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Biomedical subjects

P Lange

Publications and source records attributed to P Lange.

At least 19 recordsLinked to original sources
PubMed1992

The effect of inhaled terbutaline on FEV1, FVC, dyspnoea and walking distance in patients with chronic obstructive lung disease.

This double-blind, placebo-controlled, crossover study was performed to evaluate the effect of terbutaline administered by a turbuhaler on spirometry, walking distance and dyspnoea during exercise in patients with chronic obstructive lung disease (COLD) and to evaluate relationships between changes in spirometry and working indices. The patients had a maximum reversibility in FEV1 of 15% predicted, and to ensure the option of studying correlations between changes in spirometry and working indices in patients with COLD a wide range of reversibility in FVC was ensured. Eighteen patients (M, 12; F, 6; mean age 68.5 years) were included in the trial. Mean baseline FEV1 was 0.921 and FVC 2.081. Six minutes unpaced walking distance on flat ground (WD) and Brog dyspnoea index scale (BS) were used as working indices. Baseline mean WD was 467.9 m, and median BS 3.2. No significant difference was found in the effect of terbutaline compared to placebo on the spirometry findings or WD. However, BS during exercise improved significantly on the terbutaline day. No significant correlation was found between changes in working indices and change in spirometry. Thus, the use of exercise testing and dyspnoea-scoring may reveal patients who benefit from acute bronchodilation without significant improvement in lung function.

Administration, Inhalation↗
PubMed1992

Bismuth subsalicylate in the treatment of H2 blocker resistant duodenal ulcers: role of Helicobacter pylori.

Fifty nine patients with Helicobacter pylori positive duodenal ulcers that failed to heal after a six week course of treatment with H2 blockers were randomly assigned to one of the following three regimens: (i) bismuth subsalicylate, 600 mg three times daily (n = 19), (ii) ranitidine, 300 mg at night (n = 20), (iii) bismuth subsalicylate plus ranitidine (n = 20). Cumulative ulcer healing rates after four and eight weeks respectively were as follows: bismuth subsalicylate 74% (14/19) and 95% (18/19), ranitidine 40% (8/20) and 65% (13/20), bismuth subsalicylate plus ranitidine 80% (16/20) and 95% (19/20). Bismuth subsalicylate treatment was better than ranitidine at both four and at eight weeks (p less than 0.05). The clearance rates for H pylori after four weeks were: bismuth subsubsalicylate 58%, ranitidine 0%, bismuth subsalicylate plus ranitidine 55%. After stopping bismuth therapy bacterial recrudescence frequently occurred. After bismuth treatment 86% (19/22) of ulcers had healed if H pylori had been cleared, whereas only 65% (11/17) had healed if H pylori persisted (NS). This study shows that bismuth subsalicylate is more effective in the treatment of resistant duodenal ulcers than standard dose ranitidine. It may be that suppression of H pylori by bismuth subsalicylate promotes ulcer healing.

Bismuth↗
PubMed1992

Relationship of the type of tobacco and inhalation pattern to pulmonary and total mortality.

Data from The Copenhagen City Heart Study, a prospective population study, were analysed to investigate the influence of the type of tobacco and inhalation on pulmonary and total mortality. The study sample comprised 6,511 men and 7,703 women, selected randomly after age-stratification from the general population. There were 2,986 plain cigarette smokers, 3,222 filter cigarette smokers, 1,578 smokers of cheroots/cigars, 433 male pipe smokers and 773 subjects smoking more than one type of tobacco. From 1976 until the end of 1989, 2,765 subjects died. Lung cancer was considered as main death cause in 268. Chronic obstructive pulmonary disease (COPD) was considered as the main cause in 94 cases and main or contributory cause of death in 195 cases (COPD related mortality). Current smokers had a higher risk of total mortality compared to lifetime nonsmokers: the relative risks (RR) ranged between 1.2 for male pipe smokers and 2.4 for female plain cigarette smokers. With regard to lung cancer mortality, the RR ranged between 4.1 for male pipe smokers and 7.9 for female plain cigarette smokers. Even higher RR values were estimated for COPD related mortality. In both sexes, the RR for the investigated end-points were lower in cheroot/cigar smokers and in pipe smokers than in cigarette smokers, but these differences were markedly diminished after an adjustment for the inhalation habit. The present study substantiates the view that tobacco smoking increases pulmonary and total mortality. The small differences between the various types of tobacco are probably caused by different inhalation patterns.

