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Biomedical subjects

H Kronenberger

Publications and source records attributed to H Kronenberger.

At least 19 recordsLinked to original sources
PubMed1997

Spirometric gated quantitative computed tomography of the lung in healthy smokers and nonsmokers.

RATIONALE AND OBJECTIVES: The authors investigated the influence of cigarette smoking on healthy, asymptomatic smokers and nonsmokers with the help of spirometric triggered quantitative computed tomography. In our prospective study, the authors compared conventional lung function parameters with the computed tomography values (lung attenuation, lung area). METHODS: The study group comprised 40 healthy volunteers consisting of 20 smokers and nonsmokers (20 females and 20 males). The corresponding groups have been matched concerning their age, height, body mass, (cigarette) pack years. Computer tomography scans were triggered at 35%, 50%, 70% and 95% of vital capacity at a defined apical and a basal level. RESULTS: Functional residual capacity (FRC), total lung capacity and airway resistance showed close correlations to lung parenchymal attenuation values especially at full inspiration and expiration. For example, the authors found a correlation coefficient of r = -0.845 (P < or = 0.001) concerning the FRC and lung attenuation values in the apical lung at 35% of vital capacity in male smokers. Male smokers proved to have a significantly higher pulmonary lung density at all inspiratory states than the other groups (P < or = 0.05; Student's t test). Although male smokers had a higher vital capacity they showed a smaller cross-sectional area increase of the lung during inspiration than nonsmokers. This phenomenon is a result of the decreasing compliance of the smoker's lung, due to small airways disease and hypoxic vasoconstriction. CONCLUSIONS: Spirometric-triggered quantitative computed tomography has proved to be a sensitive diagnostic device for the investigation of early pathomorphologic changes in healthy, asymptomatic cigarette smokers.

Female↗
PubMed1995

Experimental acute hypoxia in healthy subjects: evaluation of systolic and diastolic function of the left ventricle at rest and during exercise using echocardiography.

To clarify whether or not systolic and diastolic function of the human left ventricle (LV) were decreased during acute hypoxia, at rest and with exercise, 14 healthy male volunteers [age 25.9 (SD 3.0) years, height 182.9 (SD 7.1) cm, body mass 75.9 (SD 6.9)kg] were examined using M-mode and 2D-mode echocardiography to determine the systolic LV function as well as Doppler-echocardiography for the assessment of diastolic LV function on 2 separate test days. In random order, the subjects breathed either air on 1 day (N) or a gas mixture with reduced oxygen content on the other (H; oxygen fraction in inspired gas 0.14). Measurements on either day were made at rest, several times during incremental cycle exercise in a supine position (6-min increments of 50 W, maximal load 150 W) and in 6th min of recovery. Corresponding measurements during N and H were compared statistically. Arterial O2 tension (PaO2) was normal on N-day. All subjects showed a marked acute hypoxia at rest [PaO2, 54.5 (SD 4.6) mmHg], during exercise and recovery on H-day. The latter was associated with tachycardia compared to N-day. All echocardiographic measurements at rest were within the limits of normal values on both test days. Ejection time, end-systolic and end-diastolic left ventricular dimensions as well as the thickness of left posterior wall and of interventricular septum showed no statistically significant influence of H either at rest or during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Unspecific bronchial reactivity to carbachol in healthy subjects--effect of age and smoking habits.

Chronic inflammatory processes of the airways induced by long-time cigarette consumption are a crucial factor in the pathogenesis of chronic obstructive pulmonary disease. In contrast, the role of cigarette smoking in the pathogenesis of bronchial hyperreactivity (BHR) is still unclear. The aim of this study was to assess the effect of chronic cigarette consumption on pulmonary function tests and BHR in healthy subjects. 63 healthy smokers and 63 lifetime nonsmokers matched for sex, age, height and weight were evaluated. Pulmonary function was determined by body plethysmography and spirometry. Bronchial provocation was performed by inhalation of increasing doses of carbachol (up to 25 g/l) in isotonic NaCl solution. Pulmonary function tests were within normal limits in all subjects. Nevertheless, midexpiratory flow at 25% of forced vital capacity was significantly smaller, and functional residual capacity was significantly greater in middle-aged smokers (age: 40-60 years) compared to middle-aged nonsmokers (p < 0.05, both comparisons). In young smokers and nonsmokers (age: 20-30 years) pulmonary function tests were not different (p > 0.28, all comparisons). Importantly, the carbachol concentration that provoked a 50% rise in specific airway resistance (PD50sRaw) was similar in smokers and nonsmokers of both age groups (p > 0.05, both comparisons) and did not correlate with the age of the subjects (p > 0.2). No correlations between baseline values of pulmonary function tests and PD50sRaw were observed (p > 0.34, all comparisons). The observations confirm that the distribution profile of BHR is unimodal and apparently not affected by age and smoking habits.

