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G Hoheisel

Publications and source records attributed to G Hoheisel.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Predictive factors of minimally effective nCPAP ventilation in treatment of obstructive sleep apnea?].

BACKGROUND: Nasally applied continuous positive airways pressure (nCPAP) ventilation is an effective treatment of obstructive sleep apnoea syndrome (OSAS). As the lowest effective nCPAP-level (nCPAPmin) inter-individually is quite variable individual pressure titration under polysomnographic monitoring is necessary. AIM: To determine whether nCPAPmin can reliably be predicted on the basis of clinical and polysomnographic variables. PATIENTS AND METHODS: A set of 77 unselected OSAS-patients was investigated in the sleep laboratory. We used a standard sleep-related questionnaire, examined anthropometric variables, performed lung function tests and blood gas analyses, and measured nasal cross-sectional area as well as nasal flow resistance. In the night prior to the nCPAP titration a cardiorespiratory polygraphy was performed. Stepwise multiple regression analysis using the titrated nCPAPmin as dependent variable and the clinical and polygraphic data as independent variables revealed gender (GES), neck circumference (NCF), body mass index (BMI), and apnoea-/hypopnea index (AHI) as the optimal set of predictors of nCPAPmin in this model. RESULTS: Multiple regression analysis with these factors yielded the following equation: predicted nCPAPmin = 1.95 + 0.80 x GES + 0.09 x BMI + 0.01 x NCF + 0.03 x AHI (woman: GES = 1; man: GES = 2). The reliability of the equation was tested with a second set of 180 prospective OSAS-patients. In these patients the mean nCPAP-level as titrated in the sleep laboratory was 9.1 +/- 2.0 mbar, whereas the mean predicted nCPAP-level was 8.4 +/- 3.6 mbar (p = n.s.). In 51% of the patients the difference between nCPAPmin measured and predicted was greater than +/- 1 mbar. CONCLUSION: This equation is neither sufficient to reliably predict nCPAPmin nor to prescribe nCPAP without individual pressure titration. The calculated nCPAP-level might however contribute to choosing the most suitable flow generator prior to the titration night.

Adult↗
PubMed1995

Increased soluble CD14 levels in BAL fluid in pulmonary tuberculosis.

INTRODUCTION: CD14 is a cell surface glycoprotein expressed mainly on mature monocytes and macrophages. Soluble CD14 (sCD14) is present in normal plasma and is found increased in serum of patients with septicemia, polytrauma, and sarcoidosis. In active sarcoidosis, increased levels of sCD14 in BAL supernatant have been demonstrated. STUDY OBJECTIVE: To investigate sCD14 levels in BAL of pulmonary tuberculosis (PTB), another inflammatory disease characterized by granuloma formation. METHODS: BAL was performed in 12 patients with active but untreated PTB and 12 healthy persons. Cytologic and immunocytologic characteristics were determined. sCD14 was measured by a sandwich enzyme-linked immunosorbent assay. RESULTS: The level of sCD14 in patients with PTB was increased compared with controls (mean +/- SEM: 34.4 +/- 9.6 ng/mL vs 11.5 +/- 2.2 ng/mL; p = 0.02). No correlation was found between sCD14 levels and BAL cell differentials or lymphocyte surface markers. CONCLUSION: Similar to sarcoidosis, increased levels of sCD14 are found in BAL supernatant of PTB patients.

Adult↗
PubMed1995

[Validation of the Sleep-Doc-Porti system for ambulatory sleep apnea diagnosis].

