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Biomedical subjects

M Goerig

Publications and source records attributed to M Goerig.

At least 19 recordsLinked to original sources

[Franz Kuhn (1866-1929) on the 125th anniversary of his birthday].

At the beginning of the 20th century, the German surgeon Franz Kuhn (1866-1929) was the leading protagonist of various endotracheal intubation technics. In the period between 1900 and 1912, he wrote several papers on this topic including a remarkable monograph on intubation, which was not widely appreciated for decades. In this, he discussed--among others--the advantages and possible risks of the endotracheal intubation, for patients during surgical procedures as well as in situations of cardiopulmonary resuscitation. Kuhn recommended the use of flexible metal tubes which were generally introduced into the trachea under digital control. Kuhn suggested the advantageous use of Kirstein's autoscope, too, a forerunner of modern laryngoscopes. To overcome the "pneumothorax problem" in thoracic surgery, he emphasized the positive pressure ventilation via endotracheal tubes. As an alternative, he suggested the insufflation technique for this purpose. He was the first to incorporate a carbon-dioxide absorption system within the anaesthesia apparatus. Later, he developed technical devices for the perioperative intravenous administration of fluids or the injection of local anaesthetic drugs under high pressure. In honour of Kuhn's 125th birthday, the various contributions to anaesthesia and emergency medicine are outlined.

Anesthesiology

[Friedrich Wilhelm Adam Sertürner−the discoverer of morphine].

Friedrich Wilhelm Adam Sertürner (1783-1841) was one of the most outstanding pharmacists who significantly influenced the transformation of pharmaceutical chemistry from a state of alchemistry to an acknowledged branch of science at the end of the 18th century. At the age of twenty-one, Sertürner was the first to report on some results concerning the substance which was thought to be responsible as the "sleeping-agent". This substance had been isolated by him from the poppy-plant. Since this first report remained unnoticed, he repeated his analysis and described once more on the "crystallizable" properties of the agent in 1817, which he now named morphine. To have an idea of the effects of the drug, Sertürner was able to confirm the hypnotic as well as the analgesic properties of morphine that were well-known to him since the had performed animal tests. Since he could demonstrate the alkaline qualities of morphine, something absolutely new at that time, Sertürner became the co-founder and promoter of a new type of chemistry now known as alkaloid chemistry.

Animals

Rapid increase in the activity of enzymes of eicosanoid synthesis in hepatic and extrahepatic tissues after experimental liver transplantation.

Previous studies have demonstrated a marked release of prostanoids from hepatic tissue after liver grafting. In addition, eicosanoid synthesis was shown to be regulated at the level of key enzymes. The present study addressed changes of the local availability of these enzymes during and after porcine orthotopic liver transplantation. We determined kinetic parameters of cyclooxygenase (CO), the initial enzyme of prostaglandin synthesis, of prostacyclin and thromboxane synthase (PCS, TXS), two more peripheral enzymes, in microsomal preparations of hepatic and gluteal muscle biopsies, and the activity of 5-lipoxygenase (5-LO), the key enzyme of leukotriene synthesis. Maximal velocity (Vmax) of CO and PCS showed a 4-fold increase both in liver and gluteal muscle tissue 1 hr after reperfusion of the grafted liver and a more than 20-fold increase after 24 hr (P less than 0.001), whereas apparent affinities (Km) remained unchanged. In contrast, Vmax of TXS and the activity of 5-LO disclosed a striking increase only within the hepatic graft (P less than 0.001). No changes of enzymatic activity could be observed during donor operation, cold storage, and 5 min after reperfusion. Results were independent of the duration of preservation (3 hr and 20 hr with Euro-Collins) and the addition of Iloprost, a prostacyclin-analogue. These results suggest that after liver grafting, abnormalities at the level of local enzyme expression in hepatic and extrahepatic tissues might contribute to preservation damage and systemic injury of the host.

6-Ketoprostaglandin F1 alpha

[Pollution of the workplace by anesthetic gases. Causes and prevention].

