[Neurofibromatosis and spinal deformities--a case report].
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Adult↗
Biomedical subjects
U Pfeiffer
Publications and source records attributed to U Pfeiffer.
[Prognostic factors in the indication for labor induction after previous delivery by cesarean section].
The relative importance of prognostic factors in the management of delivery after caesarean section was investigated retrospectively in 300 patients who gave birth between January 1984 and April 1986. Important factors included the parity of the patient (p less than 0.0001), the number of previous caesareans (p less than 0.001), the Bishop's Score on admission (p less than 0.005) and the indication for the previous caesarean section (p less than 0.05). On our series gestational age (p = 0.042) and estimated birthweight (n.s.) were only marginally statistically significant.
Birth Weight↗
[Hip-lumbar extensor tightness--equivalent of a nerve root irritation syndrome in the adolescent].
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Adolescent↗
Myocardial salvage prior to emergency coronary bypass surgery for PTCA-induced coronary occlusion.
The possibility of prolonged, selective coronary perfusion via angioplasty catheters was evaluated. A pump was developed featuring minimal hemolysis even at high pump pressures. Pressure requirements differed greatly between various catheter types. Catheter-induced hemolysis did not correlate with pump pressure and was mainly due to a turbulent jet effect through sideholes. In 20 of 22 closed-chest dogs, myocardial ischemia could be greatly reduced or completely prevented for over 2 hours after proximal LAD or Cx occlusion. With flow rates between 1 and 2.5 ml/min/kg body weight and using the ECG and coronary venous O2 saturation for rate adjustment, pressure within the selectively perfused vessel never reached critical values. Thus, with the appropriate equipment, prolonged coronary perfusion is feasible. In some cases of percutaneous transluminal coronary angioplasty-(PTCA) induced coronary occlusion, it may prevent ischemic myocardial damage between PTCA-induced acute coronary occlusion and subsequent surgical revascularization.
Journal Article↗
[Selective continuous coronary perfusion via an angioplasty catheter following acute vascular occlusion].
Since surgical revascularisation after PTCA-induced acute coronary occlusion in the majority of cases is delayed by at least 2 hours, we assessed the possibility of selective, volume-controlled coronary perfusion via the still indwelling angioplasty catheter for such a prolonged period using an external pump. Because of the high pressures required to provide adequate flow through many of the currently used catheters, an AC independent, pressure and volume controlled pump was developed which does not cause substantial hemolysis even at pressures beyond 10 atm. During in vitro tests the pressure-flow-rate relations and the degree of hemolysis and blood count changes were determined for various catheters. The previous catheters with a fixed wire tip caused excessive hemolysis which rendered prolonged coronary perfusion prohibitive. But even with the more recent catheters the presence of side holes near the catheter tip may at times cause significant hemolysis. In 20 out of 22 dogs the anterior descending (n = 18) or circumflex (n = 2) coronary artery was selectively perfused for 2 hours following balloon occlusion. The perfusion rate was adjusted according to the occurrence of ischemic signs in the ECG and for a drop in the coronary venous oxygen saturation which was monitored with a fiberoptic catheter. The intraluminal pressure within the selectively perfused vessel was recorded continuously but not used for adjustment of the perfusion rate. In no case was there a critical pressure increase in the selectively perfused vessel. When perfusion of the occluded vessel was stopped after 2 hours, massive myocardial ischemia developed which was reversible with resumption of perfusion. Using an adequate pump and the more recent, steerable angioplasty catheters which should not have side holes near the tip, selective coronary perfusion can be performed for at least 2 hours and is capable of preventing myocardial ischemia.
Angioplasty, Balloon↗
[Compounds with anti-gastric secretion and antiulcer activity. V. Derivatives of 3,3,4a,6,7,11b-hexahydro-2H,5H-benzo [1,4]cyclohep[1,2-b][1,4]-oxazine and related products].
