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Biomedical subjects

I Eichler

Publications and source records attributed to I Eichler.

At least 55 records · Page 3Linked to original sources
PubMed1990

Acute effects on pulmonary haemodynamics of nifedipine in adult patients with cystic fibrosis.

Hypoxic pulmonary vasoconstriction is considered to be the primary cause of pulmonary hypertension and cor pulmonale in adult patients with cystic fibrosis (CF). The acute effect on pulmonary haemodynamics of a single sublingual dose of nifedipine 20 mg has been studied in 9 adult patients with CF. Nifedipine significantly attenuated the rise in mean pulmonary artery pressure and pulmonary vascular resistance induced by inhalation of a 13% oxygen gas mix. It also slightly reduced baseline pulmonary artery pressure and pulmonary vascular resistance and lowered pulmonary artery hypertension in the patients. Oxygen delivery was unchanged. Nifedipine is potentially useful for the treatment of hypoxic pulmonary hypertension in patients with CF.

Adult↗
PubMed1990

Normal responsiveness of superficial hand veins to alpha- and beta-adrenergic stimuli in allergic asthma: effects of terbutaline and prednisolone on beta-adrenergic responsiveness.

Impaired function of the adrenergic-receptor system has been postulated to contribute to the pathogenesis of bronchial asthma. Using the dorsal hand-vein compliance technique, we compared the changes in diameter of superficial hand veins in response to phenylephrine, an alpha-adrenoceptor agonist, and to isoproterenol, a beta-adrenoceptor agonist, in 14 untreated patients with allergic asthma and in 16 nonatopic control subjects. There were no significant differences in the median effective dose of phenylephrine that produced 50% of maximal venoconstriction (ED50) or in the maximal response (Emax) between the two groups. Bronchial hyperreactivity (assessed by methacholine-challenge tests) in the patients with asthma was uncorrelated with the ED50 or Emax of isoproterenol. These results demonstrate no evidence for a generalized change in alpha- or beta-adrenergic responsiveness on smooth muscle cells in asthma. Hand-vein responsiveness to isoproterenol was unchanged after treatment for 7 days with oral terbutaline (5 mg three times per day). Thus, unlike leukocytes, smooth muscle appears not readily susceptible to beta-adrenoceptor desensitization in vivo. Local infusions of prednisolone or dexamethasone during 2 hours and systemic administration of dexamethasone (24 hours) caused a significant fall in the Emax for isoproterenol. The mechanism of attenuation of beta-adrenoceptor responsiveness by corticosteroids remains to be determined.

Adrenergic alpha-Antagonists↗
PubMed1989

Plasma concentrations of free and sulfoconjugated dopamine, epinephrine, and norepinephrine in healthy infants and children.

Plasma concentrations of free and sulfoconjugated catecholamines were measured in healthy infants and children under resting conditions. Free norepinephrine and epinephrine levels were up to three times higher in healthy children under 2 years than in adults, even under true resting conditions. In contrast, free dopamine concentrations of all age groups fell within the normal range for adults. The levels of sulfoconjugation were in the adult range.

Adolescent↗
PubMed1989

Responsiveness of superficial hand veins to adrenergic stimuli in patients with cystic fibrosis.

1. The basic biochemical defect of cystic fibrosis (CF) remains undetermined, but impaired function of the beta-adrenoceptor-mediated adenosine 3':5'-cyclic monophosphate (cyclic AMP)-dependent regulatory pathway in secretory cells is likely to be involved in the pathophysiology of the disease. 2. We have compared responsiveness to beta-adrenergic stimulation in vivo by infusing isoprenaline locally into peripheral veins of CF patients and control subjects; the dorsal hand vein technique was used to measure the vascular response to isoprenaline. 3. CF patients required significantly higher doses of isoprenaline for half-maximal dilatation of the preconstricted veins (ED50) than controls (geometric mean: 44.5 ng/min in CF patients compared with 14.8 ng/min in controls; P less than 0.05). Maximal venodilatation was 74 +/- 30% of baseline in CF patients compared with 94 +/- 50% in controls (NS between groups). 4. The clinical score of CF patients was uncorrelated with the ED50 of isoprenaline. Thus the decreased beta-adrenergic responsiveness does not seem to be related to the severity of the disease. 5. Our results indicate a defect in the cyclic-AMP-dependent pathway in vascular smooth muscle cells of CF patients. Whether this is associated with the CF gene defect itself requires further study.

