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M Schädlich

Publications and source records attributed to M Schädlich.

At least 19 recordsLinked to original sources
PubMed1991

[Beta-endorphin and substance P in the perioperative period].

The modifying impact of anaesthesia on the stress reaction related to surgical trauma was investigated on the basis of the neuropeptidergic parameters of 66 patients who had to undergo a gynaecological radical operation. Anaesthesia was either performed as neuroleptanaesthesia or as epidural analgesia by using bupivacaine in combination with general anaesthesia. The plasma concentrations of substance P and beta-endorphin were taken as neuropeptidergic parameters. Both regulatory peptides show numerous corresponding synergisms. An acceleration of these neuropeptide systems is assumed to be present in severe disturbance of homeostasis. Plasma concentrations of substance P and beta-endorphin were examined at 11 measuring points in the perioperative and intraoperative periods. The plasma concentration of substance P significantly declines in the preoperative period while the concentration of beta-endorphin in the plasma remains at a relatively constant level. In the dynamics of beta-endorphin in the plasma significant differences between the two anaesthetic techniques become apparent in the intraoperative period. Those patients given epidural analgesia have a significantly higher maximum concentration at a later date. This difference is attributed to the possible loss of the adrenal medullary function due to partial sympathetic blocking. Single observations in patients pregnant in the last trimester testify to an extraordinary adaptability at the end of pregnancy.

Adult↗
PubMed1990

[Substance P--results of observing the course of plasma levels during heart surgery].

Observing substance P plasma level changes, we examined the adaptation capacities of the human organism in hypothermia during cardiosurgical operations. It was our aim to observe stress-induced changes of substance P concentrations and to find ways of using them as indicators of good or bad adaptation capacity. Plasma level controls were made on 40 cardiosurgical patients. In all cases the substance P concentration varied in correlation to operation-induced periods of stress. There was a clear tendency for all patients to react similarly, although some individual deviations were found, too. Obviously stress provokes a consumption of substance P in plasma which is expressed in decreasing concentrations. Its rapid increase, however, indicates a good adaptation capacity. Since the need for an exogenous substance P substitution was not recognizable at the beginning of the operation, at present only the possibility of prophylactic substitution is given.

Adaptation, Physiological↗
PubMed1990

[The dynamics of beta-endorphins in plasma in the peri- and intraoperative phase of radical gynecologic surgery].

Stress produced by anaesthesia and operation results in the activation of regulatory processes aimed at maintaining homoeostasis. Numerous studies point to the opioid system acting in the adaptation process as a reserve force in homoeostatic maintenance. We made peri- and intraoperative radioimmunological measurements of the beta-endorphin, a c-terminal fragment of the pro-opiomelanocortin. In spite of the latent stress prevalent in patients before the operation, there was no change in the concentration of beta-endorphin in the plasma before the operation. As soon as the operation began a marked increase in the beta-endorphin concentration was observed, reaching a peak at the end of the operation. Postoperatively, the beta-endorphin level rapidly decreased and the initial value was attained within 24 hours. Our studies provide evidence that there is a protective mechanism guarding the organism against external disturbing factors in stress situations.

Adaptation, Physiological↗
PubMed1990

[The quality of analgesia in relation to the plasma concentration of beta-endorphin during neuroleptanalgesia and epidural analgesia].

In 66 patients who had to undergo radical abdominal hysterectomy because of cancer of the cervix uteri, the plasma concentrations of beta-endorphin were observed intra- and postoperatively. Two anaesthetic techniques were used: neuroleptanalgesia and thoracolumbar epidural analgesia with sedation and controlled inhalation of a mixture of oxygen and nitrous oxide. While the higher dosage of analgesics administered intraoperatively resulted in markedly lower plasma concentrations of beta-endorphin, there was no such effect in the postoperative phase. Patients with epidural analgesia who were absolutely painless postoperatively had, during that stage, higher concentrations of beta-endorphin in the plasma than those patients who had been given neuroleptanalgesia. They had received no analgetic treatment during the postoperative observation period. These differences are attributed to an increased adaptability of patients subsequent to neuroleptanalgesia. The neuronal block can result in a decrease in functional activity of the suprarenal medulla and impair adaptability. The stress-induced opioid analgesia can be suppressed by circulating enkephalin from the suprarenal medulla.

Analgesia, Epidural↗
PubMed1990

[Percutaneous coronary angioplasty in chronic coronary disease with single and multiple obstructed vessels (analysis of 315 interventions 1978-1988)].

315 percutaneous transluminal coronary angioplasties performed during 1978-1988 in 261 patients with ischemic heart disease were analyzed for three different variants according to primary effectiveness, failure rate the most frequent complications and costs of materials as well as duration of intervention and fluoroscopy. Only variant 3 of the proceeding (soft-tip-applicators, flat profile balloon catheter, Kaltenbach long-wire technique, streptokinase rinsing of instruments, permanent infusion of instruments during the procedure) is an applicable routine method. It has a primary effectiveness of 86%. For multiple vessel PTCA this variant however resulted in significantly prolonged investigation and fluoroscopy intervals, so it is advisable only for selected groups of patients.

Adult↗
PubMed1988

[Initial clinical experiences with heart transplantation in East Germany].

An account is given in this paper of first experience from orthotopic heart transplantation. Six of eight patients with transplants have so far survived, with two of these having been in very good general condition for more than a year. All surgical indications were derived from myocardial dilatation. A triple combination of cyclosporine A, prednisone, and azathioprine was used for immunosuppression.

Follow-Up Studies↗
PubMed1985

[Clinical liver transplantation in East Germany].

In the GDR 28 liver transplantations have been performed up to now. The 1 year survival rate amounts to 30%. At present 8 patients are alive between 3 months and 5 years. There were no biliary complications since the biliary reconstruction was performed by using a special 'mucosa suture'-technique. Ischaemic graft failure was a main cause for early postoperative mortality. A better immunosuppressive treatment may help to improve the results of liver transplantation in future.

Adult↗
PubMed1974

[Brain death].

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Brain Death↗