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Biomedical subjects

W Seeling

Publications and source records attributed to W Seeling.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Unexpected intravenous penetration of an epidural catheter].

The tip of an epidural catheter inserted by the lumbar route, penetrated into the inner vertebral venous plexus. After the position of the catheter tip had been corrected, blood neither returned spontaneously nor could any be aspirated, suggesting that it was in the correct position. A low dose (3.5 ml) of 0.75% bupivacaine was given as a test injection whereupon no signs of a systemic reaction were observed. When the entire initial dose of 10 ml was given, the patient developed tonic clonic seizures. The fit could be controlled by giving oxygen and thiobarbital. The patient was given succinylcholine and then intubated and ventilated. As no signs of cardiac depression were noted, the operation (open mobilisation of a joint) was performed under general anaesthesia. The patient recovered normally. If the position of an epidural catheter which has penetrated an epidural vein has been corrected, this does not ensure that the tip has been removed from the vein, even if blood cannot be aspirated. This incorrect position can be detected by injection of a small volume of epinephrine-containing local anaesthetic, but this procedure cannot be recommended in cases of coronary insufficiency. The anaesthesist is best advised to remove the catheter completely and place a fresh epidural at a different level.

Adult↗
PubMed1983

[The stress reaction in knee operations under continuous peridural anesthesia in comparison with neuroleptanalgesia].

30 patients undergoing knee-operations were randomized in two groups. 15 patients were operated on under neuroleptanalgesia. Piritramid was given postoperatively. The other group of patients was operated under epidural analgesia, postoperatively they were kept painfree by continuous infusion of 0.2% bupivacaine via an epidural catheter at a rate of 0.2 ml/kg.h over a period of 24 h. The aim of our study was to find out if continuous epidural anaesthesia in contrast to neurolept analgesia was able to prevent the hormoneal and metabolic response to these painful operations. Plasma glucose, insulin, C-peptidee, glucagon, cortisol, human growth hormon, and beta-hydroxybutyric acid were measured before commencing anaesthesia (point 0), after induction (point N), at the end of operation (point Op) and 1, 2, 4, 6, 12 and 24 h postoperatively (point 1, 2, 4, 6, 12 and 24). In both groups of patients an intravenous glucose tolerance test was carried out after 24 h. There were significant differences between the two groups in plasma glucose, insulin, C-peptid and cortisol, indicating that the stress response can be mitigated by continuous epidural anaesthesia. These differences however were only found in the first few postoperative hours. After a period of 24 h there were no differences at all, the metabolic alterations as indicated by the pathological glucose tolerance test, were the same in both groups, independent of the anaesthetic method used.

3-Hydroxybutyric Acid↗
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↗
PubMed1981

[Comparative studies on perioperative infusion therapy in infants].

Four different infusion solutions, consisting of various amounts of sodium, potassium, chloride, phosphate and carbohydrates, were administered to infants from ten days to six months of age. The effects of these infusions on different parameters in the blood serum and on the urinary excretion were measured. It could be demonstrated that even major variations of electrolyte administration could be compensated by the infants' renal function resulting in almost constant serum parameters and adequate water balances. The administration of sodium and chloride ranged from 5-7 mmol/kg per day or from 4.44-7.55 mmol/kg per day respectively, the substitution of potassium varied between 0.25 an 2.4 mmol/kg per day and the substitution of phosphate between 0 and 0.7 mmol/kg per day. Variations of any clinical importance could only be detected for serum phosphate concentrations if phosphate-free infusion solutions had been administered. The postoperative blood glucose concentrations did not show any alterations which could be related to the glucose or glucose-xylitol contents of the infusion solutions. Following these results and according to previously reported studies in children recommendations for the sodium, potassium, chloride, phosphate and carbohydrate contents of the infusion solutions can be made as well as suggestions for the perioperative dosage of these solutions in infants and children.

Blood Glucose↗
PubMed1979

[Comparative studies on perioperative infusion therapy in children].

Various infusion solutions--containing different amounts of sodium, potassium, chloride and carbohydrates--were compared within two groups of infants and children from six months to fourteen years of age. Among various parameters particularly blood electrolytes and urinary electrolytes were taken as important parameters to recommend certain types of the basic infusion solutions, to be used for the perioperative period in pediatric surgical cases.

