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H Fabel

Publications and source records attributed to H Fabel.

At least 19 recordsLinked to original sources
PubMed1992

[Anti-basement membrane antibody disease of the lungs without clinical kidney involvement].

Anaemia (haemoglobin 10.7 g/dl) and small spotty infiltrates in both lungs were found in an 18-year-old man who had increasing haemoptysis over the preceding 3 weeks. Bronchoscopy revealed diffuse bilateral pulmonary haemorrhage. Further diagnostic measures provided no evidence of involvement of other organs, in particular the kidneys. The demonstration of anti-basement membrane antibodies confirmed the diagnosis of a disease within the group of immune-induced alveolar haemorrhage. The radiological signs in the lungs regressed over 3 weeks of administering prednisone, initially 100 mg daily, then 60 mg daily, and the patient was discharged. While being treated as an out-patient, with reduction of prednisone to 10 mg daily, the haemoptysis recurred so that a single dose of cyclophosphamide, 1.5 g, was added to the immunosuppressive treatment. There was no further haemoptysis and the prednisone was discontinued after having been given for 15 months. The patient has now been in complete clinical remission for 3 years and anti-basement membrane antibodies are no longer demonstrable. At no time was there any evidence of renal involvement in the sense of the classical Goodpasture's syndrome.

Adolescent↗
PubMed1992

The surfactant system of the adult lung: physiology and clinical perspectives.

Pulmonary surfactant is synthesized and secreted by alveolar type II cells and constitutes an important component of the alveolar lining fluid. It comprises a unique mixture of phospholipids and surfactant-specific proteins. More than 30 years after its first biochemical characterization, knowledge of the composition and functions of the surfactant complex has grown considerably. Its classically known role is to decrease surface tension in alveolar air spaces to a degree that facilitates adequate ventilation of the peripheral lung. More recently, other important surfactant functions have come into view. Probably most notable among these, surfactant has been demonstrated to enhance local pulmonary defense mechanisms and to modulate immune responses in the alveolar milieu. These findings have prompted interest in the role and the possible alterations of the surfactant system in a variety of lung diseases and in environmental impacts on the lung. However, only a limited number of studies investigating surfactant changes in human lung disease have hitherto been published. Preliminary results suggest that surfactant analyses, e.g., from bronchoalveolar lavage fluids, may reveal quantitative and qualitative abnormalities of the surfactant system in human lung disorders. It is hypothesized that in the future, surfactant studies may become one of our clinical tools to evaluate the activity and severity of peripheral lung diseases. In certain disorders they may also gain diagnostic significance. Further clinical studies will be necessary to investigate the potential therapeutic benefits of surfactant substitution and the usefulness of pharmacologic manipulation of the secretory activity of alveolar type II cells in pulmonary medicine.

Adult↗
PubMed1991

Lipoprotein analysis in a chyliform pleural effusion: implications for pathogenesis and diagnosis.

A chyliform effusion is an uncommon high lipid pleural effusion that does not result from a leakage of the thoracic duct. Characteristically, it emerges from chronic pleurisy and contains high levels of cholesterol. The origin of this cholesterol is unknown, but it is often attributed to the degeneration of red and white blood cells. In this study we have carried out detailed lipoprotein analyses in a chyliform effusion, a chronic tuberculous effusion and three inflammatory effusions of recent onset, in an attempt to elucidate the process of cholesterol accumulation and possible lipoprotein alterations. Mean cholesterol was 92 mg/dl in the inflammatory exudates and 1,237 mg/dl in the chyliform effusion. In inflammatory effusions of recent onset most cholesterol was bound to low density lipoprotein (LDL) with corresponding apoprotein B levels. The chronic tuberculous exudate showed a shift of cholesterol binding towards high density lipoprotein (HDL). In the chyliform effusion most cholesterol was found in the HDL region. Our results suggest that in acute inflammation, the pleural barrier opens to plasma LDL. We hypothesize that in chronicity this cholesterol becomes trapped in the pleural space and undergoes a change in lipoprotein binding characteristics. In a chyliform effusion, cholesterol further accumulates and builds complexes containing triglycerides and proteins. In clinical routine, total cholesterol values above 200 mg/dl strongly suggest a chyliform effusion. Since triglyceride values may be as high as in chylous effusions (greater than 110 mg/dl), the diagnostic routine in all suspected high lipid effusions should involve cholesterol and triglyceride measurements.

