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Biomedical subjects

A Perruchoud

Publications and source records attributed to A Perruchoud.

At least 55 records · Page 3Linked to original sources
PubMed1979

[Dosage dependence of the effect of somatostatin on human splanchnic blood flow].

The effect of three different doses of somatostatin on splanchnic blood flow (SBF) and on arterial plasma insulin, glucagon and glucose was determined. 125, 250 and 500 microgram/h of somatostatin was infused during 60 minutes in 3 groups of 6 patients undergoing arterial-hepatic-venous catheterization; no patient had clinical evidence of metabolitic or hepatic disease. Continuous infusion of 125 microgram/h somatostatin was without significant effect on SBF, whereas 250 microgram/h resulted in a mean 28% reduction of SBF (p less than 0.05). Doubling the dose to 500 microgram/h affected SBF similarly (21% reduction of SBF). In contrast, administration of all three doses of somatostatin suppressed the circulating insulin and glucagon levels significantly. In a recent report somatostatin had been administered in a dose of 250 microgram/h to control gastric ulcer hemorrhage. The present studies demonstrate that this dose results in a significant reduction of SBF which cannot be further depressed by increasing the dose.

Adult↗
PubMed1979

Dose response relationship of clenbuterol (NAB 365) as a solution for inhalation.

The dose-response relationship of the new bronchodilator Clenbuterol (NAB 365, Boehringer Ingelheim) was tested in 12 patients with chronic obstructive lung disease. Clenbuterol is a beta-2-sympathicomimetic, from a series of substituted phenylethanolamines, and it is characterised by good absorption and prolonged action after systemic administration. The action of four different doses of Clenbuterol inhalation solution (6, 12, 24, and 48 microgram corresponding to 2, 4, 8 and 16 drops of a 0.006% solution) was assessed after a single inhalation on 4 successive days. The parameters monitored were bronchial resistance and FEV. The effect of all four doses was the same, both in respect of improvement in FEV and of decrease in bronchial resistance. The increase in expiratory volume and the decrease in bronchial resistance lasted for 6 h. The results show that for inhalation therapy Clenbuterol is a potent, selective bronchodilator, which is largely free of sideeffects. It has still to be determined whether a maximal effect could be achieved with a lower dose 6 microgram.

Adult↗
PubMed1979

[Thorascopy as a diagnostic and therapeutic precaution in lung and pleural diseases].

Thoracoscopy is a method involving little discomfort for the patient but of high diagnostic effectiveness for pleural alterations. A histological diagnosis was established in 56 cases out of a total of 60 pleural effusions of unknown origin. In 10 pleural or pleuropulmonary diseases, anatomical classification was possible in all cases. In cases of pneumothorax (21 patients) the bronchopleural fistula could very often be seen and closure by detaching of pleural adhesions or cauterization was possible. These manipulations are usually followed by insufflation of sterile talcum powder through the thoracoscope. Suspicion of ruptured diaphragm due to accident was easily and quickly verified. No complications occurred in our 100 thoracoscopic examinations.

Female↗
PubMed1979

[Therapeutic recommendations in idiopathic spontaneous pneumothorax].

The treatment of spontaneous pneumothorax is still controversial. To evaluate pleural drainage with a chest tube the therapeutic results in 73 patients with benign pneumothorax were reviewed. Benign spontaneous pneumothorax treated with a thick chest tube size Charrière 18-22 disappeared within an average of only 6.6 days. On the other hand, the high recurrence rate of 24% after the initial pneumothorax and 37% after the first recurrence is comparable with the results of conservative management in other pneumothorax series in the literature. Small pneumothorax without severe symptoms should therefore be supervised conservatively on an outpatient basis. The more extended forms of pneumothorax should be treated with thick chest tubes. Failure of therapeutic effect, second ipsilateral relapse or the first contralateral pneumothorax are indications for parietal pleurectomy.

Adult↗
PubMed1979

Right-to-left atrial shunt in cardiac dislocation following extensive pneumonectomy.

Previous reports dealing with cardiac herniation following intrapericardial pneumonectomy illustrate the critical and often lethal hemodynamic sequelae of this complication. In the case presented here, the first and nearly exclusive sign of cardiac herniation after left-sided pneumonectomy with extensive resection of the pericardium was systemic arterial hypoxemia. Subsequent investigations suggested inter-atrial right-to-left shunt in the presence of a patent foramen ovale, caused by slight right-ventricular outflow obstruction with consecutively reversed pressure relationships at atrial level. This explanation was supported by the operative findings, and reversibility was achieved by pericardial reconstruction with parietal pleura. When the patient died 8 months later due to general progression of a mucoepidermoid carcinoma, autopsy confirmed a large patent foramen ovale.

Adenocarcinoma, Mucinous↗
PubMed1979

Effects of smoking and inhalation of carbon monoxide on systolic time intervals and blood pressure. Differences between two types of cigarettes and a cigar.

