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Biomedical subjects

H Lang

Publications and source records attributed to H Lang.

At least 163 records · Page 9Linked to original sources
PubMed1994

[Analysis of liver hemodynamics in severe ischemia and reperfusion injury after liver transplantation].

AIM: The pathogenesis of the ischemia-/reperfusion injury after liver transplantation is not fully understood. The purpose of this study was to analyse blood flow and vascular resistance of the hepatic artery and the portal vein after long ischemic time. METHODS: A model of orthotopic liver transplantation in pigs was used. Two groups with different cold ischemic times (CIT) were formed: group A: short ischemic time (4-6 hrs CIT), 7 transplantations/group B: long ischemic time (20-24 hrs CIT), 7 transplantations. The blood flow was measured by means of electromagnetic technique. The intravascular pressure was determined in the aorta, portal vein and hepatic vein after direct punction or by inserted catheters. RESULTS: After short ischemic time and 1 hour of reperfusion a decrease of the arterial and portal venous resistance was observed, while the total hepatic blood flow remained constant. Six hours after reperfusion the arterial and portal venous vascular resistance increased and reached almost values of the donor animal. However, marked changes of hemodynamic parameters were found after long ischemic time, especially in the portal venous vascular system. The vascular resistance of the portal vein was significantly elevated and reached values ten-times higher than during the donor operation. CONCLUSION: The decrease of the vascular resistance during the early reperfusion period was surprising because of the well-known results of histological studies and analysis of the microcirculation. The cause remained unknown, but an increased perfusion via intrahepatic shunts or denervation of the transplant may be responsible for this observation. The elevated portal venous resistance after severe ischemic damage most likely reflected the increase of interstitial pressure. In the clinic monitoring of the portal venous vascular system by means of doppler-sonography may be an useful adjunct in the diagnosis of early postoperative transplant-dysfunction.

Animals↗
PubMed1994

[Subjective illness theory and coping with illness by brain tumor patients].

The present study was designed to describe theories of illness and coping with the disease in brain tumor patients. It addresses the following questions: 1. To what attribute brain tumor patients their illness? 2. How do they cope? 3. Are causal attributions and coping modes related to emotional states, such as distress, hope, and depression? N = 33 newly diagnosed patients suffering from benign or malignant intracranial tumors are included in the sample and interviewed presurgically. Assessment methods combine both qualitative and quantitative instruments. Among the causes discussed in the interviews are incidents that can be classified as mechanical traumata. They have the highest frequency. In patients' self-reports, distress is rated low, hope high. Interviewers rate distress higher and hope lower. Among the modes of coping, compliance, fighting spirit (as assessed in a questionnaire), distraction, social support, optimism, and acceptance of the disease (as assessed by interview and content analysis) are the most frequent. The results are discussed under methodological and illness-related perspectives.

Adaptation, Psychological↗
PubMed1993

[Possibilities and limits of surgical therapy of pseudomyxoma peritonei].

In a retrospective study, the potential and limitations of surgical therapy of pseudomyxoma peritonei were studied in seven patients. In all patients the pseudomyxoma had originated from the appendix. All patients were primarily treated by surgery. An R0 resection at the first operation was possible in only one patient with a benign pseudomyxoma, while significant tumor debulking with improved symptoms was achieved in all other patients. If the tumor recurred relaparotomy was performed to obtain tumor reduction. The perioperative morbidity even after multiple relaparotomies was low. The survival rates ranged between 2 and 20 years with chemotherapy (5-fluorouracil) which was of particular prognostic benefit in patients with malignant pseudomyxoma peritonei. Surgical therapy is the treatment of choice in pseudomyxoma peritonei, although an R0 resection is hardly feasible. Due to the low morbidity, relaparotomy in cases of tumor recurrence always appears to be indicated. In comparison to other gastrointestinal malignancies, the survival rates in pseudomyxoma peritonei, sometimes treated with additive chemotherapy, are superior.

