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Biomedical subjects

T Kardel

Publications and source records attributed to T Kardel.

At least 37 records · Page 2Linked to original sources
PubMed1988

Intoxication at home due to carbon monoxide production from gas water heaters.

Forensic medicine has a role to play in the community not only when dealing with criminal cases. When the forensic scientist observes fatalities that could have been prevented, he has an obligation to respond with the purpose of preventative measures. In a short period in Copenhagen there were a number of fatalities due to the production of carbon monoxide from gas water heaters. The gas water heaters were in most cases malfunctioning due to sooted convectors and installed without a flue, but at the time of installation maintenance checks were not mandatory, and if carried out they were often unprofessional. It is emphasized that even with well functioning equipment, the danger of intoxication exists when using a heater without a flue over an extended period, if the apartment is thoroughly insulated. The oxygen will then be used in the combustion and CO produced. The symptoms are insidious and uncharacteristic. Examples are described where physicians have failed to diagnose the condition in patients in adjoining apartments. The authorities finally responded to the medical reports with new regulations and with a favourable result. The responsibility with regard to the control of technical installations in a technically advanced society is discussed.

Accidents, Home↗
PubMed1985

Acute hemodynamic effects of pinacidil and hydralazine in essential hypertension.

In a double-blind, randomized, crossover study, the effects of intravenous pinacidil, 0.2 mg/kg, were compared with those of hydralazine, 0.3 mg/kg, before and after beta-adrenoceptor blockade in six subjects with hypertension. Both drugs equally reduced total peripheral resistance by about 40%. Pinacidil reduced mean blood pressure by an average of 30 mm Hg, while the reduction after hydralazine was 10 mm Hg. The difference in antihypertensive effect resulted from greater increases in heart rate, cardiac contractility (systolic time intervals), and cardiac index (thermodilution) after hydralazine. These effects after hydralazine could not be fully abolished by beta-blockade, as could the effects after pinacidil. Pinacidil decreased pulmonary blood pressure, whereas there was a slight rise in pulmonary blood pressure after hydralazine. Forearm blood flow (venous occlusion strain gauge plethysmography) increased equally after both drugs; thus pinacidil decreased forearm vascular resistance more than hydralazine did. Serum concentrations of both drugs were within the therapeutic range and correlated with the fall in mean blood pressure. Five subjects complained of side effects after hydralazine, but none were reported after pinacidil. Hydralazine increased myocardial oxygen consumption (as estimated from the rate-pressure product) by 35%; there was no change after pinacidil. It is suggested that hydralazine has direct cardiostimulatory effects that limit its antihypertensive effectiveness. These effects increase myocardial oxygen consumption and may be responsible for the common and sometimes severe cardiovascular side effects of hydralazine.

Adrenergic beta-Antagonists↗
PubMed1983

Pinacidil, a new vasodilator: pharmacokinetics and pharmacodynamics of a new retarded release tablet in essential hypertension.

In an open study increasing doses of a retarded tablet formulation of pinacidil were given twice daily for four weeks to 9 patients with untreated essential hypertension (WHO I-II). In all patients a decrease in diastolic blood pressure to below 100 mmHg, or a fall exceeding 15 mmHg, was obtained 2 h after tablet intake (p less than 0.02), but in only two patients was the effect maintained after 10 hours (n.s.). At a mean serum concentration of 100 ng/ml 2 h after pinacidil 30 mg, the mean blood pressure had decreased by 14 and 12.7 mmHg in the supine and erect positions, respectively (p less than 0.05). In contrast, mean blood pressure 10 h after the same dose was unchanged, when the mean serum concentration was 47.5 ng/ml. No change in heart rate was observed. Pharmacokinetic and pharmacodynamic investigations showed a tendency towards a more gradual and longer lasting antihypertensive effect and serum concentration-time curve after the retarded tablet than the previous tablet. Pinacidil 40 mg in the retarded tablet reduced mean blood pressure and increased heart rate for at least 8 h. There was a linear correlation between the serum concentration and the change in mean blood pressure, and between the changes in mean blood pressure and in heart rate. There was no indication of tachyphylaxis. A serum level of 50 ng/ml of pinacidil appeared to be the minimal effective concentration. The side effect consisted of fluid retention, and the body weight increased by 1.0 kg (p less than 0.05); four patients complained of oedema.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1981

Temporospatial effects on orthodromic sensory potential propagation during ischemia.

Sensory potentials recorded at two to four sites along the median nerve during ischemia in normal subjects were analyzed with respect to the effects of conduction distance and duration of ischemia. Latency increased rectilinearly with the squared duration of ischemia in minutes, and the rate of the latency increase along the nerve was a power of the preischemic latency, a measure of conduction distance. This finding indicates a temporospatial slowing of sensory conduction velocity of ischemic nerves. Calculated latencies fitted with measured values within +/- 0.2 msec in 95% of 385 recordings. The compound potential amplitude decreased exponentially with the concomitant increase in temporal dispersion, which was the major cause for the decrease in amplitude during the first 20 minutes of ischemia. The nerve conduction pattern during ischemia may serve as a model for biochemical axon membrane dysfunction, a possible factor in the pathogenesis of toxic-metabolic neuropathies.

