Analysis of Residence Time, Effective Half-Life, and Internal Dosimetry Before Radioiodine Therapy.

Radioiodine therapy has been widely used for ablation of remnant tissue after surgical treatment of differentiated thyroid carcinoma (DTC). Internal dosimetry provides a new approach to choosing the administered activity-an approach that considers the distribution and retention of I individually per patient. This study used clinical techniques of internal dosimetry to assess the accumulated activity, internal bone marrow dosimetry, and effective half-life in patients undergoing treatment for DTC.

Improvement of CPAP Therapy by a Self-Adjusting System.

The first generation of Auto CPAP devices caused respiratory arousal by apnoes, hypopnoeas, incomplete obstructions and pressurechanges. The new, second generation of CPAP devices which is based on forced oscillation technique will change the pressure with slower velocity and before the respiratory arousal reaction will occur (1, 9, 10). Fifty patients with severe sleep apnoea (AHI 66+/-26 /h) were treated with both, constant- CPAP (continous positive airway pressure) or Auto CPAP under polysomnographic control in a randomised order.

Influence of Orthotopic Heart Transplantation on Breathing Pattern Disorders in Patients with Dilated Cardiomyopathy.

Cheyne-Stokes respiration is well-known in patients with congestive heart failure. One of the causes might be a prolonged circulation time or diminished pulmonary gas stores. Improvement of cardiac function by heart transplantation might abolish Cheyne-Stokes respiration.

Influence of Low-Flow Oxygen Supply on Sleep Architecture in Patients with Severe Heart Failure (NYHA III-IV) and Cheyne-Stokes Respiration.

Patients suffering from severe heart failure may develop breathing pattern disorders during sleep, especially in the form of Cheyne-Stokes respiration. Results may be severe disturbances in sleep architecture and worsening of hemodynamics and of prognosis of these patients. Causes of the periodic breathing disorders are probably hypocapnia, hypersensitivity of respiratory control centers, hypoxemia, and prolonged blood circulation time.

Sleep-Breathing Disorders and Heart Failure.

Cheyne-Stokes respiration is known to be associated with severe left heart failure. Because of severe desaturation, sleep fragmentation, arousals, and an increase in sympathetic activity, Cheyne-Stokes respiration may lead to a further impairment of cardiac function and to a worsening of quality of life. Although the pathology of Cheyne-Stokes respiration is not fully understood, enhanced chemoreceptor sensitivity, prolonged circulation time, as well as decreased pulmonary gas stores and increased ventilatory drive may be contributing factors.

MRI and CT in the differential diagnosis of pleural disease.

Study Objective: To explore the role of MRI in the differential diagnosis of pleural disease.

Patients: Forty-two patients with pleural disease were included.

Method: Retrospective study.

Equivalence of as-required salbutamol propelled by propellants 11 and 12 or HFA 134a in mild to moderate asthmatics. German Study Group.

This randomized, double-blind, parallel-group study compared the efficacy and tolerability of as-required salbutamol 100 microg administered from either a chlorofluorocarbon (CFC) pressurized metered dose inhaler (pMDI; Ventolin) or from a non-CFC hydrofluoroalkane (HFA) 134a pMDI (Ventolin CFC-free) in patients with mild to moderate asthma. All patients (n = 423) continued with their standard asthma therapy, and recorded their daily use of study medication, morning and evening peak expiratory flow (PEF) and symptom scores, throughout the 4-week treatment period. Clinic lung function was measured at 2-week intervals.

[Effect of n-CPAP therapy on outcome of cold provocation].

Our own investigations comprising 23,174 patients suffering from sleep apnoea showed that about 4 per cent of these patients suffer from a hyperreactive bronchial system. In some of these patients treatment with nCPAP causes coughing or mild dyspnoea even after having been previously asymptomatic. Loss of water and heat on the surface of bronchial mucosa may induce reversible bronchoconstriction.

[Change in bronchial hyperreactivity with nCPAP respiration in patients with sleep related respiratory disorders].

Own results of 23,174 patients suffering from sleep apnoea syndrome showed that about 4 per cent of these patients have an increase of bronchial reactivity. In 60 patients with assured bronchial hyperreactivity we performed an inhalative bronchial provocation test using carbachol. Tests were performed before and after two days of treatment with nCPAP in the early morning.

[Effect of long-term oxygen therapy on sleep architecture in patients with severe dilated cardiomyopathy and Cheyne-Stokes respiration].

Patients suffering from severe heart failure may develop breathing disorders during sleep. Results may be heavy disturbances in sleep architecture, worsening of haemodynamics and of the prognosis of these patients. Causes of breathing disorders are probably instability of breathing regulation caused by hypoxaemia, hypocapnia, and prolonged blood circulation time.

[Restless legs syndrome and periodic leg movements during sleep in patients with sleep apnea--a therapeutic problem?].

Restless-legs syndrome and periodic movements during sleep are associated with sleep apnoea syndrome. Similar to sleep apnoea syndrome, restless-legs syndrome and periodic movements during sleep may cause severe hyposomnia and hypersomnia. Exact diagnosis may partly fail in severe obstructive sleep apnoea syndrome if only cardiorespiratory polygraphy is performed.

