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Biomedical subjects

C Mittermayer

Publications and source records attributed to C Mittermayer.

At least 181 records · Page 10Linked to original sources
PubMed1976

[Pathomorphology of intensive care treatment (author's transl)].

The pathologic consequences of intensive care treatment are manifested locally and generally. Local disturbances due to intensive care therapy are as follows: blood vessel injury, thromboembolism caused by catheterization, tracheal stenosis following tracheostomy and, most important, sepsis. The more general pathologic results of intensive care treatment are essentially brought about by shock. Shock-kidney plays a subordinate role today because it is a reversible state of renal insufficiency. In contrast, shock-lung leads to death in about 50% of the cases. The pathohistologic features of the initial stages are microthrombosis, perivascular edema and endothelial damage. These three characteristics are already apparent before hospital admission and institution of treatment. It is not yet clear to what extent the therapy augments the pathologic changes or leads to clinically manifested symptoms.

Acute Kidney Injury↗
PubMed1976

[Examinations to phenomenon of shock-lung (author's transl)].

The pathogenesis of shock lung as well as the success of therapy in this condition was studied in 79 cases of extrathoracic trauma. The water-, hemoglobin-, and DNA contents of the lungs were measured in order to determine the extent of edema, the rate of perfusion, and proliferation. The cases were divided into two groups according to whether they had or had not received medical therapy before death. The data from these two groups were compared using statistical methods in which time of survival was especially taken into account. The fluid balance, pO2, pCO2, central venous pressure, pH of the serum, total serum protein and serum creatinine were also studied in these cases. Results of the study are as follows. Three phases of the posttraumatic syndrome of shock-lung could be distinguished: phase I (initial phase): blood perfusion is increased, edema is beginning to form, and medical treatment has not yet begun. Phase II (early phase = sydrome of early respiratory failure): pulmonary edema is developing rapidly while perfusion is decreasing. Phase III (late phase = syndrome of late respiratory failure): proliferative changes predominante and the edema is still increasing. The mean weight of the lungs was 397 g (s = 170) in phase I, 774 G (S = 361) In phase II, and 1124 g (s = 310) in phase III. The survival times correlated significantly and positively with the amount of water and DNS in the lungs and significantly and negatively to the amount of hemoglobin in the lungs. Thus, increasing pulmonary edema and increasing proliferative changes occurred with decreasing pulmonary perfusion. This correlation was even noted in groups of patients who had not received medical treatment and whose survival times were short. In treated cases, the fluid balance was significantly and negatively correlated to the total serum protein.

Blood Proteins↗
PubMed1976

Effect of bleomycin on the fine structure of mouse fibroblasts.

Asynchronously dividing mouse fibroblasts (L-cells) treated with the antitumour antibiotic Bleomycin show various rather specific morphological alterations. Many of the cells exposed to bleomycin assume a more or less epitheloid cell shape and are larger than untreated cells; in addition to an increase in nuclear size these cells often contain multiple nuclei. In most of the cells nuclei show an almost complete loss of peripheral condensed chromatin. The nucleolar hypertrophy initially observed is followed by a shrinkage and segregation of the nucleolar components. The cytoplasmic alterations include dilatation of the cisternae of the rough endoplasmic reticulum as well as an increase of free, non membrane attached ribosomes, often arranged in spiral- and rosette-shaped polysomes; they are not specific for bleomycin.

Animals↗
PubMed1976

[Comparative studies on the teaching of oral pathology].

This is a self-assessment of teaching effectiveness for teacher, students and teaching-material as well. A curriculum of oral patholology was created and prepared as syllabus, lectures and audiovisual aids. In order to estimate and compare the eductional achievements of different systems, a series of written multiple choice questions were prepared. Only items with an index of discrimination of more than 0,25 were used. The average index was 0,5. The results of a short-term experimetn (1 hour) shows that a teaching sequence in the conventional lecture style was most effective in transmitting knowledge (72% of maximum), audiovisual aids rating second (63%), followed by individual homework study using printed material (48%). The differences were statistically significant in most experiments. In the second type of experiment (long-term-experiment) we registered the time the students spent with lectures over a period of six months. When permitted to chose between the different systems the students preferred the audiovisual method to the lectures. Individual testing of these students shows a positive correlation between knowledge acquired and time spent with the audiovisual machines.

Audiovisual Aids↗
PubMed1975

Myocardial damage during protracted anaphylactic shock in guinea pigs.

In ovalbumin-sensitized, mepyramine-treated guinea pigs protracted anaphylactic shock was elicited by i.v. injection of antigen. Diffuse or focal necrosis of myocardial cells was found in animals which died in protracted shock, as well as perivascular and interstitial edema. The antigen effects could be partially imitated by i.v. infusion of high amounts of adrenaline into nonsensitized guinea pigs. When adrenaline was infused during protracted anaphylactic shock, the catecholamine effects did not add to the histological effects of the antigen. Rather, the morphological alterations in the hearts were reduced, whereas the survival times were not increased, but decreased. - The findings are discussed in view of the nature of protracted anaphylactic shock.

