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Biomedical subjects

R H Brandt

Publications and source records attributed to R H Brandt.

At least 19 recordsLinked to original sources

[Monitoring respiratory and circulatory parameters in comparing various jet ventilation procedures].

Reported is a system of apparatures to control characteristic changes of cardiorespiratory function during different methods of endoscopic ventilation. The aim of the study is to measure and record simultaneously and continuously ECG, thoracic movement, tracheal pressure, pulmonary artery pressure and arterial oxygen pressure using transcutaneous technique. Measurements of arterial blood pressure and blood gas analysis (PaO2, PaCO2, BE, HCO3-, pH) are carried out in intervals. Four different methods of injector-ventilation are compared with the conventional laryngoscopic ventilation on the basis of a test program. Laryngoscopic ventilation as well as injectorventilation by CARDEN-Tubus make it possible to achieve a hyperoxaemic situation by normofrequent ventilation. Despite of hyperventilation it is not possible in every case to achieve an increased capillary oxygen pressure of 200 to 300 mm Hg by injector-ventilation with Venturi effect because of a smaller oxygen proportion. In jet-ventilation with N2O/O2-mixture (3:1) there is no appreciable hyperoxia, but a small reduction of systemic arterial blood pressure. With all techniques of mechanical respiration usual middle intratracheal pressure of respiration was not exceeded. Traumatic pressure of jets was only indirectly shown in steep rises of pressure by the applied technique of measurement.

Adult↗

[Characterization of different IPP-ventilation systems by measuring technics].

To characterize the essential values of function and capacity for the comparison of different ventilation systems, a system of measurements is described which uses the following values: initial gas pressure and proportion of oxygen; jet tubes: flow area and jet pressure at a distance of 10 and 20 or 25 mm; ventilation volume and pressure, and oxygen content in a half-open lung model. Description of results with 8 ventilation systems which are applied in the practice of different institutions.

Humans↗

[Differential diagnosis and therapy of abnormalities of the respiratory tract].

Congenital disorders of respiration, food intake and function of the voice indicate abnormalities in the rhinolaryngotracheal or oesophageal regions of the air passages and oesophagus. They immediately need differential diagnostic clarification in interdisciplinary cooperation. Methods of a sophisticated tubus endoscopy, applied also under emergency situations, play a vital role. The therapy aims at eliminating life-threatening ventilation disorders within a short time by pharyngotracheal intubation and within a longer period by tracheostomy in order to let prenatally inhibited developments postnatally come into effect, if need be to support these differentiation processes by endoscopic interventions or to perform plastically constructive operations at a prognostically convenient time.

Abnormalities, Multiple↗

[Changes in vital functions in endoscopic interventions by various anesthesia and ventilation conditions].

Three different mixed anaesthesias were compared and monitored as for the behaviour of vital functions (heart frequency, RR, ECG, respiration, pO2tc, blood gases) during endoscopy of the air passages in 3 patient groups (n = 36), using one complex measuring set-up. Hypertonic blood pressure rises and increase in the heart frequency were regularly demonstrated in all methods of anaesthesia. Initial cardiac depression with a drop of frequency and blood pressure was observed for the first time within the first minute after the injection of Hexobarbital or Radenarcon in 70 per cent of the cases. The Radenarcon-succicuran-O2 combination showed the highest rate of arrhythmia. Significantly high pO2 levels (400 torr) were attained only under pure oxygen respiration and in no case with nitrous oxide or room-air oxygen mixtures (injector respiration). The time of apnoea could be extended maximally without danger signals, provided the supply of oxygen was accordingly high.

Acid-Base Equilibrium↗

[Correlation of invasive and transcutaneous determination of capillary 02 partial pressure in ventilation endoscopies].

Transcutaneous oxygen-partial-pressure-measurement of the capillary system has proved to be a successful and reliable monitoring method, also under extreme conditions of a respirating-endoscopy with pure oxygen. The feasibility of continuous recording on an ECG-recorder with good coincidence with bloody measurements can be appreciated as being very advantageous. In unphysiological high oxygen-pressure-ranges the disadvantage of the withdrawal-caused error of the bloody determination is avoided with the transcutaneous method which delivers real values.

