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Sambale J, Koehler U, Conradt R, Kesper K, Cassel W, Degerli M, Viniol C, Korbmacher-Steiner HM. Is sleep bruxism in obstructive sleep apnea only an oral health related problem? BMC Oral Health 2024; 24:565. [PMID: 38745301 PMCID: PMC11094952 DOI: 10.1186/s12903-024-04351-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The etiology of sleep bruxism in obstructive sleep apnea (OSA) patients is not yet fully clarified. This prospective clinical study aimed to investigate the connection between probable sleep bruxism, electromyographic muscle tone, and respiratory sleep patterns recorded during polysomnography. METHODS 106 patients with OSA (74 males, 31 females, mean age: 56.1 ± 11.4 years) were divided into two groups (sleep bruxism: SB; no sleep bruxism: NSB). Probable SB were based on the AASM criteria: self-report of clenching/grinding, orofacial symptoms upon awakening, abnormal tooth wear and hypertrophy of the masseter muscle. Both groups underwent clinical examination for painful muscle symptoms aligned with Temporomandibular Disorders Diagnostic Criteria (DC/TMD), such as myalgia, myofascial pain, and headache attributed to temporomandibular disorder. Additionally, non-complaint positive muscle palpation and orofacial-related limitations (Jaw Functional Limited Scale-20: JFLS-20) were assessed. A one-night polysomnography with electromyographic masseter muscle tone (EMG) measurement was performed. Descriptive data, inter-group comparisons and multivariate logistic regression were calculated. RESULTS OSA patients had a 37.1% prevalence of SB. EMG muscle tone (N1-N3, REM; P = 0.001) and the number of hypopneas (P = 0.042) were significantly higher in the sleep bruxism group. While measures like apnea-hypopnea-index (AHI), respiratory-disturbance-index (RDI), apnea index (AI), hypopnea-index (HI), number of arousals, and heart rate (1/min) were elevated in sleep bruxers, the differences were not statistically significant. There was no difference in sleep efficiency (SE; P = 0.403). Non-complaint masseter muscle palpation (61.5%; P = 0.015) and myalgia (41%; P = 0.010) were significant higher in SB patients. Multivariate logistic regression showed a significant contribution of EMG muscle tone and JFLS-20 to bruxism risk. CONCLUSION Increased EMG muscle tone and orofacial limitations can predict sleep bruxism in OSA patients. Besides, SB patients suffer more from sleep disorder breathing. Thus, sleep bruxism seems to be not only an oral health related problem in obstructive apnea. Consequently, interdisciplinary interventions are crucial for effectively treating these patients. TRIAL REGISTRATION The study was approved by the Ethics Committee of Philipps-University Marburg (reg. no. 13/22-2022) and registered at the "German Clinical Trial Register, DRKS" (DRKS0002959).
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Affiliation(s)
- J Sambale
- Department of Orthodontics, Clinic of Dentistry, Philipps-University Marburg, Georg-Voigt-Str. 3, 35041, Marburg, Germany.
| | - U Koehler
- Departement of Pneumology, Philipps-University Marburg, Marburg, Germany
| | - R Conradt
- Faculty of Health Sciences at the University of Applied Sciences, Gießen, Germany
| | - K Kesper
- Departement of Pneumology, Philipps-University Marburg, Marburg, Germany
| | - W Cassel
- Departement of Pneumology, Philipps-University Marburg, Marburg, Germany
| | - M Degerli
- Departement of Pneumology, Philipps-University Marburg, Marburg, Germany
| | - C Viniol
- Departement of Pneumology, Philipps-University Marburg, Marburg, Germany
| | - H M Korbmacher-Steiner
- Department of Orthodontics, Clinic of Dentistry, Philipps-University Marburg, Georg-Voigt-Str. 3, 35041, Marburg, Germany
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Verdyck P, Altarescu G, Santos-Ribeiro S, Vrettou C, Koehler U, Griesinger G, Goossens V, Magli C, Albanese C, Parriego M, Coll L, Ron-El R, Sermon K, Traeger-Synodinos J. Aneuploidy in oocytes from women of advanced maternal age: analysis of the causal meiotic errors and impact on embryo development. Hum Reprod 2023; 38:2526-2535. [PMID: 37814912 DOI: 10.1093/humrep/dead201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/06/2023] [Indexed: 10/11/2023] Open
Abstract
STUDY QUESTION In oocytes of advanced maternal age (AMA) women, what are the mechanisms leading to aneuploidy and what is the association of aneuploidy with embryo development? SUMMARY ANSWER Known chromosome segregation errors such as precocious separation of sister chromatids explained 90.4% of abnormal chromosome copy numbers in polar bodies (PBs), underlying impaired embryo development. WHAT IS KNOWN ALREADY Meiotic chromosomal aneuploidies in oocytes correlate with AMA (>35 years) and can affect over half of oocytes in this age group. This underlies the rationale for PB biopsy as a form of early preimplantation genetic testing for aneuploidy (PGT-A), as performed in the 'ESHRE STudy into the Evaluation of oocyte Euploidy by Microarray analysis' (ESTEEM) randomized controlled trial (RCT). So far, chromosome analysis of oocytes and PBs has