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Biomedical subjects

H Thiel

Publications and source records attributed to H Thiel.

At least 19 recordsLinked to original sources
PubMed1995

[Propofol-alfentanil reduced cerebrovascular CO2 reactivity in comparison with isoflurane].

The present study compared the effects of propofol/alfentanil versus isoflurane anaesthesia on cerebral vascular reactivity to changes in carbon dioxide (CO2) using transcranial Doppler sonography (TCD). METHODS. Seventeen ASA class I patients undergoing minor elective surgery were studied following IRB approval and informed consent. In group 1 (n = 10), anaesthesia was induced with thiopental 4 mg/kg and alfentanil 15 micrograms/kg. Endotracheal intubation was facilitated by vecuronium 0.1 mg/kg. Anaesthesia was maintained with 1% end-tidal isoflurane and nitrous oxide (N2O) in oxygen O2 (6 l/min; FiO2 0.3). In group 2 (n = 7), anaesthesia was induced with propofol 2 mg/kg, alfentanil 15 micrograms/kg, and vecuronium 0.1 mg/kg for endotracheal intubation and maintained by infusion of propofol, alfentanil, and N2O-O2 (6 l/min; FiO2 0.3) according to the following protocol: propofol: 10, 8, and 6 mg/kg.h for 10 min each followed by 4 mg/kg.h; alfentanil: 55 micrograms/kg.h. Monitoring included measurement of mean arterial blood pressure (MAP, mm Hg), heart rate (HR), body temperature (T), end-tidal CO2 (PetCO2, mm Hg), isoflurane concentrations, and arterial O2 saturation (SaO2, %). Mean blood flow velocity (Vmean, cm/s) was measured in the middle cerebral artery using a bidirectional 2-MHz TCD system (TranspectT, Medasonics). Mechanical ventilation was adjusted to achieve PetCO2 levels of 40-50-40-30 and 40 mm Hg. Ten minutes of equilibration were allowed at each PetCO2 level. The CO2 reactivity index was calculated as delta Vmean/delta PetCO2 (cm/s.mm Hg). RESULTS. MAP, HR, T, and SaO2 were constant over time and were not different between groups. The CO2 reactivity index over the CO2 range of 30-50 mm Hg was higher in isoflurane (2.32 +/- 1.51 delta cm/s.mm Hg) compared to propofol/alfentanil patients (1.15 +/- 0.77 delta cm/s.mm Hg) (mean +/- SD, P < 0.05). CONCLUSIONS. The data show that although CO2 reactivity is maintained during both isoflurane and propofol/alfentanil anaesthesia, the cerebral vascular response to CO2 was lower in propofol/alfentanil compared to isoflurane patients. This is likely due to propofol/alfentanil-induced cerebral vasoconstriction. These data suggest that CO2 reactivity is a function of the pre-existing cerebral vascular tone induced by the anaesthetic.

Adult↗
PubMed1992

Left atrial ball thrombus in combined mitral-aortic valve disease.

This report describes a patient with left atrial ball thrombus which was detected during echocardiographic evaluation of combined mitral-aortic valve disease. Surgical correction was performed entirely on the basis of the echocardiographic diagnosis.

Aortic Valve Insufficiency↗
PubMed1990

Interrater reliability of roentgenological evaluation of the lumbar spine in lateral bending.

Interrater reliability is described for the evaluation of lumbar motion and motion coupling patterns in lateral bending. Upright neutral and lateral bending lumbar films of 58 student volunteers were marked by three examiners. Segmental tilt, segmental rotation and motion categories were computed. The performance of the examiners was evaluated using the Kappa statistic and a comparison of rater discrepancy to the experimental measurement error. Although all three raters were proficient within the context of calculated measurement error, good reliability was not universally demonstrated. Concordance for rotation was moderate to good, while agreement for lateral bending was of questionable interpretation. Reliability for the segmental motion categories was good for L1-L4, but unacceptable at L5. The poor reliability at L5 resulted in unacceptable concordance for the lumbar global motion category for three raters. The use of lateral bending radiographs for categorization of the lumbar spine in clinical practice is questioned.

Adult↗
PubMed1989

[Stetho-acoustic cardiomyopathy--characteristics in cardiomyopathies studied by echocardiography].

In 4 different forms of cardiomyopathy which had been diagnosed echocardiographically we performed stethoacoustic investigations. Hereby each of these 4 different forms of cardiomyopathy developed a specific noise. In the patients with hypertrophic non-obstructive cardiomyopathy we found a mesosystolic to protomesosystolic interval murmur in 2 L 1 and called it hypertrophic murmur. In the apical hypertrophic cardiomyopathy we found a mesosystolic murmur above the apex and called it apical hypertrophic murmur. In the obstructive cardiomyopathy (hypertrophic obstructive cardiomyopathy) we found a mesotelesystolic murmur in 4 L 3 and called it obstruction murmur. In the dilatative cardiomyopathy (COCM) existed an immediate systolic murmur above the apex and we called it dilatation murmur.

Cardiomyopathies↗
PubMed1989

[Extracorporeal lithotripsy of gallbladder calculi with piezoelectrically generated shock waves: initial experiences].