A series of hexahydrobenzo[3,4]cyclohept[1,2-b][1,4]oxazines, with different substituents at the benzene and oxazine rings and nitrogen atom, was synthetized. The diastereomers and enantiomers of the unsubstituted compound and the related derivatives hexahydrobenzo[5,6] and exahydrobenzo[6,7]cyclohept[1,2-b][1,4]oxazine, hexahydro[1]benzoxepine and hexahydro[1]benzothiepin[5,4-b][1,4]oxazine, octahydrobenzo[3,4]cyclohept[1,2-b][1,4]diazine were also prepared. Some of these compounds inhibited at low doses gastric secretion in pylorus-ligated rats and antagonized ulcers in pylorus-ligated rats plus acetylsalicylic acid and in cold+restraint-stressed rats. When the most active compounds were tested on cats with Heidenhain pouch, they induced unwanted side effects that ruled out further development of these chemical series.
Animals↗
Influence of the beta-1 selective blocker, metoprolol, on the development of pulmonary edema in tocolytic therapy.
Research on one group of nine anesthetized dogs pretreated with alpha-naphthyl-thiourea showed that doses of the beta-sympathicomimetic fenoterol such as those normally administered in clinical tocolysis (2 micrograms/kg per minute) lead to significant fluid displacement to the extravascular space of the lung in the sense of a preclinical interstitial edema. In a second group (N = 9) with the same pretreatment the addition of the beta-1 selective blocker, metoprolol (1.5 micrograms/kg per minute) served to antagonize the hemodynamic changes and possibly the increase of pulmonary capillary permeability induced by the beta-mimetic. Fluid displacement into the interstitium of the lung was prevented by metoprolol. These observations corroborate the hypothesis that pulmonary edema occurring during tocolytic therapy is largely a result of the use of beta-mimetics. In addition to its cardioprotective effect, the administration of the beta-1 selective blocker, metoprolol, may reduce the risk of the development of pulmonary edema in beta-sympathicomimetic therapy for premature labor.
Animals↗
[Improved occlusion tolerance time by continuous coronary perfusion with a modified Grüntzig coronary angioplasty catheter].
We evaluated the modified Grüntzig coronary angioplasty catheter, which allows for continuous antegrade coronary perfusion during balloon occlusion without the use of an external pump. During in vitro tests the flow rates for effective pressure differences between aorta and distal coronary vessel in the range between 25 and 100 mm Hg were determined. During in vivo tests in 10 dogs the effect of balloon occlusion with continuous perfusion (OM) was compared with conventional occlusion without perfusion (OC). The occlusion tolerance time (OTZ) as determined by the appearance of unequivocal signs of ischemia in the ECG, was 486 +/- 77 s for OM versus 256 +/- 82 s for OC with a relative, individual increase of 191 +/- 54% (p less than 0.01, data are given +/- SEM). Observed ST-elevation was less with OM than with OC (0.22 +/- 0.05 versus 0.33 +/- 0.06, p less than 0.05). Occlusion related pressure difference between aorta and occluded coronary vessel was less with OM than with OC (31 +/- 8 mm Hg versus 40 +/- 10 mm Hg, p = 0.05). In selected cases such a prolongation of the intracoronary balloon occlusion time may represent a distinct advantage.
Angioplasty, Balloon↗
Low colloid osmotic pressure improves liver preservation in the model of the isolated perfused guinea pig liver.
In order to study the effect of two perfusion solutes with a different oncotic level on the preservation of the isolated liver, we perfused 14 guinea pig livers with a modified KREBS-HENSELEIT buffer with either 3%- or 6% bovine albumin. The release of four selected plasma proteins, standard transaminases, potassium and urea and the degree of hepatic oxygen consumption were evaluated. The results show a superiority of the 3%-solution with improvement of the synthetic capacity for albumin and fibrinogen and, in contrast to the 6%-solution, a stable potassium level and hepatic oxygen consumption.
