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Biomedical subjects

W Leupold

Publications and source records attributed to W Leupold.

At least 91 records · Page 5Linked to original sources
PubMed1980

[Experiences with oral N-acetyl-cysteine treatment in children suffering from cystic fibrosis (author's transl)].

A clinical test with the oral use of Fluimucil was performed by ourselves: Forty-two children, who had been in stable condition for 8--10 years under inhalation therapy with Mucosolvin, were treated for a period of 6 months with Fluimucil used orally. We compared the clinical, bronchoscopic and lung function finding s before and after the 6-month period. In the case of 7 children the oral treatment had to be discontinued and replaced by a resumption of inhalation therapy after 6 to 12 weeks on an account of an exacerbation of the lungstate. The bronchoscopic studies showed results worse in 44% of the cases, unchanged in 22%, and improved in 34%. For lung-function the figures were 31%, 51% and 18% respectively. We can conclude from our results that it is not possible to replace inhalation therapy by an oral treatment for all children with cystic fibrosis. We can, however, surmise that such a treatment will be possible for 50--60% of the children and this must be considered as a significant step forward in the care of these children.

Acetylcysteine↗
PubMed1980

[Suggestions for diagnosis and differential diagnosis of bronchial asthma (author's transl)].

The diagnosis of bronchial asthma is difficult because dyspnea as the leading symptom is ambiguous. Often other diseases with dyspnea are called asthma. For long term treatment it is necessary to know the pathogenesis of asthma and the factors triggering attacks. This in many cases needs special investigations. In the present paper some proposals are given to make a preliminary diagnosis on the basis of history and simple clinical findings, giving the indication for consecutive investigations respectively referring the patient to a specialist.

Allergens↗
PubMed1979

[Fundamental investigations for the deposition of aerosols from radioactive solutions in the upper and lower airways (author's transl)].

By means of 99mtechnetium diphosphonate and a scintillation camera we measured the deposition of aerosols. During normal breathing rhythm and without leading the aerosol by valves the retention in the lower airways was on an average of 5.6%, that is 0.07 ml/min. By installation of suitable valves for in- and expiration and mouth tubes, deep and complete expiration with breath holding the retention of the aerosol increases to 17.3-13.8% (0.22-0.17 ml/min); with normal breathing the deposition was only 9%. In the upper airways we found the following deposition rates: Nose/hypopharynx (inhalation via mask) 2.6%; Mouth and pharynx (after rinsing) 1.6%; Larynx 0.1%. A considerable part remains in the inhalation system; by special variations we were able to reduce this portion of the aerosol. After inhaling electro-aerosols (4 kv) the deposition in the lungs was 5.6%; the more the charge was reduced the more the deposition of the aerosol in the lung increased.

Aerosols↗
PubMed1978

[Deposition of aerosols into the airways (author's transl)].

The rate of powder absorbed in the lung greatly depends on the particle diameter, and amounts to 40--50% for 1 micrometer particles and 15--20% for 5 micrometer particles. Of importance for therapy was the information that single breath will deposit in the lung 15% of a powder aerosol of 2 micrometer diameter. The liquid aerosols as prevalently used in the therapy, were retained in the lung at a rate of 15% of the original amount when using ultrasonic apparatus. If calculated per minute of inhalation time, the amount absorbed by the lung amounted to 0.2 ml and that by the upper respiratory tract to 0.06 ml. Best deposition in the lung was obtained when inhaling in a closed system with valve-controlled aerosol stream, when using a mouthpiece, and when the test person inhaled with low respiratory rate, deep inspirations, short respiratory pause and complete exspiration. Mark inhalation with closed mouth gave only one tenth of the lung deposition reached with the breathing method described. The use of a mask showed good results, however, when the test person was breathing with open mouth. Only 0.07 ml/min were retained with jet nebulizer and mouth respiration. Combination with intermittent pressure respiration showed no convincing results.

Aerosols↗
PubMed1977

[Unilateral aplasia and hypoplasia of pulmonary artery in childhood (author's transl)].

In the light of 8 observations, made by the authors, vasoanomalies underlying the syndrome of the unilateral hyperlucent lung are discussed in their correlation to homolateral bronchial lesions. There were 3 cases with unilateral aplasia of the pulmonary artery in which the unilateral hyperlucency was found always on the healthy side. In these cases there was a normal bronchogram on both sides. The vascularization by the bronchial arteries causes characteristic changes both in the X-ray-picture and endoscopy. Hypoplasia of the pulmonary artery occurring simultaneously with hyperlucency of the affected side of the lung was found in five cases, 4 times in connection with homolateral, severe, diffuse deforming bronchitis and bronchiectases and 1 case with congenital bronchus stenosis. There is the opinion that besides a congenital form of the hypoplasia of the pulmonary artery a (virus?) --pneumonia, acquired in early childhood, can lead to a pulmonary hypoplasia and a bronchopulmonary dysplasia. The diagnosis can be made only after several special examinations performed in a multi-step system. The significance of the lung scintigraphy within the scope of this complex diagnostics is especially emphasized. Indication for surgery should be made very cautiously. Antibiotic long-term therapy and dsipensary care are considered to be essential.

Adolescent↗
PubMed1976

[Pathophysiology of respiratory disturbances in children (author's transl)].

Physiological conditions of respiration in children are defined especially by - relative hyperventilation because of high oxygen uptake per body surface, - relative narrow and soft airways with high tendency to obstruction, causing atelectasis, pneumonia or severe bronchiolitis. It is useful to differentiate between bronchiolitis and spastic or asthmatoid bronchitis, the latter being sensible to Adrenalin and developing to asthma of adults. Characteristical signs of asthmatoid bronchitis are bronchial hyperreactivity, increased airway-resistance and residual volume, decreased FEV 1, pulmonary compliance, arterial PO2 and PCO2 with signs of pulmonary inhomogeneity. Mucviscidosis, starting from abnormal viscosity of bronchial secretion, is functionally characterized by similar signs, so are increased RV with air-trapping, decreased FEV 1, VC, PO2a and pulmonary inhomogeneity. Diffuse progressive interstitial pulmonary fibrosis (HAMMAN-RICH) of acute type being mostly lethal in children up to 2 years of age and of subacute type in older children shows diffusion disturbance and characteristical ventilation disturbance with reduction of inspiratory reserve volume and enlargement of functional residual capacity but normal FEV 1. Disturbances are sensible to corticoid-therapy.

Age Factors↗