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Biomedical subjects

F Haas

Publications and source records attributed to F Haas.

At least 19 recordsLinked to original sources

Serial sectioning of insects with hard exoskeleton by dissolution of the exocuticle.

The method reported here was designed to produce paraffin serial sections as thin as 5 microns of insects or other arthropods with a hard cuticle. Heads and abdomens of Apis mellifera, Eristalomyia tenax and Tenebrio molitor were fixed with Schaffer's liquid, dehydrate with 80% ethanol, 90% ethanol, two changes of 100% isopropanol (2 hr each) and 12 hr in a 1:1 mixture of paraffin (58 C melting point) at 60 C. They were molded in paraffin after 12 hr of infiltration under a partial vacuum at 60 C. Large body openings of objects were sealed with paraffin to prevent infiltration of solvents. Thereafter, the outer paraffin was removed manually and with xylene (15 min); the cuticle was rehydrated with 100% isopropanol and 100% ethanol (15 min each). The objects were then treated with Sputofluol (Merck; a mixture of NaOH and NaClO) until they became white or their colorless endocuticle was stainable with aniline blue WS (C.I. 42755) after rinsing in a 50% acetic acid solution (v/v). They were then dehydrated with 100% ethanol and 100% isopropanol (15 min each) and subsequently re-embedded in paraffin. They were molded, sectioned, stained and mounted as usual.

Animals

[Polyposis of the nasal sinuses. Epidemiology and clinical aspects of 350 cases. Treatment and results with a follow-up over 5 years on 93 cases].

The authors report a series of 350 patients referred for clinical investigation of nasal polyps between 1980 and 1990. 93 patients were followed for more than 5 years. Allergy to inhalants was rarely found (2.8%). Detailed study of past rhinosinusal and bronchial symptoms often revealed a history of vasomotor rhinitis (nasal hyperreactivity HRN) preceding the nasal polyposis by a mean interval of 8 years. The ratio non-allergic vasomotor rhinitis/nasal polyps was 4.31 in women (41.4% of the patients) and 1.74 in men (58.6% of the patients). Treatment is usually based on the use of local corticosteroids. However, because of the variable clinical pattern of nasal polyposis treatment may be medical alone or both medical and surgical, and always requires a long clinical follow-up. Intolerance to aspirin is a factor of poor prognosis. A 15% failure rate was noted among patients intolerant to aspirin.

Adolescent

Global and regional ventricular function following intracoronary application of papaverine.

Intracoronary injection of papaverine is used to determine coronary flow reserve in patients. The present study was to investigate the effect of papaverine on the performance of myocardium with reduced flow reserve. In nine anaesthetized open-chest dogs a bypass from the aorta to the left circumflex coronary artery (LCX) was established. Left ventricular end-diastolic and aortic pressure, dP/dt, stroke volume, LCX blood flow, and ECG were monitored. The performance of a segment of subendocardial wall supplied by the LCX was assessed by sonomicrometry. Peak reactive hyperaemia after 15s bypass occlusion was 1.44 +/- 0.09 times the baseline flow (41 ml/min), indicating reduced coronary flow reserve. Papaverine was injected into the bypass (0.3, 0.6, 1.2, 2.5, 5.0 mg/ml, 1 ml in 15s). The maximum LCX flow following PAPA 0.3 mg was comparable to peak reactive hyperaemia, but 10-15% higher after injection of 0.6-5.0 mg papaverine. Systolic shortening of the myocardium (control: 17.5% of end-diastolic length) became reduced in a dose-dependent fashion (5-25%) for about 1 min following papaverine injection. Stroke volume (control: 0.94 +/- 0.12 ml/kg) was reduced by about 8%, left ventricular end-diastolic pressure (control: 6.2 +/- 0.8 mmHg) increased by 15%, and dP/dtmin (control: 1850 +/- 150 mmHg/s) was curtailed by 15-25%. The ECG showed a transient T inversion and S-T depression following papaverine administration and in one experiment ventricular fibrillation occurred after the injection of 2.5 mg papaverine. The observed effects of intracoronary papaverine are consistent with the theory of transient subendocardial ischaemia arising from a redistribution of blood flow from the subendocardial to the subepicardial layers, because of greater vasodilatory capacity in the latter than in the former.

Animals

Effect of the 'specific bradycardic agent' alinidine on the function of ischemic myocardium.

