Biomedical subjects
Publications and source records attributed to J Behr.
Na+ -Li+ exchange, Na+ -K+ cotransport and the Na+ leak of human erythrocytes are not only governed by genetic factors but also by variables influenced by exogenous factors such as plasma lipid and K+ concentrations.
At defined times prior and following a Wertheim operation for cancer of the uterine cervix the patients were investigated for the functional parameters of the lower urinary tract. The residual urine was determined. Stress incontinence and urgency incontinence were measured with urethrocystometry. The sensitivity and the micturition were evaluated from subjective data. The results of 237 investigations in 192 operated women are described and compared to previous papers on the subject. Stress incontinence increased to double the pre-operative incidence following the Wertheim operation. An urgency incontinence was quite rare. A lack of feeling of fullness to the bladder as a sign of disturbed bladder sensitivity was present 5 months post-operatively in 6 of 45 patients (13%). This was present in only 1 of 119 patients (1%) after five years. 1/3 of the women had difficulty with spontaneous micturition five months following the operation. 1/10 of the women had difficulty with spontaneous micturition 5 years after the operation. There was no residual urine five months after the operation in 9/10 of the patients and five years following the operation almost 100% of the patients had no residual urine. It was noted that difficulty with spontaneous micturition with residual urine and urgency incontinence did not necessarily result in concomitant bacteriuria. Suggestions are presented how future investigations with similar questions may lead to comparable results.
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Twenty-seven patients with diffuse fibrosing alveolitis (DFA), 27 patients with granulomatous lung disease (GLD), 3 patients with homozygous alpha 1-proteinase inhibitor deficiency (alpha 1-PID), and 6 healthy volunteers (C) were studied using thin section high resolution CT (HRCT) at 50% of actual vital capacity (VC), determined and controlled spirometrically during each exposure. A fast contour tracing algorithm was used to isolate the lung parenchyma followed by a quantitative histogram analysis of the frequencies of CT values. Mean CT values enabled us to discriminate significantly between the groups of C and alpha 1-PID. Significant differences were found between the groups of GLD and DFA versus C by applying suitably selected intervals of CT values. Moreover, if the patients were assigned to four different groups according to their lung function results (normal, restrictive, obstructive, restrictive and obstructive), again significant differences existed with respect to defined intervals of CT values. Mean CT values showed a significant negative correlation with lung function tests representative of lung parenchymal disease, i.e., VC, diffusing capacity, and exercise PaO2. Moreover, CT values ranging from -899 to -800 HU correlated positively, whereas CT value frequencies above -699 HU correlated inversely with these same lung function parameters. These results indicated that certain intervals of CT values do reflect functionally different abnormalities of lung parenchyma. It is concluded that an analysis of frequencies of CT values determined by spirometrically standardized HRCT provides objective quantitative data that reflect changes of pulmonary structure corresponding to lung function impairments. Thus, spirometrically standardized HRCT may be helpful for evaluating and staging patients with diffuse pulmonary disease.
OBJECTIVE: Assessment of lung attenuation by CT reflects changes in the air-to-tissue ratio of the lung. We have analyzed the interdependence of intrathoracic gas volume, lung morphology, and functional disorder by high resolution CT (HRCT) to assess quantitative disease threshold in obstructive and restrictive diffuse lung disease. MATERIALS AND METHODS: Pulmonary HRCT was performed on 24 healthy volunteers, 11 patients with chronic obstructive pulmonary disease (COPD), and 16 patients with idiopathic lung fibrosis (IPF). HRCT measurement was standardized by taking three scans at the carina +/- 5 cm and by defining inspiration levels by percent vital capacity (VC) via spirometrically gating to the scanner. RESULTS: The mean lung density at 50% VC (DL50) for healthy subjects was -819 +/- 3.8 (mean +/- SEM) HU. In contrast, COPD DL50 was lower, averaging -861 +/- 6.4 HU, and the IPF DL50 was considerably higher (-731 +/- 17.7 HU), both significantly different (p < 0.001) compared with the control group. The accuracy of quantitative HRCT at different inspiration levels was evaluated by scanning the basal layer at 20, 50, and 80% VC. The control values were -747 +/- 5.6, -816 +/- 3.6, and -855 +/- 3.0 HU, respectively, which were significantly higher (p < 0.001) than those seen in COPD patients at 20 and 50% VC. Again, the IPF patients exhibited increased lung density (p < 0.001) at all inspiratory levels. Discrimination power was best among all cohorts at 20 and 50% VC. Position-dependent artifacts on lung density were quantified by the anteroposterior density gradient (APG). Irrespective of the underlying disease, APG at 50 and 80% VC was similar, but was up to twofold higher at 20% VC, indicating that quantitative estimates near RV may misrepresent mean lung density. CONCLUSION: Our data indicate that quantitative HRCT measurements should be performed not near full inspiration or expiration, but at an intermediate degree of lung inflation, e.g., 50% VC, for reasons of accuracy, intra- and intersubjective comparability, and feasibility. We conclude quantitative HRCT to be a sensitive tool for the evaluation of diffuse parenchymal lung disease.
According to their clinical manifestation 101 patients with scleroderma were separated in morphea (n = 17) and progressive systemic sclerosis (PSS) (n = 84). PSS was divided into Type I (Acrosclerosis, n = 19), Type II (proximal ascending scleroderma, n = 61), and Type III (trunk scleroderma, n = 4). Lung function testing was done, including vital capacity, total capacity, FEV1.0, airway resistance, CO-transfer factor, lung compliance, blood gases at rest and during exercise. Patients suffering from Type-II or -III PSS, especially when displaying signs of inflammation in blood and serum (Form A) carry a much higher risk of developing severe life-limiting lung involvement compared to patients with morphea or Type-I PSS, or those without signs of inflammation (Form B). Lung function indicates the severity of functional involvement and inables to differentiate from obstructive bronchopulmonary disease. Bronchoalveolar lavage (BAL) showed a normal cell pattern in all Type-I patients (n = 5). In contrast, only six out of 33 Type-II patients had a normal BAL. PSS patients showing signs of inflammation in blood and serum (Form A) had, compared to those without inflammation (Form B), significantly elevated numbers of inflammatory cells in BAL. These results show that in patients with a high incidence of pulmonary manifestation in PSS (Type II, III, Form A) an inflammatory cell pattern in BAL was found significantly more frequently than in those patients without this risk factor (Type I, Form B). In the course of disease lung function of patients without inflammatory activity in BAL remained unchanged irrespective of whether there was an immunosuppressive treatment or not.(ABSTRACT TRUNCATED AT 250 WORDS)
In 11 pregnant rabbits we induced labor by parenteral infusion of Dinoprost (F2) (0.05 mg/min). By application of Fenoterol (0.01 mg/min) we had complete labor inhibition (P). Increasing dosages of Atenolol (T1 = 0.05 mg/min, T2 = 0.10 mg/min, T3 = 0.25 mg/min) followed. We registered systolic, diastolic and mean blood pressure directly after punction of a femoralis, cardiac frequency, and labor by integration of action potentials of uterus. Cardiac frequency decreased with increasing amounts of Atenolol. Mean blood pressure fell significantly under Fenoterol medication. There is no further decrement by additional application of high dosages of Atenolol. A certain dosage of Atenolol could be defined, that does not increase labor activity under Fenoterol medication but does decrease cardiac frequency without influence on mean blood pressure.