The effects of smoking and inhalation of carbon monoxide on the systolic time intervals and blood pressure were examined in ten healthy smokers with a mean age of 24.3 years. Each subject smoked a low-nicotine cigarette with a ventilated filter (0.1 mg nicotine, 1.1 vol percent CO), and a high-nicotine plain cigarette (2.6 mg nicotine, 4.5 vol percent CO), as well as a cigar in random sequence and in a standardized way. Cigar smoke was not inhaled. The product heart rate x blood pressure was increased and the left ventricular ejection time index (LVETc) prolonged following smoking the high-nicotine cigarette, whereas changes after smoking the low-nicotine cigarette and the cigar were not as pronounced. These changes are presumably caused by nicotine-induced catecholamine release. Inhalation of CO did not affect cardiac performance acutely as shown by unchanged systolic time intervals. When a high-nicotine cigarette was smoked after the subject received a beta blocker, a significant prolongation of the pre-ejection period index (PEPc) occurred as a result of the increased afterload. Thus, the effects of catecholamines on parameters of myocardial contractility (PEPc, PEP/LVET) were presumably offset by the increased afterload. We conclude that the acute hemodynamic changes of smoking in healthy subjects depend upon the amount of nicotine absorbed.

Adult↗
PubMed1979

Tumoral calcinosis in a patient undergoing hemodialysis.

Recently, tumoral calcinosis was found in a patient who had been undergoing haemodialysis in this hospital. The tumor was partially removed and subsequently regressed. The tumoral calcinosis of hemodialysis patients seems to be different from classical tumoral calcinosis.

Adult↗
PubMed1978

[Lung circulation in emphysema].

Pulmonary emphysema is regularly complicated by pulmonary hypertension which is, however, mostly of minor degree. As long as pulmonary capillary pressure and cardiac output remain within normal limits, the elevated pressure in the pulmonary artery is due to an increase of vascular resistance for which hypoxia is responsible in the first place, while rarefaction of vascular ramifications due to the emphysematic destructive process in the pulmonary parenchyma plays only a secondary role. Breathing of oxygen decreases pulmonary hypertension, an effect which is reinforced by combination of oxygen with IPPB. Phentolamine lowers both vascular resistance and pressure in the pulmonary artery in short-term administration. The effect of hemodilution on pulmonary hypertension in emphysematic patients with hypoxic polycythemia is, however, somewhat disappointing if the hematocrit value remains below 60%. Some rheological causes for this therapeutic failure are discussed.

Bloodletting↗
PubMed1978

[Lung function tests in emphysema].

Several lung function tests are capable of detecting typical functional abnormalities in pulmonary emphysema, such as reduced elastic recoil of lung tissue, elevation of intrathoracic gas volumes, expiratory bronchial collapse or uneven patterns of ventilation. The measurement of elastic recoil by means of an esophageal catheter also seems to be a reliable technique for detecting early stages of emphysema, but its use for routine clinical investigations remains impracticable. The elevation of intrathoracic gas volumes determined by body plethysmography or helium dilution technique may sometimes be influenced by reversible bronchial obstructions or additional restrictive ventilatory defects. Expiratory collapse of the intrathoracic airways, however, proves to be a regular finding in advanced pulmonary emphysema. It results from decreased stability of the peripheral and central bronchial wall as well as from a shifting of bronchial and transmural pressure gradients to the peripheral airways. The occurrence of a pressure dependent expiratory stenosis can easily be demonstrated by the spirometric flow-volume curve during forced expiration, thus differentiating patients with asthma from those with chronic bronchitis and emphysema. The minimal program for detection and evaluation of emphysematous alterations of the lung by functional tests should consist in the measurement of intrathoracic gas volumes, recording of the forced expiratory volume and the analysis of the flow-volume curve.

Emphysema↗
PubMed1978

[The problem of airway collapse in lung emphysema. Correlation between intravital lung function measurements and morphometric data].

Lowering of forced expired volume in one second as a percentage of vital capacity (FEV1%VC) and check-valve phenomenon of expiratory flow curve (CVPh) are clinical signs of bronchial collapse. In this study the correlations between these functional parameters and morphologic findings are studied. The study comprises autopsy cases in which lung function had been tested 1.5 years on average before death. In 138 cases emphysema was graded on papermounted macrosections and in 52 cases bronchi were studied by morphometry. 19 of the latter were analysed more thoroughly; 9 had shown CVPh. The results were as follows: 1. Collapse phenomena occur more frequently in cases with destructive emphysema than in cases without. However, it is not exclusive to the former. 2. FEV1 and CVPh correlate with hypertrophy of bronchial glands. 3. Cases with CVPh show hypertrophy, not atrophy, of the walls of central bronchi. It follows that bronchial collapse phenomena are mainly influenced by increased bronchial secretion of viscous mucus and not by emphysematous destruction of lung parenchyma. On forced expiration, mucus plugging probably leads to a decrease of intrabronchial pressure in the downstream bronchi. Thus, the downstream bronchi may collapse because the equal pressure point between intrabronchial and intrathoracic pressure shifts from the central to more peripheral bronchi.

Bronchi↗
PubMed1978

[Cytological and histological methods for assessing lung tumours (author's transl)].

The accuracy of different histological and cytological methods were analysed in 240 patients with primary lung cancer. The diagnosis had been confirmed by either biopsy, surgery or autopsy. Using multiple diagnostic procedures a positive pre-operative diagnosis was obtained in 86.5%. Where the tumour was endoscopically visible and accessible to direct biopsy the correct diagnosis was made in 97.5%. In case of more peripheral tumour localisation positive results were obtained by cytological tests in 76.5%. The most accurate method of diagnosis was direct forceps biopsy of visible tumours (91% positive). Bronchial washing was positive in 64%, post-bronchoscopic sputum analysis in 60%, pre-bronchoscopic sputum in 55% and bronchial brushing in 30%.

Autopsy↗