The aim of our study was to validate the Sleep-Doc-Porti-System (SDPS), a simple device to monitor patients suspected of suffering from obstructive sleep apnea syndrome (OSAS). This digital recording system measures nasal flow, oxygen saturation, heart rate, and body position. To assess the reliability of results obtained by the SDPS, cardiorespiratory polygraphy and SDPS were performed simultaneously on 48 patients with OSAS (apnea/hypopnea index (AHI) 26 +/- 25) and 10 habitual snorers (AHI = 0.6 +/- 0.7). There was a strong correlation between the apnea index (AI) recorded by the SDPS and the AI (r = 98; p < 0.001) and AHI (r = 97; p < 0.001) obtained by polygraphy. However, the SDPS significantly underestimated the respiratory disturbance index, because hypopneas were not detected by the recorder (AI by SDPS vs. AHI by polygraphy: 19.6 +/- 24.4 vs. 26.7 +/- 25.3; p < 0.01). With the cardiorespiratory polygraphy as standard, the sensitivity of the SDPS in detecting OSAS ranged between 71 and 72%, and the specificity between 91 and 100%, depending on the AHI values of 5, 10, 15 and 20 chosen to define severity of the disease. Reproducibility was assessed in 23 patients who underwent in-home monitoring in two consecutive nights and yielded no evidence of a "first night effect" (AI: 30.9 +/- 24.3 vs. 33.4 +/- 23.3; p = n.s.). In 18 OSAS patients in-home monitoring was able to demonstrate the worsening effect of alcohol on the disease by a significant increase in the AI comparing the night with and without alcohol (AI: 23.1 +/- 11.9 vs. 35.2 +/- 14.8; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Procoagulant activity of PPD-stimulated human lymphocytes after cryopreservation.

OBJECTIVE: Human mononuclear cells from a previously sensitized donor generate procoagulant activity (PCA) following stimulation with purified protein derivative (PPD). Lymphocytes of tuberculous pleural effusions are also highly responsive to PPD stimulation. We examined the influence of cryopreservation on lymphocytes following stimulation with PPD. DESIGN: Peripheral blood lymphocytes of 5 healthy PPD skin test positive subjects were incubated with either PPD, thromboplastin, or concanavalin A (Con A) at concentrations of 0, 1, and 10 micrograms/ml. PCA was determined by measuring the recalcification time. Tests were repeated following cryopreservation for 4 weeks. RESULTS: Incubation of fresh lymphocytes led to a dose dependent shortening of recalcification time: PPD (0-1-10 micrograms/ml: 100-84-65%), thromboplastin (0-1-10 micrograms/ml: 100-85-62%), and Con A (0-1-10 micrograms/ml: 100-85-42%). These results were highly reproducible when tests were repeated 6 weeks later. Cryopreservation did not significantly affect the expression of PCA following incubation with PPD and with thromboplastin. In contrast, cryopreservation significantly diminished the degree of Con A generated PCA. CONCLUSION: Cryopreservation and storage of human lymphocytes is possible without alteration of PCA expression following their incubation with PPD or thromboplastin.

Blood Coagulation Factors↗
PubMed1994

Endobronchial tuberculosis: diagnostic features and therapeutic outcome.

BACKGROUND: Endobronchial tuberculosis (EBTB) is not seen often in the adult population. In most cases it is associated with pulmonary tuberculosis. During its course significant tracheobronchial stenosis may develop. In this study we report our experience with patients with EBTB. METHODS: The records of 38 patients in whom EBTB had been proved by fibre optic bronchoscopy, microbiology and histology studies were evaluated. RESULTS: Symptoms were non-specific and represented mainly the co-existing pulmonary tuberculosis. Signs characteristic of airway obstruction were rare (localized wheezing in 6%). Indications for bronchoscopy were radiographic features (87%), microscopy smear negatives (8%), wheezing (3%), and blood stained sputum (3%). The lesions were more likely to be seen in the main and upper bronchi. In 5% of patients the lower trachea was involved. Most lesions looked inflamed (51%), followed by caseous (19%), granulomatous (17%), ulcerative (12%), and fibrotic appearance (1%). The degree of stenosis was nil (22%), minor (45%), significant (13%), subtotal (13%), or total (7%). The patients were treated with a combination of antituberculosis drugs. Four patients underwent surgical procedures. Dilatation techniques were used in two patients for a right and left main bronchus stenosis respectively, with significant improvement in one. Dilatation in combination with laser therapy of a right intermediate bronchus stenosis did not result in re-expansion of the dependent part of the lung due to pleural adhesions. Left pneumonectomy was performed in one patient for destroyed lung. Twenty-two patients agreed to follow up bronchoscopy. The macroscopic appearance of the mucosa had improved in most cases but the degree of stenoses was unchanged in a considerable proportion (58%). Bronchial stenosis in one patient subsided during therapy but developed again at a later stage. CONCLUSIONS: Patients with pulmonary tuberculosis and radiographic evidence of volume loss are recommended to undergo bronchoscopy to rule out EBTB. Specific symptoms for EBTB are rare. Biopsy of inflamed areas of bronchial mucosa seems to be indicated. Despite adequate antituberculosis therapy tracheobronchial stenosis may develop. Long term follow up including bronchoscopy seems therefore advocated. Dilatational intervention may be indicated in selected cases.

