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Biomedical subjects

H Lutz

Publications and source records attributed to H Lutz.

At least 253 records · Page 14Linked to original sources
PubMed1981

[Enzymatic changes and protein metabolism in the early and late postoperative phase during intravenous feeding].

119 metabolically healthy surgical patients, who had to undergo elective intraabdominal surgery, were separated into upper - cholecystectomy, gastric resection - and lower - colonic and sigma surgery - intraabdominal procedures and divided into 8 groups with different infusion regimens. During the early postoperative period, patients with upper abdominal surgery had significantly higher postoperative enzyme changes compared with patients with lower abdominal surgery. Patients with cholecystectomy had the significantly highest postoperative enzyme changes. On postoperative day 6 the enzyme changes showed a significant dependence from the duration of total parenteral nutrition, the chosen calorie-nitrogen ratio, and the chosen energy substrate, Xylitol or glucose. We could show a significant negative correlation between the extent of the stimulation of hepatic lipid synthesis and the protein parameters. Of all chosen infusion regimens, Xylitol in a dosis of 0.11 g/kg BW x h together with the high amino acid infusion rate of 1.76 g/kg BW x day had the most favourable effect on the extent of stimulation of hepatic lipid synthesis, the late postoperative enzyme changes, and the synthesis rate of visceral proteins. This study could demonstrate that different intraabdominal surgical procedures need a more specific nutritional therapy.

Alkaline Phosphatase↗
PubMed1981

[The need for a specific postoperative, total parenteral nutrition therapy after various intra-abdominal procedures].

119 metabolically healthy surgical patients, who had to undergo elective intraabdominal surgery, were separated into upper -- cholecystectomy, gastric resection -- and lower -- colonic and sigma surgery -- intraabdominal procedures and divided into 8 groups with different infusion regimes. During the early postoperative period patients with upper abdominal surgery had significantly higher postoperative enzyme changes compared with patients with lower abdominal surgery. Patients with cholecystectomy had the significantly highest postoperative enzyme changes. On postoperative day 6 the enzyme changes showed a significant dependence from the duration of total parenteral nutrition, the chosen calorie-nitrogen-ratio, and the chosen energy substrate, xylitol or glucose. We could show a significant negative correlation between the extent of the stimulation of hepatic lipid synthesis and the protein parameters. Of all chosen infusion regimens xylitol in a dose of 0.11 g/kg BW X h together with the high amino acid infusion rate of 1.76 g/kg BW X day had the most favourable effect on the extent of stimulation of hepatic lipid synthesis, the late postoperative enzyme changes and the synthesis rate of visceral proteins. This study could demonstrate, that different intraabdominal surgical procedures need a more specific nutritional therapy.

Abdomen↗
PubMed1981

[Comparison of xylose and glucose as energy sources in hypocaloric, postoperative parenteral nutrition].

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 X h; Group II (n = 11) received 0,11 g Glucose/kg BW X h; Both groups received 1,71 g L-crystalline amino acids/kg BW X 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, Acetate, 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↗
PubMed1980

[Preoperative problems in the elderly woman. Risk groups, urgency of operation, preoperative diagnosis in general practice and in the hospital].

The risk of intraoperative complications has been considerably reduced through the introduction of new operation- and anaesthetic techniques. Further reduction of intraoperative complications can be achieved only through careful and complete preoperative preparation of the patient which can be done by the patient's personal physician on an outpatient basis. With age the frequency of organ dysfunction increases. Among these disorders cardiovascular and respiratory deficiencies represent the greatest risk for the patient. From the point of view of the anaesthesiologist there exist no differentiation as "small" and "major" anaesthesia. Therefore differences in the preoperative preparation of the patient can only be made regarding the urgency of the operation. In deciding whether a high-risk patient should be operated on or not, the risk of non-surgical treatment has to be taken into consideration. If, however, the operation becomes absolutely necessary, with sufficient preoperative preparation and good anaesthetic management the intraoperative risk in elderly women can be kept to a minimum.

Aged↗
PubMed1980

Myosin types in human skeletal muscle fibers.

