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Biomedical subjects

U Braun

Publications and source records attributed to U Braun.

At least 217 records · Page 12Linked to original sources
PubMed1994

[Difficult intubation due to facial malformations in a child. The laryngeal mask as an aid].

Variations in anatomy of the bony and soft-tissue structures of the neck and facial cranium due to trauma, disease, or dysmorphic syndromes may lead to severe intubation problems. These patients are admitted for mandibulofacial and otolaryngologic surgery. It is important to inspect the patient's outer and inner pharyngeal structures carefully during preoperative assessment, as suggested by Mallampati. The observer estimates the facility of intubation by inspection of the faucial pillars, soft palate, and uvula. Unfortunately, even careful examination does not predict every case of difficult intubation, so that unexpected problems may occur. There may also be difficulties in ventilating these patients with a face mask. Safe intubation is possible in these cases using the laryngeal mask airway (LMA), laryngoscopy with a rigid optical aid, and the fibreoptic bronchoscope. Case report. We report a 14-month-old girl with Goldenhar's syndrome (oculo-auricular dysplasia) who presented for soft-palate surgery. This syndrome belongs to the group of cranio-mandibular-facial malformations; the main symptoms are congenital unilateral malformations in the area of the 1st and 2nd branchial arches. The patient's jaw was hypoplastic with aplasia of the temporo-mandibular joint, which led to asymmetry of the lower face and an extremely short mandible. Additionally, we observed a large tongue in relation to the small jaw. Macrostomia is part of the syndrome, and may lead to underestimation of intubation problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1994

Borna disease in naturally infected cattle.

Based on the immunohistochemical demonstration of viral antigen and on the histological brain lesions, Borna disease was diagnosed in a cow and a bull which had suffered from a severe, subacute progressive disorder of the central nervous system. Virus-specific antigen was characteristically localized in neurons, predominantly in the perikaryon and dendrites. In a serum sample available from one of the animals a Borna disease virus antibody titre of 1 in 80 was demonstrated. This is the first report of the natural disease in cattle.

Animals↗
PubMed1994

A ventilator with an integrated gas-exchange monitoring function.

OBJECTIVE: To evaluate in the laboratory a new ventilator with a built-in monitoring function for gas exchange. DESIGN: Prospective laboratory evaluation of a new mechanical ventilator. SETTING: Gas exchange was simulated by injecting nitrogen and CO2 at a respiratory exchange ratio close to 1. SUBJECTS: Different settings of controlled-mode ventilation were simulated by the gas-injection model, which permitted an independent adjustment of variables. INTERVENTIONS: The influence of respiratory variables on oxygen consumption (VO2) and the CO2 production (VCO2) agreement with a reference method was investigated. MEASUREMENTS AND MAIN RESULTS: Independent variables, which may influence the accuracy and precision of the tested device, were adjusted systematically within the following ranges and resulted in 71 different combinations: FIO2 0.21 to 0.59; FIO2-mixed FEO2 0.02 to 0.05; mixed FECO2 0.02 to 0.05; inspiratory flow rate 25 to 120 L/min; inspiratory minute volume 4200 to 11,200 mL/min; tidal volume 420 to 1120 mL; respiratory rate 6 to 16 breaths/min; airway pressure 5 to 30 cm H2O. The resulting range for both VO2 and VCO2 was 140 to 390 mL/min. For each test situation, two reference measurements were taken by mass spectrometry and wet gas spirometry. Twelve measurements were taken by the gas-exchange measurement function of the tested ventilator. The two-fold standard deviation (SD) for repeated measurement differences was chosen to quantify the repeatability within each method. This repeatability coefficient gave 5.9 (4.7) mL/min for VO2 (VCO2) within the gas-exchange measurement function, compared with 3.6 (3.1) mL/min within the reference method measurements. The mean intermethod difference (test monitor--reference method) for VCO2 over all test situations was 4.1 +/- 10.7 (2 SD)%. The respective mean VO2 difference was 7.8 +/- 12.2 (2 SD)%. Eliminating test situations with inspiratory flow rates < 50 L/min (remaining n = 46) reduced the mean VO2 difference and variability by one third to 5.4 +/- 8.0 (2 SD)%. CONCLUSIONS: Assuming that limits of agreement for intermethod differences of +/- 20% are clinically acceptable, the VCO2 measurement indicates an acceptable accuracy and precision under controlled ventilation. The respective agreement for the VO2 measurement is lower, but still within the acceptable range. The systematic difference of the VO2 and the VCO2 is mainly influenced by a +8% bias in the inspiratory minute volume measurement, which seems especially susceptible to ventilator settings with inspiratory flow rates of < 50 L/min. An improvement of the minute volume detection would be desirable.

