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Biomedical subjects

M Orth

Publications and source records attributed to M Orth.

At least 91 records · Page 5Linked to original sources
PubMed1995

Effects of VLDL, chylomicrons, and chylomicron remnants on platelet aggregability.

Although influences of cholesterol-rich lipoproteins on platelet aggregation are well established, the knowledge of interactions between triglyceride-rich lipoproteins and platelets, in particular in the postprandial state, is limited and controversial. The in-vitro effects of these lipoproteins from hypertriglyceridemic subjects on the aggregation behavior of platelets from normolipemic donors were investigated with two whole-blood methods. VLDL and chylomicrons, but not chylomicron remnants, in concentrations comparable to concentrations occurring after a fatty meal, reduced platelet aggregation in a dose-dependent manner in particle counting. Impedance aggregometry failed to monitor these effects. We conclude, that triglyceride-rich lipoproteins inhibit platelet aggregation in vitro. They may, therefore, not be linked to the acute onset of myocardial infarction.

Adult↗
PubMed1995

[Noninvasive self-ventilation--successful transition aid in the waiting period before lung transplantation?].

BACKGROUND: Non-invasive mechanical ventilation is used with success for ventilatory failure due to derangements of the respiratory pump. Efficacy in pulmonary diseases is controversial. Still non-invasive intermittent ventilation is reported as a mean of bridging the period till lung transplantation can be performed. PATIENTS AND METHODS: We report of 20 patients from 5 centers who were treated with non-invasive intermittent ventilation while lung transplantation was planned. RESULTS AND CONCLUSION: Non-invasive intermittent ventilation was seen as successful in 14 patients. Of these 4 are transplanted after up to 2 years, 4 are still waiting, 2 have not yet entered a lung transplantation program, 1 continued non-invasive intermittent ventilation after refusal to be enlisted, 3 meanwhile died. In the group of non-successful non-invasive intermittent ventilation 2 patients were transplanted after a short waiting period. All remaining 4 patients died. It seems that non-invasive intermittent ventilation may be helpful in prolonging the period of survival while waiting for lung transplantation.

Adult↗
PubMed1995

[Sensitivity and specificity of pulse oximetry in diagnosis of sleep-related respiratory disorders].

As there is a great demand for polysomnography, screening tests had to be established in the diagnosis of sleep-related disordered breathing. Oxygen saturation is often used as a main diagnostic criterion of these screening tests. In 207 patients (42 women, 165 men) suspected to suffer from a sleep apnea-syndrome we compared oxygen saturation (pulse oxymetry) with apnea-hypopnea-index (AHI, polysomnography). An AHI > or = 5/h and a minimal oxygen saturation < 90% and/or more than 5 oxygen desaturations/h > or = 4% were regarded as pathological. We found a good correlation of significant oxygen desaturations measured with pulse oxymetry and AHI (r = 0.85). Compared to AHI, pulse oxymetry was seen as a sensitive method (sensitivity 0.97) to recognize sleep apnea-patients. Coincidence of COPD decreased specificity of pulse oxymetry from 0.48 to 0.23 but had no influence on its sensitivity. 13 percent of the patients without further cardiorespiratory disease had a normal AHI (< 5/h) but a pathological pulse oxymetry. We conclude, that pulse oxymetry in combination with a positive case history is a sensitive method to recognize sleep apnea-patients. Not all sleep apnea-patients' can be diagnosed only by regarding AHI without taking oxygen saturation into account.

Adult↗
PubMed1995

[Long-term acceptance of n-CPAP therapy by patients with sleep related respiratory disorders].

