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Biomedical subjects

K Koch

Publications and source records attributed to K Koch.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Effect of captopril therapy on sodium and water excretion in patients with liver cirrhosis and ascites].

UNLABELLED: Ascites in patients with cirrhosis of the liver frequently is refractory to diuretic treatment. It was postulated that vasoconstriction of the renal cortex, mediated by activation of the renin-angiotensin-aldosterone-system (RAAS), may be one course of the disturbed sodium- and water-excretion in these patients. We therefore investigated in 14 cirrhotic patients with ascites under constant diuretic treatment the effects of low-dose captopril therapy on urinary sodium- and potassium-excretion, body weight, abdominal girth, serum-sodium, -potassium, creatinine-clearance, plasma-renin-activity (PRA), plasma-aldosterone (PA) and mean arterial pressure (MAP). After a control period of 4 days the patients received 2 x 6.25 mg/d captopril for 5 days and 4 x 6.25 mg/d for further 5 days. Treatment was followed by a second control period without captopril. PRA increased significantly after 2 days of captopril treatment. 2 x 6.25 mg/d captopril induced a significant increase in sodium excretion and a significant decrease of body weight. MAP decreased slightly but significantly without clinical signs of hypotension. 4 x 6.25 mg/d captopril resulted in a further reduction of body weight and a further enhancement of sodium excretion. Three days after withdrawal of captopril sodium output was significantly reduced again. CONCLUSION: In cirrhotic patients low-dose captopril seems to be efficient in the treatment of ascites resistant to diuretics without causing major side effects.

Adult↗
PubMed1989

Inhibition of human HT29 colon carcinoma growth in vitro and in vivo by swainsonine and human interferon-alpha 2.

Swainsonine, a plant alkaloid and potent inhibitor of Asn-linked oligosaccharide processing, has previously been shown to inhibit organ colonization by metastatic murine tumor cells and to inhibit the growth of transformed fibroblasts in soft agar. In this report, we show that swainsonine has antiproliferative activity against human tumor cells growing in tissue culture and as tumor xenografts in nude mice. The antiproliferative activity of swainsonine was additive with that of human interferon-alpha 2 (HuIFN-alpha 2) in cultures of HT29 colon carcinoma, SN12 renal carcinoma, and A375 melanoma cells. In vivo, the growth rate of HT29m human colon carcinoma tumors in athymic nude mice was reduced by supplementing their drinking water with swainsonine (49%) or by administering HuIFN-alpha 2 systemically (53%); combining these treatments reduced tumor growth by 78%. Combining swainsonine and HuIFN-alpha 2 treatments enhanced the activity of the interferon-inducible enzyme 2',5'-oligoadenylate [2',5'-oligo(A)] synthetase in HT29m tumors compared to that observed in tumors from mice treated with interferon alone. In vitro, swainsonine enhanced interferon-dependent induction of 2',5'-oligo(A) synthetase activity in low-density cultures of HT29m cells. However, swainsonine alone did not stimulate 2',5'-oligo(A) synthetase activity in vivo or in vitro, indicating that the antiproliferative effect of swainsonine is independent of interferon production. The results suggest that in addition to the previously reported antimetastatic activity of swainsonine, the plant alkaloid has antiproliferative activity that is independent from, but additive with, that of interferon in vivo and in vitro.

2',5'-Oligoadenylate Synthetase↗
PubMed1989

[Diagnosis of hernia using peritoneography].

Peritoneography was performed in 1200 patients with ill-defined complaints concerning the abdominal wall, the groin or the pelvic floor. The purpose was to exclude or demonstrate the presence of a hernia. Amongst 750 patients, abnormalities were found in 53.5%. The examination was also carried out post-operatively in order to demonstrate possible recurrences which were not clinically obvious. Amongst 450 patients, a recurrence or a contra lateral hernia was demonstrated in 44%. These results show that a recurrence can only be demonstrated or excluded with certainty by means of peritoneography. The radiological examination is technically straightforward, can be carried out in a few minutes on an out patient basis and is simple for the patient.

Adolescent↗
PubMed1989

[Primary carcinoid of the choledochus].

