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Biomedical subjects

W T Ulmer

Publications and source records attributed to W T Ulmer.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Pulmo cardialis: effect of inhaled bronchodilators on airway resistance of acute left ventricular dysfunction].

Disturbance of left ventricular function leads to an impairment of ventilation: airway resistance increases, while pulmonary compliance is reduced. We therefore studied the effect of inhalable bronchodilators (Fenoterol, Ipratropium bromide) on oscillatory airway resistance in 16 patients with an acute left heart failure. The results show that the resistance can be significantly reduced to normal values by the bronchodilators. Fenoterol has the greatest spasmolytic potency, but Ipratropium bromide is also effective. Recompensation of left heart function alone does not lead to comparable acute effects on airway resistance. The possibility of immediate improvement of ventilation through the use of inhalable bronchodilators should therefore be considered in the treatment of acute left heart failure.

Airway Resistance↗
PubMed1990

[Prevalence of polyneuropathies in patients with chronic obstructive lung disease].

A multicentric study of 151 COLD patients confirmed the increased prevalence of peripheral polyneuropathies (PNP) in hypoxaemic patients with chronic obstructive lung disease (COLD). 43 (28%) of these 151 COLD patients showed a clinically manifest PNP, whereas in a comparative group of 32 asthmatics there were only 2 clinical PNP cases. Patients with known risk factors for PNP were not included in the study. The polyneuropathy observed in such patients is usually mild, mainly sensorial, distal and leg-accentuated. Of 52 COLD patients with a PaO2 up to 55 Torr, polyneuropathy was seen in 21 (40%), and of 59 COLD patients with a PaO2 above 60 Torr, 10 (17%) had polyneuropathy. In multifactorial genesis (as would be expected), the degree of severity of hypoxaemia (calculated as reduction of the actual PaO2 value below the age-adjusted nominal value), as well as the age of the patient, are statistically significant predictors of clinically manifest PNP.

Aged↗
PubMed1990

[Comparison of the course of oxygen saturation and transcutaneous oxygen pressure in nonspecific inhalative provocation].

In the case of the unspecific inhalative provocative test, a drop in arterial oxygen pressure often occurs, and can be recorded continuously, with the aid of transcutaneous measurements. In 39 patients, the course of oxygen pressure measured transcutaneously (tcpO2) was compared with the continuous measurement of oxygen saturation (SaO2) employing pulse oximetry. A close correlation was found to exist between maximum tcpO2 and maximum SaO2 decrease. The continuous measurement of oxygen saturation is thus also suitable for the monitoring of the course and for assessing an unspecific inhalative provocation; owing to the course of the oxygen-binding curve, however, the changes are only slight. A positive reaction may be suspected when the oxygen saturation decreases at least 3 per cent.

Blood Gas Monitoring, Transcutaneous↗
PubMed1990

[Dependence of bronchial hyperreactivity on the initial value of airway resistance].

In 403 patients, the influence of the initial value of the airway resistance on the incidence and extent of a positive reaction after an unspecific inhalative provocation with methacholine was investigated. The higher the original airway resistance was, the greater was the probability of obtaining a positive reaction. At an original resistance of more than 4 cm H2O/l/sec. all patients responded with an increase in airway resistance to more than 6 cm H2O/l/sec. In 91 per cent of these patients, the Rt figure increased more than 100 per cent. The extent of the increase in airway resistance following a positive response was independent of the initial value; the effect of subsequent spasmolysis following a positive test result, showed no dependence on the airway resistance prior to provocation.

Airway Resistance↗
PubMed1990

[Prognosis in cor pulmonale: predictive value of two-dimensional echocardiography].

Cor pulmonale is a common complication and frequent cause of death in COLD. No published records are as yet available on the prognostic ranking of two-dimensional echo-cardiography in this group of patients. In 79 of 85 (93%) consecutively echocardiographically examined COLD patients it was possible to effect apical imaging of the four-chamber view to assess the size of the right ventricle, as well as a subcostal imaging to analyse the respiratory performance of the vena cava inferior (vci). Among the exclusion criteria of this prospective series were a diseased condition of the left heart or other associated cardiac diseases. The patients were classified into two risk groups (RG 0 and RG 1) depending upon whether they had a normal-sized right ventricle or a complete inspiratory collapse of the vci, or not. In RG 1 the pO2 values were lower (56.8 +/- 9.2 vs 66.0 +/- 8.8 mmHg, p less than 0.0005) whereas the values for the respiratory passage resistance were higher (8.01 +/- 3.92 vs 6.22 +/- 2.87 cm H2O/l/s; p less than 0.025) than with RG 0, the values for the intrathoracic gas volume not being significantly different from each other. Fatal cardiopulmonary results were covered over a period of 2-48 months (median 24 months) to perform life table analyses according to Breslow and Mantel. Patients with an enlarged right ventricle or incomplete respiratory collapse of the vci have a lower survival rate (43.7% respectively 61.9%) than patients with a normal-size right ventricle or complete respiratory collapse of the vci (90.5% respectively 88%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Long term effect on lung function of alpha 1-protease inhibitor substitution therapy in COPD patients with Pi ZZ phenotype.

