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Biomedical subjects

E Müller

Publications and source records attributed to E Müller.

At least 271 records · Page 15Linked to original sources
PubMed1990

[The measurement of extravascular lung water--significant in the follow-up of ARDS?].

In 40 adult patients suffering from severe ARDS stage III and IV (Morel) we examined the course of the extravascular lung water (EVLW) measured by the double indicator dilution method with 858 single measurements, during mechanical ventilation with PEEP, or extracorporeal CO2 elimination (ECCO2 R). No correlation could be found between EVLW and the values of alveolar arterial oxygen difference (AaDO2) and intrapulmonary right-left shunt (Qs/Qt) or haemodynamic values such as CVP, PCWP, mean pulmonary arterial pressure, or the 24 h fluid balance. It was, therefore, not possible to estimate a prognostic trend based on a single measurement of EVLW. However, the course EVLW was more appropriate to perceive the prognostic trend of ARDS because a rapid decrease of very high EVLW was correlated with a decrease of AaDO2 (r = 0.87); whereas lethal ARDS (fibrosis) was associated with moderately increased, unchanged EVLW. However, during the ECCO2-R treatment the repeated estimation of EVLW and AaDO2 is a useful tool to assess recovery because other parameters such as Qs/Qt and chest computer tomography during long-term bypass are very difficult or impossible to employ for this purpose. A change of EVLW with increasing PEEP level could not be found. The reproducibility of 858 EVLW values was excellent with a coefficient of variation of 4.9 +/- 3.5%.

Adolescent↗
PubMed1990

[Sonography in breast diagnosis].

In a prospective study of 235 tissue masses verified histologically, we examined the diagnostic contribution of ultrasound in comparison to mammography. When the two methods were combined, 96.8% of all malignant neoplasms could be diagnosed correctly. Most (90.5%) were found by mammography alone and 4.8% were detectable by ultrasonography but not by mammography. Despite relatively good results in the evaluation of solid masses, it is not advisable to omit tissue examination. The superiority of ultrasound over mammography in the diagnosis of cystic lesions could lead to a significant reduction in needle aspirations and biopsies.

Adenofibroma↗
PubMed1990

[Lung function diagnosis using multi-frequency oscillometry with reference to lung volume].

The ranking of various oscillometry parameters was to be tested in patients with a broad spectrum of disturbances of pulmonary function, objectified by body plethysmographic and technical oesophageal pressure measurement of the respiratory resistance, lung volumes and lung elasticity. For this purpose the oscillatory resistance Rfo and the phase angle phi were measured at 8, 12 and 16Hz and phi was measured as it changed, depending on the lung volume V. It was found that enhanced respiratory resistance values are satisfactorily represented by Rfo for the purposes of preliminary and basic diagnostics. Besides, enhanced Rfo values are markedly dependent on the frequency, phi being shifted to negative values. Difference between Rfo values at 8 and 16 Hz (delta R8-16) less than 0.7 hPa/l/s phi greater than or equal to -10 degrees can be considered as being still normal with the employed measuring principle and are a valuable supplement for assessing the degree of obstruction. The difference between phi in the medium respiratory position and at 90 or 100% total capacity (delta phi) is less than 5 degrees during slow inspiration in 80% of the patients suffering from emphysema. In 80% of the persons with healthy lungs and those suffering from fibrosis there is an inspiratory negativation of phi (delta phi greater than 5 degrees) so that the phi-V relationship appear suitable for distinguishing patients with restricted vital capacity in respect of emphysema and fibrosis. Patients suffering fron fibrosis differ from healthy subjects by slightly more negative phi values. The borderline values for delta R8-16, phi and delta phi were confirmed in two further series of examinations on children and adolescents.

Adult↗
PubMed1990

[Therapy with immunoglobulins].

