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Biomedical subjects

D Köhler

Publications and source records attributed to D Köhler.

At least 145 records · Page 8Linked to original sources
PubMed1990

Acute and long-term amiloride inhalation in cystic fibrosis lung disease. A rational approach to cystic fibrosis therapy.

Cystic fibrosis (CF) is the most common inherited fatal disorder among Caucasians. Bronchial mucus in CF contains more potassium and less sodium, which may be due to increased sodium absorption, resulting in a reduced airway water content. We studied 23 patients with CF after inhalation of normal saline or amiloride (10(-3) M), a sodium transport blocker. Mucociliary clearance (MC) and cough clearance (CC) were determined with a gamma camera that traced the movement of 99mTc-labeled, hardened erythrocytes over a 1-h period after the patients inhaled these particles as an aerosol. Before and after each investigation pulmonary function tests (PFT) and blood pressure (BP) were measured. Sputum thread formation was measured by means of a filancemeter. Six of the patients also completed a 3-wk trial of amiloride inhalation therapy. MC increased significantly (p less than 0.001) after acute amiloride inhalation (bronchial deposition, 0.07 mg amiloride) compared with that in the saline control. CC also increased, but not as much as MC. After 3 wk of amiloride inhalation (2 times a day) clearance values (both MC and CC) were markedly enhanced (p less than 0.01); after a similar period of saline inhalation, clearance values were not different from baseline. Sputum filance values also decreased significantly after amiloride inhalation. There were no adverse effects of the amiloride inhalation compared with saline. We conclude that amiloride inhalation administered as a single dose or as long-term therapy is able to increase MC and CC in CF airways and that the effect of 10(-3) M amiloride inhalation on MC lasts at least 40 min. (ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1990

[New technics for producing inhalation aerosols--initial experiences and results with the piezoelectric inhalation device].

In the treatment of chronic obstructive airway diseases, the inhalative application of medicaments with a bronchodilatory effect is given preference throughout the world. In addition to inhalation solutions and powder capsules, so-called metered-dose aerosols have formed an established part of the treatment plan for approximately 30 years now. With the piezoelectric inhalation device, a fully portable ultrasonic atomiser that is small enough to fit within the pocket, has been developed for the first time. In this device, the piezoelectric effect is utilised to produced, pressure-free, microfine aerosols. Within it, an accurately metered volume containing the therapeutic dose is applied to an atomising element oscillating in the ultrasonic range. The particle spectrum generated with the piezo-system corresponds, in terms of size, to that of metered aerosol devices, and the mean particle diameter is approximately 2.1 microns. The atomisation process takes approximately one second.

Aerosols↗
PubMed1990

[Double kidney with ectopic ureteral orifice: a case report].

An ectopic ureteric opening is a relatively rare malformation, diagnosed mostly in young age because of typical signs and symptoms and more often found in female patients. The diagnosis of this malformation in adults is unusual and can be difficult because of untypical signs and symptoms, as represented in the following case report.

Adult↗
PubMed1989

[3-dimensional reconstructions of the skull, axial and extremity skeleton].

In a prospective study, 150 threedimensional reconstructions of patients with bone diseases were analyzed. It could be seen that 3 D images were relevant for therapeutic considerations in diseases of craniofacial bones, and to a lesser degree for other skeletal regions. In no case was the 3 D reconstruction the only important factor for the therapeutic decision. The study demonstrated that 3 D imaging of the pelvic bones, especially for necroses of the femoral head, is severely limited without the possibility of computer-aided disarticulation.

Bone Diseases↗
PubMed1989

[The value and consequences of nocturnal pulse oximetry in severe heart failure, suspected myocardial infarct and acute cerebral ischemia].

On extensive clinical monitoring of nocturnal oxygen saturation (Minolta Pulsox 7) we observed three groups with an increased risk of nocturnal hypoxemia. The hypoxemia was classified in terms of severity, frequency and duration into six groups of findings. The degree of oxygen desaturation was positively correlated to the severity of disease. In the group of patients with heart failure (NYHA III-IV) (n = 13) four had severe hypoxemia, and a history of previous cardiac infarction; three of them wore a pacemaker. Decrease in saturation after acute cerebral ischemia was seen in particular in patients with oropharyngeal disorders (dysphasia and dysphagia). In the group with suspected myocardial infarction (n = 16) we measured frequent short drops in saturation in ten patients, eight of whom were heavy snorers. Because of its simplicity, non-invasiveness and high information yield, especially in acute patients, pulse oximetry is important for clinical diagnosis, with immediate consequences for many patients.

