Biomedical subjects
Publications and source records attributed to K Lehmann.
From a district hospital is reported on the causes of the untimely explantation of cardiac pacemakers. Surgico-biological occasions of explantation prevail to untimely technical damages. The repeated use of cardiac pacemakers is possible and economically reasonable under certain prerequisites.
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The effects of some typical clinically tested psychotropic drugs were studied in acute experiments on awake rats. Potentials in somatosensory cortex were evoked by peripheral stimulation. Haloperidol, diazepam, medazepam, desipramin and a new substance, the MPP-sulton, caused significant modification in latency and amplitude of some components of the potentials. Between the effects of psychotropic drugs exist differences which, in turn, were clearly distinguishable from the modification of these evoked responses by unspecific narcotic effects of hexobarbital.
To stimulation of the Substantia nigra the nucleus caudatoputamen of the rat responds with the release of a short-latent sum action potential that may serve to characterize the interaction between the two nuclear areas. The partly conflicting results reported in the literature about drug effects on this potential prompted us to examine the effectiveness of dopaminergic and cholinergic substances or their antagonists following systematic administration. Chloropromazine increases the amplitude of the potential, while apomorphine has a distinct antagonistic effect. Interesting appear to be the analogical effects of Tricuran, arecoline and apomorphine, and the furtherance of the chloropromazine effect by arecoline.
It is reported on a case of Romano-Ward-syndrome in a 40-year-old female patient. The problems of the most frequent false interpretation as idiopathic epilepsy as well as the differential-diagnostic considerations concerning the exclusion of symptomatic QT(U)-elongations in the ECG are entered. The pathomechanisms which perhaps are the basis of the syndrome are discussed.
It is reported on a cyst of the spleen in a twenty-nine-year-old female patient in whom as accidental findings a splenomegaly was established. The diagnosis would be ascertained by means of laparoscopy and laparotomy. The genesis of the cyst remained unclear. The author deals with the problems of the differential diagnosis.
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The results of 250 tracheostomies, primarily or secondarily performed at the intensive care unit of the Surgical Department of the Basle University, are presented. The standardized technique of tracheotomy is described, details for the choice and management of large prestretched double-cuff tracheostomy tubes are given, a new method of low-pressure cuff-blocking is outlined. The follow-up studies --autopsy, clinical examination and tracheoscopy--demonstrate a very low complication rate, due to the technique of tracheostomy, the preferred tracheostomy tubes and the method of alternate low-pressure cuff-blocking.
With selected examples from general surgery, a better statistical elaboration of patient's data by means of operation and complication classification is demonstrated. The use of an operation and a complication key is presented. The advantage of such a classification key in documentation is the possibility of maintaining an accurate yearly review of all therapeutical methods in surgery.
On the basis of 5 casuistics of Wegener's granulomatosis the author deals with the difficulties of the diagnosis and differential diagnosis, whereby above all is referred to the preculiarities of the cases and the malinterpretation of the diagnoses on admission to the hospital.
The diagnosis and treatment of the rare stenosis of the sigmoid due to an attack of endometriosis is discussed in relation to 5 cases. Particular attention must be paid to the lack of involvement of the intestinal mucosa at the preliminary examination. The problems of definitive diagnosis arising from this, which can usually only be discovered by laparotomy, are gone into. Surgical treatment, in the form of a resection to maintain continuity is the appropriate and optimal therapy for this disease. But extensive mutilating operations on establishment of an endometriotic stenosis are not justified.
Kinetic examinations of lithium concentrations in the aqueous humour and in the liquor in man were carried out. The passage of lithium into both extravascular compartments took place in different manners. Lithium - liquor concentrations seem to be only of a rather limited positive evidence as to the concentrations at the spot of action; the possible causes for this fact are discussed.
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Follow-ups of 722 removable partial dentures that have been used for an average 5.2 years reveal that the way they were used and the type of balancing as well as the construction of the denture have an influence on the inflammation of the denture-bearing area and the loosening of the abutment teeth. In this investigation it was not possible to demonstrate the influence of daily personal oral hygience.
During and after continuous i.v. infusion of 0.25 g ampicillin (Binotal-R) per hour, serum and urine concentrations were determined in 6 healthy adults (volunteers) and in 12 geriatric patients with normal liver and kidney function. In old persons serum levels were higher and after the end of infusion decreased more slowly than in young adults. These data may be explained by a lower capillary permeability and renal clearance in older people. In patients with T-tube drainage after cholecystectomy, bile levels of ampicillin (during i.v. continuous infusion of 0.25 g/h) were equal to double those in serum. Recovery from the file was calculated as 0.1-0.2 percent.
The kinetics of lithium in the serum, liver and brain of rats is described. The serum levels resembled those of man, whereas considerable quantitative differences were observed when comparing specific kinetic parameters. The brain level increased with the increasing doses, approaching the corresponding serum level. Concentration differences between different brain areas could be observed only after repeated administrations. Striatum, cortex and hippocampus showed significantly higher levels than the thalamus. The liver content remained low with increasing doses, and was below the brain level.