Aged↗
PubMed1993

Guillain-Barré syndrome following streptokinase therapy.

Clinical and laboratory data from a patient with Guillain-Barré syndrome indicated a probable etiological correlation of polyradiculitis to the intravenous administration of streptokinase. Oligoclonal IgG bands in the cerebrospinal fluid and serum were shown to be specific for streptokinase. Serum titers of streptokinase were elevated 64-fold for IgG, 16-fold for IgM, and 4-fold for IgA compared to controls. Clinical symptoms of Guillain-Barré syndrome are thought to result from streptokinase antibody complex mediated damage to the local blood-nerve barrier. The pathogenic relevance of autoantibodies to albumin and proteins of the central and peripheral nervous systems, occurring early after onset of symptoms, remains to be determined.

Autoantibodies↗
PubMed1993

Diagnostic value of color Doppler sonography in primary liver tumors--a trend study.

In order to investigate the diagnostic value in differential diagnosis of primary liver tumors, color Doppler sonography was used preoperatively in 30 patients. Without difference, tumor hypervascularization was found in patients with hepatocellular carcinoma (2 of 4), cholangiocellular carcinoma (4 of 4), hemangioma (3 of 8), focal nodular hyperplasia (8 of 8), adenoma (3 of 4), and neuroendocrine tumor (n = 1). No vascular signal could be detected in 1 case of adenomatous hyperplasia and 2 cases of hepatocellular carcinoma, one after previous chemoembolization. Hemangioma appeared hypo- or even avascular in 5 of 8 patients. Therefore, according to our experience, the yield of color Doppler sonography is rather low for differential diagnosis and prediction of the tumor dignity. With regard to the surgical procedure, valuable information about tumor extension can be obtained particularly in central lesions close to hilar structures or liver vein confluence. Further indications result from follow-up of tumor vascularization after chemoembolization and chemotherapy.

Adenoma, Liver Cell↗
PubMed1993

Sonographic aspects of the Cruveilhier Baumgarten syndrome.

A rare case of Cruveilhier-Baumgarten syndrome with exceptional deep subcutaneous portosystemic collaterals is reported. Undetected these anastomoses represent potentially dangerous sites for hemorrhage complications. Ultrasound in combination with color-coded duplex sonography is a reliable technique in identifying portosystemic anastomoses as well as in providing valuable information about the etiology of portal hypertension.

Aged↗
PubMed1992

Coping and adaptation in pancreatectomized patients: a somatopsychic perspective.

The present study describes various strategies of coping with illness as observed in pancreatectomy patients, a group of patients which has not been investigated before in this field of research. Questionnaire data obtained from a sample of n = 134 were analyzed with regard to sociodemographic (age, sex) and medical characteristics (indication for surgery: chronic pancreatitis vs. pancreatic carcinoma; outcome after surgery: diabetes, hypoglycemia, pain). The relationships between ways of coping and several adaptation criteria were investigated. The question is put up to discussion, if it is possible to clearly separate emotion as a way of coping and emotion as an outcome of coping.

Adaptation, Psychological↗
PubMed1992

[The synthesis of collagenous and noncollagenous proteins by cells from the periodontium].

Synthesis of collagenous and noncollagenous proteins by cells originating from the alveolar bone (AB-cells) and from the periodontal ligament (PDL-cells) of 8 minipigs was analyzed in primary cell cultures. Incorporation of 3H-proline into proteins recovered from cell extracts showed, that 13.7% of protein synthesized by AB-cells and 8.0% of protein synthesized by PDL-cells were collagens. In both cell lines relative amounts of collagens synthesized decreased significantly on subculturing (AB-cells: 9.3%, PDL-cells: 6.0%). Preincubation of 2nd subculture AB-cells with beta-glycerophosphate had no significant effect on collagen synthesis. Considering the fact that relative amounts of collagen recovered from cell extracts represent only 10-20% of collagen recovered from whole culture (i.e. cells and culture medium), we suggest that collagen synthesis is an important component of in vitro-protein synthesis of cells originating from the alveolar bone and the periodontal ligament.

