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Biomedical subjects

F Kummer

Publications and source records attributed to F Kummer.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Diagnostic value of the combined determination of carcinoembryonic antigen (CEA) in pleural effusion and serum with an enzyme immunoassay (EIA). Sensitivity, specificity and relation to tumor type].

Measurement of carcinoembryonal (CEA) levels in pleural fluid are suggested to improve the unsatisfactory sensitivity of pleural cytology in the differential diagnosis of malignant pleural effusions. We evaluated simultaneously determined pleural and serum CEA levels in 117 patients with pleural effusions of different aetiology (74 malignant, 30 inflammatory exudates and 13 transudates) by use of an enzyme immunoassay (EIA). Despite considerable scatter, pleural levels of CEA in malignant effusions were significantly higher (p less than 0.001) than the values in benign effusions. Using a cut off level of 5 ng/ml, 41% (= sensitivity) of malignant pleural effusions showed elevated concentrations of CEA. Only one out of 43 benign effusions showed a level of 5 ng/ml, which is equivalent to a specificity of 98%. However, malignant effusions due to small cell lung cancer, pleural mesothelioma and metastasising ovarian carcinoma never showed elevated levels of CEA. Highest pleural values of CEA were observed in cases of alveolar cell or adenocarcinoma of the lung or metastasising breast cancer. Although pleural and serum CEA levels correlated significantly (rs = 0.77), the evaluation of serum CEA levels alone yielded a lower sensitivity (36%) and specificity (93%) than pleural levels. 77% of cases with malignant pleural effusions showing elevated pleural CEA levels were characterized by an increased ratio Pleura/Serum greater than 1, particularly in effusions due to lung cancer. The CEA ratio was significantly higher (p less than 0.05) in patients with malignant than with benign effusions. EIA appears to be more specific by avoiding false positive results in benign effusions as compared with determination by conventional RIA. In conclusion, evaluation of pleural CEA levels in patients with malignant effusions by using an EIA because of its high specificity is a valuable adjunct to pleural cytology in improving the diagnosis of malignant effusions. However, a normal CEA level in either pleural effusion or in serum is of no clinical significance. Simultaneous measurement in pleural effusion and serum is of greater value.

Breast Neoplasms↗
PubMed1986

[Neurophysiologic studies in Pickwickian syndrome].

In 11 patients clinically diagnosed as Pickwickian syndrome the results of daytime and night polysomnogramm were compared. The daytime recording was very efficient in identifying apnoea and correlating various types of apnoea to different sleep stages. In polysomnogramms of night sleep we found, as did Lugaresi, a reduction of sleep stages III and IV, and a slight increase of sleep stages I and II. Patients without apnea in daytime sleep also showed a normal apnea index in night sleep. The BAEP's especially the pontomesencephalic components were pathological in six patients (55%). This might be due to a primary lesion or to hypoxic damage of the brainstem.

Adult↗
PubMed1985

Dry aerosol of monodisperse millimicrospheres for ventilation imaging: production, delivery system, and clinical results in comparison with 81m-krypton and 127-xenon.

The production of monodisperse human albumin millimicrospheres (diameter less than 1 micron) and labeling with 99mTc is described. A system constructed to nebulize and deliver a dry aerosol yielded a lung delivery efficiency of approximately 25%. In 48 patients without and with varying degrees of chronic obstructive lung disease, quantitative comparison with 81mKr (penetration index, regional distribution of activity in the lungs) demonstrated similar penetration of the particles to the lung periphery (r = 0.89 and r = 0.94, respectively). Qualitative comparison with 81mKr or 127Xe showed complete or a high degree of diagnostic agreement in all but one patient. Semiquantitative scoring of hot spots as a substrate of local turbulent airflow showed a close inverse correlation (r = -0.82) with the forced expiratory volume in 1 s (FEV 1.0%), thus providing additional information about the severity of the airway obstruction. In 24 patients with suspected pulmonary embolism, complete agreement between aerosol and 81mKr images was found in all patients studied. For same-day ventilation/perfusion studies, labeling of the millimicrospheres with 111In yielded images of comparable quality to those obtained with the 99mTc-labeled aerosol.

Aerosols↗
PubMed1985

The comparative biomechanical, histologic, and radiographic analysis of canine lumbar discs treated by surgical excision or chemonucleolysis.

Previous experimental studies on the canine intervertebral disc treated with chemonucleolysis have shown encouraging results in preserving normal histologic, biomechanical, and radiographic disc appearance. These observations suggest that chemonucleolysis may have significant advantages over surgical disc excision in preserving normal function of the lumbar vertebral motion segment. An experimental canine study was devised to examine and compare the short and long-term effects of chemonucleolysis and surgical disc excision on the entire lumbar motion segment to determine if one treatment modality is superior to the other in providing better maintenance of motion segment function. Twenty adult beagle dogs underwent anterior laparotomy. In ten dogs, Chymodiactin was injected into the L4-5 disc and in the remaining ten, routine surgical discectomies were performed on the L4-5 disc. Preoperative and presacrifice lateral radiographs were obtained. All dogs were allowed to exercise freely. Five dogs that received Chymodiactin (Group A) and five dogs that had surgical excisions (Group B) were killed six weeks postoperatively. Five months postoperatively, five dogs given Chymodiactin (Group C) and 5 having surgery (Group D) were also killed. Mechanical testing was performed on each treated disc sample with a modified MTS machine (MTS Systems Corp., Minneapolis, MN). Axial compression, bending, shear, and torsion were assessed in ten modes. Stiffness values for each mode were calculated. Following the biomechanical tests, the facet joints and the disc with the adjacent endplate were removed intact and analyzed histologically and with high resolution radiography. Six-week biomechanical testing revealed a 50% loss of torsional stiffness, as well as loss of anterior and medial-lateral shear stiffness in the chemonucleolysis group.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1979

