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Biomedical subjects

E Deutsch

Publications and source records attributed to E Deutsch.

At least 163 records · Page 9Linked to original sources
PubMed1982

Systemic candidiasis complicating bone marrow transplantation in aplastic anemia. Case report.

A 17-year-old male patient with aplastic anemia underwent bone marrow transplantation and succumbed 4 days after marrow infusion from sudden myocardial failure. Fever of unknown origin (FUO) had accompanied the patients course from admission until death. The cause of death was fungus myocarditis, which had escaped detection in vivo, in spite of a daily culture program for bacteria and fungi, and a close monitoring of the patients circulation and ventricular performance. Commonly applied diagnostic criteria for systemic mycosis, such as topical colonization, malfunction of invaded organs and positive fungus cultures failed to provide a timely diagnosis. With regard to the problems in diagnosing systemic mycosis, the potential stem cell toxicity of antifungal drugs and the need for immunosuppressive therapy prior to marrow infusion, we strongly recommend not to start the transplantation procedure unless FUO has been treated successfully.

Adolescent↗
PubMed1982

[Secondary oxalosis in chronic renal insufficiency].

The concentration of oxalic acid was determined in the plasma of 15 patients with conservatively treated chronic renal insufficiency and 17 dialysis patients. A cumulation of oxalic acid was found in connection with uraemia. The extent to which plasma oxalic acid concentrations were raised depended on the degree of renal insufficiency and was directly related to the plasma creatinine values in all patients with or without dialysis. In the patients with chronic renal insufficiency the median plasma oxalic acid concentration was 74.4-18.5 (control group 27.0 +/- 7.4) mumol/l. In the dialysis patients the levels were even higher, at 137.5 +/- 56.0 mumol. By means of haemodialysis it was possible to lower the plasma oxalic levels by about the same amount as creatinine concentrations. The higher plasma oxalic acid concentrations seem to be an important pathogenetic factor in the formation of uraemic calcification in various organs. The therapeutic consequences are to increase the duration and frequency of dialysis and to remedy possible vitamin B6 deficiency.

Adult↗
PubMed1982

Effect of coronary blood flow on uptake and washout of Tc-99m DMPE and Tl-201.

After intravenous administration of Tc-99m DMPE the flow-dependent kinetics were studied in dogs during induced ischemia and during induced maximal reactive hyperemia. A control group was also studied. Mean time-activity curves obtained from the myocardial wall were compared within the same intervention group and also with other groups. During reactive hyperemia, there was a rapid and absolute increase in uptake followed by a rapid washout, whereas during ischemia there was a slow and decreased uptake followed by a slow washout. The magnitude of Tc-99m DMPE uptake during reactive hyperemia was slightly less than that of Tl-201, but the decreased uptake with ischemia was about equal for the two agents. Following maximal uptake in the myocardium the effective half-life of Tc-99m DMPE was one-third to one-fourth that of Tl-201. The similar kinetics of Tc-99m DMPE compared to Tl-201 suggests its usefulness in the evaluation of ischemic heart disease.

Animals↗
PubMed1982

Basal kinetic studies of Tc-99m DMPE as a myocardial imaging agent in the dog.

Newly synthesized Tc-99m dichlorobis(1,2-dimethylphosphino)ethane (DMPE) was investigated as a myocardial imaging agent with respect to its kinetics (dependent on both time and regional coronary blood flow), its percent organ uptake, and its imaging characteristics in the anesthetized dog. Most of these data are compared with those of Tl-201. Blood clearance of the two agents is essentially the same. Compared with Tl-201, Tc-99m DMPE shows faster overall kinetics, higher heart-to-lung ratio, equally good correlation with a wide range of regional blood flows, and higher liver uptake. At the time of peak myocardial uptake, the mean heart uptake of Tl-201 is 4.3%, compared with 2.9% for Tc-99m DMPE, yet only 0.9% uptake of Tc-99m DMPE is found in the lung as compared with 3.3% for Tl-201. These differences result in a heart-to-lung ratio of 2:1 for Tc-99m DMPE and 1:1 for Tl-201, based on the data obtained from the time-activity curve. The quantitative findings are supported by the superior quality of Tc-99m DMPE images of both normal and infarcted dog heart. The high hepatic uptake of Tc-99m DMPE is not a serious problem if images are obtained within 5-60 min after dose. These basic kinetic studies suggest that Tc-99m DMPE is a promising myocardial imaging agent.

Animals↗
PubMed1982

Civil liability in the field of biomedical engineering and medical physics.

The article deals with the protection the law provides against risks emanating from the use of biomedical equipment. After a brief discussion of public safety regulations, it turns to civil liability for damages involving patients or other persons. Doctors and hospitals using or failing to use biomedical equipment can be held liable for negligent conduct only. The standards of care to be observed in biomedical engineering are thus explained, as is the correct use of the equipment, the safety precautions to be taken, and the expertise of the operator. Another very important subject of the article is the liability of the manufacturers of biomedical equipment. Finally, the extremely difficult question is discussed as to what extent doctors and hospitals are obliged to acquire new but very expensive equipment, and what are the economic limits of this obligation.

Biomedical Engineering↗
PubMed1982

[Action of tioxaprofen on platelet function (author's transl)].