Adolescent↗
PubMed1994

[Roentgen findings in bronchial tuberculosis].

To determine the value of chest roentgenographic findings in the diagnosis and therapy of endobronchial tuberculosis we analysed roentgenograms of 41 patients with endoscopically confirmed tuberculous involvement of the intrathoracic airways. 40 patients had infiltrates typical for pulmonary tuberculosis predominantly in the upper lobes. Signs of diminished air entry in form of collapse or consolidations were found in 52%. 10 patients had cavities and two had a destroyed lung. In only one patient the chest roentgenogram was completely normal demonstrating a case of isolated endobronchial tuberculosis. During antituberculosis drug therapy radiological signs improved in 38 of 41 patients, but in more than half of the cases stenoses persisted as verified by bronchoscopy. We conclude that endobronchial tuberculosis is usually accompanied by lung parenchyma involvement and that roentgenological findings are characterised by signs of pulmonary tuberculosis in most cases. A normal chest roentgenogram does not exclude endobronchial tuberculosis. Despite roentgenographic improvement during therapy tracheobronchial stenoses may persist. These findings justify to perform early fibreoptic bronchoscopy. Sputum conversion during the clinical course may indicate the most appropriate time for this examination.

Adolescent↗
PubMed1993

[The content of asbestos bodies in the bronchoalveolar fluid as a parameter of an increased pulmonary asbestos load].

Pulmonary asbestos burdens are usually determined by quantitative pulmonary dust analysis. The aim of this study was to investigate the value of bronchoalveolar lavage (BAL) for this purpose. First, the upper limit of normal for asbestos bodies (AB) in BAL fluid was established using a reference group of 371 patients with no evidence of increased exposure to asbestos. 99% of these patients had less than 0.5 AB/ml. In order to see whether BAL fluid AB concentration reflected pulmonary tissue content, BAL fluid and lung tissue from a further 64 patients with diverse histories of asbestos exposure were investigated. There was a positive association between AB concentration in BAL fluid and lung tissue only for the overall group of 64 patients (r = 0.86; P < 0.001). Twelve of 13 patients with more than 1 AB/ml and ten patients with more than 5 AB/ml had more than 1000 AB/cm3 lung tissue, a value that is usually exceeded in asbestosis. When the upper concentration limit was set at 0.5 AB/ml for BAL fluid and 50 AB/cm3 for lung tissue, only two out of 64 patients had a false positive value (specificity 95%), but eleven patients had false negative results (sensitivity 58%). These investigations establish that concentrations of > or = 0.5 AB/ml are a reliable indicator of increased asbestos exposure and concentrations > 1 AB/ml are associated with a higher probability of having more than 1000 AB/cm3 lung tissue. However, exclusion of increased asbestos exposure is not possible on the basis of negative BAL findings, since the sensitivity of the method is too low.

Adult↗
PubMed1991

[Silicone endoprosthesis in the treatment of tracheobronchial stenosis. Report of the first 12 patients treated with this method].

