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Figueiredo A, Palma P, Riccetto C, Herrmann V, Dambros M, Capmartin R. Experiencia clínica y urodinámica con ácido hialurónico intravesical en el síndrome de vejiga dolorosa asociado a cistitis intersticial. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000300013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Figueiredo A, Palma P, Riccetto C, Herrmann V, Dambros M, Capmartin R. [Clinical and urodynamic experience with intravesical hyaluronic acid in painful bladder syndrome associated with interstitial cystitis]. Actas Urol Esp 2011; 35:184-7. [PMID: 21397161 DOI: 10.1016/j.acuro.2010.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 08/30/2010] [Accepted: 09/01/2010] [Indexed: 11/24/2022]
Abstract
INTRODUCTION few studies have been carried out on therapeutic options in patients with painful bladder syndrome associated with interstitial cystitis. The aim is to verify the safety and effectiveness of treatment with sodium hyaluronate through intravesical instillation in patients with painful bladder syndrome. MATERIALS AND METHODS a series of 18 female patients is presented, with a mean age of 51 years and prior diagnosis of painful bladder syndrome, who were treated by means of the weekly infusion of an intravesical solution of 40mg of sodium hyaluronate in sterile solution, over a period of eight weeks. The patients were examined clinically and urodynamically prior to their inclusion in the study and eight months after the instillations had concluded. RESULTS there was a statistically significant improvement in the urodynamic parameters and in the symptoms measured quantitatively by means of the questionnaire "Pelvic Pain and Urgency/Frequency" between the baseline situation and after the vesical instillation of sodium hyaluronate in patients with painful bladder syndrome. There was no toxicity arising from the treatment, given that no adverse effects were recorded in relation to it. CONCLUSION the clinical use of intravesical hyaluronic acid in patients with painful bladder syndrome possibly associated with interstitial cystitis has been demonstrated. The clinical improvement is also associated both with increased bladder capacity and improved bladder sensitivity. Tolerance was excellent. Clinical tests that more profoundly evaluate the therapeutic potential of this drug in this type of patients are required.
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Moldovan D, Fechete R, Demco DE, Culea E, Blümich B, Herrmann V, Heinz M. The heterogeneity of segmental dynamics of filled EPDM by (1)H transverse relaxation NMR. J Magn Reson 2011; 208:156-162. [PMID: 21106419 DOI: 10.1016/j.jmr.2010.10.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 10/29/2010] [Accepted: 10/31/2010] [Indexed: 05/30/2023]
Abstract
Residual second moment of dipolar interactions M(2) and correlation time segmental dynamics distributions were measured by Hahn-echo decays in combination with inverse Laplace transform for a series of unfilled and filled EPDM samples as functions of carbon-black N683 filler content. The fillers-polymer chain interactions which dramatically restrict the mobility of bound rubber modify the dynamics of mobile chains. These changes depend on the filler content and can be evaluated from distributions of M(2). A dipolar filter was applied to eliminate the contribution of bound rubber. In the first approach the Hahn-echo decays were fitted with a theoretical relationship to obtain the average values of the (1)H residual second moment <M(2)> and correlation time <τ(c)>. For the mobile EPDM segments the power-law distribution of correlation function was compared to the exponential correlation function and found inadequate in the long-time regime. In the second approach a log-Gauss distribution for the correlation time was assumed. Furthermore, using an averaged value of the correlation time, the distributions of the residual second moment were determined using an inverse Laplace transform for the entire series of measured samples. The unfilled EPDM sample shows a bimodal distribution of residual second moments, which can be associated to the mobile polymer sub-chains (M(2) ≅ 6.1 rad (2) s(-2)) and the second one associated to the dangling chains M(2) ≅ 5.4 rad(2) s(-2)). By restraining the mobility of bound rubber, the carbon-black fillers induce diversity in the segmental dynamics like the apparition of a distinct mobile component and changes in the distribution of mobile and free-end polymer segments.
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Affiliation(s)
- D Moldovan
- Technical University of Cluj-Napoca, Daicoviciu 1, R-400020 Cluj-Napoca, Romania
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Botelho S, Riccetto C, Ribeiro G, Gome J, Brisola M, Herrmann V, Palma P, Bigozzi M. Síntomas de vejiga hiperactiva en mujeres en fase gestacional y puerperal: ¿existe correlación entre los síntomas y la percepción de la calidad de vida? Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000900008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Botelho S, Riccetto C, Ribeiro G, Gome J, Brisola M, Herrmann V, Palma P, Bigozzi MA. [Overactive bladder symptoms in pregnancy and puerperium: is there a relationship between the symptoms score and quality of life?]. Actas Urol Esp 2010; 34:794-797. [PMID: 20843457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION AND OBJECTIVE During pregnancy, hormonal change, increase in the body mass index and the pressure caused by the enlarged uterus over the bladder and pelvic floor, are some factors involved in lower urinary tract symptoms (LUTS). This study was made to evaluate the correlation between pregnancy and delivery way with LUTS. MATERIAL AND METHOD This open prospective study was carried out using the overactive bladder questionnaire short form (OABq-SF). A total of 60 patients enrolled this study. The mean age was 24 year, raging from 14 to 40 years. The patients were evaluated during the third trimester and 6 months after delivery. Statistical analysis of the OABq-SF scores was made using the Pearson method. RESULTS Mean OABq-SF score during pregnancy was 35.2 and 6 months after delivery decreased to15. Quality of life was 82.9 during pregnancy and increased to 88.4 at 6 month after delivery. Patient's perception, that is correlation, was 55.02 (p=0.0001) during pregnancy and 36.1% (p=0.0046). Clinical correlation index was 6.7%. CONCLUSIONS Our study demonstrated that in spite of LUTS being more important during pregnancy, there is no significant clinical correlation in patient's perception.
