Search PubMed⌕ Search

Biomedical subjects

H H Wagner

Publications and source records attributed to H H Wagner.

At least 37 records · Page 2Linked to original sources

[Clinical picture of bacterial pneumonias and their differential diagnosis].

Under the influence of antibiotic therapy, bacterial pneumonias have undergone a remarkable change in the last few decades. Individual forms of pneumonia can be distinguished morphologically by their localization, the way in which they spread, their limitations, and their course. Clinically, opportunistic bacterial infections predominate. Increasingly, secondary pneumonias are observed in poststenotic areas, areas of infarction, in hypostatic areas, after aspiration, and in previously damaged lobes. Radiologic criteria for differentiating from atypical pneumonias (viruses, mycoplasmas and chlamydia) are discussed.

Bacterial Infections↗

[Ultrasound study of the portal vascular system in the puerperium].

Changes of various cardiovascular functions and intra-abdominal pressure ratios occur during pregnancy as a result of adaptation processes. Besides the arterial and venous vascular systems, the portal vascular system is also affected. Bearing this in mind, the lienoportal and mesenterioportal vascular system were studied in 87 women during the puerperium after childbirth, and compared with a group of healthy women. Sonographically, the portal vascular system was found to be dilated after pregnancy. These changes were reversible within the first three weeks after delivery. Transient portal hypertension is discussed as a possible cause of this phenomenon. This should be differentiated against acute diseases with pathological and/or already pre-existing portal hypertension.

Adult↗

[Ergotamine-induced disorders of the peripheral blood circulation--a case report].

Ergotism with severe arterial circulatory disorders, sometimes leading to amputation of the leg, is a severe complication following application of drugs containing ergotamine. Often the diagnosis is made by the typical angiographic findings. The history, clinical course and a new treatment in a very severe case is reported.

Adult↗

The short-term effects of a low-dose oral contraceptive on glucose metabolism, plasma lipids and blood clotting factors.

Twelve young women were prospectively evaluated for the short-term metabolic effects of a low-dose oral contraceptive containing 30 micrograms ethinyl estradiol and 150 micrograms levonorgestrel. To each volunteer a 50 g glucose challenge was administered monthly as a screening test for changes in the glucose metabolism. Fasting and 30 minutes glucose and insulin values were measured and blood specimens were collected for determination of fasting triglycerides, cholesterol and blood clotting factors II, VII, X. During treatment the fasting plasma glucose level decreased significantly in the first two cycles and then normalized. No change in incremental glucose values was observed. Fasting insulin concentrations, incremental insulin values and the insulinogenic index did not change during the study period. Total plasma cholesterol values decreased during treatment, whereas the plasma triglyceride levels were unaffected. Immediately after tablet intake, an increase was found in the blood clotting factors and the elevated levels continued constantly throughout the study period. Comparing the data from the present study with data from previous investigations on low-dose ethinyl estradiol/levonorgestrel compounds, there seems to be no difference in the influence on blood clotting factors, glucose and lipid metabolism between treatment for 3 and 6 months. From the study, it is concluded that the impact of oral contraceptives on metabolic functions may emerge during the initial treatment cycles.

Adult↗

[Roentgenological analysis of the mobility of the diaphragm in functional pulmonary disorders (author's transl)].

Analysis of pulmonary function and densitometric examinations were carried out side by side in 41 patients with various types of pulmonary disorders. The results of both examination methods show good correlation and enable the physician to make a definite statement on the type of bronchopulmonary disease in the examined patient. The definite information which can be gained via this specific roentgenologic method justifies its use alongside the methods of pulmonary functional analysis.

Absorptiometry, Photon↗

[Clinical experience with mammography using grids (author's transl)].

Duplicate examinations were carried out on 122 patients in order to compare the results of mammography using a grid technique (Diagnost U. Müller) with a film-screen systemadn also a conventional set without screens (Mamma-Diagnost, Müller). The results were compared with reference to film quality and dose. The new technique was superior to the conventional method in all respects, independent of the size of the gland. Another advantage of the grid technique was the larger available film size. Dose requirements for grid mammography with a film-screen system was less than for conventional techniques by a factor of about 1.8. The results speak for increased use of the grid technique in clinical practice.

Breast Neoplasms↗

[Inflammatory pulmonary lesions: resolutions and residuals (author's transl)].

There are different patterns of development and resolution of inflammatory alveolar and interstitial pulmonary lesions. Delayed resolution of peripheral pneumonia results in lung shrinkage mainly towards the mediastinum and the apices with distortion and atypical distribution of pulmonary vasculature and compensatory hyperinflation. Resolution in perivascular and peribronchial parts is often delayed and results in scarring. Interstitial pneumonia may result directly in pulmonary fibrosis with loss of volume and honeycombing. With varying microorganisms and varying immunity chronic and atypical courses are observed more frequently.

