Search PubMed⌕ Search

Biomedical subjects

H Lutz

Publications and source records attributed to H Lutz.

At least 235 records · Page 13Linked to original sources
PubMed1983

[Time and incidence of peroperative cardiovascular complications in geriatric patients].

The incidence of intraoperative and postoperative complications was determined in a retrospective study via data evaluation by computer. Two groups of patients were examined, one group comprising patients below 60 years of age, whereas the other group consisted of persons above 60 years of age. The results show that complications of the cardiovascular system are three to four times more frequent in patients older than 60 years; severe hypotension or hypertensive reactions were seen in 2.9 and 9.3% of the patients, respectively, while arrhythmias occurred in 3.9%. No differences could be found in respect of the time at which these complications became manifest (intraoperatively or in the recovery room). Enumeration of the secondary diseases covered by this study, reveals significant differences; this can explain the limited range of compensation in persons of advanced age. Hence, an optimal preanaesthetic treatment and diagnosis, as well as monitoring are mandatory in geriatric patients to ensure safe anaesthesia.

Age Factors↗
PubMed1983

[Cardiovascular complications in hypertensive patients during the peroperative phase].

Circulatory complications during the intraoperative and postoperative phases were evaluated in a prospective study on the effectivity of different modes of treatment of hypertonics. 151 patients were subdivided into four groups: Group 1: Treated hypertension, blood pressure normal Group 2: Treated hypertension, blood pressure levels above 160 mmHg Group 3: Untreated hypertension or treatment of hypertension discontinued Group 4: Patients with threshold hypertension. The results show that patients treated inadequately or for a short period only, had the highest complication rates. On the whole, more than 36% of the patients treated inadequately (group 2) during the intraoperative and postoperative periods, had complications of the cardiovascular system, whereas in the untreated patients (group 3) the rate of complications was 30%. Patients with a normal blood pressure (group 1) and with threshold hypertension (group 4), on the other hand, showed a markedly lower incidence of complications, namely, 16%. These results suggest that it would be advisable to effect a consistent preoperative treatment, thus lowering the involved risk. On no account should any possible difficulties in organizing such treatment result in discontinuance of treatment of in-non-treatment.

Adult↗
PubMed1983

[On-line acquisition of haemodynamic and respiratory data during anaesthesia].

A system is presented which in connection with monitors commonly used affords high resolution control of pulmonary mechanics, respiratory and haemodynamic parameters during surgery. Extent of monitoring as well as choice of the parameters to be monitored is not determined by the system but by the physician concerned. The essential part of the system is a microprocessor in control of all monitors connected, which can store the accumulated data for a 24 hour period. On application in over 200 anaesthetics acceptance by the user was good. Because of the still rather complicated technical procedure use of the system during minor surgery proved to be difficult.

Anesthesia, General↗
PubMed1983

[Development and use of a computerized anesthesia protocol].

The real-time anaesthetic record allows the continuous on-line monitoring and the informative graphical presentation of important anaesthetic parameters; in this respect it is superior on the conventional made record. Preoperative findings and personal data of the patient are documented and presented by the aid of formulas on the terminal screen in addition to the on-line parameters and intraoperative off-line data e.g. drugs infusions, urine production, blood loss. The concept of the system is based on a microprocessor which is linked to daily used monitors by an analog-digital-converter. The wide use of the automatic record requires a relative high standard of monitors (e.g. mass spectrography), such that the applicability is limited to very extensive procedures of high risk patients.

Anesthesiology↗
PubMed1982

[Advantage of xylitol compared to glucose as an energy source during early postoperative parenteral feeding].

After a 5-day preoperative preparing period, 24 metabolically healthy patients, who had to undergo gastric resection, were fed postoperatively by hypocaloric total parenteral nutrition for a 5-day period. Group I, n = 13; received 0.11 g Xylitol/kg BW . h; Group II, n = 11, received 0.11 g Glucose/kg BW . h. Both groups received 1.71 g L-crystalline amino acids/kg BW . day. During the whole postoperative period, group II had significantly higher serum glucose and insulin levels. Due to the high postoperative insulin concentration in group II, free fatty acids, acetoacetate, beta-hydroxybutyrate and branched chained amino acids were significantly lower. The augmented release of muscle amino acids and the covering of a part of the energy expenditure by increased fatty acid oxidation in group I led to a higher postoperative synthesis rate of visceral proteins. From postoperative day 3 on transferrin and from postoperative day 6 on albumin and total protein were significantly higher in group I. This study could demonstrate that due to its special role in the intermediary metabolism during the postoperative period xylitol leads to a significantly higher regeneration rate of visceral proteins compared to glucose during total parenteral nutrition.