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Affiliation(s)
- S Botelho
- Servicio de Obstetricia, Pontifícia Universidade Católica de Minas Gerais campus Poços de Caldas, Brasil
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Botelho S, Riccetto C, Ribeiro G, Gome J, Brisola M, Herrmann V, Palma P, Bigozzi M. Síntomas de vejiga hiperactiva en mujeres en fase gestacional y puerperal: ¿existe correlación entre los síntomas y la percepción de la calidad de vida? Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2010.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Benedito de Castro E, Palma P, Riccetto C, Herrmann V, Bigozzi M, Olivares J. Impacto de la suspensión de la cúpula vaginal al ligamento sacroespinoso sobre el compartimiento anterior. Actas Urol Esp 2010. [DOI: 10.4321/s0210-48062010000100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Botelho S, Riccetto C, Ribeiro G, Gome J, Brisola M, Herrmann V, Palma P, Bigozzi M. Overactive bladder symptons in pregnancy and puerpery: Is there a relationship between the symptoms score and quality of life? ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s2173-5786(10)70196-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Benedito de Castro E, Palma P, Riccetto C, Herrmann V, Bigozzi MA, Olivares JM. [Impact of sacrospinous vaginal vault suspension on the anterior compartment]. Actas Urol Esp 2010; 34:106-110. [PMID: 20223141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES A prospective study was conducted to assess the efficacy of sacrospinous vaginal vault fixation and its impact on the anterior compartment. The Pelvic Organ Prolapse Quantification (POP-Q) system was used to quantify pelvic organ prolapse in the apical and anterior vaginal compartments. METHODS Fifty-eight patients underwent a procedure to correct apical prolapse from March 2003 to February 2006. Mean preoperative and postoperative POP-Q scores were respectively: Aa (+0.74; -1.45); Ba (+3.17; -1.36); C (+3.41; -7.71) (p<0.001). RESULTS Cure rate was 93.1%. Preoperative and postoperative evaluation of the anterior vaginal compartment was respectively: stage 1 (5.2%; 48.3%), stage 2 (6.9%; 34.5%), stage 3 (74.1%; 5.2%), and stage 4 (13.8%; 0%). De novo cystocele occurred in 87.9% of cases. An improvement was seen in lower urinary tract symptoms of urgency, nocturia, and urge incontinence. CONCLUSIONS Sacrospinous vaginal vault suspension is effective for the treatment of apical prolapse and leads to formation of cystocele in most cases.
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Affiliation(s)
- E Benedito de Castro
- Department of Gynecology and Urology, Universidade Estadual de Campinas, São Paulo, Brasil
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Palma P, Riccetto C, Herrmann V, Miyaoka R, Fraga R. POS-01.17: The percutaneous sling for stress urinary incontinence: Towards the in-office procedure. Urology 2007. [DOI: 10.1016/j.urology.2007.06.905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Palma P, Riccetto C, Fraga R, Pagotto V, Castro E, Herrmann V, Tejerizo J, Metrebien S. POS-01.16: Level specific correction of apical and posterior prolapses: why transcoccigeal fixation makes a difference. Urology 2007. [DOI: 10.1016/j.urology.2007.06.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rocha MA, Sartori MGF, De Jesus Simões M, Herrmann V, Baracat EC, Rodrigues de Lima G, Girão MJBC. Impact of pregnancy and childbirth on female rats’ urethral nerve fibers. Int Urogynecol J 2007; 18:1453-8. [PMID: 17393052 DOI: 10.1007/s00192-007-0355-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 03/03/2007] [Indexed: 10/23/2022]
Abstract
This study aims to evaluate the urethral nerve fibers of adult female rats during pregnancy and after vaginal birth, cesarean section or simulated birth trauma. For immunohistochemical analysis of nerve fibers, 70 female rats were distributed in seven groups of ten female rats: group 1, control; group 2, pregnant; group 3, cesarean section; group 4, vaginal birth; group 5, virgin female rats with simulated birth trauma; group 6, cesarean section followed by simulation of birth trauma; and group 7, vaginal birth followed by simulation of birth trauma. The number of nerve fibers in groups 1, 2, and 3 were significantly higher than the other groups. Pregnancy and cesarean section did not cause alterations in the nerve fibers number. Vaginal birth and simulated birth trauma significantly decreased the number of nerve fibers in the female rats' middle urethra.
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Affiliation(s)
- M A Rocha
- Gynecology Department, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
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Rocha MA, Sartori MGF, De Jesus Simões M, Herrmann V, Baracat EC, Rodrigues de Lima G, Girão MJBC. The impact of pregnancy and childbirth in the urethra of female rats. Int Urogynecol J 2006; 18:645-51. [PMID: 17043741 DOI: 10.1007/s00192-006-0221-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2006] [Accepted: 08/21/2006] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate the modifications in the amount of collagen, muscular, and elastic fibers in the mid-urethra of adult female rats during the pregnancy and after the natural childbirth, cesarean, and after simulated trauma of childbirth. The authors evaluated the histomorphometric aspects (collagen, muscular, and elastic fibers) in the mid-urethra of 70 animals distributed in seven groups: group 1 (n = 10)--control, group 2 (n = 10)--pregnant female rats, group 3 (n = 10)--female rats submitted to cesarean, group 4 (n = 10)--female rats with natural childbirth, group 5 (n = 10)--virgin female rats with simulated trauma of childbirth, group 6 (n = 10)--female rats submitted to cesarean followed by simulation of childbirth trauma, and group 7 (n = 10)--female rats with natural childbirth followed by simulation of childbirth trauma. The average concentration of collagen and elastic fibers and the collagen/muscular fiber correlation in groups 1, 2, and 3 were similar and significantly inferior to groups 4, 5, 6, and 7. The average of muscular fibers was similar in groups 1, 2, and 3 and significantly superior to groups 4, 5, 6, and 7. Pregnancy and cesarean did not induce alterations in collagen, muscular, and elastic fibers. However, the vaginal delivery and simulation of childbirth trauma determined the decrease in muscular fibers and the increase in collagen and elastic fibers and the correlation collagen/muscular fiber.
