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Biomedical subjects

D Köhler

Publications and source records attributed to D Köhler.

At least 163 records · Page 9Linked to original sources
PubMed1987

Deposition of aerosols and bronchial clearance measurements.

A special inhalative device is described for reproducible deposition patterns of radioactive aerosols to measure mucociliary and tussive clearance and to evaluate the effect of drugs on the bronchial tree. Additive actions on mucus transport exist between beta 2-agonists and theophylline, but not in combination with inhalative quaternary ammonium compounds (ipatropium and oxitropium bromide). Mucolytics are generally less effective on mucociliary clearance than beta 2-agonists and theophylline, positive, negative and nonresponders are often seen due to the different viscoelastic properties of the mucus. Mucus transport is more than mucociliary clearance. Two-phase gas/liquid movement and coughing are also important transport mechanisms for bronchial mucus. Therefore, bronchodilators enhance mucus transport by increasing airway patency, which increases total and regional air flow and improves cough clearance.

Aerosols↗
PubMed1986

[Course of conservatively treated acute lumbar root compression syndrome. A computer tomography controlled study].

Of 129 patients with an acute lumbar root compression syndrome due to disc herniation 21, who were symptom-free, were examined by computed tomography (CT) on average 276 days after a three-step regimen of conservative treatment. In no instance had there been a deterioration of the original findings. In 14 patients the CT picture continued to demonstrate disc herniation, although the patients were without symptoms. In two patients a moderate, in five a marked regression of herniation was demonstrated by CT. Clinical improvement without change in the CT picture points to the compression syndrome not being explainable solely in mechanical terms. As a matter of fact, a possible cause may be a disturbance of radicular blood supply resulting in oedematous root swelling which is usually masked in the CT by prolapsed disc tissue. There is as yet no easy explanation for regression in case of prolapsed, perhaps even sequestered, disc tissue. It is possible that there have been reparative processes, such as have been described histopathologically in form of ingrown vessels. More plausibly would be a separation of the herniated and/or sequestered disc tissue in form of an asymptomatic sliding into the terminal caudal region.

Adult↗
PubMed1986

CT of the postoperative lumbar spine: the value of intravenous contrast.

Sixty-five patients with recurrent radicular complaints after operation for lumbar disc herniation underwent CT examination before and after intravenous contrast application (volume: 1.5-2.0 ml/kg body weight; flow rate: 0.35 ml/s). Postsurgical hypertrophic scar tissue showed definite contrast enhancement, whereas disc herniation remained unenhanced. Intravenous contrast application is recommended in patients previously operated upon for disc herniation.

Cicatrix↗
PubMed1986

Rapid regression of macroprolactinomas by the new dopamine partial agonist terguride.

Two patients with macroprolactinomas were treated with the partial dopamine agonist, terguride. The prolactin (Prl) levels were lowered very effectively and in both cases the clinical symptoms improved markedly during the first days of treatment. Computerized tomography (CT) and magnetic resonance imaging (MRI) follow-up studies showed distinct tumour shrinkages which were first documented by MRI within 2 weeks of treatment. Tumour residues were, however, still demonstrable by MRI after more than one year respectively 3 months of therapy. In principal, results from both imaging techniques were comparable with the exception of the one year follow-up study of patient 1. In CT no residual tumour mass was visible whereas MRI showed only little reduction when compared to the 30th week scan. Throughout the treatment terguride was well tolerated without any side effects up to a maximal daily dosage of 3 mg given orally. Presumably the partial agonistic features of terguride contributed to the good tolerance of the treatment as compared to that of full dopamine agonists like bromocriptine of lisuride. Thus, these preliminary results indicate that terguride may be a beneficial alternative in the treatment of prolactinomas and other hyperprolactinaemic states.

Adenoma↗
PubMed1986

[Determination of systolic time intervals of the fetal heart as an additional diagnosis sub partu].

The aim was to prove the usefulness of the determination of systolic time intervals PEP (pre-ejection period) and LVET (left ventricular ejection time) in the fetal cardiac cycle.--Based on the fetal electrocardiogram a second signal is necessary to get the corresponding times. In the own material we used the fetal phonocardiogram. Therefore we measured the times of Q-S1 and Q-S2. As a particularly important factor seems to be the quotient of PEP/LVET. The normal result of this quotient was 0.39 +/- 0.04 (0.35-0.43). In pathological cases the quotient was only 0.27 +/- 0.02 (0.25-0.29). These results are compared with the literature. Here are problems, because various investigators use various methods for getting the second signal (phonocardiogram, doppler ultrasonic cardiogram or fetal capillary pulse). Nevertheless determination of the fetal systolic time intervals is necessary, because many parameters are required to have an overview about the fetal condition.

Electrocardiography↗
PubMed1986

Mucociliary clearance in smokers.