Alveolitis, Extrinsic Allergic↗

Block of potassium channels of the nodal membrane by 4-aminopyridine and its partial removal on depolarization.

1. Voltage clamp experiments were done on single myelinated nerve fibres of the frog, Rana esculenta. 2. 53 muM 4-aminopyridine (4-AP) reduced IK to about one-fifth if tested with infrequent (1/min) and short (10 ms) depolarizing pulses; the onset time constant under these circumstances was ca. 160 s (14-15 degrees C). After prolonged treatment the effect was virtually irreversible. 3. At equilibrium with 4-AP, increasing the frequency of short pulses removed part of the block, the block removal accelerating with increasing pulse duration and frequency. 4. In 53 muM 4-AP unblocking of K channels during long (0.8 s) depolarizing pulses proceeded with a time constant, taur, of ca. 0.2 s. Restoration of block at the resting potential proceeded with a much larger time constant, tau'r, of ca. 1 min. 5. The stationary fraction, rinfinity, of K channels conducting in 53 muM 4-AP was 0.66, 0.41, and 0.24 at V = 120, 50, and 0 mV, respectively. 6. In a series of experiments with [4-AP] varying between 13.3 and 848 muM, taur decreased from 0.25 to 0.10 s (V = 130 mV, ca. 17 degrees C) while rinfinity followed the empirical relation 1/rinfinity = 1 + ct + cv exp(-0.77 EF/RT) with E = V - 70 mV. ct and cv are dimensionless quantities that increase with [4-AP] and reflect the voltage-independent and voltage-dependent component, respectively, of block. 7. Block of K channels and partial removal are also observed with inward IK at raised [K+]O. Removal proceeds on depolarization even if IK is additionally but temporarily suppressed by tetraethylammonium. Hence neither direction nor amplitude of IK but only the pulse potential seems to determine the extent of block for a given [4-AP].

Animals↗

Saxitoxin and procaine act independently on separate sites of the sodium channel.

1. Voltage clamp experiments were done on single myelinated nerve fibres of the frog, Rana esculenta. 2. The time course of procaine action (1.0 mM at pH 7.2) was obtained from changes in INa on changing solutions during repetitive (1 HZ) depolarizing pulses of constant amplitude following hyperpolarizing prepulses. The mean half times of onset and offset of procaine block were 3.7 and 28 s, respectively. In the presence of 1.4 nM saxitoxin (STX) the corresponding times were virtually the same, 3.1 and 27 s. 3. Similarly, the time course of partial relief from procaine block that is obtained by increasing the frequency of the prepulse-test pulse pairs from 1-10 HZ was unaffected in the presence of STX. 4. Comparison of the equilibrium effects of procaine concentrations ranging from 0.03-1.0 mM suggest a one-to-one drug-receptor reaction. The fraction of Na channels blocked at equilibrium with 1.0 mM procaine, 1.4 nM STX, and 1.0 mM procaine + 1.4 nM STX was 0.81, 0.49, and 0.90, respectively. This result and the kinetic behaviour fully agree with the idea of two separate and independent receptors for procaine and STX.

Animals↗

[The accuracy of radiological and endoscopic examinations in the diagnosis of carcinoma of the stomach (author's transl)].

The accuracy of radiology in the diagnosis of gastric carcinomas was checked on 232 cases, including 24 early examples. Accuracy depends most of all on the experience of the radiologist. Amongst 146 patients, using a satisfactory technique, a carcinoma was diagnosed in 131 patients (90%) and suspected in eight (6%). In five (3%) the changes were misinterpreted as being benign and the lesion was missed in two (1%). Of 120 gastric carcinomas submitted to operation a correct diagnosis had been made radiologically in 88% and suspected in 4%; endoscopically, the diagnosis was made in 92% and suspected in 2%. Of the 24 early carcinomas, both methods suggested the presence of a malignant lesion in 80%. The combination of radiology, endoscopy, hitology and cytology increases accuracy to 95%. These results indicated that localised changes in the gastric mucosa and the wall of the stomach can be demonstrated only by using refined radiological techniques; each lesion should be confirmed by endoscopy and histology.

Diagnostic Errors↗

The rates of saxitoxin action and of saxitoxin-tetrodotoxin interaction at the node of Ranvier.