Adult↗
PubMed1982

[Regulation of ketone body levels before and following elective surgical operations during different intravenous feedings].

44 patients who had to undergo gastric resection and 28 patients who had to undergo cholecystectomy were divided into 4 groups each. Each group received parenterally a different energy source and calorie-nitrogen ratio. We intended to investigate the influence of different intravenous regimens on pre- and postoperative acetoacetate and beta-hydroxybutyrate levels. Patients undergoing gastric resection who received 0.36 g glucose/kg BW x h together with 1.14 g/kg BW x day 1-crystalline amino acids had the lowest postoperative ketone body concentration. A comparable group who received 0.36 g/kg BW x day of a carbohydrate-mixture solution consisting of glucose-fructose and xylitol in a proportion of 1:1:1 had significantly higher ketone bodies. The comparison of glucose with xylitol in a hypocaloric dosage of 0.11 g/kg BW x h led to a physiologic ketosis only in the group with xylitol as energy source from postoperative day 2 on. In patients undergoing cholecystectomy, the sole infusion of amino acids in a dosage of 1.14 g/kg BW x h led to the highest ketone bodies from the operation day on. The intravenous infusion of a polyol-mixture solution containing xylitol and sorbitol in a relation of 1:1 in a dosage of 4.2 g/kg BW x day led to the lowest ketone body production. The infusion of a polyol-mixture solution in a dosage of 2 g/kg BW x day enabled the development of a physiologic ketosis. In this study we could demonstrate that the infusion of xylitol or a polyol-mixture solution in a dosage of 2-3 g/kg BW x day after elective surgery enables the development of physiologic ketosis.

3-Hydroxybutyric Acid↗
PubMed1982

Endoscopic ultrasonography--technique, orientation and diagnostic possibilities.

40 patients were examined by peroral endoscopic ultrasonography with two new prototypes (Prototype II and III, Olympus Optical Co., Tokyo, Japan). Indications were various intestinal diseases. Topographical orientation was facilitated by standard positions of the instrument. The organs identified included liver, gall bladder, common bile duct, pancreas, spleen and kidneys. Pathological lesions of the organs mentioned were characterized by the echo pattern known from external ultrasonography. At present endoscopic ultrasonography is not a routine method but may provide additional information to peroral endoscopy and external ultrasonography without replacing these methods.

Adult↗
PubMed1982

Antigenic relationships among homologous structural polypeptides of porcine, feline, and canine coronaviruses.

Transmissible gastroenteritis virus of swine (TGEV), feline infectious peritonitis virus (FIPV), and canine coronavirus were studied with respect to their serological cross-reactivity in homologous and heterologous virus neutralization, immune precipitation of radiolabeled TGEV, electroblotting, and enzyme-linked immunosorbent assay using individual virion polypeptides prepared by polyacrylamide gel electrophoresis. TGEV was neutralized by feline anti-FIPV serum, and the reaction was potentiated by complement; heterologous neutralization involved antibody reacting with the peplomer protein (P), the envelope protein (E), and cellular (glycolipid) components incorporated into the TGEV membrane. Electrophoretic analysis of immune precipitates containing [35S]methionine-labeled disrupted TGEV and feline anti-FIPV antibody confirmed the reaction with the P and E polypeptides and showed the nucleocapsid protein (N) in addition. Electroblotting, followed by incubation with antibody, 125I-labeled protein A, and fluorography, disclosed cross-reactions between the three viruses at the N and E levels and revealed differences in the apparent molecular weights of the latter. Enzyme immunoassays performed with standard amounts of immobilized P, N, and E polypeptides of the three viruses showed recognition of the antigens by homologous and heterologous antibody to comparable degrees. These results indicate a close antigenic relationship between TGEV, FIPV, and canine coronavirus due to common determinants on the three major virion proteins. The taxonomic implications of these findings are discussed.

Animals↗
PubMed1982

[Importance of lipid metabolism in the overcoming of trauma].