The action of 3-[4,5-bis-(4-chlorophenyl)-oxazolyl-(2)-thio]-propionic acid (tioxaprofen, EMD 26 644), a non-steroidal antiinflammatory substance, on platelet function has been studied in vitro and ex vitro. Collagen-induced aggregation and the second phase of adrenaline-induced aggregation are inhibited by small concentrations of tioxaprofen, The ADP-induced aggregation being inhibited only by higher concentrations. The generation of malonedialdehyde (MDA) is blocked. The pathological spontaneous aggregation found by the method of Born was reversed after treatment, and the pathologically increased aggregation according to platelet aggregation test (PAT I) of Breddin was normalized. Tioxaprofen blocks the formation of thromboxane most probably by inhibition of cyclo-oxygenase, but an inhibition of thromboxane synthetase cannot be excluded by our results. The in vivo action starts immediately after ingestion of tioxaprofen and is maintained by small doses. By checking the routine parameters of the blood a slight increase of creatinine and blood urea nitrogen (BUN) and a slight reduction of gamma-GT and alkaline phosphatase were found, all values remaining within the reference interval.

Adenosine Diphosphate↗
PubMed1981

Heart imaging with cationic complexes of technetium.

The cationic technetium-99 complex trans-[99TC(dmpe)2Cl2]+, where dmpe is bis(1,2-dimethylphosphino)ethane or (CH3)2P-CH2-P(CH3)2, has been prepared and characterized by single-crystal, x-ray structural analysis. The technetium-99m analog, trans-(99mTc(dmpe) 2Cl2]+, has also been prepared and shown to yield excellent gamma-ray images of the heart. The purposeful design, characterization, and synthesis of this technetium-99m radiopharmaceutical represents a striking application of fundamental inorganic chemistry to a problem in applied nuclear medicine.

Animals↗
PubMed1981

[Diagnosis of pancreatic function. Simplified screening with fluorescein dilaurate using serum concentration determinations].

Fluorescein-dilaurate has been recommended as a screening test for the assessment of exocrine pancreatic function. In this test fluorescein excretion in the urine is measured for an 8--10 hour period. To avoid urine collection the present study reports on serum fluorescein determinations following oral administration of fluorescein-dilaurate-ester. According to the results of a standard secretin-pancreozymin-test 24 subjects were classified as 10 persons with normal pancreatic function, 7 patients with mild and 7 patients with severe exocrine pancreatic insufficiency. Fluorescein concentrations were measured photometrically after TCA-precipitation. In the normal persons maximal fluorescein levels were observed 4--6 hours after oral load of the test substance. Patients with mild pancreatic insufficiency showed the same pattern and only in patients with severe pancreatic insufficiency much lower serum fluorescein concentrations were found. They were statistically significantly different from normal subjects 3--6 hours after administration of fluorescein-dilaurate.

Adult↗
PubMed1981

[Case report of a patient with intermittent fever, leucopenia and terminal fungal sepsis (author's transl)].

A fatal case of disseminated candidiasis with deep organ involvement is reported. The patient was employed as a radiologist for several decades and already showed X-ray-induced bone marrow damage at the onset of the disease. He suffered for several years from an unknown granulomatous systemic bacterial infection and had been treated with antimicrobial agents with varying degrees of success. Regarding prophylaxis of systemic Candida infections it is concluded that prolonged medication with glucocorticoids and antibiotics should be combined with the oral administration of antimycotic drugs in order to prevent invasion by potentially pathogenic fungi.

Anti-Bacterial Agents↗
PubMed1981

[Causal therapeutic management of aplastic anaemia (author's transl)].

Aplastic anaemia is characterized by hypoplasia of haemopoietic tissue. The aetiology of aplastic anaemia is multifactorial, the majority of cases being termed "idiopathic" because of lack of discernible noxious agents. Treatment can include stimulation of haemopoietic stem cells or replacement of stem cells by bone marrow transplantation. Some cases show autoimmune-mediated marrow failure and these patients may respond to immunosuppressive therapy. Pathophysiological subclassification of individual cases is necessary to ensure the correct choice of therapy offering the best chance of success, at minimum risk, from amongst a multitude of therapeutic procedures.

Adrenal Cortex Hormones↗
PubMed1981

[Prognosis of panmyelopathy: a retrospective study (author's transl)].

45 patients with pancytopenia were admitted and treated at the 1st Department of Medicine, University of Vienna, between 1972 and 1978. Retrospective analysis disclosed a significantly longer survival time in association with a hypercellular bone-marrow smear. These patients showed a higher incidence of remission with cortisone anabolic therapy, but more often developed acute leukaemia as well. The median survival time of patients with pancytopenia and a hypocellular or blank marrow was five months. This group of patients should, therefore, be considered for early bone-marrow transplantation.

Adolescent↗
PubMed1981

Comparison of the effects of muzolimine and furosemide in patients with end-stage renal failure on chronic dialysis.

The pharmacodynamic effects of muzolimine and furosemide were compared in a single dose cross-over study in 8 patients on regular dialysis treatment, who had a residual diuresis of more than 300 ml/day. The study periods comprised two dialysis-free intervals of 3 days. On the second dialysis-free day either muzolimine 240 mg or furosemide 240 mg was administered orally. Urine was collected in 12-h periods on the pre-treatment, treatment and post-treatment days, and the excretion of sodium, potassium, urea and creatinine were measured. After administration of muzolimine 240 mg urine volume rose to twice that of the previous day, and sodium excretion increased approximately threefold. In contrast, the effect of furosemide 240 mg was not a pronounced; the diuresis was only 1.6 times that on the previous day and natriuresis was only 2.2 times as large. Excretion of potassium and creatinine was only slightly increased by either substance. The elimination of urea was increased by both substances to the same degree as the corresponding increase in diuresis.

Creatinine↗