Adult↗
PubMed1992

The isolated perfused rat liver as an experimental model.

Intrinsic liver function may be specifically studied using the isolated perfused liver system. In this report, the metabolic characteristics of the perfused rat liver are described in response to lactate (5 mM) and ammonia (10 mM) loading. These conditions are analogous to the increased substrate availability that accompanies some acute disease states such as trauma. Glucose production (490 +/- 85 nm/gm liver/min) was constant during a 90-minute perfusion whereas albumin secretion exhibited a biphasic kinetic profile in the absence of exogenous amino acids. Liver oxygen consumption (VO2) was responsive to substrate loading as evidenced by a 20 to 60 per cent initial increase in VO2. The authors conclude that a large portion of hepatic VO2 may normally be directed toward substrate clearance. Additionally, although hepatic secretory protein synthesis persists despite the limitation of nutrient amino acid supply, the kinetics of secretion are complex.

Albumins↗
PubMed1992

[Distal biceps tendon rupture. Therapy and forensic insurance evaluation].

Compared with proximal ruptures of the biceps sinew, distal ruptures of the biceps sinew are extremely rare and generally need operative treatment. However, the large number of different operation techniques described in literature clearly shows that a safe method of treatment has still not been found. In the "Bergmannsheil" Hospital in Gelsenkirchen-Buer, 11 distal ruptures of the biceps sinew in 10 patients were operatively treated during 1985 and 1989. The average age of the patients was 44.6 years. All accidents occurred during physical work. The account of how the accident had happened suggested that accident and injury were related in 8 cases, especially when the findings at operation and the course were also taken into consideration. In 3 cases the rupture of the biceps sinew was not caused by any outward influence. The operative treatment took the form of transosseous reinsertion of the biceps sinew in a modification of Platt's technique in 6 patients; in 1 case the sinew was restored by means of a fascia late strip even though 49 days had passed since the accident. In the course of follow-up examinations we noted a considerable deficit of supination power remaining in the affected lower arm, although the clinical results were good otherwise; we have therefore developed our own method, taking particular account of the essentially more important function of the biceps brachii muscle as a supinator in addition to its flexion function. The method applied is described. At the follow-up examination distinctly better supination power was noted in the 4 patients operated on by this method; the flexibility of the cubital joint was not reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Forced expiratory volume in 1 second (FEV1)--a respiratory physiological measurement of considerable prognostic value].

The epidemiologic literature concerning a relationship between a decreased FEV1 and mortality, morbidity and lung cancer was reviewed FEV1 is a very potent predictor of COPD mortality and morbidity, and of lung cancer. Furthermore, FEV1 is a hitherto largely unrecognized potent predictor of general mortality and cardiovascular mortality and morbidity. The consequence of this knowledge should be a more widespread usage of spirometry, both in epidemiologic studies and in daily clinical practice.

Cardiovascular Diseases↗
PubMed1991

Effect of terbutaline on mucociliary clearance in asthmatic and healthy subjects after inhalation from a pressurised inhaler and a dry powder inhaler.

