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Biomedical subjects

M Häusler

Publications and source records attributed to M Häusler.

At least 37 records · Page 2Linked to original sources
PubMed2000

Effects of prolonged partial liquid ventilation, high frequency ventilation and conventional ventilation on gas exchange and lung pathology in newborn surfactant-depleted piglets.

Partial liquid ventilation (PLV) improves oxygenation in various animal models of respiratory insufficiency. The aim of this study was to compare the effects of conventional ventilation (CV), high frequency oscillatory ventilation (HFOV), and PLV combined with CV or HFOV on gas exchange and histopathology. Thirty anaesthetised newborn piglets (mean weight 1.94 kg, age 1-3 days) were randomized in five groups of six animals: CV, CV + surfactant (S), HFOV+S, PLV/CV, and PLV/HFOV. Thirty min after lung injury had been induced with repeated saline lavage, specific ventilatory treatment was initiated. Three animals of the CV group died within the 24 h study period, whereas none died in any of the other groups. The oxygenation index (OI) and the PaO2/FIO2 ratio improved significantly within 30 min in all groups, but not in the CV group. After 24 h all oxygenation parameters were better in the PLV groups than in CV or CV+S (P < 0.05). No differences in gas exchange were noted between HFOV+S and PLV/CV. The combination of PLV with HFOV led to an increased PaO2/FIO2 ratio when compared with PLV/CV and with HFOV+S (P < 0.05). All PLV treated animals had significantly less lung injury in the upper and lower lobes compared with gas-ventilated animals by histologic semi-quantitative lung injury score (P < 0.01) and in the lower lobes by morphometry (P < 0.001). In conclusion, HFOV+S and PLV either with CV or HFOV are effective techniques to provide adequate gas exchange in S-deficient lungs compared with CV with and without S. However, lung injury was significantly improved in both PLV treated groups compared with HFOV+S and the CV groups.

Animals↗
PubMed2000

Bronchiolitis obliterans organizing pneumonia: a distinct pulmonary complication in cystic fibrosis.

Organizing pneumonia in cystic fibrosis has hitherto been considered a nonspecific reparative process. We report on an adult patient with cystic fibrosis and histologically proven bronchiolitis obliterans organizing pneumonia, who experienced sustained clinical improvement under corticosteroid therapy. This case suggests that bronchiolitis obliterans organizing pneumonia may be a distinct pulmonary complication in cystic fibrosis and improve with specific therapy.

Adult↗
PubMed2000

Preclinical comparison in AR4-2J tumor-bearing mice of four radiolabeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-somatostatin analogs for tumor diagnosis and internal radiotherapy.

Somatostatin analogs labeled with radionuclides are of considerable interest in nuclear oncology as diagnostic or therapeutic tools for somatostatin receptor (SSTR)-expressing tumors. We investigated the suitability of DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) as a replacement for the widely used diethylenetriaminepentaacetic acid, to enable stable labeling of somatostatin analogs with both therapeutic (90Y) and diagnostic (111In) radionuclides. The three clinically relevant somatostatin agonists, octreotide, vapreotide, and lanreotide, together with the newly designed Tyr3-octreotide (TyrOc), were conjugated to DOTA and labeled with 90Y or 111In. For all DOTA-somatostatin analogs tested, irrespective of the incorporated radionuclide, we observed favorable biodistribution profiles in AR4-2J tumor-bearing mice: 1) a rapid clearance from all SSTR-negative tissues except kidney; 2) a specific uptake in SSTR-positive tissues, including tumor; and 3) an excellent tumor penetration. The main route of excretion was via the kidneys. Nevertheless, DOTATOC was clearly superior to the other DOTA-somatostatin analogs tested, as well as OctreoScan, as indicated by the highest tumor-to-nontarget-tissue ratio, including the tumor-to-SSTR-positive-tissue ratios. The presence of different SSTR subtypes in the SSTR-positive tissues possibly contributes to these differential uptakes. We assume that the very favorable behavior of DOTATOC in our mouse model makes this radioligand very promising for future applications in nuclear oncology.

Animals↗
PubMed1999

Pneumonectomy in cystic fibrosis.