Analysis of Variance↗
PubMed1994

Efficiency of a new radiant heater for postoperative rewarming.

Effective rewarming devices have only become available recently. This investigation compares the efficiency of an new overhead radiant heater (ARAGONA Thermal Ceilings TM, CTCX, 1000 W) with that of an electric blanket (50 W) or a standard hospital blanket. 35 patients undergoing postoperative assisted ventilation and continued sedation were randomly assigned to one of the treatments. Shivering, oxygen uptake, heart rate and invasive blood pressure were measured and the increase in total body heat minus body heat production was calculated as heat balance. Results are given as medians (range). Subcutaneous temperatures were taken to calculate the mean skin temperature. The evaluation was undertaken for an oesophageal temperature interval of 35 degrees to 37 degrees C. All groups exhibited a similar mean oxygen uptake i.e. thermogenesis (3.5 (2.7-4.0) ml.kg-1.min-1, 3.3 (2.7-4.9) ml.kg-1.min-1;3.2 (2.4-5.1) ml.kg-1. min-1) which correspond to a resting energy expenditure. The time of rewarming of the radiant heat treated group (n = 12) (100 (76-143) min) for this interval was significantly reduced in comparison to both other groups (183 (116-320) min; 231 (115-340) min). A slightly positive heat balance was only achieved in the group treated by radiant heat, indicating that all metabolic heat was conserved or heat losses were compensated by transfer of external heat. Shivering was significantly reduced in the radiant heater group whereas the rate pressure product was insignificantly higher. We did not find any significant effect for the electric heating blanket in comparison to the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Comparison of pancreatic morphology and exocrine functional impairment in patients with chronic pancreatitis.

A comparative analysis of pancreatic morphology and exocrine function was performed prospectively in 48 patients. All patients had transabdominal ultrasound, computed tomography, endoscopic retrograde pancreatography, and a secretin-caerulein test. Classification of ultrasound, computed tomography, and pancreatogram findings was based on the Cambridge classification. In 10 patients, no pancreatic duct changes were detected on pancreatography. Equivocal (Cambridge I), mild to moderate (Cambridge II), and considerable ductal changes (Cambridge III) were found in 10, 12, and 16 patients, respectively. Computed tomography and ultrasound changes were found to correlate in 40-50%, 67%, and 94-100% of patients with Cambridge I, II, and III abnormal duct morphology, respectively. In patients with a normal pancreatogram, no patient had a functional impairment. Seventy per cent of the patients with equivocal pancreatic duct changes had dissociated, and 30% global, pancreatic insufficiency, while 50% of those with mild to moderate abnormal duct morphology manifested dissociated, and 50% global, functional impairment. All patients with considerable pancreatic duct changes had global pancreatic insufficiency. The results of this study confirm that normal endoscopic retrograde pancreatographic findings and Cambridge III ductal changes on endoscopic retrograde pancreatography correlate extremely well with normal pancreatic function and advanced functional insufficiency, respectively. As diagnostic tools, ultrasound and computed tomography are as sensitive as pancreatography only in chronic pancreatitis with considerable morphological changes.

Adult↗
PubMed1994

Influence of age, breed, and stage of pregnancy on hepatic ultrasonographic findings in cows.

Influence of age, breed, and stage of pregnancy on hepatic ultrasonographic findings of cows was determined. In addition, the relation between body weight, height at the withers, milk production, and the measurements determined via ultrasonography was investigated. The liver of 186 cows was examined ultrasonographically. The cows comprised Swiss Braunvieh, Simmental, and Holstein breeds, and age ranged from 2.5 to 11.5 years. The ultrasonographic findings of the liver, gallbladder, caudal vena cava, and portal vein were described, and the position, size, thickness, and distal angle of the liver were determined. In addition, the position and diameter of the caudal vena cava and portal vein were determined. There was no significant difference between any of the variables determined and breed or age. Therefore, measurements for the 3 breeds and for the various ages were summarized into 1 group. There were significant correlations between body weight, milk production, and size and thickness of the liver. In 3 pregnant cows, the liver was examined ultrasonographically 8 times during the course of pregnancy. Positive correlation was detected between stage of pregnancy and diameter of the caudal vena cava. There was a negative correlation between stage of pregnancy and diameter of the portal vein. In 23 cows, the ultrasonographically determined measurements of the liver were compared with those determined at slaughter. Weight of the liver correlated well to thickness of the liver determined via ultrasonography.

