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Biomedical subjects

W Brunner

Publications and source records attributed to W Brunner.

At least 19 recordsLinked to original sources
PubMed1987

[Acquired cystic renal changes--a clinically relevant problem in long-term dialysis].

While dialysis patients survive renal failure for years and even decades, multiple morphologic alterations take place in their kidneys. One of these (so to speak) "postmortem" changes is the formation of secondary renal cysts. A patient with end stage renal failure due to amyloidosis is described who was dialysed at home for 9 years. Intravenous pyelography and renal biopsy in the predialysis period likewise documented the presence of amyloidosis and the absence of cystic disease. Ultrasonography of both kidneys, a suspicious increase in hematocrit and the autopsy finding of numerous large cysts also showed the presence of acquired cystic disease. The frequency and complications of this newly recognized disease in longterm dialysed patients are discussed. Recommendations are given concerning follow-up of these patients, with a view to early detection of tumor development within the cysts.

Amyloidosis↗
PubMed1987

[Post-traumatic/postoperative immune deficiency syndrome].

Severe trauma, major surgery and burns (TSB) are often followed by infections, adult respiratory distress syndrome and multi-organ failure, complications which are thought to be the consequence of the post-TSB immunodeficiency syndrome. The most important data and hypotheses in this regard are summarized. After a TSB event large amounts of tissue debris, endotoxins and microorganisms have to be eliminated. Further important factors in TSB are stress reactions, malnutrition, loss and replacement of fluids and therapeutic measures. The elimination of unwanted elements is partly carried out by non-specific mechanisms such as opsonisation, chemotaxis and phagocytosis by granulocytes and cells of the macrophage/monocyte lineage, while specific reactions of humoral and cellular immunity also play a role. Severe TSB is thought to be associated with growing exhaustion of the unspecific defense system, leading to deficient specific immune reactions. Routinely measurable parameters only partly reflect the complex events after TSB: there is a decline in serum levels of fibronectin, immunoglobulins and some components of complement, in chemotaxis, phagocytosis and intracellular killing, and in circulating T3 and T4 lymphocytes as well as some lymphocyte functions. Some of these measurable parameters of defense mechanisms are statistically predictive for the occurrence of infections and other sequelae of TSB. Specific prophylactic and therapeutic measures can only be taken, if at least some of the complex events after TSB are better understood.

Antigen-Antibody Reactions↗
PubMed1987

[Diagnosis of lung embolism. Prospective study].

In a prospective study over the years 1983-1985, 300 cases of acute pulmonary embolism were analyzed in relation to predisposing factors, clinical signs, arterial blood gas analysis and isotope perfusion scanning. Comparison of this prospective study with an earlier retrospective one showed similar results, with the exception of isotope scanning, an investigation which has gained increasing diagnostic reliability (highly suggestive results in 94% of patients with massive pulmonary embolism and in 64% with submassive pulmonary embolism). In two thirds of the cases the diagnosis was established during the first day after hospitalisation. In 10% of the patients pulmonary embolism occurred despite anticoagulant therapy.

Aged↗
PubMed1986

[Acute rhabdomyolysis].

By damaging cell membrane integrity, acute rhabdomyolysis leads to electrolyte shifts according to the concentration gradients and the liberation of intracellular substances. Diagnosis is confirmed by the presence of a high serum creatinkinase activity (CK) and myoglobinuria. For clinical purposes myoglobinuria is demonstrated by a blood-positive dipstick in the absence of hematuria or hemoglobinuria. Rhabdomyolysis is usually acquired and is rarely due to hereditary enzyme defects. The authors report on 61 patients admitted in the last 15 years with rhabodomyolysis. In the past 4 1/2 years the diagnosis was suggested by CK greater than 5000U/1 in 49 patients, representing 1.6% of all admissions in the departments of medicine and surgery. Originally described in crush situations, rhabdomyolysis has been observed with increasing frequency as a consequence of muscular stress and self crush due to coma or hemi- and paraplegia during the last decades. 24% of the patients with this diagnosis had had an intoxication, and in 70% there were multiple simultaneous causes. Autoimmune diseases, infections of bacterial, viral and fungal origin, endocrinopathies, and thermic and ischemic injuries can also provoke rhabdomyolysis. As a consequence of fluid shift into the damaged muscle a compartment syndrome may lead to vascular or neural defects. In 80% of cases there is initial hypocalcemia, turning later into hypercalcemia. Other frequent electrolyte disorders accompanying rhabdomyolysis are hyperkalemia, hyperphosphatemia and a widened anion gap. 6 of 13 patients showed the typical blood changes found in patients with disseminated intravascular coagulation. Acute renal failure developed in 30 patients, 15 of whom underwent dialysis or hemofiltration.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1985

Ganglioside patterns in amyotrophic lateral sclerosis brain regions.

In a search for evidence of biochemical disorders in regions of postmortem brain other than the motor cortex in amyotrophic lateral sclerosis (ALS), ganglioside patterns were also examined in the frontal, temporal, and parahippocampal gyrus cortex. In 21 ALS brains studied (20 sporadic, 1 familial), abnormal patterns were found in the frontal cortex (81%), temporal cortex (75%), motor cortex (70%), and parahippocampal gyrus cortex (71%). Patterns were established by measuring the percentage distribution of 12 ganglioside species. Two abnormal patterns were detected. One was based on low proportions of GD1b, GT1b, and GQ1b associated with high proportions of GM2 and GD3 (GM1, GD1a, GD2, and GT1a values were normal). The second abnormality was the appearance of Gx. Neither abnormality was seen in the 13 non-ALS control brains. The first, and predominant, abnormality was found in the frontal cortex in 14 brains, and the second was observed in 13 brains; 10 brains showed both abnormalities. These findings thus constitute evidence that the disease process in ALS extends beyond the motor cortex and involves neurons in several brain areas.

