AIDS accounting for most deaths. The prophylaxis regimen studied appeared safe and effective for primary prophylaxis of PCP and toxoplasmic encephalitis. Severe adverse events can likely be prevented by discontinuation of prophylaxis at the time allergic reactions are noted. Rechallenge frequently results in tolerance. Efficacy and safety compare favorably with previously studied regimens. This simple prophylactic regimen may provide a convenient alternative for patients failing or intolerant to approved regimens.

AIDS-Related Opportunistic Infections↗
PubMed2002

Long-term results after posterior fixation of thoraco-lumbar burst fractures.

Current concepts of treating thoraco-lumbar burst-compression injuries are based on posterior transpedicular fixation techniques which are angular stable. However, the long-term results of this approach are controversial due to inconsistent reports and due to a paucity of data on late outcome. In the present study we analyzed 50 patients retrospectively who had an unstable burst-compression injury at T 11-L 2 (type A 3 according to Magerl) without a neurological deficit. All fractures were stabilized by an internal fixator either with or without transpedicular spongiosa grafting. Patients were treated between 1991 and 1997. Follow-up times ranged from 36 to 103 months. Follow-up examinations collected occupational, subjective and clinical data (activity score, Hannover spine score) and included radiographic measurements. The latter were used to calculate the sagittal index (SI) which measures deformities of the fractured vertebral body, and the sagittal plane kyphosis (SPK) which additionally describes an eventual destruction of the affected intervertebral disc. Compared with the preinjury status, the percentage of subjects who were able to do physical labor was reduced by half at follow-up, and four times as many patients had a permanent disability. Correspondingly, activity scores and Hannover spine scores declined significantly. After the initial surgical correction SI remained stable until follow-up, whereas SPK decreased again towards pre-operative values indicating a progressive deformity of the intervertebral disc space. Clinical results did not correlate with radiographic results, and neither the time until follow-up nor the type of fracture n or the use of transpedicular bone grafting affected clinical or radiographic results significantly.

Adult↗
PubMed2002

No linkage of the interleukin-4 receptor locus on chromosome 16p11.2-12.1 with sarcoidosis in German multiplex families.

We typed 241 members of 62 sarcoidosis families with 136 affected siblings for three single nucleotide polymorphisms of the interleukin-4 receptor alpha-chain gene (IL4R). Allele frequencies in patients were compared to those of healthy unrelated control individuals. The segregation of the three-point IL4R haplotypes completed by two flanking highly polymorphic microsatellite polymorphisms revealed no evidence for linkage of the IL4R gene locus with sarcoidosis.

Chromosome Mapping↗
PubMed2001

Stronger reactivity of the human primary motor cortex during observation of live rather than video motor acts.

The monkey premotor cortex contains neurons that are activated both when the monkey performs motor acts and when he observes actions made by others. A similar mirror neuron system, involving several brain areas, has been found in humans. We recorded neuromagnetic oscillatory activity from the primary motor cortex of 10 healthy subjects when they observed live and videotaped finger movements. The left and right median nerves were stimulated alternatingly and the poststimulus level of the approximately 20 Hz rhythm was quantified. Compared with the rest condition, the approximately 20 Hz rhythm was dampened 15-19% more when the subjects observed live rather than videotaped hand movements, indicating stronger activation of the primary motor cortex. These results suggest that the human mirror neuron system differentiates natural and artificially presented movements.

Adult↗
PubMed2001

Results from a genome-wide search for predisposing genes in sarcoidosis.

Sarcoidosis is a systemic disease of granulomatous inflammation and unknown etiology. An inherited predisposition is involved, and many candidate susceptibility genes have been tested in association studies. We have applied the more general strategy of genome-wide microsatellite linkage analysis to identify chromosomal regions that contribute to the risk of sarcoidosis. On the basis of 225 microsatellite markers tested in 63 families with affected siblings (138 patients) and multipoint nonparametric linkage (NPL) analysis, we found the most prominent peak (six adjacent markers including D6S1666; NPL score = 2.99; p = 0.001) at the major histocompatibility complex (MHC). Six minor peaks (p < 0.05) were found on chromosomes 1 (D1S1665 ), 3 (D3S1766 ), 7 (D7S821 and D7S3070), 9 (D9S934), and the X chromosome (DXS6789). A subset of nine families with more than two affected siblings (30 patients) contributed little to the peak at the MHC (D6S1666; NPL score = 0.79; p = 0.21). Our results point to locus heterogeneity of susceptibility to sarcoidosis, with a major effect of the MHC.

Adult↗
PubMed2001

[Important acute measures after fractures. Rapid and adequate treatment of pain].