Adult↗
PubMed1994

Low-dose almitrine bismesylate in the treatment of hypoxemia due to chronic obstructive pulmonary disease.

STUDY OBJECTIVE: Assessment of acute and chronic effects of low-dose almitrine bismesylate (AB) in stable chronic obstructive pulmonary disease (COPD). STUDY DESIGN: Oral administration of AB, 25 mg three times a day, for 6 months in all patients. Pulmonary function, blood gases, and peripheral nerve conduction velocity were measured at baseline and after long-term administration of AB. In addition, oral pharmacokinetics and effects on pulmonary circulation at rest were studied in half of the patients. Intravenous pharmacokinetics were measured after a single intravenous dose of 60 mg of AB 3 months before the start of oral AB treatment in the other seven patients. SETTING: Outpatient clinic of a community hospital in a coal mining district in southwest Germany. PATIENTS: Fourteen patients with clinically stable COPD and hypoxemia. RESULTS: Acute effects of AB were as follows: a significant increase in arterial oxygen tension (PaO2) from 61 +/- 7 mm Hg to 74 +/- 8 mm Hg (p < 0.001), a decrease in arterial carbon dioxide tension (PaCO2) from 41 +/- 8 mm Hg to 38 +/- 7 mm Hg (p < 0.01), a rise of pH from 7.45 +/- 0.04 to 7.48 +/- 0.04 (p < 0.01), and a transient increase in mean pulmonary artery pressure from 26 +/- 7 to 29 +/- 6 mm Hg (not significant). After long-term treatment, once tissues were saturated with almitrine, improvement in gas exchange persisted with a PaO2 of 70 +/- 10 mm Hg (p < 0.001) and a PaCO2 of 39 +/- 6 mm Hg (not significant) without elevation of pH (7.45 +/- 0.04) or of pulmonary artery pressure (26 +/- 8 mm Hg). The terminal half-life of AB was 56 +/- 45 days after a single intravenous administration, and 55 +/- 16 days after long-term oral dosing. None of the patients developed clinically manifest peripheral neuropathy. Impaired asymptomatic peripheral motor nerve function was prevalent in 4 (29 percent) of the patients and remained unchanged during long-term AB administration. However, asymptomatic impairment of motor nerve conduction velocity developed in two patients with inadequate high AB plasma levels despite low-dose therapy. Both patients were known to have additional conditions predisposing for neuropathy. CONCLUSIONS: Low-dose AB therapy, 75 mg daily, resulted in sustained elevation of arterial oxygen tension in hypoxemic patients with COPD. Although pulmonary artery pressure increased transiently after the first dose, it remained unchanged with long-term treatment despite persistent improvement of pulmonary gas exchange.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1994

[Long-term effect of the beta 2-sympathomimetic formoterol in young smokers--study of duration and site of effect of bronchodilatation using conventional methods of lung function and monodispersed aerosols].

Formoterol is a novel selective beta 2-sympathomimetic inducing bronchodilatation after inhalation or oral application. Compared to other beta 2-sympathicomimetics the substance begins to act very rapidly even at a much lower dosage level, while it remains effective for at least 12 hours. In the present study the bronchodilatory effect of 24 micrograms MDI formoterol was investigated in 18 healthy smokers between 20 and 30 years of age means. Measurement was effected by means of conventional lung function diagnostics (body plethysmography, spirometry) and an biophysical aerosol measurement method for determining the effective airways dimensions (EAD). This method is based on the gravitational losses of a previously inspired monodisperse model aerosol during apnoea periods of different duration. It enables determination of the EAD as a function of the volumetric lung depth (VLT). A marked and universally measurable bronchodilatation is detectable directly after formoterol has been inhaled. The longterm action of formoterol was confirmed for more than 15 hours after application, using the conventional lung function test and the EAD method. Over and above this the EAD determination showed that the bronchodilatory effect was much more marked in the central airways than in the periphery of the lungs, thus confirming the effect generally described for beta 2-sympathomimetics as being mainly directed towards the central airways region.