By combining enzyme histochemistry for fiber typing with immunohistochemistry for slow and fast myosin a correlation between fiber type and myosin type was sought in human skeletal muscle. Fiber typing was done by staining for myofibrillar ATPases after preincubation at discriminating pH values. Myosin types were discriminated using type specific anti-rabbit myosin antibodies shown to cross-react with human myosin and were visualized by a protein A-peroxidase method. Type I fibers were shown to contain slow myosin only, type IIA and IIB fibers fast myosin only, and type IIC fibers both myosins in various proportions. When muscle biopsies from well-trained athletes were investigated essentially the same staining pattern was observed. However, rarely occurring type I fibers with high glycolytic activity were detected containing additional small amounts of fast myosin and occasional type IIA fibers had small amounts of slow myosin. Based on the observation of various fiber types in which slow and fast myosin coexist we propose a dynamic continuum of fibers encompassing all fiber types.

Adenosine Triphosphatases↗
PubMed1980

[Differences in postoperative metabolism after pre- and postoperative beginning of total parenteral nutrition].

In this study we intended to investigate the influence of a 24-h-preoperative total parenteral nutrition (TPN) therapy--10 surgical patients, group 1--compared with the postoperative beginning of TPN--9 surgical patients, group 2--on the postoperative metabolism. Most probably due to preoperatively depleted glycogen storages in G 2, the urinary carbohydrate losses declined more rapidly postoperatively compared with G 1. 45 mMol/l of sodium did not cover the postoperative requirements of G 1. Although we administered 90 mMol/l of potassium/24 h, several patients of G 1 needed an additional substitution. No additional phosphate substitution was necessary in either group. Except for a slight positive balance on the operation day, fluid balance was well balanced on all the other days in G 1. From postoperative day 2 on, G 2 developed a deficit of free water. It could be demonstrated very clear in this study that the postoperative fluid and electrolyte requirements are strongly influenced even by a short-term preoperative fasting period.

Adult↗
PubMed1980

Novel histone H2A-like protein of escherichia coli.

A histone-like protein (H) from Escherichia coli has been purified to more than 98% homogeneity by using its capacity to inhibit DNA functions. H protein behaves as a dimer of 28,000-dalton subunits. The histone H2A-like properties of H protein are: (i) binding to DNA at a stoichiometry of 1 H protein dimer per 75 bases; (ii) abundance of about 30,000 molecules per cell, sufficient to bind about 20% of the chromosome; (iii) limiting digestion of double-stranded DNA by micrococcal nuclease; (iv) reannealing of complementary single-stranded DNA; (v) amino acid composition resembling that of eukaryotic histone H2A; (vi) neutralization of H protein by antibody specific for H2A; (vii) heat stability; and (viii) acid solubility. The capacity of H protein to bind DNA prevents its template or substrate functions n several reactions in vitro: DNA synthesis by several polymerases; transcription by RNA polymerase; DNA topoisomerase activity; and DNA-dependent ATP hydrolysis by rep protein, dnaB protein, or protein n'. Together with other histone-like proteins of E. coli, H protein may organize the E. coli chromosome into nucleosomes, such as in eukaryotic chromatin.

Amino Acids↗
PubMed1980

[The effect on breathing of flunitrazepam and benzoctamine as adjuvants in spinal anesthesia in broncho-pulmonary risk patients].

The influence of intravenous Flunitrazepam (0.4-0.8 mg), Benzoctamine (10-20 mg) and Placebo (NaCl 0.9%) on pO2, pCO2, forced vital capacity, forced expiratory volume and peak flow were investigated in patients with reduced lung function undergoing orthopaedic surgery under spinal anaesthesia. Both drugs depress respiration: Flunitrazepam immediately, Benzoctamine about 15 min after administration. Both drugs reduce lung function in the postoperative period. They should be administered under careful observation of patients' respiration, administration of oxygen and only in special cases where sedation is necessary to reduce psychological stress. The advantage of regional anaesthesia in patients with high risk of postoperative pulmonary failure seems worth retaining compared to general anaesthesia.

Anesthesia, Spinal↗
PubMed1980

[Postoperative metabolism--differences between pre- and postoperative start of total parenteral nutrition (author's transl)].

We investigated the postoperative metabolism of patients undergoing gastric operation by beginning total parenteral nutrition pre- (group 1) and postoperatively (group 2). A third group remained fasting until 3 h after the surgical intervention. Because of the high serum glucose concentrations and the high glucose losses in the 24-h-urine on the operation day in group 1 and 2 only the basic glucose requirement (150--250 mg/24h) should be given in the early postoperative period. The low blood glucose concentration in group 3 and the elevated lactate values in group 2 underline this recommendation. Compared with group 2 and 3 group 1 had low free fatty acid concentrations of 250 muVal/l because of the continuous pre-, intra-, and postoperative infusion. Compared with normal metabolic conditions the free fatty acids don't seem to have the same insulinantagonising effect in the posttraumatic state. The fall of cholesterol after the surgical trauma reached its maximum after 12--15 h and amounted to about 40mg% in the first two groups. Albumin and total protein fell continuously in group 1 and 2. The electrophoresis in group 1 showed a rise of alpha 1-, and alpha 2-globulin to more than double the initial value, the beta-globulin showed only slight changes, the gamma-globulin dropped only slightly up to the 4th postoperative day. As a sign of an augmented catabolism the serum urea concentration rose during the postoperative state. Group 1 and 2 had a favourable nitrogen balance. The postoperative bilirubin rise could be held lower in group 1 compared to group 2.