In patients with coronary artery disease, the reduction of heart rate (HR) by beta-blockers can further impair myocardial function by reducing the contractility and coronary perfusion. This is possibly not the case for "specific bradycardic agents" like alinidine (ALI). The effect of ALI on ischemic myocardium, therefore, was studied in anesthetized open-chest dogs measuring left ventricular end-diastolic pressure (LVedP), dP/dt, aortic pressure (AoP) by catheter tip manometers, coronary blood flow (Q) electromagnetically, end-diastolic length (edL) and systolic shortening (sdL in %edL) of ischemic (RISC) and non-ischemic (NISC) wall segments by sonomicrometry. Group A (n = 11): Left coronary artery constriction to reduce Q (-53%) and poststenotic sdL (-54%), then i.v. injection of ALI (0.25 + 0.25 + 0.5 + 1.0 mg/kg), thereafter atrial pacing at HR before ALI. Group B (n = 9): Installation of an aorto-coronary bypass, pump-perfused at 50% of free flow, infusion of ALI into the bypass. The results showed that ALI iv dose-dependently reduced HR from 135/min to 90/min, LVedP rose from 8.6 to 10.0 mmHg and NISC-edL from 14.1 to 14.6 mm indicating increased ventricular filling. Non-ischemic systolic shortening did not change. Ischemic systolic shortening was improved from 9.2% to 17.5%, which was not due to an increase in RISC-edL (14.8 versus 14.7 mm), enhanced RISC-Q (13 versus 12 ml/min), reduced AoP (86 versus 84 mmHg) or change in inotropy (dP/dtmax: 2290 versus 2240 mmhg/s), but the increase in RISC-sdl correlated closely (r greater than 0.85) to the reduction in HR (oxygen-demand).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Effect of milk ingestion on pulmonary function in healthy and asthmatic subjects.

Since Maimonides, it has been common in folk medicine to proscribe milk for asthmatics because its putative stimulation of mucus production can exacerbate asthma symptoms. A literature review, however, failed to reveal any data supporting this notion. We, therefore, compared the effects of ingesting 16 oz. of whole milk (16 g lipid), skim milk (2 g lipid), and water (each on a separate day) on: (1) forced expiratory volume in 1 second (FEV1), (2) forced expiratory flow at 50% of vital capacity (V50), and (3) pulmonary diffusing capacity (DLCO) in 11 asthmatic and 10 nonasthmatic subjects. Measurements were taken at 30 minute intervals for 3 hours. The two milk types did not significantly change FEV1 or V50 in either group, indicating that the amount ingested did not change airway resistance sufficiently to alter airflow parameters. In the asthmatic group, however, DLCO decreased progressively over the 3 hours by 6.8 +/- 1.4% (mean +/- SE) per hour after whole milk (maximum reduction = 21 +/- 1.4%) but not after water or skim milk. In the nonasthmatic group, no significant effects were observed on DLCO after any of the liquids. These data suggest that milk lipids can disturb gas exchange in asthmatic patients.

Adult

The influence of coronary angiography and angioplasty on parameters of hemostasis and fibrinolysis.

The influence of invasive investigations on parameters of hemostasis and fibrinolysis is generally unknown, although this has consequences for the design of prospective studies on the association between those parameters and regression or progression of atherosclerosis. We therefore determined hemostatic and fibrinolytic factors in 12 patients who were admitted to the hospital for coronary angiography (CAG; n = 5) or percutaneous transluminal coronary angioplasty (PTCA; n = 7). Blood samples were drawn under basal circumstances on the day before, the day of and the day after CAG or PTCA. Significant changes occur in the concentrations of platelets and white blood cells, hematocrit (Ht), von Willebrand factor antigen (vWF:ag), antithrombin III-activity (AT III-ag), antithrombin III-antigen (AT III-ant), fibrinogen, plasminogen, alpha2-antiplasmin (alpha2-AP), histidine-rich glycoprotein (HRG), and plasminogen activator inhibitor (PAI)-activity. Mean values of beta-thromboglobulin, platelet factor 4, factor VIII:C, tissue-type plasminogen activator activity (t-PA act) and euglobulin clot lysis time (ECLT) do not differ significantly. After correction for Ht, no significant differences exist between the day before and the day of the procedure; but on the day after CAG and PTCA significant differences occur in white blood cells, factor VIII:C, AT III-ag, alpha2-AP and PAI-act. It is concluded that principally blood samples for investigations on fibrinolysis may be taken on the day before or the day of CAG or PTCA without a loss of quality, if the values are corrected for Ht. Samples taken on the day after the procedure are not useful for such purposes.

Angina Pectoris

Complications after cardiac operations in patients with severe pulmonary impairment.