Aging↗
PubMed1994

Ultrasonographic findings in a cow with extra-hepatic cholestasis and cholangitis.

This case report describes a 6-year-old Holstein Friesian cow with extrahepatic cholestasis. The most prominent clinical signs were disturbed general condition and behaviour, icterus, yellowish brown urine, and bilirubinuria. An increased concentration of serum bilirubin and an increase in hepatic enzyme activity were the most important laboratory findings. Ultrasonographic examination of the liver and gall bladder revealed severe bile stasis. The intrahepatic bile ducts, the cystic duct, and the gall bladder were severely dilated. Histological examination of a liver biopsy revealed cholestasis, cholangitis, and acute hepatosis. A liver abscess was also found at post mortem examination. It was assumed that cholestasis was caused by the inflammatory products resulting from cholangitis.

Animals↗
PubMed1994

Ultrasonographic examination of the ventral neck region in cows.

The position, dimensions, and structure of the thyroid gland, the portion of the esophagus in the neck, the cervical lymph nodes, and the major blood vessels of the neck were determined via ultrasonography in cattle. The left and right ventral neck regions of 30 healthy Swiss Braunvieh cows were examined ultrasonographically, using 3.5- and 5.0-MHz linear transducers and a 3.5-MHz convex transducer. The external jugular vein was situated directly beneath the skin in the upper and middle parts of the neck and 2.7 to 6.6 cm from the body surface in the lower part of the neck. In contrast, the common carotid artery was located further from the body surface along the entire ventral neck region; depending on the measuring point, this distance varied from 2.6 to 10.9 cm. The external jugular vein narrowed from caudad to craniad. The diameter of the common carotid artery remained fairly constant along its course in the ventral part of the neck and varied from 0.9 to 1.4 cm. The thyroid gland was identified via ultrasonography caudodorsal to the larynx. It appeared as an echogenic spindle-shaped structure with finely granular echogenic pattern. The esophagus appeared as a band-shaped structure in longitudinal section, and it could be followed to the thoracic inlet. Its width increased from craniad to caudad, and mean +/- SD diameter was 2.9 +/- 0.23 cm. The medulla, hilus, cortex, and capsule of the cervical lymph nodes could be clearly differentiated via ultrasonography. Mean length and width of the left cervical lymph node were 3.0 +/- 0.45 and 1.8 +/- 0.23 cm, respectively.

Animals↗
PubMed1994

Ultrasonography of the reticulum in cows.

The reticulum and adjacent organs were examined ultrasonographically in 51 cows by use of a 3.5-MHz linear transducer applied to the ventral aspect of the thorax over the sixth and seventh intercostal spaces. Examination included assessment of the contour of the reticulum, of reticular contractions, and of the organs adjacent to the reticulum. The normal reticulum appeared as a half-moon-shaped structure with a smooth contour; it contracted at regular intervals and was situated immediately adjacent to the diaphragm and ventral portion of the abdominal wall when relaxed. Contents of the reticulum could not normally be imaged because of its partly gaseous composition. The ruminoreticular groove, craniodorsal blind sac of the rumen, and the ventral sac of the rumen were observed caudally. The distal aspect of the spleen and parts of the omasum, abomasum, and liver could be imaged. Reticular motility was characterized by a biphasic contraction pattern. Four biphasic reticular contractions usually were observed during a 4-minute period. During the first (incomplete) contraction, the reticulum contracted by a mean of 7.2 +/- 2.30 cm. There was then low-grade, incomplete relaxation of the reticulum, followed immediately by the second reticular contraction, during which the reticulum usually disappeared from the 17.5-cm-deep screen. The reticulum then reappeared in its normal position. The first reticular contraction lasted a mean of 2.6 +/- 0.33 seconds and the second contraction lasted 3.9 +/- 0.55 seconds. The mean interval between 2 biphasic contractions was 44.9 +/- 10.53 seconds. The speed of the first reticular contraction was 5.4 +/- 1.32 cm/s.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Associative semantic network dysfunction in thought-disordered schizophrenic patients: direct evidence from indirect semantic priming.