Pain caused by bone fractures needs to be treated promptly and adequately to avoid negative secondary effects. Pain therapy and the healing of soft tissue are goals that are equally as important as healing of the fracture. The following factors have analgesic potential: reduction, immobilization, cooling measures, limb elevation and fasciotomy. Symptomatic treatment of pain is orientated to the WHO stepped approach, which attaches particular importance to the regular administration of analgesics, as dictated by clinical effectiveness.

Analgesics↗
PubMed2001

[When fracture pain does not subside. Recognizing complications].

Over the long term, the evolution of pain caused by fractures is determined by the quality of immobilization, the extent of edema, and by surgical, analgesic and physiotherapeutic treatment. Development of chronicity is initiated by secondary deterioration, persistence of pain in the absence of improvement, changes in the nature of the pain, its spontaneous occurrence, and the appearance of concomitant symptoms. Differential diagnostic considerations must include surgical complications, but also damage to nerves, or the complex regional pain syndrome (CRPS). A particular differential diagnostic problem is the differentiation between CRPS and other complications. Treatment must be matched to the diagnosis: conservative attempts at treatment may have to be followed up with surgical revision. Drug treatment of pain is oriented to the stepped WHO schema. Physiotherapy, physical treatment and ergotherapy play a major role in the treatment of CRPS.

Chronic Disease↗
PubMed2001

Local atomic environment of Si suboxides at the SiO2/Si(111) interface determined by angle-scanned photoelectron diffraction.

Local environments of Si suboxides at the interface between a thermally grown SiO2 film and Si(111) were studied by angle-scanned photoelectron diffraction. Si 2p core-level spectra containing chemically shifted components were recorded. The components were deconvoluted by least squares fitting and assigned to different Si oxidation states. The obtained diffraction patterns of the various suboxides exhibit different features. Comparison of these patterns with multiple scattering calculations including a multipole R-factor analysis shows that a simple chemical abrupt interface model describes well the environment of the suboxides and indicates ordered SiO2 close to the interface.

Journal Article↗
PubMed2001

Wavelet entropy: a new tool for analysis of short duration brain electrical signals.

Since traditional electrical brain signal analysis is mostly qualitative, the development of new quantitative methods is crucial for restricting the subjectivity in the study of brain signals. These methods are particularly fruitful when they are strongly correlated with intuitive physical concepts that allow a better understanding of brain dynamics. Here, new method based on orthogonal discrete wavelet transform (ODWT) is applied. It takes as a basic element the ODWT of the EEG signal, and defines the relative wavelet energy, the wavelet entropy (WE) and the relative wavelet entropy (RWE). The relative wavelet energy provides information about the relative energy associated with different frequency bands present in the EEG and their corresponding degree of importance. The WE carries information about the degree of order/disorder associated with a multi-frequency signal response, and the RWE measures the degree of similarity between different segments of the signal. In addition, the time evolution of the WE is calculated to give information about the dynamics in the EEG records. Within this framework, the major objective of the present work was to characterize in a quantitative way functional dynamics of order/disorder microstates in short duration EEG signals. For that aim, spontaneous EEG signals under different physiological conditions were analyzed. Further, specific quantifiers were derived to characterize how stimulus affects electrical events in terms of frequency synchronization (tuning) in the event related potentials.

Adult↗
PubMed2001

[cyclo-CH2[Sn(CI2)CH2Si(Me2)]2O]: synthesis and complexation behaviour of a novel, cyclic, bidentate Lewis acid and its conversion into a tin-containing fluorosilane with intermolecular Si-F...Sn bridges.

Acid-catalysed hydrolysis of [CH2[(Sn(Ph2)CH2Si(OiPr)Me2]2] followed by subsequent reaction with mercuric chloride in acetone afforded the novel silicon- and tin-containing eight-membered ring [cyclo-CH2[Sn(Cl2)CH2Si(Me2)]2O] in good yield, the crystal structure of which is reported. 119Sn NMR and X-ray studies indicate that [cyclo-CH2[Sn(Cl2)CH2Si(Me2)]2O] acts as a bidentate Lewis acid towards chloride ions exclusively forming the 1:1 complex [(Ph3P)2N]+[cyclo-CH2[Sn(Cl2)CH2Si(Me2)]2OCl]- upon addition of [(Ph3P)2N]+Cl- . Also reported are the synthesis and structure of [K(dibenzo[18]crown-6)]+[cyclo-CH2(Sn(Cl2)CH2Si(Me2)]2OF]-, the first completely characterised organostannate with a C2SnCl2F- substituent pattern. No ring-opening polymerisation could be achieved for [cyclo-CH2[Sn(Cl2)CH2Si(Me2)]2O] or for its perphenylated derivative [cyclo-CH2[Sn(Ph2)CH2Si(Me2)]2O]. The reaction of [cyclo-CH2[Sn(Cl2)CH2Si(Me2)]2O] with Me3O+BF4- gave the tin-containing fluorosilane [CH2[Sn(Cl2)CH2Si(F)Me2]2], in which the Si-F bond is activated by intermolecular Si-F...Sn interactions in the solid state.