Adequate IgG-replacement therapy as treatment of choice for patients with humoral immunodeficiencies has revolutionized the outcome of these disorders. The action of intravenous immunoglobulins (IVIG) in autoimmune diseases, especially in idiopathic thrombocytic purpura seems to be due to Fc-receptor blockade and immunomodifying qualities. Thus far, treatment for patients with subclass deficiencies is restricted to persons with recurrent infections.

Autoimmune Diseases↗
PubMed1990

[Exogenous allergic asthma following pectin exposure--a new occupational allergen].

In a 51-year-old male worker, workplace-related dyspnoea in the sense of bronchial asthma, was observed. On the basis of the medical history, the results of serology, inhalatory provocation and histamine release tests, despite a negative skin test, pectins were established to be the precipitating substances; in experiments on animals (Wistar rats), the instillation of pectins led to the development of bronchiolitis. An exogenous, allergic asthma following exposure to pectin may be considered to have been proven.

Air Pollutants, Occupational↗
PubMed1990

[Detection of pulmonary hypertension in patients with local circumscribed scleroderma].

In three patients with local circumscribed sclerodermia (duration of the disorder 6 months to 3 years), a latent or manifest pulmonary hypertension of the precapillary type in the presence of otherwise unremarkable lung function, radiological and ergometric data, was observed. The pulmonary involvement in this disease would appear to have a relatively early onset.

Biopsy↗
PubMed1990

[Long-term results following preventive iridectomy. A retrospective study].

The frequency of complications after surgical iridectomy in angle-closure glaucoma is normally considered low. In order to estimate the influence of the surgical intervention independent from other factors (such as ischemia caused by angle-closure, progression of glaucomatous disease, medical treatment), 35 eyes that had undergone a prophylactic iridectomy because of acute angle closure of the contralateral eye were investigated retrospectively. The mean follow-up time of the 35 eyes was 6.1 years. None of the prophylactically iridectomized eyes developed angle-closure during follow-up. No significant change in visual acuity was present in the group of patients less than 65 years of age (n = 12). This group had a preoperative visual acuity of 0.85 +/- 0.18 and a visual acuity of 0.81 +/- 0.20 at the last visit. A considerable decrease in visual acuity, however, was found in the group of patients more than 65 years of age (n = 23). This group had a preoperative visual acuity of 0.64 +/- 0.24 and a visual acuity of 0.36 +/- 0.23 at the last visit. Biomicroscopically, one eye (8%) in the age group less than 65 years developed further lens opacity, whereas 15 eyes (65%) in the age group more than 65 years developed further lens opacity. In 2 eyes in the older group a cataract operation was performed. Five eyes developed posterior synechiae; in all of these eyes cataract formation increased. The results indicate that cataract progresses more rapidly after iridectomy if the patients are older.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Clinical effects of an extreme Ca overdose in feed for growing piglets].

In a piggery (approx. 60 sows) nearly all the weaned piglets (about 150) showed signs of poor development, reduced feed intake, increased water consumption, markedly dry and hard faeces, urine drinking, navel suckling and drowsiness over 6-8 weeks. In blood samples of 4 affected piglets a significant hypercalcaemia (values greater than 20 mg/dl)--combined with an at times marked hypophosphataemia--was measured. In the diet offered, a Ca content of 56.2 g/kg was estimated. An intoxication due to ochratoxin or due to excessive levels of quinoxaline or vitamin D was excluded by toxicological investigations of the diet. Contamination by Datura stramonium was also ruled out.

Animal Feed↗
PubMed1989

A longitudinal study of the hyaluronan level in the serum of patients with malignant mesothelioma under treatment. Hyaluronan as an indicator of progressive disease.