The characteristics of the spread of semantic activation in associative networks in normal subjects, thought-disordered (TD) and nonthought-disordered (NTD) schizophrenic patients with respect to time and semantic distance are examined. Direct and indirect semantic priming effects at two stimulus onset asynchronies (SOA) in a lexical decision task reveal that semantic associations spread further and faster in TD schizophrenic patients than in normal controls and in NTD schizophrenic patients. From a methodological point of view, indirect semantic priming at short prime-target intervals appears to be the best indicator of associative network dysfunction. The findings are discussed within the framework of current research on the effect of dopamine on the signal-to-noise ratio in cortical neural networks. Data suggest that semantic associative memory operates at a comparatively lower signal-to-noise ratio in thought-disordered schizophrenic patients.

Adolescent↗
PubMed1993

Ultrasonographic findings in cows with traumatic reticuloperitonitis.

The morphological changes in the region of the reticulum were examined ultrasonographically in 26 cows with traumatic reticuloperitonitis, and a radiograph of the reticulum was also taken. The ultrasonographic examination included observations of reticular motility during a three minute period, of reticular contours and of adjacent structures such as the diaphragm, the anterior dorsal blind sac of the rumen, the ventral sac of the rumen, the spleen, omasum, abomasum and liver. In cows with disturbed reticular motility, biphasic contractions were slower than normal or indistinct, and the number of contractions was reduced. Fibrinous changes appeared as echogenic deposits, sometimes accompanied by hypoechogenic fluid. Abscesses had an echogenic capsule with a hypoechogenic centre. In seven cows, there was an effusion in the region of the reticulum in addition to the morphological changes. The spleen was involved in the adhesions in four cows, the omasum in three cows, the liver in one cow and the abomasum in one cow. Radiography revealed foreign bodies penetrating the reticulum of 12 cows and magnets in the reticulum of seven cows. None of these foreign bodies or magnets could be visualised by ultrasonography.

Animals↗
PubMed1993

Radiography as an aid in the diagnosis of traumatic reticuloperitonitis in cattle.

Radiographs of the reticulum, the medical records and the surgical and post mortem findings for 151 cattle were evaluated, and the radiographic findings in animals which had no pathological changes in the cranioventral abdomen were compared with those in animals with traumatic reticuloperitonitis. Features that were found to be reliable in the diagnosis of the condition included atypically positioned foreign bodies, abnormal gas shadows in the region of the reticulum, and depressions in the cranioventral margin of the reticulum. In addition to the reticulum, the remainder of the cranioventral abdomen was also assessed radiographically. An accumulation of gas or a gas-fluid interface outside the gastrointestinal tract, and intra-abdominal masses were typical findings in cattle with traumatic reticuloperitonitis. Various parameters were used to determine the reliability of radiography of the reticulum in the diagnosis of the condition; its prevalence was 50 per cent, the sensitivity of the radiographic diagnosis was 76 per cent, the specificity was 93 per cent, the accuracy was 85 per cent, the positive predictive value was 92 per cent and the negative predictive value was 80 per cent.

Animals↗
PubMed1993

Indirect semantic priming in schizophrenic patients.

Schizophrenic patients and normal controls performed a lexical decision task involving the recognition of words which were preceded (primed) by either associated, indirectly associated, or non-associated words. In contrast to normal control subjects who showed no indirect semantic priming effect at an inter-stimulus interval (ISI) of 0 ms, a trend towards such an indirect semantic priming effect was found in schizophrenic patients. With a longer ISI of 500 ms, an indirect semantic priming effect was obtained in both groups. In the framework of network models of semantic memory, the results are interpreted as further evidence for an increase in activation or decrease in inhibition in the spreading of associational activation in schizophrenic patients.

Adolescent↗
PubMed1993

Is there a cholinergic and an adrenergic phase of the oculocardiac reflex during strabismus surgery?

