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Biomedical subjects

S Probst

Publications and source records attributed to S Probst.

At least 19 recordsLinked to original sources
PubMed2002

[Treatment of a subcapsular renal bleeding after extracorporeal shockwave lithotripsy with recombinant, activated factor VII].

We report on a patient who suffered a large subcapsular and perirenal haematoma after extracorporeal shockwave lithotripsy. Despite surgical intervention the bleeding did not stop for 6 days and 10 units of packed red blood cells were transfused. With the treatment of recombinant, activated factor VIII (NovoSeven((R))) an immediate haemostasis could be reached, so that impending nephrectomy could be avoided. This is the first case where FVIIa has been successfully used to stop a trauma-related bleeding in a patient without any obvious accompanying coagulation disorder.

Blood Transfusion↗
PubMed2001

Relationship between soil lead and airborne lead concentrations at Springfield, Missouri, USA.

This study tests whether lead deposited to soil from automobiles during past years in a medium-sized US city (population 150,000) may present a current health risk. It examines the relationship between current soil lead concentrations at nine locations within the city of Springfield, Missouri, and airborne lead levels measured at the same locations during years (1975-1981) when lead emissions from automobiles were much greater than at present. A strong, significant correlation is found between soil and airborne lead levels at eight of the sites (r = 0.91, P < 0.005 for soil lead vs. 1979 airborne lead), in low-traffic areas as well as in areas adjacent to heavy traffic flow. Residual lead concentrations in these soils are relatively low, even for the high-traffic sites, as expected for a medium sized city.

Air Pollutants↗
PubMed2001

St. John's wort extract Ze 117 (Hypericum perforatum) inhibits norepinephrine and serotonin uptake into rat brain slices and reduces 3-adrenoceptor numbers on cultured rat brain cells.

Despite almost forty years of widespread use, the mode of action of antidepressant drugs is still largely unknown. There is agreement that these drugs interact with central neurotransmission. Common findings are acute inhibitory actions on reuptake mechanisms for norepinephrine (NE) and for serotonin (5-HT) at presynaptic axons and chronic adaptive effects on neurotransmitter receptors on postsynaptic membranes. In particular, beta-adrenoceptor downregulation has been observed after chronic treatment with most antidepressants in vivo and in cell culture systems. We studied the effectiveness of Ze 117 (St. John's wort) extract (Hypericum perforatum) on NE- and 5-HT-uptake into rat brain slices. Potency and efficacy of the Ze 117 extract were compared with those of tricyclic (TCA) and selective serotonin reuptake inhibitor (SSRI)-type antidepressants. A dose-dependent inhibition was seen on NE and 5-HT uptake into brain slices. The Ze 117 extract was more selective for the uptake of NE than for that of 5-HT. The maximal extent of uptake inhibition by Ze 117 extract was comparable to that of imipramine (IMI), desipramine (DMI) or fluvoxamine for 5-HT, but lower for NE transport, than that of the synthetic antidepressants. Chronic exposure (8 days) of confluent C6-cell cultures to Ze 117 extract resulted in a dose-dependent beta-adrenoceptor downregulation equal to that induced by DMI, a potent TCA. None of these effects could be achieved with either hypericin or hyperforin alone in a relevant dose range. Our results indicate that the St. John's wort extract Ze 117 contains active, but as yet unknown antidepressant principles with effects comparable to those of TCAs.

Animals↗
PubMed1998

Antisperm antibodies and microorganisms in genital secretions--a clinically significant relationship?

In asymptomatic infertility patients, no significant relationship was found between the presence of antisperm antibodies (ASA) in serum and in semen samples (IgG and/or IgA ASA), differentiated with the mixed antiglobulin reaction (MAR), and the microbial colonization of ejaculates covering a broad spectrum of microorganisms. Likewise, there was no significant association of ASA with microbial findings in patients' female partners, who also presented without symptoms of genital tract infection and were screened at the same time. Furthermore, ASA in semen (IgG and IgA) were not significantly related to several potential markers of subclinical male sexual gland infection or inflammation (leukocytes, PMN elastase, albumin, C3c) evaluated in aliquots of the same ejaculates used for immunological testing.

Adult↗
PubMed1996

Antibodies to chlamydia trachomatis in semen and relationship with parameters of male fertility.

