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Biomedical subjects

F Kummer

Publications and source records attributed to F Kummer.

At least 19 recordsLinked to original sources
PubMed1992

Serum procollagen III peptide levels in subjects with sarcoidosis. A 5-year follow-up study.

In a prospective study, Type III procollagen N-terminal peptide was measured in the sera of 38 subjects with biopsy-proven pulmonary sarcoidosis at 6-month intervals over a period of 5 yr. The subjects were divided into four groups according to their radiologic presentation and clinical course: Group A (n = 10) subjects with sarcoidosis Type I without radiologic progression over 5 yr; Group B (n = 5) subjects with sarcoidosis Type I with radiologic progression to Stage II or III; Group C (n = 9) subjects with sarcoidosis Types II and III without progression over 5 yr; and Group D (n = 14) subjects with sarcoidosis Types II and III with radiologic progression. Lung function tests (FVC, FEV1, and DLCO), chest roentgenograms, and measurements of serum angiotensin converting enzyme (S-ACE) were performed concurrently with the S-PCP-III levels. Significantly higher levels of S-PCP-III were found in group B (Type I, progressive) (18.2 +/- 1.09 ng/ml) and in group D (Type II/III, progressive) (13.9 +/- 1.2 ng/ml) compared with those of Group A (Type I, stable) (9.1 +/- 1.09 ng/ml) and Group C (Type II/III, stable) (7.6 +/- 1.1 ng/ml) or normal volunteers (9.4 +/- 4 ng/ml) (p less than 0.001 for all comparisons). Changes in S-PCP-III levels tended to parallel the clinical course, and steroid treatment resulted in a significant decrease in S-PCP-III concentrations (p less than 0.001). In contrast, serum angiotensin converting enzyme (S-ACE) levels did not correlate with either the clinical course or radiologic changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Investigations into the fat pads of the sole of the foot: heel pressure studies.

The fat pads of the heel have a structure that is optimized for load bearing. In various diseases and aging, the load-carrying ability of the heel pad is clinically impaired. The loading pattern was examined in subjects having normal heel pads and those with atrophic heel pads, both with and without clinical symptoms. Normal heel pads showed a broad region of high pressure, which accounted for a high percentage of the total load transmission. In contrast, the atrophic heels showed a high but narrow peak pressure. However, most of the load was transmitted over a large area of low pressure. There was no difference between symptomatic and asymptomatic heels. The mechanical behavior of the fat pad is discussed with particular reference to the anatomic structure of the pads. Pad thickness and septal integrity are both important to the mechanical characteristics of the fat pad. The load-bearing patterns observed are discussed in terms of the mechanical components influencing fat pad resilience. These results have direct relevance to understanding the pathophysiology of heel pain secondary to degeneration of the fat pad.

Adipose Tissue↗
PubMed1992

Investigations into the fat pads of the sole of the foot: anatomy and histology.

Anatomical, histological, and histochemical studies were performed on normal and abnormal fat pads of the sole of cadaver feet. The fat pads were found to contain a significant nerve and blood supply separate from that to the surrounding musculature and skin. Pacinian corpuscles and free nerve endings within the fat were identified. Histological analysis indicated a meshwork of fibroelastic septae arranged in a closed-cell configuration. The mechanical consequences of this organization are discussed in the context of the weightbearing role of the fat pads of the feet. Alterations seen in dysvascular or senescent feet are consistent with the hypothesis that the septal anatomy of the fat pads is central to their cushioning function.

Adipose Tissue↗
PubMed1992

[Functional and clinical differentiation of chronic respiratory failure].

Respiratory insufficiency is defined as hypoxemia due to bronchopulmonary disorders. The site of the underlying disease can be exclusively in the parenchyma and vessels of the lung, but also in the pumping mechanisms with resulting CO2-retention. A combination of these phenomena is usually seen in patients of the predominant bronchitic Type B of chronic obstructive lung disease. Vascular and parenchymatous lesions cause hypoxemia by decrease of diffusion capacity, distribution inequality of blood flow and ventilation, and also shunting mechanisms. CO2-retention is not to be expected in these cases. The therapeutic approach is based on the individual predominance of functional findings in a given patient, and include medication to relieve bronchial obstruction, substitution of oxygen and measures for mechanical support of breathing. Especially bronchial obstruction should be identified as early as possible in the course of the disease in order to prevent inevitable and irreversible morphological changes.

