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Biomedical subjects

M Scherrer

Publications and source records attributed to M Scherrer.

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

[Cross-over double-blind study using neophylline oral (proxyphylline and diprophylline) in bronchial asthma].

In a double-blind crossover trial 16 asthmatic patients were given placebo or 4 or 8 tablets of Neophyllin (each tablet containing 56 mg proxyphylline and 84 mg diprophylline) on two consecutive days. Very slight bronchodilatation independent of the oral dose and plasma level was observed 90 minutes after taking Neophyllin. However, when a betastimulator was inhaled (0.5 mg salbutamol) prior to taking 8 tablets of Neophyllin, surprisingly marked Neophyllin-induced bronchodilatation was observed after 60 and 90 minutes (p less than 0.05 and p less than 0.025). This bronchodilatation was about half that with 4 slow release coated tablets of Neo-Biphyllin (75 mg teophylline in each tablet). When Neophyllin was taken only proxyphylline caused bronchodilatation (no correlation between plasma diprophylline levels and bronchodilatation). The threshold value of plasma proxyphylline was about 13 microgram/ml plasma. Below this level proxyphylline is ineffective (likewise no correlation between plasma proxyphylline levels and bronchodilatation). An oral dose of about 600 mg proxyphylline (in Neophyllin) is needed to reach an effective plasma level within 90 minutes.

Administration, Oral↗
PubMed1979

[The rate of isometric inspiratory pressure change as a measure for the CO2 sensitivity of the respiratory center in patients with obstructive lung disease].

In healthy persons with and without loaded breathing, in asthmatics, and in patients with chronic obstructive lung disease (COLD) the rate of isometric inspiratory pressure development ([dp/dt]max) has been measured in order to assess the clinical significance of (dp/dt)max as an index of the motor output of the respiratory center in response to increased levels of carbon dioxide. During unloaded breathing normal subjects showed an excellent correlation between the ventilatory and the (dp/dt)max responses to CO2. Normal persons breathing through an external expiratory flow resistance, the asthmatics, and the patients with COLD had not only a blunted ventilatory response, but also a reduced (dp/dt)max response. The parallel changes observed in both variables indicate that under conditions of mechanical loading the (dp/dt)max does not exclusively reflect the motor output of the respiratory center, but is influenced by other factors such as the work of breathing and the mechanical efficiency of the respiratory pump. Accordingly, measurements of (dp/dt)max are of little help in deciding whether the development of CO2 retention in patients with obstructive airway disease is primarily due to increased mechanical load or to decreased sensitivity of the respiratory center.

Adult↗
PubMed1979

[Functional and oncologic results after bronchial or blood vessel anastomosis in the resection therapy of bronchogenic carcinoma].

In treatment of bronchogenic carcinoma twelve selected patients had economical resections. To avoid a pneumonectomy, lobectomies or bilobectomies were associated twice with bronchial excision, 8 times with bronchial resection (sleeve resection) and twice with resection and anastomosis of pulmonary artery. Nine patients underwent clinical, radiologic and szintigraphic control. Except one case all patients showed good functional results. The anastomosed lobes were perfused and ventilated proportionally to the number of segments. The quality of life after partial pulmonary resections had deteriorated only to a small extent compared with the preoperative state. These results were emphasized by the only poor result which (after atelectasis of the anastomosed lung) corresponded functionally to a pneumonectomy. --The two cases of anastomosis of pulmonary artery showed a short survival. Both corresponded to a stage II of tumor classification. Of the other patients (all stage I) three are alive more than five years.

Aged↗
PubMed1978

[The bronchospasmolytics salbutamol, fenoterol, terbutaline and reproterol. Their effects and side effects in asthmatics after inhalation with an electric nebulizer].