Blood Gas Analysis↗

[Combined endoscopic-endographic diagnosis of the larynx and trachea with contrast medium powders].

The endographic examination by means of pulverized contrast media such as tantalum or visotrast acid has proved to be appropriate in laryngotracheobronchial diseases as a simple and safe, endoscopy-complementing method. It gives diagnostic radiological information in addition to endoscopic, orthograde evaluation by the frontal and sagittal image of the organ in which details of the structure and alterations can be detected. In 170 different examinations of the organ no threatening side-effects could be observed, even not in cases of remarkably obstructive changes. When giving contrast media containing iodine any known iodine allergies should be avoided, despite the water-insolubility of the complex iodine compound.

Diatrizoate↗

[The control of chronic laryngitis by endoscopic and histomorphologic methods (author's transl)].

Long time endoscopic-bioptic of 111 patients with chronic laryngitis made it possible to state cancer of the larynx in 12 patients. The diagnosis was made in the prognostically favourable stages T1 and T2N0M0 provided the controls were carried out immediately, considering histomorphologic degrees of malignancy (KLEINSAZSSER). A dispensaire of patients with increased risk cancer of the larynx can considerably improve early diagnosis in collaboration between family physician, specialist and special clinic applying speculum-examination of the larynx, laryngoscopy in general anaesthesia and microlaryngoscopy, as described by HEROLD for the district of Magdeburg (1964--1974).

Biopsy↗

[Vaccinations therapy of laryngeal papillomatosis (author's transl)].

Our experiences with 49 cases of laryngeal papillomae of which 22 were submitted to a vaccine therapy are encouraging. 1. Tracheotomy as a remedial and therapeutic procedure is dispensable by ablation of papillomae in respiratory-laryngoscopy. 2. Additional application of a virus-vaccine contributes to healing by reducing the frequency of ablations. In few cases papilloma healed without endo-surgicals ablations after application of vaccine Charge 4. 3. 4 in 11 cases with delayed or complicated healing processes, a part of them after papillomatosis lasting for decades, could surprisingly be cured. In 2 females laryngectomy had finally to be carried out because of the development of laryngeal cancer, with and without preceeding vaccination, respectively. 4. Side-effects during and after vaccination could not be stated, five years ago. 5. We think vaccination to be an effective complement of the wellproved surgical ablation of papillomae under optimal endoscopical working conditions.

Female↗

[First experiences with a new electroaerosolgenarator produced by VEB TuR Dresden (author's transl)].

First clinical experiences with a new developed electroaerosolgenator connecting with an ultrasonicaerosolgenerator are described. Propositions of corrections concern the material of the inonizating tube, which be produced of non fragile plastics and the position of exhalationway. By ionometer measuring we found a directly relation between chargetransport and inhaled volume and the particleconcentration. The transportcapacity was measured by 110.10(-9) Coulomb (C) per ml. One aerosolparticle of 1 micrometer carried more than 100 elementary charges.

Aerosols↗

[Clinical treatment of tracheoesophageal fistulas due to foreign bodies (author's transl)].

Swallowed foreign bodies, fixed in the esophagus, are not uncommon in childhood. Their symptoms, complications, diagnosis and treatment are discussed. An expectant attitude is justified in regard to smaller fistulas and in big fistulas due to foreign bodies up to the remission of the localized inflammatory reaction. The present surgical methods are reviewed in the light of recent literature and a case study of a child cured by segmental resection of the trachea.

Child↗

[Immunotherapy of laryngeal papillomatosis (author's transl)].

14 children and adults suffering from laryngeal papillomatosis were treated with an inactivated tissue culture virus vaccine. The vaccine was produced from a virus of the papova group isolated out of juvenile laryngeal papillomatosis. In all vaccinated patients, objective regression of tumor mass was observed, mostly without any operative procedure. In 5 patients even with an operation microscope no residula papillomatous tissue could be seen after treatment. In 7 patients with laryngeal papillomas which had been treated for years by repeated surgery, immunotherapy induced regression of 6-12 months duration. Thereafter, recurrences were found which were clinically silent but visible by microscopy. A second vaccination was succesful in 8 of 10 patients. The vaccine treatment showed no side effects.

Adult↗