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Biomedical subjects

R Grünewald

Publications and source records attributed to R Grünewald.

14 recordsLinked to original sources
PubMed2001

[Myocardial infarction during pregnancy].

Up to now 136 cases of myocardial infarction during pregnancy have been reported, and angiography revealed normal findings in 47%. In these cases coronary spasms have been discussed as the major mechanism of the disease. In isolated cases coronary artery dissection may also present with a normal coronary angiography. The case of a 31-year-old pregnant women who developed myocardial infarction during a caesarean section under spinal anaesthesia gives rise to the assumption that an early stage of coronary artery disease may be the third cause that has to be considered. Probably as a consequence of phases of tachycardia and hypertension during the course of anaesthesia, the patient developed a myocardial infarction that she survived without sequelae. While coronary angiography showed normal coronary vessels, an intravascular ultrasound study (IVUS) demonstrated an atheroma in the left main coronary artery with a ruptured fibrous cap. Laboratory screening for risk factors of coronary artery disease (CAD) showed hypercholesterinemia, increased factor VII activity and hyperfibrinogenemia. Platelet aggregation was not inhibited by acetylsalicylic acid. It was pointed out recently that even in asymptomatic patients, plaques may be present in coronary vessels indicating an early stage of CAD that cannot be diagnosed by angiography. Plaque rupture is often triggered by hypertension and may lead to myocardial infarction, instable angina pectoris, or sudden ischemic death. As IVUS is a new diagnostic tool that allows diagnoses of even early stages of CAD we believe that myocardial infarction during pregnancy is more often caused by plaque rupture than may be expected according to the current literature.

Adult↗
PubMed1999

[Inadvertent potassium chloride infusion in an epidural catheter].

In a 65 years old male patient 38 cc of a 7.45% potassium chloride-solution was inadvertently infused within 3 hours into an epidural catheter on the first postoperative day. The epidural potassium chloride administration resulted in a paresis and painful paraesthesia of the patient's legs and a level of sensory blockade to TH 11. Furthermore vegetative symptoms like hypertension and tachycardia were observed. For therapy a single bolus of 40 mg dexamethasone was administered intravenously followed by an epidural infusion of sodium chloride 0.9% 99 cc/h for several hours. About 6 hours after the start of infusion all symptoms had disappeared. It is proposed that the use of colour-coded epidural catheter devices and coloured electrolyte solutions as well as infusion-pumps with a larger reservoir that reduce the frequency of syringe changes would be helpful in avoiding such complications.

Aged↗
PubMed1995

Mycobacterium conspicuum sp. nov., a new species isolated from patients with disseminated infections.

A new type of slowly growing, nonphotochromogenic mycobacterium was recovered from two patients with disseminated disease. The growth characteristics, acid fastness, acids were consistent with those for Mycobacterium species. The results of biochemical investigations, lipid analyses, and comparative 16S rRNA sequencing showed that these isolates represent a new slowly growing Mycobacterium species which is named Mycobacterium conspicuum.

Adult↗
PubMed1988

[Internal medicine treatment of pleural empyema].

We made a retrospective analysis with regard to the bacteriology and to the therapy of all patients with pleural empyema who were treated in the district lung hospital from 1. 1. 1982-31. 12. 1986. 92 patients had a non-specific empyema, only 3 patients had a specific empyema. All patients were aspirated repeatedly with physiological saline solution instillation and antimicrobic drug instillation in the pleural cavity. This daily aspiration and lavage was successfully in 65 patients. This method was ineffective in 30 patients. We treated 7 patients of this group by the closed drainage (rubber-tube drain), in 4 patients successfully. 3 patients had to be treated by a surgical operation. An insufficient obliteration of the cavity of empyema occurred also in 23 patients of this group. A systematic daily aspiration for a longer time led to regression of the cavity in 4 cases, whereas a surgical operation was necessary in 19 patients. We consider the daily aspiration and lavage as an effective method in patients in early acute stages of empyema.

Bacterial Infections↗
PubMed1986

[Aspergillus pneumonia].

Aspergilluspneumonia means a form of pulmonary aspergillus infection invading tissue and accidentally vessels of the lung. Because of lacking of typical clinical and roentgenological signs diagnose finding is realized by evidence of fungi (histology, culture, serology). From 87 aspergilloses 60 could staged as aspergillomas by the x-ray pictures. 27 cases were bronchiectases, carcinomas, bacterial pneumonias with aspergillus or pneumonias without other lung disorders and agents other than aspergillus. The difficulty to ensure the "pure" aspergilluspneumonia (invasive type) is pointed out, when histological proof is lacking. The therapeutical possibilities are discussed.

Aged↗
PubMed1985

[Comparison of various methods for the identification of pneumococci based on optochin sensitivity].

The sensitivity against optochin of 491 strains of Streptococcus pneumoniae respectively alpha-haemolytic Streptococci was tested in optochin-plate-method and in the diffusion-test. Discs impregnated and used in wet condition and dry discs prepared in one of the participating laboratories were equal in their efficiency. The differentiation of Streptococcus pneumoniae and alpha-haemolytic Streptococci is possible by the disc-diffusion method using the following limit of inhibition zone. Streptococcus pneumoniae diameter of inhibition zone greater than 15 mm alpha-haemolytic Streptococci diameter of inhibition zone 0-15 mm The industrial production of optochin-discs can be recommended.

Bacteriological Techniques↗
PubMed1976

[Comparison of the efficiency of a modified Ogawa medium and the media used for culture investigation on tuberculosis in routine (author's transl)].

In cooperation of nine laboratories a modified Ogawa medium containing asparagine was compared with the media used in the GDR for culture investigations on tuberculosis in routine [German Pharmacopoeia (diagnostic laboratory methods) GDR]. The efficiency of the modified Ogawa medium containing asparagine instead of sodiumglutamate was comparable to that of the original Ogawa medium and did not show any better results. By this means it is once more evident that Ogawa medium is an efficient medium for culture on tuberculosis. It is less liable to contamination and easily to be prepared.

Asparagine↗
PubMed1976

[The evidence of precipitins in Aspergillus caused disorders of the lung as a diagnostic method (author's transl)].

A report is given about serologic results of 27 aspergilloses, mostly aspergillomas. The evidence of antibodies directed against aspergillus species was carried out by radial diffusion according to OUCHTERLONY and immunoelectrophoretically. Filtrate antigens ("metabolic antigens") were used troughout. The positive yield lies in about 90%. Regarding the criteria for evaluation no positive reactions were seen in a control group of 140 patients with serious tuberculosis and other lung disorders. The method is emphasized as diagnostic mean for clearing up shadows of the lung and for pathogenetic control of aspergillus--grown from lung materials.

Adult↗
PubMed1976

[Hygienic problems during sputum provocation by aerosol (author's transl)].

An apparatus assembly is described providing hygienic conditions to obtain sputum after aerosol inhalation. It is composed of an ultrasonic nebulizer and a half-opened exhausting hood. The patient's head is placed under the hood which inhibits the delivery of expectorated germs into the environmental space. A continuous air flow in the direction of coughing is leading the sputum particles (droplet nuclei) towards a filter system. After decontamination the air may be let off outwards or back into the room.

Aerosols↗