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Biomedical subjects

H Breuninger

Publications and source records attributed to H Breuninger.

At least 109 records · Page 6Linked to original sources

[Psychogenically induced sighing attacks in a 9-year-old girl (with remarks on the physiopathology of sighing)].

A case report about psychogenic sighing attacks in a 9 year old girl, which made school attendance and living at home impossible, is presented. Subsequently a review of the literature is given. Sighing was previously regarded as a ventilatory disorder. The author disagrees with this concept and presents evidence indicating that psychogenic sighing should be regarded as a phoniatric disorder e.g. laughing and weeping and not as a ventilatory disorder.

Child↗

[Drug side-effects in ORL practice (author's transl)].

Drug side-effects as opposed to toxic effects are defined and the specific side-effects of drugs used in otorhinolaryngology are then discussed. Drug induced changes in the ear, nose, throat, mouth, salivary glands and thyroid are listed. Only the most common and most important effects are discussed in detail. Some of the less commonly encountered side-effects have only been reported in a single patient and the mechanism involved is therefore uncertain. A good history is often valuable for reaching the correct diagnosis. It is also important for the physician to know the exact mechanism of a drug's action before prescribing it and to also inform the patient of the possible side-effects when these are relatively common.

Anti-Bacterial Agents↗

[Quantitative determination of protein, albumin, and antibiotics in the nasal secretions of patients with acute sinusitis (author's transl)].

Forty outpatients with sinusitis were treated with equimolar doses of Ampicillin (556 mg) of Bacampicillin (800 mg) three times daily in a doubleblind fashion. To control the efficiency of the therapy the number of leukocytes, sedimentation rate, subjective and objective symptomes were evaluated before the first dose and on the 2nd and 10th day. On the 1st day nasal secretions were collected at the time the first dose was given and 1, 2, and 3 h later. In these samples the concentrations of the antibiotic, of protein and albumin were determined. The amount of nasal secretions collected as well as the protein and albumin content remains fairly constant during the experiment. The concentration of Bacampicillin in nasal secretions reaches its maximum of 0.92 microgram/ml 1 h after the application whereas with Ampicillin it is 0.59 microgram/ml after 2 h. These values correspond to the concentrations which were found in normal test persons. The clinical result of the therapy is slightly better with Bacampicillin only if patients with severe sinusitis were taken into account. In the patients with moderate or slight symptoms no difference was found. Two of the patients which were treated with Ampicillin had to stop the therapy because of severe diarrhoe. When using Bacampicillin no patients had diarrhoe. This study shows that Bacampicillin (as an inactive ester of Ampicillin) is resorbed quicker and gives higher concentrations in the nasal secretions. Thus, the therapeutic effect is better in severe cases as compared to Ampicillin. Moreover, the side effects are less.

Albumins↗

[Quantitative determination of protein, albumin, and antibiotics in nasal secretions of healthy probands (author's transl)].

