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Biomedical subjects

T Hürter

Publications and source records attributed to T Hürter.

At least 19 recordsLinked to original sources
PubMed1998

[Asthma and rhinoconjunctivitis caused by castor bean dust].

A 57 years old trader of agricultural goods with chronic asthma had attended our medical department for diagnosis and therapy. Since more than 35 years the patient had always experienced work-related asthma episode and rhinoconjunctivities when he worked in workplace where castor-bean oil cake as fertilizer was sold. With the intensive contact with castor-bean containing goods beginning about eight years ago, his asthma attack had become chronic. The allergological diagnosis confirmed that he had high-degree type I-allergy to castor-bean allergens.

Agricultural Workers' Diseases↗
PubMed1994

[Increasing physical endurance with salmeterol].

10 patients with mild to moderate chronic obstructive pulmonary disease were assessed by lung function tests at rest and spiroergometry before and 1 resp. 7 hours after inhalation of 50 micrograms salmeterol. The parameters changed as follows: Forced exspiratory volume in 1 second: +16% +/- 6% after 1 resp. +13% +/- 5% after 7 hours; airway resistance: -43% +/- 11% resp. -43 +/- 9%. Work capacity at the anaerobic threshold (AT): +44% +/- 17% resp. +37% +/- 16%, oxygen consumption at the AT (VO2AT): +53% +/- 18% resp. +54 +/- 23%, ventilation at the AT (VEAT): +31% +/- 11% resp. 30% +/- 7%. Maximum work capacity: +14 +/- 5% resp. +22 +/- 7%, maximum oxygen consumption (VO2max) +58 +/- 24% resp. 64 +/- 22%, maximum ventilation (VEmax) +33 +/- 10% resp. + 46 +/- 11%. In conclusion, salmeterol leads to a long lasting improvement of exercise capacity. This is related to the improvement of the ventilation caused by salmeterol. Significant changes of heart rate or blood pressure were not observed.

Administration, Inhalation↗
PubMed1992

[Metal endoprostheses for endoscopic therapy in malignant bronchial tumors].

Self-expanding metal stents were implanted in the trachea or main bronchus in 12 patients (eleven men, one woman; mean age 60 +/- 8 years) with nonresectable bronchial carcinoma (n = 11) or tracheal metastasis of a hypernephroma (n = 1). They all had pulmonary complications caused by tumour stenoses (group I: severe dyspnoea [n = 6], group II: retention pneumonia [n = 4] or lung abscess [n = 2] after unsuccessful antibiotic treatment). The procedure was undertaken after local anaesthesia with a flexible bronchoscope (in the first three cases still with a rigid bronchoscope under general anaesthesia) under fluoroscopic control. Immediate reduction in dyspnoea occurred in five of the six patients in group I. In five of the six patients in group II antibiotics cured the infection after stent placement. The therapeutic effect was immediate in severe dyspnoea and retention of secretions. The clinical improvement lasted longer in patients with abscess and retention pneumonia than those with dyspnoea (41 +/- 16 vs. 26 +/- 10 days). If strict indications are observed in cases with malignant bronchial stenosis, implantation of self-expanding stents provides rapidly effective, well-tolerated palliation.

Aged↗
PubMed1992

[Physical exercise tolerance in chronic obstructive emphysematous bronchitis and coronary heart disease under antiobstructive therapy].

19 consecutive patients (18 men, one woman, mean age 61.4 [49-73]years) with chronic obstructive airways disease (bronchitis and emphysema) together with angiographically confirmed coronary heart disease were studied to investigate their cardiopulmonary exercise tolerance and the effects of bronchodilators on their myocardial ischaemia. Because they were receiving drug therapy for angina or because they had previously undergone aortocoronary bypass operation or balloon dilatation, the patients were symptom-free. In three cases slight ischaemia was demonstrable during maximal exertion. Aerobic and anaerobic exercise capacity was determined by spiroergometry after inhalation of salbutamol (S, 0.2 mg) alone or in combination with oxitropium bromide (O, 0.2 mg). The supplementary effect of oral theophylline (T, 15 mg/kg.day) was studied in 13 patients. In terms of maximal aerobic exercise tolerance the following improvements were noted: energy output (watts): S: + 6.3%; S and O: + 12.3% (P < 0.05); S, O and T: + 14.0% (P < 0.01). Oxygen uptake (ml/min): S: + 8.2% (P < 0.05); S and O: + 18.2% (P < 0.01); S, O and T: + 35.4% (P < 0.01). Maximum exercise capacity was not significantly improved, although maximum oxygen uptake was significantly increased by the two-drug combination by 16.9% (P < 0.05) and by the three-drug combination by 19.2% (P < 0.05). Maximum minute volume and tidal volume rose significantly, though respiratory rate was unchanged. Heart rate and blood pressure remained practically unaffected by the treatment, both at rest and during exertion. There was no evidence of significant aggravation of ventricular arrhythmias or of ischaemia during ergometric testing.

