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Biomedical subjects

K Günther

Publications and source records attributed to K Günther.

At least 127 records · Page 7Linked to original sources
PubMed1983

Serum vitamin E levels in patients with chronic renal failure.

27 patients with chronic renal failure, 21 patients on chronic intermittent dialysis treatment and 27 healthy controls were tested for serum level of vitamin E estimated spectrophotometrically. Both patient groups had significant higher mean values (12.1 +/- 1.2 and 7.2 +/- 0.8 micrograms/ml respectively) in comparison with normal controls 4.6 +/- 0.7 micrograms/ml). No correlation was found to serum creatinine, hematologic values, protein and lipoprotein concentration, nor to mode and duration of treatment regimes. Vitamin E was not extracted from blood throughout dialysis. Under normal conditions of conservative or dialysis treatment of chronic renal failure patients vitamin E seems not to be a factor concerning uremic symptoms and there is no need for supplementation.

Adult↗
PubMed1983

[Amino acid loss and protein spectrum of the peritoneal dialysate during continuous peritoneal dialysis].

The loss of amino acids and the protein spectrum in the dialysate during continuous peritoneal dialysis were evaluated in 6 patients with normal kidney function in the context of a study on psoriasis therapy. On the 10th day the protein loss was lower than on the 1st day of therapy. The total loss of amino acids was only 0.6 g/day with a dialysate volume of 6 1/24 h and was thus lower than the losses quoted in the literature for an exchange volume of 10 1/24 h. As a whole the loss of amino acids apparently plays only a subordinate role as an influencing factor on protein metabolism in continuous peritoneal dialysis.

Adult↗
PubMed1982

[Occurrence of repetitive ventricular responses in programmed right ventricular stimulation].

In 30 patients with various disturbances of rhythm (17 males, 13 females) at the age of 16-72 years during a conduction analysis a programmed stimulation relating to the right ventricle was carried out and the occurrence of repetitive ventricular responses was evaluated. 9 patients did not show any repetitive ventricular responses. In 14 patients with various disturbances of rhythm a V3-phenomenon was evoked which as an interventricular reentry is a physiological phenomenon. In 6 patients with myocardial scar and extreme bradycardia, respectively, apical torsades were observed via a V3-phenomenon with transition into an intraventricular reentry (one persisting interventricular reentry) and like 2 provoked ventricular tachycardias (one with, one without observation of apical torsades) were valuated as a reference to the electric instability of the ventricular myocardium. The obtainability of apical torsades as well as of V3 was possible only in a minimal retardation of the conduction to His's bundle depending upon the frequency of stimulation and precociousness of S2. Only in a transition into an intraventricular reentry apical torsades speak for, non-evokable apical torsades do not speak against an increased electric instability of the ventricular myocardium, but for existing and not existing, respectively, suitable distal conduction conditions to the stimulation reentry.

Adolescent↗
PubMed1982

[The effect of hemoperfusion with XAD-4 resin on biological constituents of the blood].

13 patients who had undergone a haemoperfusion therapy with Amberlite XAD-4 resin (Haemoresin, Braun, F.R.G.) because of acute intoxication were examined for adsorption of biological material from the blood. Treatment lasting on average 4 hours at a blood-circulation rate of 200 ml/min resulted in a 43% reduction of thrombocytes and in changes in the concentrations of proteins, complement factors, triglycerides, aldosterone and testosterone. Low-molecular substances and electrolytes were however, except for sodium, only slightly influenced. Thus this haemoperfusion system is only suitable for shortterm application and cannot be used without substitution for chronic treatment of terminal renal insufficiency.

Adolescent↗
PubMed1982

Influence of hemoperfusion with XAD-4 resin on the concentration of biologic constituents in the blood.

13 patients, who had been subjected to hemoperfusion with Amberlite XAD-4 resin (Haemoresin, Fa. Braun), because of acute intoxications, were examined for the adsorption of bioactive material from the blood. A mean treatment period of four hours at a blood flow rate of 200 ml/min. resulted in a marked thrombocyte decrease by 43% and changes in the concentrations of proteins, complement components C3 and C4 (16-26%) triglycerides (33%), aldosterone (33%) and testosterone (20%). Low molecular weight substances and electrolytes, however, were only slightly or not affected. Thus hemoperfusion system with its poor biocompatibility and inability to remove BUN, electrolytes and water is only suitable for short-term treatment and cannot be used without detailed control of possible side effects and perhaps substitution for treatment of chronic renal or hepatic failure. Hemoperfusion has proved an efficient method of treating various exogenous intoxications. The adsorption of biologically active material from the blood constitutes several side effects which contraindicate long-term treatment, above all of endogenous intoxications such as chronic renal failure and hepatic failure. With the type of adsorber used - various charcoal preparations, resins etc. such as uncoated material or coated with different substances - these side effects vary and have not yet been investigated in a systematic, comparative and comprehensive way. The present investigations are meant to check the adsorption behaviour of Amberlite XAD-4 Resin in vivo towards some selected blood constituents and the influence of hemoperfusion on the concentrations.