Alveolar Process↗
PubMed1991

A simple ELISA procedure for HIV-1 based on the enzyme beta-lactamase.

The enzyme beta-lactamase (penicillin-amido-beta-lactam-hydrolase, EC 3.5.2.6.) has been shown to be suitable for use in ELISA procedures. The assay proposed requires a conjugate containing a beta-lactam-hydrolase as the enzymatic component, penicillin or one of its derivatives as substrate and an iodic complex (an iodine-starch or an iodine-polyvinylic alcohol complex) as the chromogenic component. Binding of conjugate molecules results in the transition of the iodic complex from dark blue to colourless. The transition is readily visualized without the aid of an EIA reader. The decolorization occurs specifically giving a clear-cut yes/no decision without a cut-off value. The rate of the colour transition strongly depends on the amount of bound conjugate. beta-lactamase-based ELISA techniques are of potential use in the immunological diagnosis of some virus diseases. The sensitivity and specificity of the assay were assessed on a panel of 670 negative and 141 positive HIV-1 sera, giving values of 100% and 99.85%, respectively.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Rat liver dimethylglycine dehydrogenase. Flavinylation of the enzyme in hepatocytes in primary culture and characterization of a cDNA clone.

Dimethylglycine dehydrogenase (Me2GlyDH), an enzyme of choline catabolism specifically expressed in the mammalian liver, was analyzed in rat hepatocytes in culture. This mitochondrial enzyme carries the FAD cofactor covalently attached to the polypeptide chain by its riboflavin 8 alpha position to N pi of histidine [Cook, R., Misono, K.S. & Wagner, C. (1980) J. Biol. Chem. 259, 12475-12480]. Subcellular fractionation of [14C]riboflavin-labelled hepatocytes and immunoprecipitation with Me2GlyDH-specific antiserum identified a [14C]riboflavin-labelled polypeptide of the size of mature Me2GlyDH only in the mitochondrial fraction. Immunoprecipitation of extracts from [35S]Met-labelled hepatocytes revealed a putative precursor protein to the mature Me2GlyDH in the cytoplasmic fraction. These Me2GlyDH polypeptides were not expressed in cells of the rat hepatoma cell line FAO. A Me2GlyDH cDNA clone of apparent full length was isolated from a rat liver cDNA bank constructed in the plasmid vector pcD-X [Okayama, H., Kawaichi, M., Brownstein, M., Lee, F., Yokota, T. & Arai, K. (1987) Methods Enzymol. 154, 3-28]. The nucleotide sequence of the cDNA contains an open reading frame encoding a protein of 96059 Da. This molecular mass agrees well with the migration on SDS/PAGE of the assumed Me2GlyDH precursor immunoprecipitated from the cytoplasm of [35S]Met-labelled cells. Proteolytic cleavage at the putative mitochondrial processing protease-recognition site Arg(-2)-Ala(-1)-Glu(+1) would lead to the formation of a protein of 91391 Da, which is in good agreement with the estimated 90 kDa of mature Me2GlyDH [Wittwer, A.J. & Wagner, C. (1981) J. Biol. Chem. 256, 4102-4108], and a 43-amino-acid leader peptide. The N-terminus of Me2GlyDH contains a conserved amino acid sequence which forms the dinucleotide-binding site in many enzymes with noncovalently bound FAD. Close to the modified histidine there is an amino acid sequence resembling a sequence conserved in thymidylate synthases and shown in these enzymes to be involved in the binding of the pteroyl polyglutamate cofactor.

Amino Acid Sequence↗
PubMed1991

A comparison between morphine, meperidine and ketobemidone in continuous intravenous infusion for postoperative relief.