Diagnosis, Differential↗
PubMed1991

The effect of arm position and capsular release on rotator cuff repair. A biomechanical study.

A cadaver study was performed to determine the effect of arm position and capsular release on rotator cuff repair. Artificial defects were made in the rotator cuff to include only the supraspinatus (small) or both supraspinatus and infraspinatus (large). The defects were repaired in a standard manner with the shoulder abducted 30 degrees at the glenohumeral joint. Strain gauges were placed on the lateral cortex of the greater tuberosity and measurements were recorded in 36 different combinations of abduction, flexion/extension, and medial/lateral rotation. Readings were obtained before and after capsular release. With small tears, tension in the repair increased significantly with movement from 30 degrees to 15 degrees of abduction (p < 0.01) but was minimally affected by changes in flexion or rotation. Capsular release significantly reduced the force (p < 0.01) at 0 degree and 15 degrees abduction. For large tears, abduction of 30 degrees or more with lateral rotation and extension consistently produced the lowest values. Capsular release resulted in 30% less force at 0 degree abduction (p < 0.05).

Arm↗
PubMed1990

[Sarcoidosis as a multi-organ disease].

Sarcoidosis meets the criteria for multi-organ disease, which differs from systemic disease in the following points: The preferred primary organ (lungs) is known, immunological processes take place only in the organs involved (T helper lymphocyte accumulation), the clinical picture depends upon the organ involvement, and granulomas are typical of the disorder. The clinical significance of the various organ manifestations covers a broad spectrum, which can also include a threat to life (myocardium), blindness, chronic invalidism (pulmonary fibrosis, hepatopathy, nephropathy), and cosmetic impairment (cutaneous sarcoidosis). Numerous organ manifestations have no clinical significance, and some are both rare and limited (tumorous CNS involvement). So-called overlap syndromes have characteristic features common to both multi-organ and systemic diseases. In addition to characteristic sarcoidosis manifestation in an organ, signs of a generalized disorder are also detectable. Examples are primary biliary cirrhosis, Crohn's disease, coeliac disease, Whipple's disease, TASS (Thyrotoxicosis, Addison, Sjögren, Sarcoidosis) as lymphomas and inflammatory diseases (tuberculosis). Outside of the primary organ, these manifestations are often clinically latent. Selective investigations bronchoalveolar lavage), however, can demonstrate the presence of sarcoidosis alveolitis. It is demonstrated that for the clinician, differentiation of multi-organ from systemic disease is meaningful in particular with respect to therapeutic consequences. In the individual case, however, possible overlapping must always be borne in mind.

Cardiomyopathies↗
PubMed1990

[Significance of expiratory bronchiolar collapse symptoms in the diagnosis of emphysema].

A club-shaped resistance curve as recorded using wholebody plethysmography, as an expression of expiratory bronchial collapse is often interpreted as a sign of pulmonary emphysema. Within the framework of a prospective study involving 32 consecutive patients, a quantification of the resistance loops was carried out. The results obtained indicate that dynamic airway collapse is not specific to emphysema. Rather, there is a highly significant correlation between the degree of bronchial collapse and the elevation of total lung capacity irrespective of whether the latter is due to a reversible hyperinflation associated with bronchospasm or to emphysema of the lungs. It can, however, be seen that, in patients with reversible hyperinflation, intensive anti-obstructive treatment also leads to a decrease in, or the disappearance of, the signs of bronchiole collapse with simultaneous decrease in TLC. We conclude from this that a repeat wholebody plethysmographic examination following a lengthy period of treatment is suitable for distinguishing between bronchiole collapse in reversible hyperinflation and emphysema.

Aged↗
PubMed1990

[Allergic alveolitis or intrinsic asthma? (A case report)].

