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Biomedical subjects

H Fabel

Publications and source records attributed to H Fabel.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Atelectasis treatment by ventilatory support using an iron lung].

Total atelectasis of the left lung occurred in a 61-year-old woman after several weeks ventilator-assisted breathing following an operation for ileus, when the tracheal cannula was removed. It was quickly replaced and artificial ventilation resumed. But despite daily bronchoscopic suction for three weeks the patient's state failed to improve (vital capacity 39%, arterial pO2 47 mm Hg, pCO2 37 mm Hg). Mechanical ventilation with an "iron lung" was therefore instituted over a six month period, at first for two hours daily (as an in-patient) and then weekly (as out-patient). During this time her condition and general state clearly improved. On re-hospitalization to remove the tracheal cannula her vital capacity was 75%, pO2 78 mm Hg and pCO2 38 mm Hg.

Carbon Dioxide↗
PubMed1989

[A modified unit for detecting sleep apnea].

A comprehensive diagnostic work-up of patients with a suspected sleep apnea syndrome must include conventional polysomnographic monitoring during the night. On account of the considerable staff and technical requirement, however, this definitive diagnostic measure is not suitable for use as a screening programme. For this reason we undertook to develop a device for the computer-aided recording of sleep apnea. The heart of the unit is a 65816 microprocessor with an address capacity of 16 Mbytes. The oro-nasal airflow is recorded with the aid of thermistors, and, after digital filtering, the respiratory rate is continuously recorded on the basis of this signal. Continuous recording of the heart rate and oxygen saturation, is also effected, the recorded data being stored in the microprocessor. On conclusion of the data acquisition phase, evaluation and a compressed display is shown on any conventional personal computer. Our preliminary experience reveals that the algorithm employed is extremely reliable for the detection of respiration rate and apnea, even in the presence of unfavourable signal forms. Clinically relevant deviations from manual evaluation do not occur. As was to be expected, processing of the signals for heart rate and oxygen saturation presented no problems.

Humans↗
PubMed1989

[The significance of endocrine, neurocrine and paracrine mediators in the regulation of bronchial reactivity].

Sympathetic and parasympathetic influences on the airway resistance under physiological and pathophysiological conditions have long been known. In recent years, this classical view had to be extended due to mounting evidence of neurocrine and paracrine peptide mediators. The term non-adrenergic non-cholinergic (NANC) nervous system was coined. Besides other effects the non-adrenergic mediators (e.g. VIP and PHI/PHM) give rise to bronchodilation, while the non-cholinergic modulators (SP, neurokinin A, and CGRP) induce bronchospasm. The axon-reflex theory postulates liberation of non-cholinergic peptide substances by afferent C-fibers exposed by bronchial epithelial cell damage as one important cause of bronchial obstruction. In addition to biogenic amines, such peptides as bombesin, leu-encephalin, beta-endorphin, calcitonin, doctrine cells of the bronchial epithelium. Our knowledge of the biological relevance of these mediators is at present very sketchy. Platelet activating factor (PAF) is released by alveolar macrophages, granulocytes, blood vessel endothelium, and platelets. The inhalation of PAF induces bronchospasm in healthy subjects and asthmatics and also prolonged bronchial hyperreactivity. The many factors influencing bronchial reactivity need to be classified by further investigations of the mode of interaction and interdependence of known and new mediators.

Airway Resistance↗
PubMed1989

[Oscillatory measurement of airway resistance with the custo vit in comparison with Oscillaire and whole body plethysmography].

The airway resistance was measured by forced oscillation technique with the pseudorandom noise method (Oscillaire, Jones) at multiple frequencies ranging from 6 to 26 Hz in steps of 2 Hz (Ros1). In addition, the oscillatory resistance was determined with the custo vit unit (Customed), the frequency of the pump generating the oscillation being selectable (Ros2), so that successive measurements were made at different frequencies. The custo vit is available in different technical versions. With the first version, a single frequency was used to measure the resonance frequency and to determine the associated resistance. By a different version, the impedance of various frequencies in the range between 6 and 16 Hz in steps of 2 Hz were determined for both methods. Finally, using 3 frequencies (8, 12 and 16 Hz) the total impedance was differentiated into resistance and reactance. In addition, the airway resistance was determined by bodyplethysmography. A clinical study was performed in a group of 21 healthy subjects and 34 patients with bronchial asthma and chronic obstructive lung disease. With both methods, the correlation of the resistance, determined by forced oscillation technique and Raw showed decreasing values with increasing frequency. In the case of the measurement of the airway resistance with the custo vit at resonance frequency, a poorer differentiation between normal subjects and patients with obstruction was obtained as compared with measurements made at a fixed frequency of 6 Hz. This is the result of a shift in the resonance frequency towards higher frequencies in the case of an obstruction, and the simultaneously occurring frequency-dependence of the resistance. A comparison of the impedance at different frequencies revealed comparable values with both methods, but in the case of the differentiation into resistance and reactance, it was seen that higher resonance frequencies were established with Ros1 as compared with Ros2 in the case of obstruction.

