Biomedical subjects
Publications and source records attributed to K Aigner.
The case of a 51-year-old man with pneumoconiosis caused by fibrous glass dust is reported. The diagnosis is confirmed by histological examination and by x-ray micro analysis using a scanning electron microscope. Pneumoconiosis following fibrous glass exposure should be taken into consideration in differential diagnosis of interstitial lung diseases.
Explore the source record for details and available documents.
Diseases of the airways increase and are of eminent social- and public health-care interest. As essential exogen noxious substance for cause in etiology is smoking considered. Incidence for bronchitis, emphysema, and lung cancer due to smoking is between 85 to 90%. Changes in the respiratory tract through smoking are also measureable function disturbances. They are more intensely than in dust-exposed nonsmoking workers. Also in passive smokers you can find such disturbances, the additional cancer risk is increased. Smoking is further one cause for centrilobular emphysema. Great international studies refer smoking as essential noxious substance for lung cancer. The minimal therapeutic success underlines the importance of early diagnosis, risk groups, significant etiologic factors, operability, chemo- and radiation-therapy. The early mortality for heavy smokers was ascertained up to 12.3 years lifetime-shortening. Overall the reason is adequate and serious enough to draw the attention to the effects of smoking to the respiratory tract besides tobacco-associated diseases of other organs with all emphasis and to make all efforts against this noxious substance.
Explore the source record for details and available documents.
Bronchitis in definition contains increased sputum production and cough. They gain importance through smoking and air-pollution. Both influences are good recordable. The last one is demonstrated by a regional air-monitor-net. Connections between air-pollution and airway diseases are seen in course-monitoring after pollution reducing actions. Essential complication of bronchitis as an airway disease in obstruction, airflow limitation. In small airways it runs at least synchronously. This obstruction is more sure and objective measureable than subjective complainted cough. This data, especially those of the flow-volume-loop, should have more weight. They correlate statistically significant in own studies in town-to-country differences to pollution, not to the only symptom of cough. Peak-Exspiratory-Flow and spirography show in comparison only a trend. The flow-rates might demonstrate more surely and objectively the environment-infrastructure in function data as possible cause for bronchitic airway diseases.
Explore the source record for details and available documents.
In order to ascertain the effect of acute isovolaemic haemodilution on haemodynamics and various laboratory parameters as well as homologous blood consumption 44 patients undergoing major liver surgery were investigated in two groups: group I (n = 22) underwent acute normovolaemic haemodilution after induction of anaesthesia; group II (n = 22) had no blood withdrawn and served as control. Haemodilution led to typical haemodynamic effects such as increase in cardiac index and decrease in systemic as well as pulmonary vascular resistance; no detrimental effect of the procedure could be observed. Haemodilution led to a marked reduction in the consumption of banked blood which was on the average 1.8 units/patient against control intraoperatively and 3.1 units/patient postoperatively summing up to a total of 4.9 units/patient.
Explore the source record for details and available documents.
Forty-five patients with acute chronic bronchitis were treated with Augmentin, an amoxycillin combined with the beta-lactamase inhibitor clavulanic acid, initially by parenteral administration followed by oral treatment after 3 days lasting in the mean 7.1 days. The over-all clinical evaluation showed a cure rate of 93%. Side-effects were comparable to therapy with other amoxycillins. Bacteriological evaluation of the sputum samples demonstrated in 91% of cases an elimination of the initially isolated organism. Prior to therapy we found in 25% of the isolated strains beta-lactamase-producing and Augmentin-sensitive organisms. The parenteral formulation of Augmentin seems to be a valuable addition to the parenteral therapy of lower respiratory tract infections.
