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Biomedical subjects

M Heitz

Publications and source records attributed to M Heitz.

32 records · Page 2Linked to original sources
PubMed1985

Mediastinal staging of bronchial carcinoma: can computed tomography replace mediastinoscopy?

In bronchial carcinoma the assessment of operability requires an accurate evaluation of the regional and mediastinal lymph nodes. For this, both mediastinoscopy and computed tomography are often used on a routine basis today. The present work considers the relative value of these two methods of investigation. Fifty-seven patients with bronchial carcinoma, in whom both investigations were carried out prior to surgery, were included in this prospective study. In the computed tomogram, lymph nodes with a diameter of more than 1 cm were defined as positive (i.e. suspected malignant infiltration). Sixteen of the 57 patients had histologically confirmed lymph node metastases; in 13 cases the metastases were detected by computed tomography, in 12 cases also by mediastinoscopy and in 3 cases only at thoracotomy. In 41 of the thoracotomized patients, no mediastinal metastases were found. As was to be expected, mediastinoscopy also proved negative in these cases. In 9 of these cases, however, the preoperative computed tomography findings were false-positive. For computed tomography the specificity was 78% and the sensitivity 81%; for mediastinoscopy, on the other hand, the specificity was 100% and the sensitivity 75%. The specificity of computed tomography is too low. Also, lymph nodes which are only inflamed may be considerably enlarged and cannot be differentiated in the computed tomogram from those with malignant infiltration. Mediastinal lymph nodes which appear enlarged in the computed tomogram therefore have to be further investigated by mediastinoscopy. However, in this prospective study, mediastinoscopy provided no additional information in those cases in whom the computed tomography findings were negative (lymph node diameter less than or equal to 1 cm); it did not detect the metastases in the 3 patients with false-negative computed tomography findings. Therefore, in the case of a negative computed tomogram, thoracotomy may be performed immediately, without previous mediastinoscopy.

Adult↗
PubMed1985

Comparison of the effect of continuous positive airway pressure and blowing bottles on functional residual capacity after abdominal surgery.

In two groups of comparable patients undergoing elective abdominal surgery, functional residual capacity (FRC) was measured preoperatively and on the first 2 days after surgery. One group was treated by regular application of continuous positive airway pressure (CPAP), the other group by bottle blowing (BB). In both groups there was a significant reduction of FRC on the first postoperative day. BB and CPAP increased FRC preoperatively by approximately 50%. Postoperative CPAP or BB increased FRC towards the preoperative value. However, 10 min after the treatment was stopped, FRC was not different from the pretreatment level. In 4 healthy subjects the resistive work of breathing produced by CPAP or BB was measured. Both treatments increased mainly expiratory and total resistive work of breathing. BB resulted in especially high expiratory and total resistive work. It is concluded that CPAP and BB increase temporarily the reduced FRC after abdominal surgery. CPAP was much better tolerated by the patients due to the lower resistive work of breathing.

Abdomen↗
PubMed1984

[Standardized disk tests for the determination of bacterial resistance ].

This paper describes the standardized Kirby-Bauer disc method for the determination of antibacterial susceptibility, also including choice of antimicrobials, interpretation of results, problems with particular bacteria, and quality control. Only a meticulous adherence to the details of the method will guarantee reliable results.

Aminoglycosides↗
PubMed1984

[Value of fecal leukocyte studies in cases of acute diarrhea].

The usefulness of screening for presence of fecal leukocytes has been investigated prospectively in 87 ambulatory patients with diarrhea. This simple test has proved valuable in helping to select patients for whom laboratory studies of stools for etiologic agents are indicated.

Adult↗
PubMed1984

[Lung diseases in the elderly. Pathogenetic significance of pollutants and environmental factors].

In the elderly pneumoconioses due to anorganic or organic dusts are not very common. The incidence of mesothelioma is increasing also in the elderly population. Mesothelioma has become the most frequent occupational malignancy. There is also evidence that mesothelioma can be produced by other fibers than asbestos particles. The paper discusses further the effect of passive smoking, where there is new evidence that passive-smokers are exposed to a higher risk for bronchial cancer than non-smokers. The interactions between smoking and air pollution and morbidity of chronic bronchitis are illustrated. New aspects of pathogenesis and pathophysiology of chronic obstructive lung disease and pulmonary emphysema due to smoking as the most frequent environmental lung disease in the elderly are further discussed. A brief overview of the therapeutical approach to chronic obstructive lung disease including new forms of treatment of cor pulmonale is finally given.

Age Factors↗
PubMed1983

[Transbronchial lung biopsy in sarcoidosis].

In patients with suspected sarcoidosis histological confirmation is generally desired. In 40 patients with the ultimate diagnosis of sarcoidosis transbronchial lung biopsy during fiberoptic bronchoscopy revealed in 83% noncaseating granulomas. With 5 biopsies per patient a positive result was obtained in 20 of 25 patients (80%) with radiographic stage I disease, in 6 of 7 (85%) with stage II disease and in 7 of 8 (87%) with stage III disease. The only complications were two small pneumothoraces and two hemorrhages. Transbronchial biopsy with its low morbidity and high diagnostic yield can be recommended as an initial procedure in diagnosing sarcoidosis.

