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Biomedical subjects

W T Ulmer

Publications and source records attributed to W T Ulmer.

At least 19 recordsLinked to original sources

[Obstructive respiratory tract diseases--new standards in therapy].

AIMS: Presentation of modern-day therapeutic procedures in various stages of obstructive airway diseases. MAIN TOPICS: Subacute bronchitis and hypersensitivity of the bronchial system are early symptoms of obstructive diseases of the airways. Highly effective prophylactic treatment includes adrenocortical hormones (ACH) (corticosteroid) inhalation and antibiotics used individually or in combination for a variety of indications, are now available. In cases of manifest airway obstruction (Stage B), bronchodilators are additionally required. Of those presently available, the beta 2 sympathicomimetics head the list. For anticholinergics and theophylline there are additional indications. If the resulting response is unsatisfactory, oral ACH must be employed in addition to ACH inhalation and bronchodilators. Cromoglycate administered for a period of four to six weeks should always be tried. In the stage of severe exacerbation (C), intravenous water-soluble ACH in combination with antibiotics, are necessary. The entire spectrum of bronchodilators should also be utilized. Functional analysis during treatment prevents under- or overtreatment. CONCLUSIONS: In particular in the early stages, the aim of treatment of obstructive airway diseases is prophylactic.

Administration, Inhalation

[Chronic obstructive bronchitis. Effect of Gelomyrtol forte in a placebo-controlled double-blind study].

In a double-blind study involving two groups of ten patients with chronic obstructive bronchitis, the expectorant Gelomyrtol forte was tested against placebo for its effectiveness and tolerance. The parameters: amount of sputum, Rt and IGV, together with all the usual clinical laboratory parameters, were determined. In addition, the color of the sputum was always noted. On the basis of patient scores, daily entries on the ability to expectorate, attacks of coughing, general coughing, and shortness of breath were made by the patients for the duration of the 14-day treatment period. On conclusion of the study, the patients were asked to assess the effectiveness of the supplementary medication, and the care-providing physician also assessed effectiveness. All score parameters related to coughing improved, in some cases appreciably, relative to the placebo group. The findings in term of sputum volume and color, were also distinctly better in the Gelomyrtol forte group. Correspondingly, both patients and physicians assessed the effectiveness of Gelomyrtol forte to be distinctly better than that of the placebo. Although the groups are relatively too small and heterogeneous, to establish statistically significant differences, the results do strongly suggest a favorable and major effect in patients with relevant cough symptoms. Both subjective and objective tolerance was excellent.

Cough

Characterization of allergenic components of rye and wheat flour (Secale, Triticum vulgaris) by western blot with sera of bakers: their effects on CD23 expression.

The allergenic components of water-soluble rye flour extract were studied by immunoblotting. Sera from 100 bakers were analyzed for their IgG, IgG4 and IgE binding pattern. Two allergens with molecular weights of 35 and 14 kD were detected. Previously, the major allergens of wheat flour extract were identified. The wheat flour components at a MW of 15/17 kD and the rye flour component at a MW of 14 kD were purified and isolated. The modulation of the low affinity receptor for IgE (Fc epsilon RII/CD23) on monocytes by separated allergenic components was studied. Depending on the allergen concentration the CD23 expression on isolated cells increased after stimulation with the rye flour component (MW 14 kD). The combined addition of the rye flour component (14 kD) with IL-4 induced a significant CD23 expression as compared to IL-4 alone.

Allergens

[Cough].

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Bronchitis

[Cough].

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Bronchi

[The inhalation 1 concentration test for the assessment of bronchial reactivity].

An unspecific bronchial provocation challenge with a 1-concentration test is a reliable method to distinguish between normal and hyperreactive persons. The patient inhales a bronchoconstricting substance such as methacholine. A significant change of lung function, for example an increase of airway resistance, characterizes a hyperreactive bronchial system. The continuous registration of transcutaneous oxygen pressure is helpful concerning a strong reaction or a peripheral airway obstruction. An exaggerated increase of airway resistance after provocation test can be treated rapidly by inhalation of sympathicomimetics. No complications were registered. Comparative studies showed a good reproducibility of this method. Summarizing, the 1-concentration test is simple, easy to perform and suitable especially for investigations in occupational medicine or epidemiology.

Airway Resistance

[Diagnostic parameters for the evaluation of work capacity: the bronchopulmonary system].

The bronchial pulmonary system can be effected by obstructive diseases with and without emphysema. The onset of these affections may be an airway allergy. In case of other mechanisms, fibrotic processes can be observed accompanied by a lung compliance decrease. Lung circulation itself is rarely affected by the development of Cor pulmonale in a state after pulmonary embolism and after the so-called primary pulmonary high pressure. These disorders can be diagnosed properly without or scarcely straining the patient by spirometry which requires the patient's cooperation, however, and by body plethysmography which does not depend on cooperation, lung compliance measurements, arterial blood gases and inhalative provocation tests. If applied by experience staff, these reliable basic methods supply qualitative and quantitative information for the assessment of working capability that scarcely can be obtained on another organ.

Bronchial Provocation Tests

[Obstructive airway diseases--emphysema. Diagnosis and therapy].

Spirometric examinations are suitable for the diagnosis of airway obstruction, but not of pulmonary emphysema. Whole body plethysmography, in contrast, is the most reliable diagnostic procedure for both conditions, both qualitatively and quantitatively. The basic treatment of any form of airway obstruction consists in the inhalation of beta-2-sympathomimetic drugs; theophyllines are also good bronchodilators, but are less powerful than beta-2-sympathomimetics. Glucocorticoids must always be given when bronchitis also presents, which is only rarely treatable with antibiotics alone. Although regression of pulmonary emphysema is not possible, progression of the destructive process would appear to be inhibited by intensive treatment of the inflammatory bronchitis. Only in the case of patients with congenital alpha-1-antitrypsin deficiency is it possible to administer such causal treatment in the form of substitution therapy. Surgical treatment can be considered only in the case of bullous pulmonary emphysema.

Airway Obstruction

[Inhalation therapy with selective beta 2-sympathomimetic drugs. Effect of pirbuterol administered via the Autohaler and salbutamol administered via the Diskhaler in obstructive respiratory tract disease].

The therapeutic success of salbutamol inhalation with the powder inhalator (Diskhaler) and of pirbuterol with an inhalation-triggered metered aerosol (Autohaler) was determined by comparing the degrees of bronchodilation in 13 patients suffering from chronic obstructive airways disease. Rt and IGV were determined by whole-body plethysmography and FEV1, peak flow and MEF50 by spirometry, and pulse rates were also measured. On average, Rt values decreased by 40 per cent; the other lung function parameters responded correspondingly. Duration of action extended to 4 hours after dosage. Pulse rates and lung functions measured after administration of the products did not differ, either. In such studies as this, whole-body plethysmographic results are superior to those obtained by spirometry.

Adult