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Biomedical subjects

F Kummer

Publications and source records attributed to F Kummer.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Therapeutic principles of bronchopulmonary infections in the aged].

Airways and lungs are equipped with a highly effective defense mechanism. These can bei found damaged in the aged: Cough is weaker, mucociliary clearance and mucous production are irregular. This damage can bei caused and increased by smoking, recurrent infection, and some sorts of air pollution (SO2). We call it a primary infection, when the organ has been intact as well as the general condition (immune defense etc), and where the causative agent is a virus or virus-like organism. A secondary infection is conditioned by previous disease, and when the causative agents are bacilli. Finally, a tertiary infection is dependent on a defense failure of the body and on opportunistic organisms. For elderly patients, secondary infections outweight the others (recurrent purulent bronchitits). However, tertiary infections must also bei considered in bedridden or post-operative patients or in those with metabolic disease. Finally, pneumonia in the aged must be differentiated in terms of underlying carcinoma, infarction, aspiration and tuberculosis. Therapy of primary (viral)infection consists mainly in prophylaxis of bacterial secondary infection. The choice of drug, dosage and duration of treatment depends on the degree of previous damage to the organ, of complications and status of the whole body and it's defense mechanisms.

Aged↗
PubMed1982

67Ga scanning for assessment of disease activity and therapy decisions in pulmonary sarcoidosis in comparison to chest radiography, serum ACE and blood T-lymphocytes.

In 60 patients with histologically proven sarcoidosis, 67Ga scanning was evaluated in terms of sensitivity and specificity for assessing disease activity and compared with chest radiography, serum ACE and blood T-lymphocytes. While 67Ga scans had the highest sensitivity (94%), the specificity was only 68%. The sensitivity of chest radiography was 80%, of serum ACE and blood T-lymphocytes 77% and 48%, respectively. While in patients with radiographical type I, 67Ga scanning, chest radiography and serum ACE had a sensitivity of 92%-100%, in patients with radiographical type II-III, only 67Ga scans had a sensitivity exceeding 90%. A 67Ga score correlated significantly with serum ACE levels (r = 0.59, P less than 0.001). After effective steroid treatment, 67Ga uptake and serum ACE activities decreased markedly. While in 25% of cases, chest radiography failed to provide reliable information, 67Ga scanning and serum ACE activities always proved useful in evaluating the course of the disease and the patient's response to steroid therapy. A negative 67Ga scan together with normal serum ACE levels seem to have a high predictive value for excluding active sarcoidosis.

Adolescent↗
PubMed1982

Assessment of activity in Sarcoidosis. Sensitivity and specificity of 67Gallium scintigraphy, serum ACE levels, chest roentgenography, and blood lymphocyte subpopulations.

The value of different factors are examined to assess activity in 60 patients with biopsy-proven sarcoidosis. In patients with active sarcoidosis (n = 35), 67Gallium scans proved to be the most sensitive method (94 percent sensitivity), followed by serum angiotensin I converting enzyme (S-ACE) levels, chest x-ray films, and lymphocyte assays. In patients with peripheral pulmonary lesions, chest x-ray films failed in 32 percent of cases to document activity (68 percent sensitivity) whereas 67Ga scans and S-ACE levels remained to give reliable results. Despite poor specificity, negative 67Ga scans together with normal ACE levels have a high predictive value for exclusion of active sarcoidosis. In patients with peripheral pulmonary lesions, chest roentgenography is of doubtful value for staging lung involvement and assessment of activity including monitoring and control of therapy.

Adolescent↗
PubMed1981

[Central regulation of breathing in idiopathic scoliosis (author's transl)].

Idiopathic scoliosis is in nearly 80% associated with an EEG deviating from a normal pattern. Therefore a possible cerebral dysfunction as one of the etiologic factors in the development of idiopathic scoliosis is discussed. In consequence, we studied the central respiratory regulation in 26 patients with idiopathic scoliosis by means of CO2 response with the CO2 rebreathing technique, also vital capacity (VC), maximal voluntary ventilation (MVV), respiratory minute volume at 50, 60 and 70 mm Hg arterial pCO2 and EEG. The CO2-index (1/min/mm Hg CO2) was significantly lower in patients with idiopathic scoliosis (0.92 +/- 0.43) than in normals (1.5 +/- 0.3). The decrease of CO2-index is mainly associated with the smaller VC of the patients (76 +/- 26% of predicted). There is no sign of an additional influence of cerebral dysfunction. Patients with idiopathic scoliosis are able to utilize 70% of the individual breathing reserve like normals when stimulated with CO2. The EEG and the VC show a negative correlation. This may possibly be due to a compensation of the preexisting cerebral dysfunction. VC however decreases during the natural course of disease. No significant correlation could be found between CO2-index and the angle of scoliosis, indicating the absence of a causal relation between the degree of deformation itself and the function of the center of respiratory regulation.

