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Biomedical subjects

R Hans

Publications and source records attributed to R Hans.

6 recordsLinked to original sources
PubMed2000

Adenosine by aortic flush fails to augment the brain preservation effect of mild hypothermia during exsanguination cardiac arrest in dogs - an exploratory study.

Most trauma cases with rapid exsanguination to cardiac arrest (CA) in the field, as well as many cases of normovolemic sudden cardiac death are 'unresuscitable' by standard cardiopulmonary-cerebral resuscitation (CPCR). We are presenting a dog model for exploring pharmacological strategies for the rapid induction by aortic arch flush of suspended animation (SA), i.e. preservation of cerebral viability for 15 min or longer. This can be extended by profound hypothermic circulatory arrest of at least 60 min, induced and reversed with (portable) cardiopulmonary bypass (CPB). SA is meant to buy time for transport and repair during pulselessness, to be followed by delayed resuscitation to survival without brain damage. This model with exsanguination over 5 min to CA of 15-min no-flow, is to evaluate rapid SA induction by aortic flush of normal saline solution (NSS) at room temperature (24 degrees C) at 2-min no-flow. This previously achieved normal functional recovery, but with histologic brain damage. We hypothesized that the addition of adenosine would achieve recovery with no histologic damage, because adenosine delays energy failure and helps repair brain injury. This dog model included reversal of 15-min no-flow with closed-chest CPB, controlled ventilation to 20 h, and intensive care to 72 h. Outcome was evaluated by overall performance, neurologic deficit, and brain histologic damage. At 2 min of CA, 500 ml of NSS at 24 degrees C was flushed (over 1 min) into the brain and heart via an aortic balloon catheter. Controls (n=5) received no drug. The adenosine group (n=5) received 2-chloro-adenosine (long acting adenosine analogue), 30 mg in the flush solution, and, after reperfusion, adenosine i.v. over 12 h (210 microg/kg per min for 3 h, 140 microg/kg per min for 9 h). The 24 degrees C flush reduced tympanic membrane temperature (T(ty)) within 2 min of CA from 37.5 to approximately 36.0 degrees C in both groups. At 72 h, final overall performance category (OPC) 1 (normal) was achieved by all ten dogs of the two groups. Final neurologic deficit scores (NDS; 0-10% normal, 100% brain death) were 5+/-3% in the control group versus 6+/-5% in the adenosine group (NS). Total brain histologic damage scores (HDS) at 72 h were 74+/-9 (64-80) in the control group versus 68+/-19 (40-88) in the adenosine group (NS). In both groups, ischemic neurons were as prevalent in the basal ganglia and neocortex as in the cerebellum and hippocampus. The mild hypothermic aortic flush protocol is feasible in dogs. The adenosine strategy used does not abolish the mild histologic brain damage.

Adenosine↗
PubMed1996

Pre-septal cellulitis--varied clinical presentations.

Preseptal cellulitis has a typically benign course when treated with antibiotics, the clinical course depending on age of the patient, aetiology and the causative organism. In this study, 14 cases of preseptal cellulitis are documented with the age ranging from 2 to 55 years. The organisms isolated were Staphylococcus aureus (7 cases), Streptococcus pyogenes (2 cases) and Pseudomonas aeruginosa (1 case). In the remaining four patients no organism could be identified. All except four patients were cured within 6 weeks. Complications seen included lagophthalmos, lid abscess, cicatricial ectropion and lid necrosis in one patient each. The prognosis for preseptal cellulitis is good with appropriate antibiotics and surgical therapy.

Adolescent↗
PubMed1990

[Incidence of autonomy and immune hyperthyroidism before and following preventive use of iodized salt in the Berlin-Brandenburg area].

The incidence of hyperthyroidism was observed in the area of Berlin (1.2 million inhabitants) and in a rural district in the geographical region of the "Mark Brandenburg" (48.115 inhabitants) during the period from 1975 und 1989. This area is characterized with a iodine deficiency grade II (WHO). In 1985 an iodine salt supplementation was introduced by law. The period before iodine salt supplementation 1975-1985 was compared to the period after iodine prophylaxis: there was an increase in hyperthyroidism in the Berlin-area by the ratio 1:3.1 and 1:2.8 (1975-83 compared to 1988 and 1989), in the rural district by 1:1.7 (1980-1985 compared to 1986/87). The ratio autonomy (non immunogenic form) to immunogenic etiology was 1:12 (1977-83), and changed to 1:1.45 in 1988 and 1:16.3 in 1989 after iodine supplementation. The sex ratio male:female was 1:10 before, and 1:6.8 after prophylaxis for hyperthyroidism in total, in autonomy the ratio was observed as 1:12 before and 1:7.7 (1988), 1:4.7 (1989) after supplementation, in immunogenic hyperthyroidism 1:10 unchanged in the early and late period of observation. The increase of hyperthyroidism after iodine prophylaxis correlated well with the consumption of thyrostatic drug Thiamazol (Methimazol) for the whole country. The defined daily dose (DDD)/1000 inhabitants/day increased during the observation time from 0.5 (1984), 0.55 (1985), 0.66 (1986), to 1.47 (1987), 1.26 (1988) and 0.81 (1989). The results are compared and discussed with reports from USA, Iceland, Great Britain, Denmark, Italy and Tasmania. During the period of seven years (1980-87) in the rural district a seasonal dependence of onset in hyperthyroidism was observed in spring time between May and June only in immunogenic hyperthyroidism, despite in thyroidal autonomy the disease began throughout the year without a seasonal peak.

Berlin↗