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  • ARDS  (2)
  • Human  (2)
  • 2000-2004
  • 1995-1999  (4)
  • 1980-1984
  • 1997  (4)
  • 1
    ISSN: 1432-1106
    Keywords: Key words Vision ; Locomotion ; Optic Flow Adaptation ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The effect of an optic flow pattern on human locomotion was studied in subjects walking on a self-driven treadmill. During walking an optic flow pattern was presented, which gave subjects the illusion of walking in a tunnel. Visual stimulation was achieved by a closed-loop system in which optic flow and treadmill velocity were automatically adjusted to the intended walking velocity (WV). Subjects were instructed to keep their WV constant. The presented optic flow velocity was sinusoidally varied relative to the WV with a cycle period of 2 min. The independent variable was the relative optic flow (rOF), ranging from −1, i.e., forward flow of equal velocity as the WV, and 3, i.e., backward flow 3 times faster than WV. All subjects were affected by rOF in a similar way. The results showed, firstly, an increase in stride-cycle variability that suggests a larger instability of the walking pattern than in treadmill walking without optic flow; and, secondly, a significant modulating effect of rOF on the self-chosen WV. Backward flow resulted in a decrease, whereas forward flow induced an increase of WV. Within the analyzed range, a linear relationship was found between rOF and WV. Thirdly, WV-related modulations in stride length (SL) and stride frequency (SF) were different from normal walking: whereas in the latter a change in WV is characterized by a stable linear relationship between SL and SF (i.e., an approximately constant SL to SF ratio), optic flow-induced changes in WV are closely related to a modulation of SL (i.e., a change of SL-SF ratio). Fourthly, this effect of rOF diminished by about 45% over the entire walking distance of 800 m. The results suggest that the adjustment of WV is the result of a summation of visual and leg-proprioceptive velocity informations. Visual information about ego-motion leads to an unintentional modulation of WV by affecting specifically the relationship between SL and SF. It is hypothesized that the space-related parameter (SL) is influenced by visually perceived motion information, whereas the temporal parameter (SF) remains stable. The adaptation over the entire walking distance suggests that a shift from visual to leg-proprioceptive control takes place.
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  • 2
    ISSN: 1432-0878
    Keywords: Key words: Interleukin-6 ; Interleukin-1β ; Tenidap ; Astrocytes ; Alzheimer’s disease ; Therapy ; Cell culture ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract. Tenidap is a structurally novel antirheumatic agent with anti-inflammatory and analgesic properties. Previous studies have shown that tenidap is able to inhibit the production and action of cytokines such as interleukin-1, interleukin-6 (IL-6) and tumour necrosis factor α. However, the mechanisms by which tenidap inhibits cytokine synthesis are not yet known. We investigated in the human astrocytoma cell line U373 whether tenidap inhibits IL-6 synthesis by inhibition of certain signal transduction processes leading to IL-6 synthesis. Cells were stimulated with different substances which have previously been shown to activate protein kinase A or C, reactive oxygen intermediates as well as transcription factors such as nuclear factor kappa B and AP-1 and which all result in IL-6 synthesis. Tenidap was a very potent inhibitor of IL-6 synthesis independent of the stimuli used, suggesting an inhibitory mechanism other than inhibition of a certain signal transduction pathway. Since IL-6 has been shown to be involved in the etiopathology of Alzheimer’s disease and since the use of nonsteroidal anti-inflammatory drugs appears to be of therapeutical benefit, it is concluded that tenidap should be tested in clinical trials in order to determine whether it may be useful for the treatment of Alzheimer’s disease.
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  • 3
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Schwerverbrannte ; Inhalationstrauma ; ARDS ; Surfactantsubstitution ; Key words Postburn victims ; Inhalation injury ; ARDS ; Surfactantsubstitution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Damage to the respiratory system caused by inhalation of toxic products of combustion and the subsequent development of adult respiratory distress syndrome (ARDS) are the main lethal factors in burns patients. Treatment with exogenous surfactant is one of the therapeutic options. However, no clinical reports have yet been published about this therapy. We report on two patients with burn injuries of second to third degree affecting 42% and 48% respectively of the total body surface plus inhalation injury complicated by ARDS. Both patients were treated with bovine surfactant (Alveofact). The therapeutic effects on oxygenation and pulmonary function were monitored. Intrabronchial application of surfactant by bronchoscopy during exhaustive conventional mechanical ventilation resulted in improved gas exchange with an increase in arterial O2 pressure (paO2); inspired O2 concentration (FiO2) was lowered and there was an improvement in lung compliance. Both patients survived this critical situation. We conclude that treatment with exogenous surfactant in postburn victims with ARDS is a promising therapeutic approach to improve the survival rate of these high-risk patients.
