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Biomedical subjects

D Radenbach

Publications and source records attributed to D Radenbach.

At least 19 recordsLinked to original sources
PubMed1991

[Tuberculosis treatment today].

In West and East Germany the incidence of tuberculosis is declining. However, with an incidence of 22 per 100,000 inhabitants in West Germany and 17 new diseases per 100,000 inhabitants in East Germany it is not a rare disease. In the chemotherapy of pulmonary tuberculosis, isoniazid (INH), rifampicin (RMP), ethambutol (EMB), streptomycin (SM), pyrazinamide (PZA) and prothionamide (PTH) are the most relevant drugs. The chemotherapy of tuberculosis is always carried out as a combination therapy of at least three drugs. A rapid cultural conversion of the sputum as well as low rates of failures and relapses are regarded as parameters of quality. Therefore six-month-regimens with initially four drugs (INH + RMP + PZA + SM or EMB) or nine-(twelve-) month-regimens with initially three medicaments (INH + RMP + PZA, or INH + RMP + EMB or INH + RMP + SM) may be recommended. Peculiarities of the therapy in patients with AIDS, with drug resistance, with relapses.

Antitubercular Agents↗
PubMed1990

[In 76% of patients with active tuberculosis treated with triple therapy (isoniazid-rifampicin-pyrazinamide) cultural conversion precedes microscopic conversion].

The time course of smear and culture conversion was studied in 50 previously untreated patients with cavitary pulmonary tuberculosis. Treatment consisted of isoniazid, rifampicin and pyrazinamide for three months, followed by isoniazid and rifampicin. After eight weeks of treatment, negative smears and cultures were obtained in 46 and 84% of the patients, respectively. In 76% of patients, cultural conversion preceded smear conversion, and in 24% of the patients, cultural conversion occurred up to 6 weeks after smear conversion. Thus, the time course of smear conversion provides reliable information on the loss of infectivity in patients with pulmonary tuberculosis receiving chemotherapy.

Adolescent↗
PubMed1990

[Pulmonary risks caused by exposure to glass fiber dust].

We observed two patients who, after inhaling glass fibre dust for 14 and 16 years, respectively, developed a cough and dyspnoea on exertion. Our investigation of transbronchially obtained lung tissue with the aid of light microscopy, electron microscopy and energy-dispersive x-ray micro-analysis revealed fibrosis of mild extension in immediate topographical relationship to phagocytosed fragments of glass fibre. We conclude from these findings that inhaled glass fibre dust can develop a fibrogenic effect.

Biopsy↗
PubMed1990

[Recurrence of lung tuberculosis: causes and sequelae].

Despite the fact that anti-tuberculous chemotherapy is highly effective, recurrent disease is occasionally observed. In 25 patients, we investigated the reasons for this. In 21 of these cases, the last chemotherapeutic treatment had not been carried out in a proper manner. In 13 cases patient compliance had been inadequate, in 7 cases the instructions given by the physician were unsatisfactory. We conclude from our results that the success of tuberculosis treatment can be improved by better management of the patient, and by improving the doctor's training.

Adolescent↗
PubMed1988

[Hemodynamics in the early postoperative period after thoracotomy and lung resection].

To evaluate how necessary and helpful invasive hemodynamic measurements after thoracic surgery are we studied 25 patients after pneumonectomies (n = 5), lobectomies and bilobectomies (n = 10), partial lobectomies (n = 6) and thoracotomies without lung resection (n = 4). Measurements were taken between half an hour and eighteen hours after closure of the rib cage using a preoperatively introduced Swan-Ganz-catheter. Pulmonary resistance was elevated in 12 out of 17 cases. 6 out of 25 patients had a mean pulmonary arterial pressure greater than 20 Torr. The cardiac index was below the lower limit of normal in 16 of 23 cases. 5 patients had an increased stroke work index. There was no correlation between the hemodynamic parameters and the type of surgery. In 7 patients the measurements indicated hypovolemia. Isolated right or left sided cardiac insufficiency was noted in one case each. Four patients received nitroglycerin intravenously resulting in a dose-dependent reduction in pulmonary arterial pressure, pulmonary resistance and heart work. Hemodynamic monitoring with a Swan-Ganz-catheter seems not to be necessary in every case. But it proved to be a safe method which can help in the management of high-risk patients.

Adult↗
PubMed1988

Pulmonary metastasizing hemangiopericytoma.

Hemangiopericytomas are rare tumors, originating from pericytes of the small vessels, that can appear anywhere in the body. From the histological picture it is difficult to determine whether or not they are malignant. The metastasizing rate depends upon the tumor's location and varies from 50 to 80%. Local recurrences occur in roughly 50% of the cases. Hemangiopericytoma is normally surgically treated because radio- and chemotherapy are generally less effective. There is limited experience in treating metastasizing hemangiopericytomas with chemotherapy. We treated 2 patients with pulmonal metastasizing hemangiopericytoma: In 1, the tumor originated in the brain and in the other, the left knee. Both patients had chemotherapy over an extended period of time. By means of x-ray, histological, and electronmicroscopical examinations we report on the course of the diseases.

Adult↗
PubMed1987

[Chemotherapy of pulmonary tuberculosis. Sputum culture conversion in 8 weeks in 84% of patients].

