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Biomedical subjects

W Dick

Publications and source records attributed to W Dick.

At least 253 records · Page 14Linked to original sources
PubMed1982

[Treatment of glycogenosis type III with total parenteral nutrition, continuous intragastric infusion and D-thyroxine].

A 4-year-old patient with glycogenosis type III suffered from hypoglycemic attacks during the night and from an enormous hepatomegaly. The latter was the cause of a life-threatening respiratory insufficiency. Shrinkage of the liver size was an urgent necessity. The beneficial influences of total parenteral nutrition, continuous intragastric infusion during the night, and of D-tyhroxin are described.

Blood Glucose↗
PubMed1982

[Delayed use of PEEP for respiratory resuscitation following standardized near-drowning with fresh and saltwater].

Investigations on the delayed use of PEEP following a standardized form of near drowning with 12.5 ml/kg body weight of either fresh or salt water were carried out on 14 anaesthetized and ventilated young pigs. After a 3 min period of apnoea the animals were ventilated with 100% oxygen and with either the same or an increased tidal volume, and a PEEP of 5 cm H2O delayed to 20 min, over a period of 2 h. In both fresh and salt water, initial values of paO2 and AaDO2 were regained by the end of the period of observation when a delayed PEEP was applied. The intrapulmonary right to left shunt, which increased to 40% of the cardiac output, fell by a half within 10 min of beginning PEEP ventilation, initial values being regained at 120 min. During the period of apnoea the arterial partial pressure of carbon dioxide almost doubled, and, when the tidal volume remained unaltered, was still some 20-30% above initial values at the end of 2 h despite the use of PEEP. Normal paCO2 levels were achieved on increasing the tidal volume by a factor of 1.4. The larger tidal volume had no influence on either the degree of shunt or the paO2. The effective compliance, which was considerably reduced after near drowning, increased again with the use of delayed PEEP ventilation. On beginning respiratory resuscitation there was an initial tachycardia and, despite a fall in stroke volume, an increase in mean arterial pressure and cardiac output because of the previous hypoxia. Only minimal cardio circulatory changes, and no change in oxygen availability, occurred secondary to the use of PEEP.

Animals↗
PubMed1982

[Studies on the effectiveness of obstetric epidural analgesia. I. Vaginal delivery (author's transl)].

In a retrospective study 1,000 women who in 1979 had undergone a delivery either under epidural-anaesthesia or without, and instead either relation training or pethidine in small doses (20-30 mg i.v.) at the Ulm Department of Obstetrics, were followed up by questionnaire. The women of the epidural group felt that they had been adequately informed about the various possibilities of pain relief during labour, while some of the control group felt that they had been inadequately or even incorrectly informed. In the epidural group, pain relief during labour was such that 90% had hardly experienced any, or only mild discomfort, similar degree of pain relief was described by a many as 68.7% of the control group. Especially in the case of primigravida, the women of the epidural group had an insufficient urge to bear down, hence the rate of forceps delivery was relatively high, whereas this problem did not arise in the control group, where the forceps rate was markedly lower. The incidence of headache and back pain was only slightly higher in the epidural as compared to the control group, where other complaints were more frequent. 82% of the epidural group said that they would again choose this form of analgesia for future deliveries, 15% would not. In the control group 22% said that they would like an epidural for future deliveries, while 21% would not. The Apgar scoring and pH values of the newborn showed no significant differences between the groups.

Anesthesia, Epidural↗
PubMed1982

[Comparative studies in the use of adult circle systems for the operative ventilation of children of all ages (author's transl)].

A modified adult circle system with Latexspiral tubing of 110 cm total length and internal diameter 10.5 mm, and a "Y" piece with a small dead space was investigated in vitro, in animal experiments and then in the clinic with respect to its usefulness in paediatric anaesthetics. The Kuhn- and Paedi-systems were taken as comparisons. The in-vitro experiments using a lung model that we have developed showed that rebreathing could be excluded with this circle-system. Clinical experiments on young piglets of weight between 4.5 and 5.0 kg with arterial blood gas estimations during spontaneous respiration, assisted and controlled ventilation, were carried out in order to compare these three systems. Every animal was subjected to all three types of system, and hence served as its own control. No impairment of ventilation was found during use of the circle-system. Clinical studies on intubated babies of bodyweight between 4.3 and 8.9 kg who were breathing spontaneously during light general anaesthesia showed no alterations in either the continuously measured transcutaneous pO2 or in the capillary blood gas values taken at the end of each period of observation. Findings which were independent of the sequence in which the systems were applied. As above, each child served as its own control. These studies show that simply by changing the tubing and "Y"-piece of an adult circle system, it becomes suitable for children of all ages.

Anesthesiology↗
PubMed1982

[Serum bupivacaine concentrations in patients with continuous peridural anesthesia administered by thoracic catheter].

Continuous infusion of a 0.2% solution of bupivacaine via a peridural catheter in a rate of 0.2 ml/kg x h is sufficient to make a patient pain-free for any time required following upper abdominal or abdomino-thoracic surgery. The zone of analgesia extends segmentally from T4 to T12/L1 so that the patient can be mobilized. If necessary an insufficient blockade can be completed by bolus injection of 10 to 15 ml of 0.2% solution. Using this technique over a period of four days after surgery, serum concentrations of bupivacaine were measured in 20 patients. The following values were found (median, range): at the end of the operation 0.85, 0.26-1.72 mg/1, after 24 h 1.70, 0.58-4.04 mg/1, after 48 h 3.46, 1.22-7.62 mg/1, after 72 h 2.80, 0.73-12.15 mg/1 and after 96 h (end of the investigation) 2.39, 0.34-9.92 mg/1. Moderate excitation was sometimes observed, while the patient was in the recovery room (shivering, restlessness) but disappeared completely within 10 h. Later on no signs of intoxication were observed, even when serum bupivacaine concentrations exceeded 6 mg/1. During continuous epidural anaesthesia, when serum bupivacaine concentrations increase gradually this level does not seem to be toxic. We consider this method to be suitable for keeping a patient pain-free following upper abdominal surgery, provided that adequate monitoring is available.