Adolescent↗
PubMed1980

[Angiotensin converting enzyme (ACE) a bloodtest for diagnosis of sarcoidosis (author's transl)].

Serum angiotensin-converting enzyme (ACE) was studied in 50 patients with sarcoidosis (39 active, 11 inactive) as well as in 50 control patients (34 with chronic nonspecific lung disease, 9 with Hodgkin and 7 with rheumatoid arthritis). There was a significant difference of ACE activity between sarcoidosis patients (28.6 +/- 11.4) and controls (14.8 +/- 4), and also between active (32.8 +/- 11) and the inactive (21.9 +/- 5.1) sarcoidosis (p less than 0.001). Coricosteroid treatment seems to lower ACE activity in patients with sarcoidosis without offering a clue for clinical improvement. Increased ACE activity in other granulomatous disorders is being discussed. ACE activity thus proves to be a valuable test especially in differentiating active from inactive sarcoidosis.

Adrenal Cortex Hormones↗
PubMed1980

[Lung function after thoracic injury--an aid for indication for an early decortication (author's transl)].

In 16 patients with severe chest injuries the pulmonary function was evaluated as early as possible. Special emphasis was laid upon the basic criteria for the indication of an early decortication in cases of organized hematothorax. A follow-up study of ten patients, who were treated conservatively and of six patients, who underwent decortication, showed that the inspiratory and expiratory reserve volume and the compliance of the lung were the most reliable criteria. They showed, if a traumatic disturbance of the lung function was reversible or irreversible. It seems that patients improve faster after decortication. If, however, signs of a quick spontaneous recovery of the lung function is seen, there is no indication for surgery.

Follow-Up Studies↗
PubMed1980

[Intraoperative measurements of the oscillatory impedance in scoliotic patients (author's transl)].

In 10 Skoliose-patients undergoing Harringtons-Operation, measurements of the oszillatory impedance and arterial blood gases were made intraoperatively. The resistance was elevated from the beginning without any change during the operation. The phase was in the inductive range with a further deviation during increasing extension. The possible reasons are the maximal rigidity of thorax and/or parenchyma or change in tracheobronchial "arborisation". Increase in dead space or changes in ventilation-perfusion ratio are suggested by the blood gas measurements. Further investigations will be necessary to determine, if the impedance of the lung is of value in determining the amount of intraoperative extension or postoperative lung function.

Adolescent↗
PubMed1980

[The suppression of bronchospasm with disodium cromoglycate (DSCG) (author's transl)].

The protective effect of DSCG (disodium cromoglycate) was tested in 23 patients with artificial bronchospasm induced by specific allergen. After premedication with DSCG there was no arise of airway resistance (Rt) in 11 of 23 patients. In 4 patients with significant bronchial reaction, spontaneous remission could be registrated. In 8 patients DSCG could not suppress artificial bronchospasm. The clinically relevant aspects of these findings are being discussed.

Adolescent↗
PubMed1980

[Pulmonary function patterns in patients with left heart failure (author's transl].

Pulmonary function patterns were found to be different in patients with "pure" mitral stenosis (= 29), with concomitant mitral incompetence (n = 18) and with coronary heart disease (n = 12). Lung function in "pure" mitral stenosis has a trend to increased airway resistance with low vital capacity, without any statistical correlation between lung function data and hemodynamics. Coronary heart disease, in contrast, was found to show lung function abnormalities indicating increased pulmonary capillary volume and passive pulmonary hypertension, both being compatible with latent congestive failure. The group with combined mitral valve disease represented an intermediate type of cardiac lung. It can be concluded that a reflex mechanism is important in mitral stenosis between interstitial lung tissue and bronchomotor tone, but not necessarily between left atrium and pulmonary arteriolar tone. This reflex apparently is weaker in combined mitral valve disease and practically absent in coronary heart disease, where the expected lung function pattern compatible with early congestion should be encountered. The different pattern of mitral stenosis seems however, not to be related to the valve stenosis, but to the longstanding increase in pressures. The same mechanisms have been demonstrated in patients with acute left heart failure.

Coronary Disease↗
PubMed1979

[Oxygen therapy by means of an oxygen concentrator (author's transl)].

Oxygen for therapy of chronically hypoxemic patients can be supplied by an oxygen concentrator (De Vilbiss, DeVO2). By these means longterm oxygen therapy can be carried out on a round-the-clock-basis without risk of hypercapnia and without the need of handling the refill of oxygen containers. 9 patients in severe respiratory failure were treated with 2 to 4 l/min from the concentrator through 4 hour 4 days. Serial bloodgas analyses showed marked improvement of hypoxemia in all patients and prevention of exercise-induced failure in one patient. The oxygen concentrator therefore is suitable for the home treatment of patients with severe hypoxemia.

Adult↗