[Oxygen therapy by means of an oxygen concentrator (author's transl)].

Oxygen for therapy of chronically hypoxemic patients can be supplied by an oxygen concentrator (De Vilbiss, DeVO2). By these means longterm oxygen therapy can be carried out on a round-the-clock-basis without risk of hypercapnia and without the need of handling the refill of oxygen containers. 9 patients in severe respiratory failure were treated with 2 to 4 l/min from the concentrator through 4 hour 4 days. Serial bloodgas analyses showed marked improvement of hypoxemia in all patients and prevention of exercise-induced failure in one patient. The oxygen concentrator therefore is suitable for the home treatment of patients with severe hypoxemia.

Adult↗
PubMed1979

[Thyrotoxicosis and sarcoidosis of the thyroid and the lung (author's transl)].

Clinical and pathological studies indicate, that sarcoidosis rarely affects the thyroid gland. The diagnosis of sarcoidosis in the lung and in the thyroid has been established by biopsies taken during surgery in a case of a 53 year old female. The manifestation of thyrotoxicosis in sarcoidosis-involvement of the thyroid has been analysed and compared with the 15 patients exhibiting sarcoidosis-involvement of the thyroid and thyrotoxicosis described in the literature.

Biopsy↗
PubMed1979

[Renal failure and carbon monoxide diffusing capacity of the lung (author's transl)].

Reduced carbon monoxide diffusing capacity of the lung (DLCO) is reported in patients with impaired renal function. Since DLCO also depends on the pulmonary capillary blood volume the role of renal anaemia was evaluated. Measurements were carried out in 43 azotaemic patients [serum creatinine (SKr) 1.5 to 14.0 mg/100 ml], without evidence of cardiovascular or pulmonary complications of uraemia, of SKr, haemoglobin concentration (Hb) and steady state DLCO. In the case of DLCO values allowance was made for body surface area and thoracic gas volume. The relation was studied of the corrected DLCO to SKr and to Hb. There was a higher statistical correlation between DLCO and Hb than between DLCO and SKr. After additional correction of DLCO for Hb, no correlation to SKr was found. It is concluded that the reduction in DLCO in uraemia is due largely to a low Hb and, hence, to renal anaemia rather than to uraemic damage of interstitial lung tissue.

Adolescent↗
PubMed1979

[Vagus mediated elevation of respiratory resistance in patients with acute myocardial infarction].

Changes in pulmonary function have been reported in patients after uncomplicated myocardial infarction, with reduction in lung volumes and flow rates. The significant increase in oscillatory resistance and impedance of the lung, was seen on the first day after myocardial infarction. The application of ipratropiumbromid, an anticholinergic broncholytic agent, significantly decreased oscillatory resistance and impedance, on the first day, but not to the same extent, after the fourth day. The reduction of oscillatory resistance and impedance could be attributed to blockade of a vagal mediated bronchoconstriction, which predominantly affects the small airways. The observed changes in pulmonary function, could therefore not only be due to congestion with increase in extravascular pulmonary fluid, but in the acute phase of myocardial infarction, also due to a reflex mechanism in which vagal mediated bronchoconstriction is demonstrated.

Aged↗
PubMed1979

[Bronchial obstruction in the aged--symptom or diagnosis? (author's transl)].

Airflow obstruction is not a clinical entity. The presence of obstruction has to be documented, at least by a timed forced vital capacity. Consequently, information must be sought about the quality and severness of the functional disturbance (pathogenesis, reversibility by medication, follow-ups). Because of the great number of possible irritants and responses, the differentiation of bronchial and extrabronchial obstruction is of great importance for the elderly patient (bronchitis plus emphysema?). The impact of other disorders on the bronchi is being discussed (e.g. pulmonary embolism, left heart failure). These considerations should be part of the routine before therapy is being initiated.

Aged↗
PubMed1979

[Immunotherapy of allergic disease. Studies on 460 patients].

The results and side effects of immunotherapy in atopic dermatitis, bronchial asthma and/or allergic rhinitis are evaluated in 460 patients. The findings are listed in terms of diagnosis, age, sex and preparations as well as duration and number of incorporated allergens of immunotherapy-vaccine. In 82% a good result was reported, while in 18% no improvement could be seen. The results increase gradually from atopic dermatitis to bronchial asthma and allergic rhinitis, although the differences fail to be significant statistically. Males respond better than females. However, in bronchial asthma only, the differences are significant (p less than 0.01). According to the preparations used (Bencard, Novo-Helisen, Allpyral), no differences could be seen. The percentage of side effects is higher than 50%, but is mainly restricted to local swelling, tiredness and itching. Again no significant differences could be seen between the vaccines used.

