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Biomedical subjects

T Schramm

Publications and source records attributed to T Schramm.

At least 19 recordsLinked to original sources
PubMed2006

[Volume and electrolyte disturbances in endurance sport].

Long-lasting endurance exercise is associated with significant losses of fluid and sodium chloride, mainly due to sweat loss. To maintain endurance capacity and to avoid negative health consequences, endurance athletes should, therefore, drink fluids containing electrolytes during and after training or competition. In long-lasting endurance exercise it is recommended that athletes drink about 600-800 ml/h of fluid including adequate substitution of sodium. The excessive ingestion of fluid, however, brings about a danger of hyponatremia, which can be avoided by suitable measures. Body weight control is one of the parameters that should be carefully monitored before and after intensive endurance exercise.

Body Water↗
PubMed2003

Congenital atresia of the portal vein and extrahepatic portocaval shunt associated with benign neonatal hemangiomatosis, congenital adrenal hyperplasia, and atrial septal defect.

A rare case of congenital atresia of the portal vein and ductus venosus, extrahepatic portocaval shunt, benign neonatal hemangiomatosis, congenital adrenal hyperplasia, and an atrial septal defect is reported. Twenty-two cases of congenital extrahepatic end-to-side shunts have been described before. Although additional anomalies are common in this type of shunt, hemangiomatosis has been described only once. Adrenal hyperplasia has never been reported in this anomaly.

Abnormalities, Multiple↗
PubMed2001

Integrated effects of the vasodilating beta-blocker nebivolol on exercise performance, energy metabolism, cardiovascular and neurohormonal parameters in physically active patients with arterial hypertension.

OBJECTIVE: The present study was designed to investigate the integrated effects of the beta-1-selective blocker with vasodilator properties, nebivolol, on systemic haemodynamics, neurohormones and energy metabolism as well as oxygen uptake and exercise performance in physically active patients with moderate essential hypertension (EH). DESIGN AND METHODS: Eighteen physically active patients with moderate EH were included: age: 46.9 +/- 2.38 years, weight: 83.9 +/- 2.81 kg, blood pressure (BP): 155.8 +/- 3.90/102.5 +/- 1.86 mm Hg, heart rate: 73.6 +/- 2.98 min(-1). After a 14-day wash-out period a bicycle spiroergometry until exhaustion (WHO) was performed followed by a 45-min submaximal exercise test on the 2.5 mmol/l lactate-level 48 h later. Before, during and directly after exercise testing blood samples were taken. An identical protocol was repeated after a 6-week treatment period with 5 mg nebivolol/day. RESULTS: Nebivolol treatment resulted in a significant (P < 0.01) decrease in systolic and diastolic BP and heart rate at rest and during maximal and submaximal exercise. Maximal physical work performance, blood lactate and rel. oxygen uptake (rel. VO(2)) before and after nebivolol treatment at rest and during maximal and submaximal exercise remained unaltered. Free fatty acid, free glycerol, plasma catecholamines, beta-endorphines and atrial natriuretic peptide (ANP) increased before and after treatment during maximal and submaximal exercise but remained unaltered by nebivolol treatment. In contrast, plasma ANP levels at rest were significantly higher in the presence of nebivolol, endothelin-1 levels were unchanged. CONCLUSIONS: Nebivolol was effective in the control of BP at rest and during exercise in patients with EH. Furthermore, nebivolol did not negatively affect lipid and carbohydrate metabolism and substrate flow. The explanation for the effects on ANP at rest remain elusive. This pharmacodynamic profile of nebivolol is potentially suitable in physically active patients with EH.

Adrenergic beta-Antagonists↗
PubMed1998

[CT angiography to determine the size of intracranial aneurysms before GDC therapy].