Aged↗
PubMed1990

[Fibrin glue and tetracycline pleurodesis in recurrent malignant pleural effusions. A randomized comparative study].

In a prospective randomized study the effect of pleurodesis using fibrin-glue was compared with pleurodesis using tetracycline in the management of malignant pleural effusions. Intrapleural therapy with fibrin-glue was significantly more effective concerning long-term results as relapse of pleural effusion and improvement of lung function just as time of draining pleural effusion and pain during the application of fibrin glue/tetracycline. Thus, intracavitary therapy with fibrin glue may be recommended in the control of malignant pleural effusions.

Female↗
PubMed1990

Peripheral neuropathies in patients with chronic obstructive pulmonary disease: a multicenter prevalence study.

To investigate the prevalence and type of peripheral neuropathies (PNP) in patients with chronic obstructive pulmonary disease (COPD), we studied lung function and blood gases, clinical signs of PNP, and neurophysiological function in 151 patients with COPD without known risk factors for PNP. Mean (SD) age was 65 (10) years, mean arterial PO2 was 59 (9) mmHg, mean ratio of forced expiratory volume in the first second to vital capacity (FEV1.0/VC) was 42 (12%). Thirty patients (20%) had clinically detectable and 6 (4%) had subclinical PNP of mild degree. Fourteen (9%) of the patients with clinically detectable PNP had symptoms due to PNP. Prevalence of PNP increased with severity of hypoxemia (p less than 0.05) and was more pronounced in the lower than in the upper limbs. Age and the degree of hypoxemia were predictors to differentiate between COPD patients with and without PNP. Although the cause of PNP in COPD patients remains unknown, our observations suggest that chronic hypoxemia may contribute to PNP.

Adult↗
PubMed1990

Effects of a PAF-antagonist (BN 52063) on bronchoconstriction and platelet activation during exercise induced asthma.

1. The effects of a specific PAF acether antagonist (BN 52063) on the response to isocapnic hyperventilation with dry cold air (ISH study) and exercise (EIA study) were assessed in a single dose and short term treatment study in 10 patients with exercise induced asthma. 2. ISH challenge was performed twice within 1 h after administration of either placebo, 240 mg BN 52063 p.o. or inhalation of 2.4 mg BN 52063. Hyperventilation increased Raw from 0.30 +/- 0.02 to 0.89 kPa s l-1 (P less than 0.001) after the first challenge and from 0.28 +/- 0.04 to 0.84 +/- 0.06 kPa s l-1 (P less than 0.001) after the second challenge. Oral pretreatment with BN 52063 did not result in a reduction of bronchoconstriction during both challenges. A significant increase of Raw was noted immediately after inhalation of BN 52063. An inhibition of PAF induced platelet aggregation (by a factor of 2) occurred after oral administration of BN 52063 after both ISH challenges (P less than 0.05). No significant inhibition of PAF induced platelet aggregation was seen after inhalation of BN 52063. At concentrations up to 30 microM in vitro, BN 52063 inhibited PAF induced platelet aggregation in a dose dependent manner. The IC50 of BN 52063 against the aggregating effect of 1 microM PAF was 7.0 +/- 2.1 microM. 3. In the EIA study the patients were challenged on the third day of treatment with either placebo or 240 mg BN 52063 p.o. or 5 mg BN 52063 by inhalation. Peak expiratory flow rates (PEFR) fell by 155 +/- 37 1 min-1 after exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1990

[Effect of the platelet-activating factor antagonist BN 52063 on exertional asthma].