We investigated the counterregulatory effect of the oculocardiac reflex (OCR) in 25 infants and children during strabismus surgery under three experimental conditions. In group 1, a series of measurements were recorded when the OCR was elicited by traction. The beat-to-beat heart rate reduction ranged from -26 to -64 beats/min (median: -46 beats/min). Constant traction increased heart rate in all patients from +23 to +50 beats/min (median: +30.5; P < 0.001). After a sudden release of the stimulation, heart rate rose further from +6 to +40 beats/min (median: +15; P < 0.001). In group 2, atropine (0.01 mg/kg) was administered 3-4 min prior to the same manipulations as in group 1. Constant traction changed heart rate from -1 to +20 beats/min (median: +4.5; P < 0.01). In group 3, a retrobulbar blockade suppressed the OCR and the counterregulation completely. These findings indicate that there is an active counterregulatory process which maintains heart rate during traction at the extraocular muscles after the bradycardic reflex has been initiated. The bradycardia and the counterregulation may be referred to as cholinergic and adrenergic phrases of the OCR. Atropine eliminates the cholinergic phase. Our study indicates that there may be receptors and afferent fibres for both phases, which can be blocked by local anaesthetics.

Adolescent↗
PubMed1993

Ultrasonographic examination of the left kidney, the urinary bladder, and the urethra in cows.

The purpose of the present study was to determine the position, dimensions and structure of the left kidney, the urinary bladder and the urethra in cattle by use of ultrasonography. The left kidney, the urinary bladder and the urethra of 12 healthy, Swiss Braunvieh cows were examined transrectally using a 5.0 MHz linear transducer 10 times within two weeks. The lobulation of the kidney in cattle could be visualized ultrasonographically. The echogenicity of various renal structures differed. The renal cortex was hyperechoic in comparison to the relative hypoechoic renal medullary pyramids. The urinary bladder was always visible but its diameter varied greatly. The vertical diameter of the left kidney was 6.2 +/- 1.0 cm in the region of the renal hilus. In 7 cows the thickness of renal cortex and medulla was between 2.0 and 2.3 cm. The diameter of the renal sinus varied from 1.1 to 2.5 cm. The interassay coefficients of variation of the variables measured varied between 8.5 and 16.5%. It was concluded that the ultrasonographic values determined in this study can be used as references for the diagnosis of morphologic changes in the bovine left kidney.

Animals↗
PubMed1993

[Specifics of anesthesiology in the operative phase of laparoscopic surgery].

AIM OF INVESTIGATION: The present investigation was initiated to quantify the effect of a CO2-peritoneum on CO2-absorption (VCO2res) and other respiratory variables during laparoscopic surgical procedures. METHODS: Gas exchange and endtidal pCO2 (petCO2) were measured continuously. Ventilation was adjusted to maintain preoperative petCO2 mainly by increasing the tidal volume. Arterial blood gas samples were taken directly before starting and directly before the end of the CO2-peritoneum. RESULTS: In 49 patients a complete set of data was evaluated for a mean duration (+/- 50) of 99 (43) min CO2-peritoneum. The mean VCO2res was 37 (30)ml/min. The VCO2 showed a steady state of 137 (29)ml/min before the start of the operation. Individual VCO2res maxima of 223 ml/min were detected. Due to a mean rise of arterial pCO2 (paCO2) of 39 (3.6) to 42.6 (4.5) mmHG the VCO2res was underestimated by about 5 ml/min. This CO2 accumulation was mainly the result of an increasing petCO2-paCO2 difference till the end of the CO2-peritoneum. No significant change in VCO2res has been detected with increasing duration of the CO2-peritoneum, though in individual courses a continuously increasing VCO2res was found. Overweight individuals (n = 17) showed a significantly lower VCO2res of 23 (12)ml/min in comparison to normal weight patients (n = 34) with 43 (16)ml/min. The static total compliance was significantly reduced by 30% at the end of the CO2-peritoneum. The ventilatory deadspeace/tidal volume relation did not change. To maintain normocapnia the average alveolar ventilation had to be increased by 38% till the end of the CO2-peritoneum. CONCLUSIONS: This increase in ventilation can easily be established in pulmonary uncompromised patients. Problems in adequately increasing minute volume are expected in chronic obstructive lung disease and with maximal VCO2res. Monitoring of at least petCO2 is strongly recommended since the individual course of VCO2res cannot be predicted.

Adolescent↗