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Biomedical subjects

H Lange

Publications and source records attributed to H Lange.

At least 127 records · Page 7Linked to original sources
PubMed1989

Cerebral effects of anaesthesia and hypothermia.

Cerebral blood flow, cerebral oxygen and glucose consumption, and cerebral lactate and pyruvate release were measured; spectral analysis of the EEG was recorded in 10 male patients who had coronary artery bypass surgery. The measurements were taken to evaluate the effects of fentanyl-midazolam anaesthesia during normothermia and during hypothermic nonpulsatile cardiopulmonary bypass at 26 degrees C venous blood temperature, when a temperature-corrected PaCO2-value of 5.3 kPa was maintained. Anaesthesia with fentanyl 7 micrograms/kg and midazolam 200 micrograms/kg as induction doses, followed by infusions of fentanyl 0.15 micrograms/kg/minute and midazolam 3 micrograms/kg/minute, was characterised by a decrease in fast-wave activity and an increase in high-amplitude, slow-wave activity in the EEG. There was also a decrease in cerebral blood flow (38%), oxygen consumption (22%) and glucose consumption (25%), while lactate and pyruvate production remained unchanged. Hypothermia of 26 degrees C venous blood temperature suppressed EEG almost completely and decreased oxygen and glucose consumption by a further 61% and 54%, respectively, with no changes in lactate and pyruvate production while cerebral blood flow increased by 145%. These results show that the effects of fentanyl-midazolam anaesthesia on cerebral metabolism are enhanced during hypothermic cardiopulmonary bypass while the influence of anaesthesia on cerebral blood flow is overshadowed by the practice of a temperature-corrected acid-base management.

Adult↗
PubMed1989

[Electron microscopic virus detection in fecal samples from swine with enteric diseases between 1981 and 1987].

Results of electron microscopical studies of 517 fecal samples from diarrhoeic pigs out of the years 1981 and 1987 were reported. Coronavirus was found in 26.3%, rotavirus in 4.3%, parvovirus in 2.1%, coronavirus like particles in 2.9% and picornavirus like particles in 2.3% of the samples. In some cases (2.3%) double infections could be detected occurring as well between corona- and rotavirus, parvovirus or picornavirus like particles as between rotavirus and parvovirus and picornavirus like particles, respectively. The results were reported annually.

Animals↗
PubMed1989

Sufentanil does not block sympathetic responses to surgical stimuli in patients having coronary artery revascularization surgery.

The effects of a moderate dose of sufentanil (1 microgram.kg-1 + 0.015 micrograms.kg-1.min-1) plus nitrous oxide (30% O2/70% N2O) anesthesia (group I; n = 8) and of high-dose sufentanil/O2 anesthesia (10 micrograms.kg-1 + 0.15 micrograms.kg-1.min-1) without N2O (group II; n = 8) on cardiovascular dynamics, myocardial blood flow, myocardial oxygen consumption, myocardial lactate balance, and hypoxanthine release were studied in two groups of male patients scheduled for elective coronary artery bypass surgery. All patients were on maintenance doses of calcium channel blockers and nitrates with the last doses of medications given the morning of operation. All patients were premedicated with flunitrazepam (2 mg orally), piritramide (7.5 mg IM) and promethazine (25 mg IM). Measurements were performed before the induction of anesthesia with the patients premedicated but awake; 20 min after induction of anesthesia with sufentanil plus pancuronium 0.1 mg.kg-1 for muscle relaxation before surgery; and during sternotomy and sternal spread. Sufentanil at either dose decreased mean arterial pressure, as well as cardiac and stroke volume index while heart rate remained unchanged. Following the induction myocardial blood flow and myocardial oxygen consumption decreased 23% (79 ml.min-1.100 g-1 to 61 ml.min-1.100 g-1 and 28% (9.2 ml O2.min-1.100 g-1 to 6.6 ml O2.min-1.100 g-1) in group I and 14% (78 ml.min-1.100 g-1 to 67 ml.min-1.100 g-1 and 18% (8.7 ml O2.min-1.100 g-1 to 7.1 ml O2.min-1.100 g-1) in group II. Myocardial ischemia was seen in one patient of group II (patient No. 4), as indicated by a hypoxanthine release into the coronary sinus, when after the induction MAP decreased from 93 to 67 mm Hg and heart rate increased from 56 to 71 min-1. During sternotomy 8 of 16 patients (50%) developed hypertension and 9 of 16 patients (56%) showed signs of myocardial ischemia, i.e., a lactate and hypoxanthine release.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[The effect of sufentanil in high doses on hemodynamics and electroencephalography activity in coronary patients].

