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Biomedical subjects

L Brandt

Publications and source records attributed to L Brandt.

At least 235 records · Page 13Linked to original sources
PubMed1983

Effects of topical application of a calcium antagonist (nifedipine) on feline cortical pial microvasculature under normal conditions and in focal ischemia.

Cat cortical arterioles and venules were exposed in vivo to the Ca2+ antagonist nifedipine under normal conditions and in focal ischemia. Topical application of nifedipine caused a marked, concentration-dependent arteriolar dilatation. The dilatatory responses increased significantly with decreasing arteriolar size. Perivenular microapplication of nifedipine invariably caused dilatation that was less pronounced but more long-lasting than that on the arteriolar side. Arterioles, which constricted after middle cerebral artery occlusion, invariably dilated following nifedipine application. These dilatatory responses were transient but could be repeated, and on some occasions were accompanied by a return of flow in vessels in which stasis had been present. The results suggest that nifedipine is able to dilate cerebral vessels both under normal conditions and when contracted during focal ischemia.

Animals↗
PubMed1983

Are the vascular effects of naloxone attributable to the preservatives methyl- and propylparaben?

In vitro, the Nalonee preparation of naloxone caused a concentration-dependent relaxation of human pial cortical arteries contracted by potassium, noradrenaline, serotonin, prostaglandin F2 alpha (PGF2 alpha), and haemorrhagic cerebrospinal fluid, or inhibited contractions elicited by these agents. However, the preservatives in the Nalonee preparation, methyl- and propylparaben, had similar effects. Pure naloxone alone had no effect on potassium or PGF2 alpha-induced contractions. It is suggested that the relaxant effects on vascular smooth muscle of Nalonee can be attributed to the alkylparabens rather than to naloxone. The pronounced relaxations induced by the alkylparabens had a rapid onset, and they were stable and could easily be cleared after rinsing.

Arteries↗
PubMed1983

Chromosome pattern and survival in acute non-lymphocytic leukaemia in relation to age and occupational exposure to potential mutagenic/carcinogenic agents.

The bone marrow karyotype was investigated in 98 patients with acute non-lymphocytic leukaemia (ANLL). The patients were divided into two groups according to age. (1) 47 patients were 20-54 (median 40) years old. 21 had a history of occupational exposure to chemical solvents, insecticides, or petrol products, and 26 were considered occupationally not having been exposed to such agents. In 4 exposed patients (19%) all bone marrow cells had clonal chromosomal aberrations (designated AA), while also 4 of the non-exposed patients (15%) were AA. Thus in young ANLL patients, there was no significant association between occupational exposure to potential mutagenic/carcinogenic agents and the AA constitution of the leukaemic cells. (2) 51 patients were 55 years of age or older (median 65 years). 16 were exposed and 8 of these (50%) had the AA constitution. 35 patients were non-exposed and only 4 (11%) were AA. It is known from previous studies that the survival of ANLL patients with AA is extraordinarily short. Accordingly the overrepresentation of AA in exposed patients 55 years or older, was associated with a shorter survival than that of the non-exposed elderly patients. The results suggest that etiologic factors may influence the clinical course of ANLL, especially in elderly patients.

Acute Disease↗
PubMed1983

Temporary clipping during early operation for ruptured aneurysm: preliminary report.

Temporary arterial occlusion was performed in 16 patients undergoing early aneurysm operation. Ten patients had a ruptured middle cerebral artery (MCA) aneurysm, and 6 had a ruptured anterior communicating artery aneurysm. Premature aneurysm rupture during operation necessitated temporary arterial occlusion in 10 patients. In 5 patients, temporary arterial occlusion was performed to facilitate dissection of the aneurysm. In 1 patient with a large MCA aneurysm, temporary occlusion was performed to provoke collapse of the completely exposed aneurysm sac, thus making clipping of the base possible. The results do not indicate that temporary occlusion by the standard aneurysm clips now in general use leads to angiographically detectable arterial wall changes or increased thromboembolic complications. Temporary clipping of the MCA proximal to the perforating arteries may be well tolerated for up to 20 minutes during early aneurysm operation. Temporary occlusion of one or both anterior cerebral arteries or temporary pericallosal clipping need not unconditionally lead to disastrous consequences if rendered necessary during aneurysm operations performed in the acute stage.

Adult↗
PubMed1983

Causes of unfavorable outcome after early aneurysm operation.