The differential diagnosis of obstructive disease processes of the common bile duct can be very difficult even when sonography, endoscopic retrograde cholangiopancreatography (ERCP) and angiography are applied. In most cases, morphological changes are due to stones or carcinoma. We report on a case of a carcinoid tumor located in the intrapancreatic part of the common bile duct. Exact localization, delineation and demonstration of the local extension of such a tumor requires at least ERCP and angiography, as these are the most efficient imaging techniques for these purposes.

Aged↗
PubMed1989

[Pancreatic kinetics of ampicillin].

Intravenous application of 50 mg/kg of ampicillin was followed by determination of ampicillin concentrations in surgically removed pancrease tissue of human patients and dogs. Concentration curves in pure pancreatic juice were recorded from dogs in which external pancreatic fistulae had been surgically induced. The ampicillin concentrations recorded from both human tissue and dogs were as low as six to eight per cent relative to corresponding serum levels. Values as low as 0.13 to 1.5 per cent relative to corresponding serum levels were recorded from pure pancreatic juice of dogs and from one human patient. These findings are likely to suggest that the permeation of ampicillin into the pancreas i too low and, consequently, cannot be effective for prophylaxis and therapy in the context of infectious complications.

Ampicillin↗
PubMed1988

Effects of repeated oral doses of fenflumizole on platelet aggregation and thromboxane formation in man ex vivo.

Anti-platelet effects of fenflumizole, a new cyclo-oxygenase inhibitor, were studied in man ex vivo. Fenflumizole was given to male volunteers at the oral doses of 25, 50 or 100 mg per day, each dose for a period of seven days. The formation of thromboxane B2 (TXB2) during whole blood clotting, platelet aggregation induced by arachidonic acid and ADP, the formation of TXB2 during aggregation as well as serum concentration of fenflumizole were measured repeatedly during drug administration and for a fortnight after drug discontinuation. TXB2 formation during whole blood clotting was decreased dose-dependently by fenflumizole. The degree of inhibition of TXB2 formation was proportional to fenflumizole concentration in serum within each individual. The lag phase of platelet aggregation induced by arachidonic acid was prolonged and the formation of TXB2 during aggregation decreased by fenflumizole. No total inhibition of either TXB2 synthesis or platelet aggregation was caused by the fenflumizole doses used. The results show that the degree of inhibition of platelet thromboxane forming capacity by repeated doses of fenflumizole is closely related to the concentration of the drug in blood. Platelet aggregation however is less sensitive to changes in fenflumizole levels and cannot be assessed solely on the basis of cyclo-oxygenase activity.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

[Arthrographic diagnosis of rupture of the anterior syndesmosis of the upper ankle joint].

We describe 114 cases based on 2020 arthrographies of the ankle joint for diagnosing fresh tears of the tibio-fibula syndesmosis without bone lesions. Comparison of the arthrographical diagnosis with the intra-operative diagnosis showed good agreement. Diagnosis of the isolated tear of the tibio-fibular syndesmosis revealed a sensitivity of 90% and a specificity of 67%. The technical procedure and the isolated tear of the tibiofibular syndesmosis in combination with other capsuleligament lesions are presented, using typical x-ray images as examples.

Ankle Injuries↗
PubMed1988

Axial versus distal motor impairment in Parkinson's disease.

We measured axial (head rotation) and distal (wrist flexion and extension) movements in parkinsonian patients with varying stages of disability, before and after administration of L-dopa. Velocities for both movements were proportionately reduced in all stages of disease. L-Dopa administration provided a small but consistent increase in distal movement velocity for most patients, whereas in patients with advanced disease (stages III to V), axial movement velocity actually declined after administration of L-dopa. This decline may be partially responsible for the failure of L-dopa administration to reverse the loss of "righting reflexes" in these patients. Measurement of axial motor control may be a useful tool in evaluating therapeutics for Parkinson's disease patients.

Aged↗
PubMed1987

New technique for treating occlusive and stenosing tumours of the trachea and main bronchi: endobronchial irradiation by high dose iridium-192 combined with laser canalisation.