Adolescent↗
PubMed1982

[Causes of death in the aged and their significance for surgery].

Based on an analysis of the most frequent causes of death in old age, i.e. cardiovascular diseases, pulmonary diseases and neoplasia, a number of consequences can be drawn from the surgical point of view. It is undoubtedly difficult still to find ways and means of prolonging the life of an elderly person suffering from an acute illness in the presence of degenerative cardiac and vascular diseases. Yet we feel, that interdisciplinary cooperation with a high degree of responsibility between surgeons, internal specialists and anesthetists still offers possibilities to achieve this aim. All efforts should be focused on relieving cardiovascular and respiratory insufficiency. Furthermore, we regard surgery at the time of choice as an opportunity to reduce mortality rates which are greatly influenced by complications of diseases requiring an operation. The success of an operation depends on precise surgical work and swift acting. It should be a moral duty not only of the medical profession, but also of young people to treat the elderly with esteem, respect, love and care.

Age Factors↗
PubMed1981

[Detoxication by hemoperfusion].

In 13 patients (2 males, 11 females, 15-70 years of age) on account of severe intoxications with hypnotics sedatives, psychopharmaca, in most cases mixed intoxications, with propranolol and halogenized hydrocarbons a 4--8-hour haemoperfusion treatment with amberlite XAD-4-Resin was performed. 11 patients survived, 1 patient died in irreversible cardiogenic shock of a propranolol intoxication, another patient of the sequels of a crotylbarbital and methaqualone intoxication. The curves of the course of the blood concentration of the individual substances showed a good elimination for phenobarbital and crotylbarbital, methaqualone, meprobamat and didropyridine as well as trichlorethylene, a less good elimination for nitrazepam, propranolol and tetrachlorethylene, Altogether the effectiveness of the detoxication clearly higher in the time unit, compared with the dialysis.

Adolescent↗
PubMed1981

[Possibilities of electrotherapy in tachycardial rhythm disorders].

The pacemaker therapy of tachycardiac disturbances of rhythm used a great number of different methods which are applied according to the kind of disturbance of rhythm. A specialised intracardiac diagnostics is frequently necessary in order to select the suitable stimulation technique. A short survey of the different technical stimulation methods is given which are known from literature and for which own experiences are present. In the perspective a high value is ascribed to the pacemaker therapy in tachycardias.

Cardiac Pacing, Artificial↗
PubMed1981

[Experimental autoradiographic study on the proliferation kinetics of the ischemically injured rat small intestine].

The kinetics of proliferation of the ischemically injured small intestine in rats were tested after recovery of the circulation in dependence on the age by means of the autoradiography. The marking index and the middle density of silver grain were applied. The time of the anoxia amounted to 3 hours, since in that case a regeneration can hardly be expected after this time. With a complete regeneration both the number of the synthesizing cells and the synthesized DNA quantity can be calculated after the recovery of circulation. Differences dependent on the age become clear, in a similar way to the physiological kinetics of proliferation. The values of comparison with the control group are reached in rats at an age of 6 weeks already after nearly 18 to 20 hours. On the other hand the time of the regeneration amounted to nearly 36 to 48 hours in the rats at the age of 12 months. The demand of an early diagnosis and recovery of the circulation within 3 hours is emphasized.

Age Factors↗
PubMed1980

[Clinical value of the refractory period behavior of the atrioventricular transconduction].

Issuing from the estimation of the maximum 1 : 1-transconduction in rapid stimulation of the atrium (so-called maximum isorhythmia) as a suitable parameter for the refractory behaviour of the atrio-ventricular transconduction the estimation of the refractory periods of the atrio-ventricular transconduction by means of programmed stimulation of the atrium is discussed and particularly the dependence on frequency of all refractory periods of the atrioventricular transconduction is shown. It is emphasized the peculiarity of the effective refractory period of the atrioventricular node to grow longer with increasing frequency of stimulation. It renders the atrioventricular node to the frequency limiting segment of the atrioventricular transconduction, to the so-called "gate" of the atrioventricular transconduction. Apart from the prolongation of the individual refractory periods recognizable by the maximum isohythmia the establishment of a deviating behaviour of the atrioventricular transconduction which depends on frequency is of clinical importance. This is shown as an example for sinus bradycardia, sinus tachycardia and for investigations of medicaments in general (here for cordanum and obsidan) as well as in therapy studies in the individual patient (here for alupent).