Adult↗
PubMed1989

Nonopsonic antibodies in cystic fibrosis. Pseudomonas aeruginosa lipopolysaccharide-specific immunoglobulin G antibodies from infected patient sera inhibit neutrophil oxidative responses.

Antibody opsonins from cystic fibrosis (CF) patients were investigated using nonmucoid and mucoid lipopolysaccharide (LPS) immunotype 1 Pseudomonas aeruginosa as bacterial ligands and PMN phagocytes. CF sera were compared to normal sera, polyvalent PA LPS hyperimmune globulin, and isotype switch variant monoclonal antibodies (MAbs) specific for type 1 PA LPS. Sera from PA-infected CF patients (CF PA+) had elevated levels of PA LPS and alginate IgG antibodies and promoted significantly greater antibody-dependent PMN chemiluminescence responses than sera from uninfected CF patients (CF PA-) or normal human sera (NHS). After adjustment for autologous IgG PA LPS antibody content, however, CF PA+ sera had less antibody-dependent opsonic activity than sera from CF PA- patients (P less than 0.025) or NHS (P less than 0.0025), suggesting qualitative opsonic defects of IgG PA LPS antibodies in CF PA+ sera. Antigen-specific immunoprecipitation of PA LPS antibodies enhanced opsonization by 40% of CF PA+ sera while uniformly reducing that from CF PA- sera (P less than 0.01), indicating LPS-specific nonopsonic antibodies in some CF PA+ sera. Alginate antibodies were not critical opsonins in most uninfected CF patient sera. PA LPS IgG antibodies isolated by immunoaffinity chromatography from NHS, hyperimmune globulin, and CF PA- sources were opsonic and had greater activity at equal antigen-binding concentration than identical antibodies isolated from infected CF patients (P less than 0.01-0.05); the majority of isolates from CF PA+ sera did not promote PMN oxidative responses above nonopsonic baseline. A potential isotypic basis for these findings was supported by differences in PMN responses to PA opsonized with MAbs of identical specificity but differing isotypes. PA LPS-specific IgG antibodies inhibiting PMN oxidative responses in infected patient sera demonstrate antigen-specific immunomodulation of host responses by chronic bacterial parasitism in CF, which may play a role in the pathophysiology of lung disease.

Antibodies, Bacterial↗
PubMed1988

Isolated growth hormone deficiency after severe head trauma.

In a 12-yr-old boy growth arrest occurred after severe head trauma. Evaluation of pituitary endocrine function revealed isolated growth hormone (GH) deficiency. Lack of GH response to GH-releasing factor indicated that the responsible lesion was most likely to be localized in the pituitary gland. GH substitution resulted in biochemical (somatomedin increase) and clinical (catch up growth) response.

Adolescent↗
PubMed1988

Reproducibility of skin prick testing with allergen extracts from different manufacturers.

Allergen extracts for skin prick testing (SPT) are available from several manufacturers. Although these solutions are specified according to well-defined internal company standards, there is no generally accepted overall standardization. To assess the comparability of skin prick test solutions of various manufacturers, we compared extracts of nine different allergens from four companies by SPT in 29 children sensitive to one or more of the allergens, in a double blind fashion. RAST (Pharmacia) and EAST (Kallestad) were determined in simultaneous blood samples. Allergen extracts were also examined by rocket immunoelectrophoresis for their content of major allergens. Skin reactions, assessed by mean diameter of wheals, to identical allergen extracts varied significantly between the four vendors (P less than 0.05-0.001). Correlation between RAST and EAST was good for all allergens except birch pollen and mugwort. Content of the major allergen in corresponding extracts varied significantly between the different companies (less than 1%-2000%). These data underline the need for international reference extracts as intracompany standardization of test solutions alone is not enough to yield general reproducibility of skin prick test results.

Adolescent↗
PubMed1987

[Chordoid chondroma--a rare finding in neurosurgery].

Among the multitude of space occupying processes in the base of the skull chordomas and chondromas or mixed forms of the two tumors types are rare findings. A report is given on such a tumor. This leading symptom was a loss of vision; a surgical treatment was carried out.

Adult↗
PubMed1987

[Sweat collection and osmometry in the diagnosis of cystic fibrosis: a new method].

