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Biomedical subjects

G Pfeifer

Publications and source records attributed to G Pfeifer.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Effect of isoflurane on intracranial pressure].

The influence exercised by isoflurane on intracranial pressure is studied in a total of 22 patients subjected to neurosurgery. Of these, 12 patients had brain tumours, 4 hydrocephalus occlusus (preoperative measurement of the intracranial pressure) and 6 severe craniocerebral trauma (continuous monitoring of intracranial pressure). In the patients suffering from cerebral tumours the intracranial pressure remained generally unchanged under isoflurane or dropped only slightly in accordance with the drop in median arterial pressure. This drop in median arterial pressure was considerable (-20% to -30%). In patients with hydrocephalus occlusus a biphasic course of the intracranial pressure was frequently observed. After a transient rise the pressure dropped again to the starting level. Isoflurane, on the other hand, led to marked increases in intracranial pressure in 5 patients with craniocerebral trauma (+4 to 22 mmHg). If the median arterial pressure also dropped at the same time, critical ranges were occasionally calculated for the cerebral perfusion pressure. The influence of nitrous oxide in respect of the performance of isoflurane in connection with intracranial pressure is discussed. It appears possible that in contrast to halothane isoflurane does not further increase the intracranial pressure if used in low doses and in the presence of nitrous oxide. However, the results presented here point to the need to exercise caution when using isoflurane in patients with markedly limited intracranial compliance.

Anesthesia, General↗
PubMed1986

[Insertion behavior of miniature IBW-79 pressure transducers in the left heart].

It is reported on the properties of the new catheter-tip pressure transducer IBW-79 (Ch 5) for applications in the left heart. The approach to the left ventricle was carried out with the help of Seldinger-technique (Ch 10) via A. femoralis. In all cases positioning of the pressure transducer in the left ventricle succeeded, but in 2 out of 12 patients there were complications after diagnostic program caused by the puncture. The pressure measurements were from a high quality and high fidelity. Zero shifts during the measurements were in the order of -0.5 kPa (-3.8 mm Hg), directions are given for correction or compensation. In our opinion the IBW-79 is a valuable new sensor-catheter for measuring the pressure in the left heart, above all for scientific applications.

Adult↗
PubMed1986

[Course of central body temperature in the laminar airflow operating room in various anesthesia procedures].

The oesophageal body temperature of 130 patients was measured pre- and intraoperatively. 92% (n = 116) of the operations (implantation or replacement of hip prostheses) were performed in an operating room having a laminar air flow system with horizontal air flow. 9% (n = 14) of the operations (laparotomies) were performed in a room of identical design without an air circulation system. Three different forms of anesthesia were investigated with regard to their influence on interior body temperature: 1) general anesthesia with a volatile anesthetic (INH); 2) peridural anesthesia with additional general anesthesia (KPDA+ITN); and 3) neuroleptic anesthesia (NLA). A drop in temperature during the operation was found in all patients. In the conventional operating room the mean drop was 0.3 degrees C/h. In the operating room with laminar air flow the INH-patients sustained the greatest decrease in temperature; the mean value in the first hour was 1.1 degrees C/h, and up to 4.6 degrees C/3 h toward the end of the operation. There was a comparable drop in temperature in the first hour in patients anesthetized with KPDA+ITN, but the rate slowed down toward the end of the investigation (2.2 degrees C/3 h). NLA caused a characteristic temperature behavior, with an initial fall in temperature, plateau phase, and subsequent rise (total: -1.0 degrees C/3 h) Temperature regulation was influenced least by NLA in the operating room with laminar air flow; thus, in this context, NLA proved to be a favourable form of anesthesia.

Anesthesia, Epidural↗
PubMed1985

[How much labor assistance should the emergency physician render?].

Seven case reports of emergency obstetrics serve to demonstrate to what extent an emergency physician can be of help and where the limits of his field of activities are. The article describes the emergency physician's tasks in general as well as the education and training which may reasonably be expected in young physicians. It is concluded, among other things, that it is not one of the tasks of an emergency physician to supervise or initiate parturition since that is no longer part of the physician's training in the FRG.

Emergency Medical Services↗
PubMed1985

Pharmacokinetic aspects of cerebrospinal fluid penetration of fosfomycin.