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Affiliation(s)
- M A Rocha
- Gynecology Department, Federal University of São Paulo, São Paulo, SP, Brazil.
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Scarpa KP, Herrmann V, Palma PCR, Riccetto CLZ, Morais SS. Prevalence and correlates of stress urinary incontinence during pregnancy: a survey at UNICAMP Medical School, São Paulo, Brazil. Int Urogynecol J 2005; 17:219-23. [PMID: 16021326 DOI: 10.1007/s00192-005-1361-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Accepted: 06/20/2005] [Indexed: 11/26/2022]
Abstract
The aim of this study was to evaluate the prevalence of stress urinary incontinence (SUI) in women in the third trimester of pregnancy. In total, 340 patients attending the Antenatal Clinic at the State University of Campinas (UNICAMP) were interviewed. Overall, 170 women (50%) presented SUI. Stress urinary incontinence did not correlate to either body mass index (BMI) or race. There was no correlation between parity and SUI, but when considering distinct types of effort, urine leakage on coughing (P = 0.0478) and laughing (P = 0.0046) were highly more frequent in multiparous women. One hundred eleven women had had only vaginal deliveries and 68 delivered by cesarean section. There was no difference between the two groups concerning incontinence, but multiparous women (> or = 4) who delivered exclusively vaginally demonstrated 2.0 times more chances to leak urine when compared to nulliparous women. This fact strongly suggests parity to be more relevant than delivery route as a risk factor to stress urinary incontinence. Nulliparous women presented with a high percentage (45.5%) of the symptom, emphasizing the elevated risk of SUI during first pregnancy.
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Affiliation(s)
- K P Scarpa
- Department of Obstetrics and Gynecology, State University of Campinas, São Paulo, Brazil
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Abstract
OBJECTIVE We present our initial experience with the Perigee system for anterior vaginal wall prolapses repair. MATERIAL AND METHOD 15 patients with anterior vaginal wall prolapse (mean age: 62 years old) underwent implanted with Perigee system which is composed by a mesh for correcting central defect and four self-attached horns for correcting lateral defect. The implanted procedure consist of four steps: 1) lateral vaginal wall dissection as far as isquiopubic branch; 2) performance of two upper marks at genitofemoral fold and two lower marks at 2 cm laterally and 3 cm lower; 3) insertion of the upper needles parallel to the isquiopubic branch and connection with the mesh's "arms" plus insertion of the lower needles vertically and connection with mesh's "legs"; 4) to adjust the mesh free tension. The system POP-Q was used as an objective measure of correction rate. RESULTS Preoperatively, the point Aa was 0.09. After 6 weeks and three months postoperatively was -3.00 and -2.73 respectively. Preoperatively, the point Ba was 1.73. After 6 weeks and three months postoperatively was -2.82 and -2.82 respectively. No major complications were presented. No vascular damage or significant bleeding was observed. CONCLUSION The transobturator correction of cystocele is an attractive alternative. The initial good outcome may be expected to be long lasting.
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Affiliation(s)
- P Palma
- Servicio de Uroginecología, Universidade Estadual de Campinas-UNICAMP, Campinas, Brasil
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Palma P, Rane A, Riccetto C, Herrmann V, Dambros M, Tarazona A. Corrección transobturatoria de los cistoceles. Actas Urol Esp 2005. [DOI: 10.4321/s0210-48062005000100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Palma PR, Riccetto CZ, Dambros M, Thiel M, Fraga RD, Tamanini JN, Herrmann V, Netto Jr. N, Grossi O, Zangone M, Paladini M, Retto H, Colaço J, Castro Díaz D. Safyre: Un nuevo concepto de cabestrillo ajustable mínimamente invasivo para la incontinencia urinaria por estrés femenina. Actas Urol Esp 2004. [DOI: 10.4321/s0210-48062004001000006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Aft R, Ylagan L, Sadeghi S, Eberlein T, Herrmann V, Dietz J, Fracasso P, Naughton M, Weilbaecher K. Effect of neoadjuvant chemotherapy on bone marrow micrometastases in women with locally advanced breast cance. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Aft
- Washington University, Saint Louis, MO
| | - L. Ylagan
- Washington University, Saint Louis, MO
| | | | | | | | - J. Dietz
- Washington University, Saint Louis, MO
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Herrmann V, Arya LA, Myers DL, Jackson ND, Palma PC, Riccetto CL. Urethral resistance measurement: a new method for evaluation of stress urinary incontinence in women. Int Urogynecol J 2004; 15:208-11. [PMID: 15168003 DOI: 10.1007/s00192-004-1142-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2003] [Accepted: 01/31/2004] [Indexed: 11/26/2022]
Abstract
The aim of this study was to evaluate a new method to measure urethral resistance among 66 women with urinary incontinence. A stainless steel sphere attached to a guide wire was developed. The sphere is inserted into the bladder and withdrawn through the urethra at a steady rate. Serial measurements with spheres of 5, 6 and 7 mm were performed. The mean urethral resistance as measured by the largest sphere (0.07+/-0.03) was significantly greater than that measured by the medium sphere (0.06+/-0.02, p<0.0001), which was significantly larger than that measured by the smallest sphere (0.04+/-0.01, p<0.0001). There was good correlation of urethral resistance with maximum urethral closure pressure (MUCP) by this technique, but no correlation with Valsalva leak point pressure (VLPP).
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Affiliation(s)
- V Herrmann
- State University of Campinas (UNICAMP), Rua: Alexander Flemming 101, Mailbox 6081, 13083-970, Campinas, São Paulo, Brazil.
