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Biomedical subjects

U Herrmann

Publications and source records attributed to U Herrmann.

At least 37 records · Page 2Linked to original sources
PubMed1992

Environmental factors in the pathophysiology of recurrent idiopathic calcium urolithiasis (RCU), with emphasis on nutrition.

A number of environmental factors are under discussion as possibly implicated in the etiology of RCU. On the basis of data in the literature and our own results, we attempted a critical weighting up of the possible contributions of climate, pollution, stress, nutrition in general and especially oxalate and minerals in the nutrition. It was concluded that there is a need for more in-depth research into the response of the body to challenges from the environment, in particular nutrition.

Calcium↗
PubMed1992

Citrate and recurrent idiopathic calcium urolithiasis. A longitudinal pilot study on the metabolic effects of oral potassium citrate administered over the short-, medium- and long-term medication of male stone patients.

In idiopathic recurrent calcium urolithiasis (RCU) in men (n = 37) the metabolic effects of oral tripotassium citrate (PC) were investigated in a longitudinal field study. The patients were either normo- (n = 22) or hypocitraturic (n = 15). Laboratory examinations were performed before, and after 3, 6, and more than 12 months of medication. Acceptance of PC was poor, mainly because of the salty taste of the tablet preparation chosen, and a number of participants dropped out of the study. In the remaining participants, compliance was acceptable when evaluated on the basis of urinary potassium and undesired side effects did not occur. In the short term (up to 3 months), PC evoked compensated metabolic alkalosis (pH and citrate in urine increased; blood gases remained normal), a drop in urinary calcium, together with increasing oxaluria, hydroxyapatite supersaturation, and calcium phosphate crystalluria. In the long term (greater than 12 months) PC urinary pH and citrate "dissociated", in that pH returned to pretreatment baseline values, whereas citrate stayed at high levels. In normocitraturics but not in hypocitraturics, urinary urea and sodium increased with PC. Hypocitraturics appeared to be less sensitive to the effects of PC, as reflected by the relatively small rise in urinary pH and citrate, and they maintained higher mean levels of indicators of bone metabolism (osteocalcin, alkaline phosphatase, hydroxyproline) despite continuous administration of PC. It was concluded that although the PC tablet preparation was effective it may not be an ideal anti-stone drug treatment in the long term and that, especially in hypocitraturics, the intrinsic metabolic defect of RCU may not be sufficiently well controlled.

Acid-Base Equilibrium↗
PubMed1992

Crystalluria in idiopathic recurrent calcium urolithiasis. Dependence on stone composition.

A retrospective study was done on the nature and degree of crystalluria in fasting and postprandial urine in patients with recurrent idiopathic calcium urolithiasis (RCU) for whom stone analysis was available. RCU was stratified into subgroups in accordance with stone analysis. The crystals were obtained and identified using a filter technique and polarization microscopy, respectively. Crystalluria score, relative saturation products (RSPs), and low-molecular-weight inhibitors were assessed. Calcium oxalate crystals were never observed in either male or female patients with stones composed exclusively of calcium oxalate, and only sporadically in patients with mixed stones (the additional component was calcium phosphate in most cases). Other crystalluria phases, such as amorphous calcium phosphate, a urate-containing phase, and a phase presenting as spherolytic particles, were slightly more frequent in patients with mixed stones. In contrast to crystalluria, RSPs and inhibitors differed in male and female patients, suggesting that crystalluria may not be under the exclusive control of these factors. The following conclusions were reached. (1) Calcium oxalate crystalluria is absent from RCU with pure calcium oxalate stones; hence, calcium oxalate crystalluria does not qualify as a diagnostic aid. (2) The co-existence of the isotropic phase and mixed stones may indicate that the formation of these concretions is characteristic for a major RCU subgroup. (3) On the basis of clinical chemistry and physicochemical data in urine and of crystalluria, it appears that the pathogenesis of RCU differs in male and female subjects.

Adult↗
PubMed1992

Citrate and recurrent idiopathic calcium urolithiasis. A longitudinal pilot study on the metabolic effects of oral potassium sodium citrate administered as short-, medium- and long-term to male stone patients.

