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Biomedical subjects

J Kugler

Publications and source records attributed to J Kugler.

At least 73 records · Page 4Linked to original sources
PubMed1993

[The language of pediatric asthma patients. A study of symptom description].

BACKGROUND: Questions on asthma symptoms like "wheezing" or "whistling in the chest" must be easily understood by the general population. In preparation of a standardized German questionnaire we investigated, how children with asthma and their parents would describe symptoms during an asthma attack. METHODS: From June until December 1991, 72 children aged 13-15 years, and parents of 138 children aged 7-15 years with diagnosed asthma, where interviewed whilst they visited the outpatient department of the universities of Berlin, Leipzig, and Munich. The parents and children were asked to answer a questionnaire which included a list of adjectives and descriptions proposed to describe the child's breathing during an asthma attack. The items included descriptions which have been used on German questionnaires, others which we considered possibly useful, anc control items which we considered inappropriate. Parents and children were asked to rate on scales how much they would agree or disagree to the proposed items as possible descriptors. Descriptive and cluster analyses revealed those descriptions which received the best ratings. RESULTS: The rating was rather independent of the sex of the child, the respondent (child vs parent) and the severity of attacks, but differences between regions were observed. CONCLUSION: The verbal descriptors with the best rating will be used for the wording of a German questionnaire on asthma symptoms.

Adolescent↗
PubMed1992

Secretion of salivary immunoglobulin A in relation to age, saliva flow, mood states, secretion of albumin, cortisol, and catecholamines in saliva.

Salivary immunoglobulin A (IgA) is one characteristic humoral factor of the local immune system in the upper respiratory tract. Epidemiological studies emphasize the importance of secretory IgA in the protection from infections of the upper respiratory tract. However, due to high interindividual variability of secretion of salivary IgA, it remains difficult to define normal ranges. This series of studies focused on identification of factors influencing basal secretion of salivary IgA. The results indicate a significant relationship between age and salivary IgA concentration. Children below 7 years have lower salivary IgA concentration than children above 7 years or adults. Furthermore, a significant inverse relationship between saliva flow and salivary IgA concentration was found. Gender, mood states, salivary albumin, salivary catecholamines, and salivary cortisol were not associated with salivary IgA. It can be concluded that for defining normal ranges of salivary IgA, age and saliva flow have to be considered.

Adolescent↗
PubMed1992

[Ketamine racemate or S-(+)-ketamine and midazolam. The effect on vigilance, efficacy and subjective findings].

Ketamine is a racemic mixture containing equal amounts of optical isomers that have almost identical pharmacokinetic properties but different pharmacodynamic effects. The S-(+)-isomer of ketamine has about twice the anaesthetic and analgesic potency of the racemic ketamine preparation and is judged to induce less psychic emergence reactions and to be followed by a more rapid recovery of vigilance. The present study was designed to assess whether the S-(+)-isomer of ketamine is superior to the racemic mixture in cardiovascular characteristics, emergence reactions and cognitive functions, and whether side effects may be reduced or prevented by administration of midazolam prior to injection of S-(+)-ketamine. METHODS. Following ethics committee approval and informed consent, 30 volunteers were randomly allocated in this double-blind study to three groups of 10 each. Group 1 received 2 mg/kg bw racemic ketamine, group 2, 1 mg/kg bw S-(+)-ketamine and group 3, 1 mg/kg bw S-(+)-ketamine after premedication with 0.1 mg/kg midazolam i.v. Cardiovascular changes, state of vigilance, cognitive performance, subjective mood and acceptance of anaesthesia were assessed by means of haemodynamic routine monitoring, electroencephalography (EEG), psychometric tests and interview. RESULTS. The increases in mean arterial pressure and heart rate following the injection of racemic ketamine and S-(+)-ketamine were identical and the differences from baseline values significant after both. Premedication with midazolam ensured stable haemodynamics after injection of S-(+)-ketamine. EEG analysis displayed the characteristic changes well known from ketamine anaesthesia for both racemic and S-(+)-ketamine. The vigilosomnoscript showed an identical profile of vigilance up to 30 min after injection of both drugs. The vigilance status after 125 min was less impaired by S-(+)-ketamine than by racemic ketamine. Psychological assessment showed a prompter recovery of visual attentiveness and sensorimotor performance in the S-(+)-ketamine group. Subjective mood was judged by the volunteers to be significantly better after S-(+)-ketamine, and volunteers found S-(+)-ketamine to be more acceptable than racemic ketamine. The frequency of dreams was the same after both drugs. No unpleasant dreams were reported after S-(+)-ketamine, but one of the volunteers who received racemic ketamine had uncomfortable dreams. Midazolam prevented any unpleasant emergence sequelae. On the other hand, the cognitive performance could not be restored to the baseline values until at least 240 min after injection of S-(+)-ketamine, because of the sedative effects of midazolam. DISCUSSION. These results suggest that S-(+)-ketamine offers the advantages of faster recovery of cognitive performance, greater acceptance by the volunteers and identical depth of anaesthesia after injection of half the dose compared with racemic ketamine. The clinical use of S-(+)-ketamine therefore seems to be justified. Premedication with benzodiazepines, e.g. midazolam, is essential. The dose to be administered, however, should be carefully selected in order not to abolish the positive effect of S-(+)-ketamine on vigilance by the sedative effects of the benzodiazepine.

