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Biomedical subjects

O C Burghuber

Publications and source records attributed to O C Burghuber.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Uni- and bilateral lung transplantation: functional results. Vienna Lung Transplant Group].

At the end of December 1990 11 patients had survived lung transplantation at the 2nd Department of Surgery, University of Vienna. In these patients 7 single lung (SLTX) and four bilateral lung transplantations (DLTX) were performed. The indication for operation in 6 cases was emphysema, in 2 cases mucoviscidosis, in 2 cases pulmonary fibrosis, and in 1 case secondary pulmonary hypertension, following operation of a ductus Botalli. By means of fitness tests, blood-gas analysis, pulmonary function tests and ventilation respectively perfusion scan a marked improvement of the clinical status of the patients following lung transplantation could be shown.

Adult↗
PubMed1990

Serum neuron-specific enolase is a useful tumor marker for small cell lung cancer.

Small cell lung cancer (SCLC) may be potentially curable. A correct diagnosis of cancer cell type is important and serum markers are of great value. Although several markers have been suggested, they have been of limited value because of insufficient specificity. To assess the value of serum neuron-specific enolase (S-NSE) as a possible marker of SCLC, the serum levels of 81 patients with SCLC (59 patients with extensive disease and 22 patients with limited disease) were compared with the serum levels of patients with non-small cell lung cancer (N-SCLC) and 93 patients with nonmalignant lung diseases. The S-NSE level also was measured in 104 patients with extensive disease of various other malignancies, including 71 solid tumors and 33 malignant hematologic disorders. From 105 healthy control subjects, the upper limit of the normal range (x + 2 standard deviations [SD]) was determined as 12.3 ng/ml. The S-NSE level was elevated in 78% of patients with SCLC, including 11 of 22 (50%) with limited disease and 52 of 59 (88%) with extensive disease. In contrast, the S-NSE level was raised only in 18% of patients with advanced N-SCLC (nine of 50) and 6% of patients with nonmalignant lung diseases (six of 93). Twelve patients (17%) with other solid malignant tumors and two patients (6%) with malignant hematologic disorders had raised S-NSE levels. Serial N-NSE levels were obtained in 13 patients with SCLC. S-NSE levels fell in all patients responding to chemotherapy and increased again with progression of disease. Our results indicate that S-NSE seems to be specific for SCLC (85%), whereas sensitivity seems to be dependent on the stage of disease. Further, S-NSE may be a useful marker for monitoring treatment and predicting relapse in patients with SCLC.

Biomarkers, Tumor↗
PubMed1990

Acute effects on pulmonary haemodynamics of nifedipine in adult patients with cystic fibrosis.

Hypoxic pulmonary vasoconstriction is considered to be the primary cause of pulmonary hypertension and cor pulmonale in adult patients with cystic fibrosis (CF). The acute effect on pulmonary haemodynamics of a single sublingual dose of nifedipine 20 mg has been studied in 9 adult patients with CF. Nifedipine significantly attenuated the rise in mean pulmonary artery pressure and pulmonary vascular resistance induced by inhalation of a 13% oxygen gas mix. It also slightly reduced baseline pulmonary artery pressure and pulmonary vascular resistance and lowered pulmonary artery hypertension in the patients. Oxygen delivery was unchanged. Nifedipine is potentially useful for the treatment of hypoxic pulmonary hypertension in patients with CF.

Adult↗
PubMed1990

Interstitial lung disease in progressive systemic sclerosis: high-resolution CT versus radiography.

High-resolution computed tomographic (HRCT) scans and chest radiographs were obtained in 23 patients with progressive systemic sclerosis (PSS) to assess the diagnostic merits of HRCT compared with chest radiography in detecting interstitial lung involvement in these patients. HRCT scans showed interstitial disease in 21 patients (91%). The most frequent finding was the so-called subpleural lines, which were demonstrated in 17 patients (74%). Honeycombing was seen in seven patients (30%), while parenchymal bands were seen in six patients (26%). Chest radiographs, on the other hand, showed definite interstitial opacification patterns in only nine patients (39%); six patients (26%) had equivocal reticular areas of attenuation, while eight patients (35%) had normal chest radiographs. Thus, HRCT is much more sensitive than chest radiography when assessing minimal interstitial lung involvement in patients with PSS.