Adult↗
PubMed1982

[Complications of bronchoscopy].

1500 bronchoscopies performed in the Department of Pneumology, University of Basle, were analyzed for frequency and severity of complications. 500 patients were investigated by rigid tube in local anesthesia, 500 patients by rigid tube in neuroleptanalgesia and 500 patients by flexible fiberbronchoscope. The rate of complication for all patients was 4.1%, which agrees well with the previously reported complication frequency of 1-11%. The complications were minor in 3.5% of patients, moderate in 0.5% and major in 0.1%. There were no deaths. The incidence of severe complications and deaths was thus lower than in other studies. There was a higher incidence of complications (p less than 0.001) in the group examined with the rigid tube in neuroleptanalgesia, due to the more frequently observed minor complications. The incidence of complications can be reduced by a careful indication for bronchoscopy, adequate yet sparing use of anesthesia, and choice of the right instrument.

Adolescent↗
PubMed1982

Influence of vagus nerve on catecholamine production of dog lungs.

The effect of electrical stimulation of the cut cervical vagal nerves in dogs on airway resistance and circulating catecholamine concentrations was determined before and after propranolol. Airway resistance increased after 1 min of stimulation and decreased after 9 min of stimulation. The circulating catecholamine levels increased significantly in the pulmonary artery after 1 min of stimulation. After 9 min of stimulation the increase in the femoral artery was relatively more than in the pulmonary artery. This late increase most probably represents catecholamine supply from lung structures.

Airway Resistance↗
PubMed1982

Theophylline serum concentration and therapeutic effect in severe acute bronchial obstruction: the optimal use of intravenously administered aminophylline.

In 20 patients with acute exacerbation of bronchial obstruction, the therapeutic effect of high (20 mg/L) and low (10 mg/L) serum concentrations of theophylline was compared in a double-blind randomized study. The theophylline dose, administered as a continuous aminophylline infusion, was individually adjusted by means of repeated measurements of serum concentrations. At 28 h after starting therapy the high concentration group showed a significantly greater improvement in pulmonary function as assessed by FEV1 (0.57 +/- 0.52 L (mean +/- SD) versus 0.1 +/- 0.18 L, p less than 0.01) and FVC (1.0 +/- 0.65 L versus 0.01 +/- 0.66 L, p less than 0.02). As a measure of the overall clinical improvement, the time during which intravenous therapy was required was also shorter in the high-dose group (61.7 +/- 25.8 h (mean +/- SD) versus 116 +/- 49.7 h, p less than 0.02). The occurrence of side effects in the two groups was not significantly different. In patients with severe acute bronchial obstruction, serum theophylline concentrations around 20 mg/L seemed to offer a definite therapeutic advantage, thus, routine serum concentration measurements and the use of accurate infusion devices for optimal dose adjustment may be justified.

Adult↗
PubMedDate not supplied

Gaseous contaminant emissions as affected by burning scrap tires in cement manufacturing.

We studied the environmental impact (gaseous emissions) of using scrap tires as a fuel substitute at a cement plant that produces one million tons of cement per year. Using a combination of tires and coal as opposed to only coal caused variations in the pollutant emission rate. The study recorded a 37% increase in the rate of emission for CO, a 24% increase for SO2, an 11% decrease for NOx, and a 48% increase for HCl when tires were included. The rate of emission for metals increased 61% for Fe, 33% for Al, 487% for Zn, 127% for Pb, 339% for Cr, 100% for Mn, and 74% for Cu, and decreased 22% for Hg. On the other hand, the emission rate of organic compounds dropped by 14% for polycyclic aromatic hydrocarbons, 8% in naphthalene, 37% in chlorobenzene, and 45% in dioxins and furans. We used a Gaussian model of atmospheric dispersion to calculate the average pollutant concentration (1-h, 24-h, and annual concentrations) in the ambient air at ground level with the help of the ISC-ST2 software program developed by the USEPA. When tires were used, we observed (i) a 12 to 24% increase in particulate matter, this range considering the concentration variation depending on the average used (1-h, 24-h, and annual basis), 31 to 52% in CO, 22 to 34% in SO2, 39 to 52% in HCl, 12 to 27% in Fe, -3 to 8% in Al, 30 to 37% in Zn, and 270 to 885% in Pb; (ii) a decrease of 8 to 13% in NOx, 9 to 13% in polycyclic aromatic hydrocarbons, 6 to 7% in naphthalene, 32 to 39% in chlorobenzene, and 32 to 45% in dioxins and furans. The results obtained showed that the maximum ground-level concentrations were well within the environmental standards (for operation with only coal as well as for operation with a combination of coal and tires).

Air Pollutants↗