Bilirubin↗
PubMed1980

[Data processing system for patients requiring artificial ventilation (author's transl)].

In the surgical intensive care unit of the Mannheim medical Centre a computer program has been developed to assist in the management of patients suffering from ARDS. It is based on a Dietz MUL-TI-USER system. 34 parameters of pulmonary mechanics, hemodynamics and blood gases were recorded off-line routinely. From these data 8 parameters were calculated according to established physiological relationships. Apart fom normal data printout a terminal scope offers graphical display of the interaction of any two parameters chosen. Data may be averaged regarding single patients, groups of patients or time. Data may be stored as hard copies. Operating instructions are very simple. Off-line data feeding is of advantage regarding data allocation, Calibration and plausibility control. We report on the development of the off-line computer system and on clinical efficiency and accuracy of the system in the treatment of patients in respiratory distress.

Adult↗
PubMed1980

[Germ cells of the bird embryo: early localization, migration and colonization of gonadal anlagen].

Several experimental and morphological papers are analyzed concerning germ cell origin, migration and proliferation within sexually undifferentiated gonads. The germ material which is first localized in both anterior and posterior halves of the unincubated blastoderm assembles in the anterior area only at the beginning of incubation. In gonads the germinal population does not depend on the initial quantity of germ cells in the early blastoderm: its value seems to be determined by the somatic cells of the gonadal stroma. During the migratory phase, it is suggested that regulated interactions occur between the glycoconjugates of the moving germ cells and the physico-chemical characteristics of the extracellular matrices acting as substrates for the movement.

Animals↗
PubMed1980

[Infusion therapy during transurethral prostatectomy].

In 24 patients undergoing transurethral resection (TUR) of the prostate, sodium, potassium, calcium, magnesium, osmolarity and protein in serum were measured every 15 min. Depending on the composition of the electrolyte solution, there is a sharp fall in serum sodium and osmolarity caused by the leakage of irrigation fluid into the patients circulation. There is also a rise in central venous pressure and a fall of serum protein. There is a correlation between the fall of serum sodium and osmolarity and the rise of central venous pressure. Our results allow the conclusion that a restricted infusion programme with high sodium concentrations can be recommended. Depending on the patients serum protein, preoperative albumin solutions (20%) can be necessary to prevent a dangerous fall of oncotic pressure intraoperatively. The pathophysiology of the TUR syndrome and the importance of an adequate infusion therapy are discussed.

Aged↗
PubMed1980

[Computer-assisted documentation in anesthesia (author's transl)].

Details are given of a Dietz microprocessor with 48 K Bytes core memory for anaesthetic documentation. The experiences gained with this equipment over a period of two years are reviewed. The storage capacity is sufficiently large to allow its use by several persons for the processing of more than 20,000 anaesthetic records per year. The preparation of the anaesthetic record takes a skilled technician about two minutes. The prompt evaluation of the data and their presentation on either screen or print-out are the main advantages of this system. Information regarding the course of anaesthesia, complications, the identity of the anaesthetist are available instantly and at any time and can be referred to if organizational problems arise. The fact that all relevant data and criteria can be called up whenever wanted also acts as a spur to make use of the information. The system still needs some improvement to make it more efficient.

Anesthesiology↗
PubMed1980

[Objective criteria for the pre-operative evaluation of the surgical risks (author's transl)].

In 1975 a check list was introduced for the pre-operative evaluation of the surgical risks. In contrast to assessing the general condition of the patient according to the ASA nomenclature, the check list is largely based on objective criteria with a point system for evaluation. The number of points determines the magnitude of risk. 140,250 anaesthesias are avaluated with regard to the frequency of cardiovascular complications. The incidence of complications increases steadily in the presence of hypertension and arrhythmia in four consecutive risk groups and in the presence of hypotension and asystole in all five groups.

Adolescent↗