Inoperable tracheobronchial stenoses are most often due to malignant disease. Apart from systemic therapy, various local treatment modalities such as laser resection, cryotherapy and endobronchial radiation therapy have been designed to maintain airway patency. Recently, various models of tracheobronchial stents (or endoprostheses) have been designed to maintain airway patency. They prevent recurring endobronchial tumor growth or progressive extrinsic compression of dilated airways. Silicone stents are highly suitable for this purpose. We treated 12 patients (11 males, 1 female, median age 68,5 years) suffering from bronchial carcinoma (6), esophageal carcinoma (4), metastatic colon carcinoma (1) and metastatic osteosarcoma (1). One stent per patient was inserted at the following sites: 6 in the right main bronchus, 4 in the trachea, 1 in the left main bronchus and 1 tracheobronchial left. We observed 2 complications: one obstruction of a bronchial stent by secretions which could be managed by fiberbronchoscopy and one short fire to a bronchial stent on repeat laser therapy. Rapid and lasting relief of dyspnea was observed in all patients. Our initial experience with a median follow-up of 2 months confirmed the easy insertion technique, the excellent effect and tolerance as well as the simple postoperative care of these silicone stents. Their use immediately after relief of a tracheobronchial obstruction by local means can be recommended.

Aged↗
PubMed1991

[Involvement of the central nervous system in disseminated tuberculosis].

Four weeks after starting tuberculostatic treatment (with isoniazid, rifampicin, streptomycin and pyrazinamide) a 21-year-old man with pulmonary tuberculosis developed symptoms of a radiculomyelopathy as well as mild renal failure. After isoniazid and streptomycin had been discontinued and ethambutol and high doses of vitamin B6 had been added all signs and symptoms improved. However, 4 weeks later tuberculous meningitis occurred which at first seemed to respond to administration of 5 antituberculosis drugs and dexamethasone. But 3 weeks later the patient sustained a partial hemiparesis. Its cause was proven to be a tuberculoma in the region of the brainstem. During further administration of tuberculostatic drugs and glucocorticoids the symptoms gradually receded over 8 months. A 54-year-old man with pulmonary tuberculosis developed cranial nerve pareses and symptoms of cerebellar involvement (trunk ataxia, intention tremor, dysdiadochokinesia) 3 weeks after starting tuberculostatic treatment. Computed tomography revealed multiple intracerebral tuberculomas which gradually shrank with continuation of the tuberculostatic treatment plus glucocorticoids. These two case reports illustrate that in tuberculosis involvement of the CNS can express itself clinically through complex symptoms, sometimes even after the start of tuberculostatic treatment.

Adrenal Cortex Hormones↗
PubMed1990

[Efferent projections of "classical" peptidergic neurons of the neurosecretory system of the telencephalon in reptiles (Scincus scincus L. and Chalcides ocellatus Forskal; Lacertilia, Squamata].

In both species of lacertilian reptiles investigated, the peptidergic hypothalamic supraoptic and paraventricular nucleus project with efferents to the telencephalon, to caudal parts of the brain, and to the spinal cord. The marked system of efferents of the "classic" peptidergic neurosecretory nuclei to the telencephalon was mapped. The unlabeled peroxidase-antiperoxidase immunocytochemical procedure revealed at the light microscopical level neurophysin- respectively mesotocin- or vasotocin-containing exohypothalamic fibres in the septal area, in subcortical regions (ventral striatum and hypopallium), and in all layers of the cortical areas (medial, dorsal and lateral cortex). Within the different parts of the brain, there seems to be a characteristically quantitative ratio of the mesotocin and vasotocin fibres. The terminals of the exohypothalamic fibres contact perikarya and processes of neurons of the target regions intimately. In a selected area, peptidergic synapses could be demonstrated at the electron microscopical level using an ultrahistochemical method. It is assumed that the nonapeptides mentioned are released from the fibre terminals and then act as neurotransmitters/neuromodulators influencing different brain functions.

Animals↗
PubMed1986

[Somatostatin in lamprey brains (Lampetra planeri Bloch)].

In the brain of larval and adult lampreys (Lampetra planeri Bloch) a distinct somatostatin system using somatostatin antiserum with the unlabeled peroxidase-antiperoxidase technique was demonstrated. The immune reactive perikarya are localized in the nucleus ventralis hypothalami and they are restricted to this nucleus without exception. A small number of immune positive efferences invades the commissura praeinfundibularis. In the neurohypophysis localized caudally from this commissure and in the adenohypophysis no somatostatin fibres could be visualized. Most of the efferences leave the hypothalamus as exohypothalamic fibres and form a system of somatostatin fibres which extends from the telencephalon to the medulla oblongata. Regionally, this system is organized in a net-like manner.