A piezoelectric lithotripter ("Piezolith 2300") was used in 24 patients for extracorporeal fragmentation of radiolucent gallbladder stones. In 19 patients with one stone and 4 patients with two stones (diameter: 0.8-3.1 cm) fragmentation to a maximal fragment size of 7 mm was achieved. One to three treatment sessions were necessary (mean 1.5). During adjuvant oral litholytic therapy with chenodeoxycholic acid and ursodeoxycholic acid (500 mg each daily up to 80 kg bodyweight and 750 mg in patients with more than 80 kg bodyweight) 4 patients came to be completely free of stones within a mean follow-up time of 15 weeks. Treatment was well tolerated by all patients, no analgesia or sedation was needed. Side effects were cutaneous petechiae in two patients, microscopic haematuria in two others and leucocyturia in another. We conclude that lithotripsy of gallbladder stones can be performed safely and effectively not only by the established underwater spark discharge type of lithotripter but also by the piezoelectric system.

Adult↗
PubMed1986

Detection of proteins in wheat flour extracts that bind human IgG, IgE, and mouse monoclonal antibodies.

Wheat flour was extracted with phosphate-buffered saline. The biologic significance of the extracted cereal proteins was demonstrated. Basophil leukocytes were obtained from patients suffering from "baker's asthma disease." Histamine release in vitro was induced by addition of the aqueous flour extract. By means of ELISA, as well as immunoblotting technique, IgG and IgE binding to wheat flour proteins was demonstrated. Wheat-specific antibodies could be detected in sera obtained from healthy and atopic individuals. Further analysis of the cereal components by monoclonal antibodies revealed that several wheat molecules exhibit identical epitopes.

Allergens↗
PubMed1985

Alterations of serum carboxypeptidases N and angiotensin-I-converting enzyme in malignant diseases.

The activities of serum carboxypeptidases N (E.C. 3.4.17.3) and serum angiotensin-I-converting enzyme (E.C. 3.4.15.1) were spectrophotometrically measured in patients with hematological disorders and in histologically proven bronchogenic carcinomas. The enzyme activities have been compared with various laboratory parameters. Controls were healthy subjects. No significant sex differences of carboxypeptidases N and angiotensin-I-converting enzyme were found in the healthy controls or in the whole patients' group. The carboxypeptidases N were significantly elevated in patients with lung cancer (p less than 0.0001) compared to the healthy controls. The angiotensin-I-converting enzyme was significantly reduced (p less than 0.0001) in serum of patients with bronchogenic carcinoma. In responders to chemo- and/or radiotherapy, the carboxypeptidases decreased and the angiotensin-I-converting enzyme increased to normal enzyme values. In non-responders to these therapies no change in these enzymes could be observed.

Adenocarcinoma↗
PubMed1985

[Automatic contour search and segmentation of sonographic transverse sectional pictures of the uterus with regard to optimization of individual isodose planning in uterine cancer].

Intrauterine ultrasonography has proved to be an adequate method to represent the normal myometrium as well as its pathologic modifications, especially for the assessment of localization and extent of malignant processes. So for the first time, intracavitary radiotherapy of the carcinoma of the body, especially the afterloading technique, can work by means of the produced crossections with a precisely defined target volume, because the sonographic probe and the afterloading probe have identical geometric configurations. A method is presented which allows a computer-assisted determination of the tumor volume by means of the segmentation of organ sections and a pseudo-threedimensional projection in combination with the energy dose distribution of the radioactive source.

Brachytherapy↗
PubMed1985

[Protease inhibitors, serum endotoxin and serum immunoglobulins following portacaval end-to-side anastomosis in animal experiments].

In order to clarify the pathophysiological mechanism of certain biochemical and immunological changes (endotoxin in serum, protease inhibitors, immunoglobulins) found in a former study on human cirrhosis of the liver the porto-caval end-to-side anastomosis of rats with unaffected livers was chosen as test model. With the aid of this bypass the "spill-over" phenomenon of the liver can be completely imitated. In this study, 7 operated and 5 or 14 control animals resp. are referred to. Serum endotoxin, acid-stable and acid-unstable protease inhibitors and immunoglobulins IgG, IgA and IgM were determined 20 months after operation. For the determination of potential hemodynamically or toxically induced effects on these organs, morphologic liver and lung examinations were performed. On the average, the operated rats showed a weight loss of 8 percent, i.e. from 378.4 +/- 9.2 g to 348.4 +/- 17 g. Compared to control rats, their relative liver weights were significantly lower (34%) (mean = 2.23 +/- 0.2 compared to 3.4 +/- 0.44 g, p less than 0.0005). Serum immunoglobulins IgG, IgA and IgM in operated animals were significantly higher (p less than 0.005 or p less than 0.025 resp. and 0.0025). Endotoxin in serum could be identified in 4 out of 7 operated animals (57, 1%), but in none of the control animals. While there was no difference in serum levels of acid-unstable protease inhibitors between the two groups levels of acid-stable protease inhibitors were in operated animals by 24% higher than in control animals (mean = 35.3 +/- 3.3 compared to 28.5 +/- 2.3 mU/ml, p less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Defective desaturation and elongation of n-6 and n-3 fatty acids in hypertensive patients.

Hypertensive patients had higher levels of linoleic acid (LA) in serum lipids than normal controls. Administration of large doses of LA failed to raise the percentage of its metabolite arachidonic acid (AA) in serum lipids. Similarly, intake of large amounts of alpha-linolenic acid (alpha-LNA) failed to increase the amount of eicosapentaenoic acid (EPA). The percentage of EPA in serum lipids could readily be increased by direct administration of comparably low doses in a mackerel diet. Hypertensive subjects seem to desaturate and elongate LA and alpha-LNA only very slowly.

Animals↗