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Dietz JR, Rastelli A, Bokern J, Herrmann V. Mammary ductoscopy to further characterize ductal lavage-diagnosed atypia: Correlation between cytology, endoscopy, and surgical pathology. Ann Surg Oncol 2004. [DOI: 10.1007/bf02524129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Palma PCR, Riccetto CLZ, Dambros M, Thiel M, de Fraga R, Tamanini JTN, Herrmann V, Netto NR, Grossi O, Zangone M, Paladini M, Retto H, Colaço J, Castro Díaz D. Safyre. Un nuevo concepto de cabestrillo ajustable mínimamente invasivo para la incontinencia urinaria por estrés femenina. Actas Urol Esp 2004; 28:749-55. [PMID: 15666517 DOI: 10.1016/s0210-4806(04)73176-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION SAFYRE is a new readjustable and minimally invasive sling for the treatment of stress urinary incontinence (SUI). Attempts to restore the normal suburethral hammock using an anatomical approach have been made in recent years. The authors report their experience with this device, which associates the efficacy of slings with readjustability. MATERIAL AND METHODS A total of 100 consecutive patients with clinical and urodynamic diagnosis of SUI underwent SAFYRE sling procedure. The age range was from 40 to 71, mean age 63 years. Seventy-five patients (75%) presented previous failed anti-incontinence procedures. Physical clinical examination, stress test, pad use and a urodynamic study were performed before the surgery. All the patients presented symptoms of SUI and 30% also reported mild urgency. RESULTS The average follow up period was 14 months (12-30 months). The mean operative time was of 25 minutes. Dystopia repair was performed whenever necessary, during the same procedure. The average hospital stay was 24 hours. In 3% of the implants, bladder perforation occurred. During the postoperative period, 26 patients developed urgency symptoms. During that follow up period, 92% were found to be continent, 3% reported an improvement and 5% were dissatisfied. CONCLUSION SAFYRE is a safe and quick procedure that allows for postoperative readjustment. This technique may be an attractive alternative if the good result obtained so far proves to be long lasting.
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Affiliation(s)
- P C R Palma
- División de Urología, Universidade Estadual de Campinas, UNICAMP
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Herrmann V, Zimermann M, Matz H, Konecny E, Elazar J, Gehring H. VERWENDUNG VON ULTRASCHALL ALS ORTUNGSSYSTEM FÜR NICHTINVASIVE OPTISCHE REFLEXIONSMESSUNG IM GEWEBE. BIOMED ENG-BIOMED TE 2003. [DOI: 10.1515/bmte.2003.48.s1.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
This paper deals with main aspects of pathogenesis of urinary tract infection (UTI). Bacterial and host-related factors such as defense mechanisms and predisposing factors are described. Special aspects of UTI in elderly patients and during pregnancy are discussed. Recurrent cystitis and prophylactic measures are also reported.
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Affiliation(s)
- V Herrmann
- UNICAMP, Rua Alexandre Flemming 101, 10383-970 Campinas, SP, Brazil
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Guarisi T, Pinto-Neto AM, Herrmann V, Faúndes A. Urodynamics in climacteric women with urinary incontinence: correlation with route of delivery. Int Urogynecol J 2002; 13:366-71; discussion 371. [PMID: 12466907 DOI: 10.1007/s001920200081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to compare the urodynamic findings among climacteric women complaining of urinary incontinence who had only vaginal deliveries with those who had only cesarean sections. The study group comprised 30 climacteric women with complaints of urinary incontinence consulting at the Menopause Outpatient Clinic, State University of Campinas, submitted to anamneses and complete urodynamic testing. Nineteen women had had only vaginal deliveries and 11 were delivered only by cesarean section. Vaginal delivery was significantly associated with a reduced normal and strong desire to void and maximum cystometric capacity compared to women who delivered only by Cesarean section. Detrusor instability was four to five times more frequent among women who had had only vaginal deliveries. There was no difference between the two groups concerning uroflowmetry parameters. Climacteric women with urinary incontinence who had had only vaginal deliveries are at a higher risk of urodynamic abnormalities.
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Affiliation(s)
- T Guarisi
- State University of Campinas, Campinas, Sâo Paulo, Brazil
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Herrmann V, Krebs P. Temperature Dependence of Optical Absorption Spectra of Solvated Electrons in CD3OD for T .ltoreq. Tc. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100018a007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Patients who develop cholestatic jaundice during chronic total parenteral nutrition (TPN) can develop significant hematologic complications due to hypocupremia if copper supplementation is withheld. A 36-year-old female with short bowel syndrome developed progressive liver dysfunction 6 months after initiation of TPN. Trace elements were omitted from her TPN because of cholestasis and persistent hyperbilirubinemia. Despite chronic diarrhea, absorption of some dietary copper was anticipated from her oral diet. Fifteen months later, the patient became red cell transfusion dependent, and her neutrophil and platelet counts steadily declined. After 19 months of receiving TPN without trace elements, her serum copper level was 25 microLg/dL (normal: 70 to 155 microg/dL). Provision of trace elements for 2 months was associated with increased serum copper, neutrophil and platelet counts and independence from red cell transfusions. When the serum copper level reached 186 microg/dL, copper supplementation was discontinued. Over the next 3 months, serum copper level fell to 10 microg/dL, neutrophil and platelet counts fell precipitously, and red cell transfusions were resumed. Once again, copper, neutrophil and platelet levels promptly rebounded with parenteral copper supplementation. Although anemia and neutropenia are well-recognized hematologic consequences of copper deficiency, thrombocytopenia rarely has been reported. This is the first report of pancytopenia secondary to TPN-related copper deficiency in which the association was confirmed when hypocupremia recurred.
