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Biomedical subjects

H Kaloud

Publications and source records attributed to H Kaloud.

At least 19 recordsLinked to original sources
PubMed1997

Iatrogenic ruptures of the tracheobronchial tree.

We did a retrospective study in 12 patients with iatrogenic tracheal or tracheobronchial ruptures treated since 1975. Ten female subjects, one male subject, and one child (age range, 8 to 72 years), all of whom had undergone intratracheal intubation, were admitted to the hospital. Four patients had been intubated with a double-lumen catheter (two Carlens type with carinal spur, two Robertshaw without spur), and seven had had "high volume-low pressure" tubes, placed under emergency conditions in three of those seven cases. In one further case, an unsuccessful attempt of percutaneous tracheostomy had been made. The localization of the ruptures (all of them longitudinally in the membranaceous wall; length, 2 to 13 cm; mean, 7 cm) comprised both cervical and intrathoracic trachea in seven, the intrathoracic trachea in three instances, and the left main stem bronchus in two cases. Ten patients had mediastinal and subcutaneous emphysema, seven presented with a pneumothorax, and nine had intratracheal bleeding. The interval until the onset of symptoms and diagnoses differed widely: twice diagnoses were made intraoperatively, during thoracic surgery. The longest interval until diagnosis was 5 days; only then did the patient show subcutaneous emphysema and have retrosternal pain. All patients had surgical repair. Nine recovered without sequelae, and three died of septic multiorgan failure.

Adult↗
PubMed1995

[Education of the medical student in first aid, emergency and disaster medicine--the Graz model].

In Austria emergency and disaster medicine is a young interdisciplinary subject. It is only a borderline discipline encompassing different medical subjects and was subdivided into emergency medicine for medical doctors only and first-aid for lay people and emergency technicians. In fact, since emergency medicine without first-aid can't be successful, the Department of Anaesthesiology at the University of Graz let all students of the medical faculty have a comprehensive education in the treatment of injured of acutely ill patients. According to the three steps of the study lectures and practices, all parts of first-aid, emergency and disaster medicine were offered. In spite of the short time since this has been running, we found a good acceptance and we hope to increase the interest evinced by medical students in our training programme.

Austria↗
PubMed1994

[Propofol in emergency care--areas of application and initial experiences].

So far propofol has only been used in clinical settings for sedation and induction of anaesthesia. This study describes several indications in preclinical and emergency events. All users were anaesthetists, so that experience of administration and dosage was extremely helpful. Since the drug met the expected criteria it is now regularly used for the sedation of ventilated patients during transport. The most important indications for preclinical induction of anesthesia with propofol are patients with isolated head injury and patients with respiratory insufficiency due to status asthmaticus resistant to therapy. After repeated unsuccessful attempts at therapeutic intervention with benzodiazepines and other antiepileptics we were able to interrupt status epilepticus in 11 patients by means of propofol, thereby preventing the patient from being intubated as a consequence of iatrogenic respiratory failure. However, emergency doctors must always be aware of the severe cardiocirculatory side effects of the drug, and must, hence, ensure that hypovolaemia or cardiac failure is excluded or corrected prior to propofol administration.

Adult↗
PubMed1978

[Comparative investigations on polymorphism of the red cell enzymes in Franconia and West Hungary (author's transl)].

The distribution of the phenotypes of the red cell enzymes adenosine deaminase, adenylate kinase, glutamate pyruvate dehydrogenase, 6-phosphogluconate dehydrogenase and phosphoglucomutase was studied in blood samples of 794 West Hungarian subjects and 955 subjects from Franconia in Bavaria. All enzymes were separated on cellulose acetate foil, SEP in starch gel. The method of separation has been described elsewhere. The phenotypes of all enzymes were found to be distributed according to the Hardy-Weinberg law. The calculated gene frequencies were in good agreement with data from the literature, according to the results of other investigations carried out in Germany and the central European region. No significant difference was found between the gene frequencies of these enzyme phenotypes in West Hungary and Franconia, although the PGM2 frequency level was higher in West Hungary than in Franconia.

Acid Phosphatase↗
PubMed1978

[Gene frequencies of both forms of galactosaemia in the western Hungarian province of Vas (author's transl)].