The mucociliary clearance characteristics and the correlation between the extent of smoking and bronchial mucociliary dysfunction were studied in 71 smokers (15 without chronic bronchitis, 16 with simple and 40 with obstructive chronic bronchitis). Mucociliary clearance (MC) was measured with 99mTc-tagged human erythrocytes. Lung function values were determined by whole body plethysmography. All three smoking groups had significantly (p less than 0.001) lower TMC60.min rates (total MC in 60 min) on the average than the predicted values. The mean TMC60.min rates of heavy smokers with simple and obstructive chronic bronchitis were significantly (p less than 0.001) lower than that of light smokers without chronic bronchitis. There was no significant difference between the TMC60.min rates of smokers with simple and obstructive chronic bronchitis. The decrease in the MC rates was more pronounced in the central than in the peripheral airways. A significant (p less than 0.001) correlation was found between the extent of smoking (pack years) and the decrease of MC. The results suggest that the decrease of MC is an early functional abnormality in smokers, which precedes the development of symptoms of chronic bronchitis as well as functional detectability of airways obstruction.

Bronchitis↗
PubMed1985

[Clinical picture of multiple sclerosis in the magnetic resonance tomogram].

We performed magnetic resonance tomography (MRT) on 22 patients with multiple sclerosis (MS) using varying scan sequences. In 21 patients MRT produced abnormal findings demonstrating multiple lesions, giving varying signals. The MRT appearances of MS have the following characteristics: circular configuration and homogeneous structure of individual lesions, multiple foci, with involvement of all parts of the brain, but with preference for the periventricular region and white matter. This constellation of MRT features is characteristic for MS, but is largely independent of the varying clinical symptoms. The appearance of the individual lesions and the distribution pattern of the foci is sufficiently characteristic to support the clinical diagnosis of MS in younger patients.

Adult↗
PubMed1985

[Spondylolysis and -listhesis. A computed tomographic differential diagnosis of lumbar discopathy].

Spinal CT scans of 680 patients with suspected disc herniation were reviewed to detect lumbar spondylolysis. In this group of patients, 3.23% (n = 22) had pars interarticularis defects at L4 or L5. Disc herniation at the interspace of the pars defect was seen in 27.27% (6/22) of patients with spondylolysis. Using Meyerding's method, which measures the degree of vertebral forward dislocation, grade 2 and grade 3 spondylolisthesis were most often seen. While moderate and severe spondylolisthesis can be already detected via lateral localiser image (scout view), pars defects with only little forward dislocation can be easily underdiagnosed. Sources of diagnostic error are: 1. an atypically posterior disc margin which extends beyond only one vertebral body and presents the appearance of disc herniation, 2. pars defects simulating the adjacent facet joints involve the risk of overlooking spondylolysis, 3. CT sections made through the intervertebral discs and facet joints only, may fail to show up the pars defect 10 or 15 mm above the disc plane.

Adolescent↗
PubMed1985

[Magnetic resonance tomography in syringomyelia].

Thirteen patients with a clinical diagnosis of syringomyelia were examined by nuclear tomography (0.35 T magnet) in the spin-echo mode. In all thirteen patients, the T1 images (SE 400/35) showed a longitudinal cavity with a signal intensity of CSF. The shape and extent of the syrinx could be adequately demonstrated in 12 of the 13 examinations. Downward displacement of the cerebellar tonsils was seen in eight cases. The examination took between half and one hour. Advantages of magnetic resonance tomography (nuclear tomography) include the absence of artifacts, images in the line of the lesion and its non-invasiveness.

Adult↗
PubMed1985

Pulmonary deposition of aerosols by different mechanical devices.

With a new method for easy labeling of beta 2-agonists we measured intra- and extrapulmonary aerosol deposition after the administration of a bolus from a metered-dose inhaler at residual volume (RV) inhaling after a pause of 2 s and after immediate administration into the inspiratory flow at functional residual capacity (FRC). Immediate administration during a slow inspiratory vital capacity maneuver gives the highest intrapulmonary deposition (30-40%). Compressed air and ultrasonic nebulizers with a particle distribution pattern of 2-5 micron aerodynamic mass median diameter (AMMD) allow in normal subjects to achieve an intrapulmonary deposition of 30-60% during standardized tidal breathing at rest, the magnitude of the deposition depending mainly on each subject's larynx geometry. The outlet system leads to different deposition patterns in aerosol generators with the same AMMD. Many commercially available aerosol generators do not fulfill the criteria for any intrapulmonary aerosol deposition. For drug administration into the lungs, condensation aerosol generators ('steam boiler nebulizers') are useless as well as compressed-air, ultrasonic and steam driven nebulizers with a particle size of more than 10 micron AMMD.

Adrenergic beta-Agonists↗
PubMed1985

Influence of 0.2 mg ipratropium bromide on mucociliary clearance in patients with chronic bronchitis.

14 patients with chronic bronchitis were subdivided into 2 groups of 7 patients. They were given at random 10 puffs of placebo or ipratropium bromide (0.2 mg). The mucociliary clearance rate was measured immediately after ipratropium inhalation (group 1) or 24 h after ipratropium inhalation (group 2). In group 1, the mucociliary clearance after ipratropium bromide was significantly better than after placebo (p less than 0.01). In group 2 there was no difference in the mucociliary clearance rates measured after ipratropium bromide or placebo, but the clearance rate still tended in favour of ipratropium bromide. We conclude that ipratropium bromide should be inhaled in high doses (0.2 mg) by hypersecretory patients with chronic bronchitis to improve mucociliary transport.

Adult↗