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Biomedical subjects

H Ochs

Publications and source records attributed to H Ochs.

16 recordsLinked to original sources

25-hydroxy-vitamin D levels in a patient with hypervitaminosis D.

We measured the concentrations of serum calcium and 25-hydroxy-vitamin D in a patient with hypervitaminosis D during 3 months of therapy directed toward correcting the hypercalcemia. Serum calcium could not be maintained at normal concentration without specific therapy until 9 weeks after vitamin D was discontinued. Concentration of 25-hydroxy-vitamin D at the time was 285 ng/ml, approximately half of the value measured three weeks after withdrawal of vitamin D. Serial measurements of the concentration of 25-hydroxy-vitamin D seem to be a useful means of assessing the degree of intoxication in patients with hypervitaminosis D.

Aged

[Clinical study of the biological availability of lanatoside C and digoxin in long-term tests].

The bioavailability of digoxin and lanatoside C from tablets and dragees and from solutions of the two substances has been investigated intraindividually in patients on maintenance therapy. Plasma levels and urinary excretion were analyzed by radioimmunoassay. Both plasma concentrations and urinary excretion were significantly higher after digoxin tablets (1.5+/-0.17 ng/ml; 0.15 mg/24 h) than after lanatoside C dragees (0.98+/-0.15 ng/ml; 0.1 mg/24 h). When equimolar solutions of both drugs, corresponding to 0.5 mg digoxin, were given, plasma concentrations and urinary excretion after digoxin (1.6+/-0.08 ng/ml; 0.14 mg/24 h) were again significantly higher than after lanatoside C (1.18+/-0.09 ng/ml; 0.1 mg/24 h). These results suggest that while the absorption of lanatoside C is lower than that of digoxin, it is better than has been generally assummed. The variability in the absorption of lanatoside C between patients is no greater than with digoxin.

Adolescent

[Digoxin and beta-methyldigoxin concentrations in cerebrospinal fluid and plasma (author's transl)].

12 patients were treated for at least two days with digoxin or beta-methyldigoxin before a lumbar punction was done for diagnostic purposes. At the same time venous blood was drawn and both samples were radioimmunologically analysed for digoxin concentration. The relationship of concentrations from plasma to cerebrospinal fluid was 2 for beta-methyldigoxin and 8 for digoxin.

Central Nervous System

[Clinical and pharmacokinetic studies in patients with digitalis intoxication (author's transl)].

6 patients with severe digitalis intoxication were studied while hospitalised in a coronary care unit. 2 and 4 patients had ingested high doses of lanatosid C and digoxin, respectively. In three cases ventricular arrhythmias, in one of these and two further cases SA blocking and an additional A-V-block in one case were observed. Maximum blood levels of digoxin between 3.4 and 20 ng/ml were determined several hours after the ingestion. The maximal blood levels were achieved in one patient only 52 h after ingesting lanatosid C and in one patient taking digoxin after 12.5 h. Potassium concentrations in plasma were elevated in 4 patients. Antiarrhythmic and electrolyte therapy is discussed and the usefulness of a stomach lavage for diminishing the quantity of absorbed lanatosid C is shown in one patient who had a maximal blood level of 3.4 ng/ml after taking 23.7 mg of lanatosid C. Cumulative urinary excretion of this patient was 0.68 mg within 5.5 days. This result confirms the minimal enteral absorption under the therapy chosen.

Adult

Plasma 25-hydroxyvitamin D and urinary cyclic AMP in German patients with subtotal gastrectomy (Billroth II).

In an attempt to clarify the pathogenesis of the disturbed calcium metabolism which sometimes follows partial gastrectomy, we determined plasma 25-hydroxyvitamin D (25-OH-D) concentrations and urinary cyclic 3',5'-adenosine monophosphate (cAMP) excretion in patients who had previously undergone Billroth II gastrectomy and who were without clinical evidence of bone disease. In 17 Billroth II patients plasma 25-OH-D concentrations were reduced (12.6 +/- 4.6 ng/ml, mean +/- SD) compared to values in 17 control patients with diseases not affecting calcium metabolism (31.6 +/- 12.9 ng/ml, P less than 0.001). Urinary cAMP excretion, in part reflecting parathyroid function, was higher in 17 Billroth II patients (5.0 +/- 2.5 micronmol/day) than in the control patients (2.6 +/- 1.3 micronmol/day, P less than 0.001). These results suggest impaired nutrition of vitamin D and secondary hyperparathyroidism in Billroth II patients. While the cause of this phenomenon is unclear, it may contribute to the disturbance of calcium metabolism in patients who have had subtotal gastrectomy.