Journal Article↗
PubMed2001

Gene polymorphisms of immunoregulatory cytokines and angiotensin-converting enzyme in Wegener's granulomatosis.

Wegener's granulomatosis is a granulomatous and vasculitic disease of unknown origin. Gene polymorphisms are known to affect phenotypes of numerous diseases. Polymorphisms within the angiotensin-converting enzyme (ACE), transforming growth factor-beta1 (TGF-beta1), and interleukin-10 (IL-10) genes are suspected to modify the course of granulomatous disorders. We examined whether the genotype frequencies of the named polymorphisms differ in Wegener's granulomatosis from those in healthy controls. Thirty-nine patients with Wegener's granulomatosis were genotyped for the deletion/insertion polymorphism in intron 16 of the ACE gene, a biallelic polymorphism in codon 25 of the TGF-beta1 gene and a biallelic polymorphism at position -1082 of the IL-10 gene and compared with healthy blood donors. For the ACE polymorphism no significant differences were detected neither in the allele frequencies nor in the genotype frequencies. For TGF-beta1 a trend to genotype CG was found. The most interesting result was the observed, significant shift to genotype AA of the IL-10 polymorphism in Wegener's granulomatosis. IL-10 and TGF-beta1, immunoregulatory cytokines capable of down-regulating T helper cell type 1 response, showed a significant shift or a trend, respectively towards genotypes associated with reduced cytokine release, leading to the hypothesis that different immunoregulatory cytokine patterns dependent on gene polymorphisms might be involved in the pathogenesis of Wegener's granulomatosis.

Adult↗
PubMed2001

Wavelet entropy in event-related potentials: a new method shows ordering of EEG oscillations.

In this work we show the application of a measure of entropy defined from the wavelet transform, namely the wavelet entropy (WS), to the study of event-related potentials (ERPs). WS was computed for ERPs recorded from nine healthy subjects with three different types of stimuli, among them target stimuli in a cognitive task. A significant decrease of entropy was correlated with the responses to target stimuli (P300), thus showing that these responses correspond to a more "ordered" state than the spontaneous EEG. Furthermore, we propose the WS as a quantitative measure for such transitions between EEG ("disordered state") and ERP ("ordered state").

Adult↗
PubMed2001

Event-related oscillations are 'real brain responses'--wavelet analysis and new strategies.

The EEG consists of the activity of an ensemble of generators producing rhythmic activity in several frequency ranges. These oscillators are active usually in a random way. However, by application of sensory stimulation these generators are coupled and act together in a coherent way. This synchronization and enhancement of EEG activity gives rise to 'evoked' or 'event-related oscillations'. The compound evoked potential manifests as superimposition of evoked rhythms in the EEG frequencies ranging from delta to gamma ('natural frequencies of the brain'). The superimposition principle is described with efficient strategies and by utilization of an efficient algorithm. The wavelet analysis confirms the results of the combined analysis procedure obtained by using the amplitude frequency characteristics (AFCs) and digital filtering. The AFC and adapted digital filtering methods are based on the first approach to analyze average evoked potentials. In contrast, the wavelet analysis is based on signal retrieval and selection among a large number of sweeps recorded in a given physiological or psychological experiment. By combining all these results and concepts, it can be stated that the wavelet analysis underlines and extends the expression that alpha-, theta-, delta-, and gamma-responses described in this report are the most important brain responses related to psychophysiological functions. The wavelet analysis confirms once more the expression 'real signals' which we attribute to EEG frequency responses of the brain. It will be demonstrated that the delta, theta, and alpha responses (i.e. the rhythms 'predicted' by digital filtering) are real brain oscillations. The frequency components of the event-related potential vary independently of each other with respect to: (a) their relation to the event; (b) their topographic distribution; and (c) with the mode of the physiological measurements.

Algorithms↗
PubMed2001

Selectively distributed gamma band system of the brain.

Experiments from the cat brain demonstrate that gamma responses can be recorded in cortex, hippocampus, cerebellum, formatio reticularis and thalamus, independent of the mode of sensory stimulation. These results support the hypothesis of a selectively distributed gamma system of the brain.

Animals↗
PubMed2001

Functional aspects of alpha oscillations in the EEG.

Experimental evidence suggests a functional significance of EEG alpha rhythms. Event-related, evoked, and induced alpha rhythms may have functional correlates in primary sensory processing and preparatory processes. These results are in accordance with the view that spontaneous and induced EEG alpha rhythms have quasi-deterministic properties.

Alpha Rhythm↗