Adolescent↗
PubMed1978

[Changes of serum-zinc in breast cancer (author's transl)].

Serum-zinc-levels were evaluated in patients with breast cancer in relation to the various stages. Patients with metastatic breast cancer had significantly depressed zinc-levels, wereas patients with disease apparently localized to the breast and draining lymphnodes had nearly normal serumzinc levels. It appears that the determination of serumzinc in breast cancer patients may be of value in discriminating between localized and metastatic disease.

Breast Neoplasms↗
PubMed1976

[Conditions for the efficacy of nutritional therapy].

This is to discuss regulatory mechanisms which enable the organism to respond optimally to special nutritive conditions. Those regulatory mechanisms are often in disorder with patients who need nutritive therapy. However, normal functions of the body are required for nutrition. Disarrangements in microcirculation, oxygen supply, water and electrolyte metabolism and acid-base metabolism are described and the way they will influence nutrition therapy. Furthermore, we try to describe special conditions of metabolism in stress and its influence to efficiency of nutritive therapy.

Acid-Base Equilibrium↗
PubMed1975

[Significance of trace elements within the scope of parenteral feeding as illustrated on the example of the elements copper, zinc and chromium].

Biochemical function and biological significance of Cu, Zn and Cr are reviewed briefly. During a longterm perenteral nutrition a depletion of the organism of copper and zinc is to be expected. Therefore, in parenteral nutrition, an early substitution of zinc seems to be usefull. Up to now a similar recommendation for copper cannot be given. As many infusion solutions are contaminated with chromium, there is no need to substitute this element in parenteral nutrition.

Chemical Phenomena↗
PubMed1975

[The biological significance of zinc (author's transl)].

Zinc takes part in the catalytic function of many metalloenzymes. In others it plays a role in conformational stability. In zinc deficient animals protein synthesis is disturbed. Conversely zinc metabolism is influenced by protein deficiency. Zinc takes part in drug metabolism, in mobilizing vitamin A from the liver, and in a system defending the organism against free radical damage. Zinc distribution in the organism is influenced by steroid hormones and leucocytic endogenous mediators. Of the intracellular zinc only a small part is bound to metalloenzymes, most being coordinated to binding sites of nonspecific proteins. Thus the organism defends itself against conformational changes of irritable enzymes which may bind excess zinc to side chains. Zinc can protect the organism against cadmium toxicity. In the serum the smaller part of zinc is firmly bound to several specific proteins, the majority being loosely bound to albumin. Some aspects of human zinc metabolism in health and disease are reviewed. Zinc deficiency in man is rare. In Iran and Egypt a syndrome of iron and zinc deficiency associated with anaemia, hepatosplenomegaly, dwarfism, and hypogonadism is known. In wound healing and tissue repair substitution of zinc is beneficial only if a zinc deficiency exists. For purposes of long term parenteral nutrition zinc should be added to the different infusion solutions.

Animals↗
PubMed1975

[Studies on the behavior of chromium in serum and urine in polytraumatized patients as well as on the chromium concentration of various infusion solutions].

Determinations of the oligoelement chromium were carried out by flameless atomic absorption spectroscopy in serum, whole blood, and urine of patients, undergoing intensive care, as well as in a great part of the solutions used for parenteral nutrition. With rising amino acid and protein content, respectively, the chromium content of the infusion solutions increased due to contamination. Pure nonglucose-carbohydrate-electrolyte solutions contained 16.5-49.0 mug chromium/litre, amino acid-carbohydrate solutions 36.5-105.0 mug chromium/litre and human albumin solutions, depending on concentration, 86.9-394.2 mug chromium/litre. The average chromium concentration in the patients' serum was 11.3 +/- 0.26 mug/litre, which is twenty times more than the normal values determined by this method, and increased from 8.3 to 16.4 mug/litre within the first seven days. The urinary chromium concentrations were 37.7 +/- 4.1 mug/litre, being three times higher than the average serum values, but remained constant from day to day. The approximate chromium administration by parenteral infusion therapy was 160-250 mug chromium/day, the urinary chromium excretion was 111 +/- 20.5 mug/day. Consequently, great amounts of parenterally supplied chromium seem to be stored in the patients' tissues. Effects and risks for the organism caused by these unphysiological chromium concentrations are discussed.

Accidents, Traffic↗