In a consecutive series of 160 patients in Hunt and Hess Neurological Grades I to III who were operated upon for a ruptured supratentorial aneurysm within 3 days after the hemorrhage, 42 patients (26%) had an unfavorable outcome. Delayed ischemic cerebral dysfunction with permanent deficit accounted for the unfavorable outcome in 18 patients (43% of all unfavorable results or 11% of the total series), whereas the unfavorable outcome was due to deficit ascribed to surgical trauma in 11 patients (26% of all unfavorable results or 7% of the total series) and to the initial hemorrhage in 7 patients (17% of all unfavorable results or 4% of the total series). Impaired outflow of cerebrospinal fluid with shunt dependency occurred in 3% of the total series. Of the patients with an unfavorable outcome, 17 (40%) had had arterial hypertension before the hemorrhage. The incidence of unfavorable outcome in good grade patients (Grades I and II) was not influenced by timing of operation (Day 1, 2, or 3 after hemorrhage). The results favor the opinion that it is principally the patient's condition during the acute stage that determines the outcome. (Neurosurgery 13:629-633, 1983).

Acute Disease↗
PubMed1983

Subnormal response of blood lymphocytes to phytohaemagglutinin in adult coeliac disease complicated by intestinal lymphoma.

Surface markers and the response to phytohaemagglutinin (PHA) were determined in blood lymphocytes from five patients with adult coeliac disease (ACD) complicated by intestinal lymphoma, eight ACD patients without lymphoma, and control individuals without signs of ACD. The proportions of lymphocytes forming rosettes with sheep erythrocytes, lymphocytes with surface IgM, and lymphocytes with Fc IgG receptors were similar in all groups. A subnormal response to PHA was found in the patients with ACD and concomitant intestinal lymphoma. In ACD without lymphoma the PHA response was normal. In ACD patients with relapse of abdominal symptoms despite a gluten-free diet, the demonstration of a subnormal PHA response may strengthen the suspicion of a complicating intestinal lymphoma.

Adult↗
PubMed1983

[100 years of intubation anesthesia. William Macewen, a pioneer of endotracheal intubation].

Endotracheal anaesthesia with the help of orotracheal intubation is 100 years old. In 1880, William Macewen was the first to describe and to perform that technique. In his paper entitled "clinical observations on the introduction of tracheal tubes by the mouth instead of performing tracheotomy or laryngotomy' he describes in addition two cases of endotracheal intubation lasting at least 36 h. He can, therefore, be said also to have performed the first long-time intubation.

Anesthesia, Endotracheal↗
PubMed1983

[Effect of therapeutic hyperventilation on blood lactate concentration].

The increase of blood lactate is a well known side effect of active and passive hyperventilation. In 22 patients who underwent controlled respiration after head injury or elective neurosurgical operations, we measured lactate, pyruvate, pH, and bicarbonate in central venous blood and investigated their interference by hypocapnia. The level of ventilation was between pCO2 equal 25 mmHg and pCO2 equal 45 mmHg, measured in the central venous blood. With decreasing pCO2, pH showed an increasing (from 7.40 +/- 0.015 to 7.50 +/- 0.068) and bicarbonate a decreasing tendency (from 25.46 +/- 1.32 mMol/l to 23.28 +/- 3.76 mMol/l). Lactate and pyruvate remained within the normal range down to a central venous pCO2 of 31 mmHg. But then with increasing hypocapnia both increased significantly (lactate 2.001 +/- 1.08 mMol/l, 0.098 +/- 0.068 mMol/l). At a pCO2-range of 25-27 mmHg (central venous) lactate continued increasing to 2.212 +/- 0.995 mMol/l whereas pyruvate dropped to 0.087 +/- 0.05 mMol/l. Therefore the possibility of hypocapnia-induced lacticemia seems to arise at a ventilation level less than 30 mmHg (pCO2 central venous). Production of excess-lactate may begin at a central venous pCO2 of 27 mmHg.

Adult↗
PubMed1983

[The rediffusion system. Limitation of nitrous oxide increases the cuff pressure of endotracheal tubes].