We report on a 37-year old patient with a simple viral infection who presented with acute bronchitis with bronchospasm, a productive cough and severe dyspnoea. Because of his specific occupational history--the patient is a forester and was exposed to wood dust and fungi--he was at high risk for extrinsic allergic alveolitis with mucoid impaction, so that the cause of hypoxemia and cyanosis was obvious. Repeated immunological parameters including gel-precipitations were negative: The lung function pattern (reduced vital capacity, a reduced FEV1, reduced flow values at low vital capacity and with the characteristic shape of the flow volume-curve but normal airway-resistance) suggested the diagnosis of intrinsic asthma limited to the small airways - "bronchiolar asthma" - severe small airway disease.

Adult↗
PubMed1988

Neutrophil elastase alpha 1-proteinase inhibitor complexes in pleural effusions.

Polymorphonuclear (PMN) granulocyte derived neutrophil elastase (NE) is rapidly antagonized by alpha 1-proteinase inhibitor (alpha 1 PI) in vivo. To determine the clinical value of elastase alpha 1-proteinase inhibitor complexes (E-alpha 1 PI) in pleural effusions, fluid samples of 99 patients were examined. Fifty-six had malignant effusions, 30 had non-malignant exudates (pleural protein above 3 g/dl) mainly of inflammatory origin, and 13 patients had low protein transudates (below 3 g/dl) due to congestive heart failure. Nonmalignant exudates showed significantly higher (P less than 0.001) concentrations of E-alpha 1 PI compared with malignant effusions or low protein transudates (P less than 0.001). Malignant exudates secondary to lung cancer were characterized by higher (P less than 0.001) median pleural E-alpha 1 PI concentrations compared to malignant exudates due to primarily extrathoracic malignancies. Total pleural leukocyte counts and pleural neutrophil counts were performed in 68 effusions. By this means no clear-cut differentiation between malignant and nonmalignant exudates seems possible except for marked empyema. In conclusion, E-alpha 1 PI complexes in pleural fluid may better reflect the stage of inflammation of pleural effusions rather than mere pleural leukocyte counts. Low levels of E-alpha 1 PI complexes (less than 75 ng/ml) in pleural exudates with protein values above 3 g/dl are characteristic of malignant exudates. Determination of E-alpha 1 PI in pleural exudates may serve as a sensitive marker of inflammation and useful adjunct to pleural cytology in aspects of differential diagnosis of pleural effusions.

Blood Proteins↗
PubMed1987

[Diagnosis and therapy of nocturnal asthma].

The bronchial tonus depends on circadian oscillations like all other organ functions. The tendency to increased nocturnal bronchoconstriction in some asthmatic subjects is well known. The reasons of such individual variations are different concentrations of cortisol, adrenaline, histamine, cAMP in serum as well as imbalance between vagal and sympathetic interactions. In practice, the early diagnosis of severe nocturnal bronchial constriction is important for prevention of asthma attacks and status asthmaticus. We report on our circadian measurements of airway resistance (Ros) or peak-flow. By adequate therapy an improvement of the individual bronchial tolerance could be achieved, however the biorhythm remained unchanged. Measurements of airway resistance at 2 a.m. were significantly improved by therapy, as was the mean level measurements during 4-hourly readings. High dose bedtime or slow release theophylline decreased the number of nocturnal asthma attacks.

Airway Resistance↗
PubMed1987

Nuclear medicine in diseases of the lung--present status and future. Introduction--clinical aspects.

Clinical needs for noninvasive radionuclide methods have often been an important stimulus to further progress in techniques. In disorders such as pulmonary thromboembolism, however, the correct interpretation can only be made with the help of a broad synoptic basis, formed by the treating physician, the X-ray, and the nuclear medicine specialist. This trivial statement has been of topical interest over the past 20 years in the history of ventilation-perfusion (V-P) scanning. Considerable achievements and promising results have undoubtedly been obtained in the examination of aerosol clearance (alveolar permeability and mucociliary transport), regional ventilation, workup for malignancy, identification of inflammation of the parenchyma in the absence of radiological signs, and in noninvasive diagnosis of pulmonary blood flow and volume. Future developments may be very expensive and require highly specialized equipment (PET, cyclotron, etc.), with no assurance that routine clinical application will be available in the near future.

Humans↗