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Biomedical subjects

R M Huber

Publications and source records attributed to R M Huber.

86 records · Page 5Linked to original sources

Effects of albuterol (salbutamol) on esophageal motility and gastroesophageal reflux in healthy volunteers.

Orally or intravenously administered beta 2-adrenergic drugs have been found to inhibit esophageal motor function. Since inhalation of these drugs results in less systemic side effects, the present double-blind study was designed to investigate the influence of inhalation of the beta 2-adrenergic agonist albuterol (salbutamol) on esophageal motor function and gastroesophageal reflux in ten healthy volunteers. Esophageal motor function was recorded using a pneumohydraulically perfused multilumen manometry tube. Twenty-four-hour pH profiles were measured while the volunteers were ambulatory using a combined glass electrode connected to a portable recorder. Inhalation decreased neither lower esophageal sphincter pressure nor esophageal peristaltic amplitudes. Gastroesophageal reflux was similar on both occasions during inhalation of albuterol (3.1% [range, 1.0% to 25.5%] median upright time, with esophageal pH less than 4; and 0.1% [range, 0.0% to 10.7%] supine time) and during placebo treatment (3.6% [range, 1.6% to 19.8%] upright and 0.0% [range, 0.0% to 2.5%] supine time). Our data support the study of inhalation of beta 2-adrenergic drugs in asthmatic patients with accompanying gastroesophageal reflux.

Administration, Inhalation↗

[Endoluminal irradiation of tracheobronchial tumors using a high dose rate iridium-192 afterloading device].

We report about 50 patients with inoperable bronchus tumors treated since March 1986 in a prospective non randomized study with high dose rate iridium-192 afterloading (AL) irradiation in 140 applications. 26 patients were treated combined with external irradiation. 32 were treated before with laser therapy, one with chemotherapy (small cell carcinoma). The actuarial survival rate (Kaplan-Meier) was 26% after 36 weeks for all patients; 38% for combined endoluminal and external irradiation and 9% for patients treated with AL alone. Death was caused by the local tumor in 85%. In 41% lethal bleeding was seen.

Adenocarcinoma, Bronchiolo-Alveolar↗

[Diagnosis of a perforating aortic aneurysm as a late complication following enlarging aortoplasty using central venous digital subtraction angiography].

11 years after patch aortoplasty due to coarctation of the aorta a 33 year-old patient experienced two spontaneous haemoptyses. A centralvenous digital subtraction angiography demonstrated a large aneurysm of the proximal descending aorta penetrating the left upper lobe of the lung. The successful emergency surgical treatment consisted of implantation of a dacron-prosthesis.

Adult↗

[Recurrent pulmonary hemorrhage with normal kidney function].

A case of Goodpasture's syndrome with normal renal function is described. Clinical, morphological and prognostic features of the diagnosis are compared with the findings in Goodpasture's syndrome with progressive renal failure and with the findings in idiopathic pulmonary hemosiderosis.

Adult↗

[A simple system for emergency coniotomy].

The successful clinical application of a new emergency cricothyrotomy device is reported. We used it first in a patient who was in acute respiratory insufficiency and could not be intubated because of a large tumour in the pharynx. Emphasis is placed on the description of the easy handling especially for less experienced physicians and of the atraumatic procedure.

Acute Disease↗

Elastic deformation properties of implanted endobronchial wire stents in benign and malignant bronchial disease: A radiographic in vivo evaluation.

PURPOSE: To evaluate the long-term mechanical behavior in vivo of expandable endobronchial wire stents, we imaged three different prostheses in the treatment of tracheobronchial disease. METHODS: Six patients with bronchial stenoses (three benign, three malignant) underwent insertion of metallic stents. Two self-expandable Wallstents, two balloon-expandable tantalum Strecker stents and two self-expandable nitinol Accuflex stents were used. Measurements of deformation properties were performed during voluntary cough by means of fluoroscopy, at 1 month and 7-10 months after implantation. The procedures were videotaped, their images digitized and the narrowing of stent diameters calculated at intervals of 20 msec. RESULTS: After stent implantation all patients improved with respect to ventilatory function. Radial stent narrowing during cough reached 53% (Wallstent), 59% (tantalum Strecker stent), and 52% (nitinol Accuflex stent) of the relaxed post-implantation diameter. Stent compression was more marked in benign compared with malignant stenoses. In the long term permanent deformation occurred with the tantalum Strecker stents; the other stents were unchanged. CONCLUSION: Endobronchial wire stents can be helpful in the treatment of major airway collapse and obstructing bronchial lesions. However, evidence of material fatigue as a possible effect of exposure to recurrent mechanical stress on the flexible mesh tube may limit their long-term use. This seems to be predominantly important in benign bronchial collapse.

Airway Obstruction↗

Comparison of CT with MR imaging of endobronchial tumors.

Twenty-nine patients suspected of having an endobronchial mass were examined by magnetic resonance (MR) and CT. Seventy-nine pathological and 319 normal bronchi were confirmed by bronchoscopy and/or operation in these patients. The studies were evaluated by two observers (A and B): By MR, only 72% (A) or 71% (B) of the pathological and 45% (A) or 43% (B) of the normal bronchi, respectively, were visualized. Computed tomography identified all pathological and 97% of the normal bronchi (A and B). Therefore, comparison between MR and CT was based only on those bronchi that were adequately visualized on MR as well as CT. For these bronchi the sensitivity of MR was 88% (A) or 77% (B) and of CT 96% (A) and 93% (B). Specificity was 92% (A) and 94% (B) for MR and 97% (A and B) for CT. At the present stage of development CT proved to be superior to MR in demonstrating endobronchial lesions.

Adenocarcinoma↗

Genotoxicity of nitroso compounds and sodium dichromate in a model combining organ cultures of human nasal epithelia and the comet assay.

Genotoxic effects of xenobiotics are a possible step in tumor initiation in the mucosa of the upper aerodigestive tract. Using the comet assay, detecting genotoxicity in human tissue has been restricted to single incubations in vitro, but in vivo most xenobiotics harm their target in a repetitive or chronic manner. Therefore, we propose a model, which provides repetitive incubations in human upper aerodigestive tract mucosa cultures. Samples of human inferior nasal turbinate mucosa (n = 25) were cultured according to a modified version of a technique originally described by Steinsvåg. On day 1 fresh samples and on days 7, 9 and 11 organ cultures were incubated with N-nitrosodiethylamine (NDEA), sodium dichromate (Na2Cr2O7) and N'-methyl-N-nitro-N-nitrosoguanidine (MNNG). Mucosa samples and organ cultures, respectively, underwent a modified comet assay on days 1, 7 and 11. Genotoxicity could be shown for NDEA, Na2Cr2O7 and MNNG on days 1, 7 and 11. Duration of tissue culture and repetitive incubations did not significantly influence the results for NDEA. Nevertheless, Na2Cr2O7 and MNNG caused higher genotoxic effects on cultures subjected to the comet assay on day 11. This model may help to assess genotoxic hazards posed by environmental pollutants that have a cumulative character in repetitive or chronic exposure in vivo.

Adult↗