Continuous epidural opiate analgesia with an implantable, percutaneously refillable pump was induced in 6 patients with chronic pain of malignant origin. The efficacy of this method was compared with that of on-demand bolus-injections of epidural opiate. Side-effects and development of tolerance were not observed during a more than one year period of treatment. Increased daily doses for some days were only necessary in case of additional pain sources, e.g. induced by an intermediate operation. There were no hygienic problems (bacteriologic investigations) or problems due to technique of implantation (localisation of the implant, stability of the fixation, patency of the catheter). Examination of post mortem explanted pumps (determination of the flow rate, inspection for precipitation within the pump, testing of permeability of filters) and catheters (electron microscopy, testing of the material for surface conditions, tensile strength and elongation) as well as histological findings for local compatibility did not reveal adverse reactions after long-term treatment. Indications for this new method of pain treatment were established.
In two patients suffering from numerous liver metastases in both lobes from colorectal primary isolated liverperfusion with 5-fluorouracil was performed. By means of a special cannulation system the hepatic artery and the portal vein were arterialized. The patients recovered rapidly after the operation. Sonographic measurements, CAT scans, pulse cytophotometry, and second-look operations with histological examinations of metastatic tissue verified extensive tumor regression. No complications occurred within 6 months after the perfusion treatment.
Following isolated liver perfusion with different cytotoxins - 5-fluorouracil (5-FU), methotrexate (MTX), dacarbazine (DTIC) cis-platinum (cis-PT) - liver tissue of dogs was examined with the electron microscope (a) directly after the perfusion and (b) after a survival time of 4 weeks (5-FU and DTIC). Acute disintegration of the granular endoplasmic reticulum and depletion of the glycogen stores occurred after perfusion with 5-FU, MTX, and DTIC, while cis-PT induced disintegration of the granular endoplasmic reticulum accompanied by an accumulation of glycogen. Four weeks after perfusion with DTIC signs of remarkably increased cellular activity were observed, while 4 weeks after perfusion with 5-FU the parenchymal liver cells revealed a well-balanced and moderate recovery of the cellular structures.
Explore the source record for details and available documents.
In 22 patients isolated extremity perfusion with cis-platinum for treatment of malignant melanoma was performed; 18 had local metastastic disease (M. D. Anderson stages II and III A, B, AB) and four were stage I. A further five patients were submitted to isolated DTIC perfusion. DTIC-perfused tumors showed regression rates of 30%-80%, followed by recurrences within 4 months. After cis-platinum perfusion stage-III AB cases tended to show tumor recurrence within 4 months, while to date stage-III A and stage-II cases have reached disease-free survival times of 17 and 20 months respectively. While in DTIC perfusion the tissue temperature may range between 40 degrees and 41 degrees C, in cis-platinum perfusions 40 degrees C should not be exceeded; otherwise neural damage will occur.
The effect of isolated cytostatic perfusion was determined in in-transit metastases from malignant melanomas at various times after therapy. Fluorescence-microscopically positive tumor cells (formalin-induced fluorescence) were regarded as viable and possibly capable of dividing. Most of the metastases examined showed fluorescent cells even after perfusion, and these were often found at characteristic sites within the metastases. Under the electron microscope, the cell damage was seen mainly in the nucleus, but also in the organelles of the cytoplasm. The source of cell damage might be multifactorial, and the cytostatic effect could not be clearly separated from the effect of hyperthermia or hypoxia.
Adriamycin is known as an antineoplastic agent with a broad spectrum of activity for human malignancies. To determine the highest tolerable concentrations of adriamycin in isolated perfusion of the extremities the hind legs of 12 dogs were isolated in an extracorporeal circuit and perfused under normothermic conditions. Dosages of about 10 mg/l perfused extremity were well tolerated by the animals, and lower concentrations did not result in any side effects. However, in most cases, dosages higher than 10 mg adriamycin/l extremity volume induced severe edema, pain, and histological changes.
Of 16 patients treated, all who could be examined after isolated hyperthermic lower limb perfusion with cis-platinum showed peripheral nerve damage, particularly of the lower leg and foot. We found a close correlation between the severity of neurological deficit and the perfusion temperature. The dose of cytostatic agent also plays a role in development of the nerve lesion. The major cause of the nerve damage seems to be the neurotoxicity of cis-platinum. The edematous swelling in the compartments in the lower leg have an influence. The reversibility of the pareses was generally very small.