[The "neuron-specific enolase" tumor marker as a prognostic indicator in small cell bronchial carcinoma]. / Der Tumormarker "neuronspezifische Enolase" als Prognoseindikator beim kleinzelligen Bronchialkarzinom.

To assess the predictive value of the tumour marker NSE in respect of survival time prognosis in patients with small-cell bronchial carcinoma we performed serial measurements of the NSE concentration in 67 patients in whom the small-cell bronchial carcinoma had been newly diagnosed, before and during chemotherapy or radiotherapy. Pretherapeutic NSE determination proved an important predictive parameter with regard to survival time prognosis. In patients with an initial NSE concentration of over 60 ng/ml the survival time was significantly reduced (from 12.1 months to 8.4 months, p < 0.01). The pretherapeutic NSE concentrations are associated with the initial tumour stage. Serial NSE determinations reflect the course of the disease. A drop in NSE concentrations during the early phase of therapy may be important as a secondary prognosis indicator.

[Effect of CPAP and BIPAP on stroke volume in patients with obstructive sleep apnea syndrome]. / Einfluss von CPAP und BIPAP auf das Herzzeitvolumen bei Patienten mit obstruktivem Schlafapnoesyndrom.

We studied the effect of CPAP and BIPAP on cardiac output (CO) in 23 male obstructive sleep apnea (OSAS) patients with cardiac history but without congestive heart failure (CHF) during wakefulness using the thermodilution method. CPAP was applied at 10 cm H2O and 15 cm H2O, BIPAP at 10/0 cm H2O and 15/10 cm H2O. CO only decreased significantly by 14.6 +/- 11.8% at 15 cm H2O CPAP and by 13.4 +/- 10.0% at 15/10 cm H2O BIPAP. CPAP and BIPAP did not differ in altering hemodynamics. So sleep apnea patients without CHF develop no severe decrease of CO during nasal positive pressure ventilation up to 15 cm 2O.

[Continuous noninvasive blood pressure measurement in obstructive sleep apnea syndrome without and with CPAP therapy]. / Kontinuierliche, nicht-invasive Blutdruckmessung bei obstruktivem Schlafapnoesyndrom ohne und mit nasaler CPAP-Therapie.

The obstructive sleep apnea syndrome is accompanied with episodic increases of systemic blood pressure (B.P.) and possibly with persistent hypertension. to find out the influence of nCPAP therapy on systemic blood pressure in sleep apnea patients, 10 patients (apnea index 9-51/h) were monitored by means of continuous noninvasive blood pressure measurement during polygraphy, circulation was examined before and 2-7 days after CPAP therapy. Every 30 minutes a 2-minute period of the systolic and diastolic B.P. was visually averaged and from these data the mean pressure of 7 hours nocturnal sleep was calculated. The mean systolic pressure before therapy was 139 +/- 32 mmHg and decreased to 122 +/- 14 mmHg under nCPAP (significant), the mean diastolic pressure before therapy was 74 +/- 17 mmHg and decreased to 64 +/- 8 mmHg under nCPAP. The maximal B.P. during the 7-hour measurement decreased from 155 +/- 27 mmHg to 137 +/- 20 mmHg under nCPAP.

[Ambulatory monitoring of frequency of apnea in patients with suspected sleep apnea syndrome. Comparative studies using a thermistor sensor]. / Ambulantes Monitoring der Apnoefrequenz bei Patienten mit Verdacht auf Schlafapnoesyndrom. Vergleichende Untersuchungen mit einem Thermistorsensor.

To record and evaluate the number and duration of nocturnal apneas, and easy method is needed in an outpatient setting. New methods such as recording the tracheal sounds, heart frequency, and O2 saturation, are now available. Recording of thermal convection by Thermistor has not been performed on an outpatient basis so far. Hence, we developed a method by which a thermistor was placed on a mask to record the nasal and oral flow. A specially developed computer hardware evaluates date, time, period, number and mean values of the apneas. The parameters were compared with the conventional methods of recording apneas (thoracic and abdominal movement. O2 saturation, heart frequency and 3 thermistors at mouth and nose). 20 patients, mean age 53.1 +/- 1.6 years, were examined. In 12 patients the apnea frequency was between 0 and 50 apneas per night, in 8 between 50 and 550. Patients with an apnea frequency of more than 50 per night (polygraphy) could be identified with the thermistor method. Our results show that the method is sensitive in respect of the oral and nasal flow. The method seems valid to differentiate between normal persons and patients with increased risk of apnea syndrome.

[Comparative studies on the effect of nasal CPAP, theophylline and oxygen in patients with sleep apnea syndrome]. / Vergleichsuntersuchungen zur Wirkung von nCPAP, Theophyllin und Sauerstoff bei Patienten mit Schlafapnoesyndrom.

In patients with sleep apnea-syndrome nasal CPAP-therapy is the method of choice. The apnea phases are practically completely eliminated. However some patients with SAS don't accept CPAP-therapy. In this group Theophylline or O2-therapy respectively is discussed. We examined therefore 21 patients (55.8 +/- 9 years) with sleep-apnea syndrome and an apnea-index of 39 +/- 19.9 during 4 consecutive nights (diagnosis, nCPAP-therapy, O2-therapy by 21/min, by nasal prongs and Theophylline 375-400 mg in the evening and calculated apnea-index, the longest apnea and the lowest O2-saturation. On CPAP the number of apneas was practically reduced to 0. On Theophylline there was a relevant reduction of the apnea frequency. On O2-therapy only few patients with non-compliance Theophylline-therapy can be of some benefit in patients with moderate sleep-apnea syndrome. However the apnea-index cannot be normalized.