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Biomedical subjects

W Thal

Publications and source records attributed to W Thal.

At least 19 recordsLinked to original sources
PubMed1993

[Genetics of bronchial asthma with reference to allergy].

No uniform opinion exists to date in respect of the transmission of a genetic disposition to asthma bronchiale and atopy. Literature references discuss both monogenic, autosomal dominant or recessive and multifactorial-polygenic heredity. The following contribution discusses the results of an own study on the occurrence of atopy and asthma bronchiale in 153 families. Multifactorial-polygenic heredity with threshold value range is most suitable for the interpretation of our findings, even though an autosomal dominant heredity with reduced penetrance and variable expressivity might well be the basis for the transmission of a disposition to atopy and asthma bronchiale. In multifactorial-polygenic heredity with threshold value range, empirical risk data are important for predicting the disease risk. Such data can be obtained only on the basis of extensive family research and apply only to the population for which they were obtained. The risk of occurrence of atopy or asthma bronchiale in families already affected by the increases, in our experience, with the number of the patients already suffering from the disease and with the closeness of relationship with the patients concerned. We found a recurrence risk for further children of 40-45% for atopy and of 5-10% for asthma bronchiale in those marriages where both one parent and already one child are suffering from the disease.

Asthma↗
PubMed1993

[Findings of combined ventilation/perfusion scintigraphy in children with abnormalities of the bronchi, the lung and lung blood vessels].

Combined ventilation/perfusion scintigraphy with 133Xe/99mTc-HAM was performed within the framework of bronchological diagnostics in 38 children suffering from malformations of the bronchi, lungs and pulmonary vessels, and in 9 children after surgery of hernia of the diaphragm. The findings in stenoses, cysts in the bronchial system and in children with pulmonary vessel malformations, in one child with pulmonary agenesia and in a few other malformations, are presented. The significance of these findings in bronchological diagnosis in case of pulmonary malformations or clinical follow-up is discussed. Combined ventilation/perfusion scintigraphy is a valuable contribution to preliminary diagnosis and in follow-up of children with pulmonary malformations.

Bronchi↗
PubMed1993

[Treatment strategy in childhood bronchial asthma].

Although bronchial asthma is the most frequent chronic disease in childhood, not all of the affected children are readily recognised as asthmatics well in time for appropriate treatment. Since most of the children can get rid of the symptoms if all the available treatment methods are made use of systematically, early diagnosis and correct estimation of the disease pattern are essential for good long-term prognosis. New pathogenetic knowledge on the importance of inflammatory processes affecting the bronchial mucosa has definitely shifted the points of emphasis in asthma treatment as is evident from the international consensus recommendations. Focus of drug therapy is on prophylactic antiphlogistic treatment. Only in cases of severe asthma continual bronchodilatory medication is also recommended. The inhalative route is beneficial and feasible for all age groups. Long-term treatment, wherever necessary, also includes continual medical supervision in consultation with a paediatric pneumologist.

Anti-Inflammatory Agents↗
PubMed1991

[Value of bronchography in childhood with special reference to nuclear medicine preliminary examinations].

One month to 16 years old 288 children suffering from recurrent and chronic bronchitis, asthma, cystic fibrosis, malformations and various other lung diseases have been undergone 133Xe-Gas/99mTc-HAM lung scintigraphy. By means of results and taking in consideration scintigraphic findings the strategy of bronchographic indication is laid open being of higher load for the children based on anaesthesia and x-ray. Thus the number of bronchographs could be reduced from 47 (1984) via 33 (1985) to 22 (1986) by means of lung-scintigraphic imaging.

Adolescent↗
PubMed1991

[The significance of the flow-volume curve in pediatric lung diseases].

Even slight obstructions in small airways are detectable by means of the flow-volume curve. Therefore this method is to recommend for early diagnosis and especially in infancy. Advantages were demonstrable at the examination of different groups of asthmatics and in children with cystic fibrosis. The great sensitivity of the flow values was also shown at the bronchospasmolytic test and for provocation tests particularly. The flow-volume curve is an important routine method in pediatric pulmonology to determine the dimension and location of ventilation disorders and for follow-up studies and therapy supervision.

Airway Resistance↗
PubMed1990

[Current aspects of the therapy of bronchial asthma in childhood].

The management goals common to all age groups are to reduce symptoms, to permit a normal physically active lifestyle, and to prevent irreversible airway obstruction. Main measures are environmental manipulation (avoidance of allergen contact, cigarette smoke and pets; psychotherapeutic management), assessment of severity, training for self management, hyposensitization (pollen, HDM, insect venoms) and pharmacotherapy. Medication should be adapted to age and severity of the disease, and the different drugs should be used stepwise. The first step includes the application of bronchodilators in which beta-2-stimulants are to be preferred. If we use spacers or jet nebulizers infants can also be treated successfully. The value of xanthines is discussed controversially. The next steps tend to reduce the inflammatory reaction. In this direction sodium cromoglycate and ketotifen are useful especially in childhood, and inhaled steroids have increasing importance. The use of oral corticosteroids should be the last step.

