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Biomedical subjects

W Bachmann

Publications and source records attributed to W Bachmann.

At least 19 recordsLinked to original sources

[Intraocular availability of liposome encapsulated monoclonal antibodies in the rabbit model. Results of a pilot study].

The results of local application of monoclonal antibodies (mAb) in rabbit eyes are presented. To improve intraocular access of the high-molecular-weight protein it was entrapped in large (0.2 microns) unilamellar, negatively charged liposomes. Concentrations of the free or encapsulated drug were measured by ELISA in different eye compartments following repetitive drop administration or single subconjunctival injection. Although mAb became measurable in specimens of conjunctiva and cornea, it was not detectable (less than 0.5 ng/ml) in aqueous humor, lens or the vitreous body. In contrast, concentrations of the liposome-encapsulated drug were measurable as little as 30 min after topical application in the aqueous humor.

Animals

[Laser-induced occlusion of corneal blood vessels with variable emission and absorption].

Laser light has repeatedly been proposed for the occlusion of corneal neovascularizations. Priority has to be given to minimize laser energy in order to limit side effects such as corneal burns. We investigate the influence of variable emission wavelength using a dye laser or dye-enhanced absorption with intravenous sodium fluorescein. Laser energy can be reduced using intravenous dyes at vessel diameters less than 50 microns. Permanent occlusion is achieved in 43% instead of 28% without dye-enhanced absorption. Vessels measuring greater than 50 microns in diameter can be occluded best at lowest laser energy levels when 575 nm laser light is used, which approximates the absorption maximum of hemoglobin.

Absorption

[Combination therapy with insulin/sulfonylurea in the long-term therapy of type II diabetes following "secondary failure"].

In type 2 diabetes with "secondary failure of sulfonylurea therapy" good metabolic control can seldom be achieved by insulin therapy even with high insulin doses. Hyperinsulinemia however is a possible risk factor of cardiovascular disease in type 2 diabetes. Maintaining the effects of sulfonylurea action insulin should be added in as small amounts as possible to avoid hyperinsulinemia and to ameliorate hyperglycemia. 16 type 2 diabetics with "secondary failure" were treated either with insulin alone (group A; n = 8) or with 3.5 mg b.i.d. glibenclamide plus small amounts of intermediate insulin (group B; n = 8) in a randomised order. After the inpatient period outpatient control was performed monthly up to six months, later on four times a year up to two years. Both groups were comparable with regard to age, duration of diabetes, body weight and metabolic control. The daily insulin dose was 14 +/- 2 IU (means +/- SEM) after one month and 19 +/- 2 IU after two years in group B. In contrast 30 +/- 3 IU and 43 +/- 5 IU respectively were needed in group A (p less than 0.001). All patients B were treated with one daily injection, all patients A needed two injections. Resulting in nearly identical metabolic control in group A basal insulin levels exceeded those in group B after two years significantly (28.6 +/- 3.7 vs. 18.6 +/- 1.6 mcU/ml; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Effectiveness of combined treatment with glibenclamide and insulin in secondary sulfonylurea failure. A controlled multicenter double-blind clinical trial].

The effectiveness of combined insulin and glibenclamide was compared with that of insulin alone in a multicenter double-blind trial of secondary sulphonylurea failures. Protocols of 176 patients at 26 centers were available, but only 68 could ultimately be included in the analysis. Combined insulin and glibenclamide (Euglucon N) had been taken by 37 patients, combined insulin and placebo by 31. The final criterion, postprandial one-hour blood sugar level of less than or equal to 220 mg/100 ml after 24 weeks, was attained by nearly 75% of patients in both groups. Fasting blood sugar and postprandial one-hour blood sugar as well as HbA1 did not differ during the entire test period of 24 weeks. Mean daily insulin dose was 20 IU in the insulin/glibenclamide group, 35 IU in the insulin/placebo group. This increased the number of second evening insulin injections by 50% in the insulin/placebo group compared with the insulin/glibenclamide group. The frequency of mild hypoglycemia was similar in the two groups. The results indicate that combined insulin/glibenclamide, given over a period of six months to patients with secondary sulphonylurea failure, provided metabolic results as good as those with insulin alone. The required insulin dosage was thus reduced by more than a third.

Adult

Strategy for the primary and secondary prevention of occupational diseases in the German Democratic Republic.