To screen for infection with Chlamydia trachomatis in semen samples from asymptomatic men in couples consulting for infertility and to determine the relationship of seminal chlamydial antibodies with clinically relevant parameters of male fertility, 197 randomly chosen patients were enrolled in a prospective study. The median duration of infertility was 4 years (range 1-18). Screening for C. trachomatis and chlamydial antibodies of the immunoglobulin (Ig) A and IgG classes were performed in ejaculates and, in parallel, endocervical material from the partners of the patients and serum samples from both partners were evaluated. A comprehensive examination of semen quality included sperm analyses, semen cultures, local antisperm antibody (ASA) testing, the determination of potential infection markers, and sperm-cervical mucus interaction testing in vitro (SCMPT) and in vivo (post-coital testing). Chlamydial IgA antibodies were found in the semen samples of 18.8% (37/197) of the patients, while chlamydial IgG antibodies were found in 8.1% (16/197) of the patients. Screening for C. trachomatis was negative in all semen and cervical specimens. Only 5.5% of men remembered a past genital infection. Chlamydia antibodies (IgA/Ig/G) in semen were significantly correlated with chlamydia IgG antibodies in serum samples (P < 0.001). No marked relationship was found between the presence of seminal chlamydial antibodies and the major parameters of sperm analysis, semen cultures, local ASA and sperm penetration testing as an indicator of functional capacity. Seminal chlamydial antibodies were not significantly associated with potential infection or inflammation markers in aliquots of the same ejaculates. However, a significant relationship of chlamydial antibodies in patients' semen with past genital infections of their female partners was found with clinical relevance for a tubal infertility factor. The results indicate that in asymptomatic patients the presence of chlamydial antibody IgA or IgG in semen is not associated with reduced semen quality, potential seminal infection markers or impaired functional capacity as important determinants of male fertility; however, seminal chlamydial antibodies suggesting a previous sexually transmitted disease are significantly related to a tubal infertility factor of female partners.

Adult↗
PubMed1996

Recruitment and retention: perceptions of rural mental health workers.

Recruitment and retention of professionals is a major issue in rural health care. Following a literature review and series of focus groups, a questionnaire to ascertain why professionals applied for, stayed in and would consider leaving rural mental health work was constructed. The questionnaire also included questions regarding possible initiatives that could be undertaken to improve recruitments. The questionnaire was distributed through informal networks to over 900 professionals. Four hundred and seventy eight questionnaires were returned, representing a 52% return rate. According to the response work related issues were generally more important than lifestyle/personal issues particularly as reasons for applying for rural work. Lack of organisational support and professional isolation were important detractors of rural work, with strong support being expressed for initiatives that would address these issues. The findings suggest that recruitment action might highlight the scope, variety, challenge and autonomy aspects of work, with retention focusing on professional support and contact and increased organisational support.

Australia↗
PubMed1996

Induction of immunoresponse by subclinical male genital tract infection?

OBJECTIVE: To determine the relationship of subclinical infection or inflammation of the male genital tract, as evaluated with seminal markers, with local antisperm antibodies as potential parameter of immunoresponse. PATIENTS: One hundred ninety-one randomly chosen males of subfertile couples who were asymptomatic in terms of genital tract infection. SETTING: Outpatient Infertility Clinic of the University of Heidelberg, Germany. MAIN OUTCOME MEASURES: Determination of leukocytes rates in semen using an immunocytochemical method for differentiation of round cells and measurement of polymorphonuclear (PMN) granulocyte elastase concentration in seminal plasma in addition to semen cultures as screening for subclinical infection of the male genital tract. Determination of local antisperm antibodies (Ab) with the mixed antiglobulin reaction ([MAR] immunoglobulin [Ig] G and IgA) in aliquots of the same ejaculates. RESULTS: Leukocyte rates of the round cells ranged from 0% to 93%, leukocytospermia was found in 6.8%. This was not related significantly to the presence of local antisperm antibodies of the IgG or IgA class. There was also no significant association of antisperm Ab with the concentration of PMN granulocyte elastase in seminal plasma and the outcome of semen cultures. CONCLUSIONS: The results of this prospective study suggest that when the rate or number of leukocytes or the concentration of PMN elastase in semen are taken as markers for subclinical infection or inflammation of the male genital tract, this is not associated significantly with the production of local antisperm Ab of the IgG or IgA class as indicator of immunoreaction.

Adult↗
PubMed1995

[Prevention of myocardial ischemia. Study following aortocoronary bypass operation with the calcium antagonist diltiazem].