Female↗
PubMed1990

Interpretation of plasma concentrations of human atrial natriuretic peptide (hANP) in congestive heart failure.

The present study reports about novel findings concerning the interrelationship between release of human atrial natriuretic factor (hANP) and the clinical situation of patients suffering from congestive heart failure. Estimations of plasma hANP were done by specific and sensitive extraction-based RIA. The normal range was 5 to 80 ng/l, mean +/- SEM = 30 +/- 15 ng/l, n = 106. Influence of response to therapy on hANP-release was studied in altogether 14 patients. 12 of these patients had elevated plasma hANP at admittance, surprisingly peptide levels were normal in 2 patients throughout the study. 9 out of the 14 patients responded well to therapy (shift from NYHA IV/III to NYHA II within about 10 days), hANP-levels decreased to normal values: 235 +/- 104 ng/l vs. 65 +/- 13 ng/l; p less than 0.001. The 5 residual patients responded to therapy only partially (shift from HYHA IV to NYHA III within an observation interval of about 2 weeks). Plasma hANP values decreased from 225 +/- 94 ng/l to 137 +/- 22 ng/l (p less than 0.02), but were still supranormal. Atrial fibrillation, which persisted in 8 out of the 14 patients after therapy did not influence hANP levels: hANP levels paralleled clinical signs of improvement, irrespective of atrial fibrillation. Right heart catheterization revealed very high mean right atrial pressures in those 2 patients mentioned above, who had normal pretherapeutic hANP.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial Fibrillation↗
PubMed1989

Long-term treatment with disodium cromoglycate does not alter bronchial hyperreactivity in patients with perennial bronchial asthma.

The purpose of this study was to examine whether a 3-month therapy with disodium cromoglycate (DSCG) is able to lower bronchial hyperreactivity in patients with perennial bronchial asthma and hyperreactive airways. Therefore, 24 patients with this condition (11 women, 13 men; age range from 16 to 41 years) were randomly allocated to either active treatment (20 mg DSCG four times daily) or to placebo in a prospectively designed, double-blind study. Bronchial hyperreactivity was assessed by acetylcholine-induced bronchoconstriction before and after 6 and 12 weeks of either DSCG or placebo treatment, respectively. As test values, the variations in FEV1 and oscillatory resistance (Ros) before and after inhaled acetylcholine was used. Despite the fact that DSCG significantly attenuated acetylcholine-induced acute bronchoconstriction in all patients studied, it did not exhibit a significant reduction in bronchial hyperreactivity in this patient population.

Adolescent↗
PubMed1989

Effects of somatostatin and oral potassium administration on terbutaline-induced hypokalemia.

Terbutaline, a beta 2-adrenergic agonist, has been shown to cause hypokalemia and an increase of plasma glucose and serum insulin concentrations. We considered that terbutaline-induced hypokalemia may be due to the insulin-induced shift of potassium (K+) from the extracellular to the intracellular space. If so, then inhibition of insulin secretion by somatostatin would prevent terbutaline-induced hypokalemia. Further, we wondered whether oral potassium pretreatment could prevent terbutaline-induced hypokalemia. Therefore, 10 healthy volunteers (5 men, 5 women; mean age, 23 yr +/- 3 SD) received either sodium chloride (NaCl) or somatostatin intravenously together with 0.25 mg terbutaline subcutaneously in a double-blind crossover design. On a third test day, they received 39 mval of K+ powder orally before terbutaline injection in an open trial. Terbutaline caused a significant decrease of K+ (from 3.96 +/- 0.08 to 3.3 +/- 0.13 mmol/L +/- SEM; p less than 0.0005), accompanied by a significant increase in plasma glucose (from 83 +/- 3.6 to 101 +/- 4.4 mg/dl +/- SEM; p less than 0.01) and serum insulin concentrations (from 11.7 +/- 0.9 to 19.9 +/- 1.1 microU/ml +/- SEM; p less than 0.001), confirming earlier data. Somatostatin pretreatment inhibited the terbutaline-induced hypokalemia; the small fall of K+ (from 3.7 +/- 0.08 to 3.5 +/- 0.2 mmol/L) was no longer significant. Insulin secretion was completely blocked by somatostatin, leading to an even more pronounced increase of blood glucose. Hypokalemia after terbutaline injection was not prevented by oral potassium pretreatment. In summary, the present findings confirm that terbutaline-induced hypokalemia is associated with increased plasma glucose and insulin levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1989

A case of decompression sickness in a commercial pilot.