Administration, Inhalation↗
PubMed1994

[The value of studies of pulmonary gas exchange during exercise for evaluation of reduced arterial oxygenation at rest in asymptomatic long-term smokers].

The aim of this study was to elucidate extent and nature of an impairment of gas exchange after long time cigarette-smoking. Pulmonary gas exchange at rest as well as during steady state exercise and conventional lung function tests (LFTs) were studied in 32 clinically healthy, asymptomatic severe cigarette-smokers (S; 48.1 +/- 15.7 pack-years) and 32 healthy lifetime nonsmokers (N) between 40 and 60 years of age, respectively, individually matched for age, body height, body weight and gender. Pulmonary function tests of all subjects were within the limits of normal values. Except for a slight reduction of MEF25 in S (p < 0.05) and a slight increase of FRC (p < 0.05), the groups did not differ with respect to LFTs. At rest, however, S had markedly lower values for PaO2, TLO2, DCO and KCO, and higher values for AaDO2 and QVA/Qt. Resting measurements for VD/VE and PaCO2 did not differ between N and S. During ergometry PaO2 and TLO2 increased respectively; AaDO2 and QVA/Qt fell concomitantly with VD/VE and PaCO2. On termination of exercise no significant difference between N and S for the above variables could be discerned any longer. Our findings confirm that even in clinically healthy asymptomatic cigarette-smokers a distinct impairment of gas exchange is present. Their improvement during physical exercise primarily indicates the presence of reversible ventilation-perfusion mismatching and excludes relevant morphologic changes in the lung in these cases.

Adult↗
PubMed1990

[Drug-induced disseminated lung diseases].

Disseminated pulmonary diseases sensu stricto are interstitial lung disorders, pulmonary edema, diffuse pulmonary bleeding as well as bronchiolitis obliterans and thrombo-embolic disorders. Three important pathogenetic mechanisms are direct toxicity, allergy/immunology and idiosyncrasy; however, unfrequently essential elements of pathogenesis are unknown. The multitude of potential noxious agents implies that the clinician principally has to consider the possibility of drug-toxicity in all cases of disseminated pulmonary diseases. In order to give a complete presentation summaries organized as tables could not be avoid. The most sensible measure for disseminated lung diseases is the functional parameter DLCO; it is more sensible than the conventional X-ray. The drug of choice for a treatment are corticosteroids.

Drug Hypersensitivity↗
PubMed1990

[Transbronchial biopsy of the lung and bronchoalveolar lavage in the diagnosis of sarcoidosis].

The outcomes of a complex study of sarcoidosis and other interstitial pulmonary diseases in 1325 patients are presented. An important role of intrapulmonary biopsy and bronchoalveolar lavage methods in defining the diagnosis and the process activity, especially when they are used in combination, is demonstrated. Complications in the form of bleedings and pneumothorax were registered in a limited number of the patients, mainly as a result of rigid bronchoscope procedures. Differential and diagnostic signs of sarcoidosis and some other disseminations in the lung, obtained by means of biopsy, bronchoalveolar lavage and clinical data studies, are given.

Biopsy↗
PubMed1990

[Results of a questionnaire survey of pulmonary complaints of dental technicians: effect of the duration of occupational activity (total exposure time)].

UNLABELLED: With the aid of a questionnaire survey conducted among 3,415 dental laboratories in Hesse and North Rhine Westphalia, the incidence of pulmonary symptoms among dental technicians, and their relationship to dust (exposure time: ET) was established. A total of 5,100 questionnaires were evaluable. The median age of the participants was 29 years, the ET 8 years. A total of 49.1% smoked cigarettes, 15.8% were ex-smokers, and 38% non-smokers. SYMPTOMS: 33.9% had unproductive cough, 25.4% experienced dyspnoea on effort, 18.9% had a productive cough, 5.7% episodic apnoea, 5.2% apnoea with audible wheezing, 3.6% apnoea at rest. In order to eliminate the "overlapping" influence of smoking habits, age and sex, in a matched-pair analysis, a comparison of short exposure time groups (SET: ET less than 5 years), and long exposure time groups (LET: ET greater than or equal to 5 years) was made for each symptom. The median ET for all SET was 3 (range: 0-4); for all LET 10 (range: 5-40) years. The frequency of the symptoms was generally greater in the LET group than in the sET group. Statistically significant differences were found for unproductive cough, productive cough, apnoea of effort, and episodic dyspnoea. No differences were found for apnoea at rest and dyspnoea with audible wheezing. Since such confounding factors as sex, age and smoking habits were excluded, our results point to a causal relationship between the pulmonary symptoms of dental technicians and occupational exposure to dust in the dental laboratory. These results are supported by the results of clinical and radiological study.