Albuterol↗
PubMed1992

Endobronchial sonography: feasibility and preliminary results.

Endobronchial sonography, a new ultrasound technique, has been evaluated for the assessment of normal lungs and bronchial carcinomas. The procedure was performed with ultrasound catheters, which were introduced into central and peripheral bronchi through the operating channel of fibreoptic bronchoscopes. The bronchial wall is highly echogenic and laminated. The lung parenchyma appears echo rich and patchy. Pulmonary arteries can be identified by the pulsatile changes and floating echoes within the echo free lumen. Echo poor bronchial carcinomas were detected in 69 out of 74 patients with endoscopically visible tumours and in 19 out of 26 patients with peripheral carcinomas. The correct implantation of metallic stents was facilitated by endobronchial sonography in nine patients. The sonographic examination carried no particular risk and caused little discomfort.

Adult↗
PubMed1992

Fibrosing alveolitis responsive to corticosteroids following Legionnaires' disease pneumonia.

Two male patients ages 54 and 58 years had persisting pneumonia with dry cough, dyspnea, weight loss, and fever up to 39 degrees C that did not respond to erythromycin treatment. There was extensive restrictive impairment of ventilation and loss of diffusing capacity for carbon monoxide. Histologic examination of the basal pulmonary infiltrates showed fibrosing alveolitis. Serologic titers indicated that the patients had suffered from Legionella pneumophila infection. We believe that Legionella had caused the fibrosing alveolitis since there was absence of any other causative agents or factors. Both patients responded to corticosteroid treatment with rapid clinical improvement but delayed radiologic regression.

Humans↗
PubMed1991

[The implantation of self-expanding metal prostheses (stents) into the bronchial system in central neoplasms].

This paper reports the use of an endobronchial metallic prosthesis (wall stent) for palliative management of 6 patients with central neoplasms and life-threatening airway obstruction. In five of six patients implantation of the stent resulted in improvement of their dyspnoea. However, functional data showed only a slight amelioration. In case of endobronchial growth, tumour may protrude easily through the meshwork of the stent. Therefore, use of the stent in these patients only seems appropriate if combination with other forms of therapy (radiation, laser) is possible. The easy feasibility of stent implantation and the lack of severe side effects and migration indicate that the stent may be an effective means in patients suffering from peribronchial tumour compression.

Airway Obstruction↗
PubMed1991

[Bronchial endoprostheses (stents) in inoperable bronchial carcinoma].

Three patients suffering from bronchial carcinoma with severe bronchial obstruction have been successfully treated by implantation of metallic stents. Two of them suffered from peribronchial tumor growth while the third one complained about dyspnoea caused by the instability of the central airways. Stents were implanted into the left main bronchus or the intermediate bronchus either through a flexible bronchoscope under local anaesthesia and sedation or through a rigid bronchoscope under general anaesthesia. The successful dilatation of the stenosis could be demonstrated by bronchography. The patients tolerated the stents well. We found no dislocation, deformation or ulceration of the bronchial mucosa. The implantation of metallic stents thus seems to offer new possibilities for the palliative treatment of bronchial carcinoma.

Aged↗
PubMed1991

[Myocarditis caused by Toxoplasma gondii and Aspergillus fumigatus after orthotopic heart transplantation].

This report describes the case of a 56-year-old patient, who died 53 days after orthotopic heart transplantation due to myocarditis caused by infection with Aspergillus fumigatus and Toxoplasma gondii. Aspergillosis was diagnosed by transthoracic needle aspiration of a pulmonary infiltration. Endomyocardial biopsy showed toxoplasma pseudocysts. Autopsy revealed myocardial infection with both infectious agents. Despite specific therapy, myocarditis determined the fatal outcome in this case. The value of invasive techniques for specific diagnosis of infectious diseases in immunocompromised patients is discussed.