Animals↗
PubMed1979

Peptide containing vesicles within neuro-neuronal synapses.

In the descending part of the classical neurosecretory system, the axon terminals are not differentiated or they take the form of presynaptic elements which then form synaptoids or synapses with pituicytes or adenohypophyseal glandular cells respectively. In contrast, the axon terminals of the ascending part fulfil the criteria of true presynaptic elements which form synapses with other neurones. The presence of neurophysin vesicles in the presynaptic element is a particular morphologic feature of these neuro-neuronal synapses.

Animals↗
PubMed1978

The reticular formation of lampreys (Petromyzonidae)--a target area for exohypothalamic vasotocinergic fibres.

The octapeptide vasotocin, which is formed in the classical neurosecretory nuclei of lampreys (Petromyzonidae), is transported, bound to the carrier protein neurophysin, not only to the neurohypophysis but also to various other regions of the brain via exohypothalamic fibres. A target area of this exohypothalamic vasotocinergic system is, in the brook lamprey (Lampetra planeri Bloch), a relatively well circumscribed area in the isthmus region of the rhombencephalic tegmentum motoricum, which is called area lateralis tegmenti. In this area, which belongs to the reticular formation, the vasotocinergic fibres form synaptic contacts with nerve cell perikarya and processes. The vesicles contained in the fibres were identified, ultrahistochemically, as neurophysin vesicles. They correspond to the neurophysin vesicles observed in the neurohypophysis of the same species. The functional significance of the vasotocinergic supply to portions of the reticular formation in lampreys is open to discussion.

Animals↗
PubMed1977

[Studies on the tolerance of the organism to X 5 CrNiMo 18.10 steel (Königsee). III. Electron microscopic studies on the tissues surrounding X 5 CrNiMo 18.10 steel implants in the animal experiment].

The surrounding tissue of X 5 CrNiMo 18.10-steel implantates in guinea-pigs was analyzed by electron microscopy. Corroding products of the implantates were marked by sulfide-silver-reaction. Metallic alien material was only proven in the cells of connective tissue covering the implantates. Immediately around the implantates one can not prove products of corroding, evidently depending on their minimal size and amount. In the cells of the intermediate and the vascular zone, however, single or accumulated particles in vesicular or vacuolary organellae, resp. without membraneous cover can be demonstrated. The findings are described and discussed with regard to damages which might arise by means of alloy parts and lysosomal structures.

Animals↗
PubMed1977

[Myelinized oxytocinergic neurosecretory fibers in the region of the median eminence of the rat].

The hypothalamo-neurohypophysial tract of the rat passes the zona interna of the median eminence. The oxytocinergic fibres of this tract were demonstrated by their yellow secondary fluorescence using the pseudoisocyanine-technique. In the same area the staining for myelin sheats gives positive results. The electron microscopical analysis has shown, that nerve fibres containing neurophysin vesicles in the hypothalamo-neurophysial tract can be myelinated partially. The myelinated part of the fibre tract is localized between the caudal end of the optic chiasma and the proximal part of the infundibular stalk. In the infundibulum and in the neurohypophysis myelin sheats are lacking, but the preterminal part of the paraventriculo-neurohypophysical tract is myelinated partially. Concerning the functional significance of the myelin sheats of oxytocinergic fibres it is assumed that in the region of the median eminence a release of neurohormones is prevented.

Animals↗
PubMed1976

[The postnatal development of synapses at the dendrites of rabbit mitral cells].

Olfactory bulbs from 4 specimen of the 1st, 4th, 6th, 9th and 60th postnatal day were used. Relative mature unidirectional and reciprocal synapses are present at the mitral cell dendrites already at the first day. During postnatal development the amount of electrondense postsynaptic material increase. The vesicles were always spheric; their number increase significantly with age only at granule cell side of the reciprocal synapses. Length and width of the synaptic cleft do not change with age.

Aging↗