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Biomedical subjects

H Mrochen

Publications and source records attributed to H Mrochen.

30 records · Page 2Linked to original sources
PubMed1984

C-reactive protein and clinical kidney transplantation.

50 patients were serially monitored for C-reactive protein (CRP) in serum after kidney transplantation. Compared with a control group the post-operative peak at days 1 and 3 was strongly depressed in the immunosuppressive-treated transplant group (p less than 0.01). In 29 out of 30 patients CRP concentration showed an average rise from 9.4 to 30.0 micrograms/ml between the 5th and 2nd day before onset of the rejection episodes (p less than 0.01). The dynamics of CRP concentration before, during and after prednisolone anti-rejection bolus therapy was considered in 22 cases. The first bolus led to a greater or smaller decrease in CRP concentration in almost all patients. After the second bolus treatment CRP dropped to zero already in more than half of the patients with reversible rejection episodes (p less than 0.01). In case of irreversible rejection crises CRP never reached zero.

Adult↗
PubMed1984

Fatty acid patterns of the serum phospholipids, cholesterolesters and triglycerides in patients with myocardial infarction (MI) during the acute phase and a follow-up of one year.

We examined the fatty acid patterns of serum phospholipids, cholesterolesters, triglycerides and serum testosterone, estradiol, total cholesterol, triglycerides and HDL-cholesterol levels in the acute phase and after one, 6 and 12 months in a group of 27 male patients with myocardial infarction. These results were compared with the corresponding values of 19 healthy controls. Significant differences were discussed as the consequence of disturbed metabolism in patients with ischaemic heart diseases.

Cholesterol Esters↗
PubMed1983

Prevention of osteonecrosis following renal transplantation by using vitamin D2 (ergocalciferol).

Osteonecrosis is a frequently disabling complication of renal transplantation. Thirty-one of 244 patients (12.7%), who received cadaver renal transplants from 1968 to 1978 developed an osteonecrosis. An analysis of 14 possible risk factors suggested that only the following were significantly more frequent in the osteonecrosis group: greater than 3 pulse doses of 1.2 g prednisolone, serum creatinine greater than 133 mumol/L, steroid-induced diabetes mellitus and second and subsequent transplantation. An important decline in the incidence of osteonecrosis (26.7 per cent to 6.5 per cent) was seen with prophylactic vitamin D2 treatment and the onset of osteonecrosis was on average one year later. Dangerous side effects of the large doses of vitamin D2 were minimal. Hypercalcaemia due to overdosage with vitamin D2 during simultaneous prednisolone therapy was usually mild and returned to normal in a few days by dose reduction.

Ergocalciferols↗
PubMed1982

Optimum PEEP selection using a desk top computer.

Considering the problem of the selection of an optimum end-expiratory pressure level in mechanically ventilated intensive care patients suffering from acute respiratory insufficiency a procedure is presented for the display of the physiological response to various end-expiratory pressures using an HP 9845 desk top computer. The response is generated as an interpolated curve using natural cubic spline functions. The method was applied in 15 intensive care patients. For any patient a proposed best level of end-expiratory pressure is obtained; moreover, the display allows an insight into the occurring physiological changes. This is completed by an estimation of the extent of the beneficial effect in individual cases.

Adult↗
PubMed1981

Effect of PEEP on gas exchange, pulmonary mechanics, and hemodynamics in adult respiratory distress syndrome (ARDS).

The effect of positive end-expiratory pressure on a value resulting in maximum static effective compliance was studied in 13 artificially ventilated patients suffering from adult respiratory distress syndrome. Applying positive end-expiratory pressure in this manner resulted in improvement of oxygen delivery and left ventricular stroke work. In the patients with high venous admixture under zero end-expiratory pressure cardiac output increased but in those with moderate pre-existing venous admixture cardiac output decreased. We conclude that the response to positive end-expiratory pressure depends on the importance of the venous admixture. Artificial ventilation with positive end-expiratory pressure on a level resulting in maximum static effective compliance is indicated in cases with high venous admixture.