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Affiliation(s)
- M P Fuhrman
- Nutrition Support, Saint Louis University Hospital, Missouri 63110, USA
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Abstract
beta-Adrenergic receptor (betaAR) activation and/or increases in cAMP regulate growth and proliferation of a variety of cells and, in some cells, promote cell death. In the current studies we addressed the mechanism of this growth reduction by examining betaAR-mediated effects in the murine T-lymphoma cell line S49. Wild-type S49 cells, derived from immature thymocytes (CD4(+)/CD8(+)) undergo growth arrest and subsequent death when treated with agents that increase cAMP levels (e.g., betaAR agonists, 8-bromo-cAMP, cholera toxin, forskolin). Morphological and biochemical criteria indicate that this cell death is a result of apoptosis. In cyc(-) and kin(-) S49 cells, which lack G(s)alpha and functional protein kinase A (PKA), respectively, betaAR activation of G(s)alpha and cAMP action via PKA are critical steps in this apoptotic pathway. S49 cells that overexpress Bcl-2 are resistant to cAMP-induced apoptosis. We conclude that betaAR activation induces apoptosis in immature T lymphocytes via G(s)alpha and PKA, while overexpression of Bcl-2 prevents cell death. betaAR/cAMP/PKA-mediated apoptosis may provide a means to control proliferation of immature T cells in vivo.
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Affiliation(s)
- L Yan
- Department of Pharmacology, University of California, San Diego, La Jolla, California 92093-0636, USA
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Herrmann V, Büscher R, Go MM, Ring KM, Hofer JK, Kailasam MT, O'Connor DT, Parmer RJ, Insel PA. Beta2-adrenergic receptor polymorphisms at codon 16, cardiovascular phenotypes and essential hypertension in whites and African Americans. Am J Hypertens 2000; 13:1021-6. [PMID: 10981553 DOI: 10.1016/s0895-7061(00)01188-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Beta2-adrenergic receptors (beta2-AR) contribute to cardiovascular regulation by influencing several functions and previous studies suggest that a decreased function of the beta2-AR may be involved in essential hypertension. Beta2-AR are polymorphic and certain polymorphisms of these receptors are of functional importance. We focus here on the Arg16-->Gly16 beta2-AR polymorphism, which shows enhanced agonist-promoted downregulation of the receptor and which, in two recent studies, yielded opposite results in terms of association with essential hypertension: an increased frequency of the Gly16 variant in African-Caribbean hypertensives and of the Arg16 variant in offspring of Norwegian white hypertensive parents. In the current study, we genotyped 243 subjects, including both African-American and white individuals, for codon 16 polymorphism and assessed blood pressure and cardiovascular function using impedance cardiography and pressor sensitivity to phenylephrine. We found similar patterns of cardiovascular function and expression of hypertension with the two genotypes of codon 16. There was no statistically significant difference in the overall allelic distribution of the two genotypes: among African-Americans, 51% of the hypertensives and 50% of the normotensives carried the Arg16 allele, whereas among the white subjects 40% of the hypertensives and 47% of the normotensives were carriers of the Arg16 allele. Although we observed a statistically significant increase in the Arg16/Gly16 heterozygotes in the African-American population, the Gly16 allele was not significantly increased in the African-Americans compared to whites. These findings indicate that the codon 16 polymorphisms are not associated with hypertension in a mixed American study population nor do they appear to substantially impact on a variety of hemodynamic variables.
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Affiliation(s)
- V Herrmann
- University of California at San Diego, Department of Pharmacology, La Jolla 92093-0636, USA
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Fuchs B, Breithaupt-Grögler K, Belz GG, Roll S, Malerczyk C, Herrmann V, Spahn-Langguth H, Mutschler E. Comparative pharmacodynamics and pharmacokinetics of candesartan and losartan in man. J Pharm Pharmacol 2000; 52:1075-83. [PMID: 11045887 DOI: 10.1211/0022357001774994] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The angiotensin II antagonistic effects of candesartan and losartan were compared in-vivo after single and repeated doses. Effects were related to antagonistic activity in plasma. In this double-blind, crossover study, 12 healthy male volunteers received, in random order, daily oral doses of 8 mg candesartan cilexetil or 50 mg losartan for seven days. On day 1 and day 8, dynamics and kinetics were assessed up to 48 h after dosing. Antagonistic effect was determined from the antagonist-induced rightward shifts of the diastolic blood pressure response curves to exogenously administered angiotensin II measured as the dose ratio (DR). The antagonistic activity in plasma was measured using an ex-vivo/in-vitro radioreceptor assay. Specific high-performance liquid chromatography assays determined plasma concentrations of candesartan, losartan and its active metabolite EXP-3174. The pharmacokinetic properties of candesartan and losartan were comparable and antagonistic activity in plasma almost identical (ratio candesartan: losartan = 0.97 and 1-2 after single and multiple doses, respectively). However, the antagonistic effects of candesartan and losartan in-vivo were quite different. Twenty-four hours after single dosing with candesartan a clinically relevant rightward shift in the angiotensin II dose-response curve (DR= 3.2) occurred that was more pronounced than that following losartan administration (DR=2.1, ratio candesartan: losartan= 1.65). Twenty-four hours after multiple doses of candesartan or losartan, the values of the DR were 4.8 and 2.3, respectively (ratio candesartan: losartan = 1.94). The values of DR for candesartan were significantly higher compared with losartan between 6 and 36h after a single dose and between 3 and 24 h post-dose following multiple dose administration. A counter-clockwise hysteresis was apparent between antagonistic activity in plasma and antagonistic effect. Despite equivalent angiotensin II antagonistic activity in plasma, the pharmacodynamic effect of candesartan cilexetil was greater than that of losartan. Candesartan appeared to have a slower off-rate from the angiotensin AT1-receptor compared with losartan, nevertheless differences in distributional phenomena or the extent of insurmountable antagonistic activity cannot be ruled out.