Abdomen↗
PubMed1982

Complement, coagulation and fibrinolytic parameters in hereditary angioedema (HAE).

The intrinsic clotting, the kinin generating and the fibrinolytic systems were investigated in 10 patients with hereditary angioedema (HAE), 10 patients with chronic urticaria and 18 healthy volunteers. In spite of the fact that patients suffering from HAE severely lack C1 INH, neither the intrinsic coagulation nor the fibrinolytic systems are impaired. There was a slight decrease of plasma kallikrein--as already known--and moreover a greater decrease in HMW-kininogen, and increase in Factor XII levels. Furthermore, activation of pre-kallikrein was delayed in these patients. These findings make it apparent that lowered HMW-kininogen levels compensate the lack of C1 INH, thus preventing an enhanced activation of the intrinsic clotting and the fibrinolytic systems.

Angioedema↗
PubMed1982

[Effectiveness of obstetric epidural analgesia. II. Caesarean section].

A questionnaire was sent to 260 women who in 1979 had undergone a caesarean section under either epidural or general anaesthesia. Those women who had an epidural for their caesarean section were on average very well informed about the procedure. In contrast, those who had been given a general anaesthetic felt that they had been badly or inadequately informed. Over 90% of the patients of both the epidural and the general anaesthetic groups described the type of anaesthesia which they had received as "very good" to "adequate". In the epidural group, 80% of the patients described the experience of the birth as very intense. Headache, back pain and other complaints such as abdominal pain and wound pain were significantly more frequent in the general anaesthetic as compared to the epidural group. 85.8% of the women given an epidural said that they would choose the same again for a future caesarean, 12.1% would not. Of the group given a general anaesthetic, 29.9% said that in the future they would choose an epidural, and 62.3% that they would prefer to have a general anaesthetic again. The Apgar score at one minute, and the umbilical artery pH values of the newborn of the epidural group were significantly better than those of the general anaesthetic group, whereas at 5 and 10 min the Apgar scores of the babies of both groups showed no differences.

Anesthesia, Epidural↗
PubMed1981

[Serum lysozyme activity of serum and umbilical cord blood in newborn babies-diagnostic value of the enzyme in infants with susceptibility to infections and in cases of septicemia. (author's transl)].

Lysozyme levels were determined in serum and umbilical cord blood of 352 newborns and prematures. Levels in premature babies were found to be significantly lower than those of matures at the first day of life. A correlation was seen between the serum lysozyme and the birth weight of 219 mature newborns. In 14 premature babies with clinical signs of sepsis the concentrations of serum lysozyme were particularly decreased in cases of septicemia caused by gram-negative organisms. Serum levels of lysozyme in cord blood were significantly lower in 38 newborns with predisposition to septicemia (above all premature rupture of membranes greater than 24 hr.) comparing with healthy infants. The decreased serum levels of lysozyme in newborns with septicemia and the remarkable susceptibility of infections in male newborns are discussed.

Birth Weight↗
PubMed1981

[Practical-clinical aspects in primary clearing of the upper respiratory tract in newborn (author's transl)].

There are contradictory descriptions in the literature about the methods as well as the sequence of clearing the upper respiratory tract of new-born babies. In order to clarify this problem anatomical, physiological and pathophysiological aspects of the fetal and neonatal respiratory system are described. Intrauterine asphyxia can lead to aspiration of amniotic fluid (containing meconium, squamous epithelium, lanugo hair). During delivery the fetal airway is cleared by compression of the thorax. Through suction of the mouth, throat and nose--in exactly this defined sequence--before birth of the thorax, aspiration of potentially damaging material can be prevented. The particular problem associated with meconium-steined amniotic fluid is described.

Amniotic Fluid↗
PubMed1981

A chromogenic assay for evaluation of alpha 2-macroglobulin level in serum and cerebrospinal fluid.

A photometric assay using the chromogenic substrate carbobenzoxy-valyl-glycyl-arginine-p-nitroanilide acetate (CHROMOZYM TRY) for the determination of alpha 2-macroglobulin which binds trypsin as a trypsin-protein complex, thus preserving its amidolytic activity, even in the presence of aprotinin, has been studied in serum as well as in cerebrospinal fluid (CSF). Normal range in sera was found to be mean = 10.2 +/- 3.3 kU/l (male), mean = 10.9 +/- 3.2 kU/l (female), and mean = 11.9 +/- 5.0 U/l in CSF. Within-run precision in sera was ascertained to be C.V. = 2.06%, and in CSF C.V. = 2.15%, respectively. There was a good correlation with immunochemical methods: r = 0.974 in 60 sera (p less than 0.001) and r = 0.976 in 16 pathological samples of CSF (p less than 0.001).

Chromogenic Compounds↗
PubMed1981

Factor XII assay with the chromogenic substrate chromozym PK.

A chromogenic assay for the determination of factor XII using the chromogenic substrate Chromozym PK was evaluated. The assay was linear in the range 10 U/l to more than 200 U/l. Using the assay, the normal range of factor XII (50 healthy volunteers at random) was 136 U/l +/- 27 U/l. Kallikrein-inhibiting concentrations of aprotinin did not influence factor XII. Comparison of the chromogenic with the clotting assay resulted in a correlation coefficient of r = 0.831 (p-value less than 0.001). In patients with deep vein thrombosis, factor XII level was found to be reduced to about 60% of normal activity.

Adult↗