BACKGROUND: beta Agonists have been shown to increase mucociliary clearance in some studies but not all. Whether the formulation of beta agonists affects mucociliary clearance is not known but may be important as the use of dry powder inhalers increases. METHODS: The effect of different methods of administration of inhaled terbutaline on mucociliary clearance and forced expiratory volume in one second (FEV1) was assessed in 10 patients with asthma and 10 healthy subjects. Terbutaline (1 mg) was administered through a metered dose inhaler with a spacer (Nebuhaler) or a dry powder inhaler (Turbuhaler), or both treatments were given, in a four way double blind, double dummy trial. Mucociliary clearance was measured by bronchoscintigraphy. RESULTS: Clearance of radioactivity from the lobar bronchi increased in the asthmatic patients by a median of 32% after terbutaline was given by metered dose inhaler and 55% after a combined dose of 2 mg from both inhalers (1 mg from each) compared with placebo but by only 9% after 1 mg of terbutaline was given by a dry powder inhaler. In the healthy subjects mucociliary clearance increased by 51% when terbutaline was given by a dry powder inhaler, by 66% when given by a metered dose inhaler, and by 66% when given by both inhalers combined. The effect of terbutaline on FEV1 was the same with each of the inhalers. CONCLUSION: Despite similar changes in FEV1 with the two formulations terbutaline increased mucociliary clearance significantly in asthmatic and healthy subjects when inhaled from a metered dose inhaler whereas when it was inhaled from a dry powder inhaler its effect was significant only in healthy subjects. The reason for the difference in asthmatic subjects is unclear, but may be associated with differences in the deposition of terbutaline.

Administration, Inhalation↗
PubMed1991

Ventilatory function impairment and risk of cardiovascular death and of fatal or non-fatal myocardial infarction.

The relationship of ventilatory function to cardiovascular events was studied in 12,511 men and women, enrolled in 1976-1978 in a prospective population study. Until the end of 1983, 388 subjects died because of a cardiovascular disease, 133 died within 30 days of developing myocardial infarction (fatal myocardial infarction), while 238 had a non-fatal myocardial infarction. Cox proportional hazards models were employed for the analysis. In the models including tobacco smoking, cholesterol level, blood pressure, diabetes mellitus and body-mass index as covariates, forced expiratory volume in one second in percentage of predicted (FEV1% pred), forced vital capacity in percentage of predicted (FVC% pred), and the ratio between FEV1 and FVC (FEV1/FVC) were significantly related to the risk of cardiovascular death, e.g. compared with subjects with FEV1% pred or FVC% pred greater than or equal to 80 the risk of death from cardiovascular disease among subjects with FEV1% pred or FVC% pred less than 60 was approximately twice as high. There was a nonsignificant trend towards an increased risk of fatal myocardial infarction with reduction of FVC% pred, but in general the regression models did not show consistent relationship between lung function impairment and risk of myocardial infarction. In the regression models, which only included age and sex as covariates, reduced FVC% pred and FEV1% pred were significantly related to both cardiovascular mortality and to fatal myocardial infarction, but not to the non-fatal infarction, whereas the FEV1/FVC ratio was not related to fatal or to non-fatal myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The role of omeprazole (40 mg) in the treatment of gastric Helicobacter pylori infection.

The efficacy of omeprazole in the elimination of Helicobacter pylori was investigated in a prospective randomized-controlled trial. 50 patients with upper gastrointestinal symptoms and chronic active H. pylori-associated gastritis were allocated to one of the following four therapeutic schedules: 1) omeprazole 40 mg/d for 4 weeks (n = 13); 2) bismuth subsalicylate (BSS) 3 x 600 mg for 4 weeks (n = 12); 3) omeprazole plus BSS for 4 weeks (n = 13); 4) triple therapy (BSS for 4 weeks, amoxicillin 3 x 750 mg and metronidazole 3 x 400 mg for 10 days) (n = 12). Clinical symptoms, endoscopic and histologic findings, and H. pylori status were reassessed immediately after therapy, and 1 and 6 months later. After cessation of therapy bacterial clearance rates were: 1) omeprazole 2/13 (15%); 2) BSS 6/12 (50%); 3) omeprazole plus BSS 5/13 (38%); 4) triple therapy 10/12 (83%). The degree of density of gastric mucosal infestation with H. pylori and the degree of activity of gastritis was reduced in all treatment groups but was most prominent after triple therapy. Clinical symptoms improved in all treatment groups. One and six months after completion of therapy H. pylori eradication rates were: 1) omeprazole 0/13 (0%); 2) BSS 1/12 (8%); 3) omeprazole plus BSS 1/13 (8%); 4) triple therapy 10/12 (83%). Our study shows that 40 mg/d omeprazole is ineffective in eradicating H. pylori. Dual therapy with omeprazole and bismuth subsalicylate does not improve bacterial elimination. Only triple therapy effectively eradicates H. pylori.

