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Biomedical subjects

G Goeckenjan

Publications and source records attributed to G Goeckenjan.

At least 19 recordsLinked to original sources
PubMed1992

Cellular autofluorescent pigment and interstitial fibrosis in smoker's lung.

The mechanisms by which cigarette smoking lead to bronchopulmonary diseases are incompletely understood. The most characteristic lesion is a chronic macrophage-alveolitis accompanied by slight fibrosis and emphysema. The macrophages contain a ceroid-like granular autofluorescent pigment in their lysosomes. Using immunohistochemical methods, open lung-, transbronchial biopsies and cells obtained by broncho-alveolar lavage from cigarette smokers were studied: anti-human macrophage serum and anti-human elastase, immune sera against type I, type III collagens and fibronectin were used in the demonstration of the cellular components of alveolitis and the connective tissue constituents of fibrosis. The characteristic red-brown autofluorescent pigment of the macrophages was also found in an extra-alveolar location mainly in peribronchial, septal and pleural scars. Similar emission colour occurred focally in the elastic laminae of fibrotic alveoli and sclerotic arteries. Granular fluorescent pigment was found in many bronchial epithelial cells. The epithelial pigmentation was associated with increased transcription of nucleic acid proteins, revealed by colloid silver (AgNOR) reaction. The results suggest that the autofluorescent pigment substances in macrophages may indicate or also play a role in the development of pathological connective tissue and epithelial changes of smoker's lung, in addition to the known mediators and enzymes.

Adult↗
PubMed1988

Lung function disturbances versus respiratory muscle fatigue in patients with systemic lupus erythematosus.

In 23 consecutive patients (mean age, 38.6 years) with systemic lupus erythematosus (SLE) and in 17 healthy subjects (mean age, 37.5 years) fatigue of respiratory (diaphragm, musculi intercostales externi) and leg muscles (musculus gastrocnemius) was determined comparatively by electromyography. Additionally, routine lung function parameters, including maximum inspiratory (PImax) and expiratory (PEmax) mouth pressures, were measured. The SLE patients showed lower values of vital capacity (VC), total lung capacity (TLC), thoracic gas volume (TGV), FEV1, PImax and PEmax than the healthy controls, while FEV1/VC, residual volume and specific airway conductance were not significantly different in either group. Lung compliance, corrected for TGV, was normal in the SLE group. Breathing through stenoses with increasing resistances resulted in fatigue of the diaphragm in 73% of the SLE group and in 41% of the control group. The corresponding values of the external intercostal muscles were 74% (SLE group) and 29% (control group). Electromyographic signs of respiratory and leg muscle fatigue occurred at lower loads in the SLE group than in the healthy subjects. The pattern of lung function data in patients with SLE was characteristic neither of lung restriction nor of airway obstruction. Respiratory muscle weakness can explain the decrease in TLC, VC, TGV, FEV1, PImax and PEmax.

Adult↗
PubMed1985

[Cimetidine and ranitidine in intensive care patients. Double-blind randomized cross-over study on intravenous administration: hemodynamics, plasma coagulation, blood gases and acid-base status].

Intravenous cimetidine 200 mg, and ranitidine 50 mg were administered as 2 minute infusions to 50 intensive-care patients. Cimetidine and ranitidine differed significantly in their effect on systolic arterial blood pressure measured during the second minute (alpha = 0.01). In the case of cimetidine the haemodynamic parameters measured over 10 minutes revealed a clearly defined fall in systolic, diastolic and mean arterial blood pressure as well as a rise in heart rate. The initial values were regained 5 minutes after drug application. Adverse effects of ranitidine on haemodynamics were much less than those of cimetidine. Neither drug produced any essential change in clotting parameters (partial thromboplastin time, plasma thrombin time, thromboplastin time and fibrinogen) measured before and 5 minutes after application, nor had they any effect on blood-gases or acid-base status.

Acid-Base Equilibrium↗
PubMed1985

Long-term follow-up of pulmonary hypertension in patients with and without anorectic drug intake.

Over a period of up to 18 years, 24 patients (mean age: 33.8 years) with primary vascular pulmonary hypertension (PVPH) of unknown aetiology (group A) and 18 subjects (mean age: 45.3 years) with PVPH due to anorectic drug intake (group B) were comparatively studied. The following main tendencies became apparent: 1) The 10-year cumulative survival rate in group A (0.31) was lower than in group B (0.63). 2) Patients of group A showed more marked X-ray and ECG signs of pulmonary hypertension and right ventricular hypertrophy in comparison with group B. In contrast to group B, the ECG signs of hypertrophy in group A increased during the observation period. 3) Mean pulmonary artery pressure (PAP) significantly increased in group A (from 48.8 to 61.0 mmHg), while it decreased (from 47.6 to 33.3 mmHg) in group B. 4) The diameter of the descending branch of the right pulmonary artery increased with rising PAP only in group A, while the relationship between PAP and the Sokolow-Lyon index was significant only for the whole group of PVPH patients but not for the subgroups A and B. A regression of pulmonary hypertension in patients with anorectic drug intake was obvious, in contrast to the course in patients with PVPH of unknown aetiology.