    Notes: Schädigungen des Respirationstraktes durch Inhalation von toxischen Verbrennungsprodukten mit nachfolgender Entwicklung eines ,,akuten respiratorischen Distress-syndroms`` (ARDS) sind eine der Haupttodesursachen bei Verbrennungspatienten [22, 36]. Eine Behandlung mit exogenem Surfactant bietet hier eine therapeutische Option, über die jedoch bislang keine Erfahrungen für diese Patientengruppen vorliegen. Wir berichten über 2 Schwerverbrannte mit Verbrennungen II. bis III.° von 42% bzw. 48% der Körperoberfläche (KOF) sowie einem durch ARDS komplizierten Inhalationstrauma, die mit bovinem Surfactant (Alveofact®) substituiert wurden. Der Einfluß dieser Substanz auf Oxygenierung und Lungenmechanik wurde ausgewertet. Bei ausgeschöpften Parametern der maschinellen Beatmung kam es nach bronchoskopisch intrabronchialer Applikation von Surfactant zu einem verbesserten Gasaustausch mit Anstieg des arteriellen O2-Partialdruckes (paO2) unter Verringerung der inspiratorischen O2-Konzentration (FiO2) sowie zu einer verbesserten Lungencompliance. Beide Patienten überlebten trotz initial infauster Prognose. Wir sehen in der Substitution von exogenem Surfactant bei inhalationstraumatisierten Schwerbrandverletzten mit ARDS einen vielversprechenden Ansatz, die Überlebenschancen dieser Hochrisikopatienten zu verbessern.
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  • 4
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Wegener-Granulomatose ; Glomerulonephritis ; ARDS ; Extrakorporale Membranoxygenation ; ECMO ; Key words Wegener’s granulomatosis ; Glomerulonephritis ; Respiratory distress syndrom ; Adult ; Extracorporeal membrane oxygenation ; ECMO
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Wegener’s granulomatosis is a distinct clinicopathologic entity characterized by granulomatous vasculitis of the upper and lower respiratory tract and glomerulonephritis. This disease can present as a clinical picture which resembles sepsis and adult respiratory distress syndrome (ARDS). Wegener’s disease requires immunosuppression which can have detrimental consequences when used in sepsis. The following case report illustrates the diagnostic difficulties encountered by intensiv care physicians treating severe pulmonary failure and multiple organ dysfunction in Wegener’s granulomatosis appearing as ARDS with sepsis. Case report: A 19-year-old female patient had developed acute respiratory and renal failure after a prolonged period (many months) of antibiotic resistant otitis, sinusitis and mastoiditis. The patient had required intubation at another hospital and there was a history of tension pneumothorax and cardiopulmonary resuscitation during mechanical ventilation. Emergency extracorporeal membrane oxygenation (ECMO) for acute hypercapnic and hypoxic respiratory failure was instituted and the patient was transported to our institution while on ECMO. The patient was treated empirically for suspected pulmonary and systemic infection and received hydrocortisone (0,18 mg/kg/h) as part of a protocol-driven treatment of septic shock in addition to antibiotic and antimycotic regime. The use of ECMO was required for 10 and mechanical ventilation for another 50 days after admission. After successfull extubation, central nervous system dysfunction became evident with a somnolent and generally unresponsive patient. When the hydrocortisone dose was gradually tapered, the clinical status of the patient further deteriorated, pulmonary gas exchange worsened and she developed renal failure with proteinura and hematuria. A renal biopsy was performed demonstrating vasculitis and focal segmental glomerulonephritis, a systemic granulomatous vasculitis was suspected; the serum was tested for anti-proteinase 3 antibodies (PR3-ANCA) and turned out to be positive (17.5 U/ml; normal range 〈7 U/ml). The morphologic findings from renal biopsy, the positive test for antiproteinase 3 antibodies and the pulmonary-renal involvement with evidence of multisystem disease established the diagnosis of Wegener’s granulomatosis. Immunosuppressive therapy with cyclophosphamide and prednisolon was instituted resulting in rapid improvement with recovery of pulmonary, renal and central nervous system function within two weeks. The use of ECMO in this patient served as a life – saving immediate measure usefull to ”buy time” until a definite diagnosis could be established. ARDS represents an uniform pulmonary reaction to a large number of different noxious stimuli and disease entities. This case demonstrates that intensiv care physicians caring for critically ill patients with ARDS should include even rare causes of pulmonary injury into their differential diagnosis.
    Notes: Zusammenfassung Wir berichten über eine 19jährige Patientin, bei der unter dem typischen Bild eines schweren ARDS mit Multiorganversagen für insgesamt 10 Tage der Einsatz einer extrakorporalen Lungenersatztherapie (ECMO) erforderlich war. Therapieverlauf: Unter einer kalkulierten antibiotischen und antimykotischen Therapie sowie einer Behandlung mit Hydrocortison als adjuvanter Therapie bei septischem Schock besserte sich erst nach wochenlangem und kompliziertem klinischen Verlauf die Lungenfunktion soweit, daß eine Extubation möglich war. Die Patientin zeigte jedoch unverändert eine Mehrorgandysfunktion von Niere, Lunge und ZNS. In den folgenden Wochen nach Beendigung der Hydrocortisontherapie verschlechterten sich Nierenfunktion, pulmonaler Gasaustausch und Vigilanz wieder. Diagnostik: Der histologische Befund der Nierenbiopsie mit Arteriitis und Glomerulonephritis bei beidseitiger Vergrößerung der Nieren im CT und der Nachweis von Proteinase 3-ANCA im Serum ermöglichten letztlich bei Würdigung des gesamten klinischen Bildes und seiner genauen Vorgeschichte eine Diagnose: Wegener-Granulomatose. Durch immunsuppressive Therapie kam es innerhalb kurzer Zeit zu einer Remission mit vollständiger Erholung insbesondere der ZNS-Funktion. Schlußfolgerung: Dieser Fallbericht zeigt, daß im Einzelfall auch seltene Krankheitsbilder mit pulmonaler Beteiligung wie die Wegener-Granulomatose in die Differentialdiagnose des ARDS einbezogen werden müssen.
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