The serum hyaluronan levels of 37 patients with malignant mesothelioma were followed during the course of treatment (high doses of methotrexate were given to 32 of these patients). The patients could be divided into the following two groups: (1) those with progressive disease (n = 17) or (2) those showing improvement during therapy (complete remission [n = 2], partial remission, or no change [n = 18]). On admission to the hospital, the patients with progressive disease showed significantly higher initial serum hyaluronan levels (median value, 250 micrograms/l) than those in the second group (median value, 97 micrograms/l) (P less than 0.005, Wilcoxon). Serum hyaluronan as a predictor of progressive disease has a sensitivity of 65% and a specificity of 85%. There was a significant increase in serum hyaluronan levels during treatment in patients with progression (P less than 0.01). In three patients with initially high levels there was a clear decrease in parallel with the reduction in tumor burden. In the remaining patients of the responder group, the values were constantly low. There was no significant correlation between the hyaluronan level and any other laboratory test performed on blood samples. Pleural fluid was removed for medical reasons from 13 patients. Neither the presence of pleural fluid nor its hyaluronan level were correlated to the progression of the disease. However, there was an interesting negative correlation between serum and pleural hyaluronan levels, indicating that an elevated serum hyaluronan level does not reflect high production in the pleural cavity.

Adult↗
PubMed1989

Different sensitivity of Pseudomonas aeruginosa exotoxin A and diphtheria toxin to enzymes from polymorphonuclear leukocytes.

We demonstrate that exotoxin A (ExoA) of Pseudomonas aeruginosa is one to two orders of magnitude more sensitive than diphtheria toxin (DT) of Corynebacterium diphtheriae to lysosomal enzymes from polymorphonuclear leukocytes (PMN). It is especially sensitive to PMN elastase which inactivates its cell free enzymatic activity and its cytotoxicity as measured with the Chinese hamster ovary cell assay and the rabbit skin test. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) showed a rapid fragmentation of ExoA into small peptides at low PMN elastase concentrations, whereas DT remained largely uncleaved at PMN elastase concentrations 10 times higher. PMN elastase also removed the cell surface receptors for ExoA and DT on Chinese hamster ovary cells, suggesting that both toxins may be ineffective at local sites of severe inflammation. A comparison of fibroblasts from cystic fibrosis patients and normal healthy individuals revealed no differences in susceptibility to either DT or ExoA; this tends to exclude a genetic defect as an explanation for the absence of ExoA effects in cystic fibrosis patients.

ADP Ribose Transferases↗
PubMed1989

Antigenic relationship between the dermonecrotic toxins produced by Pasteurella multocida type D and type A.

Crude dermonecrotic toxins (DNT) were prepared from Pasteurella multocida (P.m.) type D and type A strains isolated from pigs with atrophic rhinitis. Rabbits were immunized with the DNT of P.m. type D. This serum neutralized the DNT of P.m. type A to the same degree as the homologous one both in vitro (cytopathogenicity for tissue culture cells) and in vivo (mouse lethality and dermonecrotic activity in guinea pig).

Animals↗
PubMed1989

Protection by toxoid-induced antibody of gnotobiotic piglets challenged with the dermonecrotic toxin of Pasteurella multocida.

A crude dermonecrotic toxin (DNT) of Pasteurella multocida (P.m.) type D was prepared by repeated sonication and freezing. It was sterilized by filtration. A toxoid was then made and pigs were hyperimmunized with it to get an antiserum. A control serum was obtained by hyperimmunization of pigs with a preparation derived from nontoxigenic P.m. type D in the same manner as the toxoid. Three gnotobiotic piglets were injected with the antiserum. This resulted in neutralization indices (NI) of 25 in their sera, as tested on mice. Three litter-mated controls were given the control serum. Their NI remained 1. All piglets were challenged intramuscularly 4 times, every third day, with 30 mouse LD50 of the DNT. When euthanized 15 days after the last DNT administration no snout lesions were found in passively immunized piglets, whereas control animals showed severe turbinate atrophy and other changes typical for atrophic rhinitis. The next experiment was identical to the previous one except for the challenge, which was given intranasally (4 times 300 mouse LD50). Also in this case circulating antitoxin protected the piglets from damage of the nasal turbinates caused by the DNT.

Animals↗