Adult

Effects of propranolol on regional myocardial function, electrograms, and blood flow in conscious dogs with myocardial ischemia.

The effects of coronary occlusion and of subsequent propranolol administration were examined in 18 conscious dogs. Overall left ventricular (LV) function was assessed by measurements of LV pressure and dP/dt, and regional myocardial function was assessed by measurements of segment length (SL), velocity of SL shortening and regional myocardial "work", i.e., pressure-length loops in normal, moderately, and severely ischemic zones. Regional intra-myocardial electrograms were measured from the same sites along with regional myocardial blood flow as determined by the radioactive microsphere technique. Coronary occlusion resulted in graded loss of function from the normal to severely ischemic zones with graded flow reduction and graded elevation of the ST segment. Propranolol depressed overall LV function, function in the normal zone (work fell by 17+/-4%), and in the majority of moderately ischemic segments (work fell by 7+/-3%). In severely ischemic segments the extent of paradoxical motion and post-systolic shortening was reduced by propranolol. After propranolol regional myocardial blood flow fell in the normal zone (11+/-2%) and rose in the moderately (15+/-4%) and severely (63+/-10%) ischemic zones. Thus, in the conscious dog with regional myocardial ischemia, propranolol induces a redistribution of myocardial blood flow, with flow falling in normal zones and rising in moderately and severely ischemic zones. The improvement in perfusion of ischemic tissue was associated with slight but significant depression of shortening, velocity, and work in the moderately ischemic zones and of paradoxical bulging and post-systolic shortening in the severely ischemic zone.

Animals

[Aplastic anaemia and thymonal].

The combination of aplastic anaemia and thymona was observed in a 49-year old woman. Concomitant with severe normochromic anaemia and reticulocytopenia was a cell-rich bone marrow smear in which erythropoietic precursors were almost absent. Immunological phenomena could not be demonstrated. The erythropoietin level was maximally increased. Pathological anatomy typically revealed a predominantly spindle-cell thymonal with only minor capsular invasion.

Anemia, Aplastic

[Idiopathic thrombosis of the superior vena cava (author's transl)].

In contrast to secondary occlusion idiopathic thrombosis of the superior vena cava occurs rarely. With a good collateral flow through anatomically preformed venous channels the clinical picture may have an insidious course obscuring diagnosis. Collateral circulation via upper oesophageal varices is commonly overlooked. Anticoagulants should be given to prevent progression. Surgically vein transplants, by-pass operations, and thrombectomy have been tried. Follow-up in 4 patients shows that even without surgical intervention the prognosis is good despite the danger of haemorrhage from the varices.

Adult

[Biological availability of diagoxin in patients with or without gastric resection (Billroth II) (author's transl)].

Biological availability of digoxin tablets was measured during maintenance therapy in ten hospitalized patients who had had a Billroth II gastric resection at least two years previously. Twelve patients on digoxin maintenance for heart failure but without gastro-intestinal disease served as controls. The mean value of daily digoxin urinary excretion over ten days in the resection group was 38.09 +/- 0.70% of the administered dose. The serum-digitalis level 12 and 24 hours after the last dose of glycoside (0.5 mg) was 1.30 +/- 0.04 ng/ml and did not significantly differ from that of the control group, nor did digoxin elimination in urine and the digoxin/creatinin excretion ratio. It is concluded that two-third gastric resection with exclusion of antigrade duodenal passage does not influence biological availability of digoxin given in tablets.

Adult

[Intravenous injection of thermometer mercury (author's transl)].

The possible complications in two women who had injected themselves intravenously with thermometer mercury with suicidal intent are discussed with reference to the few comparable cases. A manifest pulmonary hypertension due to multiple mercury emboli in the lesser circulation in one patient who developed a dyspnoea on exertion could be excluded by cardiac catheterization. Signs of acute and chronic mercury poisoning could not be demonstrated in our patients, in contrast to some cases reported in the literature. So far, specific therapy has therefore been dispensed with.

Adult

[The Bland-White-Garland syndrome: hemodynamics, clinical picture, therapy].

Two patients with anomalous origin of the left coronary artery from the pulmonary artery are presented. Anatomy, embryology, the problem of the direction of blood flow in the anomalous vessel, and the clinical symptoms of this syndrome are discussed. In spite of large fibrotic areas in the myocardium, the ECG-changes were minimal. Therefore, a nearly normal ECG does not exclude this anomaly. In patients with sudden, unexpected death one should suspect an anomalous origin of a coronary artery. The classification in an "infantile" and "adult" type reflects the extent to which collateral vessels have developed. Ligation of the anomalous coronary artery at the side of its origin with concomitant aorto-coronary bypass appears to be a rational and the only effective way of therapy.

Adult