We report a case of decompression sickness (DCS) followed by pulmonary edema in a 47-year-old commercial pilot who operated a non-pressurized turboprop twin at flight level 290. He became unconscious and recovered after an emergency descent. The pilot collapsed and a pulmonary edema occurred 8 h after landing. The patient improved rapidly with fluid replacement and without hyperbaric therapy, which was not available at that time. This course of DCS is unusual because it is reported that fluid replacement without hyperbaric therapy normally cannot recover severe cases of DCS. The considerable increase in body weight of this pilot within the last 6 months may have been a predisposing factor for development of decompression sickness.

Aerospace Medicine↗
PubMed1988

[Principles and general practice of goal-oriented planning of training in patients with diabetic nephropathy and in dialysis patients].

Uremic patients on hemodialysis suffer from marked reduction of physical exercise capacity. This reduction cannot solely be explained by the underlying disease and co-existing anemia. We wondered, whether reduced exercise capacity in these patients might be due to lack of physical exercise and whether anaerobic exercise training (AET) would lead to improved work capacity. 8 patients were enrolled in this study. At the beginning and at the end of the training period, which lasted 4 to 6 weeks, a symptom-limited incremental bicycle-spiroergometry was performed. AET led to a significant increase in exercise capacity without any changes in the renal status and hematocrit as well as hemoglobin values. From these data we conclude, that decreased exercise capacity in uremic patients on dialysis is due to inadequate exercise performance of these patients and that AET is able to improve exercise capacity.

Diabetic Nephropathies↗
PubMed1988

Right ventricular performance and pulmonary haemodynamics in adolescent and adult patients with cystic fibrosis.

A combined haemodynamic and radionuclide approach was used to evaluate right ventricular performance in 16 adolescent and adult patients with cystic fibrosis (CF). There were nine patients with mild arterial hypoxaemia (PaO2 greater than 80% of predicted) and normal resting pulmonary artery pressure and seven patients with severe arterial hypoxaemia (PaO2 less than 70% of predicted) and resting pulmonary arterial hypertension (PH). The right ventricular ejection fraction (RVEF) by equilibrium angiocardiography using krypton 81m as a tracer and stroke volume index (SVI) by thermodilution techniques were measured simultaneously and right ventricular end-diastolic and end-systolic volumes were derived. RVEF was normal in CF patients without PH (58.9 +/- 7.2%) but was reduced in those with PH (45.4 +/- 2.6%). There was a statistically significant inverse linear correlation between RVEF and afterload as assessed by mean pulmonary artery pressure (Pap: r = -0.76) and pulmonary vascular resistance (PVR: r = -0.78), indicating that RVEF ist afterload-dependent. Right ventricular function, however, as assessed by right ventricular end-systolic pressure-volume relations was even higher in CF patients with PH, indicating preserved or even increased right ventricular function in the face of an increased afterload stress.

Adolescent↗
PubMed1988

Recurrent paradoxical embolism complicating severe thromboembolic pulmonary hypertension.

A patient with a three-year history of recurrent pulmonary embolism is presented. Thromboembolic pulmonary hypertension was proven in the final stage of disease in the presence of repeated episodes of systemic embolic events. Paradoxical embolism was assumed to be present on the basis of blood-gas analysis and contrast echocardiography that demonstrated a right-to-left shunt at atrial level. Autopsy revealed a patent foramen ovale and provided strong evidence for the accuracy of the clinical diagnosis.

Adult↗
PubMed1988

Right-ventricular contractility in chronic obstructive pulmonary disease: a combined radionuclide and hemodynamic study.