Airway Resistance↗
PubMed1988

Malignant mesothelioma of the pleura. A prospective therapeutic study of 132 patients from 1981-1985.

Between March 1981 and February 1985, 93 out of 132 patients with a histologically confirmed diagnosis of malignant pleural mesothelioma were eligible for therapy and were prospectively assigned to receive either combined therapy or best supportive care, according to their personal preferences. Fifty-seven patients underwent multimodal therapy including surgical resection where possible, polychemotherapy, and radiation therapy in case of partial remission. Thirty-six patients received maximal supportive care only, as did 39 patients who were not eligible for treatment. The median survival was 13 months for treated patients compared to 7 for those receiving best supportive care and 5 for patients not amenable to treatment. Median progress-free survival was 6, 2, and 1 month respectively. Surgical resection did not prolong life expectancy within the treated group. In view of significant differences in the distribution of various cofactors over the two study groups, stepwise Cox model analyses were performed. Prognostic nontreatment variables related to prolonged survival were: good performance status, stage I and II, absence of chest pain, age below 50 years, and epithelial histology. Although in the Cox model analyses the survival improvement of patients being treated could be greatly attributed to other cofactors, multimodal treatment showed some prolongation of life expectancy.

Adult↗
PubMed1987

[Changes in lung function following administration of eyedrops containing timolol, metipranolol, pindolol and pilocarpine in healthy probands and patients with mild bronchial asthma].

Lung function was studied double blind and randomized in 5 patients with mild asthma bronchiale and 10 normal adults before and 30, 60 and 90 minutes after one drop of 0.5% Timolol, 0.6% Metipranolol or 0.9% NaCl in each eye. In the asthmatics bronchoconstriction was seen after both beta-receptor blocking agents, more pronounced after Timolol than after Metipranolol. There was a decrease in the forced expiratory volume in one second (FEV1.0) of 32, respectively 18%. No changes were observed in the normal subjects. In a separate study no significant changes were seen in the mean values of 10 other asthmatic subjects after 1% Pindolol, 3% Pilocarpin or 0.9% NaCl. However, in two patients FEV1.0 was reduced by 15% and 20% of the control values after applying Pindolol. In summary, not only beta-receptor-blocking agents without ISA produce a bronchoconstriction in asthmatic subjects, but also beta-blocker with ISA in individual cases.

Airway Resistance↗
PubMed1985

[Asthma, eosinophilia and systemic vasculitis: Churg-Strauss syndrome].

In two female patients asthma, marked eosinophilia and symptoms of systemic vasculitis could be classified clinically or histologically as allergic angiitis and granulomatosis (Churg-Strauss syndrome). The course in one patient went back over 20 years, characterized by an asymptomatic interval of 16 years. It is to be assumed that the disease is more frequent than it is diagnosed. It has to be thought of when, in addition to asthma and eosinophilia, there is evidence of involvement of other organs.

Asthma↗
PubMed1985

[Clinical picture of bacterial pneumonias and their differential diagnosis].

Under the influence of antibiotic therapy, bacterial pneumonias have undergone a remarkable change in the last few decades. Individual forms of pneumonia can be distinguished morphologically by their localization, the way in which they spread, their limitations, and their course. Clinically, opportunistic bacterial infections predominate. Increasingly, secondary pneumonias are observed in poststenotic areas, areas of infarction, in hypostatic areas, after aspiration, and in previously damaged lobes. Radiologic criteria for differentiating from atypical pneumonias (viruses, mycoplasmas and chlamydia) are discussed.

Bacterial Infections↗