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Affiliation(s)
- B Fuchs
- Center for Cardiovascular Pharmacology, ZeKaPha GmbH, Mainz/Wiesbaden, Pharmacological Institute, Johann-Wolfgang-Goethe-University, Frankfurt Germany
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Büscher R, Herrmann V, Ring KM, Kailasam MT, O'Connor DT, Parmer RJ, Insel PA. Variability in phenylephrine response and essential hypertension: a search for human alpha(1B)-adrenergic receptor polymorphisms. J Pharmacol Exp Ther 1999; 291:793-8. [PMID: 10525102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Genetic polymorphisms in drug receptors, in particular adrenergic receptors, may contribute to intersubject differences in pharmacologic response. We tested patients and first-degree normotensive and hypertensive relatives of patients with essential hypertension and found substantial intersubject variability in blood pressure response to infusion of the alpha(1)-adrenergic agonist phenylephrine. Because response to phenylephrine depends upon interaction with alpha(1B)-adrenergic receptors, we tested whether polymorphisms in this receptor contribute to the variable responses. Accordingly, we developed a polymerase chain reaction-based method, generating four exon-spanning fragments, to identify polymorphisms in the coding sequence of the two exons of the human alpha(1B)-adrenergic receptor. We sequenced the entire coding sequence of exon 1 from 51 subjects and exon 2 from 16 of these 51 subjects. Compared with the published sequence for the alpha(1B)-adrenergic receptor, we found one amino acid addition in exon 2 at position 368 (Arg) and one substitution (Arg371Gly) in all subjects. We thus suggest we have defined the correct coding sequence of the human alpha(1B) receptor. We found two "silent" polymorphisms in exon 1, one of which occurred in 3 of 51 subjects. These polymorphisms were unrelated to blood pressure status or response to phenylephrine. The 95% confidence intervals for expression of polymorphisms in exons 1 and 2 were 0 to 11%. Our data reveal that although phenylephrine response varies in humans, frequent polymorphisms in the coding sequence of the human alpha(1B)-adrenergic receptor appear not to account for this variation or for the increased blood pressure in patients with essential hypertension.
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Affiliation(s)
- R Büscher
- Departments of Pharmacology and Medicine, University of California-San Diego, La Jolla, California, USA
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Affiliation(s)
- R Büscher
- University of California at San Diego, Department of Pharmacology, La Jolla 92093-0636, USA
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Abstract
alpha- and beta-adrenergic receptors belong to the superfamily of G-protein-coupled, seven transmembrane domain receptors and regulate a variety of cellular processes. Previous studies have demonstrated that changes in the amino acid sequence can result in substantial changes in the function of the receptors and it has been suggested that there may be an association between different disease states and the altered structure of alpha- and beta-adrenergic receptors. Accordingly, we have developed a simple PCR method for the identification of polymorphisms in the coding sequences of the human beta2-adrenergic receptor and the alpha1B-adrenergic receptor. This method may be useful for screening individual patients or at-risk populations for endocrine-metabolic disorders, as well as for asthma, cardiovascular disorders, and neuropsychiatric diseases.
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Affiliation(s)
- R Büscher
- Department of Pharmacology, University of California at San Diego, La Jolla, California 92093-0636, USA
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Malerczyk C, Fuchs B, Belz GG, Roll S, Butzer R, Breithaupt-Grögler K, Herrmann V, Magin SG, Högemann A, Voith B, Mutschler E. Angiotensin II antagonism and plasma radioreceptor-kinetics of candesartan in man. Br J Clin Pharmacol 1998; 45:567-73. [PMID: 9663812 PMCID: PMC1873652 DOI: 10.1046/j.1365-2125.1998.00722.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/1997] [Accepted: 01/06/1998] [Indexed: 11/20/2022] Open
Abstract
AIMS The pharmacodynamic properties of the angiotensin II antagonist candesartan in humans were assessed from the rightward shifts of angiotensin II dose-effect curves (Schild regression technique). The pharmacokinetic characteristics were determined by radioreceptor assay (r.r.a.) and h.p.l.c. METHODS Twelve healthy male volunteers received single oral doses of 4, 8 and 16 mg candesartan cilexetil and placebo. Plasma was obtained for h.p.l.c. and r.r.a. (receptors: rat lung; radioligand: [125I-Sar1Ile8]-angiotensin II). Before and up to 24 h post dosing angiotensin II was infused in ascending dose steps until blood pressure (systolic and/or diastolic) increased by +25 mmHg. Individual angiotensin II dose-effect curves were fitted according to an Emax model and dose ratios (DR) calculated from the antagonist induced rightward shifts. RESULTS Candesartan, the active metabolite of candesartan cilexetil, declined from peak concentrations at about 4 h with a t1/2 of about 6 h. A linear relation (slope 1) between h.p.l.c. and r.r.a. data revealed that there is no other active metabolite. DR at 6-9 h post dosing reached a maximum of about 30 and at 24 h still amounted to 4-7, indicating the persistence of a relevant antagonistic effect in vivo. The apparent Ki-doses (derived from Schild regression plots) indicated a high potency (1.9 mg at 24 h) and slow decline of effect. Between plasma concentrations and antagonistic effect a counterclockwise hysteresis was visible. CONCLUSIONS A longer persistence of the antagonistic effect at the receptor site than expected by the presence in plasma indicates a slow off-rate of candesartan cilexetil from in vivo receptors. This provides an additional rationale for the observed 24 h therapeutic activity of candesartan cilexetil.