Adult↗
PubMed1991

Reduced concentration of secretory IgA indicates changes of local immunity in children with adenoid hyperplasia and secretory otitis media.

Children with adenoid hyperplasia and secretory otitis media show significantly lower immunoglobulin A (sIgA) concentrations in their saliva compared to matched controls. Salivary albumin and cortisol levels do not differ in both groups. Changes in local immunity, dilution or stress as possible factors for the reduction of sIgA concentrations are discussed.

Adenoids↗
PubMed1991

Sleep deprivation, epilepsy and the ability to operate a motor vehicle.

This study is based upon 207 examinations for the evaluation of the ability to operate a motor vehicle in persons with transient disturbances of the cerebral function. In 26 persons, the EEG was repeated after sleep deprivation. There was EEG activation with transient disturbances in seven cases (not present in the routine EEG). In five individuals, there were transient disturbances in the routine EEG as well as after sleep deprivation. No abnormalities were recorded in 14 persons. No driver's license could be granted in five patients with unequivocal spike wave complexes or spike wave paroxysms following sleep deprivation. In two patients, however, the permission to drive could be granted. These patients showed spike wave patterns in the routine EEG, but no seizures had occurred for several years and their performance in the experimental-psychological evaluation (with simulator) were superior. In persons with suspected and clinically obscure cerebral attacks, as well as in persons with known seizure disorder but seizure-free for several years, the EEG after sleep deprivation must be regarded as a highly informative test which may crucially influence the decision. The method of activation corresponds with a type of stress with which the motorist must deal frequently. This test can be carried out on an outpatient basis and with negligible iatrogenic damage.

Adult↗
PubMed1991

[Emotional status and immunoglobulin A in saliva--review of the literature].

Salivary immunoglobulin A, secreted by the local secretory immune system of the upper respiratory tract, plays an important role in the protection of infections. Psychoneuroimmunological studies postulating influences of mood states on secretion of immunoglobulin A are reviewed and discussed with regard to their internal and external validity. The results on the influence of emotional stress are heterogeneous: Lower, as well as higher, as well as unchanged secretions of salivary immunoglobulin A have been reported. This may be due to insufficient control of intervening variables, to different methodologies and to selection of non-representative subject populations, so that the relationship between emotional stress and secretion of salivary immunoglobulin A remains still under discussion. On the other side, two studies indicate that mental relaxation procedures can lead to increased secretions of salivary immunoglobulin A in comparison to vigilance task, finger touching or no explicit treatment. However, more research is required, especially on the size and duration of the induced effect. Future psychoneuroimmunological research strategies should consider to a greater extend emotion-specific and person-specific aspects, methods used in experimental virology and mediators between mood and salivary immunoglobulin A.

Arousal↗
PubMed1991

Electroencephalography 60 years later.

The birthday of Electroencephalography (EEG) is dated back to the 22nd of April 1929. On this date Hans Berger submitted the first of his 14 contributions "Uber das Elektrenkephalogramm des Menschen" to the "Archiv für Psychiatrie und Nervenkrankheiten" for publication. Therefore in 1989 Electroencephalography was 60 years of age. In spite of controversy over its usefulness during this period, Electroencephalography substantially contributed to progress in medicine. Today is the beginning of its Renaissance due to a dramatic diversification of Clinical Electroencephalography into applied neurophysiological specialties. Progress became possible by the introduction of new techniques. However it will become obvious that new instrumentations cannot replace intelligence and human understanding. The dispute of importance and nonsense, use and misuse of Electroencephalography is without doubt useful and stimulates new orientations.

Animals↗
PubMed1990

[The effect of functional impairments and autonomic symptoms on the quality of life after the therapy of tumors in the ENT area].

Life quality in tumour patients has received growing scientific and public attention. While most studies focus on patients with tumours in the thorax or abdomen, less is known about determinants of life quality in patients with tumours in the head-neck region. In this report, we focus on the role of tumour localisation, clinical staging, functional impairments, and vegetative symptoms on the rating of life quality. In a structured interview, 222 tumour patients regularly followed-up by the Department of Otorhinolaryngology were asked about aspects of their illness, especially with regard to life quality. The results show that clinical stage of tumour had an U-shaped effect on life quality. Patients on stage 1 or on stage 3 had higher life quality ratings than patients on stage 2, which may indicate divergent coping styles of the patients. Patients with impairments of swallowing, tasting, whispering or breathing rated significant lower on life quality. Moreover, patients suffering from pain, with sleeping problems, with impairments of their bodily appearance or of their sex life rated significantly lower on life quality. Tumour localisation had no effect on ratings of life quality. In conclusion, it can be stated that life quality of tumour patients in otorhinolaryngology is influenced by clinical stage of the tumour, functional impairments and vegetative symptoms.

