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Biomedical subjects

K Rommelsheim

Publications and source records attributed to K Rommelsheim.

At least 55 records · Page 3Linked to original sources
PubMed1979

[Classification of x-ray findings and correlated oxygen tensions in "shock lung" (author's transl)].

The classification of the radiological features of the "shock lung" into stages represents a description of the characteristic radiological changes as they develop in the course of the lesion. As these changes do not succeed each other step by step but are superimposed their attribution to a particular stage therefore describes only the dominant substrate. Since the radiological changes and the corresponding oxygen tensions generally show satisfactory correlation a lack of correspondence during treatment may be an early sign of secondary disturbances or complications.

Humans↗
PubMed1979

[Pneumoperitoneum induced by artificial respiration and its diagnosis by peritonel lavage (author's transl)].

Ventilation with increased end-exspiratory pressure may, especially in cases of blunt chest trauma, result in pneumoperitoneum although there are no intestinal injuries. The case histories of four persons who developed this complication are reviewed. Differentiation between such a complication and a condition requiring laparotomy is often difficult because other injuries, particularly a cerebrocranial trauma, may obscure the clinical symptoms. Diagnostic peritoneal lavage may help towards differentiating between a ventilation-induced pneumoperitoneum and an "acute abdomen" caused by perforation or rupture of an intra-abdominal hallow organ.

Accidents, Traffic↗
PubMed1979

[X-ray equipment for standardized diagnostic radiology in intensive care units (author's transl)].

The increasing demands made by intensive care medicine on chest and abdominal radiography and on angiography have created the need for new X-ray equipment that combines short exposure with high tension. Battery-operated medium-frequency generators have an adequate output to satisfy these demands. For visualizing peripheral vessels in intensive care patients xeroradiographic arteriography has proved its value.

Angiography↗
PubMed1978

[Recurrent collapse of one lung (author's transl)].

A case of recurrent collapse of one lung is reported. It developed within 90 minutes after reexpansion of a completely collapsed lung induced by pneumothorax. There was no demonstrable cause for the recurrence of the atelectasis. Treatment was by means of a bird respirator (ventilation via a mouthpiece) with respiratory resistance. Factors possibly responsible for the secondary atelectasis are discussed.

Adult↗
PubMed1978

[Changes in pulmonary blood flow during surgery in the lateral position; a computer-scanning study (author's transl)].

The changes in blood flow in the pulmonary circulation arising from the lateral position during surgery were tested by means of 99mTc microspheres and a scanning camera computer system in 30 patients who had urological operations. Blood flow in the undermost lung increased by an average of 17% of the total pulmonary blood flow (SD = 8.0) in a group of 18 persons whose average age was 39.9 years. This redistribution occurred immediately after the patient was placed on his side and was more marked in younger persons than it was in older ones. Accompanying changes in O2 pressure showed no quantitative correlation with the changes in perfusion. The lateral position also affected ventilation by reducing ventilation of the undermost lung. This ventilatory disturbance which was demonstrable in more than 50% of the cases persisted for a short time after the operation whereas the pulmonary circulation returned to normal immediately after the patient resumed a normal position.

Adult↗
PubMed1978

Active enhancement of canine liver allografts with polyspecific antigen.

Of 34 canine liver allograft recipients, 17 in the control group survived for 6.9 +/- 1.5 days. Six recipients, group 3, were given 780 milligrams per kilogram of body weight polyspecific semisoluble antigen prepared from 20 spleens together with 10 milligrams per kilogram of body weigth prednisolone on days 15, 8 and 1 before transplantation. The mean survival time of this group was 10.1 +/- 2.0 days, p less than 0.01, compared with the control group. Six other recipients, group 4, were similarly treated with antigen from a pool of 70 spleens. Three survived for more than three weeks, and the other three died on days 1, 7 and 8 postoperatively with signs of accelerated rejection. Donors and recipients were not identical for leukocyte defined determinants. The recipients displaying accelerated rejection had markedly higher lymphocytotoxic and hemagglutinating antibodies. In addition, all recipients undergoing progressive rejection showed an inhibition of leukocyte migration. After three antigen dosages, rosette forming lymphocytes were present in increased numbers in peripheral blood and remained unchanged thereafter.

Animals↗
PubMed1977

[Extracorporeal perfusion with baboon liver in the treatment of hepatic coma (author's transl)].

In 11 patients with hepatic coma (stage IV and V according to Abouna) extracorporeal haemoperfusion using the Scribner shunt (radial or profunda femoris artery) was performed over 12 to 27 hours with 22 baboon and one human livers. Eight patients emerged from coma, six of them showed sufficient regeneration of the diseased liver. Four patients were discharged as cured, one patient died of acute pancreatic necrosis, a further one due to bleeding from an old gastric ulcer. In the 2 remaining patients the coma recurred within 48 hours. Tree patients never came round from coma. After perfusion no antibodies against baboon proteins were demonstrable in the patients. Thus there is very little danger of an anaphylactic reaction when perfusion is repeated. The titre of preformed cytotoxic antibodies against baboon cells in patients' serum rises only after 1-2 weeks and decreases again after 4 weeks. In our experience extracorporeal liver perfusion with baboon or human livers is the most promising method for treatment of hepatic coma.

Adult↗
PubMed1977

[Active enhancement of canine liver allograft by pretreatment with polyspecific spleen alloantigen (author's transl)].