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Affiliation(s)
- C Malerczyk
- Center for Cardiovascular Pharmacology, ZeKaPha GmbH, Mainz/Wiesbaden, Germany
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35
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Breithaupt-Grögler K, Malerczyk C, Belz GG, Butzer R, Herrmann V, Stass H, Wensing G. Pharmacodynamic and pharmacokinetic properties of an angiotensin II receptor antagonist--characterization by use of Schild regression technique in man. Int J Clin Pharmacol Ther 1997; 35:434-41. [PMID: 9352392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The pharmacodynamic properties of a new angiotensin II receptor antagonist (BAY 10-6734) in humans were to be quantitatively characterized from the rightward shifts of the agonist dose-response curves after administration of different doses of the antagonist. METHODS 24 healthy male volunteers received single oral doses of 20-300 mg BAY 10-6734. Before and up to 23 h post dosing (p.d.) plasma was obtained for HPLC measurement of parent compound and active metabolite BAY 10-6735. Exogenous angiotensin II was infused in increasing dose steps until blood pressure had increased by +25 mmHg. Angiotensin II dose-response curves were fitted individually using the sigmoidal Emax model. From the antagonist-induced rightward shifts, as compared to a premedication curve, dose ratios (DR) were determined and DR-1 plotted versus applied dosages and measured plasma concentrations. From these Schild regression plots the fictive doses and concentration (Ki) inducing a DR-1 = 1, i.e. a 2-fold shift in agonist dose-response curves, were derived. The "doubling (t2.0) time" of the apparent Ki doses was calculated. RESULTS BAY 10-6734 dose-dependently induced rightward shifts of the angiotensin II blood pressure response curves, mean maximum DR at 2 h p.d. ranged from 42 (80 mg) to 216 (300 mg), and at 23 h p.d. decreased to about 2 (80 mg) to 4 (300 mg). Pharmacodynamic (3.4-4.6 h) and pharmacokinetic half-lives (3.4-4.3 h) were nearly identical. Apparent Ki doses increased from about 1-2 mg at 2 h p.d. to about 80-100 mg at 23 h p.d., their time course revealed a doubling (t2.0) time of 3.5-3.8 h. A Ki concentration of about 10 micrograms/l was obtained for the active metabolite BAY 10-6735. CONCLUSIONS Oral administration of BAY 10-6734 in man antagonized angiotensin II dose blood pressure response curves in a dose-dependent manner. The time kinetics of the pharmacodynamic effect, derived from the decay of DR-1 values, as well as the doubling time of the apparent Ki values well agreed with the pharmacokinetic half-life. Schild regression revealed competitive angiotensin II antagonistic properties within the dose/concentration range tested. This technique was shown to be an adequate means to evaluate pharmacodynamic potency and kinetic behavior of an angiotensin II receptor antagonist in vivo.
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Abstract
A total of 30 women with stress incontinence underwent periurethral injection of autologous fat under spinal anesthesia. The fat was harvested from the abdominal wall by liposuction. Preoperative evaluation consisted of history, physical examination, and urodynamic evaluation. For study purposes, some patients also underwent bladder and urethral ultrasonography and magnetic resonance imaging studies. The first 13 patients received a single periurethral lipoinjection, and the following 17 patients received sequential injections when needed at 3-month intervals. Results were assessed by subjective questionnaire performed at 3 and 12 months. All patients had intrinsic sphincteric deficiency. Of the first group, there were only four patients (31%) cured after 1 year of follow-up. On the other hand, in the group that received repeated injections, there were 11 patients (64%) cured with a mean of two injections at 1-year follow-up. Our results show that this procedure warrants continued clinical investigation because it may be useful in selected cases of urinary stress incontinence.
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Affiliation(s)
- P C Palma
- Dept. of Urology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, UNICAMP, San Paulo, Brazil
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37
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Herrmann V, Nakayama K. Relativistic effects in proton-proton bremsstrahlung. Phys Rev C Nucl Phys 1992; 46:2199-2212. [PMID: 9968346 DOI: 10.1103/physrevc.46.2199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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38
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Herrmann V, Nakayama K. Comparison of nucleon-nucleon potential models in proton-proton bremsstrahlung. Phys Rev C Nucl Phys 1992; 45:1450-1457. [PMID: 9967899 DOI: 10.1103/physrevc.45.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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39
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Herrmann V, Nakayama K. Spin observables in pp bremsstrahlung and off-shell effects of the NN interaction. Phys Rev C Nucl Phys 1991; 44:R1254-R1257. [PMID: 9967592 DOI: 10.1103/physrevc.44.r1254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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40
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Rogers MV, Henkle KJ, Herrmann V, McLaren DJ, Mitchell GF. Evidence that a 16-kilodalton integral membrane protein antigen from Schistosoma japonicum adult worms is a type A2 phospholipase. Infect Immun 1991; 59:1442-7. [PMID: 2004822 PMCID: PMC257861 DOI: 10.1128/iai.59.4.1442-1447.1991] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Type A2 phospholipase (PLA2) activity has been observed in integral membrane protein extracts of Schistosoma japonicum. Antiserum raised against bee venom PLA2 recognized a single 16-kDa band in the parasite extracts; it also localized to antigen in the gut lining of fixed adult schistosomes as shown by immunofluorescence techniques. Evidence was obtained that the molecule was expressed at low levels in comparison with other integral membrane proteins and was weakly immunogenic in rabbits. Two oligonucleotide probes were constructed on the basis of highly conserved regions between the nucleotide sequences of rat, bovine, rattlesnake, and bee venom PLA2; these probes were used to isolate S. japonicum genomic DNA phage clones. A 1.8-kb FnuD2 fragment was shown by Southern blot analysis to strongly hybridize with the 5' 32P-labeled PLA2 oligonucleotides in both S. japonicum genomic DNA and DNA from one of the phage clones. The nucleotide and predicted amino acid sequences of this fragment revealed homology with the C terminus of PLA2s from different species.
