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Biomedical subjects

M Fischer

Publications and source records attributed to M Fischer.

At least 685 records · Page 38Linked to original sources
PubMed1980

[Thyroid hormone levels after surgical stress reaction (author's transl)].

In a larger collective of surgical patients the behaviour of the individual thyroid parameters (T4, T3, rT3, TBG and thyroxine-binding capacity) were studied before, during and after operation and set in relation to each other. There are significant shifts in T4 metabolism towards the formation of rT3. In spite of its greatly reduced metabolic activity compared with T3, an important regulatory effect is attributed to rT3, in thyroid metabolism in stress situations.

Adult↗
PubMed1980

Lateralization procedures in primary aldosteronism.

The diagnostic validity of adrenal isotopic scanning, adrenal venous aldosterone, adrenal phlebography and computed abdominal tomography (CT) was studied in 44 patients with primary aldosteronism. In all patients the diagnosis was confirmed by surgery (unilateral adrenal adenoma n = 32, bilateral adrenal hyperplasia n = 12). Both adrenal scintiscan, adrenal venous aldosterone and CT allowed in a comparable high percentage of patients (71%0 the exact classification of the adrenal lesion(s), whereas adrenal phlebography could distinguish adenoma from hyperplasia in 57%. Marked differences between the lateralization procedures, however, were observed in predicting incorrect preoperative indentification: adrenal scintiscan 29%, adrenal venous aldosterone 3%, adrenal veno-graphy 6% and CT 0%. Finally, the percentage of patients in whom no differentiation between the two main subgroups of primary aldosteronism could be obtain varied between 0% with adrenal isotopic scanning and 37% with adrenal phlebography (CT 29% and adrenal venous aldosterone 26%). Both scintiscan and adrenal venous aldosterone were not improved by the administration of dexamethasone. Our findings document that adrenal venous aldosterone determinations, adrenal isotopic scanning and computed tomography are equally valid in differentiating unilateral adenoma from bilateral adrenal hyperplasia in primary aldosteronism. However, adrenal scintiscan is hampered by a relative high percentage of incorrect results independant whether dexamethasone was used or not. Contrary, adrenal venous aldosterone and computed tomography seemed to have no or only a minor risk in assuming an incorrect classification of the adrenal lesion(s).

Adenoma↗
PubMed1980

[Treatment of upper-abdominal pain in chronic gastritis. Results of therapy with the motility regulating drug Bromopride].

After discussing the aetiological role of the reflux from the duodenum in causing and maintenance of chronic gastritis, the author studied the effect of bromopride, a drug regulating gastrointestinal motility, on the subjective complaints of individuals suffering from the disease. In a randomized double-blind trial, 31 subjects with upper abdominal complaints, histologically established antrum gastritis and endoscopic signs for disorders of pyloric function were treated with one capsule three times daily of bromopride or a placebo, over a period of three weeks. The positive therapeutic results in 12 of 13 patients on bromopride provide support for the clinical use of a drug regulating gastrointestinal motility in the treatment of duodeno-gastric reflux causing the discomfort of individuals with chronic gastritis. Subjects exhibiting a sensation of fullness and pressure, flatulence, pain in the epigastrium and eructations, were found to be most responsive to bromopride. No relationship between side-effects and drug treatment was observed.

Abdomen↗
PubMed1980

[Computer tomographic localisation in primary aldosteronism. Comparison with adrenal scintigraphy (author's transl)].

13 patients with verified primary aldosteronism (unilateral adrenal adenoma = 10, bilateral idiopathic hyperplasia = 3) underwent examination by CT and 131J-cholesterol-scintigraphy. CT-scan can successfully employed for localization of unilateral adenoma exceeding 10 mm in diameter. Small lesions and hyperplasia are rare CT-findings. The value of 131J-cholesterol-scintigraphy for differentiation of the two main subgroups of primary aldosteronism--adenoma and hyperplasia--is limited. In our experience both non-invasive methods are helpful to avoid misleading interpretation. In controversial cases bilateral adrenal venous blood sampling by catheterization is mandatory.

Adenoma↗
PubMed1980

[Effect of planned treatment policy in patients with upper gastrointestinal bleeding using endoscopic neodymium-YAG laser therapy (author's transl)].

In a prospective trial with and without laser therapy the outcome on 105 patients was evaluated according to a defined protocol and terminology. Only patients with actively bleeding lesions during early endoscopy had laser therapy. Patients showing evidence of recent bleeding or no bleeding had none. Defects of the laser equipment or impossibility of reaching a bleeding lesion prevented its use in some patients (control group). There was no difference concerning rate of recurrent bleeding or mortality. Controlled trials with defined groups of patients are urgently needed.

Adolescent↗
PubMed1980

[A randomized clinical study of stress ulcer prophylaxis with cimeytidine in severe multiple injuries].

In a surgical intensive care unit a controlled clinical trial for stress ulcer prophylaxis with cimetidine was performed in patients with severe polytrauma. Severe polytrauma was defined as affection of at least 3 body cavities (head, thorax, abdomen), 2 body cavities and 1 extremity fracture, 1 body cavity and 2 extremity fractures of 3 extremity fractures. An extremity fracture was defined as a fracture of a long bone i.e. humerus, femur. Initially the trial was planned as randomized double-blind using a fixed sample size. It was executed as a sequential single-blind study only and stopped for ethical reasons before the bounderies were reached and was analyzed according to the advice of an external referee using Fisher's exact test (p < 0.025). Cimetidine was highly effective in preventing stress ulceration in severe polytrauma patients, but mortality was the same in the cimetidine and in the placebo group.

Cimetidine↗
PubMed1980

[Temporary hepatic support by extracorporeal baboon liver perfusion in acute hepatic failure (author's transl)].

Eight patients in acute hepatic failure were treated by a total of 41 extracorporeal baboon liver perfusions. Only one has survived to the present. Parameters of good function proved to be oxygen consumption and bile production. Highly elevated aromatic amino acids decreased significantly during one single passage through an extracorporeal perfused baboon liver, as did ammonia while urea increased significantly. The prognosis of these very ill patients can be improved only when the regeneration of their damaged livers starts up again during temporary hepatic support therapy.

Adolescent↗
PubMed1980

[Extracorporeal pig liver perfusion in normo- and moderate hypothermia (author's transl)].

32 allogeneic extracorporeal pig liver perfusions were performed for a period of 3 hours to examine the viability of the isolated liver. The perfusion apparatus consisted of 3 independently regulated pumps and of a semiautomatic flow regulation by a capacitive level transducer. The bile secretion alone gives a rough estimation only when external influences like the temperature are taken into consideration. The oxygen consumption correlated to pressure and flow is a suitable parameter indicating the viability of the extracorporeally perfused liver. By combining these bed-side parameters we were able to determine the functional capacity of an isolated liver properly. Under moderate hypothermia (34 degree to 35 degree C) the oxygen consumption falls by 25%, while the bile secretion falls by 487.8%. The success of an extracorporeal liver perfusion will depend on achieving normothermal conditions. For clinical use one may concentrate on these quick and easy bed-side parameters. Because other tests of viability like clearance methods or assays of metabolites are very time-consuming they are of little value in the immediate control of a running perfusion.

Animals↗