The postoperative courses of 39 patients with severe lung disease (31 with obstructive disease and 8 restrictive) who underwent a cardiac operation were retrospectively reviewed. The stay in the intensive care unit of the study group was 7.9 +/- 10.3 days (mean +/- standard deviation) compared with 2.4 +/- 3.9 days for the control group (100 patients with less impaired pulmonary function) (p less than 0.001). The study group also had a greater number of valve replacements than did the control group (p less than 0.01). Patients with obstructive disease had more respiratory complications than did patients with restrictive disease (p less than 0.05). There were 21 cases of atelectasis. Effusions were noted in 11 patients. Ten patients had bronchospasm. Bronchial secretions were a major problem in 6 patients. Pneumonia developed in 4 patients, and pneumothorax occurred in 3 others. The two in-hospital deaths were not directly related to pulmonary complications. Our findings indicate that (1) patients with severe lung impairment generally do well after a cardiac operation but have more postoperative pulmonary complications than patients with less impairment; (2) patients with restrictive pulmonary disease appear to fare better than those with obstructive disease; (3) pulmonary function tests can alert the clinician to the possible risk of postoperative complications, but they cannot, by themselves, be used to exclude patients from operation; and (4) patients with severe pulmonary impairment facing valve replacement are at greater risk of pulmonary complications than patients having other types of cardiac surgical intervention.

Bronchial Spasm

Pentoxifylline improves pulmonary gas exchange.

Pentoxifylline is a xanthine derivative with hemorrheologic and vascular properties that may improve gas exchange in patients with chronic obstructive pulmonary disease (COPD). We tested this hypothesis in 12 patients with COPD (mean FEV1 = 40 percent predicted; mean DCO, 8.6 ml/min/mm Hg) randomly divided into a treatment and control group and six healthy volunteers. Following establishment of baseline DCO and maximum expiratory flow volume (MEFV) curve values, each subject in the treatment and healthy groups took 400 mg of pentoxifylline three times a day for 12 weeks. Weekly DCO and MEFV curves were measured before treadmill exercise in both COPD groups and before and after exercise in the healthy group. The MEFV curve parameters from the final three weeks of therapy did not differ significantly from baseline values. During this time, however, the treatment COPD group's resting DCO rose by 8.2 +/- 2.4 percent over baseline level (p less than 0.01). Treadmill walk time increased from 17.7 +/- 2.9 minutes to 23.2 +/- 2.9 minutes (p less than 0.02). This was accompanied by improved exercise oxygen saturation measured by oximetry (SoxiO2). Premedication SoxiO2 fell from 92.8 +/- 1.2 percent to 88.6 +/- 2.5 percent during exercise, and from 94.4 +/- 1.1 percent to only 91.8 +/- 1.0 percent after 12 weeks of medication (p less than 0.05). No such improvement was noted in the control COPD group. Although the healthy group's resting SoxiO2 and DCO did not change during treatment, their exercise DCO increased significantly from 36.3 +/- 3.1 ml/min/mm Hg to 41.8 +/- 3.5 ml/min/mm Hg (p less than 0.001). These data demonstrate that pentoxifylline improves gas exchange, possibly by increasing cardiac output, and/or by raising mixed venous PO2, and/or by improving blood flow to underperfused alveoli.

Adult

[Skull vault bone graft in augmentation septorhinoplasty].

We describe our technique of augmentation rhinoplasty with bone grafting. Degloving is used as the surgical access in collapsed noses, and midcolumellar incision allows further buildup of the nasal contour. A V cutting is made on the dorsum to receive the graft. A split skull graft is taken with a drill and an osteotome. The sculpted bone implant is maintained in position with a miniaturized screw. We compare various bone grafts and types of surgical access.

Bone Transplantation

Aortic arch anomaly presenting as exercise-induced asthma.

We present the case of a young woman with a right aortic arch who first became symptomatic when she began a vigorous exercise program. Her symptoms were very suggestive of exercise-induced bronchospasm. Her flow-volume curves, however, showed evidence of variable intrathoracic large airways obstruction. A magnetic resonance imaging scan confirmed the presence of severe tracheal narrowing caused by her right aortic arch.

Adult

Immunohistological characteristics of nasal polyps. A comparison with healthy mucosa and chronic sinusitis.

Immunohistological investigations were performed on a series of samples from 37 patients with nasal polyps, 22 with chronic sinusitis, and 15 controls with healthy nasal and sinusal mucosa. Mean numbers of plasma- and mast cells were not different in the various groups. Immunoglobulin isotypes were always predominantly IgA and IgM; IgE were scarce. Deposited immune complexes were always absent. A statistically significant difference, however, was observed in the number of eosinophils within the mucosa. Patients with nasal polyps had up to ten times more eosinophils per surface unit than patients with sinusitis or healthy mucosa.