shown that precocious separation of sister chromatids (PSSC), Meiosis II (MII) non-disjunction (ND), and reverse segregation (RS) are the main mechanisms leading to aneuploidy in oocytes. STUDY DESIGN, SIZE, DURATION Data were sourced from the ESTEEM study, a multicentre RCT from seven European centres to assess the clinical utility of PGT-A on PBs using array comparative genomic hybridization (aCGH) in patients of AMA (36-40 years). This included data on the chromosome complement in PB pairs (PGT-A group), and on embryo morphology in a subset of embryos, up to Day 6 post-insemination, from both the intervention (PB biopsy and PGT-A) and control groups. PARTICIPANTS/MATERIALS, SETTING, METHODS ESTEEM recruited 396 AMA patients: 205 in the intervention group and 191 in the control group. Complete genetic data from 693 PB pairs were analysed. Additionally, the morphology from 1034 embryos generated from fertilized oocytes (two pronuclei) in the PB biopsy group and 1082 in the control group were used for statistical analysis. MAIN RESULTS AND THE ROLE OF CHANCE Overall, 461/693 PB pairs showed abnormal segregation in 1162/10 810 chromosomes. The main observed abnormal segregations were compatible with PSSC in Meiosis I (MI) (n = 568/1162; 48.9%), ND of chromatids in MII or RS (n = 417/1162; 35.9%), and less frequently ND in MI (n = 65/1162; 5.6%). For 112 chromosomes (112/1162; 9.6%), we observed a chromosome copy number in the first PB (PB1) and second PB (PB2) that is not explained by any of the known mechanisms causing aneuploidy in oocytes. We observed that embryos in the PGT-A arm of the RCT did not have a significantly different morphology between 2 and 6 days post-insemination compared to the control group, indicating that PB biopsy did not affect embryo quality. Following age-adjusted multilevel mixed-effect ordinal logistic regression models performed for each embryo evaluation day, aneuploidy was associated with a decrease in embryo quality on Day 3 (adjusted odds ratio (aOR) 0.62, 95% CI 0.43-0.90), Day 4 (aOR 0.15, 95% CI 0.06-0.39), and Day 5 (aOR 0.28, 95% CI 0.14-0.58). LIMITATIONS, REASON FOR CAUTION RS cannot be distinguished from normal segregation or MII ND using aCGH. The observed segregations were based on the detected copy number of PB1 and PB2 only and were not confirmed by the analysis of embryos. The embryo morphology assessment was static and single observer. WIDER IMPLICATIONS OF THE FINDINGS Our finding of frequent unexplained chromosome copy numbers in PBs indicates that our knowledge of the mechanisms causing aneuploidy in oocytes is incomplete. It challenges the dogma that aneuploidy in oocytes is exclusively caused by mis-segregation of chromosomes during MI and MII. STUDY FUNDING/COMPETING INTEREST(S) Data were mined from a study funded by ESHRE. Illumina provided microarrays and other consumables necessary for aCGH testing of PBs. None of the authors have competing interests. TRIAL REGISTRATION NUMBER Data were mined from the ESTEEM study (ClinicalTrials.gov Identifier NCT01532284).
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Affiliation(s)
- P Verdyck
- Centre for Medical Genetics, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - G Altarescu
- Shaare-Zedek Medical Center, The Hebrew University School of Medicine, Jerusalem, Israël
| | - S Santos-Ribeiro
- IVI-RMA Lisboa, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - C Vrettou
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | - U Koehler
- MGZ-Medizinisch Genetisches Zentrum, Munich, Germany
| | - G Griesinger
- Department of Gynecological Endocrinology and Reproductive Medicine, University Hospital of Schleswig-Holstein, Campus Luebeck, Lübeck, Germany
| | - V Goossens
- The European Society of Human Reproduction and Embryology, Strombeek-Bever, Belgium
| | - C Magli
- SISMER, Reproductive Medicine Unit, Bologna, Italy
| | - C Albanese
- SISMER, Reproductive Medicine Unit, Bologna, Italy
| | - M Parriego
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - L Coll
- Department of Obstetrics, Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - R Ron-El
- Shaare-Zedek Medical Center, The Hebrew University School of Medicine, Jerusalem, Israël
| | - K Sermon
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - J Traeger-Synodinos
- Laboratory of Medical Genetics, National and Kapodistrian University of Athens, 'Aghia Sophia' Children's Hospital, Athens, Greece
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Koehler U. [Jean-Nicolas Corvisart (1755-1821) - Personal Physician of Napoleon, Preserver of Auenbrugger's Chest Percussion and Founder of Modern Cardiology]. Pneumologie 2021; 75:536-538. [PMID: 33711847 DOI: 10.1055/a-1396-8067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Jean-Nicolas Corvisart des Marets (1755-1821) was the personal physician of the Emperor Napoleon I. He was one of the leading french physicians to promote and teach clinical and anatomical medicine. Corvisart was a pioneer of modern cardiology. He became famous by his contribution to the development and popularization of the chest percussion technique of Leopold Auenbrugger (1722-1809).