OBJECTIVE: To examine in a model and in clinical practice whether CT angiography (CTA) is suitable to determine the size of intracranial aneurysms. METHODS: For an aneurysm model the contrast medium-filled balloon of an occlusion catheter was used. At different levels of filling images were obtained by both CTA and digital subtraction angiography (DSA). In the CT image the size of the simulated aneurysm was calculated from the CTA data at the workstation while from the DSA images it was performed by the DSA system with the use of both an external reference structure (two-ring method) and a stereotactic system (ANGIOLOG). In 7 patients, the size of the aneurysm was determined by CTA and DSA prior to aneurysm occlusion by means of guglielmi detachable coils (GDC therapy). RESULTS: On the basis of 2 D reconstructions of the CT average size deviations in the XY plane of 1.6% and on the Z axis of 3.2% were determined. These errors increased to 3.4% (XY plane) and 5.6% (Z axis) with 3 D reconstructions. By use of the two-ring model, DSA gave an average size deviation of 3% while with the stereotactic system (ANGIOLOG) it was as high as 11%. In 6 of the 7 patients, the appropriate spiral size was chosen primarily after CTA measurements. CONCLUSIONS: CTA enables the reliable determination of the size of an intracranial arterial aneurysm and in individual cases can give a better representation of an anatomic situation at the base of an aneurysm than DSA. Thus, CTA imaging of an aneurysm prior to GDC therapy is useful.

Adult↗
PubMed1997

[Etiology of stomach carcinoma--opinions and facts--yesterday and today].

Recent research demonstrated that views on the etiology of gastric cancer, which had been considered true over decades do not correspond with the real situation. Therefore, efforts for primary prevention of gastric cancer could not be successful. The bacteria Helicobacter pylori is considered today to be an important but not the only etiologic factor of this disease. Eradication of this bacteria decreases the risk of gastric cancer.

Gastritis↗
PubMed1995

[Endometrial carcinoma and vaginal ultrasound: studies of the diagnostic validity].

BACKGROUND: Up to now, there has been no effective diagnostic procedure for early diagnosis of endometrial cancer. During recent years, however, study results on transvaginal sonography (TVS) of the endometrium have been published recommending TVS as a screening method for early diagnosis of endometrial cancer in postmenopausal women. OBJECTIVE: The purpose of this study was to determine the sensitivity and specificity of TVS in measuring endometrial thickness and the resulting performance under screening conditions. PATIENTS AND METHODS: Patients with postmenopausal bleeding were included in a prospective blind diagnostic study. Endometrial thickness was measured with TVS before D&C. The histological findings of D&C were used as a control. Sensitivity and specificity were calculated after combining the separately and blindly determined findings. RESULTS: The study comprised 195 patients. Endometrial cancer was diagnosed in 29 of these patients, a prevalence of 15%. The median endometrial thickness was 5.5 mm (0-10 mm) in women with endometrial cancer and 4 mm (0-15 mm) in women without cancer (p > 0.05 Mann-Whitney U-test). For a cut-off > or = 4 mm, the sensitivity is 62% and the specificity is 50%. The sensitivities and specificities for all cut-offs are displayed in a receiver operating characteristic (ROC) curve. The relationship between the positive predictive values and the different prevalences is demonstrated in another curve. Using the results of this and other comparable studies, only very low positive predictive values can be calculated (0.03-1.9%) with prevalences expected under screening conditions (0.02-0.12%). CONCLUSION: Transvaginal sonography is not a useful method in early diagnosis of endometrial cancer.

Aged↗
PubMed1994

[Familial akinesia-hypokinesia sequence (Pena-Shokier phenotype)].

The Pena Shokeir phenotype (PSP) is characterised by multiple ankyloses, camptodactyly, facial dysmorphisms and lung hypoplasia with hydramnios. The basic neuromuscular defect leads, through a fetal hypokinesia-akinesia, to the development of this nonspecific phenotype and a respiratory insufficiency with early postnatal mortality. Severe central nervous anomalies are described in one-third of the reported cases. In this paper a foetus with PSP and 4 further foetuses with severe cerebral malformations and only discrete lung hypoplasia are described. It is not clear whether the cerebral malformations represent a primary or secondary developmental defect.

Abnormalities, Multiple↗
PubMed1993

Plasma vigabatrin enantiomer ratios in adults and children.