A double-blind crossover trial was conducted in 10 asthmatic patients for comparison of fenoterol with salbutamol, in 12 other asthmatic patients for comparison of reproterol with salbutamol, and in 15 other asthmatic patients for comparison of terbutaline with salbutamol. The following doses were given: 1.25 mg fenoterol, 2.5 mg reproterol, 2.5 mg terbutaline and 1.25 mg salbutamol. 5 drops of each of the inhalation solutions (in 2 ml of saline) were aerosolized by a powered machine and inhaled for 15 min. FEV1 was measured before, and 15 and 45 min after inhalation. Immediately before FEV1 the following parameters for side effects were also determined: 1. heartbeats per min, systolic and diastolic blood pressure; 2. minute ventilation, arterial PCO2 and oxygen consumption; 3. arterial SO2, PO2 and the alveolar-arterial O2-gradient (AaDO2). To estimate the selectivity of each of the 3 betastimulators the ratio (formula: see text) was established for each parameter and compared to that obtained with salbutamol. In further steps the ratio of all parameters for side effects was shown, then only that of the 3 most important side effects tachycardia, hypocapnia (PaCO2) and hypoxemia (PaO2). The following order of selectivity was found: 1. salbutamol, 2. fenoterol, 3. terbutaline, 4. reproterol.

Adult↗
PubMed1978

[Programming of freely written anamnesses for the computer].

The case histories of more than 5000 outpatients with respiratory diseases were stored in free text from 1974 untill 1977. The retrieval efficiency was tested using STAIRS-IBM program product with the syntax operators "or", "and", "not", "with", and "adj". Chronic bronchitis in lung cancer patients was chosen as an example. The first word constellation was compiled as a retrieval argument for chronic bronchitis. The second word constellation was used as a retrieval argument for chronic bronchitis subsisting for more than 5 years before the diagnosis of lung cancer. The third word constellation retrieved documents without clear time relationship between chronic bronchitis and lung cancer. The review of each history of the 473 lung cancer patients issued a first group of 219 cases composed of lung cancer patients with histories of chronic bronchitis for more than 5 years. A second group of 180 patients had no history of preexisting chronic bronchitis. This manual selection of cases (reading of all 473 case histories) took 3 months compared to 4 h by computer dialogue selection. 87% of the first group (preexisting chronic bronchitis for more than 5 years) and 74% of the second group (no history of chronic bronchitis) were correctly obtained by the brief computer dialogue. This efficiency of the computer dialogue was further improved without difficulty by slight modifications of the dialogue strategy, so that only approximately 10% of documents remained falsely classified. It can be seen that free text analysis of case histories is possible by the STAIRS-IBM program and enables a doctor to observe new clinically important correlations in a very short time. Final deductions, however, must be followed by careful checking of all individual histories.

Computers↗
PubMed1978

[Smoking, chronic bronchitis, bronchiolar obstruction and bronchial carcinoma].

The case histories of 474 patients with lung cancer were screened. Chronic bronchitis was assumed to precede lung cancer if chronic cough and sputum had been present for more than five years. Daily consumption of cigarettes, cigars (= 5 cigarettes) or pipes (= 1 cigarette) and the number of pack-years were noted. FEV1 in percent of the slowly inspired vital capacity (FEV1 %VC) was regarded as a sensitive index for the degree of bronchial obstruction. Group 1 included 221 lung cancer patients with a clear history of preexisting chronic bronchitis. Group 2 included 175 cases without such history. Heavy smokers and severely obstructed patients were found more often in group 1 than in group 2 (p less than 0.0005). A lack of correlation was evident between smoking habits and FEV1 %VC when group 1 was fused with group 2: r= -0.071, p greater than 0.20. Indeed, light, heavy, and very heavy smokers were evenly distributed in group 1 among severely and slightly obstructed patients. However, in group 2 heavy and very heavy smokers were found more frequently in patients with slight bronchial obstruction than in patients with severe bronchial obstruction (p less than 0.01). It appears that an important subgroup of heavy and very heavy smokers with lung cancer are protected from chronic bronchitis as well as from bronchial obstruction. The reasons for this protection are not clear.

Adult↗
PubMed1978

[Exercise-induced asthma and placebos].