Waste anesthetic gas concentrations were measured in areas corresponding to the breathing zones of the anesthetists and operating room nurses for personal exposure (n = 27, time-weighted values) and during special work practices (n = 65). Leaks related to anesthetic machines and high-pressure nitrous oxide components were investigated during (n = 60) and after anesthesia (n = 85). The effect of a local scavenging system on occupational exposure during inhalation induction of anesthesia in children was studied (n = 60). Concentrations of nitrous oxide, halothane, isoflurane, and enflurane were determined by using active dosimeters (SKC 222) and different infrared gas-analyzers. Factors that increase waste anesthetic gas concentrations in operating rooms can be divided into several categories, such as low air conditioning systems, anesthetists' work practices, equipment leakage, including leakage from high-pressure nitrous oxide systems, and inadequate scavenging devices. Equipment leakage is almost invariably present in low-pressure components of the anesthesia machine because so many seals and joints are necessary to permit disassembly for cleaning and replacement. Waste anesthetic gases are also distributed in the exhaled air of patients recovering from anesthesia. To restrict the levels, exposure must be as low as can be achieved with reasonable efforts. Thus, the anesthetic equipment should be designed to avoid leakage, leakage tests should be performed before the use of anesthetic machines, and waste anesthetic gases should be scavenged by central as well as by local systems. Regular and periodic use of a trace gas analyzer permits direct observation of gas leakage and enables anesthetists to modify their work technique in order to reduce avoidable leakage.

Air Pollutants, Occupational

The LDL receptor pathway delivers arachidonic acid for eicosanoid formation in cells stimulated by platelet-derived growth factor.

Animal cells can convert 20-carbon polyunsaturated fatty acids into prostaglandins (PGs) and leukotrienes. These locally produced mediators of inflammatory and immunological reactions act in an autocrine or paracrine fashion. Arachidonic acid (AA), the precursor of most PGs and leukotrienes, is present in the form of lipid esters within plasma lipoproteins and cannot be synthesised de novo by animal cells. Therefore, AA or its plant-derived precursor, linoleic acid, must be provided to cells if PGs or leukotrienes are to be formed. Because several classes of lipoproteins, including low-density lipoproteins (LDL), very-low-density lipoproteins, and chylomicron remnants, are taken up by means of the LDL receptor, and because LDL and very-low-density lipoproteins, but not high-density lipoproteins, stimulate PG synthesis, we have suggested previously that PG formation is directly linked to the LDL pathway. Using fibroblasts with the receptor-negative phenotype of familial hypercholesterolaemia and anti-LDL receptor antibodies, we show here that LDL deliver AA for PG production and that an LDL receptor-dependent feedback mechanism inhibits the activity of PGH synthase, the rate-limiting enzyme of PG synthesis. These results indicate that the LDL pathway has a regulatory role in PG synthesis, in addition to its well-known role in the maintenance of cellular cholesterol homeostasis.

Animals

Prostanoid release in experimental liver transplantation.

Prostanoids are biologically active mediators of inflammation and tissue injury. To investigate the role of prostanoids in orthotopic liver transplantation we used a porcine model and determined prostaglandin E2, 6-keto-prostaglandin F1 alpha, and thromboxane B2 in arterial, portal, and hepatic venous blood during organ harvesting, the recipient operation, and the early postoperative period. There were no significantly increased serum levels during the donor operation or at the end of cold storage. As early as 1 or 5 min after initiation of reperfusion of the transplanted organ, prostanoids in hepatovenous blood increased dramatically (100-500-fold). Changes in arterial and portal blood (10-50-fold) were less pronounced but still statistically significant. In surviving animals these values returned to normal within 24 hr. The hepatic release of metabolites of the arachidonic acid cascade after liver grafting indicates that the synthesis of prostanoids might contribute to morphological and functional alterations of the transplanted graft. In addition, the increased arterial values of circulating prostanoids may potentially participate in severe cardiovascular, hemostatic, and immunological alterations known to occur after liver transplantation.

6-Ketoprostaglandin F1 alpha

[Georg Perthes--a pioneer of modern regional anesthesia technics?].

In regional anesthesia, the localization of peripheral nerves and plexuses is possible by means of mechanical or electrical stimulation. Electrical stimulation for this purpose was first described in 1912 by the surgeon Georg Perthes (1869-1927) of Tübingen, who reported his own experiences. The original description and results of electrostimulation are transposed upon a modern point of view of regional anesthesia.

Anesthesia, Conduction