In male patients with idiopathic recurrent calcium urolithiasis (RCU) the effects of oral potassium sodium citrate (PSC) on acid-base, citrate and mineral metabolism were investigated. There were 17 normocitraturic and 15 hypocitraturic patients. The examination time points in our clinical laboratory were prior to medication and after 3, 6 and over 12 months of medication. Urine collection periods were over 24 h, 2 h--after an overnight fast--3 h postprandially. Acceptance by the patients was poor, a large number refusing to take PSC for 12 months. Compliance of the patients continuing with the study was adequate as assessed by the urinary excretion of potassium and sodium. No unwanted side effects were observed. After 3 months of PSC medication a compensated metabolic alkalosis developed; in the urine calcium was decreased, while citrate, pH and oxalate were increased, as were hydroxyapatite supersaturation and calcium phosphate particles. After more than 12 months of PSC medication, citrate and pH tended toward the pretreatment baseline values, while hydroxyapatite supersaturation and calcium had already returned to pretreatment values. Despite ongoing PSC intake, patients with pre-existing hypocitraturia had lower urinary citrate than patients with previous normocitraturia, while the concomitant pH and hydroxyapatite supersaturation in the urine of the former remained at levels close to those of the latter. Under the influence of PSC, parathyroid gland function remained unchanged, but serum levels of bone alkaline phosphatase and osteocalcin were low, and urinary hydroxyproline was high.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1992

Comparison of energy deposition and utilization of feedstuffs and rations between growing and adult pigs.

The effect of energy deposition and the utilization of feedstuffs and rations were compared between growing and adult pigs. The good agreement in the data leads to the conclusion, that the energy deposition effect of feedstuffs and rations in growing pigs can be estimated with an equation based on measurements in adult pigs. Exceptions are feedstuffs which are digested bacterially to a relatively high part in the large intestine, as e.g. sugar beet pulp, raw potatoes or similar feed.

Aging↗
PubMed1992

Two components of muscle activation: scaling with the speed of arm movement.

1. The temporal waveform of muscle activity was related to the speed of arm movement. Speed was expressed in terms of the duration of a fixed amplitude movement or the "movement time." 2. Human subjects moved their arms to targets in three-dimensional space. The right arm started at a standard initial position and moved directly to the target in a single stroke. The targets were placed in various directions in a vertical plane. The arm movements consisted of shoulder and elbow rotations. 3. Subjects were required to vary the speed of their movements. In most of the experiments, trials with different movement times were randomly ordered. One of the experiments also included randomly interspersed static trials, in which the subject held the arm still at the initial posture, the final posture, or halfway between the two extremes. 4. Electromyographic (EMG) activity was recorded from several superficial elbow and/or shoulder muscles. The time base of rectified EMG records was normalized for movement time such that records from movements with various speeds were compressed to align the ending times of the movements. 5. A principal component (PC) analysis revealed that the compressed EMG waveforms could be described by a summation of PC1 and PC2 waveforms; each individual EMG waveform was approximated by a weighted sum of these two components. 6. The PC1 weighting coefficients scaled down in a monotonic relationship with movement time such that the fastest movement corresponded to a large positive weighting coefficient and the slowest movement corresponded to a small positive weighting coefficient. The PC2 weighting coefficients exhibited a similar monotonic scaling, but the values ranged from positive to negative. Further analysis demonstrated that these two components can be mathematically transformed into a tonic waveform with a constant mathematically transformed into a tonic waveform with a constant weighting coefficient and a phasic waveform with positive weighting coefficients that scale down with movement time. 7. The amplitude scaling of EMG records cannot be described by a single component, but instead requires a summation of two separate components. The tonic component may correspond to the force element needed to counteract gravity, because the magnitude of this element does not scale with movement speed. The phasic component may correspond to the force element that scales quadratically to produce a linear increase in velocity.

Arm↗
PubMed1992

[Selective proximal vagotomy with and without pyloroplasty in uncomplicated chronic duodenal ulcer. Results of a randomized clinical study 5 and 10 years following surgery].

SPV with and without pyloroplasty were compared in a randomized clinical study for uncomplicated chronic duodenal ulcer. Additional pyloroplasty according to Finney reduced recurrence rate nor after 5 years (7.9:7.9%) neither after 10 years (16.7:12.5%) in comparison to SPV without pyloroplasty. Functional postvagotomy-syndromes dumping and diarrhoea, which were increased until 5th postoperative year after SPV with pyloroplasty, decreased in both groups to a lower level. Cause of late recurrences and decrease of postvagotomy-syndromes was seen in the vegetative reinnervation of stomach. There was no decrease in the lactase-deficiency-syndrome after SPV. Clinical results did not reveal any significant differences between both groups. It was suggested, that SPV without pyloroplasty is the best adequate operation for uncomplicated chronic duodenal ulcer.

Aged↗
PubMed1991

Crystalluria determined by polarization microscopy. Technique and results in healthy control subjects and patients with idiopathic recurrent calcium urolithiasis classified in accordance with calciuria.