Sufentanil, a synthetic opioid that is 5-10 times as potent as fentanyl, has been suggested by some authors to prevent hypertensive responses to noxious stimuli in patients undergoing coronary artery bypass surgery much better than fentanyl, while in other studies it has failed to maintain cardiovascular stability during surgical stimulation. This study was designed to investigate the cardiovascular and electroencephalographic effects of high-dose sufentanil/O2/pancuronium anesthesia in patients undergoing coronary artery bypass surgery. METHODS. Two different doses of sufentanil were administered to two groups including a total of 20 male patients. Patients in group 1 (n = 10) received 10 micrograms.kg-1 sufentanil as an induction dose plus 0.15 microgram.kg-1.min-1 as a continuous infusion, while 10 micrograms.kg-1 plus 0.3 microgram.kg-1.min-1 were administered to the patients in group 2 (n = 10). Hemodynamic measurements were performed with the patients awake (I), 15 min following the induction of anesthesia with sufentanil and pancuronium at rest (II), and during sternotomy and sternal spreading (III). Patients were ventilated with oxygen in air (FiO2 = 0.5). Cerebral electrical activity was recorded by periodic analysis of the EEG, and plasma concentrations of sufentanil were measured throughout the entire study period. RESULTS AND DISCUSSION. The dosage scheme used in this study, which consisted of a sufentanil bolus followed by a continuous infusion, prevented plasma concentrations of sufentanil from declining in both groups during the entire study period. Following induction there was a significant decrease in systolic arterial pressure by 12% in group 1 and 20% in group 2 accompanied by a reduction in cardiac index by 25% and 21%, respectively, and in stroke volume index by 19% in group 1 and 24% in group 2, while systemic vascular resistance increased by 27% and 10%, respectively. Sternotomy led to a rise in systolic arterial pressure that did not exceed the awake values in both groups, while diastolic and mean arterial pressures (MAP) increased by 17% and 14% and by 15%, respectively, due to further increases in systemic vascular resistance by 57% and 41% above the control values. Cardiac and stroke volume indexes stayed significantly lower than the awake values, whereas heart rate remained essentially unchanged during the course of the study. There were no statistically significant differences between the groups during all measurements. In the EEG, sufentanil anesthesia was characterized by a decrease in the number of higher frequency waves and an increase in lower frequency (delta) waves, which did not change during sternotomy in 17 of the 20 patients.

Adult↗
PubMed1989

[Microbiological study results (bacteriology and electron microscopy) of diarrhea in dog whelps].

Bacteriological examinations of 159 faeces and intestinal contents of dogs with diarrhoea revealed E. coli in 157 specimens. 73 of these samples contained non haemolytic strains, 18 haemolytic isolates, and 66 haemolytic, as well as non haemolytic strains. Klebsiella sp. and Staphylococcus aureus were found in 9 cases, and Salmonella sp. (group B) was isolated once only. By electron microscopy parvovirus could be detected in 19 samples. Ten were positive for coronavirus and one for rotavirus. Morphologically not finally identified coronavirus like and picornavirus like particles were found in 3 cases, respectively. A significant relationship between the occurrence of virus infections and the isolation of certain bacteria species was not found. In 45 E. coli strains virulence factors, such as the heat labile enterotoxin (LT) and the verotoxin (VT), could not be detected, but 31 of these isolates showed different haemagglutination patterns which were still present by 14 of them in the presence of mannose (mannose resistant haemagglutination, MR-HA). These MR-HA inducing E. coli isolates were present more often in parvovirus positive samples (in 6 of 10) than they could be detected in parvovirus negative ones (in 8 of 35), implicating a potential pathogenic role of these E. coli strains for the parvovirus enteritis of dogs.