The effectiveness of a placebo in 15 patients with exercise-induced asthma (E.I.A., decrease of FEV1 by more than 10% after a standard run uphill on a treadmill) has been measured. 7 patients repeated the test without placebo protection, to separate the psychological effect of placebo from the emotional influences of the unusual environment of a technically highly developed hospital and adaptation to test procedures. On selection day FEV1 in % of preexercise value 10 min after exercise was 68.2 +/- 7.9% and on control day 67.1 +/- 9.5% (no statistical difference). The second stage comprised 14 patients who took the placebo or Cromolyn (Lomudal) before exercise; on selection day FEV1 in % of preexercise value 10 min after exercise was 70.1 +/- 4.8%; on placebo day it was 76.0 +/- 3.4% and on Cromolyn day 90.7 +/- 3.3%. There was statistically significant (p less than 0.025) protection by placebo. However, the protective effect of Cromolyn was much better than that of placebo (p less than 0.005). Placebo has a significantly greater protective effectiveness in E.I.A. than expected, and one much greater than previously suggested in preexisting asthma. As environmental influences were ruled out, the only explanation for the high degree of protection by placebo is the patients' trust in the placebo.

Adolescent↗
PubMed1978

[Indications and costs of long-term oxygen therapy].

Nowadays, domiciliary long-term O2 therapy is given to certain patients with chronic arterial hypoxemia (PaO2 less than 55 mm Hg). However, it is important to exclude cases with severe CO2 retention (PaCO2 greater than 55 mm Hg). Hypoxemic and only slightly hypercapnic patients chiefly suffer from COLD and sometimes from a severe restrictive ventilatory disorder such as chronic bilateral pleural effusions or advanced kyphoscoliosis. The most important precondition for long-term O2 therapy is correct adjustment of all other procedures of pulmonary treatment, as well as total abstention from smoking. Common sources for domiciliary O2 therapy are bottles delivered to the patient's home weekly by the O2-producing firm. A new machine which appears to offer for greater facilities is the O2 concentrator of Rimer-Birlec (Cardiff, Wales). 2 liters O2/min are given via a naso-pharyngeal tube for 15 h per day. Without O2 during 9 h per day, the patient is able to follow appropriate employment. In domiciliary long-term O2 therapy the cost of O2 supply by the O2 concentrator is half that of bottles delivered to the home weekly. The new O2 concentrator for domiciliary long-term O2 therapy is recommended as by far the most economical source of O2. Other sources of O2 such as liquid O2 or chemically produced O2 are uneconomical for domiciliary use. Only hospitals will benefit from supplying their pipelines from a container with liquid oxygen instead of using gaseous O2 from bottles. The cost of the former is 3/4 that of the latter.

Breathing Exercises↗
PubMed1978

[Genetic transmission of Lowe's oculo-cerebro-renal syndrome in girl].

A girl who had all the clinical laboratory features of Lowe's syndrome is described. In the literature there are at least 5 other females recorded. They could arise by the preferential inactivation of the normal chromosome (lyon's hypothesis) or alternatively an autosomal dominant mode of inheritance with weak penetrance could be postulated.

Child, Preschool↗
PubMed1977

[Arterial CO2- and O2 partial pressure at rest and during exertion in pulmonary emphysema].

In 83 patients with severe, largely irreversible bronchial obstruction (FEV1/VC less than 40% and FEV1 after orciprenaline inhalation less than 120% of the control value) and radiologie evidence of AD-emphysema, arterial PCO2 and PO2 were measured at rest in supine position and on the bicycle ergometer during a steady-state exercice of 5 min. Alveolar hypoventilation (PCO2 greater than 45 mm Hg) was most often observed in the cases with FEV1 less than 1.01 (in 22 patients [27%] at rest and in 26 patients [31%] during exercise). However, there was no significant correlation of the PCO2 increase with the degree of bronchial obstruction. In all patients there was a marked inhomogeneity of the alveolar ventilation or the alveolar-capillary O2 transfer in relation to alveolar blood perfusion. Indeed, the alveolar-arterial PO2 difference was increased (40 mm Hg at rest and 45 mm Hg during exercise). The additional increase of this gradient during exercise was due to an unequal distribution of alveolar O2 diffusing capacities in connection with the alveolar blood flow (preceding measurements of the N2 gradient between alveolar air and arterial blood revealed a mean fall from 18 at rest to 8 mm Hg during exercise). The observed deterioration of hypoxemia during exercise (without additional hypercapnia) is to a great extent related to the degree of bronchial obstruction measured by simple spirometry. Thus, measurements of PCO2 and PO2 at rest and during exercise appear to be a helpful adjuvant to routine spirometry in the diagnosis of subclinical emphysema.

Arteries↗