A retrospective study was done on the nature and degree of crystalluria in spontaneously voided fasting and postprandial urine of patients with recurrent idiopathic calcium urolithiasis (RCU) divided into normocalciuria (20 males, 20 females) and hypercalciuria patients (20 males, 20 females), and controls (20 males, 20 females). The crystals were obtained using a filter technique and identified by microscopy. In addition, individual data, clinical chemistry variables and indices reflecting the risk of calcium phosphate and calcium oxalate crystallization were evaluated. In contrast to findings of other investigators of crystalluria we observed only a few crystals on the filters. The most frequently occurring phases were (in this order) a urate-containing phase (tentatively termed uric), an amorphous calcium phosphate phase (tentatively termed isotropic) and a phase of spheroid-like particles, not yet definitely characterized (tentatively termed spheroid). Calcium oxalate crystals were found only exceptionally. There was no relationship between the degree of calciuria (normo- versus hypercalciuric RCU) and crystalluria. Among RCU, males generally had a predominance of the isotropic, females of the spheroid phase, as compared with controls. Also, RCU females were generally obese, and their spheroid score and lean body mass correlated negatively and significantly. The calcium phosphate and calcium oxalate risk indices were always low in normal individuals, higher in RCU. Patients of both sexes with urinary stones had normal parathyroid gland function, but higher total calcium in fasting serum and higher urinary pH as compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[The energetic utilization of rations with dried concentrates, potatoes, sugar beets, apple pectin and cane sugar by growing, intact and ileorectostomized swine. 1. Results in swine with ileorectal anastomoses].

Rations with dried feedstuffs and rations with between 30 and 50% raw potatoes in the dry matter as well as steamed potatoes and sugar beets, sucrose and apple pectin were tested in measurings of the total metabolism in growing pigs with ileo-rectal anastomoses. The prececal digestibility of the energy of the rations ranged between 42% (rations with raw potatoes) and 79% (rations with sucrose). The digestibility of the rations with a 50% quota of steamed potatoes was better by 30%--units than that of rations with raw potatoes. In addition to crude nutrient digestibility, data are given on the digestibility of starch, water soluble carbohydrates and pectin. The wide variation in the N retention of 6-25 g/animal.day can only be partly connected with energy retention. Urine energy amounted to between 2.5 and 5% of gross energy. The average utilization of metabolizable energy amounted to 69.4%. A connection is to be seen with the value of energy maintenance requirement of 646 kJ retention energy/kg LW0.62.d.

Anastomosis, Surgical↗
PubMed1991

[The energetic utilization of rations with dried concentrates, potatoes, sugar beets, apple pectin and cane sugar by growing, intact and ileorectostomized swine. 2. Comparison of results].

Results of the measuring of the total metabolism of growing intact pigs (INT) and pigs with ileorectal anastomoses (IRA) are compared. The 16 comparisons are based on studies with rations of dried feedstuffs and rations containing between 30 and 50% of the DM raw or steamed potatoes and sugar beets, sucrose and apple pectin. On an average of all comparisons the relative values for the digestibility of energy, DM and the organic matter as well as for the metabolizability of the energy were between 81 and 82% (values measured at INT animals = 100). The comparison also refers to the crude nutrients, the water-soluble carbohydrates, the starch and the pectin. As a tendency, the IRA utilized the metabolizable energy better than the INT animals. The energy maintenance requirement of the IRA animals was--by 15%--significantly higher than that of the INT animals. There is not yet an answer to the question in how far comparative studies of INT and IRA animals make verified statements with regard to the differences in the energetic utilization of the precaecally and postileally digested nutrients possible. For this, further experiments will be necessary.

Anastomosis, Surgical↗
PubMed1991

[Does fetal reaction to vibro-acoustic stimulation depend on its activity state?].

The value of vibro-acoustic stimulation of the fetus in predicting fetal well-being remains controversial. This prospective randomised study comprised of 25 women with pregnancies ranging between 37 and 41 weeks. The fetal response in each case was investigated before and after a real and a sham stimulation. Each real stimulation led to immediate fetal movements (p less than 0.0001). The fetal reaction was independent of the preexisting behavioral state; vibro-acoustic stimulation can induce a change in the behavioral state. Fetal bradycardia following vibro-acoustic stimulation was not observed.

Arousal↗
PubMed1990

Severe neonatal asphyxia due to X-linked centronuclear myopathy.

