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Biomedical subjects

W Pankow

Publications and source records attributed to W Pankow.

At least 37 records · Page 2Linked to original sources
PubMed1995

Determinants of circadian blood pressure rhythm and blood pressure variability in obstructive sleep apnoea.

The prevalence of hypertension in patients with obstructive sleep apnoea (OSA) is high and blood pressure profile is characterized by nocturnal blood pressure (BP) elevation and increased nocturnal BP variability. Ambulatory 24-hour-blood pressure monitoring (ABPM) is a valid, non-invasive method to describe circadian BP variation. Circadian BP profile and nocturnal BP variability were related to OSA severity (apnoea-hypopnoea index, mean low O2), age and body mass index (BMI) in 73 patients with OSA. Prevalence of hypertension was 75%, and in 59% BMI was greater than 30 kg m-2. A nocturnal decline of at least 10% from daytime mean BP values (night/day BP ratio <0.9; dipper) was found in only 25% of hypertensive patients and 39% of normotensive patients. Comparison between dippers and non-dippers showed significant differences in apnoea severity (apnoea-hypopnoea index 32 + 19 vs. 50 + 23/h, P < 0.01; mean low O2 84.5 + 4 vs. 80.2 + 5.8%, P < 0.01) but not for age and BMI. In multiple regression analyses with age, body mass index, apnoea-hypopnoea index and mean low O2 as independent and BP ratios and BP variability as dependent variables, sleep apnoea severity was the only independent predictor for circadian BP rhythm and nocturnal BP variability. The results presented here suggest that independent of age and obesity the severity of sleep apnoea is an important determinant of circadian BP variation and nocturnal BP variability.

Journal Article↗
PubMed1995

Influence of obstructive sleep apnoea on circadian blood pressure profile.

A high prevalence of systemic hypertension in obstructive sleep apnoea (OSA) has been described but data on circadian blood pressure (BP) profile are limited and give inconsistent results. The present study examines 24-h BP in 106 patients referred because of loud snoring or excessive daytime sleepiness in combination with snoring. Patients were classified as OSA (n = 62) or habitual snorers (HS) (n = 44). Respiratory disturbance index (RDI) in OSA was 47 + 24 vs. 2 +/- 2 in HS. Mean age and body mass index in OSA was significantly higher. BP was measured non-invasively at 15-min intervals during a 24-h period. Daytime and night-time BP was higher in OSA compared to HS. BP night/day ratio in OSA was 0.92 +/- 0.07 vs. 0.86 + 0.06 in HS (P < 0.05). To investigate the influence of variables other than breathing abnormalities during sleep on our results we compared BP profiles of 25 OSA and 25 HS matched for sex, age and body weight. Again differences in daytime and night-time BP and BP night/day ratio were significant. Using a value of at least 10% fall in nocturnal BP to describe a regular BP profile (dipper) 68% of OSA were classified as non-dippers vs. 24% of HS. Influence of short-term (2-4 days) nCPAP therapy on circadian BP profile was investigated in 34 patients with OSA. Systolic and diastolic nocturnal (but not daytime) BP was significantly reduced. The percentage of non-dippers was 79% before and 50% after treatment. In conclusion results of this study indicate a causal link between OSA and abnormal circadian BP profile.

Journal Article↗
PubMed1995

Human alveolar macrophages: comparison of cell size, autofluorescence, and HLA-DR antigen expression in smokers and nonsmokers.

To investigate the influence of cigarette smoking on alveolar macrophages (AM) we compared morphologic and immunocytochemic characteristics of bronchoalveolar lavage cells collected from 10 smokers and 8 nonsmokers. AM were studied using single cell fluorescence photometry. AM of smokers were larger in size (p < 0.001), showed stronger autofluorescence (p < 0.001), and expressed fewer HLA-DR antigens (p < 0.001) compared with AM of nonsmokers. AM of smokers were more heterogeneous in respect to cell size, autofluorescence, and HLA-DR antigen expression. HLA-DR antigen density on AM of smokers was independent of cell size and autofluorescence. This suggests that tobacco smoke reduces HLA-DR antigen expression in AM of different maturational states and that this defective expression of HLA class II antigens is not dependent on the amount of phagocytosed autofluorescent tobacco particles.

Aged↗
PubMed1992

[Osteoporotic vertebral fractures in systemic mastocytosis without skin involvement].

Radiological investigation of the vertebral column in two patients with low-back pain (53-year-old woman and a 52-year-old man) revealed unusually marked osteoporosis and sintering fractures of the 3rd, and 1st and 4th lumbar vertebrae, respectively. Biochemical tests failed to provide any evidence about metabolic or endocrinological abnormality. Iliac crest biopsy showed mastocytosis. There were no skin changes in either patient. Additional examinations excluded involvement of any internal organs. Despite treatment with calcium, sodium fluoride, vitamin D3 and calcitonin in the woman, and aspirin and chromoglycinic acid in the man the osteoporosis has slowly progressed during the last 7 and 5 years, but the disease has remained limited to the skeletal system. In a case of unusually marked osteoporosis, mastocytosis should be included in the differential diagnosis even in the absence of urticaria pigmentosa.