Autonomic Nervous System Diseases↗
PubMed1990

Hospital supervised vs home exercise in cardiac rehabilitation: effects on aerobic fitness, anxiety, and depression.

This study focused on the effects of hospital supervision and type of prescribed home exercise in cardiac rehabilitation programs on aerobic fitness, anxiety, and depression. Men who had a myocardial infarction were randomly assigned to four exercise programs: The first program consisted of purely hospital-based exercise. The second and third programs combined hospital and home exercise, including either bicycling or walking at home. In the fourth program, patients were encouraged to exercise at home, but were given no specific guidance. Fifty-two patients finished the eight-week exercise program and 35 completed the psychologic questionnaires. At the end of the eight weeks, there were significant differences in the programs' effects on aerobic fitness. Purely hospital-supervised exercise and the combination of hospital-supervised bicycling with home walking increased aerobic fitness more than completely unsupervised exercise. Furthermore, there were differences in the programs' effects on manifest anxiety. The combination of home and hospital bicycling was less beneficial than home walking and hospital bicycling or even completely unsupervised exercise at home. The results indicate that the degree of hospital supervision and the type of prescribed home exercise are important design features which may affect the success of cardiac rehabilitation exercise programs. No effects of the different exercise programs on patients' depression could be found. In general, a close relationship between aerobic fitness and anxiety or depression could not be demonstrated. Implications of these findings for the design of cardiac rehabilitation exercise programs are discussed.

Adult↗
PubMed1989

[A new formulation of etomidate in lipid emulsion--bioavailability and venous provocation].

In a prospective, randomized study of 16 volunteers, a new galenic formulation of the induction hypnotic etomidate in lipid emulsion was compared with the commercial form in propylene glycol (Hypnomidate). After 0.3 mg/kg etomidate plasma levels (HPLC) and hypnotic effects (visual EEG analysis) of both formulations were almost identical. Onset of action occurred after 41.6 s in the propylene glycol group (group I) and 35.6 s in the lipid emulsion group (group II). The hypnotic effect (greater than or equal to D0) lasted 7 min 20 s in group I and 6 min in group II. Plasma levels in group I decreased from 630 ng/ml after 2 min to 170 after 8 min and 37 after 130 min. With group II the plasma levels decreased from 770 ng/ml after 2 min to 150 after 8 min and 42 after 130 min (Fig. 1). In the propylene glycol experiment, 4 of 8 volunteers reported pain on injection. Within 7 days 4 persons developed phlebitis or thrombophlebitis. One showed signs of an allergic reaction (urticaria). With the new formulation of etomidate in lipid emulsion, neither venous sequelae nor allergic reactions were observed in any of the 8 volunteers (Table 2).

Adult↗
PubMed1988

Influence of bleeding order on plasma corticosterone concentration in the mouse.

The influence of the order of bleeding on corticosterone release in the mouse was examined. Female C57/BL6 mice were housed in groups of five animals in a low noise environment. After 10 days, they were successively captured and sacrificed every 2 minutes. The corticosterone levels increased in the fourth and fifth mice in a cage, i.e. within the time intervals from 4 to 6 minutes and from 6 to 8 minutes after the capture of the first animal. These results suggest that quiescent corticosterone levels can be measured only when the blood samples are obtained within 4 minutes following the capture of the first mouse.

Animals↗
PubMed1988

Comparison of two myoepicardial pacemaker leads: follow-up in 80 children, adolescents, and young adults.

Although several types of commercially available epicardial leads exist, few postimplantation data have been reported. To compare "screw-in" (6917-35) leads with "stab-on" leads (4951-35) from the same manufacturer, we reviewed the records of 80 young patients (age 8 days to 29 years) who underwent ventricular epicardial pacemaker implantation from 1973 to 1986. Follow-up for the 57 patients with the 6917-35 model ranged from 3 months to 17 years (median 6.5 years) and for the 23 patients with the 4951-35 model 9 days to 4.25 years (median 2.0 years). Actuarial life table analysis revealed significantly (P less than 0.001) fewer 4951-35 leads were functioning at each of 1-5 years after implant, compared to the 6917-35 leads. Analysis of available threshold pulse width data revealed no difference (P = 0.08) acutely (6 weeks after implant), but a significantly (P = 0.05) higher mean threshold for the 4951-35 leads was found chronically. No significant correlation was found for lead failure with age, underlying heart disease, lead site (i.e., left or right ventricle), or surgical approach. Using the sutureless, stab-on technique, the 4951-35 lead is associated with higher thresholds and lower survival rate when compared to the 6917-35 lead.

Actuarial Analysis↗