Adult↗
PubMed1979

A, B, H antigens in transitional cell tumors of the urinary bladder: correlation with the clinical course.

The A, B, H blood group antigens can be detected in normal transitional epithelium of the urinary bladder by the red cell adherence (RCA) test. We examined the possibility that the reactivity for these antigens is lost or decreased in transitional cell carcinomas and that such a change may reflect the future evolution of these tumors. We studied several bladder biopsies from 60 patients who presented with noninvasive transitional cell carcinomas and were followed for at least 5 years or until muscle invasion was histologically demonstrated. Eighty-one percent of patients whose tumors were RCA positive in the initial biopsy did not subsequently develop invasive tumors and 27% of these patients had no recurrences. All 34 patients whose tumors were negative in the initial biopsy experienced recurrences and 62% of them developed invasive lesions. In 81% of patients, the recurrent tumors retained the same pattern of RCA reactivity for blood group antigens on serial biopsies. These results suggest that the presence of readily detectable A, B, B antigens correlates with a favorable prognosis whereas their absence denotes an aggressive potential.

ABO Blood-Group System↗
PubMed1979

Toxic effects of di-n-octyltin dichloride on the thymus in mice.

The effects of di-n-octyltin dichloride (DOTC) on the thymus in mice were studied in dependence on the route of administration. Single administrations of 30, 60 and 120 mg/kg of DOTC i.m. induced a dose-related decrease of the thymus weight and of the number of nucleated cells in the thymus of male mice. 4 days after intravenous injection of 8 mg/kg of DOTC the thymus weight and the number of thymocytes were reduced to 50 percent of the control. In oral route of administration higher doses of DOTC (300 mg/kg) were necessary to provoke a thymus atrophy. After pretreatment of mice with carbon tetrachloride the toxic effects of orally administered DOTC were increased. The reduction of the thymus weight and of the number of thymocytes in mice after parenteral administration was accompanied by a depression of thymus-dependent antibody formation against sheep red blood cells.

Animals↗
PubMed1979

Scanning electron microscope and microprobe investigation of phosphate phases in uroliths.

In uroliths various phosphate phases can be detected which indicate different formation conditions. Structure and topography of the respective phosphate phases are characterized by scanning electron microscopy and microprobe techniques. Trace element enrichment is investigated and illustrated; for example, sulfur is found preferentially in carbonate apatite. From the distribution of the phosphate phases, conclusions can be drawn concerning the urolith genesis.

Crystallography↗
PubMed1979

Submicroscopic investigations on calcium oxalate stone genesis.

Scanning electron microscopy of calcium oxalate stones indicates a zonary structure of the Weddellite crystals of urine concrements which is due to concentration-dependent growth oscillations representing the precipitation of various calcium oxalate hydrates. In addition to the phenomenological demonstration of Weddellite crystal shapes, incubation experiments with different solutions give rise to the postulation of a dehydration process of primary Weddellite crystals via dissolution and recrystallization to Whewellite. The solvent attack starts at energetically preferred corners, edges and lattice disorders of the Weddellite crystals. The Weddellite-stabilizing role of urinary Mg ions is emphasized.

Calcium Oxalate↗