Voltage clamp experiments were done on single nodes of Ranvier of Rana esculenta. Equilibrium effects were obtained from INa-V curves, the rates of action from changes in INa on changing solutions during repetitive depolarizing pulses. 2. Saxitoxin (STX) exclusively and reversibly blocked Na channels, the effect being fully described by a one-to-one reaction between STX and a receptor at the channel with an equilibrium dissociation constant, Ks, of 1.4 nM; the mean offset rate constant k2s, was 1.76 X 10(-2) sec-1 (16 +/- 1 degree C;pH 7.2), 1.7 times the value for tetrodotoxin (TTX). 3. At pH 5.6, K2S WAs increased by a factor of 1.33 while the equilibrium STX effects was decreased in a way suggesting competition between STX and protons. 4. After pretreatment of nodes with 3.1 nM TTX the extra block on adding 9.0 nM STX as well as its relief on taking out STX of the TTX-STX mixture revealed transients in the time course of receptor occupation. 5. These non-monotonic time courses are incompatible with the idea of two independent blocking sites (for STX and TTX) per channel but could be quantitatively fitted by analog-computed curves assuming competition between STX and TTX for the same site.

Animals↗

The reaction between tetrodotoxin and membrane sites at the node of Ranvier: its kinetics and dependence on pH.

Voltage clamp experiments were done on single nodes of Ranvier to study the inhibition of the sodium permeability by tetrodotoxin (TTX). Equilibrium results could be excellently fitted on the assumption that a sodium channel is blocked when one toxin molecule binds to it, the equilibrium dissociation constant, KT of this reaction being 3.6 nm at 20 degrees C. Onset and offset of block could be quantitatively interpreted to be determined by the rates of the TTX-channel reaction whose average constants, at room temperature, were 3 times 10-6M-minus 1s-minus 1 for the association (k1) and 1.4 times 10-minus 2 s-minus 1 for the dissociation (k2). The dependence of the constants on temperature could be described by Arrhenius plots yielding activation energies of 29.3, 85.5 and 41.0 (57.3) kJ/mol for KT, k2 and k1 (K1 derived from onset alone), respectively. At low pH the relative TTX effect was clearly less than at neutral pH. These results could be explained by a model involving the competition of TTX and protons for the same receptor to which protons bind as a function of membrane potential.

Animals↗

The influence of pH on equilibrium effects of tetrodotoxin on myelinated nerve fibres of Rana esculenta.

1. The experiments were done on single nodes of Ranvier of Rana esculenta. The effects of tetrodotoxin and H ions were determined either by the reduction of the maximum rate of rise, VA, of action potentials evoked with threshold stimuli or in the voltage clamp by the decrease of the peak Na permeability, PNa. 2. With the tetrodotoxin sample used throughout the investigation the equilibrium dissociation constant, KT, of the toxin-receptor reaction at neutral pH was determined to be 2-8 nM. Between 1-55 and 15-5 nM tetrodotoxin the normalized value, A, of VA, was found to be related to the normalized toxin concentration cT = [TTX]/2-8 nM by the empirical equation log [(1-A)/A] = 1-22 log cT-0-573. 3. On increasing the pH (up to 8-8) the effect of tetrodotoxin diminished as revealed by an increase in A. The apparent reduction of cT (as calculated from A) suggests that the toxin is active only in its cationic forms. 4. Weakly acid tetrodotoxin solutions (7-3 less than pH less than or equal to 5-5) reduced A to a lesser degree than did neutral toxin solutions in spite of the inherent depressing effect of acid pH on A (A = 0-5 at about pH 5-5). In more acid toxin solutions A decreased again and at pH 4-6 it was about equal to the value in toxin-free solution. 5. When, after equilibrium in an acid toxin solution, the perfusate was suddenly changed to neutral Ringer solution A jumped to a higher value A' as measured 1 sec after the switch. Since the blocking effect of hydrogen ions subsided within a fraction of a second while the time constant of the toxin washout is of the order of 1 min, A' reflects the number of Na channels blocked by tetrodotoxin at acid pH. 6. In acid toxin-free solution the peak PNa as obtained in voltage clamp experiments was reduced by a voltage-dependent factor (cH + 1)-1 with CH = [H+]/KH(E) and KH(E) = 2-04 muM exp (0-34 EF/RT). Adding tetrodotoxin resulted in another reduction by a constant factor p'T. 7. Experiments employing various combinations of toxin concentration (3-1-93 nM) and pH values (7-3-5-2) confirm the decreased toxin effect at low pH. Moreover, p'T was smaller (the additional toxin effect larger) when the membrane had been kept depolarized and thus cH reduced during equilibration. This suggests that tetrodotoxin cations and H ions compete for the same blocking site. A quantitative fit, however, requires additional assumptions.

Action Potentials↗