The therapeutic effect in application of n-CPAP therapy (nasal continuous positive airway pressure) is dependent on both the acute effect of this therapy and the long-term acceptance and consequent palliation respectively avoidance of sequelae. We present 50 patients (47 male, 3 female) treated with n-CPAP therapy because of severe sleep-related disorders of breathing. All patients had polysomnography, and in addition questionnaires were mailed to all 50 patients in order to get information concerning the symptoms of sleep-related disorders of breathing before and under n-CPAP therapy, mode of therapy and side-effects in application of n-CPAP therapy. Patients were treated for at least three to a maximum of 25 months with n-CPAP (average 10.5 months). Long-term acceptance with n-CPAP was defined as persistent use of n-CPAP during every night for at least five hours. On average continuous positive airway pressure of 8.6 mbar (range 4-18) was effective in normalizing formerly severe pathological respiratory parameters. Apnea-index decreased from 22.8 to 2.17/h on average. Regarding the symptoms of sleep-related disorders of breathing before and under n-CPAP therapy, we saw that almost 100% of our patients complained of the main symptoms of sleep-related disorders of breathing. By regular n-CPAP application a complete reduction of these symptoms could be achieved in nearly 80% of patients. Long-term acceptance of n-CPAP therapy was reported by 78% of our patients who used their n-CPAP device every night for at least five hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Pleuro-mediastinitis in pulmonary actinomycosis as a rare differential bronchial carcinoma diagnosis].

A 48-year old patient complaining of immitigable coughing with purulent and sanguineous sputum and a loss of weight of 8 kg within the last three months was admitted to our hospital. Due to anamnesis and radiological findings (tumor of the right side upper lung field with infiltration of the chest wall and the mediastinum) we suspected a bronchogenic carcinoma. As bronchoscopy and histological examinations of biopsies revealed no hints to the underlying disease, we submitted the patient to a right side explorative thoracotomy. It showed a tumorous involvement of the right side upper lung field with infiltration and partial destruction of the chest wall and infiltration of the apical segment of the lower lobe of the lung and a phlegmonous infiltration of the paratracheal tissue. Histological examination confirmed chronical course of actinomycosis. Therapy consisted in resection of the affected tissue and long-term administration of antibiotics. Response to therapy was excellent concerning both radiological findings and subjective complaints.

Actinomycosis↗
PubMed1993

[Unexplained confusion in the aged as a sequela of central sleep apnea syndrome--a case report].

Central sleep apnoea syndromes (cSAS) represent a heterogeneous group of sleep-related disorders of breathing during sleep. cSAS may develop in the course of neurological syndromes or congestive heart failure. Frequency increases with age. A case of a 89-year old man is reported who was sent to hospital because of a state of confusion. He fell asleep all day with periods of restlessness during night. Sleep-related apnoeas could already be observed during daytime. Cardiopulmonary daytime diagnostics did not reveal any abnormal findings. Polysomnographic measurements, however, showed an apnoea-hypopnoea index of 37.8 apnoeas/hypopnoeas per hour with predominantly central apnoeas. Pernasal application of 1 litre of oxygen per minute during sleep normalised breathing patterns, daytime sleepiness, and the nighttime states of confusion stopped. Consequently, sleep-related disorders of breathing have to be considered in the differential diagnostics of unclear states of confusion in old age. In these cases polysomnography is indicated even in geriatric patients.

Aged↗
PubMed1992

[The long-term therapy of familial hypercholesterolemia with heparin-induced extracorporeal LDL precipitation].

The long-term tolerance to and effectiveness of heparin-induced extracorporeal LDL precipitation (HELP) in combination with lipid reducing drugs and diet was tested in six patient (5 males, 1 female; mean age 48 +/- 4 years). Follow-up period was over 50 months, in one patient over 24 months, while one man had a sudden cardiac death 57 weeks after starting treatment. The study was divided into three phases. In phase I (24 months) treatment consisted of HELP and conventional lipid-reducing drugs; in phase II (12 months) of lovastatin (80 mg daily) and cholestyramine (12-24 g daily); and phase III (14 months) of HELP, lovastatin and cholestyramine. In phase I it was possible to lower the pre-treatment level of LDL-cholesterol from 306 +/- 18 mg/dl to 173 +/- 13 mg/dl (43.5%). A similar effect (from 307 +/- 21 mg/dl to 155 +/- 17 mg/dl [-49.5%]) was obtained in phase II. The resumption of HELP reduced the pre-treatment LDL concentration to 136 +/- 9 mg/dl (-55.7%). The various treatment regimens were well tolerated. Biochemical data remained unchanged except for iron loss requiring substitution. Thus combined HELP, lovastatin and ion exchange offer for the first time an effective and reliable means in familial hypercholesterolaemia of clearly reducing long-term the mean LDL cholesterol level below the atherosclerosis threshold of 120 mg/dl.