Adult↗
PubMed1990

[Clinical aspects and diagnosis of chronic berylliosis--a case report].

Three case reports of patients with chronic berylliosis are presented. The examination findings of these three cases are all unspecific. Merely the lymphocyte transformation test (LTT), which has, in the meantime, become an established procedure, is capable of demonstrating, at a high level of sensitivity and specificity, the presence of sensitisation towards beryllium, a condition that accompanies the disease itself. All three patients showed a positive LTT. A modification of the diagnostic criteria worked out by Sprince, is proposed, which takes into account the LTT performed in blood and bronchoalveolar fluid.

Adult↗
PubMed1990

[Results of a questionnaire survey of pulmonary complaints in dental technicians: effect of inhalation exposure to heavy metal dusts (cobalt-chromium alloys)].

In the course of their working lifetime, dental technicians are exposed to numerous different dusts, some of which also contain toxic substances (Co-Cr alloys), which are employed in the so-called model casting. In order to establish the influence of the nature of the exposure associated with various dental technical procedures on pulmonary symptoms, 24588 questionnaires were sent to 3415 dental laboratories. The return rate was 21.3%. An evaluation of 4328 questionnaires (with account being taken of the influence of smoking, age and sex), revealed a significant relationship between the duration of work on model casting, and the common symptoms "dry cough", "dyspnoea on exertion" and "productive cough". In agreement with other case reports, the results emphasize the significance of the inhalation of heavy metal dusts in the aetiology of pneumoconiosis in dental technicians.

Adult↗
PubMed1987

[Peroral transluminal dilatation of malignant bronchial stenosis].

We performed balloon-dilatations of complete malignant bronchial stenoses in three patients as a method of acute relief of tumor-induced atelectases before the institution of scheduled endobronchial laser-treatment. In all three cases we were able to reopen the affected bronchi without complications even in a at least two months existing complete atelectases. In four patients we performed bronchography of the pre- and poststenotic bronchi to demonstrate anatomy for safe endobronchial laser-treatment of these complete occlusions.

Aged↗
PubMed1986

[Bleaching agent poisoning with sodium chlorite. The toxicology and clinical course].

A woman gardener of 49 years of age suffered an inhalational intoxication from chlorine dioxide while bleaching dried flowers. Preparation of the bleaching solutions was associated with a sharp pungent smell, coughing, pharyngeal irritation and headache. Seven hours later increasing cough and dyspnoea led to hospitalisation. Clinical findings were tachypnoea, tachycardia, and rales of auscultation; clinical chemistry revealed marked leucocytosis. Chest X-ray did not yield any abnormal findings. Initially the vital capacity and forced expiratory volume in 1 s markedly reduced and the resistance correspondingly enhanced. Blood gas analysis showed hypoxaemia despite alveolar hyperventilation. Administration of corticosteroids resulted in significant alleviation of complaints and in improved lung function with stabilisation in a highly normal range, as confirmed by follow-up examination two years later. The chlorine dioxide intoxication had been due to pH level reduction resulting from an incorrect proportioning and handling of the individual bleaching agent components when preparing the solution.

Chlorides↗
PubMed1986

The long-term course of airflow obstruction in obstructive variants of the fibrotic stage of sarcoidosis and of idiopathic pulmonary fibrosis.

We investigated patients with obstructive variants (FEV1/VC less than 65%) of FSS (N = 9) and IPF (N = 12) and assessed the course of the lung function parameters of AO during observation times of 2 to 10 years. Three groups of patients could be formed: group 1 (N = 9), no significant change of FEV1/VC and Raw; group 2 (N = 3), significant decrease of FEV1/VC and significant increase of Raw; group 3 (N = 7), divergent changes of FEV1/VC and Raw. Two patients died before they could be assigned to a group. The definite constancy of FEV1/VC (group 1 and the majority of group 3) assessed in this long-term study corroborated our previous results. Thus the great majority of our patients showed no deterioration of AO. "Divergency" of Raw (group 3) can at least partially be interpreted as "false positive." The prognosis of the obstructive variants is essentially not inferior to that of the nonobstructive groups in these two conditions.

Adult↗