Kinin generation in acute pneumonia and chronic bronchitis.

Kinins are potent inflammatory mediators, liberated from kininogens by different kininogenases. The aim of this study was to investigate the kinin generation pathways in acute and chronic inflammation of the lower airways. We studied bronchoalveolar lavage fluid (BALF) of patients with acute pneumonia, patients with chronic bronchitis and healthy controls.

Central sleep apnea.

A central apnea is a disorder characterized by apneic events during sleep with no associated ventilatory effort. Central sleep apnea syndrome is characterized by repeated apneas during sleep resulting from loss of respiratory effort. Although the etiology of central apnea remains obscure in most cases, current investigations into breathing control system during sleep and association with certain diseases have pointed out possible mechanisms.

[Evaluating physical fitness after unilateral lung transplantation with ergometry and blood gas analysis].

7 patients aged 30-56 years with the perception of subjective increased fitness 4-22 months after single lung transplantation were tested for the objective benefit. Using a standardized ergometric test protocol cardiopulmonary parameters (ventilation, blood gases, gas exchange, blood pressure, ECG) were measured 5 males and 2 females. After transplantation in all patients the objective fitness was increased by 30-60 watts and the blood gases were markedly improved.

Gastroesophageal reflux in patients with sleep apnea syndrome.

Unlabelled: Gastroesophageal reflux (GER) may be associated with pulmonary diseases. The aim of this study was to investigate the role of GER in patients with sleep apnea syndrome (SAS). We evaluated, therefore, in patients with SAS the occurrence of GER during simultaneous apnea monitoring, and whether GER is related to the severity of SAS.

[Theophylline acceptance in long-term therapy of patients with obstructive sleep related respiratory disorder].

In 1,150 patients with sleep apnea syndrome, the apnea number, the morning theophyllin level, the symptom of morning exhaustion were recorded for the first night of theophyllin therapy and in the follow-up period of up to 5 years; in addition, side effects were noted at the end of the observation period. Prior to start of the therapy, the average apnea number was 97 per night; this decreased to 25 per night in the initial therapy. In the observation period of between 3 and 28 months, the number of apnea phases increased slightly on average.

[Polysomnographic results before and after uvulopalatopharyngoplasty (UPPP)].

Uvulo-palato-pharyngo-plastic is one possibility for treatment of obstructive sleep-apnea. We examined in a prospective study design 36 patients, suffering from polysomnographically ensured obstructive sleep-apnea-syndrome, who were undergone uvulo-palato-pharyngo-plastic. We analysed pre- und postoperative polysomnographic data.

[Effect of n-CPAP therapy on the 24-hour blood pressure profile in severe obstructive sleep apnea syndrome].

We examined circadian blood pressure rhythm before and two days after onset of n-CPAP therapy in 50 patients, suffering from polysomnograhpically ensured severe obstructive sleep-apnea-syndrome. Measurements were performed using a non-invasive blood pressure registration. Patients with normal circadian blood pressure conditions and those with disturbed circadian rhythm could be differentiated.

[Effect of n-BiPAP therapy on the hemodynamics in patients with central sleep apnea].

We report of five patients, suffering from central sleep-apnea. All patients had a global respiratory failure during day-time and developed severe pulmonary artery hypertension during sleep. Therapy with n-BiPAP leeds to an improvement of blood gases and a decrease of pulmonary artery hypertension during sleep.

[Occurrence of obstructive sleep related respiratory disorder in conjunction with gastroesophageal reflux].

In 30 patients with suspected or, respectively 27 patients with confirmed, sleep apnea syndrome, 24-h esophagus pH metering was carried out. The patients were divided into two groups (number of apnea per 6 h > or < 100). A pH value of < 4 was defined as a pathological reflux when it occurred in total in at least 4% of the measuring period.

[The effect of nCPAP respiration on hyperreactivity in patients with sleep related respiratory disorder].

Of the 8,973 patients with sleep related breathing disorders examined in our department, about 4% were found to have a hyperreagible bronchial system. Provocation tests were performed before and after a 3-day CPAP therapy in 8 male patients with confirmed bronchial hyperreagibility. Two of these 8 patients revealed a marked increase of the respiratory path resistance and a decrease in FEV1.

[Long-term follow-up of patients with central apnea].

This is a report on 297 patient with central asphycia. The patients were divided into three groups according to the blood gases. 21 patients were in group three.

[Effect of nasal positive pressure ventilation in patients with dilated cardiomyopathy (NYHA III-IV)].

5 patients suffering from dilatative cardiomyopathy (NYHA III-IV) were investigated by polysomnography, haemodynamics and CPAP-BIPAP-breathing. In 4 patients IPAP-breathing with 6 cm H2O resulted in better haemodynamics.

[Long-term treatment of sleep apnea with evening administration of oral retard theophylline].

In 776 patients suffering from sleep apnoea long-term treatment with sustained-release theophylline was investigated. Responders show a significant reduction of apnoea phases. Using an individual theophylline dosage with morning theophylline concentrations between 5 and 8 micrograms/ml, only few side effects occurred.