This review explains the German Democratic Republic's strategy for preventing occupational diseases, which is considered one of the primary purposes of public health. It is a complex challenge that is being tackled through close cooperation between enterprise-linked occupational health services, the inspectorates of industrial hygiene, public health centers, and trade unions. In primary prevention, planning is based on results obtained in thorough analyses of all the relevant parameters, such as work conditions, industrial accidents, occupational diseases, morbidity records, and the quality of social services, and a complex work analysis has been developed to provide comprehensive and measurable information on health hazards due to harmful physical and chemical factors, dust, and job-related physical and neuropsychic stresses. Primary prevention is realized mainly through the elimination of health hazards and the improvement of work conditions, both based on a comprehensive framework of legislation. At the level of secondary prevention, company-linked occupational health services are a part of the national health services. A nationwide information system consists of compatible components for primary and secondary prevention, thus enabling control of exposure-effect relationships and the optimization of health policy.

Accident Prevention

[Clinical testing of a new blood glucose measuring system. A cooperative study at 8 centers].

The glucometer II system is a small measurement device with built-in batch-specific pressbutton calibration. The corresponding test strip "Glucostix" uses a two-color system. The blood glucose test strip can be evaluated both visually and by instrument. The precision determined in series was between 2.0% and 6.7% using control sera. The day-to-day precision was between 1.5% and 7.9%. Comparison of the methods on the basis of 781 and 109 capillary blood samples respectively revealed a good agreement between the hexokinase method or the glucose oxidase method (Beckman analyser) and the glucometer II values. The precision of measurement by the system was comparable in the two test strip batches employed. Visual reading of the test strips revealed a good agreement with the laboratory method in the hypoglycemic and normoglycemic range; at higher concentrations of blood glucose, a trend to underestimation of the measurement values was shown. The easy handling and small size of the instrument facilitates measurement of blood glucose by the patient under everyday conditions.

Blood Glucose

Sustained normoglycemia and remission phase in newly diagnosed type I diabetic subjects. Comparison between continuous subcutaneous insulin infusion and conventional therapy during a one year follow-up.

After onset of type I diabetes 7 diabetics were randomized to subcutaneous insulin pump treatment (CSII) (age 12 to 29 years, mean: 21 years) and 7 diabetics to conventional insulin treatment (CI) (age 14 to 28 years, mean: 21 years). HbA1, glycosylated serum proteins and mean blood glucose (MBG) as parameters of metabolic control were determined monthly. After 2 months both groups showed HbA1 values in the normal range. Mean MBG values were (mean +/- SD) 116 +/- 7 mg/dl for CSII and 118 +/- 14 mg/dl for CI. Residual insulin secretion was determined monthly by fasting C-peptide. After 14 days, 5, 7, 8 months fasting C-peptide values were significantly (P less than 0.05) higher in CI. After one year fasting C-peptide was comparable in both groups (CSII and CI mean: 0.06 nmol/l). The administered insulin dose was comparable in both groups with a 55% reduction of insulin dose after 5 months in CSII (0.35 +/- 0.15 U/kg/24 h) and in CI after 7 months (0.31 +/- 0.28 U/kg/24 h). After 12 months of insulin therapy about 60% of the initial insulin dose was injected in both groups. 1 patient on CSII (12 years) and 2 patients on CI (15, 28 years) showed a complete remission (for 3-9 months) with no exogenous insulin and normal HbA1 values. 50% of the patients had episodes where they did need less than 0.2 U/kg/24 h insulin to maintain optimal diabetic control (3 CSII, 4 CI). During the first year of insulin treatment in type I diabetes with CSII as well as with CI a comparable near normalisation of diabetic control could be achieved.

Adolescent

Lack of a lipoprotein-induced insulin resistance in hepatoma cells in culture.

A lipoprotein-induced resistance to the action of insulin has been postulated. To test this hypothesis, cultured rat-derived hepatoma cells, designated FAO, and human-derived hepatoma cells, designated HEP-G2, were incubated for 20 h in the presence or absence of lipoprotein; specific 125I-insulin receptor binding and labeled glucose incorporation into glycogen were then measured. Very low density lipoproteins (d less than 1.006 g/ml) in physiologic (0.5 mg/ml) or pathophysiologic (5 mg/ml) concentrations did not modify insulin receptor binding of FAO or HEP-G2 cells. This was true for very low density lipoproteins derived from normal human, diabetic human, and streptozotocin-diabetic rat plasma. Low density lipoproteins (d = 1.019 - 1.063 g/ml) isolated from normal human plasma similarly failed to modify insulin receptor binding. Concerning insulin action, the different very low density lipoprotein preparations did not modulate either basal or insulin-stimulated glucose incorporation into glycogen of the cells. Thus, very low density lipoproteins and low density lipoproteins did not induce insulin resistance in cultured hepatoma cells either at the insulin receptor level or at the post-receptor level.

Animals

[Experiences with Reflolux in blood sugar self testing].

As to correctness and accuracy the Reflolux system is comparable to the conventional measurement of blood glucose under laboratory conditions. Its handling is simple and safe so that diabetic patients are able to check their blood sugar reliably by self-control. Skilled patients achieve just as good results as laboratory personnel.

Blood Glucose