A 17-year-old boy and a 12-year-old girl with cystic fibrosis (forced expiratory volume in 1 sec, 36% and 14% of predicted values, respectively) developed severe right-sided lung infections with abscess formations and complete atelectases unresponsive to medical therapy. In both patients, unilateral emergency pneumonectomy resulted in rapid clinical improvement. Despite her severe underlying lung disease, the girl experienced a remarkable increase in quality of life; 2 years after surgery, she died from respiratory failure. The male patient has now survived for 4 years, and lung transplantation still remains a therapeutic option for him. We believe that pneumonectomy is a valuable rescue therapy for patients with cystic fibrosis and intractable unilateral lung infections who are at high risk of dying while waiting for lung transplantation.

Adolescent↗
PubMed1999

The clinical outcome after inferior vena cava thrombosis in early infancy.

UNLABELLED: The clinical outcome after inferior vena cava thrombosis in early infancy is unknown. We report the clinical long-term follow-up of 12 patients presenting inferior vena cava thrombosis within their first months of life (gestational age: 24-41 weeks; follow-up: 7+/-3 years). Accompanying renal venous thrombosis occurred in 9, and adrenal bleeding in 4 patients. A central venous catheter was related to the thrombosis in only four patients. Heterozygous factor V Leiden mutation was found in two of the eight infants without central venous catheter. Thrombolysis was performed in seven and effective in three infants; one infant required surgical thrombectomy. In three of eight infants with ineffective or with no therapy, spontaneous recanalization occurred during follow-up. No patient died of the thrombosis. Although no long-term anticoagulatory prophylaxis was performed, none of the children with persisting occlusion (n = 5) or stenosis (n = 1) of the inferior vena cava developed symptomatic thrombo-embolic complications. However, extensive internal collaterals (n = 6), visible varicosis (n = 5), pain in the legs (n = 3) and persisting renal disease (n = 3) with arterial hypertension (n = 2) were observed during follow-up. CONCLUSION: Inferior vena cava thrombosis of early infancy frequently persists and may cause considerable long-term morbidity. New strategies for early and long-term therapy are necessary.

Child↗
PubMed1999

Inhaled budesonide in ventilator-dependent preterm infants: a randomized, double-blind pilot study.

The aim of this randomized, double-blind pilot study was to evaluate the short-term efficacy of early inhalation therapy with budesonide in ventilator-dependent preterm infants. The primary outcome variable was the duration of artificial ventilation; secondary outcome variables were the need for supplemental oxygen and the release of several inflammatory mediators in the tracheobronchial aspirate fluid. The infants of the budesonide group could not be weaned earlier from the ventilator. The ventilatory parameters on day 14 of life and the need for supplemental oxygen were similar in both groups. The release of inflammatory mediators was not reduced in the budesonide group. No adverse side effects were observed in either group. In conclusion, aerosolized budesonide failed to demonstrate significant short-term pulmonary improvement in ventilator-dependent preterm infants.

Administration, Inhalation↗
PubMed1999

[Psychic coping with spontaneous abortion].

Spontaneous abortion is the early and involuntary loss of pregnancy and occurs in about 15 to 20% of all pregnancies. In this study, Filipp's heuristic model for critical life events was used to evaluate general and specific causal attributions and depressive symptoms after spontaneous abortion. A sample of 100 women was investigated at four measuring points between diagnosis and five weeks after the spontaneous abortion. The results regarding depressive symptom levels showed that two days after the miscarriage, 50% of the women were severely depressed, and five weeks later 30% were still depressed. Depressive symptoms were increased in cases of prior reproductive loss and when pregnancy was planned or desired. With regard to general causal attributions, women who tended to more internal, stable, and global attributions showed a significantly higher level of depressive symptoms than women with external, unstable, and specific attributions. In the area of specific attributions regarding pregnancy loss, the same patterns of results were found.

Abortion, Spontaneous↗
PubMed1998

[Psychological aspects of pain experience in amniocentesis].

