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Biomedical subjects

U Reinhard

Publications and source records attributed to U Reinhard.

At least 19 recordsLinked to original sources
PubMed1989

[10 years of dental care of hemophiliacs].

Increased consciousness of oral hygiene, improvement of sanitation degree and decrease of the number tooth extractions have been proved a success and an expression of high compliance within the scope of long-term interdisciplinary care of haemophilic patients. At the same time both patients registration and concentration at an out-patient department facilitate cooperation with the paediatricians and internal specialists being in charge of them, in addition a change-over from children to adult dispensary care is ensured. Haemophilic patients suffering from hepatitis B or HTLV-III/HIV antibodies carrier may be registered immediately. All patients undergoing dispensary care are subject to preventive test obligations.

Adult↗
PubMed1987

[Epidemiology of Hodgkin's disease from the pathophysiologic viewpoint--review].

The aetiology of Hodgkin's disease remains unclear, however epidemiological characteristics have led to directive conceptions. The description of the rare familiar appearance of lymphogranulomatosis among other things by two cases of our own population and the presentation of milieu factors influencing incidence and prevalence rates give a extensive basis of discussion to develop pathophysiological ideas and to prove it by clinical, pathological, genetical and immunological knowledge. Genetical determination by an autosomal-dominant allele, with incomplete penetrance, predisposing insufficiency of immune suppression and disease inducing virus infection seems less to be three competing aetiologic systems; they rather form a causing trinity, which internal connexions we are at present not able to understand.

Cross-Sectional Studies↗
PubMed1986

Lung diseases after bone marrow transplantation. Results of a clinical, radiological, histological, immunological and lung function study.

The case histories of 72 subsequently treated patients - 44 with acute leukemia, 10 with chronic myeloid leukemia, 16 with severe aplastic anemia and 2 with neuroblastoma - were analyzed after bone marrow transplantation (BMT) with respect to pulmonary diseases. Thirty-eight patients suffered from a total of 51 pulmonary complications, which led to death in 20. Of 13 patients, 3 died of bacterial pneumonia, all of them during granulocytopenia; 2 of 6 patients died of fungal pneumonia and 2 out of 3 of a mixed bacterial-mycotic infection. Adult respiratory distress syndrome (ARDS) led to death in 2 patients. A granulocyte count under 500/microliter correlated significantly (P less than 0.002) with the fatal outcome of bacterial, fungal and ARDS pneumonia as well as with bronchitis. Viral pneumonia led to death in 8 of 9 patients; in each there was a significant correlation (P less than 0.05) with graft-versus-host disease (GvHD). Patients with repeated episodes of pulmonary illness had significantly more chronic GvHD (P less than 0.05); several of these patients displayed a reduction in helper T cells and an increase in suppressor T cells in the peripheral blood. The natural killer (NK) cells were reduced and the percentage of activated NK cell level lay between 6% and 69%. B-cells were absent or deficient. These findings explain in part the absence of specific antibody reactivity. Five of these patients also contracted GvHD-associated obstructive bronchiolitis, which did not respond to therapy. Pulmonary infiltrates of unknown origin (including idiopathic interstitial pneumonia) occurred in 8 of the patients (11.1%), with a fatal outcome in 3 patients. Significant changes (P less than 0.05) in lung function after BMT appeared in the form of reduced vital capacity (VC) increased residual volume (RV) and an increase in RV expressed as the percentage of total lung capacity. Pulmonary diseases were the most common complication and cause of death in our patients after BMT.

Adolescent↗
PubMed1986

Lung function changes after allogenic bone marrow transplantation.

The lung function of 21 patients with leukaemia (11 with acute myeloid leukaemia, six with acute lymphatic leukaemia, four with chronic myeloid leukaemia) and of five with severe aplastic anaemia was tested before and after allogenic bone marrow transplantation. Vital capacity (VC) was lowered in patients with leukaemia before transplantation. VC and FEV1 fell significantly after transplantation. Residual volume (RV) and RV as a percentage of total lung capacity (RV % TLC) were already increased and rose significantly after transplantation. Patients with severe aplastic anaemia had noticeably increased RV and RV % TLC, values that did not change after transplantation. In contrast to the patients with aplastic anaemia, the patients with leukaemia had significantly reduced VC, RV, RV % TLC, and FEV1 before and after transplantation. The specific airway resistance (sRaw) was raised significantly before and after transplantation in the leukaemic patients. In addition, transfer coefficient (Kco) fell significantly more after transplantation in the patients with leukaemia than in those with severe aplastic anaemia. In three patients with histologically established obstructive bronchiolitis in conjunction with chronic graft versus host disease after transplantation, VC, FEV1 and FEV1 % VC fell, while RV, RV % TLC, and sRaw rose; Kco was far below normal. On the basis of these findings it is concluded that in patients with leukaemia obstructive disorders of ventilation develop or, if they are already present, worsen. In patients with severe aplastic anaemia lung function was not impaired in the early phase after transplantation. These differences are probably due to the more intensive immunosuppressive and cytotoxic preparatory regimen before transplantation in the leukaemic patients. Obstructive bronchiolitis, a complication of graft versus host disease, first manifests itself in a typical rise in specific airway resistance and must be treated early.