Adolescent↗
PubMed1979

[Scanning electron microscopic examination of intra-arterial PO2 electrodes (author's transl)].

Continuous blood gas measurement by means of indwelling intraarterial electrodes facilitates and contributes to considerably improve the monitoring of pulmonary gas exchange in intensive care and anaesthesiology. Knowledge of the behaviour of the electrode surface in the blood stream is necessary to assess the characteristics of the measuring and the possible risks or complications. Scanning electron microscopic examinations were performed in a commercial-type polarographic PO2 electrode after in vitro and in vivo application. 14 electrodes were examined after continuous intra-arterial measurements in patients with chronic obstructive pulmonary disease and in intensive care patients. Duration of intra-arterial measurements was 2-109 h. Already after a measuring period of 2 h in nearly all cases a protein film was discovered on the electrode surface. Microthrombotic deposits were seen in 2 cases, in one of these despite of treatment with heparin. The electrode membrane showed a network ofmicro-cracks, small bubbles and dents. The membrane changes were probably the result of the drying process during the electron microscopic preparation, because the membrane material (Hydron) is hydrophil and swells during the measurement. Yet it cannot be excluded that these changes occur, in part, during the measurements. From these and other studies we conclude that the intra-arterial application of this electrode has a low risk of thromboembolic complications. The deposits on the electrode surface and the membrane changes may probably affect the response time and possibly also the stability of the electrode.

Blood Gas Analysis↗
PubMed1979

[A simple method for pleural drainage (author's transl)].

21 patients had pleural drainage with a rubber valve (Heimlich) on account of pneumothorax (15) and massive pleural effusion (6). The method succeeded in every case. It has the advantage that it dispenses with suction and bottles, that it needs no turning-off when the patient gets up, but maintains its draining action, and that in cases of persisting broncho-pleural fistula there is no additional suction. The technique represents a simplified alternative to the customy methods of pleural drainage.

Humans↗
PubMed1979

Continuous measurement of arterial PO2. Significance and indications in intensive care.

The use of continuous arterial PO2 monitoring with the aid of intra-arterial electrodes is discussed with reference to 50 patients in an intensive care unit specializing in internal medicine. Monitoring time ranged from 2 h to 15 days. There were no serious complications which could, with certainty, be attributed to the intravascular measurement of PO2. The advantages of this method lie particularly in the early detection of hypoxemias, in the uninterrupted monitoring of artificial respiration and in the immediate indication of favorable and unfavorable response to therapy. Finally, a list is given of possible indications in which this method can be used in intensive medicine.

Aged↗
PubMed1979

[Evaluation of lung function tests by means of a programmed minicomputer (author's transl)].

A computer programme for a small programmable electronic calculator is introduced which considerably facilitates the offline evaluation of tests of the ventilatory lung function and mechanics of breathing, including the establishment of individuel ideal values. This favourably priced computer reduces the time required for calculation by about one-third compared with the conventional method. The process of assessment is rendered strikingly simple and hence safer by this highly versatile computer.

Computers↗
PubMed1979

Use of the continuous transcutaneous PO2 measurement in lung function tests.

Continuous measurements of transcutaneous PO2 are of interest in pulmonary function tests by which dynamic processes of pulmonary gas exchange are examined. The aim of the present study is to clarify the question of whether the transition function of transcutaneous PO2 after a step change of inspiratory oxygen concentration could give information about pulmonary gas exchange. In 8 healthy volunteers and 31 patients with chronic obstructive pulmonary disease of various degrees the half-value mixing times of transcutaneous PO2 were correlated with parameters of respiratory mechanics and pulmonary gas exchange. In spite of a damping of rapid changes of arterial PO2 by the transcutaneous measurement, there were significant correlations of the mixing times with physiologic right-to-left shunt; with physiologic dead space, alveolar ventilation, and blood gases; and with the parameters of lung overinflation and airway obstruction. There was a significant correlation with the age of the subjects, too. This had to be attributed mainly to an increase in severity of lung function disturbances with advancing age. Aging of the skin seemed to have a minor influence. According to these results, the transition function of transcutaneous PO2 after a step change of inspiratory oxygen concentration is determined mainly by the alveolar ventilation and the ventilation-perfusion inhomogeneity. This paper describes a short test that only takes some minutes of oxygen breathing and that has nearly the same diagnostic value as the measurement of the half-value mixing time.

Adult↗