Biomedical subjects
Publications and source records attributed to G Kugler.
A case report is presented in which post-operatively a distinct macroglossia including an additional swelling running up to the trachea developed within the framework of a neurosurgical intervention in a seated position. Pathomechanisms and possible therapeutic methods are described and discussed with the help of a review of the literature.
The use of opioids in the treatment of chronic pain is sometimes accompanied by inadequate pain relief and opioid-specific side-effects. Opioid rotation is a therapeutic approach, that can improve analgesia and provide a more advantageous analgesia and toxicity relationship. This article presents a case report and discusses the mechanisms, indications and possibilities of opioid rotation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The coronary venous efflux of lactate, inosine and hypoxanthine during pacing-induced angina has been compared with myocardial extraction of the catabolites during exercise-induced angina. Inosine and hypoxanthine were analyzed by enzyme assay after separation by column chromatography. Myocardial lactate extraction at rest (15 +/- 9%, mean +/- SD) was converted to production levels (-34 +/- 26%) during pacing-induced angina (p less than 0.0005) and increased (24 +/- 13%) during exercise (p less than 0.05). The arterial values at rest (850 +/- 330 mumol/1) were unchanged during pacing and increased five-fold during exercise (4380 +/- 1860 mumol/1). The mean myocardial inosine extraction at rest (33 +/- 10%) was transformed to release values (-41 +/- 30%) during pacing (p less than 0.0005) as well as during exercise (-20 +/- 27%) (p less than 0.0005). The hypoxanthine extraction at rest (25 +/- 11%) decreased during pacing (-7.8 +/- 29%) (p less than 0.0025) and exercise (10 +/- 25%) (NS). The slight increase of arterial inosine and hypoxanthine values was not significant. Myocardially produced lactate, a sensitive marker of pacing-induced ischemia, was obscured by elevated arterial concentrations during exercise. However, inosine significantly correlated with lactate during pacing, and was useful in detecting ischemic myocardial energy deficiency during exercise-induced angina.
The applicability of the adenosine triphosphate (ATP) catabolites, inosine and hypoxanthine as markers of myocardial ischemia in humans with coronary artery disease has been investigated. Inosine and hypoxanthine were assayed enzymatically after separation by a new column chromatographic method. The myocardial lactate extraction at rest (17 +/- 13%) changed to production values (-23 +/- 28%) during pacing-induced angina (P less than 0.0005). Coronary venous inosine values increased from 535 +/- 185 nmol/l at rest to 1030 +/- 740 nmol/l during angina (P less than 0.005), the arterial values amounted to 770 +/- 325 nmol/l and 805 +/- 515 nmol/l respectively (P, NS). The calculated myocardial uptake of inosine at rest (27 +/- 16%) changed to production values (-25 +/- 29%) during angina (P less than 0.0005). Coronary venous hypoxanthine increased from 1000 +/- 760 nmol/l at rest to 1235 +/- 800 nmol/l during angina (P, NS), the arterial values amounted to 1300 +/- 1040 nmol/l and 1235 +/- 800 nmol/l respectively (P, NS). The myocardial extraction changed from 20 +/- 18% at rest to -5.4 +/- 29% during angina (P less than 0.0025). The significant positive correlation (r = 0.61, P less than 0.0025) between myocardial release and uptake of inosine and lactate during severe angina demonstrates that anaerobic glycolysis is accompanied by ATP breakdown. During a second pacing period at less increased pressure--rate product after nitroglycerin, lactate production (-1.7 +/- 22%) already occurred whereas extraction of inosine (19 +/- 19%) and hypoxanthine (24 +/- 15%) did not change. In conclusion, lactate functions as a sensitive marker of myocardial ischemia and inosine is useful in detecting ischemic myocardial energy deficiency by the indication of insufficient glycolytic ATP supply.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Sensitivity and value of the quantitative measurement of the isoenzyme creatine kinase-MB by means inhibitory antibodies were studied in a number of experiments. The results indicate that concentrations of more than 3 U/1 are abnormal: they were found only in patients with myocardial cell damage but not after intramuscular injection or physical exercise. Determining CK-MB apparently offers a better way of assessing low or moderate increases of total CK activity than, e.g., the CK/GOT ratio. The method should therefore be introduced into clinical diagnosis. But the question of whether CK-MB measurement can differentiate between myocardial infarction and reversible myocardial cell damage remains unanswered: it is not 100% specific for myocardial infarction.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Rapid tilting into the 90 degrees upright position after 20 mg ISDN sublingually demonstrates a better orthostatic tolerance of the older group (in spite of a lower cardiac output) in comparison to the younger one. This can be explained by a higher tone of the resistance vessels and a stronger stretch resistance of the arteries of the elastic type (and probably of the veins), which are opposing the hydrostatic effects of orthostasis and guarantee a minor shifting of blood to the lower extremities. The increase of rigidity of the blood vessels with aging declares the better drug resistance of the older group but also points - on the other hand - to the borders of ISDN therapy.