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Biomedical subjects

G Lenz

Publications and source records attributed to G Lenz.

At least 109 records · Page 6Linked to original sources
PubMed1987

Positive minor cross-reaction due to red blood cell T-activation in a neonate with perforated colon.

We report the case of a prematurely born, 39-day-old male infant with a history of mechanical ileus and perforated colon in which blood grouping showed group 0 Rh (D)-positive without particularities. Minor tests, however, were distinctly positive in 4 units of blood, whereas all major tests were negative. There is strong evidence that the positive minor cross-reaction was caused by in vivo RBC T-activation with subsequent donor serum anti-T agglutination.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1987

[Success rate and complications of a modified retrograde intubation technic in 36 patients].

The main disadvantage of guided blind intubation (Waters technique) is injury to the mucous membrane and cartilaginous skeleton of the larynx. Thirty-six patients scheduled for laryngectomy were intubated using a modified Waters technique. The practicability of this technique as well as the type and extent of damage to the laryngeal tissue were evaluated under controlled conditions. Intubation was successful in 35 patients (first attempt, 31 patients; 2-3 attempts, four patients). A stenosing carcinoma of the larynx required a tracheotomy in the remaining patient. No serious damage to the mucous membrane or cartilage was demonstrated in the 26 controlled resected larynges. In a difficult intubation, the guided blind technique is a possible alternative because of the relatively low extent of damage and technical requirements; maintenance of spontaneous respiration is not required.

Adult↗
PubMed1986

[Endoscopic findings following chymopapain injection in animal experiments].

Myeloscopic normal findings are demonstrated in the rhesus monkey (macaca fascicularis, crab-eating monkey). It can also be shown that six weeks after intrathecal administration of the proteolytic enzyme chymopapain, obvious pathological changes can be seen endoscopically in the nerve roots. It can, therefore, be said that the intrathecal administration of chymopapain is strictly contraindicated due to the proven unfavourable neurotoxic side effects.

Animals↗
PubMed1986

First-rank symptoms and Bleuler's basic symptoms. New results in applying the polydiagnostic approach.

By comparing six different operational diagnostic systems (International Classification of Diseases, Diagnostic and Statistical Manual; 3rd ed., Research Diagnostic Criteria, St. Louis criteria, Taylor criteria and Vienna Research Criteria), the data presented in this paper illustrate how attribution to various categories of functional psychoses varies according to the applied algorithms. Bleuler's basic symptoms are obviously considered by all of the compared systems to be more significant for attribution to schizophrenia than first-rank symptoms.

Diagnosis, Differential↗
PubMed1986

Symptoms, diagnosis and time in hospital. A polydiagnostic study of schizophrenia.

The relationship between diagnostic assignment and specific symptomatology on admission and the duration of the first hospital stay was investigated in 200 patients with a functional psychosis. There were considerable differences in the mean duration of stay in hospital for patients fulfilling different diagnostic criteria for schizophrenia: the broader the concept of schizophrenia, the shorter the duration of stay. In looking at symptomatology, it could be demonstrated that patients with formal thought disorder had the highest mean duration of first inpatient episode.

Diagnosis, Differential↗
PubMed1986

Mutual concordance between different diagnostic criteria for depression.

200 patients with an ICD diagnosis of 295, 296, 297 or 298 at their first admission were rated positive or negative for a series of different diagnostic criteria for functional psychoses. Criteria with a very wide concept of affective disorder like the VRC or the DSM-III or Taylor or St. Louis are in contrast to more narrowly defined concepts in RDC or ICD. Because of these differences there is a great need for more effective validation studies based on the simultaneous application of different diagnostic criteria. This has been called the 'polydiagnostic approach'.

Bipolar Disorder↗
PubMed1986

[Effect of hydroxyethyl starch, oxypolygelatin and human albumin on the phagocytic function of the reticuloendothelial system in healthy subjects].