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Affiliation(s)
- M V Rogers
- Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
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41
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Herrmann V, Speth J, Nakayama K. Nucleon-nucleon bremsstrahlung at intermediate energies. Phys Rev C Nucl Phys 1991; 43:394-415. [PMID: 9967085 DOI: 10.1103/physrevc.43.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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42
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Miller LW, Merkle EJ, Herrmann V. Outpatient dobutamine for end-stage congestive heart failure. Crit Care Med 1990; 18:S30-3. [PMID: 2293976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Eleven patients with refractory class IV congestive heart failure who were not candidates for cardiac transplantation were given iv dobutamine therapy on an outpatient basis. All patients underwent hemodynamic evaluation to confirm a beneficial response to low dose (5 micrograms/kg.min) dobutamine and to establish arrhythmia control both on and off dobutamine before hospital discharge. Six of the 11 patients could not be weaned from dobutamine in hospital and were discharged on continuous infusion (maximum dose, 5 micrograms/kg.min), while four were discharged with an infusion regimen ranging from 3 to 5 consecutive days/wk. All patients had a chronic venous access placed and were instructed on the use of an external battery-powered infusion pump with a container holding a concentrated solution of dobutamine hydrochloride. All infusions were delivered at home on an ambulatory basis. Intravenous drug support was discontinued gradually over an average of 3.2 months; seven of 11 patients were able to be weaned entirely from iv inotropic therapy and were maintained on oral therapy alone. Seven of the 11 patients (six of whom were maintained on oral therapy alone) required no hospital readmission during the infusion or follow-up period.
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Affiliation(s)
- L W Miller
- Department of Medicine, St. Louis University Medical Center, MO
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Affiliation(s)
- C S Maas
- Department of Otolaryngology-Head and Neck Surgery, St. Louis University Medical Center, MO 63104
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44
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Herrmann V. [Animal experiment and biopsy studies on the cause, manifestations and diagnostic relevance of perifascicular muscle fiber atrophy]. Z Gesamte Inn Med 1985; 40:417-23. [PMID: 2931906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
On the basis of previous (n = 23) and current muscle biopsies (n = 25) as well as five animal-experimental investigations, the paper deals with the cause and the manifestation of perifascicular muscle-fiber atrophy. A deteriorated trophic situation of the subfascial or marginal muscle fibers in patients suffering from immunocomplex vasculopathies in connection with a reduced supply of blood to the muscles is seen as the cause of the areactive weight loss (atrophy). This is accompanied by a considerably reduced capillary supply of blood to the muscle fibers. Even in normal conditions, the portion of collateral vessels and capillaries is lower in the subfascial region than in the center of the fascicle. When the blood supply is disturbed, the marginal fibers are in a trophic situation worse than that of the central muscle fibers. They become atrophied. In responsive patients, the muscle fibers regenerate and recapillarize during the convalescence period. This can be shown histochemically by means of the alkaline phosphatase reaction. The extent of perifascicular musclefiber atrophy can be fixed in quantitative terms by the method of Baumli and Mumenthaler. Where a second biopsy is indicated, results can be obtained regarding the changes in the perifascicular atrophy as a consequence of the therapy provided.
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45
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Walther J, Herrmann V. [Problem of diagnostic muscle tissue removal: biopsy, preparation and preservation]. Psychiatr Neurol Med Psychol (Leipz) 1983; 35:252-5. [PMID: 6346361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Intensive professional cooperation of all diagnostical branches needed incl. surgery is presupposition for the investigation of muscle biopsies. Knowledge needed on diagnostic clearing in advance and correct determination of kinds of biopsy as well as careful detraumatic taking of tela have decisive influence on the statement value of the result of investigation techniques concerning fine-tela. Muscle biopsies should be made exclusively at such places where the technical basis is available for optimum investigation and preparation.
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46
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Herrmann V. [Autoimmunologic activity of skeletal muscles in so-called collagenoses]. Z Gesamte Inn Med 1981; 36:855-63. [PMID: 7342506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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47
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Herrmann V. [Clinically significant histologic, histochemical and morphometric parameters in the evaluation of muscle biopsies]. Z Gesamte Inn Med 1981; 36:65-72. [PMID: 7013300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Many of the diagnostic advances in the field of myopathies have been achieved by the examination of samples of muscle removed by biopsy. A muscle selected for biopsy must be obtained atraumatically with the fibres orientated longitudinally. Artefacts are avoided by freezing the sample in liquid nitrogen. The typing of muscle fibres by using the ATPase and dehydrogenase reactions is of advantage to the interpretation of muscle diseases. An accurate method for the determination of changes in the size of muscle fibres is a must. The construction of histograms, standard values for mean fibre diameters, the estimation of the proportion of various types of fibres, variability coefficient, atrophy and hypertrophy factors are a help. A few studies have been performed concerning the effect of a physical therapy on the composition of the fibres of skeletal muscles. A more differentiated physiotherapeutic treatment based on the histochemical and morphometrical results of the muscle biopsy is essential for the therapy of the myopathies.
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Abstract
The effect of various modalities on maintaining a high intragastric pH in acutely ill patients was evaluated. Twelve patients with one or more organ system failures had the effect of nasogastric suction, intragastric antacid instillation, and intravenous cimetidine administration on intragastric pH determined by an indwelling, intragastric pH probe. Each therapeutic modality was administered for 12 hours and the order of performance randomized. Nasogastric suction was associated with a constant intragastric pH of less than 2.0. Mean intragastric pH with cimetidine administration was significantly higher than with antacid administration and consistently greater than 5.0. If low intragastric pH represents susceptibility to acute mucosal lesions, cimetidine therapy was more effective than antacids in the doses and frequency of administration used in this study in maintaining a high intragastric pH, and it may be effective in preventing stress ulcer formation.
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50
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Bonte W, Herrmann V. [Activity alterations of unspecific esterases during wound healing. Investigations by means of electrofocusing (author's transl)]. Z Rechtsmed 1978; 82:179-87. [PMID: 742209 DOI: 10.1007/bf02092334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Electrofocusing of skin-wound extracts on polyacrylamide flat gels is appropriate for zymographic separation of the esterase isoenzymes. In animal experiments and corpse material most fractions indicated non-synchronous, wound-age depending alterations of activity. As early as 15 minutes after incision obvious activity increases of A1-3-isoenzymes could be demonstrated, followed by a transitory decrease and another maximum. Important activities of the A4-isoenzymes became evident not before the 1st (human) resp. 3rd hour (guinea pig) after incision. There are no sufficient correlations between activity alterations and wound age, to allow a fairly exact time interval classification.
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