Adolescent

Aerobic training effects of electrically induced lower extremity exercises in spinal cord injured people.

Eleven people with spinal cord injury (SCI) (C4-T6) participated in a program of functional electric stimulation (FES) of their paralyzed leg muscles using the REGYS I system. Individualized protocols consisted of an initial phase of weight lifting, an intermediate phase of ergometer pedalling against 0 Kilopond (kp) alternated with 1/8kp for six two-minute runs separated by two-minute rest periods, and a final phase of 36 sessions of continuous ergometer pedalling against variable resistance. A metabolic analyzer measured exercise stress test parameters before and after each phase while subjects pedalled against incremented resistance. Peak oxygen consumption and total stress test time increased markedly. The respiratory exchange ratio (R=VCO2/VO2) at termination, however, did not differ from unity at any phase, indicating that fatigue (defined as a failure to maintain a pedalling frequency of 35 rpm) occurred when the anaerobic threshold was reached, and that FES exercise can increase the aerobic capacity of persons with SCI. The initial velocity of quadriceps shortening (derived from patellar tendon displacements) also decreased in five of eight subjects tested, suggesting corresponding increases in quadriceps twitch time. Since muscle inactivity converts slow-twitch to fast-twitch fibers, our subjects' increased muscle endurance accompanied by decreased muscle-shortening velocity were compatible with a disproportionate increase in the function of slow-twitch fibers relative to fast-twitch fibers. Although these findings demonstrate that lower extremity FES exercises can safely achieve significant aerobic training effects in patients with SCI, the peak levels of cardiorespiratory performance were similar to those reported for quadriplegic people performing maximal voluntary upper extremity exercises.

Adult

Autotransfusion of drained mediastinal blood after cardiac surgery: a reappraisal.

In a randomised prospective study the efficacy of autotransfusion was investigated in two groups of 25 patients, a study group in which autologous blood was collected from the mediastinal tubes and retransfused, and a second, control group, in which only stored blood was used. In the study group, a reduction of 50% in the amount of stored blood required was observed. However, in two out of 25 patients the transfusion system could not be used due to clot formation in one of its components. From the total bloodloss per patient about 25% became available for autotransfusion. No significant differences between the two groups were found for hemoglobine, hematocrite, white blood count, platelets and fibrinogen level. Coagulation studies of the drain blood indicate that an active process of mediastinal clotting, followed by fibrinolysis occurs during the losing and collecting. The blood available for retransfusion contained a considerable amount of small-sized debris. It is concluded that autotransfusion of drain blood is not to be recommended for routine use.

Blood Coagulation

Respiratory load compensation in neuromuscular disorders.

First-breath ventilatory responses to graded elastic (delta E) and resistive (delta R) loads from 10 people with spinal muscular atrophy (SMA), 15 people with Duchenne muscular dystrophy (DMD), and 80 able-bodied people were compared. The SMA and DMD groups produced equal tidal volume, respiratory frequency, inspiratory duration (TI), expiratory duration, mean inspiratory airflow, and duty cycle responses to both delta E and delta R. Thus SMA (primarily a motoneuron disorder) and DMD (primarily a muscle disorder) have the same net effect on loaded breathing responses. The SMA and DMD groups failed to duplicate the normal group's short expirations during delta E, long inspirations during delta R, and thus, extended duty cycles during both delta E and delta R. The deficit in load compensation therefore was due to impaired regulation of respiratory timing (reflecting neural mechanisms) but not airflow defense (reflecting mechanical and neural mechanisms). One-fifth of the normal but none of the SMA or DMD subjects actively generated an "optimal" TI response (defined theoretically as TI greater than 160% control during large delta R and TI less than 75% control during large delta E). This lack of optimal responses, which is the same abnormality exhibited by quadriplegic people, suggests that SMA and DMD also impair human ability to discriminate between large delta R and delta E. These findings support the hypothesis that neuromuscular disorders can lead to disturbances in respiratory perception.

Adult

Changes in serum K+ in healthy and in asthmatic subjects during exercise.