RES phagocytic function was determined in healthy volunteers prior to and up to 5 h after application of 10 ml/kg body weight of 6% hydroxyethyl starch (450,000; 0.7), 5.5% oxypolygelatin (30,000), or 5.0% human albumin solution. Phagocytosis (phagocytic index K) was evaluated in vivo by intravascular lipid clearance (Lipofundin clearance test). Immediately after infusion, the phagocytic rate increased by 30% in the hydroxyethyl starch group (n = 10; p less than 0.05), 14% in the oxypolygelatin group (n = 10; ns), and 24% in the albumin group (n = 8; ns). 2 h after infusion phagocytosis was still increased by 35% in the hydroxyethyl starch group (n = 10; p less than 0.05), by 18% in the oxypolygelatin group (n = 10; ns), and 13% in the albumin group (n = 8; ns). 5 h after infusion, K values had returned to normal in the albumin group (n = 4), but were still increased by 40% in the hydroxyethyl starch group (n = 4; ns). No statistically significant differences could be established among the 3 groups. The increase in the phagocytic rate, particularly after application of hydroxyethyl starch, might be explained by a dilution effect.

Adult↗
PubMed1986

[Intraoperative monitoring in artificial respiration of premature and newborn infants. I. Monitoring of respiratory parameters and alveolar ventilation].

Monitoring of ventilation serves to ensure adequate alveolar ventilation and arterial oxygenation, and to avoid pulmonary damage due to mechanical ventilation. Basic clinical monitoring, i.e., inspection, auscultation (including precordial or oesophageal stethoscope) and monitoring of heart rate and blood pressure, is mandatory. Mechanical ventilation is monitored by ventilation pressures (peak pressure, plateau pressure and endexpiratory pressure), ventilation volumes (measured at the in/expiratory valve of the respirator and by hot-wire anemometry at the tube connector), ventilation rate, and inspiratory oxygen concentration (FiO2). Alveolar ventilation should be continuously and indirectly recorded by capnometry (pECO2) and by measurement of transcutaneous pCO2 (tcpCO2), whereas oxygenation is determined via measurement of transcutaneous pO2 (tcpO2). Invasive monitoring of gas exchange is essential in prolonged or intrathoracic interventions as well as in neonates with cardiopulmonary problems. paCO2 may be estimated by capillary or venous blood gas analysis; arterial blood gas analysis is required for exact determination of paCO2 as well as arteriocutaneous pCO2 (atcDCO2) and arterio-end-expiratory (aEDCO2) gradients.

Acid-Base Equilibrium↗
PubMed1986

Failure of thyrotropin releasing hormone to reverse fentanyl-flunitrazepam anesthesia in man.

The effect of thyrotropin releasing hormone (TRH) on modified neuroleptanesthesia with fentanyl-flunitrazepam was investigated in an open pilot study of 15 neurosurgical patients. Before and 15, 30, and 60 minutes after extubation and subsequent administration of 400 micrograms TRH, the following parameters were evaluated: PaO2, PaCO2, vigilance, and pain sensation. Although no TRH-related impairment of postoperative analgesia was observed, respiratory depression and impaired vigilance were not significantly reversed. These findings contradict a number of experimental studies using animal models which indicated that TRH, due to its centrally mediated ergotropic activity, antagonizes the narcotic effect of various CNS depressants and anesthetics.

Adult↗
PubMed1986

Description of flow phenomena in magnetic resonance imaging.

The magnetic resonance (MR) signal from the hydrogen nuclei of blood is not only determined by the MR parameters T1, T2 and proton density, but is strongly dependent on the movement of the protons. Magnetic resonance imaging (MRI) offers therefore the possibility to visualize the distribution of moving spins, especially blood flow, noninvasively and without contrast agents; moreover, the velocity of the moving spins can be quantified. Flow phenomena in MRI are a pretentious field because the complicated hydrodynamics of the living system is coded in the MR signal; therefore, an understanding of the underlying physical principle of the MR signal is required to interpret and extract flow information from the image. However, rather simple theoretical and experimental models of fluid transport in vessels allow to explain the main features of various effects observed in images.

Blood Circulation↗
PubMed1986

[Intraoperative monitoring in artificial respiration of premature and newborn infants. II. Monitoring of arterial oxygenation].