Adult↗
PubMed1981

Experimental investigations in adult respiratory distress syndrome (ARDS). Repeated pulmonary lavage in LEWE-mini-pigs. I. Pulmonary mechanics, gas exchange, and pulmonary hemodynamics.

Disturbed water balance at the alveolo-capillary membrane resulting in decreased pulmonary compliance is one of the functional characteristics in the Adult Respiratory Distress Syndrome (ARDS). In artificially ventilated LEWE Mini Pigs repeated pulmonary lavage was performed. The aim was to produce a state like ARDS by affecting the lung alveolar surfactant system which is included into the sum of factors which are responsible for the normal water balance of the alveolo-capillary membrane. This condition was supposed to be maximized if the lung compliance reached its lowest value after pulmonary lavage. Regarding this the pathophysiologic changes in this ARDS model were characterized by increased airway resistance and dead space ventilation as well as decreased arterial oxygenation. Severe ventilation perfusion abnormality was represented hemodynamically by the increased pulmonary vascular resistance and the decreased pulmonary non-shunt blood flow. The morphological (macroscopic, light-and electronmicroscopic) changes indicate strongly that in this type of ARDS model all functional compartments of the alveolocapillary membrane are severely affected. Decreased colloid osmotic pressure of blood plasma samples underlines the severity of changes in the water balance at the alveolo-capillary membrane in this type of lung injury.

Airway Resistance↗
PubMed1980

Application of bromhexine metabolite VIII (NA 872) and bromhexine-glucose in treatment of adult respiratory distress syndrome; experimental and clinical results .

The authors study the changes in cardiopulmonary function after application of bromhexine metabolite VIII (NA 872) in an animal model of adult respiratory distress syndrome (ARDS) and bromhexine glucose solution (BGS) in ARDS patients. After damage of the lung alveolar surfactant by intratracheal atomization of 0.2 M HCl in LEWE Minipigs significant changes in lung compliance, dead space ventilation, venous admixture, alveolo-arterial oxygen tension difference, pulmonary vascular resistance, and oxygen uptake are present under application of NA 872 in comparison to untreated animals. In ARDS patients treated with BGS, pulmonary function is significantly ameliorated indicated by changes in static effective compliance, oxygen exchange ratio, and alveolo-arterial oxygen tension difference.

Animals↗
PubMed1979

Gas exchange, pulmonary mechanics and haemodynamics in adult respiratory distress syndrome: experimental results in Lewe miniature pigs.

Adult respiratory distress syndrome (ARDS) is a common medical emergency in respiratory care complicating a great variety of traumas and diseases. An animal model from Lewe miniature pigs has been developed to study the ARDS under standardized conditions; it is based on aspiration pneumonitis, a disorder often observed in ARDS, injuring the lung alveolar surfactant system. The experimental study was conducted under neuroleptanalgesia. ARDS was produced by intratracheal application of hydrochloric acid (0.2 mol/l) in an amount of 1.0 ml/kg body wt. The animals were ventilated automatically by a standardized ventilatory pattern in IPP mode. In all animals the time course of oxygenation ratio (Pa,O2/F1O2), arterial CO2 tension (Pa,CO2), ratio of alveolo--arterial oxygen tension difference to inspired oxygen fraction (Aa,DO2/F1O2), oxygen exchange ratio ((AaDO2/Pa,O2), lung compliance (CL), inspiratory airway resistance (RrsI), dead space ratio VD/VT), pulmonary artery pressure (PAP) and systemic blood pressure were studied. Changes in quasi-static volume--pressure curves, percentage change in lung water content and gross pathological finding were used to integrate the findings into a system of pathophysiological changes in ARDS. The animal group to which hydrochloric acid was administered shows severe pulmonary distress leading to death within 3.5--7.5 h. No significant changes in the measured parameters could be observed in the control group over a 14 h period. The results suggest that aspiration pneumonitis in Lewe miniature pigs is very suitable to investigate various problems in pathogenesis of ARDS. The model provides reproducible results which correlate very well with findings in different ARDS states. The models serves both to compare clinical states and to search for newer therapeutic manoeuvres.

Animals↗