Animals↗
Evaluation of liver function in an improved model of isolated liver perfusion.
A perfusion system was described for maintaining isolated guinea pig livers in a stable functional state for five hours. Oxygen supply, oxygen consumption, as well as perfusate flow were within physiologic limits. Liver function was investigated by means of indocyanine green elimination and galactose elimination. Both test substances showed no significant decrease in liver function throughout perfusion. Isolated liver perfusion is a useful tool to investigate problems in organ preservation and liver transplantation.
Animals↗
[Respiratory functional hypoxia in ruminants under general anesthesia].
General anesthesia causes a marked hypoxia in ruminants. We compared this phenomenon with anaesthesia related changes in the dog. Under alfentanil/etomidat anaesthesia some variables of the pulmonary circulation (TPR, PAP, PCWP) as well as arterial and venous blood gases and saturation (HbO2, pO2, ph) in dogs, sheep and calves were measured and calculated. The calculated pulmonary shunt fraction was compared between the three species. In ruminants there was an increase of total pulmonary resistance being associated with elevated PAP and decreased PCWP. The pulmonary shunt fraction was increased significantly and markedly during the surgical tolerance period, too. These parameters were not significantly changed in the dog. Ruminants seem to take an exceptional position concerning the anaesthesia related alterations of the pulmonary ventilation/perfusion system.
Adjuvants, Anesthesia↗
Influence of neonatally administered dehydroepiandrosterone on reproduction of rats.
Male and female rats were injected with dehydroepiandrosterone (DHEA) from day 2 after birth to day 12 on alternate days. The inhibition of the growth of testes, seminal vesicles, adrenal glands and pituitary was found immediately after cessation of treatment. When adult, the neonatally DHEA treated males showed diminished copulatory activity. In contrast, no impairment of sexual behaviour could be found in females. However, neonatal DHEA treatment resulted in a dose dependent impairment of cyclicity in the females, accompanied by sub- or infertility. These findings suggest that DHEA shows some dissociation between its organizing influence on gonadotropin secretion and sexual behaviour.
Animals↗
Does the administration of the calcium-antagonist verapamil in tocolysis with beta-sympathicomimetics still make sense?
In tocolysis with beta-sympathicomimetics Verapamil is administered universally to reduce the subjective and objective cardiovascular side effects. The efficacy of the calcium-antagonist has not yet been substantiated. This has now re-emerged as an important issue due to the increasing occurrance of cardiopulmonary complications in tocolysis, some fetal. Nine mongrel German shepherds were anesthetized and relaxed, and their breathing was controlled at constant volume. After infusion of Fenoterol (0.06 microgram/kg/min) and subsequent administration of Verapamil (2 microgram/kg/min) a continuous record was made of the parameters of the pulmonary and systemic circulatory systems, the cardiac dynamics, the acid-base balance, the blood gases with O2 absorption and CO2 output, electrolytes and the colloid osmotic pressure. Furthermore, the intrapulmonary fluid volumes in the vascular system and the interstice were measured. During infusion with Fenoterol the changes expected from a beta-adrenergic were observed in the form of a hyperkinetic cardiac situation, metabolic acidosis and increased exchange of gases. Also pronounced fluid shifts in the lungs occurred from the intravascular space to the interstice. Subsequent administration of the calcium antagonist showed no influence on the beta-mimetic-induced changes demonstrated in the present work. The results agree with previous clinical investigations. According to the known dosage curve, the dosage of Verapamil would have to be increased multifold to achieve an effect, which is hardly possible due to the cardiodepression and peripheral circulation drop with hypotension that this would entail. The administration of Verapamil in tocolysis no longer appears expedient.
Adrenergic beta-Agonists↗
[Investigations in animal experiments into the influence of the beta-1-selective blocking agent metoprolol on the cardiovascular and metabolic side effects of the tocolytic fenoterol].
