Biomedical subjects
Publications and source records attributed to W Härtl.
In 25 patients suffering from chronic obstructive bronchitis, it has been shown that the administration of nifedipine brings about a decrease in the beat rate of nasal cilia which, in the individual case, may be very marked. The addition of salbutamol can more than compensate for this decrease in cilial beat rate.
As the third "pillar" in the treatment of chronic obstructive airway diseases after acute treatment and long-term drug treatment aimed at avoiding late sequelae of the disease, this article describes the "patient school". Its aims are, on the one hand to motivate the patient to develop better compliance, and, through the utilisation of non-medicamentous possibilities, to greatly improve the patient's quality of life and his long-term prognosis. The Bad Reichenhall model is characterized as an integrated concept with the following main thrusts: helping the patient to better cope with and accept his disease, to provide education and behavioral training with the aim of permitting the patient to adapt his activities to the constraints of his disease.
In a pilot evaluation study, 186 out of-so far-600 patients who underwent 40 "educational cycles" were submitted to a controlled interview to determine the learning effect, patient's views on educational matters and, at least in part, on the success of the latter in terms of improved quality of life, treatment and the social environment. For this purpose, questions that appeared similar while having the identical content, were asked prior to "schooling", immediately following such instruction and six months later. The return rate of the 6-month questionnaires achieved an astonishing almost 80%, which represents a very good figure. Sixteen questions were asked about the contents of instruction, which, in turn, divided up into six complexes.
The contraindication between optimal treatment and, nevertheless, increasing morbidity and mortality in bronchial asthma results in interest being focussed on patient education aimed at improving the patient's own responsibility. The decisive object of any educational measures must be to increase this sense of own responsibility. In Germany, such educational measures are rarely provided, for the most part being offered by rehabilitation centres. At the present time, statistical data on the effect of such measures are available for some 500 patients. These patients are better informed and are better able to cope with their disease on a day-to-day basis, while therapeutic discipline is improved. The patients themselves desire such education in close conjunction with hospitals (rehabilitation centres) and their own physicians. The newly founded working group Patient Education at the Germany Society for Pneumology and Tuberculosis, has set itself the task of coordinating presently available activities. In an initial phase, current activities offered are made known and matched to one another. The next step is to work put the common essentials of the educational aims, contents and forms for children and adults with asthma, bronchitis and emphysema. The final objective is to establish standards for educational programmes to be provided by hospitals and rehabilitation centres, and for pre- and post-instruction by the patient's own physician.
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In the present study, the erythropoietic activity of fetal serum was characterized. Using fetal bovine serum (FBS) as a source of the erythropoietic activity and serum-free cultures of fetal mouse livers (FMLC assay) as a detection system, we found that FBS stimulated colony formation from late erythroid progenitor cells (CFU-E) in a dose-dependent fashion. The slope of the dose-response curve, however, was significantly different from that for erythropoietin (Ep), the best-characterized erythropoietic activity so far. The erythropoietic activity of FBS was found in the 120-160- and 40-70-kD range at neutral pH. In the presence of 1 M acetic acid, however, the erythropoietic activity had an apparent molecular mass between 3 and 13 kD. From ion exchange experiments with DEAE-cellulose, the isoionic point of the activity was estimated to about pH 5. Furthermore, the erythropoietic activity of FBS was found to be co-eluted on Sephadex G-150 with the binding proteins of insulinlike growth factors (IGF). The IGF I concentration determined by radioimmunoassay was 70 ng IGF I/ml. The Ep activity of FBS was less than 5 mU/ml when determined with the posthypoxic polycythemic mouse assay for Ep. These results suggest that the erythropoietic activity of FBS is related to IGF and not to Ep. The erythropoietic activity of FBS was abolished by an antiserum against IGF I. Furthermore, IGF I was a factor of approximately 40 more potent than IGF II in stimulating erythroid colony formation. All of these findings suggest that the erythropoietic activity of FBS is IGF I.