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Biomedical subjects

H P Friedl

Publications and source records attributed to H P Friedl.

At least 19 recordsLinked to original sources
PubMed1992

Tobacco-related cancer in relation to prevalence of drinking and smoking in eastern Austria.

Eastern Austrian regional mortality patterns of oral cancer (oral cavity, pharynx and larynx) and oesophageal, lung and urinary bladder cancer were compared to smoker rates and to liver cirrhosis mortality by type of residence: Vienna (1.7 x 10(6) inhabitants), middle towns (50,000-100,000 and 10,000-50,000 inhabitants), small towns (2000-10,000 inhabitants) and rural areas categorized by agrarian quota less than or equal to 10%, 10%-20% and greater than 20%. The study area (Vienna, Lower Austria and Burgenland) covers 23,600 km2 with 3.23 x 10(6) inhabitants. In men, liver cirrhosis correlated negatively with smoker rates (r = 0.74, P = 0.1). Deaths from oral cancer and oesophageal cancer correlated significantly with deaths from liver cirrhosis (r = 0.81, P = 0.03; r = 0.78, P = 0.04, respectively) but not with smoker rates; lung cancer and bladder cancer correlated significantly with smoker rates (r = 0.91, P = 0.01; r0.83, P = 0.04, respectively), but not with liver cirrhosis. In women, similar urban-rural gradients for all parameters resulted in a positive correlation between liver cirrhosis and smoker rates (r = 0.59, P = 0.22) and a significant correlation of lung cancer with liver cirrhosis (r = 0.75, P = 0.05). Oral cancer correlated significantly with liver cirrhosis (r = 0.83, P = 0.02), but not with smoker rates; lung cancer correlated more significantly with smoker rates (r = 0.92, P = 0.01) than with liver cirrhosis; bladder cancer correlated positively with smoker rates (r = 0.70, P = 0.12). Geographical distribution of oral and oesophageal cancer in Eastern Austria seems thus to be highly subject to the prevalence of heavy drinking. Sociocultural influences upon the occurrence of these cancers seem to be mediated through drinking habits rather than through smoking habits alone.

Adolescent↗
PubMed1992

[Multiple trauma: definition, shock, multiple organ failure].

Multiple organ failure (MOF) following major trauma occurs in response to perfusion deficits, a persistent inflammatory focus, or a persistent focus of dead and/or injured tissue. Several pathophysiologic aspects are considered relevant to current clinical practice. Their application in settings of trauma and surgical sepsis reduces overall mortality and incidence of multiple organ failure. With regard to the pathophysiologic background (I) microcirculatory resuscitation, (II) source control, and (III) metabolic support appear to be important therapeutic principles. (I) Microcirculatory Resuscitation: Since time is a critical factor in damage control, resuscitation and restoration of microvascular perfusion needs to occur as soon as possible if multiple system organ failure is to be avoided during the later time course. (II) Source control: The best treatment for multiorgan failure appears to be prevention. With early, aggressive control or removal of risk factors for multiple organ failure, namely early surgical intervention for control of hemorrhage, control of potential septic sources, decompression, and early fracture stabilization reductions in the incidence and mortality of MOF have been observed. Metabolic support: Malnutrition appears to be an important cofactor in morbidity and mortality. (III) Metabolic support needs to be started early and prior to the phenomenon of nitrogen retention during the hypermetabolic state of multiple organ failure.

Humans↗
PubMed1992

Childhood leukaemia following the Chernobyl accident: the European Childhood Leukaemia-Lymphoma Incidence Study (ECLIS).

The objective of the European Childhood Leukaemia-Lymphoma Incidence Study (ECLIS) is to investigate trends in incidence rates of childhood leukaemia and lymphoma in Europe, in relation to the exposure to radiation which resulted from the accident at the Chernobyl nuclear power plant in April 1986. In this first report, the incidence of leukaemia in children aged 0-14 is presented from cancer registries in 20 European countries for the period 1980-1988. Risk of leukaemia in 1987-1988 (8-32 months post-accident) relative to that before 1986, is compared with estimated average dose of radiation received by the population in 30 geographic areas. The observed changes in incidence do not relate to exposure. The period of follow-up is so far rather brief, and the study is planned to continue for at least 10 years.

Accidents↗
PubMed1992

Temporary lung support using an intravascular gas exchanger.