The new anticonvulsant vigabatrin (gamma-vinyl-gamma-aminobutyric acid) is normally supplied as a racemate, but its anticonvulsant effect is thought to reside in its [S]-enantiomer only. The plasma concentration ratio of the [R] to [S] enantiomers appears to remain constant across the vigabatrin dosage interval in adult volunteers, and in the present study this has also proved to be the case in 12 chronically treated adult epileptic patients. However, in 8 epileptic children chronically treated with other anticonvulsants and given add-on vigabatrin therapy because of failure to control seizures, plasma [R]:[S]-vigabatrin ratios changed across the drug dosage interval, the [R]-vigabatrin levels tending to be relatively higher soon after intake, and to fall more rapidly than the [S]-vigabatrin concentrations over the next few hours (mean half-lives 2.52 +/- SD 0.49 and 6.53 +/- SD 6.62 hours). The reason for the shorter half-life of [R]-vigabatrin in children remains to be elucidated, but it appears that measurement of racemic vigabatrin plasma concentrations in children, though not in adults, may lead to somewhat misleading conclusions as regards the amount of the circulating anticonvulsant [S]-vigabatrin.

Aged↗
PubMed1992

Vigabatrin--plasma enantiomer concentrations and clinical effects.

Plasma concentrations of the [R]- and [S]- enantiomers of the new anticonvulsant vigabatrin were measured by an enantiospecific gas-liquid chromatographic assay in a group of therapy-resistant epileptic patients in whom racemic vigabatrin was added to their existing antiepileptic drug regimens. The peak plasma concentrations of the biologically active [S]-enantiomer of vigabatrin were correlated with those of the [R]-enantiomer, with drug dose, seizure frequency and change in score on various tests of psychological function administered prior to and when the subjects were under steady-state conditions following vigabatrin therapy. Plasma [S]-vigabatrin concentrations correlated with drug dose, [R]-vigabatrin concentration and change in score of certain psychological tests reflecting verbal memory, recall and speed of information processing. No definite pharmacokinetic interactions were detected, though plasma phenobarbitone concentrations tended to fall during vigabatrin administration. There were too few data to assess the relation between [S]-vigabatrin concentrations and seizure frequency.

Adolescent↗
PubMed1991

[Negligence of the physician's duty to care during "therapeutic local anesthesia"].

Therapeutic local anaesthesia, although a seemingly simple procedure, requires informed consent by the patient as well as proper indication and careful execution. Four cases selected from a medico-legal experience illustrate some severe complications. Nausea, dyspnoea and respiratory arrest (anaphylactic shock) occurred in a 34-year-old woman shortly after injection of 0.5% Bupivacaine into the paravertebral musculature for the treatment of acute neck pain. She had to be hospitalized for 18 days, at times requiring mechanical ventilation. Three other patients (women aged 40, 43 and 52 years, respectively) developed a pneumothorax after supposedly intramuscular injection of a local anaesthetic. They were hospitalized for 7 to 12 days for treatment by drainage. Anatomical variations were excluded by ultrasound in the 40- and 43-year-old patients. These case reports demonstrate that doctors performing such procedures do not always possess the necessary anatomical knowledge, and the possible occurrence of complications is underestimated.

Adult↗
PubMed1991

Parvovirus B19 infection of the fetus. Histology and in situ hybridization.

Fetal tissues from 16 spontaneous abortions, two terminations, and one perinatal death, 18 of which were associated with maternal human parvovirus B19 infection, were examined for B19 infection by histology and in situ hybridization using a digoxigenin-labeled B19-DNA probe. In 15 spontaneous abortions and one termination, erythroblasts with intranuclear inclusions (lantern cells) reacted with B19-DNA by in situ hybridization. No internal or external fetal malformations were observed. Because 13 (86.7%) spontaneous abortions with lantern cells occurred between the 20th and 28th weeks of gestation, it is postulated that B19 infection may be a particular threat to the fetus during this stage of gestation.

Adult↗