The effect of pulmonary artery hypertension on right-ventricular performance in patients with chronic obstructive pulmonary disease (COPD) is unclear. Decreased values of right-ventricular ejection fraction (RVEF) have been reported, but most patients with stable COPD are not in cardiac failure and have normal or even increased cardiac outputs. We therefore hypothesized that RVEF may be afterload dependent, and thus a poor parameter of cardiac function, and that right-ventricular contractility may be normal even in COPD patients with pulmonary hypertension. We therefore studied 24 COPD patients using a combined hemodynamic and radionuclide approach. RVEF and thermodilution stroke volume index were measured simultaneously at rest in all 24 patients and also during bicycle ergometry in 9 patients. We then calculated end-diastolic and end-systolic volume indices and derived right-ventricular systolic pressure-volume relations in all and the slopes (E) of the pressure-volume line in 9 patients. RVEF was normal in COPD patients without pulmonary hypertension, but was reduced in those with pulmonary hypertension. A strong inverse linear relation between RVEF and mean pulmonary artery pressure (r = -0.73; p less than 0.001) and pulmonary vascular resistance (r = -0.69; p less than 0.001) could be demonstrated, indicating RVEF to be highly afterload dependent. Right-ventricular end-diastolic volume index was significantly higher in patients with pulmonary hypertension, indicating increased preload as the major mechanism to maintain adequate stroke volume in the face of an increased afterload. Right-ventricular end-systolic pressure-volume relations, a good parameter to define right-ventricular contractility independent of systolic loading conditions, were not different between COPD patients with or without pulmonary hypertension, nor did the slopes of the pressure-volume lines in the 9 patients studied during exercise show any difference. From these data we conclude that (a) RVEF is a poor indicator of overall right-ventricular function; (b) right-ventricular contractility is well preserved in stable COPD patients; (c) the major mechanism of maintaining stroke volume in the face of increased right-ventricular afterload seems to be preload augmentation.

Blood Pressure↗
PubMed1988

Human atrial natriuretic peptide secretion in precapillary pulmonary hypertension. Clinical study in patients with COPD and interstitial fibrosis.

Human atrial natriuretic peptide (hANP) is stored by granules of both human atria. Atrial distension appears to be a major stimulus for hANP secretion. Precapillary pulmonary hypertension increases right ventricular afterload and may thus cause right atrial distension. We therefore hypothesized that hANP plasma concentrations (1) are higher in the right atrium than in the peripheral vein, (2) are increased in patients with precapillary pulmonary hypertension, and (3) correlate with right atrial pressure. Thirty-three adult patients with chronic obstructive pulmonary disease (COPD) or interstitial fibrosis were examined by right heart catheterization. Mean pressures were measured in the right atrium, pulmonary artery, and pulmonary capillary wedge position, and blood was drawn from the right atrium and from a peripheral vein for determination of hANP levels. In general, hANP plasma levels in the right atrium were significantly higher than in a peripheral vein. Seventeen out of 33 patients had pulmonary hypertension, whereas 16 patients exhibited normal pulmonary artery mean pressures. In all patients, pulmonary arterial wedge pressure was normal. Plasma hANP concentrations were significantly higher in patients with pulmonary hypertension than in patients with normal pulmonary artery pressure. A strong correlation between central or peripheral hANP plasma levels (or both) and mean right atrial pressure could be observed (r = 0.75; p less than 0.001). From these data, we conclude that the increased secretion of hANP in our patients with precapillary pulmonary hypertension appears to be mediated by right atrial distension.

Adult↗
PubMed1988

Right ventricular contractility is preserved in patients with cystic fibrosis and pulmonary artery hypertension.

A combined hemodynamic and radionuclide approach was used to evaluate right ventricular contractility in 16 adolescent and adult patients with cystic fibrosis (CF). Nine patients had normal resting pulmonary artery pressure, and seven had resting pulmonary artery hypertension (PH). Right ventricular ejection fraction (RVEF) was observed by radionuclide angiocardiography, and stroke volume index (SVI) by thermodilution techniques. By combination of these measures right ventricular end-diastolic and end-systolic volumes were derived. RVEF was normal in CF patients without PH (58.9 +/- 7.2%) but was reduced in those with PH (45.4 +/- 2.3%). There was a strong inverse linear correlation between RVEF and afterload, as assessed by mean pulmonary artery pressure (r = -0.76), indicating RVEF being afterload-dependent. Right ventricular contractility, however, as assessed by right ventricular end-systolic pressure-volume relations was even higher in CF patients with PH, indicating preserved or even increased contractility in the face of an increased afterload stress. The acceleration time, evaluated by pulsed Doppler echocardiography, was normal in CF patients without PH (117.3 +/- 5.5 msec) and significantly reduced in those with PH (85.1 +/- 6.4 msec). Both RVEF and AT were efficient in estimating pulmonary artery pressure in these patients.

Adolescent↗