We studied the pre- and postoperative lipid metabolism in 24 metabolically healthy surgical patients who had to undergo gastric resection during intravenous substitional infusion. Group I, n = 10, received 0,36 g/kg Bw x h of a carbohydrate mixture solution together with 1.14 g L-crystalline amino acids/kg Bw . day. Group II, n = 11, received 0.11 g Glucose/kg Bw x h; group group III, n = 13, received 0.11 g Xylitol/kg Bw x h. Both groups II and III received 1.71 g L-crystalline amino acids/kg Bw x day. After the preoperative infusion period the free fatty acids fall significantly in all groups. beta-hydroxybutyrate falls on the operation-day in all groups also with no significance. Postoperatively the free fatty acid levels remain significantly reduced in all groups. From postoperative day 1 to 5 the FFA levels in group III are significantly higher compared with group I and II. From postoperative day 2 on beta-hydroxybutyrate levels rise in all groups. From postoperative day 1 on beta-hydroxybutyrate and acetacetate levels in group III are significantly higher compared with group I and II. In conclusion the hypocaloric postoperative infusion of xylitol directs fat metabolism to reasonable physiologic pathways. A short term postoperative hypercaloric nutrition seems inadequate in patients with normal body weight.

Acetoacetates↗
PubMed1982

Gel electrophoresis-derived enzyme-linked immunosorbent assay of serum from cows resistant to and cows susceptible to challenge exposure with Mycoplasma bovis.

The gel electrophoresis-derived enzyme-linked immunosorbent assay (GED-ELISA) technique combines the high resolving power of sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) to separate complex molecules by their molecular weights, with the high sensitivity of the ELISA to detect specific antibody, Sera from 4 cows that demonstrated resistance to challenge exposure and 4 cows that were susceptible to challenge exposure with live virulent Mycoplasma bovis strain 201 were subjected to GED-ELISA to determine reactivity with M bovis antigenic components separated by SDS-PAGE. The GED-ELISA mean reactivity of sera from the 2 groups did not differ significantly (P = 0.17) when subjected to analysis of variance. Sera from both groups recognized distinct fractions of M bovis.

Animals↗
PubMed1982

[Incidence of complications with plexus anaesthesia; a computer-assisted evaluation (author's transl)].

4,042 plexus anaesthesias were analysed for systemic complications by means of computer-assisted data processing. This allowed the large case material to be analysed statistically in great detail. The incidence of complications of this anaesthetic technique and the advantages arising from computer-assisted data processing are reviewed. Specific problems due to technical factors were also investigated.

Anesthesia, Conduction↗
PubMed1982

[Computer-assisted admission and work load statistics in a surgical intensive care ward (author's transl)].

The introduction of the dialogue programme has the advantage that the data are immediately available at any time. From a yearly admission of 400 patients exact information cn be obtained of the work load and the type of work done at the unit. The value of the system can be summarized as follows: 1) data processing and retrieval are easy and do not require special skills; 2) a multiple of data can be processed; 3) older and more recent data can be compared at any time; i.e. previously obtained information is available for use in the current investigation of a problem; 4) statistical and complicated numerical analyses can be made more quickly and more precisely.

Computers↗
PubMed1982

[The risk of anaesthesia. Investigations based on 153,660 anaesthetic procedures (author's transl)].

153,660 protocols of general and local anaesthesias were evaluated according to the complications observed during anaesthesia. The complications recorded were analysed with respect to the following criteria: type of anaesthetic procedure, experience of the anaesthesiologist, urgency of the operation and pre-operative condition (risk group) of the patient. The study shows that under the requirements of anaesthetic treatment at a university clinic, the degree of risk connected with anaesthesia is only slightly dependent on the type of the anaesthetic procedure and the experience of the physician performing the anaesthesia. Distinct differences in the complications recorded are found to be dependent on the urgency of the operation (cardiovascular and technical complications) and on the pre-operative condition of the patient (cardiovascular complications). A further decrease of the anaesthetic risk is only possible if all measures for optimal preparation before an operation are fully met and compromises are avoided to the utmost. However, spectacular improvement must not be expected with these measures.

Anesthesia↗
PubMed1982

[Computerized evaluation of intraoperative complications during intubation anaesthesia, spinal- and peridural analgesia (author's transl)].

With the aid of computer assisted data processing, the intraoperative complications of spinal, epidural and general anesthesia are shown. The complications are presented in correlation to the anaesthetic risk which was assessed by a check-list. Using the computer it is possible to calculate better the frequency of intraoperative complications. The system can be used, therefore, to assist in deciding on the choice of anaesthesia.

Anesthesia↗