Two methods of sweat testing (Gibson and Cooke's vs. sweat osmolality) for the diagnosis of cystic fibrosis were compared in 33 subjects (26 healthy subjects and 7 patients aged 23 days to 28 years). Sweat was collected with a "macroduct"-sweat collection-system, osmolality was measured with the Wescorvapor-pressure osmometry. In a further 18 subjects (13 healthy, 5 patients) electrolytes were determined from filter-paper and the Vescor-macroduct-system. The osmolality in sweat of healthy subjects and patients with CF differed significantly (p less than 0.001). In healthy subjects maximum osmolality was 198 mmol/kg (means 158 +/- 21.3 mmol/kg), in patients with CF 283.9 +/- 10.2 mmol/kg. Assessment of sweat osmolality is a highly reliable procedure for confirming the diagnosis of CF provided borderline-values between 180 and 220 mmol/kg are reevaluated with the conventional filter-paper assay.

Cystic Fibrosis↗
PubMed1986

[Intrapulmonary percussion in cystic fibrosis].

Endobronchial percussion was performed in eight cystic fibrosis patients of 15 to 26 years of age using a high-frequency ventilator system. Lung function changes and blood gas parameters were examined. The method resulted in an improved FEV1 (P less than 0.025) and in blood gas improvements such as pO2, base excess (P less than 0.001) and oxygen saturation (P less than 0.001). Endobronchial percussion offers the advantage of being largely independent of patient cooperation in chronic obstructive lung disease such as cystic fibrosis. The decision in favour of long-term treatment depends in each case on the individual acceptance by the patient.

Adolescent↗
PubMed1986

[Spinal lipoma with a dural closure defect as a cause of neurogenic bladder and chronic renal failure].

It is reported on a 6-year-old boy, in whom 3 years after the appearance of a neurogenic disturbance of the urinary bladder a lipoma in the spinal canal of the inferior thoracic region was diagnosed myelographically. The operative removal of the growing and displacing fatty tissue which by a (congenital?) dural gap continued in epidural direction indeed resulted in a far-reaching regression of the paresis of the lower extremities, not, however, in an improvement of the urological picture of the disease. The renal insufficiency caused by the hydronephrosis was no more reversible, which emphasizes the importance of the early diagnosis of this relatively infrequent malformation.

Child↗
PubMed1986

[Neuro-ophthalmologic findings in tumors of ventricles I-III].

The ophthalmological findings obtained in 254 patients with space occupying processes of the lateral and third ventricles are analysed. Visual disturbances (78%), defects of the visual field (69%), findings of the fundus of the eye (67%) and motility restrictions (24%) were identified. Only in eight per cent the findings of the eye-ground no particular findings were observed. As was expected, signs of cerebral compression were frequently found. Postoperative improvements were found in the choked papilla and motility restrictions were seen where as defects of the visual field and a decrease of the visual acuity were in most cases unchanged or had even increased.

Blindness↗
PubMed1986

[Radiotherapy in tumors of ventricles I-III].

The indications for a radiation therapy as the exclusive or adjuvant form of therapy in the treatment of supratentorial ventricular tumors is discussed. In particular the change with respect to the indications in the last ten years is dealt with. 254 patients with tumours of the ventricles I to III were treated at the Neurosurgical University Hospital of Leipzig in the period 1953-1983. 25 of them were irradiated.

Cerebral Ventricle Neoplasms↗
PubMed1986

[Gastrointestinal complications in cystic fibrosis: meconium ileus equivalent].

In contrast to bloatedness and steatorrhoea the meconium ileus equivalent is a less well known gastrointestinal complication in cystic fibrosis and thus less frequently correctly diagnosed. The term, first used by Jensen in 1962, notifies partial or complete obstruction due to increasing viscosity of gut contents. The occurrence of the meconium ileus equivalent increases with age (approx. 10%), recurrences are possible. Among 73 patients with cystic fibrosis 8 patients with ileus equivalents were observed, two of them had a recurrence Surgery was performed only in one case. In all other patients the intestinal obstruction was relieved by oral and enema administration of N-acetylcysteine.

Acetylcysteine↗
PubMed1986

[Complications following implantation of ventriculo-atrial and ventriculoperitoneal shunts].

A report is given on some of the various complications occurring after implantation of ventriculo-atrial and ventriculo-peritoneal shunts. It is based on a group of 90 patients in whom a total of 126 shunt operations were performed. In 27.7 per cent of the total number of patients revisions had to be carried out. In the first position of the complications there were infections followed by functional disturbances of the efferent catheters, by disconnections, overdrainage, catheter breakage and valve invagination.

Cerebrospinal Fluid Shunts↗