Aspergillosis↗
PubMed1990

[Endobronchial sonography in the diagnosis of pulmonary and mediastinal tumors].

Endobronchial sonography was performed during bronchoscopy in 58 patients (48 males and 10 females; mean age 59 [29-76] years) with confirmed pulmonary or mediastinal tumour using a 6.2 or 9 F ultrasound catheter. The procedure was successfully performed in 50 patients from the trachea down to the smallest bronchi (of 2 mm diameter). Tumour tissue was not visualized in five patients with small peripheral carcinomas. In three patients the catheter probe could not be passed through the tumour region. The method provided a three-dimensional image of the bronchial wall, corresponding to the histological tissue layers of mucosa, cartilage and adventitia. Pulmonary arteries were identified by the echo-free lumen and pulsatile oscillations in calibre. Tumours and lymph-nodes were echo-poor and could thus be distinguished from the echo-rich bronchial wall. Several consequences arose from these findings: laser treatment was not proceeded with in two cases, because a fairly large pulmonary artery lay near the stenosis; in three cases malignant tumours were recognized to lie either entirely intramurally or peribronchially, which had not been seen on bronchoscopy alone. It is concluded from these preliminary observations that endobronchial sonography is a highly promising addition to conventional bronchoscopy.

Adult↗
PubMed1990

Possible involvement of the retinoblastoma gene in undifferentiated sinonasal carcinoma.

Retinoblastoma tumor formation is initiated by the loss of function of both alleles of the RB-1 gene on chromosome 13. Patients with the hereditary form of retinoblastoma carry a germ line mutation at one of the two homologous gene loci in all cells and have an increased risk for nonocular tumors (mainly osteosarcoma and other mesenchymal tumors) in later life. The authors studied a 38-year-old patient with sinonasal undifferentiated carcinoma (SNUC) who had been treated for bilateral retinoblastoma by enucleation (left eye) and irradiation (right eye), respectively. Using molecular probes for the RB-1 gene and other loci on chromosome 13, the authors detected a deletion at the RB-1 locus in metastatic SNUC cells that was not present in normal tissue. These findings indicate that somatic mutations at RB-1 locus may be involved in the formation or progression of ectodermal tumors.

Adolescent↗
PubMed1990

[Persisting alveolitis after Legionella pneumonia].

Pneumonia was diagnosed radiologically in three patients (43, 54 and 58 years old, respectively), presenting with temperatures between 39 degrees and 40 degrees C, cough and weight loss. These signs persisted for 6, 7 and 13 weeks, respectively, but the pathogens could not be cultivated. Lung function analysis showed partial respiratory insufficiency with extensive restrictive impairment of ventilation. Samples of lung tissue were obtained in all three cases and histology revealed fibrosing alveolitis. In two patients serology yielded antibody titres of 1:512 and in one patient of 1:128, against Legionella pneumophila. Treatment with 1 g erythromycin three times daily was unsuccessful. Therefore, the patients were given prednisone at an initial dosage of 50-100 mg which was subsequently reduced. Lung function normalised during this treatment course, radiological findings and antibody titres receded. Hence, treatment with corticosteroids should be attempted if there is an urgent suspicion of fibrosing alveolitis caused by Legionella pneumophila, after having excluded a florid infectious pneumonia and after failure of erythromycin treatment.

Adult↗
PubMed1990

[Phagocytosis of Staphylococcus aureus and Pseudomonas aeruginosa by pulmonary neutrophilic granulocytes].

The elimination of Staphylococcus aureus (S. a.) and Pseudomonas aeruginosa (P. a.) by pulmonary neutrophilic granulocytes was investigated in vitro. The elimination rate of P. a. is appreciably smaller than that of S. a.. The reason for this is apparently a reduced degree of phagocytosis of P. a. in consequence of the slight adherence to the granulocyte membrane. The liberation of oxidants differs only to a negligible degree.

Bronchoalveolar Lavage Fluid↗
PubMed1990

[Reproducibility of differential bronchoalveolar lavage cytology in sarcoidosis in relation to elapsed time between bronchoalveolar lavage and sample processing].