Anticholesteremic Agents↗
PubMed1992

Human serum gangliosides in hypercholesterolemia, before and after extracorporeal elimination of LDL.

Total content, pattern and transport by lipoproteins of gangliosides have been studied in the sera of 10 patients with hypercholesterolemia and manifest cardiovascular disease. Half of the patients with hypercholesterolemia and 3 healthy controls were treated with heparin-induced extracorporeal LDL precipitation (HELP). In the sera of the untreated group total gangliosides and cholesterol were elevated about 2-fold. Ratios of normal ganglioside components were not altered and abnormal ganglioside species not detected. Treatment with HELP resulted in an almost selective removal of lipid-bound sialic acid carried on LDL. The re-increase of total serum gangliosides was strictly correlated to that of LDL-cholesterol and apolipoprotein B. Total gangliosides and ratios of individual components carried on single LDL- and HDL-particles were not altered by the HELP treatment. Our results indicate that gangliosides are excreted into the serum along with nascent apolipoprotein B-containing lipoproteins, which are of hepatic origin. In hypercholesterolemia excretion of gangliosides into the circulation is elevated and surplus of circulating gangliosides is bound to increased numbers of 'atherogenic' LDL. Biosynthesis of different ganglioside components, most probably by the liver, and total amount of gangliosides bound to lipoprotein particles seem not to be altered.

Adult↗
PubMed1990

Altered concentrations, patterns and distribution in lipoproteins of serum gangliosides in liver diseases of different etiologies.

Concentrations, patterns and distribution in different lipoprotein classes of human serum gangliosides were investigated in acute and chronic liver diseases of different etiologies. The total concentrations of gangliosides were moderately elevated in sera of patients with cirrhosis and acute B or NANB virus hepatitis, but almost 3-fold in those with severe cholestasis. Up to three unknown gangliosides appeared in the sera of six out of nine patients with alcoholic cirrhosis. They accounted for 11-27% of total serum gangliosides. In acute viral hepatitis very small amounts of these gangliosides were inconsistently detected. In severe cholestasis (bilirubin greater than 10 mg/dl) the distribution of serum gangliosides was altered in different lipoprotein classes including lipoprotein X (LP(x)). The results indicate that the liver produces serum gangliosides. The diseased liver is supposed to affect the total concentration, pattern and distribution of serum gangliosides in different lipoprotein classes as a result of at least two different pathogenetic events: the qualitative and quantitative alterations of their biosynthesis and secretion into the circulation (cirrhosis); and the alteration of lipoprotein metabolism following cholestasis.

Acute Disease↗
PubMed1989

Gangliosides in normal human serum. Concentration, pattern and transport by lipoproteins.

The total content and pattern of gangliosides were determined in the unfractionated sera of 11 healthy human adults and in isolated lipoproteins. The total content of lipid-bound sialic acid was 10.5 +/- 3.2 nmol/ml serum. The ganglioside profile consisted of more than ten different components. The major ganglioside was GM3, followed by GD3, GD1a, GM2, GT1b, MG-3 (sialosyllactoneotetraosylceramide), GD1b and GQ1b. Traces of four additional gangliosides could not be quantified reliably. Ganglioside patterns did not vary in sera taken from healthy adults of different age and sex. Approximately 98% of human serum gangliosides were transported by serum lipoproteins, predominantly by LDL (66%), followed by HDL (25%) and VLDL (7%). The quantitative distribution of individual gangliosides in VLDL and LDL was almost the same as that in the unfractionated serum; some differences existed with the ganglioside profile in HDL.

Adult↗
PubMed1989

[Fracture resistance of human maxillary molars with MOD amalgam or composite fillings].

The fracture resistance of human maxillary molars was tested following different types of cavity preparation and filling with various materials. The untreated controls and teeth treated with amalgam/Dentin Adhesive showed the highest strength values. A comparable fracture resistance was found in teeth with amalgam or composite fillings and direct composite inlays, these values being significantly lower than in the controls. The lowest strength values measured were those of the unfilled teeth with prepared cavities.

Composite Resins↗