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A Mailänder

Publications and source records attributed to A Mailänder.

2 recordsLinked to original sources

An expert system for synoptic interpretation of lung function tests.

We simulate the interpretation process by the testing of preformed working hypotheses. A clinical syndrome, "bronchial obstruction," is described by a set of suitable parameters (FEV1, MMEF, Raw, etc.). For a given patient, this set forms a normalized vector. It has to be compared with equivalent data derived from patients which fulfilled the criteria for the clinical syndrome in question. If the patient's vector has a similar direction as the vector of the collective, the working hypothesis is accepted. The length of the vector is then used to quantify the severity of the functional disturbances in verbal terms ("slight," "moderate," "severe"). The limits used for severity grading and the typical parameter pattern for the given syndrome are adapted to the user's criteria by a built-in learning capability. On the other hand, the assembled data may be used for the training of newcomers. The use of vector algorithms allows for a high flexibility of our program with respect to all methods used in lung function testing.

Algorithms↗

[Comparison of respiratory control responses in bronchial and external airway stenosis].

Respiratory responses during allergen-induced airway obstruction and external airway stenosis were investigated in anaesthetised sheep. The results were compared to those obtained from healthy subjects during external airway stenosis. Allergen-induced increase in airway resistance results in an increased respiratory frequency, mainly due to a shortening of expiration (TE) and only partially due to a shortening of inspiration (TI). Tidal volume is diminished while respiratory changes in oesophageal pressure (delta Poes) are increased. Both results in an increase of dynamic elastance (Edyn) representing airway resistance. Based on the increase in the slope and amplitude of inspiratory pressure (delta Poes/TI), the mean inspiratory airflow (VT/TI) remains almost unchanged. In spite of an increased ventilation PaO2 decreases, whereas PaCO2 increases only slightly. External airway stenosis, however, results in a decrease of respiratory frequency, mainly depending on a prolongation of inspiration. Changes in Poes and VT are similar to those of allergen-induced airway obstruction. delta Poes/TI, however, increases less than during allergen application and results in a decrease of mean inspiratory airflow, tidal volume and ventilation. Respiratory responses of healthy subjects during external airway stenosis were similar to those described in experimental animals. The results of our investigation show a different pattern in the control of breathing during bronchial and external stenosis-induced airway obstruction and thus indicate different vagal reflex mechanisms.

Airway Obstruction↗