Conversion rate to negativity of sputum culture and microscopy in 50 patients, previously untreated, with open cavernous pulmonary tuberculosis was analysed. Treatment consisted of isoniazid, rifampicin and pyrazinamide for three months, followed by administration of isoniazid and rifampicin. Conversion to a negative sputum culture had occurred after four weeks in 30% of patients, after eight weeks in 84%, and after 14 weeks in all patients. In 76% of patients the cultural conversion preceded the microscopic one. Treatment was well tolerated; only one patient had side effects requiring a short interruption of drug administration. The results confirm that this regimen is effective against pulmonary tuberculosis without significant side effects.

Adolescent↗
PubMed1987

The acute effect of a single oral dose of 200 mg almitrine on gas exchange in patients with chronic obstructive bronchitis and emphysema, bronchial asthma and lung fibrosis.

We studied the acute effect of a single, oral dose of 200 mg almitrine and of placebo on arterial blood gas tensions, ventilation, gas exchange and pulmonary mechanics in 28 patients with chronic obstructive bronchitis and emphysema (COPD), 20 patients with bronchial asthma and 10 patients with interstitial lung disease. Almitrine significantly increased PaO2 in COPD, had a borderline effect in bronchial asthma and no effect in lung fibrosis. In all groups of patients almitrine significantly increased minute ventilation and decreased arterial carbon dioxide tension (PaCO2). Placebo had no effect on arterial oxygen tension (PaO2) and PaCO2 in any of the groups. Therefore, despite similar effects on ventilation, the improvement of arterial PO2 by almitrine depends on the underlying disease.

Administration, Oral↗
PubMed1985

[Chemotherapy with mitomycin C, vindesine and ifosfamide in the treatment of inoperable non-small cell bronchial carcinoma].

27 patients (24 male und 3 female) with inoperable non-small-cell lung cancer were treated with combined mitomycin C, vindesine, and ifosfamide. The performance status of all patients was over 70%. 20 patients had extensive disease, 7 limited disease. The most frequent histology was squamous cell carcinoma found in 20 patients. Only 3 patients had large cell carcinoma and 4 patients adenocarcinoma. 2 complete (7.7%) and 9 partial remissions (34.6%) were achieved. 3/26 (11.5%) patients showed a minor response. In 7/26 patients (26.9%) there was no change, 5/26 (19.2%) showed progressive disease. Because of the short observation time, no deductions regarding the duration of remission and survival time of the patients can be made. The toxicity of the regimen was relatively mild. In particular, the subjective gastro-intestinal symptoms occurred only in 50% of our patients. The hematological toxicity was acceptable. Also the renal toxicity did not pose problems. Considering an exact lung function analysis with diffusing capacity and spirometric data, we found an unexpectedly high proportion of pulmonary toxicity in about 30%, but clinically obvious in only 10% of patients. According to the remission rates, this regimen is comparable to combinations with cisplatin and appears to have much less toxicity.

Adenocarcinoma↗
PubMed1984

[Cisplatin, vindesine and VP 16-213 in the treatment of inoperable non-small cell bronchial carcinoma. A clinical phase II study].

In the treatment of non-small-cell lung cancer a drug-combination of cis-platinum, vindesine and VP-16 seemed logical because the drugs were non cross-resistant and there would be an additive effectiveness with acceptable toxicity. That was the basis for a phase-II trial started in July 1981 in which 60 patients with untreated non-small-cell lung cancer were entered until November 1982. There were 51 male and 9 female evaluable. The performance status of all patients was over 70%. Over 65% had extensive disease. The most frequent histology was squamous cell carcinoma that we found in 45% of our patients with bronchial carcinomas. Only 14 patients had large cell carcinomas and only 8 patients adenocarcinomas. 40% was the objective remission rate (5% complete remissions and 35% partial remissions). 9 patients (=15%) had a minor response; in 18 patients (=30%) there was no change, 9 patients showed progressive disease. The median survival time of responders is presently 14.9 months, which is significantly higher than the 9.1 months of non-responders. The toxicity of the triple-drug-combination was tolerable. The greatest problem was gastrointestinal toxicity with nausea and vomiting. The hematological toxicity was not as severe as expected. The renal toxicity was not a problem. We did not see drug related deaths.

Adenocarcinoma↗
PubMed1981

[Nitroglycerin also as a broncholytic].

0,8 mg nitroglycerin administered sublingually to 10 patients with asthma bronchiale and chronic obstructive pulmonary disease effects a reduction of airway resistance up to 21% in the second and fifth minute. Even one hour after application the oscillatory resistance (Ros) is 15% lower than at the beginning. In the same patients 0,4 mg inhaled fenoterol has a stronger effect (-30%). After intravenous administration of nitroglycerin (2,5 mg/h) over 15 minutes there is a significant decrease of the plethysmographic measured resistance (Rt) (-23%), an increase of the vital capacity and a decrease of the residual volume. Side effects are a small reduction of pO2 and blood pressure and an increase of heart rate. Orthostatic disturbances may occur. The venous lactate concentration does not change. The investigation shows that patients with obstructive airway disease may benefit from the application of nitroglycerin.

Airway Resistance↗