Severe neonatal centronuclear myopathy is inherited as an X-linked condition characterized by primary asphyxia, extreme muscular hypotonia and absent spontaneous movements. We report seven cases from three families to point out the importance of diagnosis with regard to prognosis, outcome and genetic counselling. In hypotonic diseases, analysis of cerebrospinal fluid, electromyography, nerve conduction velocity creatine kinase and a skin biopsy for fibroblast cultures for metabolic investigations are usually carried out. Needle muscle biopsy is an additional valuable investigation to establish diagnosis. In all our patients we found an increased number of centrally located nuclei with perinuclear halos confirming the diagnosis of centronuclear myopathy. The diagnosis of this disorder will become of greater importance as soon as carrier detection and prenatal diagnosis by DNA-technology are routinely available.

Asphyxia Neonatorum↗
PubMed1990

[Diagnosis of malignant tumors of the uterus by transabdominal ultrasonography: a utopia?].

Two hundred non-pregnant women with suspected uterine disease were included in a prospective study designed to assess the accuracy of sonography in conforming or excluding the presence of uterine cancer. All patients were operated on and the preoperative sonographic findings were compared with the final histological diagnosis. The predictive value of sonographic evidence of malignancy was 43.9% (18/41), the predictive value of benign disease was 94.8% (147/155). Sensitivity was 66.7% (18/27) and specificity 85% (147/173). The sonographic detection of uterine cancer is in need of improvement. At present it cannot be used as a substitute of invasive diagnostic tools in patients with suspected uterine cancer.

Adenoma↗
PubMed1990

[Prolonged pregnancy: pathophysiology and clinical aspects].

The postdate pregnancy remains an unresolved clinical problem with the threat of medicolegal consequences in cases of unfavorable outcome. Placental dysfunction leading to fetal hypoxia may develop in these pregnancies at any time and for the truly postmature fetus there is a considerable risk of asphyxia. Fetal hypoxia, accompanied with hemoconcentration due to a maternofetal fluid imbalance, leads to diminished fetal urine production and a reduced amniotic fluid volume, which can cause cord compression. According to this simplified pathophysiological cascade, the monitoring of postdate pregnancies should be based mainly on ultrasound assessment of amniotic fluid volume and cardiotocography. At our institution, instead of an obligatory induction of labor at a fixed gestational age, induction is performed when the largest amniotic fluid pocket measures less than 3 cm (vertical) or when variable decelerations of the fetal heart rate appear. A nonreactive nonstress test calls for a complete biophysical profile. As long as these monitoring techniques indicate fetal well-being, pregnancy is allowed to continue, especially in the presence of an incompatible condition of the cervix.

Asphyxia Neonatorum↗
PubMed1990

[Routine measurement of the biggest amniotic fluid pocket in the 3d trimester: prognostic significance?].

The largest pocket of amniotic fluid was measured routinely during the last trimester of pregnancy in 577 patients representing risk and nonrisk cases. The measurements were performed at two clinics between 26 and 42 weeks of gestational age. A statistically significant relationship between a value of less than 30 mm and the following perinatal parameters was found: 5-min Apgar score less than 7, umbilical cord blood pH values less than 7.15, severe neonatal complications, intrauterine growth retardation, perinatal mortality. The good predictive value of decreased amniotic fluid measured by the largest pocket, and the simple practicability of the method raise the question whether the largest pocket of amniotic fluid should not be assessed routinely at each ultrasound examination during the last trimester. The consequences of a decreased value are discussed.

Amniotic Fluid↗
PubMed1990

[Prececal crude protein digestion and amino acid absorption during the use of ileorectostomy and fistula technic in swine].

Described in this paper are ileocecal cannulation and ileorectostomy, two methods used for quantitative collection of chyme in the context of protein assessment on the basis of prececally absorbable amino acids. Reference is made to the manufacture of new, flexible intestinal cannulas of biocompatible material and to the surgical approaches in connection with either method. Determination of prececal digestibility of crude nutrients and absorption of amino acids in three rations fed to pigs with ileorectal anastomoses and ileocecal cannulas gave identical data or fair agreement with the extension of two amino acids. The conclusion was drawn that data recorded by means of the two methods can be used in the preparation of tabulated values.

Absorption↗
PubMed1990

[Gallstone ileus. A report of 104 cases].

An analysis of 104 cases of gallstone ileus in 102 patients is presented. Biliary stones reach the intestinal tract through a biliodigestive fistula in 80-85% and on natural way in 15-20%. Clinical symptoms depend on mechanism of obstruction. It shows 3 forms of course: peritonitical form (20%), remittent form (30%) and typical intestinal obturation (50%). Roentgenological findings show aerobilia in 36%, dystope radiopaque stones in 8% and signs of obstruction in 97% of investigations. The main concern in gallstone ileus should be to relieve the intestinal obstruction and not cholelithiasis. The mortality rate declined during reported time from 40-50% to 25%.

Aged↗