Adolescent↗
PubMed1990

[The development of pediatric bronchology].

The authors give a statistical survey about the development of paediatric bronchology in the German Democratic Republic since 1957. They draw conclusions from this survey about the future trends in this field, which is part of paediatric bronchopneumology.

Bronchial Diseases↗
PubMed1990

[Initial experiences with "Oranienburg" slow-release theophylline in asthma therapy of children and adolescents].

Experiences in 50 patients show that Theophyllin retard Oranienburg (280 mg theophylline) could be used as an effective bronchospasmolytic drug on conditions of mono- and combination-therapy. Advantages of this preparation are improvement of the compliance and an undisturbed night-sleep in patients. However an optimum dosage is hardly maintained in children by the present dose of a single tablet of 280 theophylline content. The effectiveness in therapy of childhood asthma could be improved by stronger sustained release effect and different doses of tablets.

Adolescent↗
PubMed1989

[The effect of bronchologic studies on blood gases and hemodynamics in children].

During 78 bronchological examinations in children of all age groups out of 6 centers of children bronchology of the GDR PaO2, PaCO2 and pH were registered, in a part of them additionally pulse, systolic and diastolic blood pressure. Following to the intubation--under ventilation with 100% oxygen or a halothane-NO2-oxygen mixture--there was a marked rise of PaO2, which normalized after extubation quickly. After extubation a slight hypoxemia occurred for a short period, a quick rise of PaCO2 and a slight acidosis, too. Besides, the hearth rate, systolic and diastolic blood pressure elevated following to the intubation and diminished after extubation.

Acid-Base Equilibrium↗
PubMed1988

[Peculiarities of theophylline therapy in childhood].

Profound knowledge of the pharmacokinetics of theophylline is a prerequisite to successful therapy. In children the clearance of theophylline is considerably greater than in adults. The required higher dosage in relation to body weight results in more pronounced oscillations of drug levels in serum. Investigations in 280 children in the age of 1 to 18 years with bronchial asthma, treated with theophylline compounds, confirm the necessity of individual dosage and surveillance of the drug level in serum. Instead of the determination of the drug level in serum, its measurement in saliva is sufficiently reliable and less molesting. Checks of drug level are also a valuable educational measure to improve patients' compliance with drug intake. The effectivity of asthma therapy in children could be decisively improved by an adequate formulation of a slow release preparation of theophylline.

Adolescent↗
PubMed1988

[Ultrasonic evaluation of the upper abdomen in cystic fibrosis].

Abdominal sonography should compulsory be used in patients with cystic fibrosis (CF). It is not difficult to detect early morphologic changes at liver, gall-bladder, pancreas, spleen, and vessels by ultrasound. As a non-invasive method sonography is a very useful tool for a comprehensive special care of outpatients with CF.

Adolescent↗
PubMed1988

[Combined 113Xe/99mTC human serum albumin microspheres lung scintigraphy in children with recurrent and chronic bronchitis].

A total of 117 children with recurrent and chronic bronchitis aged from 2 months to 16 years were subjected to combined ventilation-perfusion scan of the lungs with 133Xe-gas and 99mTc-HAM. It served as a screening before bronchological examination with the aim to get a more exact indication for bronchography which leads to a higher stress in children because of anaesthesia and radioscopy. Due to combined lung scan, the number of bronchological examinations could be reduced from 109 in 1984 to 79 in 1985 and even to 54 in 1986. Among the 117 children suffering from bronchitis, we found normal scans in 16 cases, perfusion defects in 59 cases, combined ventilation-perfusion defects in 41 cases and one case showed a pure ventilation defect. The lung scan should be applied in the framework of bronchopulmonary standard diagnosis.

Adolescent↗
PubMed1988

[Noninvasive examination methods in the detection of right heart hypertrophy in children with mucoviscidosis].

Pulmonary hypertension with right ventricular hypertrophy (Cor pulmonale) is a critical complication in cystic fibrosis patients. Early detection and therapy might decrease mortality. Noninvasive diagnostic methods as vector-ECG, m-mode echocardiography and thallium myocardial scintigraphy were performed in 50 children with cystic fibrosis to determine the degree of right ventricular hypertrophy.

Adolescent↗
PubMed1988

[Bronchologic studies in East Germany: current status and perspectives].

Within a period of 8 years (1979 to 1986) there were performed in 21 centres of the German Democratic Republic 15,049 bronchoscopic investigations (in 49.6 per cent combined with a subsequent bronchography) in 11,717 children, including 2,054 (17.5 per cent) up to one year of age. The detailed analysis shows important trends, which allow a reasonable prognosis of the perspectives of pediatric bronchology in the GDR.

Bronchography↗