UNLABELLED: This study describes the psychological aspects and the experience of pain in 2 groups of women undergoing amniocentesis in relation to the different indication for the procedure and duration of gestation in the respective groups. METHODS AND SUBJECTS: Data were collected after amniocentesis from 100 pregnant women, 50 of whom underwent age-related amniocentesis (14 weeks of gestation) and 50 for measurement of amniotic fluid insulin levels (30 weeks of gestation). A semi-structured psychological interview was used to collect information concerning experience of pain, cognition before amniocentesis, knowledge about the procedure and the most distressing aspects of amniocentesis. Visual analog scales (VAS, 0 to 10) were used to assess the degree of pain and emotional mood state. RESULTS: The results showed that emotional mood state before amniocentesis was fair (mean = 4.6) and increased after amniocentesis (mean = 8.1) The degree of pain during amniocentesis was assessed at a mean value of 2.9 measured on the 10-point visual analog scale. Fifty per cent of the sample considered the physical, the other 50% the psychological (anxiety and uncertainty) aspects as the most distressing factor of amniocentesis. Although women were given prior detailed information about amniocentesis they overestimated the degree of pain, related risk factors, and duration of the medical procedure. There were no differences in the investigated variables between the two different indications for amniocentesis or the weeks of gestation. CONCLUSION: The findings of the study indicate the psychological distress associated with amniocentesis, which is limited to a short period of time, and is independent of the indication for amniocentesis.

Adaptation, Psychological↗
PubMed1998

The extracellular matrix: an early target of preservation/reperfusion injury and acute rejection after small bowel transplantation.

BACKGROUND: Endothelial cells are known to be an early target of preservation/reperfusion injury and acute rejection, whereas the extracellular matrix (ECM) may also play an equally important role in the sequelae of both events. METHODS: Syngeneic and allogeneic rat small bowel transplantations (SBTX) were performed after 6 hr of preservation. Animals were subsequently killed at defined time points for determination of ECM parameters within the graft and in plasma. RESULTS: Laminin levels were significantly increased 20 min after reperfusion (syngeneic SBTX: 357+/-65.9 ng/ml; allogeneic SBTX: 361+/-79.6 ng/ml; P< or =0.01). After syngeneic transplantation, laminin levels normalized by postoperative day (POD) 7, whereas there was a rejection-induced increase after allogeneic SBTX (POD 7: 179+/-60.1 ng/ml; POD 9: 333+/-13.6 ng/ml; P< or =0.01 vs. syngeneic SBTX). This increase was accompanied by an increase in tumor necrosis factor-alpha levels at POD 9. Hyaluronic acid levels were significantly elevated after 24 hr (syngeneic SBTX: 1086+/-176 microg/L; allogeneic SBTX: 918+/-108 microg/L; P< or =0.01). After syngeneic SBTX, hyaluronic acid levels normalized by POD 7, whereas persistently higher levels were observed after allogeneic SBTX. Immunohistochemistry confirmed early changes (20 min after reperfusion) at the ECM. Anti-laminin and anti-CD44 staining normalized at POD 5 after syngeneic SBTX. After allogeneic SBTX, rejection-specific changes were evident with anti-laminin staining commencing on POD 5 and progressing until POD 9. At similar time points, increased expression of fibronectin- and interferon-gamma-positive material was evident. CONCLUSIONS: The ECM can be considered to be an early target of preservation/reperfusion injury and acute rejection. Plasma parameters reliably reflected the changes observed within the graft. Laminin and hyaluronic acid levels may be used as indicators of initial graft function. Furthermore, the increase in laminin levels was an early indicator of acute rejection. Determination of these parameters may significantly improve monitoring after SBTX.

Animals↗
PubMed1998

First adult patient with fibrosing colonopathy.

An adult patient with cystic fibrosis and chronic abdominal complaints developed symptomatic fibrosing colonopathy several months after the beginning of high dose pancreas enzyme therapy. Despite the absence of a stricture, surgical resection was performed. Since then the abdominal complaints have not recurred.

Abdominal Pain↗
PubMed1998

[L-arginine administration improves mucosal structure in the early phase of reperfusion of small intestine transplants].

L-arginine and molsidomine application prior to reperfusion significantly reduced the preservation and reperfusion-related injury after small bowel transplantation. The architecture of the mucosa was best preserved after treatment with L-arginine and methylprednisolone. The macroscopic appearance of the mucosa was improved (less watery and less thin than after reperfusion of non-treated recipients). The histological appearance was improved. But the most prominent changes were observed by antilaminin staining showing an almost normal architecture of the basement membrane compared with compressed and thickened basement membrane structures in non-treated recipients. This was accompanied by a decrease in CD44-expression within the villi cores and crypts 20 minutes and 24 hours after reperfusion. The release of hyaluronic acid into the plasma was also lower after treatment with L-arginine and molsidomine in combination with methylprednisolone than in non-treated recipients. These improvements may result from increased NO-production by L-arginine which may scavenge superoxid anions. The latter are known intermediates that cause significant injury at the endothelial level and at the extracellular matrix including the basement membrane.

Animals↗