In a randomised single-blind crossover study we assessed the effects of a specific PAF acether antagonist, BN 52063, on the early asthmatic response to exercise in six patients with exercise induced asthma. After a treatment period of two days an exercise challenge on the third day was preceded by administration of either placebo or BN 52063 240 mg p.o. 3 hours or 5 mg by inhalation 30 minutes before the challenge. After the oral intake of 240 mg BN 52063 there was no effect on the initial exercise induced bronchoconstriction, but the prolonged reduction of PEF was significantly attenuated expressed as a smaller AUC (p less than 0.02). In the placebo period there was a marked increase in plasma concentrations of both platelet factor 4 (PF4) and beta-thromboglobulin (beta-TBG). Intake of BN 52063 diminished the rise in plasma concentrations of PF4 and beta-TBG after the exercise challenge significantly. The results show that platelet activation after exercise induced asthma was markedly inhibited by BN 52063, indicating that PAF acts as a mediator in exercise induced asthma.

Administration, Inhalation↗
PubMed1990

[Prevalence of polyneuropathies in patients with chronic obstructive lung disease].

A multicentric study of 151 COLD patients confirmed the increased prevalence of peripheral polyneuropathies (PNP) in hypoxaemic patients with chronic obstructive lung disease (COLD). 43 (28%) of these 151 COLD patients showed a clinically manifest PNP, whereas in a comparative group of 32 asthmatics there were only 2 clinical PNP cases. Patients with known risk factors for PNP were not included in the study. The polyneuropathy observed in such patients is usually mild, mainly sensorial, distal and leg-accentuated. Of 52 COLD patients with a PaO2 up to 55 Torr, polyneuropathy was seen in 21 (40%), and of 59 COLD patients with a PaO2 above 60 Torr, 10 (17%) had polyneuropathy. In multifactorial genesis (as would be expected), the degree of severity of hypoxaemia (calculated as reduction of the actual PaO2 value below the age-adjusted nominal value), as well as the age of the patient, are statistically significant predictors of clinically manifest PNP.

Aged↗
PubMed1990

[Effects of intravenous prostaglandin E1 on bronchial histamine reactivity].

The effects of infusion of different doses of prostaglandin E1 (12.5, 25, 50 ng kg-1 min-1) on airway responsiveness to inhaled histamine dichloride were observed in 16 subjects with normal and high bronchial reactivity. Subjects were randomized to receive PGE1 or placebo within an interval of three days. Normal saline was infused on one day and PGE1 on the other days. 10 minutes after starting the PGE1 infusion bronchial provocation was induced by histamine aerosol challenge. The provocation concentration of histaminedihydrochloride causing a 50% increase in bronchial resistance increased from 0.36 +/- 0.12 to 0.57 +/- 0.19 mg/ml in hyperreactive subjects (n.s.) and from 0.77 +/- 0.12 to 1.57 +/- 0.19 mg/ml in normal subjects (beta less than 0.05) after administration of 50 ng kg-1 min-1 PGE1 (p less than 0.05). Partial flow rates measured at maximal bronchoconstriction increased dose-dependently during the infusion of PGE1 (p less than 0.05). We conclude that intravenous administration of PGE1 partially protects against histamine-induced bronchoconstriction. In hyperreactive subjects PGE1 selectively increases flow at low lung volumes indicating an action on peripheral bronchial resistance.

Airway Resistance↗
PubMed1990

[Methodologic comparison of the polyfrequency oscillation method, transcutaneous oxygen pressure measurement and body plethysmography in bronchial provocation with methacholine].

A bronchial provocation challenge test was conducted with 30 subjects using metacholin. In randomised sequence lung function analysis tests were carried out with the bodyplethysmograph (Raw, FEV1) and the polyfrequent oscillation method (resistance, reactance between 2 and 52 Hz), whereas the transcutaneous oxygen pressure (tc-PO2) was measured continuously. Correlations between the various parameters, the change of the values at PD60 sGaw in relation to the initial values, the interindividual variability and the reactivity were determined. Medium correlations were found for the oscillatory parameters and Raw, whereas for tc-PO2 and Raw the correlation was markedly lower. In terms of percentage the greatest change was found in reactance, in relation to the initial value, followed by Raw and FEV1. The interindividual variability resulted in the highest values for the reactance, followed by Raw and FEV1. Interindividual variability showed the highest values for the reactance before oscillatory resistance and Raw. In respect of reactivity, reactance also had the highest values. Overall evaluation showed that bodyplethysmography and the polyfrequent oscillation method (reactance or resonance frequency) are comparably sensitive.

