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Biomedical subjects

H Müller

Publications and source records attributed to H Müller.

At least 667 records · Page 37Linked to original sources
PubMed1984

Surgery of the primary tumor of metastasizing renal carcinoma.

40% or 116 of 350 patients with renal carcinoma had distant metastases at the time of hospital admission (M1, N0-4). Women fell ill less often than men did (3:7). 82 of 116 patients (71%) received nephrectomy primarily. Lethality within the first 30 days was 6%. Patients with nephrectomy survived longer than those without, women with nephrectomy survived longer than men. Patients with a grade II tumor survived longer than those with a grade III tumor. Palliative nephrectomy can therefore be recommended as treatment of choice, if the general condition of the patient allows it, the more so as there are no alternative ways of treatment.

Adult↗
PubMed1984

Urinary excretion rates of 6-keto-PGF1 alpha in preterm infants recovering from respiratory distress with and without patent ductus arteriosus.

Patency of the ductus arteriosus in preterm infants is mediated by vasodilating prostanoids; however, reliable methods to monitor prostanoid activity or production in preterm infants are lacking. We measured the excretion rates of major and characteristic urinary metabolites of prostacyclin (PGI2), PGE1, and PGE2, 6-keto-PGF1 alpha, and 7 alpha-hydroxy-5,11-diketotetranorprostane-1,16-dioic acid (PGE-M), respectively. Besides these parameters which reflect total body prostanoid turnover and production, the urinary levels of PGE2 and PGF2 alpha, the primary prostaglandins, were measured as an index of renal prostanoid synthesis. There were four study groups. One contained 11 thriving preterm infants; a second, six preterm infants with respiratory distress syndrome (RDS); a third, 30 preterm infants with RDS and patent ductus arteriosus (PDA); and a fourth, nine fullterm infants. All infants with RDS required artificial ventilation. There were no significant differences in PGE-M, PGE2, and PGF2 alpha excretion rates among the various groups; however, a significant increase of the 6-keto-PGF1 alpha excretion rates was observed in the groups of infants with RDS and with and without PDA (P less than 0.01 and P less than 0.02, respectively). Spontaneous (n = 2) or indomethacin-induced (n = 6) closure of PDA was associated with weaning from the respirator and a concomitant drop into the normal and subnormal range of the excretion rates of 6-keto-PGF1 alpha (P less than 0.01) and PGE-M (P less than 0.02).

6-Ketoprostaglandin F1 alpha↗
PubMed1984

[Substitution of antithrombin III by synthetic thrombin inhibitors].

Synthetic, low-molecular weight thrombin inhibitors may substitute for antithrombin III in inactivating thrombin in vitro and in vivo. They are superior to heparin as antithrombotic agents in antithrombin deficiency or consumption. Studies in experimental animals show the effectiveness of synthetic thrombin inhibitors in immunologic antithrombin depletion, thrombin-induced consumption and CCl4-induced liver failure.

Animals↗
PubMed1984

[Hemodynamic effects in antagonism of neuromuscular blockage: atropine-pyridostigmine versus ipratropium bromide-pyridostigmine].

Antagonism of neuromuscular block using cholinesterase inhibitors and atropine is charged with several risks, which are at least partly caused by pharmacological characteristics of the anticholinergic drugs, e.g. short duration of action causing secondary bradycardia. Compared to atropine, ipratropium bromide, a new anticholinergic drug, is--due to its quarternary ammonium compound--characterized by longer duration of action. In contrast to atropine, this substance does not penetrate the blood-brain and placental barrier. Our present study was designed to compare the haemodynamic effects of both substances, using invasive monitoring, during antagonism of neuromuscular block with pyridostigmine. In contrast to atropine, ipratropium bromide induced a higher degree of initial tachycardia but did not allow secondary reduction of heart rate by rebound vagal stimulation. While cardiac output was almost constant, ipratropium bromide caused changes in stroke volume, which were due to alterations in heart rate. There were no clinically relevant changes of the other haemodynamic parameters. Cardiac arrhythmia were observed more often after administration of atropine and were of longer duration. In conclusion, ipratropium bromide is a useful alternative to atropine in patients with pre existing low heart rate and bradyarrhythmia.

Atropine↗
PubMed1984

[Ultrasound diagnosis of the thyroid].

Ultrasonography of the thyroid gland provides information about the size and shape when localization is normal. Furthermore, by means of density changes, a cyst can be shown as well as disintegration in the cyst or parenchymal changes. Rarefication of sonic echos indicates an increase in fluid (edema, hyperemia, and sometimes tumors). An increase in echos suggests consolidation of tissue (multiplication of fibrous tissue, calcareous deposits). This is demonstrated by ultrasonic examinations of the thyroid, in which the results found by scintigraphy, cytology or operation and histology were verified. In contrast to scintigraphy, ultrasonic diagnostics do not give information about biochemical processes of the activity of the thyroid.

Adenoma↗
PubMed1984

[A new ELISA micromethod for the determination of tetanus antibodies].

Due to its simplicity, accuracy and economy, the ELISA technique is a suitable method also for the determination of tetanus antibodies. By the method described, a titration curve is established from each serum to be investigated as well as from a standard serum. The horizontal distance between standard and unknown serum expressed in log2 titre steps is called titre difference. From this titre difference and the concentration of the standard serum the concentration of the unknown serum can be calculated. By means of an appropriate computer this evaluation can be done automatically. The variation coefficient with regard to concentration was 18.3%. A comparison with the toxin neutralisation test showed a correlation coefficient of 0.87. The application of this method to various problems is described.

Antibodies, Bacterial↗
PubMed1984

[Free thyroid hormones in pregnancy].