Adrenergic mechanisms modulate exercise-induced changes in blood serum K+ concentration ([K+]). Impairment of these same mechanisms may be associated with bronchial hyper-reactivity. If this is accurate, asthmatic subjects should show disturbed K+ regulation during exercise. We measured [K+] and FEV1 in 13 healthy control and in 13 asthmatic subjects pre-exercise, at peak exercise (within 1 min of stopping exercise), and 10 min postexercise. This was done on 2 separate days, one with and one without bronchodilator (BD) pretreatment. Both groups were equally fit, exercising to the same O2 consumption and heart rate. Resting [K+] was normal for both groups (two-day averages were 4.00 +/- 0.07 and 4.09 +/- 0.07 mmol/L, mean +/- SEM, in control and asthmatic subjects, respectively). Without BD pretreatment, at peak exercise, [K+] in control subjects rose by 0.56 +/- 0.08 compared with 0.96 +/- 0.09 in asthmatics (p less than 0.01). After exercise, [K+] returned to baseline (4.12 +/- 0.08) in control subjects but remained elevated in asthmatics (4.60 +/- 0.12, p less than 0.01). Although FEV1 was unchanged in control subjects, in asthmatics it fell after exercise (p less than 0.01). With BD pretreatment: peak exercise [K+] increased by 0.55 +/- 0.09 in control subjects, and by 0.49 +/- 0.01 in asthmatics (p less than 0.01). By 10 min postexercise, it returned to baseline in both groups (4.15 +/- 0.11 for control subjects and 4.32 +/- 0.07 for asthmatics). The asthma group's fall in FEV1 was also abolished. These data indicate that postexercise K+ remains elevated in asthmatics, supporting the suggestion that their adrenergic function is impaired.

Adult

Respiratory load-compensating mechanisms in muscular dystrophy.

First-breath ventilatory responses to graded elastic and resistive loads were obtained from 15 people with Duchenne muscular dystrophy (DMD), 5 people with facioscapulohumeral MD (FSH), 3 people with Becker MD, and 3 people with limb-girdle MD. For each load tidal volumes from different individuals ranged from relatively small to comparatively large values, indicating a correspondingly wide range of end-inspiratory efforts; strong tidal volume defenders generally employed longer inspirations and higher mean inspiratory airflows than did weak tidal volume defenders; and individual frequency responses were mediated by changes in inspiratory and/or expiratory timing. Thus the loaded breathing responses of people with MD are qualitatively the same as those of quadriplegic and able-bodied people. Quantitatively, however, the DMD group generated considerably larger tidal volumes than did the FSH group during both elastic and resistive loading. These larger tidal volumes were achieved by both longer inspirations (a neurally mediated phenomenon) and higher mean inspiratory airflows (a mechanically and/or neurally mediated phenomenon). These findings, which could not be attributed to differences in respiratory motor function, suggest that there are differences between the respiratory sensory and/or central functions in the Duchenne and facioscapulohumeral types of MD.

Biomechanical Phenomena

Effect of aerobic training on forced expiratory airflow in exercising asthmatic humans.

Pulmonary function after exercise was evaluated in 22 asthmatic subjects before and after a 36-session training sequence of aerobic exercise. Training did not change pulmonary function values, except for a small increase in maximal voluntary ventilation (P less than 0.02), which was attributed to respiratory muscle training. After aerobic training, both external work at a given heart rate and peak O2 consumption increased by 30 and 15%, respectively. At the same minute ventilation (VE), immediate postexercise forced expiratory airflow was higher after training (P less than 0.02), and reduction in forced expiratory airflow during the first 9 min postexercise was less after training (P less than 0.01). The posttraining airflow response to the pretraining work load was, as expected, less than the pretraining response (P less than 0.02). Although the difference in maximal-to-minimal airflow at the same VE was similar before and after training, the airflow increase accounted for 50% of the response after training compared with 16% of the pretraining response. Furthermore the strong negative correlation (P less than 0.01) between maximal and minimal airflow both pre- and posttraining indicates that exercise-induced bronchospasm (EIB) severity is, in part, determined by the degree of exercise-induced bronchodilation. We conclude that aerobic training significantly increases exercise-induced bronchodilation and diminishes EIB.

Aerobiosis

[Gluing of the Achilles tendon with a fibrin adhesive].

Reported in this paper are clinical findings and results obtained from follow-up checks, using computed tomography, in the wake of fibrin adhesive treatment of Achilles tendon ruptures. Complaints had almost completely disappeared from 27 in 35 patients who had undergone the above operations, between 1981 and 1985. These findings were confirmed by functional follow-up examinations. Investigations of Achilles tendons, using computed tomography, revealed increase in both tendon cross-section and density, within two to eight weeks from fibrin-adhesive surgery.

Achilles Tendon