Even today antibiotic therapy of postoperative or posttraumatic meningitis remains a problem. In patients in a neurosurgical intensive care unit, nosocomial microorganisms with high resistance are mainly found. There are no antibiotics available which have simultaneously a good efficacy on the higher resistant nosocomial microorganisms and a good penetration through the blood-brain or blood-cerebrospinal fluid barrier. We analysed the cerebrospinal fluid (CSF) penetration of fosfomycin carrying out the investigations in patients in whom a CSF drainage was required for a neurosurgical indication. The blood-brain barrier was considered to be largely intact (total CSF protein and cell counts with in the normal range). Five or 10 g fosfomycin were administered to adults in 30 min infusions. After administration of 5 g, the CSF concentration formed a plateau between 8.6 and 9.9 micrograms/ml 3 to 6 h after the infusion. Increasing the dose infused (10 g) markedly shortened the latency period between reaching a sufficient concentration of fosfomycin in the CSF. With repeated doses of fosfomycin (3 X 5 g/day) the concentration in the CSF did not fall below the therapeutic level. Even in the presence of an intact blood-brain barrier, fosfomycin in our investigation showed a satisfactory penetration into the CSF. This is attributable to the favourable physicochemical state of fosfomycin (relative molecular mass 182).

Adolescent↗
PubMed1984

[Anesthesia in neuroradiology].

Cerebral angiographies can be performed under general anaesthesia, analgosedation in the presence of an anaesthesiologist, and under local anaesthesia. The criteria governing the choice of the most appropriate method of anaesthesiology are discussed. In computed tomography of the head, general anaesthesia is indicated only if it proves impossible to achieve satisfactory cooperation with the patient. Discographies , myelographies and the now rare pneumoencephalography are performed almost without exception under local anaesthesia or without anaesthesia. If general anaesthesia is preferred, it will be necessary to take into account the special pathophysiological conditions obtaining in neurosurgical patients (disturbance of cerebral blood flow due to enhanced intracranial pressure or caused by stenosing vascular processes).

Adult↗
PubMed1983

[Dissolution determination in the rotating flask model. Effect of rotation rate and fluid volume on the solubility determination of standard test tablets in the Resotest dissolution tester].

The influence of two important factors, the rotational speed and the fluid volume within the system, on the release characteristics of prednisone-test tablets in the rotating flask dissolution-tester (Resotest-apparatus after Koch) has been investigated. As a result, standard conditions for dissolution experiments with the rotating flask model, i.e. a mean rotation number of 30 r.p.m. and an actual fluid volume of 500 ml, are proposed.

Chemistry, Pharmaceutical↗
PubMed1983

[Documentation of clinical death in preliminary death certificates].

The emergency physician acting within the framework of organised first-aid service, is not obliged to perform a post-mortem examination or to hold a coroner's inquest and to issue a death certificate. It is easy to understand why the relevant authorities must insist on the immediate submission of a death certificate. Such a certificate can be issued only if unequivocal signs of death definitely confirm that the decrease is an indisputable fact. To cope with this situation, a printed form has been designed which is used to document the occurrence of clinical death.

Brain Death↗
PubMed1982

Separation and individuation in an African society: the developmental tasks of the Gusii married woman.

In this paper we will apply a psychoanalytically informed perspective to understand psychosocial adaptation and self-development in a group of women living in a standard African culture, the Gusii of southwestern Kenya. Specifically, we will draw upon the concept of separation-individuation to understand psychological development among married Gusii women (abasubaati, sing. omosubaati). We will briefly describe the institutional context of Gusii life, the psychological tasks of a Gusii woman's adult life course, and the progress of three particular women, each at a different stage in her childbearing career. The predominant theme running through our data concerns the process by which all Gusii women leave, forever, their natal homes and attempt to establish themselves in what they may initially perceive as a foreign and often inhospitable place. The process of giving up primary attachments and forming new ones certainly is not unique to Gusii women. The extremeness of their situation, however, provides an opportunity to explore a set of particular adaptations to what may well be a universal task in human development, the process of separation-individuation.

Adaptation, Psychological↗
PubMed1981

Classification of facial malformations.

The Hamburg classification of craniofacial anomalies is introduced; it was first published by Pfeifer in 1967 and has been used in our hospital ever since. This morphogenetic classification is based on embryological data and divides the head into three major regions. Subclassification in the individual regions is done according to anatomical details. This system of classification has proved to be simple and useful. It can cope with every malformation and combination of anomalies. It meets all our needs for documentation and data processing. Last, but not least, it is a good aid for teaching students and young residents in embryology and in the understanding of malformations and syndromes.

Adult↗
PubMed1981

[An experimental study of the effects of ketamine on the central sympathetic system, respiration and circulation (author's transl)].