Airway Resistance↗
PubMed1990

[A computerized processing unit for ambulatory diagnosis of sleep apnea and nocturnal hypoxemia].

A new mobile device for the evaluation of the sleep-apnoea-syndrome in outpatients prior to conventional polysomnography, processes and stores the oronasal airflow detected by a thermistor, and the heart rate and oxygen saturation in a microprocessor unit. The major problem in on-line data processing of these variables is the interpretation of the thermistor signal for correct apnoea detection. This preliminary study investigates the reliability of the computer algorithm by control of the automatic airflow assessment. With a sensitivity of 97.3% the algorithm proved to be extreme reliable. Combined with the detection of heart rate and oxygen saturation it provides the capacity for comprehensive analysis of cardiorespiratory events and appears to be suitable for application in an outpatient setting.

Algorithms↗
PubMed1990

[Unilateral lung transplantation--a new perspective in the treatment of pulmonary fibrosis].

In patients with pulmonary fibrosis and progressive respiratory failure despite conservative treatment, unilateral lung transplantation offers a new therapeutic alternative. At the Medical School in Hannover, five patients--the first to be thus treated in Central Europe--with terminal pulmonary fibrosis of the lung have so far been successfully treated with unilateral lung transplantation. All five patients are still alive, and all experienced a marked improvement in their pulmonary function parameters, such that they have been enabled to lead a normal life again.

Adult↗
PubMed1990

[Diagnosis of lung function in patients with ankylosing spondylitis].

In a group of 55 men of 18 to 58 years of age who were suffering from ankylosing spondylitis, changes in lung function were analysed by measuring the static parameters and by differentiating between the thoracic and abdominal parts in breathing at rest and under stress, using CO2 rebreathing. In accordance with the reduction in vital capacity, the thoracic share is restricted already at rest. At rest, there is compensation via the abdominal compartment, in contrast to the stress in CO2 rebreathing in which the abdominal part does not compensate.

Adolescent↗
PubMed1990

[Measuring airway resistance with the oscillation method: Oscillaire and Custovit].

Measurement of airway resistance by the oscillation method was done on the one hand by means of the pseudo random noise method (Oszillaire, Jones Company) multifrequence from 6 to 26 Hz in steps of 2 Hz. In addition, the oscillatory resistance was also determined by means of the custo vit (Customed), the frequency of the pump producing the oscillation being variable so that measurements were carried out successively at different frequencies. 2 different versions were tested. In the first version the resonance frequency was measured and then monofrequently the pertaining resistance. In another version the impedance (total airway resistance) was measured at different frequencies in a frequency range between 6 and 20 Hz in steps of 2 Hz with both methods. Additionally, the airway resistance was also measured by bodyplethysmography. A clinical study was carried out in a group of 21 healthy subjects and 34 obstructed patients with asthma bronchiale and chronic obstructive lung disease. When measuring the airway resistance with the custo vit at the frequency of resonance there was poorer differentiation between normal and obstructed subjects compared to a measurement at a fixed frequencies yielded comparable values for both methods.

Airway Resistance↗
PubMed1989

[Portal hypertension and chronic arsenic exposure. A differential diagnostic challenge].

We are reporting on a 62 year old female patient with portal hypertension (splenomegaly, esophageal varicosis) without signs of liver cirrhosis, who was hospitalized for sclerotherapy of her esophageal varices. Physical examination showed up palmar- and plantar hyperkeratosis and Morbus Bowen or basalioma-like skin lesions++. Anamnestic evaluation revealed, that the patient's psoriasis had been treated with arsenic for many years. This kind of treatment may have induced intraluminal proliferation and obliteration of the portal vein's endothelium, thus being the etiologic factor responsible for noncirrhotic portal hypertension in this patient.

Arsenates↗