Eight patients suffering from alpha 1-protease inhibitor (alpha 1-PI) deficiency (Pi ZZ phenotype) and chronic obstructive lung disease received substitution therapy (60 mg.kg-1 weekly) for a period of up to 30 months. Intrathoracic gas volume, airway resistance and arterial oxygen tension were followed once every three months. There was no trend for these indices to deteriorate or improve over the period of observation.

Airway Resistance↗
PubMed1990

[Pulmonary gas exchange in conventional ventilation and high frequency ventilation in severe respiratory insufficiency].

During high frequency jet ventilation (HFJV) adequate alveolar ventilation may be achieved with lower (-35%, p less than 0.0005) central airway pressures than during conventional mechanical ventilation (CMV). Due to increasing ventilation-perfusion inequalities, however, intrapulmonary shunt is then considerably increased (+52%, p less than 0.0005). In disease states with extensive shunting (e.g. ARDS) both ventilation modes can provide sufficient oxygenation only if high PEEP is applied.

High-Frequency Jet Ventilation↗
PubMed1990

[Bronchopulmonary diseases and the environment: a generation problem. The environment and pneumology: recognizing damage--damage containment].

The bronchopulmonary system is at particular risk from environmental pollution. At the same time, numerous natural and personal confounding variables are also effective, and investigations need to give then careful consideration. In particular such diseases as pulmonary emphysema, bronchitis, obstructive airways diseases and carcinoma of the lung may be due to environmental factors. Highly reliable methods of detecting such diseases are presented. The use of these methods by specially trained staff with the requisite skills and knowledge, is a precondition for reliable results. Numerous uncertainties associated with these requirements led to a certain unreliability of the results obtained in earlier studies. Provided that the above requirements are met, the present state of the technological art makes it possible to identify even more subtle damage that can be caused by environmental factors.

Air Pollution↗
PubMed1989

[Liver function of patients with arterial hypoxemia in chronic obstructive respiratory tract disease and the effect of nasal oxygen insufflation].

Patients suffering from chronic obstructive airway disease often have arterial hypoxemia, which is more or less severe. If hypoxemia deteriorates the function of the liver is still unknown. The aim of this study was to determine, if a mostly oxygen dependent process of liver metabolism (galactose elimination capacity) is disturbed and if it can be increased by oxygen insufflation. Under the same conditions an oxygen independent process (indocyaninegreen clearance) should not be influenced. Our results show, that galactose elimination capacity under room air was pathologic and can be increased significantly by oxygen breathing. No change of indocyaninegreen clearance was seen under the same conditions. After termination of oxygen therapy the galactose elimination capacity was as bad as before oxygen breathing. Dysfunctions of the liver, which are caused by hypoxemia, can be positively influenced by oxygen, but only for the duration of oxygen insufflation.

Aged↗
PubMed1989

[Pulmonary emphysema. Clinical aspects and open questions].

The development of airway obstruction is decisively influenced by the formation of emphysemata. Preventing the formation of emphysemata will have a substantial influence on the progression of obstructive airway diseases. Absolute as well as relative protease excess can be regarded as essential cause for emphysemata. Alpha 1-antitrypsine as significant protease inhibitor in alveolar regions is capable of compensating for a protease imbalance. Processes accompanied by an excess of proteases in the alveolar region should be influenced by adequate alpha 1-antitrypsine substitution to prevent the development of emphysemata. This promising preventive as well as therapeutic principle is apt to be extended and specified.

Humans↗
PubMed1989

Biochemical reaction of alpha 1 antitrypsin during the substitution therapy of patients with homozygote PI-ZZ deficit.

The homozygote deficit of alpha 1 antitrypsin (alpha 1 PI-ZZ) in patients frequently results in a premature development of emphysema in the lung due to incomplete protection against proteases. An active inhibitor substitution appears to be useful. The presented study proves the biological effect of alpha 1 antitrypsin infused into 8 patients. The results were an activity increase of leukocyte elastase and trypsin inhibition in serum as well as doubling of alpha 1 antitrypsin in sputum. This therapeutical conception (with a dose of 60 mg/kg body weight/week) results in an efficient protection. Inhibitors specific for mucosa are not influenced. An improvement of lung function during 6 weeks of intravenous therapy was not achieved. The progressive destruction of lung parenchyma can be probably prevented, however.

Adult↗