Action Potentials↗
PubMed1981

Immediate central and peripheral haemodynamic effects of a new vasodilating agent Pinacidil (P1134) in hypertensive man.

The purpose of this study was to evaluate the immediate central and peripheral haemodynamic effects of a new vasodilating agent P 1134, in hypertensive man. After oral administration of 25 mg P 1134, the maximal haemodynamic changes were (mean +/- 1 SEM): mean blood pressure fell from 121.8 +/- 6.5 to 80.5 +/- 7.8 mmHg, heart rate increased 24.2 +/- 4.5 beats/min, cardiac output rose 2.9 +/- 0.3 1/min and forearm blood flow increased 1.0 +/- 0.1 ml/100 ml tissue/min. Stroke volume increased 17.0 +/- 2.1 ml and the inotropic state of the heart as judged from systolic time intervals increased. Total peripheral resistance and forearm vascular resistance were both reduced by approx. 50%. Linear correlations were found between the serum concentration of P 1134 and the change in mean blood pressure and total peripheral resistance. Changes in the other parameters mentioned above occurred progressively with changes in mean blood pressure and total peripheral resistance. It can be concluded that P 1134 is a very potent hypotensive agent with a haemodynamic profile identical to that seen with vasodilators with preferably act on precapillary resistance vessels. Potency and maximal efficacy exceeds that of hydralazine and seems like that of minoxidil. P 1134 is remarkably free from side-effects apart from causing water retention as all other vasodilators. It can be administered orally as well as intravenously. This makes P 1134 a very interesting compound in the treatment of moderate to severe hypertension, and further studies are well-founded.

Adult↗
PubMed1975

Delayed decrement of the nerve impulse propagation during induced limb ischaemia in chronic hepatic failure.

Sensory thresholds for vibrations and electrical shocks and the sensory nerve conduction velocity (median nerve) were measured during 30 minutes of induced limb ischaemia in 10 normal subjects and 15 patients with chronic hepatic failure. Sensory action potentials were recorded simultaneously at the wrist and elbow. Seven patients (group A) had a normal perception time for vibrations. As in normal subjects, the potential amplitude decreased from the onset of ischaemia, more pronounced at the elbow than at the wrist, and the conduction velocity became reduced more rapidly in the wrist-elbow than the first digit-wrist segment, indicating impulse propagation with decrement. Eight patients (group B) had a markedly prolonged perception time for vibrations. The reduction of potential amplitude and conduction velocity was considerably delayed, and the impulse propagation showed no evidence of decrement for 20-25 minutes of ischaemia. A rise of the threshold for electrical shocks was absent or very delayed. As in the two other groups, the rise was abrupt and occurred at the moment when the potential below the occluding cuff (elbow) was extinct. In both groups of patients there was an increasing temporal dispersion of action potentials and in patient group A a desynchronization of the late phase of the potential took place early in the course of ischaemia. Differences between groups A and B could not be predicted from the pre-ischaemic nerve conduction data.

Adult↗
PubMed1975

Liver volume estimated by ultrasonic scanning before and after portal decompression surgery.

In 12 patients with cirrhosis of the liver, determination of the liver volume by ultrasonic scanning and of the galactose elimination capacity (GE) were made before and after portal decompression surgery. The liver volume decreased significantly, with a median decrease of 402 ml (psmaller than 0.01). Also the GE decreased, but relatively less than the liver volume, so that the calculated GE per unit liver volume increased, with a median increase of 5 mg per minute times 100 ml liver volume (psmaller than 0.005). The decrease in liver volume following portal decompression is assumed to be due in part to reduction of liver blood volume, in part to loss of tissue water and fat, and probably to some loss of parenchyma, accounting for a reduction of the GE.

Adult↗
PubMed1975

Preoperative liver function tests correlated with encephalopathy after porta-caval anastomosis.

In 31 patients with cirrhosis of the liver undergoing porta-caval shunt surgery, the prognostic value of some liver function tests was studied. The surgical mortality was not correlated with the test results. Serum concentrations of bilirubin, albumin, and prothrombin were not correlated with postoperative encephalopathy, but the mutually correlated preoperative galactose elimination capacity and age of patients were correlated with encephalopathy development. Incapacitating encephalopathy mainly occurred in patients above 60 years of age, and when the galactose elimination capacity was at or less than an arbitrary limit of 225 mg/min. The liver function decreased significantly following operation.

Adult↗