The incidence of postoperative myocardial infarction (MI) is proportional to the incidence of myocardial ischaemic episodes. Therefore, the prevention of such episodes is of great clinical importance. METHODS. In 90 patients undergoing coronary artery bypass grafting (CABG), perioperative i.v. treatment with either nitroglycerin (NTG), diltiazem (DIL), or the combination of DIL/NTG was used until arrival in the intensive care unit. Myocardial ischaemic episodes were monitored with an automatic ECG-ST-trend analyser (Marquette 7010). RESULTS. Significantly less ischaemic episodes were seen in the DIL group (6.7%) compared to the NTG group (13.2%) or DIL/NTG group (13.5%). Furthermore, significantly less ischaemic episodes were associated with relevant haemodynamic alterations in the DIL group (58.1%) compared to the NTG (89.1%) or DIL/NTG group (80.0%). Increases in heart rate were markedly reduced in the DIL group. DISCUSSION. DIL results in marked haemodynamic stabilisation during CABG, especially in the period immediately after extra-corporeal circulation. This might serve as an explanation for the significant reduction in ischaemic episodes in the DIL group compared to the other two groups. Therefore, perioperative prevention of myocardial ischaemia with the calcium antagonist DIL seems to be favourable in patients during CABG.

Adult↗
PubMed1995

Screening for subclinical inflammation in ejaculates.

OBJECTIVE: To determine the clinical significance of albumin determination in ejaculates by means of an easy office test to screen semen samples for subclinical infection-inflammation. PATIENTS: One hundred fifty-nine randomly chosen males of couples with longstanding infertility (median duration of infertility 4 years (range 1 to 19 years) without clinical signs or symptoms of genital tract infection. SETTING: Outpatient Infertility Clinic of the University of Heidelberg, Germany. MAIN OUTCOME MEASURES: Screening of ejaculates for subclinical infection-inflammation by means of a ready-to-use kit for semiquantitative detection of albumin in addition to determination of leukocytes rates by means of monoclonal antibodies for differentiation of round cells and measurement of granulocyte elastase concentration in semen samples. Evaluation of sperm quality by means of standard sperm analysis including determination of local antisperm antibodies with the mixed antiglobulin reaction, evaluation of sperm functional capacity in vitro with the standardized sperm-cervical mucus (CM) penetration test, and semen cultures. All tests were performed from aliquots of the same ejaculates. RESULTS: Screening of semen samples for elevated albumin with the modified paper strips proved to be very easy, quick, and suitable for routine use. Positive results were not related markedly to medical history and outcome of clinical examination as well as to standard parameters of sperm analysis and were not influenced by local antisperm antibodies of the immunoglobulin (Ig)G and/or IgA class and microbial colonization. However, albumin-positive semen samples were significantly less frequent in case of very good outcome of the sperm-CM penetration test. A significant relationship was found with high rates of leukocytes of the round cells in semen samples (total range 0% to 96%) and the concentration of granulocyte elastase (total range 1 to 880 micrograms/L). CONCLUSIONS: The results of this prospective study suggest that the determination of albumin in semen samples with ready-to-use test kits might be a valuable additional marker for subclinical infection-inflammation of the male genital tract and therefore suitable for screening during infertility investigation.

Adult↗
PubMed1994

Prolongation of the QT-interval during induction of anesthesia in patients with coronary artery disease.

During induction of anesthesia in 60 patients undergoing coronary artery bypass grafting (CABG), we measured the QT-interval (QTI) in the ECG, heart rate (HR) and mean arterial pressure (MAP). Based on the HR, we corrected the QT-interval (QTcI). Prior to induction, six patients (10%) already had abnormal prolongation of QTcI (> or = 440 ms). After injection of fentanyl and vecuronium, the QTcI increased significantly (P < 0.01); to a far lesser extent after injection of hypnotics (i.e. etomidate, midazolam or propofol). Orotracheal intubation caused significant shortening of QTcI (P < 0.01). HR decreased markedly after injection of fentanyl. MAP decreased, however, only after injection of hypnotics. In the immediate post intubation period, HR and MAP increased significantly. The various hypnotics produced no significant difference in HR and QTcI at any measurement point. MAP changed only after injection of hypnotics. The decrease of HR and MAP during induction of anesthesia is thought to result from a corresponding reduction of adrenosympathetic stimulation. We believe that QTcI is similarly influenced.

Anesthesia, Intravenous↗
PubMed1994

Droperidol causes a dose-dependent prolongation of the QT interval.

To further investigate possible prolongation of the frequency-corrected QT interval (QTc interval) after administration of droperidol (DRO), we studied 40 surgical patients who were randomly assigned to one of three groups, receiving an intravenous (IV) injection of either 0.1 mg/kg (Group 1, n = 10), 0.175 mg/kg (Group 2, n = 10), or 0.25 mg/kg (Group 3, n = 20) of DRO at induction of anesthesia. The QTc interval, heart rate, and arterial pressure were registered before and 1, 2, 3, 4, 5, 7.5, and 10 min after the respective dose injection. Significant prolongations of the median QTc interval were found in patients from all groups, ranging from 37 ms (8.0%) in Group 1, to 44 ms (10.6%) in Group 2, to 59 ms (14.9%) in Group 3, when compared with control. The heart rate showed a significant increase in all groups. Mean arterial pressure (MAP) was slightly but significantly decreased in Groups 1 and 3. Prolongation of the QTc interval is a predictable and dose-dependent side effect after injection of high-dose DRO.