The physiological saline solution that is usually employed for BAL is not suitable as a storage medium for BAL cells for any longer period of time: even when cooled to 4 degrees C, the lymphocyte component decreases significantly after a latency period of 24 hours. With respect to the differential cytology performed on BAL fluid, the tissue culture medium RPMI 1640 + 5% AB serum can be employed as a storage medium. But even with this medium, a very clear reduction in the total cell count in BAl is seen at 24 hours.

Bronchoalveolar Lavage Fluid↗
PubMed1989

[Phagocytosis of Staphylococcus aureus and Pseudomonas aeruginosa by pulmonary macrophages and granulocytes].

The elimination (by human alveolar macrophages and pulmonary granulocytes) of one laboratory strain and one wild-type strain each of Staphylococcus aureus and Pseudomonas aeruginosa has been investigated in vitro. Administering 10(6) alveolar macrophages to 5 x 10(6) staphylococci leads to a reduction of viable colony-forming units (CFU) to 5.8 x 10(5) (L] (laboratory strain (L) and 6.9 x 10(5) (wild-type strain (W)) after 60 minutes. The corresponding values of Ps. aeruginosa are 4.3 x 10(6) (L) and 4.4 x 10(6) (W). The peak chemiluminescence values are 9, 160 (L) and 12,300 (W) counts/10(5) cells for Staph. aureus and 7,670 (L) and 8,950 (W) for Ps. aeruginosa. The addition of heat-inactivated serum increases the number of staphylococci observed within alveolar macrophages from 1.57 to 3.18 (L) and from 1.32 to 2.79 (W). Fresh serum enhances ingestion to 8.15 (L) and 9.73 (W) staphylococci/macrophage. The number of phagocytized pseudomonads in pure culture medium is 0.51 (L) and 0.46 (W) bacteria/macrophage. An increase by the addition of serum is not possible. While staphylococci adhere to the membrane of the macrophage over a wide area, the pseudomonads adhere to it in a highly circumscribed manner. The following ingestion steps do not differ from one organism to the other. After 60 minutes, cultivation of 10(6) granulocytes with 5 x 10(6) staphylococci leads to a reduction of the viable CFU to 7.5 x 10(5) (L) and 9.4 x 10(5) (W). In the case of Ps. aeruginosa, the number of surviving CFU is 4.5 x 10(6) (L) and 3.8 x 10(6) (W). After the addition of Staph. aureus, peak values of 37,800 (L) and 35,500 (W) counts/10(5) cells are measured. The corresponding values for Ps. aeruginosa are 28,900 (L) and 33,100 counts/10(5) cells (W). The addition of heat-inactivated serum leads, in the case of Staphylococcus aureus, to an increase in the ingestion of the laboratory strain from 1.07 to 1.94 and of the wild-type strain from 0.94 to 2.41 bacteria/granulocyte. Fresh serum brings about a further increase to 5.52 (L) and 4.82 (W). In the case of Ps. aeruginosa. 0.75 (L) and 0.69 (W) ingested bacteria/granulocyte are observed; the addition of serum fails to bring about any increase. In contrast to the staphylococci, pseudomonads adhere to the granulocyte membrane in a punctate manner only. No differences of ingestion are seen.

Bronchoalveolar Lavage Fluid↗
PubMed1989

[Disorders of intestinal absorption in patients treated with cytostatic chemotherapy].

We have investigated the acute and chronic side effects of cancer chemotherapy on the intestinal absorption of adult patients with neoplastic diseases. D-xylose absorption was reduced by 35% in 34 of 50 patients within 48 hours after one course (p less than 0.001), while the vitamin B12 absorption was diminished by 41% in 27 of 38 patients (p less than 0.001). The serum digoxin level fell in 7 of 8 patients by 43% at the first day (p less than 0.01) and normalized after one week. Electron microscopy of the jejunal biopsy specimens revealed damages of the microvilli and defects in the glycocalix. Chronic effects, which were measured after several courses and a pause of four weeks, showed a diminished D-xylose absorption of 36% in 16 of 19 cases (p less than 0.01). Vitamin B12 absorption was reduced by 37% in 11 of 13 patients (p less than 0.01). Microscopical investigations of the jejunum revealed a shortening of the villi and a destruction of microvilli. Acute and chronic malabsorption after cancer chemotherapy should be considered in patients, who are treated with enteral medication and nutrition.

Adult↗