Adolescent↗
PubMed1981

Latent portasystemic encephalopathy. I. Nature of cerebral functional defects and their effect on fitness to drive.

Forty patients with chronic liver disease and portal hypertension but without clinical signs of portasystemic encephalopathy (15 patients with nonalcoholic cirrhosis, 15 patients with alcoholic cirrhosis, and 10 patients with minimal EEG changes) and a control group of 12 patients with chronic alcohol pancreatitis were studied using an extensive psychometric program, which, in the same form, is used for expert reports on driving capacity. Of the cirrhotic patients, 60% were considered unfit to drive; in 25% driving capacity was questionable, 15% (only nonalcoholic cirrhotics) were considered fit to drive. In contrast 75% of the patients with alcoholic pancreatitis were considered fit to drive. Major defects were found only in three heavy alcoholics. Patients with alcoholic cirrhosis scored lower than patients with nonalcoholic cirrhosis. This was due to differences in liver function rather than to the effect of alcohol consumption. Patients with minimal EEG changes were practically all considered unfit to drive.

Adult↗
PubMed1980

[Pulmonary fibrosis due to working with hard metals (author's transl)].

Hard metals are worked with in numerous small industries. Thus hard metal fibroses are probably more frequent than has been supposed up to now. Observations on three patients have shown that a dry cough may preceed demonstrable manifestations by several months. As the full picture of the disease is hard to influence therapeutically an immediate change of job should be encouraged as soon as suspicious symptoms occur.

Adult↗
PubMed1980

[Spiroergometrical criteria in the non-invasive evaluation of work-induced variation in lactic acid levels and acid-base equilibrium during unsteady-state exercise (author's transl)].

During an incremental exercise test the spiroergometric parameters Respiratory Quotient (RQ), Ventilatory Equivalent for oxygen (AEO2 = VE/VO2) and Ventilatory Equivalent for carbondioxide (AECO2 = VE/VCO2) initially decrease. These values then increase continuously at various work load levels until exhaustion. Experiments on 40 healthy untrained men between 20 and 40 years of age using upright bicycle ergometry and computer assisted on-line ergospirometry in which the work load was increased each minute by app. 16.3 watts show that the following 3 performance levels can be used to sufficiently describe the incremental exercise test: 1. Minimum AECO2 (77.9 +/- 22.3 watts approximately 1183 +/- 320.1 ml VO2 approximately 45.1 +/- 9.62% VO2 max), 2. Minimum AECO2 (148.5 +/- 32.7 watts approximately 1883 +/- 388.9 ml VO2 approximately 71.8 +/- 11.43% VO2 max), 3. Maximal power output (220.1 +/- 30.6 watts approximately 2638 +/- 442.3 ml VO2) (mean +/- SD). In addition simultaneous determinations of lactic acid levels and acid base equilibrium from arterialized capillary blood sampled at one minute intervals were carried out on a further 15 persons. It is shown that VO2 at the rise of AEO2 from its minimum is closely correlated with VO2 at the first significant increase of lactic acid levels (r = 0.942). There is less correlation between VO2 at the rise of AECO2 from its minimum and VO2 at the begin of the decompensation of the work induced metabolic acidosis (r = 0.854). The results indicate that through the use of spiroergometric parameters it is possible to obtain further information on the peripheral and cardiopulmonary adaptability of the organism under low submaximal work load conditions avoiding the necessity of invasive measurements.

Acid-Base Equilibrium↗
PubMed1979

Determination of anaerobic threshold by the ventilation equivalent in normal individuals.

In 131 untrained healthy volunteers, unsteady-state upright bicycle ergometry was carried out by means of computer-assisted on-line ergospirometry. In 11 males and 4 females capillary lactate and blood gas analyses sampled simultaneously at 1-min intervals revealed that it is possible to determine the 'anaerobic threshold' (AT) and a 'threshold of decompensated metabolic acidosis' (TDMA) from the respiratory gas exchange by controlling the ventilation equivalent for oxygen (VEO2 = VE/VO2) and carbon dioxide (VECO2 = VE/VCO2). There is no necessity of invasive measurements. Solely ergospirometrical tests in 66 males and 50 females, aged 20--65 years, showed the expected higher work load levels and VO2 at AT and TDMA in males. There was a significant negative correlation to age. In contrast, there are no differences with regard to sex in AT and TDMA for weight-corrected work rates. In the age group 20--39 years, AT is about 1 W/kg body weight, TDMA at about 2 W/kg body weight. The larger maximum exercise capacity weight corrected for males (3 W/kg) in comparison to females (2.6 W/kg) was dependent on a greater capability in the range of maximum exertion and not on a different level of AT and TDMA.

Adult↗