A new concept for an alternative gastransport mechanism in the lungs is introduced. It is based on an enhancement of diffusive processes in the bronchial tree and allows gas exchange under quasi apnoic conditions. This enhancement is achieved by a modified high frequency jet ventilation technique utilizing frequencies up to 3000/min. The technical equipment used for this so called forced diffusion ventilation consists of a solenoid valve that interrupts the flow from a high pressure source with adjustable frequencies and impulse pause ratios. A special tracheal tube with an additional jet line implement in its wall carring a nozzle at its tip had to be developed. Animal experiments demonstrate that a sufficient gas exchange even with frequencies of 3000/min can be achieved with this FDV. Under this conditions the lung can be kept in its expiratory inflation level. This technique using frequencies of 350/min has been successfully applied to a patient suffering from multiple bronchopleural fistulas over 16 days. Also the mechanism of FDV is jet not quite clear, penetration of fresh gas into further generation of the bronchial tree, axial diffusion and convective transport due gas oscillations and the volume displacement of the beating heart seem to be responsible for the gas exchange.

Adult↗

PubMed1980

[Inversed ratio ventilation (IRV). Role of the respiratory time ratio in artificial respiration in ARDS].

Considering the advantages shown by the experiences of Reynolds on prolonged inspiration time it was suggested to study this type of ventilation also in ARDS. We tried the inverse ratio ventilation (IRV) in patients with ARDS and in postoperative cardiac surgical patients. An obvious improvement of gas transfer in the lung is seen and becomes better with increased duration of this type of ventilation. A better filling of various parts of the lung with longer time constants is achieved with prolonged inspiration. An effect similar to PEEP caused by an air trapping mechanism, can be seen with the shortening of expiration time. This air trapping mechanism is followed by autonomous adaption of PEEP for the local situation in various parts of the lung. A higher PEEP in poorly ventilated areas is automatically adjusted with IRV, than in areas with a short time constant (individual PEEP).

Biophysical Phenomena↗

PubMed1979

Trials of adjuvant therapy in breast cancer.

Explore the source record for details and available documents.

Alopecia↗

PubMed1979

Trials in breast cancer.

Explore the source record for details and available documents.

Breast Neoplasms↗

PubMed1979

Effect of treatment on the immunological status of women with advanced breast cancer.

An immunological profile has been serially studied in 72 patients with advanced breast cancer during the course of a randomized trial of chemotherapy and hormonal manipulation. DNCB+ patients were more likely to respond to either therapy, but no other test was predictive of response. In the follow-up period all chemotherapy patients had a reduction in white-cell count which was significantly greater in those responding to treatment. None of the other tests (phytohaemagglutinin response, immunoglobulins G, A and M, or Mantoux test) demonstrated changes that could be related to treatment or response, but there was a gradual unexplained fall in IgM levels in all groups the study progressed. It is concluded that the chemotherapeutic regimen (cyclophosphamide, vincristine, adriamycin and 5-fluorouracil) is relatively non-immunosuppressive, and that hormonal therapy (oophorectomy, tamoxifen or androgens) had no detectable effect on the immune response.

Antibody Formation↗

PubMed1979

Acupuncture anesthesia for open heart surgery: a report of 800 cases.

This article reports the utilization of acupuncture in combination with chemical anesthesia and neuromuscular relaxant for patients with cardiac surgery, including valvular disease and by-pass. In 800 patients studied using this type of combination of anesthetic techniques, it was found that this procedure can be successful for cardiac surgery and that it allows light planes of anesthesia with less interference to circulatory regulation. There is a certain advantage of using acupuncture anesthesia when compared with chemical anesthesia, as the pharmacological agents are not used and hence post no metabolic load for the patients. From the 800 patients studied, it seems justifiable to recommend this anesthetic procedure for cardiac surgery.

Acupuncture Therapy↗

PubMed1979