Adolescent↗
PubMed1978

[The value of submaximal ergometer tests for the determination of physical fitness].

Maximal work endurance of heart and circulation measured by submaximal work load on an ergometer can be estimated with reasonable accuracy by means of the physical working capacity 170 (PWC 170) only in healthy individuals aged 30 years or below. Limitation of exercise by pulmonary factors does not appear to bias the results essentially. In healthy people aged 40 or over, the risk of miscalculating maximal working ability based on PWC 170 increases considerably despite maintenance of high statistical correlation to maximal work load. In patients with coronary heart disease, there is no statistical correlation between PWC 170 and maximal work load; therefore, symptom-limited ergometry is required in these patients. For the assessment of quality in follow-up tests, the watt-pulse at submaximal work load appears to be the most adequate parameter. It is recommended that submaximal tests be also carried out in a rectangular-triangular manner, for the purpose of comparison with symptom-limited tests and for evaluation of changes in the dynamics of pulse and blood pressure regulation.

Adolescent↗
PubMed1978

[Comparison of oscillation method and body plethysmography for assessment of airway resistance (author's transl)].

Airway resistance was measured by body plethysmography and also by an oscillographic method for assessment of the impedance of the respiratory tract. The results were compared in 42 unselected patients. The correlation between the two values for airway resistance was satisfactory (r = 0,804 p less than 0,001). However, when correlation was sought between each type of resistance-value and other lung function data (FEV1, IGV), the resistance measured by plethymography correlated better than the one measured by the oscillation method. This difference was even more pronounced when 21 patients with manifest bronchospasm were reevaluated after bronchodilatation. Nevertheless, the oscillation method for assessment of the resistance of the respiratory tract serves as a new and practicable tool for bed-side lung function testing, as well as for testing of patients who are unable to cooperate for routine spirography.

Adolescent↗
PubMed1978

[Angiotensin converting enzyem (ACE) - a blood chemistry parameter in the diagnosis of sarcoidosis].

Serum angiotensin converting enzyme (ACE) activity was studied in 50 patients with sarcoidosis (39 active, 11 inactive sarcoidosis), as well as in 50 control patients (34 chronic lung diseases, 9 Hodgkin-disease, 7 rheumatoid arthritis). There is a significant difference (p less than 0.001) of ACE-activity between sarcoidosis patients and controls, and between active (without steroid treatment) and inactive sarcoidosis. Steroid treatment apparently lowers ACE-activity in sarcoidosis, however, without evidence for clinical improvement. Increased ACE-activity was also found in a patient with primary biliary cirrhosis.

Adrenal Cortex Hormones↗
PubMed1978

[Atelectases as part of the convex-sided lungs in thoracic scoliosis (author's transl)].

In 4 patients with juvenile idiopathic thoracic scoliosis an atelectasis as part of the convex-sided lungs was found. In all cases there was a small sagittal diameter of the chest; the atelectases were situated in the right lower and middle lobe and caused by the close topographical relation of large bronchi and scoliotic spine (sometimes compression of the bronchus) demonstrable by tomography, bronchoscopy and bronchography. The therapeutic approach of these atelectases is discussed. Thoracic casting either for conservative correction and treatment of scoliosis or as postoperative immobilisation after fusion was done. In all cases, it may influence the occurrence of an atelectasis.

Adolescent↗
PubMed1978

[Determination of maximal aerobic capacity using simple ergometry in various training conditions].

Exercise tests were performed in 21 competition rowers, before and after a 4 month training period. The significance of differences in VO2, VT, and specific ventilation (Sp. V) at equal work loads, were tested. The influence of the relative VO2 Trel VO20 = VO2/kg BW) on the correlation between maximal workload (Wmax) and VO2 max, was investigated. The VO2 at all workloads, showed a highly significant increase after the period of training. Multiple linear regression analysis, demonstrates an increase of the correlation coefficient from r = 0,65 (single) to R = 0,95 (multiple). The precision of estimation concerning maximal exercise, improves considerably when rel. VO2 is taken into account, as well as, Wmax. The rel. VO2max as a parameter for the state of training can be estimated from an exact training history (total amount of training with direct cardiopulmonary influence = endurance type of training). Combined with Wmax this training history can be included into the multiple regression equation VO2max - 1060 + 6.3 Wmax + 57.3 rel. VO2max. By these means, including ergometry and the training history, even a practicing internist can to a fair estent estimate the capacity for sport.

Exercise Test↗
PubMed1977

[Radiological aspects of emphysema (author's transl)].

Radiology is the basic factor in diagnosis of emphysema. Further differentiation is possible by assessment of the concomitant cardio-vascular changes. By these means, the type of emphysema (accompanying emphysema in chronic bronchitis, or primary emphysema) can be established.

Adult↗