Animals↗
PubMed1989

[Electron microscopic detection of herpesviruses in a mass death of Greek tortoises (Testudo hermanni) and four-toed turtles (Agrionemys horsfieldii)].

In a population of about 130 tortoises, consisting mainly of Hermann's tortoises (Testudo hermanni) and Four-toed tortoises (Agrionemys horsfieldii), 50% of the reptiles died within 3 months in autumn 1987. Post mortem analysis of 5 necropsied turtles revealed thick, caseous coatings in the upper digestive tract, hepatomegaly and enteritis. By microbiological examination a lot of ubiquitous bacteria could be isolated. By electron microscopy of concentrated and negatively stained gut specimens herpes virus particles were found in two Hermann's tortoises and one Four-toed tortoise. Isolation experiments in embryonic turtle tissue cultures showed no evidence of a cytopathogenic agent. The results are discussed in respect of their importance for the high mortality observed in the population of mediterranean land turtles.

Animals↗
PubMed1989

[Differential diagnostic significance of lactate in acute abdominal diseases].

Fourty-four patients with abdominal complaints were analysed for blood lactate levels prior to surgery. Exploratory surgical diagnoses were co-related with blood lactate levels and these co-relations are summarised here. Rise in blood lactate level was found to be significant in all cases of mesenteric infarction (n = 10). The lactate levels were also high in all cases of general peritonitis (n = 4) and 50% (5 out of 10) of cases of bowel strangulation. In all the other surgical explorations, besides the above mentioned, blood lactate was found to lie within a normal range. From the aforesaid study, although pertaining to a small group, it seems plausible that patients presenting with abdominal diseases associated with an elevated blood lactate level represent a surgical emergency. Measurement of blood lactate level can be of great help in the diagnosis of acute surgical emergencies needing early exploration, especially in cases of mesenteric infarction.

Abdomen, Acute↗
PubMed1989

Granulocyte-related bioincompatibility of hemodialysis: inhibition of oxidative metabolism, degranulation reaction, enzyme release and leukocyte sequestration in the lung.

Hemodialysis (HD) induced contact of granulocytes with cuprophan and modified cuprophan, i.e. hemophan, membranes leads to over-stimulation of their oxidative metabolism. This is shown by the fact that after starting HD the peripheral granulocytes are less stimulable to chemiluminescence (CL) and peroxide production (cytochrome C reduction). Such alterations are likely to be connected with a granular staining loss, enzyme release and sequestration of granulocytes in the lung, which coincides with reported clinical features like dyspnoea and drop in arterial oxygen pressure. HD with polysulfone membranes causes a degranulation reaction too, but does not produce granulocyte inhibition and pulmonary sequestration of leukocytes, clearly indicating that these phenomena strongly depend on the different dialyzer membranes.

Biocompatible Materials↗
PubMed1988

Striatal deficiency of L-pyroglutamic acid in Huntington's disease is accompanied by increased plasma levels.

L-Pyroglutamic acid (L-PGA), a cyclized glutamate analogue, was measured in plasma, cerebrospinal fluid and brain tissue of patients with Huntington's disease (HD) and controls. In HD, plasma L-PGA was elevated and possibly reflects an increased requirement of cell membranes to be protected against peroxidative damage. L-PGA was decreased in caudate and putamen of HD patients. We suggest that striatal deficiency of L-PGA in HD is a consequence of neuronal loss which characteristically occurs in HD striatum.

Adult↗
PubMed1988

High expression of functional adenovirus DNA polymerase and precursor terminal protein using recombinant vaccinia virus.