Brain Ischemia↗
PubMed1989

[Validity testing of time-density curves in determining the degree of arterial stenosis by DSA].

106 patients with a stenosis of the carotid arteries or the common iliac arteries were examined by digital subtraction angiography. The haemodynamic effectiveness of a stenosis was supposed to be measured by time-density curves. Evaluation of time-density curves produced by videodensitometry did not allow to judge the degree of a stenosis of the carotid or the common iliac arteries. Causative for the insufficient accuracy of the results is a patient related change of examination quality. Disturbing factors are reduced cardiac output, moving artifacts, overshadowing of the examined region by air and reduced contrast due to obesity.

Absorptiometry, Photon↗
PubMed1989

[Clinical and computed tomographic follow-up of conservatively treated disk prolapse].

Of a total of 238 patients suffering from root compression syndrome, 41 successfully conservatively treated patients were followed up both clinically and via CT. At follow-up time they were all largely free from complaints. 71% showed unchanged prolapse on CT examination. 29% had a moderate or marked regression of disk prolapse. All unchanged cases of prolapse were medial prolapses. The reason for regression of the sequestered disk tissue is discussed controversially and has not been satisfactorily clarified to date. Improvement of findings in unchanged prolapse is mainly explained by the adaptability of the root if there is enough space for shifting.

Adult↗
PubMed1988

New method for easy labeling of beta-2-agonists in the metered dose inhaler with technetium 99m.

The actual deposition pattern of micronized drugs from metered dose inhalers (MDI) is incompletely known because there are no methods available to label the drugs (beta 2-agonists) with gamma-emitters. Indirect measurements of the distribution of the drug in man differed greatly due to the method used. Our method uses the better solubility of 99mTcO4- in the beta 2-agonist-micronized drug in relation to the propellant with surfactant. The principle is to extract the 99mTcO4- from the original water phase into the liquid phase of the propellant with ethyl methyl ketone. For labeling the micronized drug particles, the original MDI must be cooled to -60 degrees C and some labeled propellant (including surfactant) with high specific activity of 99mTcO4- is added through an aperture in the bottom of the container. The aperture is sealed with a screw. After rewarming the MDI, more than 90% of the added 99mTcO4- is dissolved in the beta 2-agonist-micronized drug in relation to its volume. This is proved by comparing the distribution of the radioactivity component with chemical analysis. The pattern of deposition of both MDIs - placebo and beta 2-agonist-micronized drug - was shown to be similar in healthy volunteers. With a labeled MDI a preliminary study with 2 different inhaling maneuvers was performed in 7 volunteers: inhaling from residual volume after a pause of 2 s the intrabronchial deposition was 18.7%, and inhaling at 50% of vital capacity maneuver the intrabronchial deposition was 33.0%. The data obtained with actual measurement of the inhaled drug from MDI suggest greater intrabronchial deposition than was assumed before in the literature.

Adrenergic beta-Agonists↗
PubMed1987

[A new biopsy needle for transcutaneous histology procurement].

The new Vacu-Cut biopsy needle differs from previous types by its simpler manipulation and the production of a stronger vacuum to extract the tissue core. This vacuum is caused by withdrawal of a stylet through an air-tight sealing membrane. The instrument is a hollow needle with an inner cutting-edge and a diameter of 0.95 mm. 49 patients with suspected lesions of the pulmonary parenchyma were biopsied transcutaneously under x-ray monitoring. The biopsy material allowed a clearcut diagnosis in 44 patients, including 2 repeat biopsies; the success rate was thus 86% of all biopsies performed. 7 attempts (14%) did not yield useful material as the lesions were too small (diameter below 2.5 cm) or were not penetrated. In 35% of all biopsies small pneumothoraces were observed after a few hours. In two cases transitory hemoptysis occurred.

Biopsy↗