There is an increase in endotracheal tube-cuff volume and pressure due to nitrous oxide diffusion into the cuff during anaesthesia. A rise of the cuff pressure up to 100 mm Hg (high volume-low pressure cuffs!) within only two hours is nothing out of the ordinary. The inspiratory nitrous oxide concentration influences the cuff pressure rises. The rate of pressure rise depends on the diffusion constant of the cuff material for nitrous oxide, on the cuff wall thickness, and on the difference of nitrous oxide concentration between cuff and trachea or tracheal tissue. An innovation of the blocking system--we call it the Rediffusion System--reduces the nitrous oxide-induced rise of cuff pressure even during long lasting endotracheal anaesthesia with a high FIN2O. The principle of the Rediffusion System is the enlargement of the pilot balloon in order to improve its diffusion capacity for nitrous oxide. In this way a rediffusion into the air is enabled for that nitrous oxide that diffused into the blocking system through the cuff wall. In endotracheal tubes with a Rediffusion System, cuff pressure never exceeds capillary perfusion pressure of the tracheal mucosa. In our in vitro-experiments we found an increase of cuff pressure from 14.2 +/- 0.5 mm Hg to only 27.3 +/- 1.9 mm Hg within six hours (FIN2O = 0.66). Within 150 minutes of endotracheal anaesthesia (FIN2O = 0.66) cuff pressure rose from 14.6 +/- 0.5 mm Hg to only 21.5 +/- 3.6 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1982

The outcome in 100 consecutive cases of early aneurysm surgery.

A retrospective study has been carried out on 100 consecutive patients undergoing direct surgery for ruptured aneurysms of the anterior part of the Circle of Willis within 3 days following subarachnoid haemorrhage. All patients were preoperatively in neurological Grades I, II or III. 76% of the patients made a good recovery whilst the morbidity was 10% and the mortality 14%. The results are compared with the estimated results of delayed treatment as well as with the natural history of the disease. The incidence of hydrocephalus requiring a shunt procedure was 2% and the incidence of permanent ischaemic deficits of delayed onset 16%.

Adolescent↗
PubMed1982

Cardiac and coronary arterial involvement in infants and children from New England with mucocutaneous lymph node syndrome (Kawasaki disease). Angiocardiographic-echocardiographic correlations.

Forty-four patients, aged 6 months to 11 years, meeting the clinical criteria for mucocutaneous lymph node syndrome (Kawasaki disease) were studied from March 1980 to March 1981. A protocol was designed for evaluation of cardiac involvement including electrocardiogram, chest X-ray film, cardiac enzyme determinations and M mode and two dimensional echocardiograms. Aspirin was given during the acute febrile period as an anti-inflammatory agent in a dosage of 100 mg/kg per day; followed by 30 mg/kg per day for 10 weeks or longer if platelet counts were elevated. Angiocardiography was performed in 38 patients. Twenty-one patients (48 percent) showed abnormal M mode echocardiographic findings (flat or greatly decreased ventricular septal motion, pericardial effusion or decreased left ventricular function) during the acute febrile stage. Coronary artery disease developed in seven patients, all of whom had abnormal M mode echocardiographic abnormalities in the acute stage. Five patients had coronary aneurysms and two patients had dilated coronary arteries. Two dimensional echocardiograms identified coronary arterial lesions accurately if present proximally but failed to detect aneurysms beyond 1.5 cm from the aortic root. The study shows that serial M mode and two dimensional echocardiograms provide sufficient information to rule out cardiac involvement in Kawasaki disease. Echocardiograms should be obtained every 3 to 4 days during the acute febrile stage because all patients with coronary artery disease detected with angiography had abnormal echocardiographic findings during that period.

Angiocardiography↗
PubMed1982

Manifestations of Kawasaki disease in New England outbreak of 1980.

Twenty-five children with Kawasaki disease were studied during the spring of 1980. All had fever, rash, conjunctivitis, and at least two of the remaining three diagnostic criteria. They ranged in age from 7 months to 10 years with an average of 3.2 years. Cardiac manifestations were present in 64%; one had a myocardial infarct, and two had coronary aneurysms, with iliac and femoral aneurysms as well in one of these. Shock requiring dopamine therapy occurred in two; congestive failure requiring digoxin and furosemide occurred in these two and in four others. Many other problems, including hydrops of gallbladder, meningoencephalitis, cranial nerve palsies, and hypertension were also present. Thrombocytopenia occurred in two transiently, and in one of them signs suggestive of hemolytic-uremic syndrome were also present. This experience was gained during largest outbreak of Kawasaki disease yet reported in the United States.

Cardiovascular Diseases↗