The following parameters were measured in 95 euthyroid subjects and in 55 healthy pregnant women: TT4, TT3, rT3, RT3-Uptake, TSH, FT4 and FT3. In addition, FT4-index, TT4/TBG, FT3-index, TT3/TBG and the balance of free hormone indices were calculated. The results of FT4 and FT3 measurement indicated an euthyroid status in late pregnancy. Though the FT4 and FT3 levels were significantly lower than those of the euthyroid subjects, they did not fall outside the normal range.

Adolescent↗
PubMed1984

[Anesthesia in dystrophia myotonica using the capnogram].

The dangers associated with anaesthesia and postoperative care in patients with dystrophia myotonica are reviewed. Weakness, atrophy and myotonia of the respiratory muscles and abnormal drug responses are among the many features of the disease which create specific problems. Capnography is obviously a monitor of particular value, yet capnograms in dystrophia myotonia patients have never been published. Abnormal capnograms recorded in a patient with dystrophia myotonica before and after the administration of neostigmine are described. A technique of anaesthetic management avoiding drug liable to produce abnormal reactions, and with the capnogram as a guide, is discussed.

Adolescent↗
PubMed1984

[Thyroid diagnosis today].

For functional diagnostics the FT4 index is calculated from the T4 and T3U values. Hyperthyroidism is suggested or borderline values are found; the T3 test is carried out. An index of free iodine hormones (IFIH) can be calculated. (formula; see text) Hypothyroidism and borderline cases require TSH evaluation or even a TRH test. T4 and T3 autoantibodies can cause high or low values in spite of euthyroidism or hypothyroidism. Differences in FT4 values are found if the kits used were not made by the same manufacturer. These values help to determine hyperthyroidism in pregnancy. The FT3 value is better than the TT3 value in determining T3 hyperthyroidism in borderline cases. Autonomy can be guaranteed by the 123 I short test or the 20-min 99 m Tc uptake test before and after administration of T4. Location diagnostics by scintigraphy after administration of 99m Tc or radioiodine determine localization, size, shape, and distribution of functioning thyroid tissue and metastases by iodine accumulation. This is imaging of biochemical processes. By ultrasonography, a physical method, cysts, disintegration cysts or parenchymal nodes can be recognized. X-ray films of the trachea can determine stenosis caused by a struma. In addition to the exact proof of an intrathoracal struma (front and back mediastine), a retrotracheal or retroesophageal thyroid gland can be seen on CT. RIA determination of the tumor markers calcitonin and TG supports the diagnosis of medullar and follicular or papillary thyroid carcinoma.

Autoantibodies↗
PubMed1984

[Diagnostic and prognostic significance of hemodynamic and respiratory parameters in venous air embolism].

In 25 patients undergoing neurosurgical operations in the sitting position we investigated the reliability of different continuously monitored haemodynamic and respiratory data for hypoxia, which is the most important alteration for the prognosis of air embolism. Simply referring to characteristic changes of end-tidal carbon dioxide (pCO2E) we were able to establish the diagnosis of venous air emboli in 12 of these patients. Besides a decrease in pCO2E, only the reduction of arterial oxygen concentration was statistically significant. Using a simple regression-test, however, no sufficient correlation between the two parameters could be found. Including pCO2E and haemodynamic data in our statistical comparison, multiple regression revealed an optimal correlation with the decrease in arterial pO2. Pathophysiological effects of air embolism are due to a transient accumulation of air in the pulmonary arterioles. Continuous monitoring of pCO2E is the most direct and therefore most reliable method for detection of pulmonary air emboli. Hypoxia, prognostically the most decisive alteration, develops parallel to the decrease in pCO2E and, being of multifactorial aetiology, is also influenced by haemodynamic effects of air embolism.

Carbon Dioxide↗
PubMed1984

[Long-term experiences with continuous peridural opiate analgesia with an implanted pump].

Continuous epidural opiate analgesia with an implantable, percutaneously refillable pump was induced in 6 patients with chronic pain of malignant origin. The efficacy of this method was compared with that of on-demand bolus-injections of epidural opiate. Side-effects and development of tolerance were not observed during a more than one year period of treatment. Increased daily doses for some days were only necessary in case of additional pain sources, e.g. induced by an intermediate operation. There were no hygienic problems (bacteriologic investigations) or problems due to technique of implantation (localisation of the implant, stability of the fixation, patency of the catheter). Examination of post mortem explanted pumps (determination of the flow rate, inspection for precipitation within the pump, testing of permeability of filters) and catheters (electron microscopy, testing of the material for surface conditions, tensile strength and elongation) as well as histological findings for local compatibility did not reveal adverse reactions after long-term treatment. Indications for this new method of pain treatment were established.

Aged↗
PubMed1984

[A case of anaphylactoid reaction following administration of etomidate].

After injection of etomidate during surgery for herniation of an intervertebral disk an anaphylactoid reaction occurred. Generalized erythema, severe urticaria, and rise in heart rate and blood pressure drop were observed. After treatment with an antihistaminic and a corticosteroid the phenomenons completely disappeared within 45 minutes.

Alcuronium↗
PubMed1983

Yeast pheromone alpha-factor is synthesized as a high molecular weight precursor.

The sex pheromone alpha-factor of Saccharomyces cerevisiae, a tridecapeptide of approx. 1,700 molecular weight, was found to be synthesized in vivo as a high molecular weight precursor of Mr = 28,000. Inhibition of N-linked glycosylation by tunicamycin leads to three precursor species of lower molecular weight indicating three carbohydrate residues linked to the alpha-factor precursor molecule. A molecular weight of 18,000 was determined for the unglycosylated molecule.

Animals↗