Aspirin↗
PubMed1991

Reduction in HLA-DR antigen density on alveolar macrophages of smokers.

The expression of HLA class II genes is essential to the antigen-presenting function of monocytes and macrophages. With a new cytofluorometric method of single-cell analysis we investigated the density of HLA-DR antigen expression on alveolar macrophages (AM) of smokers. Although all AM of nonsmokers (100 +/- 1%) expressed HLA-DR antigens, only 79 +/- 12% of AM from smokers showed positive findings (p less than 0.001). Furthermore, the antigen density of those cells expressing this antigen was significantly reduced in smokers (p less than 0.001). The defective expression of class II genes on AM of smokers might contribute to the impaired antigen-presenting function found by some previous investigators.

Antibodies, Monoclonal↗
PubMed1991

[Which factors promote chronic alveolar hypoventilation in patients with obstructive sleep apnea?].

The pathogenesis of obesity hypoventilation is incompletely understood. We investigated 505 patients with sleep apnoea in respect of determinants that correlate with chronic hypercapnia. 14 patients (2.8 per cent) exhibited daytime hypercapnia (PCO2 greater than or equal to 45 mmHg). Compared with the entire group of patients, these patients showed heavier overweight (p less than 0.001) and their nightly respiratory dysregulation defined by the apnoea index was more severe (p less than 0.001). If these patients were compared with 14 normocapnic controls matched for apnoea index, weight and age, there was no difference in respect of lung function data. We conclude that overweight and the severity of sleep apnoea are determinants that predispose to chronic alveolar hypoventilation.

Adult↗
PubMed1990

A cytofluorometric method to quantify membrane antigens on individual alveolar macrophages.

An immunofluorescence method for assaying membrane-bound antigens on individual alveolar macrophages (AM) collected by bronchoalveolar lavage (BAL) is described. Cells were labelled with FITC-conjugated anti-HLA-DR antibodies in a single (direct) step. Quantification of the fluorescence was performed by computer-assisted cytophotometry. Alveolar macrophages, especially when obtained from cigarette smokers, exhibited an autofluorescence which interfered with the measurement of specific fluorescence. The specific fluorescence was calculated by determination of total fluorescence in the wave-length optimal for FITC and the non-specific fluorescence in a different wavelength during a second measurement. Specificity and reproducibility testing confirmed the reliability of the method.

Analysis of Variance↗
PubMed1990

[Single cell fluorescence photometry for quantification of antigens on alveolar macrophages].

The quantitation of cell surface antigens on alveolar macrophages (AM) using flow-cytometry is complicated by strong autofluorescence and wide variation of cell- size and autofluorescence. Therefore a microscope-fluorometric method was developed which allows simultaneous assessment of fluorescence of fluorochrome-labelled monoclonal antibodies and size in individual cells. Autofluorescence of smokers AM was found to be variable and considerably stronger than autofluorescence of nonsmokers AM. By means of a multi step determination of autofluorescence and specific fluorescence using different filter combinations of the microscope fluorometer density of membrane bound HLADR-antigens could be efficiently determined also in strongly autofluorescent smoker AM.

Antigens, Surface↗
PubMed1990

[Bronchial carcinoma associated with pulmonary osteoarthropathy (Marie-Bamberger)].

Hypertrophic pulmonary osteoarthropathy (HPO) is characterised by clubbed, or drumstick, fingers and a painful periostitis of the extremities, and occurs most frequently as paraneoplastic symptom in association with bronchial carcinoma. Much rarer are inflammatory pulmonary changes such as lung abscesses. Curative treatment of the underlying disease will always also alleviate the pain in the extremities. This article reports on a case of a bronchial carcinoma masked by a pulmonary abscess. Despite the treatment of the abscess the patient developed the typical pattern of signs and symptoms of hypertrophic pulmonary osteoarthropathy for the bronchial carcinoma which was identified only later and which had been masked by the abscess. Persistence of hypertrophic pulmonary osteoarthropathy in case of a successfully treated pulmonary abscess should, therefore, always be regarded as a possible pointer towards an undetected bronchial carcinoma.

Adult↗
PubMed1989

[Persulfate asthma in hairdressers].

At the a two-year apprenticeship, a young female hairdresser developed rhinoconjunctivitis and bronchial asthma, induced by a hair bleach containing the substance persulphate. On each occasion, her symptoms occurred in the form of an immediate reaction. The causative role of the bleach was demonstrated with the aid of an inhalation challenge test. In addition, the prick test produced a positive reaction vis-a-vis persulphate. The long latency period and the positive prick test might militate in favour of an allergic pathomechanism.

Adolescent↗
PubMed1988

M cell in the immune system of the lung.

The M cells of the lung are specialized epithelial cells overlying the luminal bronchus-associated lymphoid tissue. The present state-of-the-art paper, based on a review of recent studies, scrutinizes their morphology and probable tasks. They seem to perform specific functions of transport, permitting antigens to penetrate the barrier of the mucosa and thereby enabling contact with immunocompetent lymphatic cells. Although many particulars have not yet been exhaustively explored, the evidence so far suggests that the M cell may perform an important task in the immune system of the lung.

Bronchi↗