Blood Pressure↗
PubMed1993

[ST segment changes in the ECG. Anesthesia induction with propofol, etomidate or midazolam in patients with coronary heart disease].

Induction of anaesthesia with propofol and fentanyl can lead to marked reductions in mean arterial pressure (MAP) and heart rate (HR). Thus, the application of propofol in patients with severely reduced coronary artery perfusion is controversial. METHODS. The study group consisted of 60 patients undergoing coronary artery bypass grafting (CABG). Anaesthesia was induced over 30 s with propofol (P 1.5 mg/kg), etomidate (E 0.3 mg/kg), or midazolam (M 0.15 mg/kg) following a bolus dose of fentanyl (5 micrograms/kg). Vecuronium was used as a muscle relaxant. During induction we continuously measured MAP and HR and recorded the occurrence of myocardial ischaemia using an automatic ST-segment analyser (Marquette 7010). ST-segment deviations of more than 1 mm in leads II and V5 were interpreted as significant signs of myocardial ischaemia. RESULTS. All groups showed reductions in MAP and HR on induction that were marked in the P group. Intubation caused elevation of MAP and HR to pre-induction levels (HR: all groups) or slightly above (MAP: E, M). Four patients in the P group and 3 in each other group showed significant ST-segment deviation prior to induction. In the P group these deviations disappeared in 2 patients after injection while they remained unchanged in the M group. In the E group injection had no effect on the ischaemic ECG changes but produced another case of significant ST-segment deviation. Laryngoscopy and intubation produced no further significant ST-segment deviation in either group. DISCUSSION. Induction is a critical phase of anaesthesia, especially in patients with limited coronary reserve. Induction agents should alleviate the stress response while causing minimal haemodynamic changes. Despite marked reductions in MAP in the P group, the number of patients with ischaemic ECG changes was cut by half. Their number was unchanged or even raised in the other groups. After application of P, with an alleged reduction of coronary perfusion, a compensational reduction in myocardial oxygen consumption may occur.

Aged↗
PubMed1991

[Cardiac adverse effects following an intravenous injection of pirenzepine are an expression of deficient receptor sensitivity].

Under the aspect of life-threatening pneumonias in long-term ventilated patients receiving ant-acids or H2-antagonists the prophylaxis of stress ulcer with pirenzepine gains new importance. This study was aimed at detecting cardiac side effects of pirenzepine due to low receptor specificity. Pirenzepine (10 mg) was given via the peripheral or central venous route at an injection velocity of 5 or 30 seconds as well as a control of 2 ml normal saline solution via the central venous route for 5 seconds, 20 times each. Heart rate and blood pressure were determined before and after the injection. Independent of the injection site or velocity, an increase in the heart rate was found after the injection of pirenzepine. The increase was more marked if the central venous route was used. The percentage rise in heart rate was up to the thirteenth minute highly significant when comparing pirenzepine to normal saline solution. There were no changes in blood pressure. If M1-cholinoceptors are blocked, a reduction of the heart rate is seen. Blocking M2-cholinoceptors causes a rise in the heart rate. Injecting 10 mg of the M1-antagonist pirenzepine results in a significant increase in the heart rate, independent of site or velocity of injection which can be explained by blocking M2-cholinoceptors at the same time. To prevent this probably dose-dependent effect, pirenzepine should be given slowly over a couple of minutes.

Adult↗
PubMed1991

[Thiamine deficiency as a cause of life threatening lactic acidosis in total parenteral nutrition].

Two patients aged 37 and 44 years developed life-threatening lactic acidosis following abdominal surgery and a period of about 3 weeks of total parenteral nutrition. Septicaemia and hypoxia were excluded as possible causes. Conventional treatment including high doses of buffer agents was unsuccessful. Thiamine (vitamin B1) depletion was suspected as the cause of the metabolic acidosis, and two doses of 400 mg thiamine were given. In both patients, the lactic acidosis improved immediately, and it disappeared following the second dose of thiamine. Both patients were subsequently discharged as symptom-free. As part of the pyruvate-dehydrogenase (PDH) complex, thiamine was capable of improving the life-threatening situation.