Anaphylaxis↗
PubMed1975

[Postanastomotic renal-artery stenosis after renal transplantation].

A particular kind of renal-artery stenosis was observed in three of 60 renal transplantations performed between 1969 and 1974. It was always 1.0-1.5 cm distal to the anastomosis and, as histological examination demonstrated, was definitely due to vessel injury after removal of the transplant. To avoid it the proximal arterial stump should be cut off before transplantation. The postanastomotic region must be dissected free during the operation and an extended graft venoplasty or sleeve resection performed.

Adult↗
PubMed1975

Suppression of isoprenaline-induced increase in plasma renin concentration by vasoconstrictors in rats with nonfunctioning Macula densa.

The mechanism of the increase in plasma renin concentration caused by the beta-sympathomimetic agent isoprenaline has been further investigated. Rats were pretreated by occluding the left renal artery for 2 hrs, thus rendering the macula densa cells of this kidney nonfunctioning. After contralateral nephrectomy infusion of isoprenaline (1.5 mug/kg min) still caused a strong increase in plasma renin concentration. This increase was significantly suppressed by simultaneous infusion of angiotensin II (1.0 mug/kg min). The alpha-sympathomimetic amine phenylephrine (60 mug/kg min) or octapressin (10 mU/kg min). The results exclude any mediator-role of the macula densa receptors in the isoprenaline-induced release of renin. The possibility of a stimulation of renin release via the baroreceptors or a direct "secretomotoric" action of isoprenaline is discussed.

Angiotensin II↗
PubMed1975

Pathogenetic aspects of bromocarbamide intoxication.

In bromocarbamide intoxication in humans, as in rabbits, the predominant feature is the endothelial damage characterized by desquamation and vacuolisation, followed by interstitial oedema. Consumption coagulopathy, as observed in some cases of human bromocarbamide intoxication and also in our experimental model, can be prevented by anti-coagulant therapy with heparin and also, as could be shown in rabbits, with aggregation-inhibiting agents. These findings strongly suggest that consumption coagulopathy is only a secondary phenomenon which develops in the course of primary endothelial damage. Similarities in the histological findings of endothelial damage between bromocarbamide intoxication in humans and in rabbits and the so-called "Adalin purpura", which can be observed after chronic use of bromocarbamide, are discussed.

Animals↗
PubMed1975

Experimental investigations into the pathogenesis of endocarditis due to shock.

Generalized Shwartzman reaction (GSR) was induced in rabbits by two intravenous injections of endotoxin 24 hours apart. Consumption coagulopathy was found in all cases. Histological investigations showed an abacterial endocarditis (thrombotica or verruccosa simplex), comparable to the one seen in humans after shock, in 69% of the treated animals. Biopsies of mitral valve were investigated by electron microscopy. In the early stage of GSR the valvular alterations were characterized by an oedema of the entire valve, an increase in the number of microvesicles in the endothelial cytoplasm, and a marked enlargement of endothelial cell surface by numerous cytoplasmic projections. At a later stage autophagic vacuoles, often showing a destruction of their membranes, and degenerative changes in cytoplasmic organelles occurred in many cells of the valve. On the other hand there were cells in the endothelium, which presented a distinctly increased number of Golgi complexes and of cisternae of rough endoplasmic reticulum. In other regions ruptures of endothelial plasmalemma, as well as hemorrhages into the valvular stroma were observed. Thus predestined loci for thrombogenesis were formed. In conjunction with these structural changes three factors may be involved in the formation of endocarditis due to shock: 1. hypercoagulability in the course of consumption coagulopathy, leading to precipitation of fibrin and platelets in the circulating blood; 2. turbulences of the blood flow, which are produced by the closure of the heart valves, and favour thrombogenesis on valves: 3. direct changes of the endocardium during endotoxemia. Quantitative changes in the different compartments of intracytoplasmic organelles in many cells of the endothelium during the later stage of GSR are discussed.

Animals↗
PubMed1975

[Patho-histological findings on pulmonary biopsy in patients after mitral commissurotomy and morphometric studies of the upper and lower pulmonary lobes (author's transl)].

Histological morphometric examination of the lungs of 22 patients with acquired mitral stenosis and 15 control persons is reported. The quotient obtained from wall thickness and lumen diameter of the pulmonary venules gives a reliable estimation of the haemodynamic changes found in the pulmonary vascular system in mitral stenosis patients. The typical changes in the pulmonary vascular system in these patients were observed particularly in the lower pulmonary lobe and to a lesser extent in the lingular of the upper lobe. Biopsy of the lower lobe is preferable in mitral stenosis operations because it results in a better clinical diagnosis.

Biopsy↗
PubMed1975

Pulmonary radiographic abnormalities in shock. Roentgen-clinical-pathological correlation.

Pulmonary insufficiency is one of the most frequent causes of death in patients subjected to shock. The continuous radiographic series, clinical data and autopsy findings in 46 patients are described. The changes in the chest radiograph can be related to the histological findings and are clearly related to changes found by arterial blood analysis. Given the appropriate history, the radiographic picture can provide a clue for the diagnosis of a shock syndrome.

Adolescent↗