Morphine, meperidine and ketobemidone used in continuous i.v. infusion for postoperative pain relief were compared in a double-blind, controlled, prospective study in 81 consecutive consenting adult patients after open-heart surgery, with permission from the hospital ethics committee. During the first postoperative period, the infusion rates were fixed. Later on, when the infusion rate could be regulated according to individual patient needs, the variation in infusion rate was large, in accordance with earlier studies. No significant differences were demonstrated between the three analgesics with respect to efficacy of analgesia or side effects like shivering, nausea or vomiting. Respiratory depression following extubation was not observed. During shivering, there was a significant increase in the arterio-mixed venous difference of oxygen in all groups. The amounts of opioids used were relatively small compared to amounts used in patients following abdominal surgery. When interviewed some days after surgery, 18/74 patients remembered moderate pain and 11 severe pain during the stay in the ICU.

Double-Blind Method↗
PubMed1991

The results of a large multicentre study comparing low-dose lisinopril-hydrochlorothiazide with the monocomponents.

The efficacy, tolerability and metabolic effects of a fixed combination of lisinopril 10 mg and hydrochlorothiazide 12.5 mg (L/HCTZ) and those of the monocomponents were compared in 286 mild to moderate hypertensive patients in a 17-centre study using a double-blind, randomized, parallel-group design. After 2 weeks of placebo run-in, patients were randomized to one of the three treatments for 8 weeks. Supine and standing BPs were measured at peak blood levels (4-8 hours post dose) after 4 weeks, and at trough blood levels (24-28 hours post dose) after 8 weeks. The BP reduction from baseline was greater with L/HCTZ than with the monocomponents at weeks 4 and 8; at week 8 the reduction was statistically significant vs lisinopril for standing DBP (P less than 0.027) but not for standing SBP; the reduction was significant with L/HCTZ vs hydrochlorothiazide at week 4 [P = 0.0002/0.0001 (SBP/DBP) supine; P = 0.0002/0.0002 standing] and at week 8 (P = 0.0001/0.0001 supine and standing). Response at week 8 (supine DBP less than or equal to 90 mm Hg) with L/HCTZ (87.0%) was greater than with hydrochlorothiazide (29.0%; P less than 0.0001) and marginally greater than with lisinopril (74.2%; P = 0.069). Heart rate fell statistically significantly more with L/HCTZ (by 3.3 beats/minute) than with HCTZ (by 0.86 beats/minute; P = 0.018). L/HCTZ treatment significantly increased plasma uric acid levels compared with lisinopril. L/HCTZ decreased potassium, while lisinopril increased potassium. L/HCTZ decreased cholesterol; HCTZ increased it. Adverse effects were more common on L/HCTZ vs lisinopril (P = 0.033) but not vs hydrochlorothiazide.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Neuropathy of the gingival autonomous nerve system in inflammatory diseases of the periodontium. Ultrastructural analysis].

In a comparative study the influence of periodontal disease on the autonomous nerve-system of human attached gingiva was analysed ultrastructurally in 20 gingiva specimens. The test group was formed by 10 patients with adult periodontitis (AP) and compared with 10 patients with clinically healthy gingiva. The specimens were prepared for ultrastructural evaluation. The autonomous nerve fibres near the epithelium, in the connective tissue, and at the blood vessels were qualified and quantified by means of electron microscopy. In the test group clear signs of neuropathy of the autonomous nerve system like lysis of axoplasm, evagination of axons from their Schwann's sheaths, de- and regeneration pistons and reduction of axons were found. The possible pathogenic significance of this neuropathy of the autonomous nerve system in periodontal disease is discussed.

Adult↗
PubMed1991

[Measurement of O2 concentration in the fresh gas supply of the Kuhn system].

To accomplish the requirement of inspiratory O2-concentration measurement on the Ayre-T-piece modified by Kuhn we developed a special device. It is mounted in the fresh gas hose and then connected to the sensor of the O2-concentration measuring and warning instrument of the circle system.

Anesthesia, Inhalation↗