Acid-Base Equilibrium↗
PubMed1991

[Automated, continuous ST segment analysis in the ECG as a monitor of myocardial ischemia during aortocoronary bypass surgery].

UNLABELLED: Patients with coronary artery disease (CAD) who are subjected to cardiac and major noncardiac surgical procedures have a high incidence of perioperative myocardial ischemia. Earlier studies in patients undergoing coronary artery bypass graft surgery (CABG) indicated the frequency of postoperative myocardial infarction to be directly proportional to the incidence and severity of pre-bypass myocardial ischemia. METHODS: We investigated the incidence of pre-bypass ischemia in 50 patients undergoing elective CABG using an automated ST segment monitoring system (Marquette 7010). Analyzing leads I, II, and V5, this device measures ST segment deviations 60 ms after the J-point. Occurrence of myocardial ischemia was defined as follows: new ST segment deviations larger than 1 mm = 0.1 mV that lasted for more than at least 10 consecutive heartbeats. RESULTS: In 19 out of 50 patients (38%) we found 96 episodes of myocardial ischemia in the pre-bypass period; 47% of all ischemic episodes were associated with significant hemodynamic changes, e.g., tachycardia, hypertension, or hypotension. The incidence of ischemia was different between population sub-groups: patients with a previous infarction had a lower incidence of ischemia (35%) than patients without infarction (44%). Patients with preoperative left ventricular end diastolic pressure (LVEDP) less than 15 mm Hg had a lower incidence of ischemia (29%) than patients with LVEDP greater than 15 mm Hg (50%). Patients treated preoperatively with beta-blockers showed a significantly lower incidence of ischemia (9%) when compared to untreated patients (46%, p less than 0.05). No difference was found between patients with or without unstable angina pectoris or between patients of NYHA classes II, III, or IV. Postoperative myocardial infarction occurred in 2 patients, both with evidence of pre-bypass myocardial ischemia. CONCLUSION: Our study confirms that automated ST segment analysis is able to detect myocardial ischemia similarly to that documented in previous studies using conventional ECG lead analysis.

Aged↗
PubMed1990

[Life-threatening lactic acidosis during total parenteral nutrition. Successful therapy with thiamine].

Two patients, 37 and 44 years old, respectively, developed severe metabolic acidosis after abdominal surgery which was followed by three weeks of total parenteral nutrition. Septicaemia, peritonitis or hypoxia were excluded as possible causes. Both patients had very high serum lactate concentrations (24.3 and 22.8 mmol/l, respectively). Conventional treatment with buffer agents was unsuccessful. Because vitamin B1 deficiency was suspected, two doses of 400 mg thiamine were administered. In both patients the extreme lactic acidosis disappeared immediately after the injections. Both patients were later discharged without any symptoms.

Acidosis, Lactic↗
PubMed1990

Clinical evaluation of hypothermic ventricular fibrillation, multi-dose blood cardioplegia, and single-dose Bretschneider cardioplegia in coronary surgery.

37 patients undergoing coronary revascularization were randomly assigned to three protocols for intraoperative myocardial protection: hypothermic ventricular fibrillation (HF) (n = 13), multi-dose blood cardioplegia (BCP) (n = 12) and single-dose Bretschneider's crystalloid cardioplegia (CCP) (n = 12). As intraoperative markers of ischemic damage myocardial ultrastructure, ATP, and CP contents were determined in left ventricular biopsy specimens taken before and after cardiac arrest. Release of serum enzymes (CK, CK-MB, LDH, SGOT) was determined pre- and postoperatively. Hemodynamic data were assessed before, during, and after operation. The incidence of low cardiac output, positive inotropic support, intraaortic balloon counterpulsation, peri-operative myocardial infarction, rhythm disturbances, and the rate of spontaneous defibrillation was compared between groups. The results show a better preservation of high energy phosphates in the BCP group as compared to the HF and CCP groups. Myocardial ultrastructure showed moderate ischemic damage in the hypothermic fibrillation group; in contrast, only slightly deteriorated cells were seen after cardiac arrest, when cardioplegia was used. The incidence of rhythm disturbances was 25% for HF and 42% for CCP. In contrast, only 17% of new rhythm disturbances were seen in the BCP group. Functional recovery (i.e. CI and SWI) of hearts protected with BCP was generally greater as compared to HF and CCP. Release of MB-creatine-kinase isoenzyme was higher in the HF group as compared to cardioplegia. Clinical outcome in terms of incidence of peri-operative infarction, positive inotropic support and low cardiac output was superior in the BCP group but not significantly different between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardioplegic Solutions↗