Initiation of Adenovirus (Ad) DNA replication occurs by a protein-priming mechanism in which the viral precursor terminal protein (pTP) and DNA polymerase (pol) as well as two nuclear DNA-binding proteins from uninfected HeLa cells are required. Biochemical studies on the pTP and DNA polymerase proteins separately have been hampered due to their low abundance and their presence as a pTP-pol complex in Ad infected cells. We have constructed a genomic sequence containing the large open reading frame from the Ad5 pol gene to which 9 basepairs from a putative exon were ligated. When inserted behind a modified late promoter of vaccinia virus the resulting recombinant virus produced enzymatically active 140 kDa Ad DNA polymerase. The same strategy was applied to express the 80 kDa pTP gene in a functional form. Both proteins were overexpressed at least 30-fold compared to extracts from Adenovirus infected cells and, when combined, were fully active for initiation in an in vitro Adenovirus DNA replication system.

DNA Replication↗
PubMed1988

Increased systemic availability of albendazole when taken with a fatty meal.

We have studied the systemic availability of oral albendazole in 6 patients with echinococcosis either fasting or with breakfast. Albendazole sulphoxide, the pharmacologically active principle, was assayed by HPLC. Mean plasma concentrations and AUCs were 4.5 times higher when albendazole was given with breakfast than when administered in the fasting state. We conclude that therapy of echinococcosis with albendazole requires the drug to be taken with meals and that administration on an empty stomach might be more appropriate when intraluminal effects are desired, e.g. for intestinal parasites.

Adult↗
PubMed1988

Steady-state extrarenal sorbitol clearance as a measure of hepatic plasma flow.

Hepatic plasma flow was assessed with sorbitol (hepatic extraction = 0.96) at steady state. After infusion of 50 mg/min for 3 h, total and renal sorbitol clearances were calculated, and the extrarenal clearance was obtained by taking the difference between the two. In normal volunteers, the mean (+/- SD) extrarenal sorbitol clearance was 10.6 +/- 2.1 ml/min.kg. In patients with various liver diseases, it was correlated more closely to the fractional clearance of indocyanine green (r = 0.83, n = 57) than the galactose elimination capacity (r = 0.66, n = 55). Hepatic vein catheterization showed that the hepatic extraction of sorbitol was always much higher than the extraction of indocyanine green; there was no evidence for extrahepatic, extrarenal sorbitol elimination. On the basis of these findings, sorbitol is kinetically superior to indocyanine green and, although the noninvasively determined extrarenal sorbitol clearance at steady state may not be equal to total hepatic plasma flow, it may at least be regarded as a measure of parenchymal liver plasma flow.

Adult↗
PubMed1988

Effects of propofol on cardiovascular dynamics and coronary blood flow in geriatric patients. A comparison with etomidate.

The cardiovascular and myocardial effects of propofol and etomidate were studied in 20 geriatric patients (age 65-84 years) who underwent major upper abdominal surgery. Ten patients received propofol 1.5 mg/kg for induction of anaesthesia followed by a continuous infusion of 0.1 mg/kg/minute for maintenance; 10 patients received etomidate 18 mg for induction followed by 2.4 mg/minute for maintenance. Vecuronium was used for neuromuscular blockade. Cardiovascular dynamics were recorded in the awake state one minute after induction and 1, 5 and 30 minutes after tracheal intubation; coronary blood flow (argon wash-in) and myocardial oxygen consumption were determined in the awake state and 5 and 30 minutes after intubation. Both anaesthetics decreased systolic, diastolic and mean arterial pressures, heart rate and cardiac index to the same extent. Myocardial blood flow and oxygen consumption were also reduced in both groups due to a reduction in cardiac work. Tracheal intubation produced a marked increase in arterial pressure in the etomidate group, while haemodynamic changes were absent in the propofol group, Myocardial lactate production was not observed in either group 5 or 30 minutes after tracheal intubation.

Aged↗