Severe respiratory failure may be difficult to overcome by conventional mechanical ventilation. As an alternative to the very demanding lung support using various modalities of extracorporeal circulation (ECMO, ECLA, etc.) we evaluated an intravascular gas exchanger (IVOX) in a "reversible" bovine model. Several degrees of hypoventilation were studied with and without intravascular gas exchange in 5 endotracheal intubated, anaesthetized, and volume-controlled ventilated animals (body weight 73 +/- 4 kg). After systematical heparinization (300 IU/kg body weight) the animals were instrumented with EKG electrodes, thermodilution pulmonary artery catheter with continuous measurement of O2-saturation, central venous and femoral arterial catheter, etc. The intravascular gas exchanger made from siliconized microporous polypropylene hollow fibres was placed in the caval veins under radiofluoroscopic control. The following scenarios were studied without and with intravascular gas exchange (gas inlet 100% O2): Normoventilation (with 14-20 strokes/min) at F10(2) 0.50 and at F10(2) 0.21; Hypoventilation (ventilator frequency reduced to 50% and tidal volume reduced to 50% of normoventilation) at F10(2) 0.50 and at F10(2) 0.21. Hemodynamics, mixed venous O2-saturation, arterial and venous blood gases, and gas-exchanger exhaust were analyzed after stabilization over 15 minutes (mean +/- standard deviation). Blood gas analyses showed significant improvement with intravascular gas exchange during hypoventilation at F10(2) 0.21: pH moved from 7.10 +/- 0.17 to 7.19 +/- 0.15*, PaCO2 moved from 9.9 +/- 4.2 kPa to 8.7 +/- 2.8*, PaO2 moved from 6.5 +/- 1.2 kPa to 7.3 +/- 0.8* and mixed venous O2-saturation moved from 33.9 +/- 16.0% to 48.1 +/- 4.6* (* = p less than 0.05 for without versus with intravascular gas exchange).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Callus distraction in traumatology: concepts and indications].

The understanding of the conditions under which bone and soft tissue can be regenerated by distraction has opened a new era in the field of limb reconstruction. Success in lengthening for posttraumatic limb length discrepancy has led to different applications of the distraction techniques. We present an overview of the clinical new possibilities, the strategy, the techniques and the complications using the distraction technique in the trauma patient. The optimal biologic method (limb distraction after resection or callus distraction by a transport technique) and the optimal fixation devices depend on the indication (local aspect, polytrauma, patient, motivation).

Bone Lengthening↗
PubMed1992

[Extended surgical indications in combined shoulder girdle fracture].

The combination of an ipsilateral clavicule and scapula fracture causes a double instability of the shoulder. In opposite to an isolated clavicule or scapula fracture this injury should be treated operatively. Diagnosis of the scapula fracture in polytrauma can be difficult. If there is a clinical or radiologic suspicion, the indication for a CT scan is given. Osteosynthesis with plates from separated approaches, first the scapula from dorsal then the calvicule from ventral has proven good. The nervus suprascapularis must be treated carefully and, if necessary, liberated from the fracture. The optimal treatment of this injury is not always possible in polytraumatised patient.

Clavicle↗
PubMed1992

[Surgical management of severe pelvic crush injuries].

Control of hemorrhage and prevention of septic complications are the predominant difficulties associated with severe pelvic crush injuries. According to our experience spontaneous tamponade, external compression (MAST/G-suits), and blind ligation of the hypogastric artery seem to be ineffective, whereas angiography followed by embolization, controlled ligation or vascular reconstruction, packing with scheduled 2nd look reexploration, and rigid fixation of the pelvic ring are recommended to control severe hemorrhage associated with these injuries. Moreover, early repair of bowel and urinary tract lesions, diverting colostomy with rectal wash-out, radical debridement, and open wound care of degloving avulsion injuries appear to be the most important procedures to prevent posttraumatic sepsis. Our pelvic crush trauma protocol is based on 84 consecutive cases treated between 1972 and 1990. In all cases the Injury Severity Score (ISS) was over 40 points, each patient required at least 10 units of whole blood or red cells, the overall mortality rate was 41 out of 84 patients.

Combined Modality Therapy↗
PubMed1991

Role of oxygen radicals in tourniquet-related ischemia-reperfusion injury of human patients.

In the current study we evaluated effluent blood from extremities of human patients undergoing reconstructive surgical treatment which is routinely accompanied by upper extremity exsanguination and application of a tourniquet. Following tourniquet release (reperfusion), there were immediate increases in the plasma levels of xanthine oxidase activity, uric acid, and histamine. Xanthine dehydrogenase activity was not detectable. Plasma also contained products consistent with the formation of oxygen-derived free radicals, namely hemoglobin and fluorescent compounds. Our data indicate in humans that ischemia-reperfusion events are associated with the appearance of xanthine oxidase activity and its products in the plasma effluent.

Adult↗
PubMed1991

Incidence of cancer of the respiratory and upper digestive tract in urban and rural eastern Austria.