Adult↗
PubMed1980

[Current therapeutic principles as well as new therapeutic aspects of idiopathic hypertrophic subaortic stenosis. II. Chemotherapeutic and direct surgical therapy].

The severity of the functional obstruction of the outflow tract of an idiopathic hypertrophic subaortic stenosis is essentially determined by the contractility of the myocardium, the left-ventricular volume and the peripheral vascular resistance. Though in the acute experiment a clear reduction of the degree of stenosis by beta-receptor-blockers may be proved the long-term results of such a therapy are unsatisfactory, particularly in patients with obstruction in rest. The use of calcium antagonists seems to promise more favourable results. The progression of the disease is, however, scarcely influencible by pharmacological measures alone. Nitrobodies are not suitable for treatment and glycosides should be used only within a manifest insufficiency of the left heart. An effective reduction or removal of the ventriculo-ventricular pressure gradient as well as a decrease of the left-ventricular telediastolic pressure may be achieved on operative way. There is an indication to this, when the complaints increase despite medicamentous therapy. At present the transaortic myotomy under use of the heart-lung-machine is regarded as most favourable method. A simultaneous or only substitute of the mitral valve should be restricted only to those cases which, apart from the functional, still show an organically conditioned insufficiency of the mitral valve. The early and late results of the palliative surgical interventions are very favourable in experienced centres. However, secure long-term prognoses may not yet be derived from this.

Adrenergic beta-Antagonists↗
PubMed1980

[Current therapeutic principles as well as new therapeutic aspects of idiopathic hypertrophic subaortic stenosis. II. Pathophysiology, natural course and diagnosis].

Idiopathic hypertrophic subaortic stenosis is a noncompensatory hypertrophy of the myocardium which above all concerns the ventricular septum in its upper part near to the basis. The etiology is not yet sufficiently clarified, though a genetic component is regarded as ascertained on account of the proved familial accumulations. Haemodynamically the morphologic changes effect a systolic obstruction of the left-ventricular outflow, an insufficiency of the mitral valve and an aggravated diastolic filling of the left ventricle. Further pathophysiological symptoms of the functional subaortic stenosis are an extremely rapid ejection of blood in the early, not obstructive phase of the systole as well as a pathological forward movement of the mitral valve beginning in the midst of the systole. The disease has a bad prognosis. To be sure, the natural course is usually characterized only by a slow progression of the complaints, however, particularly in adolescents frequently sudden cases of death appear by disturbances of the cardiac rhythm or a relative coronary insufficiency. The disease which is already frequently to be diagnosed according to anamnesis, auscultation, ECG and form of the pulse curve may be ascertained using the ultrasound echocardiography as well as heart catheterization including angiography. Apart from a direct measurement of the ventriculo-ventricular pressure gradient during wuch examinations the size of the functional obstruction may further be characterized by certain pharmaca or physical methods which influence the volume of the ventricle or the afterload.

Angiocardiography↗
PubMed1980

[Digoxin therapy in the aged under serum level control with special reference to hypertension].

In 125 patients with hypertension in the clinical degree of severity II despite normal concentrations of creatinine and potassium in the serum at the age of more than 65 years significantly higher digoxin serum concentrations of 2.36 +/- 1.19 nmol/l (= 1.84 +/- 0.93 ng/ml) and intoxications than in younger patients with 1.45 +/- 0.55 nmol/l (= 1.13 +/- 0.43 ng/ml) were found. After discussion of the results of other investigators comes the recommendation in patients at an older age (beginning with about 65 years) and in renal insufficiency to apply digitoxin instead of digoxin, taking into consideration the mean maintenance dose of 0.1 mg/die.

Adult↗
PubMed1979

[Programmed stimulation for the analysis of arrhythmias].

On the basis of the examination of a left bundle-branch heart block depending on frequency, of a paroxysmal tachycardia in functional conduction dissociation in the atrioventricular node and a WPW-syndrome of type A is shown that and how by means of programmed stimulation of the right atrium in order to establish the times of conduction and the refractory periods of all conduction sections of the conduction system of the heart also under influence of medicaments the diagnostic repertoire is enriched for the analysis of disturbances of the rhythm without comprehensively or finally estimating the clinical valency of the method.

Adult↗