[Thio- and oxybarbiturates inhibit peristalsis in the Guinea-pig ileum in vitro]. / Thio- und Oxybarbiturate hemmen die Dünndarmperistaltik. In vitro-Untersuchungen am Meerschweinchenileum.

INTRODUCTION: Inhibition of gastrointestinal motility by drugs used for anaesthesia or sedation in critically ill patients in the ICU is a major problem leading to various complications. Thus this study examines whether the thio- and oxybarbiturates thiopentone and pentobarbitone exert an inhibitory effect on intestinal peristalsis. METHODS: Peristalsis in isolated segments of the guinea-pig small intestine was elicited by distension of the gut wall through a rise of intraluminal pressure and recorded via the intraluminal pressure changes associated with the aborally moving peristaltic contractions. Thiopentone and pentobarbitone (0.1 - 300 microM)-induced inhibition of peristalsis was reflected by an increase of the peristaltic pressure threshold (PPT). RESULTS: Thiopentone (EC50 = 19,8 microM) and pentobarbitone (EC50 = 99.7 micro M) concentration-dependently increased the PPT. While the vehicle (saline) and 0.1 - 10 micro M thiopentone and pentobarbitone were without any effect on the PPT, 100 micro M caused a significant increase in PPT, and complete abolition of peristalsis occurred after 300 micro M thiopentone or pentobarbitone in all segments tested. Inhibition was reversed by changing the bath solution. CONCLUSIONS: Thio- and oxybarbiturates inhibit intestinal peristalsis in the guinea-pig ileum. It is assumed that thiopentone and pentobarbitone affect propulsive peristalsis also in the human small intestine.

Effects of implantation of Alzet 1007D osmotic minipumps upon 2-deoxyglucose uptake in the cerebral cortex of mice.

The smallest Alzet osmotic minipumps (1007D) were implanted into mouse cerebral cortex. The flow of saline from a minipump produced a large necrosis of cortical tissue and still larger zone of decreased metabolic activity around the site of cannula implantation. Stimulus evoked uptake of 2-deoxyglucose located several millimeters from the implantation site was not affected.

[Euphylong in patients with chronic obstructive airway diseases]. / Anwendung von Euphylong bei Patienten mit chronisch-obstruktiven Atemwegserkrankungen.

25 patients suffering from chronic obstructive lung disease with a delta FEV1 greater than 15% were included in an open uncontrolled study. Only 17 of these patients participated during the entire length of the study, for there were 8 dropouts (five because of side effects). 13 of these 17 patients had been treated with Euphylong (2 capsules a 375 mg theophylline every evening, i.e. a daily dose of 750 mg theophylline once every evening.) 4 patients were given additionally another capsule of Euphylong in the morning because their theophylline requirements were higher. After this dose titration, the patients were continually treated for another 5 days; on the last day, a 24-hour profile of the peak flow and of serum theophylline concentration was recorded at 2-hour intervals. The course of serum theophylline concentration showed a typical "plateau" profile in all the patients, the maximum values being attained in the night and during early morning hours. The maximum value Cmax of 13.7 +/- 1.3 or 14.4 +/- 3.1 mg/l occurred on the average 8.1 +/- 1.1 or 7.5 +/- 0.9 hours after intake in the evening (the first-named value at once-daily dosage, the second at twice-daily dosage). Fluctuation at single dosage was 82 +/- 9% and at twice daily dosage 44 +/- 10%. the average daily level (CAV) was in the therapeutic range with both dosage schemes (10.1 +/- 0.9 or 12.0 +/- 2.5 mg/l). There was no morning dip in the early morning hours. Because of the observed side effects that are typical of theophylline, we recommend to administer Euphylong in the first phase of therapy initially in small doses gradually increasing to the desired maximum, in accordance with the procedure usually followed in optimised theophylline treatment courses.

[Long-term acceptance of nasal continuous positive airway pressure therapy in 70 patients with sleep apnea over a 6-month treatment period]. / Langzeitakzeptanz der nCPAP-Therapie bei 70 Patienten mit Schlafapnoe über eine Behandlungsdauer von mehr als 6 Monaten.

NCPAP therapy is considered to be an effective method of treatment in cases of obstructive and mixed sleep apnea (SA). We investigated its effectiveness during initiation of therapy, and the acceptance of the ambulatory long-term treatment. Here we present the first 70 patients (68 m, 2f) treated with nCPAP for at least six to a maximum of 20 months (on average: eleven months). Sixty-seven of the 70 patients were effectively treated with a nCPAP pressure of 5-15 mbar. The apnea index was reduced from 49 apnea episodes per hour (range 12-125) to 2 episodes per hour (range 0-8) on average. Therapy failed in one case (anatomical defect of the nasopharynx) and had to be abandoned in two cases (claustrophobia, acute rhinitis). Sixty-three patients, decided in favour of ambulatory long-term therapy. These patients were asked to complete a questionnaire about their experience with nCPAP. Four patients abandoned therapy (all within the first four weeks because of intolerance towards the apparatus), and one patient died 10 days after terminating treatment of an infection of the upper airway. Fifty-eight patients (82% of all) are still undergoing treatment. Eighty-eight per cent of these are using nCPAP for 5-7 nights a week throughout the entire sleep period, or at least for five hours. All patients report a marked reduction in or elimination of subjective symptoms. Mild local side effects occur quite frequently, but can be greatly reduced or eliminated in most cases. In individual cases they lead to a shortening of the nocturnal duration of application.(ABSTRACT TRUNCATED AT 250 WORDS)

Attenuation of augmented ventilatory response to hypoxia in essential hypertension in the course of aging.

36 patients with essential hypertension and 15 of their adult descendants were investigated and compared with age-matched control groups of 33 and 15 healthy subjects, respectively. The ventilatory response to oxygen breathing and to progressive normo- und isocapnic hypoxia were studied. The reduction of ventilation during hyperoxia was significantly greater in all hypertensive patients. An augmented ventilatory response to hypoxia was found in 20- to 40-year-old patients whereas the older patients (41-60 years) were not different from the age-matched control subjects. Our results indicate that the augmented hypoxic sensitivity in early hypertension, as found also in the young adult descendants with family background of hypertension, is attenuated with age, similar to the normotensive subjects.