Aged↗
PubMed1985

Influence of N-acetylcysteine on the hexachlorobenzene induced porphyria in rats.

The course of hexachlorobenzene (HCB) induced porphyria was not influenced by the concomitant administration of N-acetylcysteine (NAC) to the animals: urinary excretion of total porphyrins and porphyrin precursors as well as the hepatic aminolevulinate synthase activities were not influenced by NAC treatment. In addition, no differences could be shown between the HCB and the HCB/NAC combination group concerning the hepatic cytochrome P-450 contents or the P-450 dependent enzyme activities.

5-Aminolevulinate Synthetase↗
PubMed1984

[Changes in gastric mucosa, liver and mesenteric vessels following bipolar electrocoagulation].

The implications of bipolar electrocoagulation with a modified probe (BICAP) were tested in rat gastric mucosa, liver tissue and mesenteric vessels. This was done during the coagulation and at different intervals, up to 14 days later, by intravital microscopy of the exposed organs. A histological treatment of the respective tissues ensued at the closing of each experiment. Applying a current of 25 watt and contact times lasting for 5 secs and longer, perfect tissue necrosis develops which has clean and straight edges. The extensions on the surface and into the depth of gastric mucosa match precisely the contact area with the instrument. In the deeper mucosal layers there is a fungiform spread of necrosis while in the liver it remains uniform and shows the same diameter as on the surface. As a late result and notwithstanding the confinement of the coagulation to the mucous membrane, a local peritonitis may develop. Within contractile vessels the action of bipolar coagulation stops the blood flow which is only irreversible, when the current and contact times are extended to bring about necrosis in neighbouring tissue. Within the microcirculation of the liver the blood flow is preserved up to the very boundary of the necrosis.

Animals↗
PubMed1978

[Investigation of inflammatory paranasal sinus diseases with scintigraphy (author's transl)].

In the course of inflammatory diseases affecting the paranasal sinuses, a number of complications may occur. One of those is the involvement of neighbouring skeletal portions. By this study evidence is given, that there is a high rate of inflammation, spreading to adjoining bone areas. This applis also to early stages and first manifestations. Especially in cases of surgery, complete recovery is rare. The pattern of chronic recurrent osteomyelitis may develop.

Adult↗
PubMed1977

[The bronchial alveolar carcinoma as a solitary coin lesion].

Bronchiolo-alveolar carcinoma is a well-differentiated adenocarcinoma which starts as a peripheral solitary nodule and gradually spreads via the bronchi to give rise to a disseminated, diffusely infiltrative tumor. A series of 17 cases presenting with solitary nodules is reported. A long interval before operation did not adversely affect prognosis, provided the nodule remained relatively small and there were no lymph node metastases. Radical cure by resection was possible only with solitary nodules, but not with multinodular or infiltrative tumors. Prognosis was worse if lymph nodes were involved but not if there was intrapulmonary lymphatic invasion without spread to lymph nodes. Large solitary nodules shortened survival, especially if the radiographic diameter was greater than 5 cm. On the other hand, in four cases where evaluation was possible, the rate of growth had no effect on prognosis. Patients with positive cytology had shorter life expectancy since the tumor had already spread to the bronchi. Unexpectedly, cellular signs of malignancy had no influence on prognosis. Invasion of blood vessels, however, was a poor prognostic sign and was not observed in early cases or in patients with prolonged survival.

Adenocarcinoma↗
PubMed1977

[The spontaneous, non-traumatic chylothorax. Therapy by means of pleurectomy and decortication].

Two cases of chronic spontaneus chylothorax were successfully treated by small thoracotomy with parietal pleurectomy or decortication after unsuccessful needle aspiration and intercostal tube drainage with suction. In the one case the chylous effusion occurred spontaneously 29 years after extrapleural pneumothorax. The tuberculosis was long cured. In the other, apparently idiopathic case, the chylothorax on the left side disappeared completely after pleurectomy. Six months later a chylous effusion appeared on the right side. Mediastinoscopy then revealed an oatcell carcinoma in lymph nodes without a primary pulmonary tumor. One year after radiotherapy the patient died in heart failure. No primary tumor was found. Residual chylothorax was present only on the right side.

Aged↗
PubMed1976

[Effects of short time extreme hemodilution with and without hypothermia on hemodynamic and biochemical parameters in the pig (author's transl)].

Extreme hemodilution as "Total Body Washout" (TBW) is a feasible method for the clinical therapy of endo- or exogenous intoxication. This method was modified for a simple and quick setup. Landrace pigs were hemodiluted with a special heart-lung-machine. Within 4 minutes the hematocrit was lowered to less than 1%. The rectal temperature fell hereby in a normothermic group (n = 15) to 35, 1 +/- 1, 1 degrees C and in a hypothermic one (n = 13) to 31,1 +/- 1,3 degrees C. The TBW was followed by a total exchange transfusion. Most of the parameters that were studied did not show significant differences between cold and warm perfusion. The proceeding was well tolerated by the animals, they were observed up to 6 weeks. Disadvantages of initial surface cooling may be avoided by extreme hemodilution with exclusive extracorporal cooling, when cardiac arrest in hypothermia is intended.

Animals↗