A new technique is described for treating patients with inoperable malignant tumours causing occlusion or stenosis of the trachea or main bronchi. High dose iridium-192 (20 Ci) was introduced by an afterloading device under computer control via a 4 mm delivery tube into the tumour mass. In 29 of the 56 patients the tumour mass was canalised by a neodymium-YAG laser immediately before the afterloading delivery tube was introduced. In 44 (79%) of the patients, there was impressive relief of dyspnoea, accompanied by tumour regression observed at endoscopy and also by highly significant improvement in ventilatory function values, lung perfusion scans, and levels of arterial oxygen tension. In the other 12 patients (21%) there was no detectable improvement. The findings suggest that this recently developed combination treatment is of value in patients with advanced tumours of the trachea and main bronchi in whom there is no possibility of further treatment by external irradiation or repeated laser coagulation.

Aged↗
PubMed1987

[The behavior of viruses in conventional and 2-step anaerobic-mesophilic stabilization of clarified sludge with pre- and postpasteurization].

In a pilot-plant of semi-technical scale for the digestion of sewage-sludge with two single operated reactors and five coupled reactors investigations about the influence of anaerobic mesophilic sludge digestion and pasteurisation of raw and digested sludge on viruses were carried out. Following test-viruses were used: bovine enterovirus ECBO strain LCR-4, bovine parvovirus strain "Haden" and reovirus type I. In the case of a daily addition of virus-contaminated raw sludge both ECBO-virus LCR 4 and Reovirus--with one exception--were inactivated by a conventional single stage sludge digesting process with a mean hydraulic retention time (t/R) of 20 d as well as by a two-stage digesting process with 2 d tR in the anaerobic pretreatment and 8 d tR in the main-digestion process with and without prepasteurisation of the raw-sludge. Bovine Parvovirus was inactivated completely by a single-stage sludge digesting process with 20 d tR and pasteurisation of the digested sludge. All other investigated processes did not inactivate Parvovirus completely.

Anaerobiosis↗
PubMed1987

[Experiences with afterloading irradiation of malignant head and neck tumors].

Since the introduction of afterloading (AL) treatment more than twenty years ago, this kind of cancer therapy has become a standard method in other medical disciplines. With the development of new devices with short-term treatment and complete protection of the medical staff, AL became interesting for head and neck cancer treatment. This paper describes the method in detail and reports on initial results of treatment. From our experience with 20 patients it can be concluded that, from a technical point of view, AL is a convincing method. Moreover, it can be expected that in future AL will play a major role as a standard method in head and neck cancer treatment, even though a variety of questions (e.g. indication, fractionation) still require an answer.

Evaluation Studies as Topic↗
PubMed1986

[New methods in the radiotherapy of bronchial carcinoma. Endobronchial small-field irradiation using the iridium-129 high-dose afterloading technic in combination with the neodymium-YAG laser].

106 patients with inoperable malignant tumours constricting the central bronchial tree underwent endobronchial small-field radiotherapy with iridium-192 at high dose between June 1983 and September 1985. Treatment was performed using the computer-guided after-loading technique and a flexible bronchoscope under local anaesthesia. In complete occlusion of a bronchus by the tumour, a neodymium YAG-laser was applied (57 patients) to allow insertion of the after-loading probe. Endoscopy showed tumour regression in 75% of the patients, accompanied by clinical improvement. Pulmonary function tests, arterial blood gas analyses and pulmonary perfusion scans yielded a highly significant improvement of data after treatment. The procedure also proved effective upon exhaustion of external radiation. Apart from its positive palliation, endobronchial small-field radiotherapy using high doses of iridium-192 also has a curative effect, thus opening up a new approach to the therapy of advanced bronchial carcinoma.

Aged↗
PubMed1985

[A new possibility in treating stenosing tumors of the upper gastrointestinal tract].

A new method for treating inoperable patients with stenosing malignant tumors of the upper gastrointestinal tract consists in the combination of laser beam followed by direct internal radiation of the tumor using the afterload technique. It brings rapid improvement of dysphagia and resumption of oral feeding. Improvement in quality of life such as this has been achieved in 21 of 24 patients without any signs of complication due to therapy.

Ambulatory Care↗