The influence of the highly selective beta-1-adrenergic blocker Metoprolol on cardiovascular and metabolic side effects of the beta-mimetic Fenoterol, used for labour inhibition, was investigated in anesthetized mongrel dogs. In a dosage of 1.5 microgram/kg BW/min Metoprolol antagonized the positive inotropic and chronotropic cardiac effects of Fenoterol (0.06 microgram/kg BW/min) thus compensating the impaired energetic balance of the myocardium. As expected, there was no influence on the beta-mimetic mediated metabolic alterations. Taking into account its pharmacologic actions, the additional application of Metoprolol in labour inhibition with beta-mimetics seems to be advantageous. On account of the proven results a reduction of the more or less considerable missensations and a cardioprotective effect may be expected.
Animals↗
[Metomidate anesthesia in dogs with different premedications].
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Anesthesia↗
[Does the calcium antagonist verapamil protect from myocardial damage during tocolysis with beta-sympathicomimetics? (author's transl)].
Under general anaesthesia nine mongrel dogs were first injected with fenoteral 0.06 mg/kg/per minute and later with fenoteral 0.06 mg/kg/per minute and verapamil 2 mg/kg/per minute. A microtip manometer was placed into the left ventricle and cardiac pressures continously monitored. The resulting pressure curves were used in micro-computer to calculate the cardiac pressure parameters including the inotropic measurements and the myocardical oxygen consumption. The intravenous infusion of the beta-mimetic fenoterol resulted in marked increase of the cardiac rate and contractility as measured in the different measurement of the ionotrophy. A corresponding increase of the myocardical oxygen consumption was found. The addition of the calcium antagonist verapamil did have no influence of the measured parameters. A protective effect of the calcium antagonist on the myocaridium was excluded in the animal experiment. A protective effect during tocolysis with beta-sympathicomimetics cannot be expected because of the expected low serum concentrations.
Animals↗
[Liquid shifts in the lung under fenoterol and verapamil. Experimental study on the origin of pulmonary oedema under tocolysis. III (author's transl)].
The question of the causal relationship between tocolysis and pulmonary edema has been unresolved up till now. Eight mongrel dogs were given infusions of Fenoterol (0.06 mcg/kg/min) and later of Fenoterol (0.06 mcg/kg/min) and Verapamil (2 mcg/kg/min). In the case of infusion of Fenoterol alone measurements by the thermo-dye-technique showed massive shifts of lung fluids from the intravascular to the extravascular space corresponding to interstitial edema. The addition of Verapamil induced no further changes. The intrapulmonary haemodynamical overload by increased cardiac output and pulmonary arterial pressure which we measured after infusion of Fenoterol must be regarded as the main cause of the shifts in fluid volumes. They seem to be amplyfied by central nervous-, metabolic- and localized toxical effects of the betamimetic drug. A direct cardiac cause as well as serious changes in electrolytes and colloidosmotic pressure could be excluded.
Animals↗
[Respiratory and circulatory parameters under fenoterol and verapamil. An experimental study on the origin of pulmonary oedema under tocolysis. II (author's transl)].
In order to explain the development of pulmonary edema it is, in addition to determine shifts of lung fluids, indispensible that changes in the circulatory system be evaluated as well as changes in the breathing function by means of analysis of blood gases and acid and base status. The relevant parameters were continuously registrated for 8 anaesthesized mongrel dogs after the infusion of Fenoterol (0.06 mcg/kg/min) and later of Fenoterol (0.06 mcg/kg/min) and Verapamil (2 mcg/kg/min). A cardiac disfunction and irregularities in the ventilation process in the lung could be excluded. The proven changes such as an increase in cardiac output with increased venous backflow, and intrapulmonary shunt-formation as well as acidosis after an infusion of the betamimetic drug are to be regarded among the causes of a development of pulmonary edema. Verapamil produced no further changes in the evaluated parameters.
Animals↗