Cats were given basal anaesthesia (nitrous oxide-oxygen) with artificial ventilation. They were then injected intravenously with 5 mg/kilogram bodyweight of ketamine. The injection was followed by a marked ketamine. The injection was followed by a marked reduction in both the tone of the central sympathetic system and the activity of the phrenic nerve which lasted for 10 minutes and 30 minutes respectively. Doses of 10 mg/kilogram bodyweight caused a longer lasting and more pronounced lowering of sympathetic activity while phrenic activity was approximately the same as with the smaller dosage. Injection of 2.5 mg/kilogram bodyweight reduced the sympathetic tone only if it was accompanied by asphyxia (central stimulation). Administration of 5 mg and of 10 mg/kilogram bodyweight was followed by a fall in blood pressure by 15-45 per cent up to 2 minutes after the injection. The heart rate at rest was unaffected but in the presence of asphyxia there was a dose-dependent reduction in the expected bradycardia. Ketamine also induced definite central inhibition thereby preventing the circulatory activation which occurs when the drug is used for anaesthetic purposes. The observation that the bradycardic effect arising from central stimulation was weakened suggests a reduction of central vagal activity.

Animals↗
PubMed1980

Haemodynamic changes in patients with severe head injury.

Haemodynamic studies were carried out in 12 patients who had sustained severe head injury. Radial artery pressure(AP), pulmonary artery pressure(PAP), central venous pressure(CVP), and pulmonary wedge pressure(PAWP) were directly measured. Heart rate was monitored from the ECG, and cardiac output (CO) was measured intermittently by the thermodilution technique. Arterial and mixed venous blood samples were withdrawn simultaneously for measurement of PH, PCO2, PO2, and oxygen saturation. Additional cardiovascular data were calculated from standard formulae. The haemodynamic pattern in these head-injured patients was characterized by high cardiac index, low systemic vascular resistance, moderately high systemic pressure and heart rate, high pulmonary artery pressure and wedge pressure, and normal stroke index. These findings may be the result of autonomic or adrenergic stimulation by the injured brain.

Adult↗
PubMed1980

[The forensic importance of surgical lesions of sensory nerves in the maxillofacial region].

Operative lesions of sensory nerves involve direct or also indirect effects on nerve trunks, peripheral fibers, or terminal plexuses in the mucoperiosteum. Iatrogenic trauma produced by infiltration anesthesia, tooth extraction, or intraoral operative procedures may lead to various complaints accompanied by simultaneous hyperesthesia, normal esthesia, hypoesthesia, or also anesthesia. Transitory and permanent lesions should be differentiated forensically, prognostically, and thereapeutically. If the nerve conduction structure is intact, re-sensitization may require up to one year. Operative measures are available which help alleviate persisting scar complaints. Since constant pain can usually be traced back to scars, the therapeutic concept consists of using release procedures to create more favorable scar conditions (e.g., neurolysis and underpadding with soft andoor hard tissue). The prognosis of microsurgical procedures for nerve defects is all the more favorable if as little time as possible elapses between injury and reconstruction.

Anesthesia, Dental↗
PubMed1980

[The haemodynamic effect of dehydrobenzperidol in cranio-cerebral injuries (author's transl)].

The haemodynamic effects of dehydrobenzperidol (DHB) in persons with craniocerebral injuries were studied before and after administration of noradrenaline in doses of 0.6 gamma/kg bodyweight. Nine comatose patients were hyperventilated up to PaCO2 of 32 mmHg. Heart rate (HR), arterial blood pressure (BP), pulmonary arterial pressure (PAP), central vein pressure (CVP), pulmonary wedge pressure and cardiac output (via a Swan-Ganz catheter) were measured; blood gas analyses of arterial and mixed venous blood were also made. Further haemodynamic parameters were calculated with the aid of standard formulas. The haemodynamic pattern in craniocerebral trauma was characterized by an increase in HR, B, PAP, wedge pressure and cardiac index (CI). Peripheral resistance was at the lower limit of normal. Administration of DHB (0.3 mg/kg bodyweight) was followed for up to three minutes by a fall in BP, CI, HR and left ventricular output while PAP and wedge pressure remained unchanged. Immediately after DHB administration the noradrenaline action was less affected than was the initial haemodynamic situation. The effects were largely reversible for up to 20 minutes. The pronounced immediate haemodynamic action of DHB is mainly attributable of depression of the autonomic nervous system; later on the weak peripheral action of the drug becomes manifest.

Adult↗