The incidence of head and neck, oesophagus and lung cancer between 1981 and 1985 was studied in Eastern Austria for an urban-rural division. In males, rural rates of oral cavity, oropharynx and oesophagus tumours were higher than urban rates. For lung tumours, urban rates slightly exceeded rural rates. In females, the incidence of oral cavity, oropharynx, larynx, hypopharynx, oesophagus and lung cancer showed an urban predominance, steepest for head and neck and oesophagus cancers. Cancer of the oral cavity, pharynx, larynx, oesophagus and lung had a high male preponderance.

Austria↗
PubMed1991

Lung injury and complement activation: role of neutrophils and xanthine oxidase.

Evidence is presented that oxygen products generated from xanthine oxidase (XO) may also be involved in the pathogenesis of neutrophil-mediate lung injury following intravascular activation of complement with cobra venom factor (CVF). CVF injection in rats resulted in a rapid increase in plasma of both XO activity (but not xanthine dehydrogenase) and its reaction product, uric acid. These changes were greatly attenuated in allopurinol-treated animals. The appearance of XO activity was paralleled by a rise in plasma of histamine. Prevention of histamine release by pretreatment of rats with cromolyn abolished both the rise in plasma histamine and the increase in XO activity. Since we have previously shown that histamine can enhance XO activity in vitro and in vivo (Am. J. Pathol. 135:203, 1989), these observations suggest that the increase in plasma XO activity following CVF injection is related to the appearance in plasma of histamine. Accordingly, pretreatment of rats with xanthine oxidase inhibitors (allopurinol, lodoxamide) or prevention of histamine release by pretreatment with cromolyn significantly attenuated development of lung injury following injection of CVF. Our data support the concept that oxygen radicals derived from both neutrophils and XO are playing a role in the CVF-induced acute lung injury.

Animals↗
PubMed1990

[Breast cancer: morbidity and mortality in Austria. Descriptive epidemiology 1983-1987].

The incidence and mortality rate from breast cancer in Austria from 1983 to 1987 were obtained from data of the Austrian Cancer Register. There were on average 3012 new cases per year (75.8 per 100,000 women). Age-standardized incidence (European standard population) as calculated by the WHO was 64.1 per 100,000. Distribution by stages ("US end-result group") showed stage I (localized) in 44.7%, stage II (spread to immediate neighbouring structures and regional lymph nodes) in 41.3% and stage III (generalized) in 14%. There was no significant difference between the various age groups regarding stage distribution. The number of deaths increased from 1,462 in 1983 to 1,675 in 1987, a raw mortality rate of 36.8 and 42.2, respectively. Age-standardized mortality increased from 29.0 to 31.2, respectively. These data point to a further increase in incidence and mortality rate from breast cancer in Austria.

Adolescent↗
PubMed1990

Histamine: a promoter of xanthine oxidase activity in intestinal ischemia/reperfusion.

Xanthine oxidase (XO)-derived oxygen radicals are thought to play an important role in the intestinal injury resulting from ischemia and reperfusion. In vitro data shows enhanced XO activity in the presence of histamine. Histamine is known to be released during intestinal ischemia and reperfusion. The purpose of this study was to evaluate the relationship between histamine and XO in vivo in intestinal ischemia/reperfusion injury. Using an established model of gut ischemia and reperfusion, portal venous plasma was obtained and assayed for histamine levels, XO activity, and xanthine dehydrogenase (XD) activity following injury. Intestinal ischemia for 120 minutes resulted in a 200% increase in plasma histamine levels (263.4 +/- 36.9 nmol/mL control, v 548.7 +/- 35.1 nmol/mL experimental, P less than .05). Reperfusion for 15 minutes resulted in a further increase in plasma histamine (to 658.3 +/- 33.9 nmol/mL), compared with 120 minutes of ischemia alone. No significant change in plasma XO activity resulted after simple ischemia for 120 minutes. However, XO activity doubled within 15 minutes of reperfusion of the ischemic intestine (6.37 +/- 0.53 nmol O2- per milliliter per minute v 3.12 +/- 0.25 nmol O2- per milliliter per minute, P less than .05). Reperfusion for 60 minutes resulted in the maximal observed increase in plasma XO activity (9.49 +/- 0.67 nmol O2- per milliliter per minute). Analysis of XD activity demonstrated no significant decrease compared with controls until 120 minutes of ischemia and 60 minutes of reperfusion (1.62 +/- 0.49 nmol uric acid per milliliter per minute at 60 minutes of reperfusion, versus 5.02 +/- 0.52 nmol uric acid per milliliter per minute control, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