Monitoring of adequate arterial oxygenation serves to avoid periods of hypoxaemia and hyperoxaemia with potentially life threatening or organ-damaging sequelae. Basic clinical monitoring, i.e., inspection and auscultation, is mandatory. In all infants, paO2 may be continuously and indirectly monitored by measurement of transcutaneous pO2 (tcpO2). The use of pulse oximetry for non-invasive measurement of arterial oxygen saturation (SaO2) is still undergoing clinical testing. Invasive monitoring of gas exchange is essential in prolonged or intrathoracic interventions as well as in neonates with cardiopulmonary problems. paO2 can be estimated by capillary blood gas analysis; arterial blood gas analysis, however, is required for exact determination of paO2 and of the arterio-cutaneous pO2 gradient (atcDO2). Intraarterial fibre optic determination of oxygen saturation or determination of paO2 with an intraarterial Clark electrode does not appear to be well suited for intraoperative conditions.

Anesthesia, General↗
PubMed1985

Clinical evaluation of language and thought disorders in patients with schizophrenic and affective psychoses.

56 patients with RDC diagnoses of schizophrenia (n = 40) and mania (n = 16) were interviewed with a structured interviewing procedure. The evaluation was performed by 2 raters who were blind for diagnosis. Two instruments were used for evaluation concerning thought and language disorders: the 'Scale for Assessment of Thought, Language and Communication' developed by Andreasen and the 'Endogenomorphic Schizophrenic Axial Syndrome' by Berner with its emphasis on thought disorders. The interrater reliability for both instruments was found to be good to acceptable for the essential items. A comparison of the frequency of thought disorders according to the two different instruments showed an occurrence of derailment and incoherence of the Andreasen scale in both diagnostic groups, while thought disorders of the schizophrenic axial syndrome were represented only in the group of schizophrenics. This is because in contrast to the Andreasen scale, the presence of pressure of speech is considered as an exclusion criterion for the schizophrenic axial syndrome. Thus, thought disorders according to the schizophrenic axial syndrome are seen to possess diagnostic significance.

Bipolar Disorder↗
PubMed1985

[A simple method for monitoring spontaneous respiration].

For respiratory monitoring of spontaneously breathing patients in the operation theatre, recovery room and intensive care ward a gauze attached on the nose may be used successfully. This continuous optical and practically cost-free aid has proved to be valuable in such cases when electronic monitoring is not available.

Anesthesia↗
PubMed1985

[Anesthesiologic problems in unsuspected extra-adrenal pheochromocytoma].

Although surgical mortality associated with pheochromocytoma has been markedly reduced in recent years, due to improvements in medical and anesthesiologic management, surgery in patients with unsuspected pheochromocytoma is still accompanied by a high fatality rate. A 20-year-old man without history of hypertension and previously in good health is reported who presented for exploratory thoracotomy and removal of a highly vascular mediastinal tumor. Intraoperatively a pheochromocytoma was suspected. Problems associated with establishing the diagnosis as well as difficulties in treating rapid changes of sympathetic adrenergic activation and hypotension following tumor resection are discussed. Despite the comparative rarety of pheochromocytoma the anaesthesiologist should be aware of unusual clinical manifestations.

Adult↗
PubMed1985

[Anesthesiologic treatment of 3,665 patients in Red Cross hospitals in Thailand, Lebanon, Pakistan and Indonesia].

Between the end of 1979 and the beginning of 1984, the authors served as anaesthetists for Red Cross missions in surgical field hospitals on the Thai-Cambodian and the Afghan-Pakistan borders, in Lebanon, and in Indonesia. A total of 3665 civilian emergency patients were anaesthetised. 643 were operated on under local anaesthesia; 639, under regional anaesthesia, in most cases spinal anaesthesia. In spite of principal preference for local and regional anaesthetic techniques, 65% of the patients (2383 patients) were managed under general anaesthesia, which was maintained with halothane in 947 cases and ketamine in 1345 cases. 877 general anaesthesias with ketamine were performed with spontaneous breathing of ambient air; endotracheal anaesthesia was necessary in 1238 patients. In spite of the high risk for the patients and of the operative interventions and in the light of the simple and sometimes even primitive working conditions, no anaesthesia-related fatalities occurred. Postoperative lethality was 2%. In all cases, the duties of the anaesthesist involved more than performance of anaesthesia, which was sometimes assigned to paramedics. Other duties included preoperative examination, postoperative intensive care, consultation services in nonsurgical emergency cases, resuscitation, and training of local assistants.

Anesthesia↗