The two enzymes of galactose metabolism, namely galactokinase and galactose-1-phosphate uridyltransferase (Gal-1-PUT), were measured in 3653 subjects aged 7 months to 84 years in der to obtain the incidence of the gene deficiency causing galactosaemia in the Western Hungarian province of Vas. To date nothing is known about these frequencies in this particular region. It was of special interest whether these enzyme defects are to be found more frequently in gypsies than in a comparable population of West Hungary. The frequency of homozygous Gal-1-PUT deficiency amounts to 1:23,500; the respective incidence of galactokinase deficiency is 1:64,000. Both enzyme deficiencies in this province are not higher than in other countries. Considerable differences were established in the gene frequencies in individual areas and for various groups of subjects with variations from 1:30,000 to 1: 127,000 for galactokinase deficiency and from 1:5,300 to 1:81,000 for Gal-1-PUT deficiency. Neither gene deficiency occurred more frequently in gypsies than in the general population. This study demonstrates that the results of such analyses are relevant only to the investigated region and the greatest possible number of subjects must be taken in order to draw reliable conclusions.

Adolescent↗
PubMed1977

Excretion of galactitol in the urine of heterozygotes of both forms of galactosemia.

In 36 heterozygotes with Gal-1-PUT deficiency and 3 heterozygotes with galactokinase deficiency galactitol (and galactose) was determined in the urine 2 and 4 h after an intravenous injection of 350 mg galactose/kg body weight (maximum dosis in adults 16 g). For the sake of comparison 10 healthy children and 5 adults, also 4 homozygotes with Gal-1-PUT deficiency and one sick child with galactokinase deficiency were included in this study. The heterozygotes with Gal-1-PUT deficiency demonstrated the same galactitol excretion as the healthy probands, while heterozygotes with galactokinase deficiency excreted a four-fold higher quantity of galactitol than the healthy and heterozygous probands of Gal-1-PUT deficiency. The child with the galactokinase deficiency excreted galactitol for a period of more than 24 h. These results are discussed.

Galactose↗
PubMed1976

Biokinetics of galactose in the homozygotes and heterozygotes of both forms of galactosemia.

41 heterozygoes and 4 homozygotes with a deficiency of galactose 1-phosphate uridyl transferase and also 3 heterozygotes and 1 homozygous patient with galactokinase deficiency were subjected to intravenous galactose loading tests with a dose of 350 mg/kg body weight in order to answer the question whether it is possible to detect the heterozygotes of both types of galactosemia by this method. For comparison, 38 healthy children and adolescents, 24 children with epidemic hepatitis and 4 children with cirrhosis of the liver, which was verified by histology, were included in the study. The elimination half-life (and also the other pharmacokinetic parameters as inaugurated by Dost) was the same for all the heterozygotes for both types of galactosemia almost without exception, and for the healthy cs, children in the acute stages of hepatitis and patients with cirrhosis of the liver was prolonged 2 to 5 times the normal. In patients with hepatitis, however, the elimination half-life was normal before the transaminases. Accordingly, the galactose clearance was decreased to half and one-fourth of the normal. Hence, heterozygotes with galactosemia cannot be detected with galactose loading tests.

Adolescent↗
PubMed1975

[Activity of enzymes of galactose metabolism in so-called congenital cataract (author's transl)].

Activity of galactokinase (69 subjects) and galactose-1-phosphate uridyl transferase (92 subjects) were measured in haemolysed blood from children (predominantly of school age) with congenital cataract. chi2 tests, gene-frequency determination and metabolic-kinetic studies indicated that the changes in the lens in congenital cataract are partly due to a manifest or latent disorder of galactose metabolism, in particular a glactose-1-phosphate uridyl transferase defect.

Austria↗
PubMed1975

[Biochemical and clinical findings in congenital abnormalities of galactose metabolism (author's transl)].

Current knowledge of the biochemical basis of abnormalities in galactose metabolism are discussed. The clinical picture, analysis of frequency and therapy are described. Although the galactokinase defect hat been described only rarely, abundant literature has been published on the Gal-1-PUT defect. Five variations of this defect are known (Duarte, Los Angeles, Rennes, Indiana and Negro variants), but these simulate only partially the clinical picture of galactosaemia. The UDP-Gal-4-epimerase defect has only once been described. Defects in galactose metabolism which show autosomal recessive inheritance are demonstrated in milk-fed infants by means of the Guthrie test. If the clinical picture arouses the suspicion of a defect in Gal-1-PUT or galactokinase, then a milk-free diet should be given until the diagnosis has been verified by enzyme analysis. Children who have been fed on a lactose-free diet show normal physical and mental development. If possible the entire family of the proband should undergo enzyme analysis in order to detect and to counsel all the heterozygotes in the family. Genetic counselling is considered to be absolutely indicated in this case. Termination of pregnancy is not indicated under any circumstances.

Adenosine Triphosphate↗