This study on the pharmacokinetics of antibiotics in nasal secretions was carried out with two orally applicable penicillin derivatives which show different resorption patterns. Each of the antibiotics (Ampicillin and Bacampicillin) was given in equimolar doses to 20 healthy young volunteers, with normal mucosa, in a double blind cross over fashion. Nasal secretions were collected 1, 2, 3, 4, 6, and 8 h after the application of a single dose to the overnight fasted persons. In 10 of them blood was taken at 0.5, 1, 1.5, 2, 3, and 4 h after the administration. For the sampling of the nasal secretions cotton wool was weighed together with an airtight vial containing 300 microliter of phosphate buffered saline (PBS). The dry cotton wool stayed in the nasal cavity for 20 min, was then put into the PBS and weighed again. The difference determines the amount of secretions collected. After 30 min the soaked cotton wool was pressed out into a vial with a sterile syringe. One hundred microliters of this solution was taken to determine the antibiotic concentration by a micromodification of the agar diffusion technique. In the remaining fluid total protein and albumin were quantitatively determined. The amount of nasal secretions which have been collected are, on average, independent of the time (Fig. 1). With rising secretion the protein content decreases (Fig. 5) as is the case with the albumin concentration. Regarding all persons, the protein content and albumin (Fig. 4) remain constant during the experiment from 8 a.m. to 4 p.m. The differences between the values shown in the figures are not significant. Comparing the mean concentration for the antibiotic at different times after the application, it is obvious that the agents show different curves (Fig. 6). With ampicillin the maximum of 0.13 microgram/ml is reached at 2 h after the administration whereas with becampicillin the maximum of 0.84 microgram/ml is reached after 1 h. The concentrations in the nasal secretions are clearly dependent of the serum values. In the serum the maximum of the mean values plotted against the time of 2.7 microgram/ml is to be found at 2 h, if ampicillin is given, whereas the maximum of 9.3 microgram/ml is reached at 1 h after bacampicillin administration. In both cases in serum and nasal secretions the mean concentration maximum is about three times higher after bacampicillin as compared with ampicillin. As a reference for the concentration of the antibiotic the total protein content of the sample is more suitable as compared with sample volume and albumin because of its easy and exact determination. The results show that the nasal secretions can be used as a model to evaluate the pharmacokinetics in the mucosa of the upper respiratory tract if an adequate number of test persons is used.

Adult↗

On the influence of the middle ear muscles upon changes in sound transmission.

The influence of artificially induced impedance changes on the frequency response of the middle ear has been investigated in three experienced listeners. The tensor-reflex has been simulated by application of positive and negative air-pressure to the outer ear canal. In this test-situation, the thresholdshift ("l) obtained is greatest in the surrounding of the first resonance of the middle ear ("l = 8 dB at 500 Hz). For bone-conduction, the effect is weaker by about 2 dB than for air-conduction. The change in sound transmission is constant for all SPL's and is mainly due to the impedance change of the middle ear. In contrast the influence of the stapedial reflex is strongly dependent on SPL. In the range between hearing-threshold and 70 dB (HL) the attenuation is only 2 dB below l kHz. At higher levels the attenuation may amount to 30 dB. Thus excitation of the cochlea remains nearly constant. We suppose that the intensity-dependent influence of the stapedius reflex on sound transmission is due to a change of the stapes motion. The regulating device works without considerable distortion but with an attack-time of about 100 ms. The phenomenon of conductive recruitment in otosclerosis is probably due to the lack of this regulating effect by the fixed stapes. One function of the stapedial reflex could be the protection of the ear from high amplitudes during phonation and shouting. Furthermore, because frequencies above l kHz are also attenuated, a protective function of the stapedial reflex in industrial noise exposure can be assumed.

Acoustic Impedance Tests↗

[Indications for percutaneous fracture fixation in bone surgery].

Because of its technical improvement percutaneous pinfixation of bones is now a successful procedure of osteosynthesis. The indications of this method are: Open fractures of second and third degree, emergency treatment of polytraumatized persons with debris fractures, fractures in combination with vascular injuries or burns, elongating osteotomy, pseudarthrosis, osteomyelitis and arthrodesis. External pin-fixation offers the following advantages: High range of stability with the possibility of early exercises. In case of resorption of the bone fragments it is possible, to correct the axial compression. No lesion of the fragments periosteum or endosteum. The operative damage to cortical vascular supply is minimized. The danger of bone infection is reduced. Subsequent correction of the bone axis can be performed. Altogether the pin-fixation is a safe and satisfactory method of osteosynthesis without physical strain for the patient.

Adolescent↗

[Pharmacologic aspects in the management of inner ear disease (author's transl)].

Our knowledge of the effects of drugs on the inner ear is extremely insufficient when compared to their effects on other organs. The role of drugs commonly recommended for therapy of inner ear disorders (such as, procaine, antihistaminics, diuretics, osmotics, corticoids and substances changing blood viscosity) has yet to be clarified since the clinical effects of these pharmaceuticals or vasoactive substances often cannot be confirmed by experimental study. Under present circumstances, the use of definitive therapy to prevent deafness has only limited application--as in thyroid hormone substitution to prevent deafness from cretinism.

Bicarbonates↗