Because it is not possible to use donor specific antigens for the induction of immunological enhancement in cadaveric organtransplantation, attempts were made to use polyspecific antigens in the enhancement of orthotopic canine liver allotransplants. Of 34 mongrel recipients, 17 controls survived for 6.9 +/- 1.5 days. Six recipients (group 3) were given 750 mg/kg polyspecific, semisoluble antigen prepared from 20 spleens (PSEA 20) together with 10 mg/kg prednisolone on days 15, 8 and 1 before transplantation. The mean survival time of this group was 10.1 +/- 2.0 days (P less than 0.01 compared with the control group). Six other recipients (group 4) were treated similiarly, except that the antigen had been prepared from a pool of 70 spleens (PSEA 70). Survival was variable here: 3 survived for more than 3 weeks and the other 3 died on days 1, 7 and 8 post-operatively, with signs of accelerated rejection. Donors and recipients were not identical for LD determinants, but one donor recipient pair with near identity showed a higher degree of enhancement. The recipients displaying accelerated rejection had markedly higher lymphocytotoxic and haemagglutinating antibodies. Animals surviving for longer periods had low antibody titres. In addition, all recipients progressive rejection were found to show inhibition of leucocyte migration. After three antigen doses rosette-forming lymphocytes were present in increased numbers in peripheral blood, and remained unchanged thereafter.

Animals↗
PubMed1977

[Ulcerative tracheo-esophageal fistula--a complication of longterm respiratory support (author's transl)].

A case of ulcerative tracheoesophageal fistula following long term respiratory support is described. After establishing the diagnosis of TEF, an attempt at surgical repair should be made as quickly as patient's condition permits it, ideally immediately. We suggest right side thoracotomy with the resection of the fourth rib, thereby facilitating preparation of a pedicled flap which should be interponated between trachea and esophagus after the closure of the esophagus defect by sutures has been performed.

Adult↗
PubMed1976

[Treatment of comatose patients by extracorporeal hemoperfusion with activated charcoal].

Hemoperfusion with activated charcoal is indicated in intoxications and in hepatic comma because the charcoal absorbs toxic substances. Good results have been obtained so far with activated charcoal liver perfusion in barbiturate intoxications, but less satisfactory results in hepatic comma. The indication for perfusion should also be made in clinically hopeless cases. The principal complications with activated charcoal perfusion are a decrease in thrombocytes and microemboli of charchoal particles. These complications can be avoided by coating the charcoal particles. A flow-rate of 200-300 ml/min is best in humans because this flow-rate ist guaranteed by an AV shunt in the forearm.

Capsules↗
PubMed1976

[Scanning in progessive pulmonary failure (shock-lung): preliminary results of a clinical study].

Lung scanning was performed on five patients with shock lung. It gave no evidence of morphological (pre-capillary) arterio-venous shunts or of increased pulmonary arterial pressure. Nor was there evidence of perfusion-ventilation inequality in the scan. The cause of the progressive pulmonary insufficiency was most likely due to maldistribution of gases in the microscopic region and to diffusion abnormalities.

Adult↗
PubMed1976

[Radiological lung changes in progressive pulmonary insufficiency (author's transl)].

Chest radiographs can reflect increasing pulmonary insufficiency of shock lung. In the early and intermediate stages, there is almost pure interstitial oedema which, in the later stages becomes alveolar-interstitial. In addition one may find evidence of broncho-pneumonia. Respiratory insufficiency is due to abnormalities of perfusion and distribution and is aggravated by disturbance of oxygen diffusion. The latter is due to an increase in the alveolo-capillary diffusion distance in the presence of interstitial oedema. It was not possible to demonstrate quantitatively significant precapillary shunts greater than 25 mu.

Adult↗
PubMed1976

[A review of the findings on chest examinations and at autopsy in surgical patients under intensive care (author's transl)].

The present paper deals with the findings on examination of the chest and at autopsy in 100 selected surgical patients under intensive care; of these 17% were post-traumatic, 55% had post-operative lung complications and in 28% there had been no trauma or previous operations. The accuracy of the radiological diagnosis was checked against the autopsy findings. Pneumonia and pulmonary oedema were the most common lung complications in all three groups, with an incidence of 59 to 82%, and were diagnosed with an accuracy of 92 to 95%. Other conditions which were looked for were pulmonary congestion, emboli and lung infarcts, pleural effusions, atelectasis, pulmonary haemorrhage or contusion and pneumothorax. The most common mis-diagnosis was in the demonstration of emboli and infarcts, where accuracy was only 64%. The difficulties in differential diagnosis of the radiological appearances due to these pulmonary complications are discussed.

Autopsy↗
PubMed1976

[Treatment of hepatic coma using extracorporeal perfusion with baboon and human liver as well as with activated charcoal].

In the 6 patients with hepatic coma hemoperfusions with 8 baboon and 2 human livers were carried out. Four awoke from the coma, one women could be discharged, but the others died of various complications and liver insufficiency. In the 4 patients with hepatic coma, 11 hemoperfusions with activated charcoal columns were performed. Two awoke from the coma, but they died of liver insufficiency. We were able to detect the elevation of preforming antibodies in a discharged patient.

Acute Disease↗
PubMed1976

Active enhancement of canine liver allografts--effect of pretreatment with prednisolone and donor-specific antigen.

We investigated the active enhancement of liver allografts in 44 pairs of beagle dogs by pretreatment with semisoluble and soluble donor-specific spleen antigens. If the antigen were administered together with prednisolone, time of survival was significantly prolonged--with soluble antigen by 36.8 +/- 5.9 days and with semisoluble antigen by more than 3 years. Antigen pretreatment alone or antigen in combination with postoperative treatment of minimal immunosuppressive drugs had no significant effects. We found no correlation between the titer of lymphocytotoxic antibodies in the serum of recipients at the time of transplantation and survival times.

Animals↗