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg
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4
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Oppermann TS, Cassel W, Koehler U, Ziller V. Chronischer Reizhusten bei Frauen: Zusammenhang mit postmenopausalen Beschwerden beim klimakterischen Syndrom? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - W Cassel
- Universitätsklinikum Marburg, Pneumologie
| | - U Koehler
- Universitätsklinikum Marburg, Pneumologie
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Moaeri S, Hildebrandt O, Cassel W, Viniol C, Schäfer A, Kesper K, Sohrabi K, Gross V, Koehler U. [Analysis of Snoring in Patients with Obstructive Sleep Apnea (OSA) by Polysomnography and LEOSound]. Pneumologie 2020; 74:509-514. [PMID: 32492719 DOI: 10.1055/a-1155-8772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Snoring was monitored in patients with obstructive sleep apnea (OSA) using the LEOSound-Monitor and simultaneously polysomnographic (PSG) recording. In obstructive apneas snoring is normally apparent after apnea termination and the beginning of ventilation. We wanted to know how often obstructive apneas are terminated by ventilation in combination with snoring. METHODS AND INTENTION In 40 patients with OSA (AHI > 15/h) simultaneous polysomnographic recordings were performed amongst long-term respiratory sound monitoring using the LEOSound monitor. Patients' average age was 57 ± 11 years. Average weight was 100 ± 19 kg by a mean body mass index (BMI) of 33 ± 7 kg/m2. 12 out of 40 recordings had to be rejected for further analysis because of artifacts. Snoring recorded by polysomnography was compared with snoring monitored by LEOSound. RESULTS 3778 obstructive apnea episodes were monitored. LEOSound identified snoring in 1921 (51,0 %), polysomnography in 2229 (58,8 %) obstructive apneas. Only in one patient there was a higher difference in snoring episodes between PSG and LEOSound. DISCUSSION In nearly 60 % of obstructive apnea events we found snoring during apnea-terminating hyperpnoea. LEOSound is a good diagnostic tool to monitor snoring. It is necessary to clarify why only 60 % of all obstructive events/hyperpnoea develop snoring. From a pathophysiological point of view opening of collapsed upper airway should lead in a very high percentage to turbulences in airstream and committed snoring.
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Affiliation(s)
- S Moaeri
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - W Cassel
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - C Viniol
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - A Schäfer
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - K Kesper
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - K Sohrabi
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - V Gross
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
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Koehler N, Weissflog A, Koehler U, Sohrabi K. [Antoni van Leeuwenhoek and the Pulmonary Medicine - A Brilliant Discoverer of the Microcosm]. Pneumologie 2019; 73:482-485. [PMID: 31117134 DOI: 10.1055/a-0889-1559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- N Koehler
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - A Weissflog
- Thora Tech GmbH, Clinical Research, Anwenderzentrum für Medizintechnik, Gießen
| | - U Koehler
- Klinik Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Marburg
| | - K Sohrabi
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
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Schudt F, Gross V, Sohrabi K, Fischer P, Hofmann S, Noeh C, Hildebrandt O, Koehler U. [The Nocturnal Respiratory Rate in COPD Patients of Varying GOLD Severity with/without Nicotine Consumption: Calculation by Means of Breath Sound Analysis]. Pneumologie 2019; 73:465-469. [PMID: 30895593 DOI: 10.1055/a-0859-4643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Respiratory rate is an important risk marker and enables early detection of critically ill and vulnerable patients in clinical routine. The aim of this pilot study with 31 patients (COPD severity levels II - IV) was to determine the mean nocturnal respiratory rate based on breath sound recordings and to investigate the dependence of respiratory rate on COPD severity level and smoker status. The mean respiratory rate of the total collective was 19/min. For the COPD-GOLD severity levels, no significant differences in mean respiratory rate could be observed. When nicotine consumption is taken into account, active smokers showed a significantly higher mean respiratory rate of 20.84 ± 4.45/min compared to non-smokers with 17.41 ± 3.14/min (p < 0.05). In addition, active smokers in the study were significantly more frequent among patients with night-time wheezing (60 % vs. 23.8 %). This might suggest that smokers need to perform increased breathing work with increased breathing rate to compensate for oxygen deficiency in bronchial obstruction. The results of the present study show that with the acoustic recording of breath sounds, a reliable representation and calculation of the breath frequency is possible.
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Affiliation(s)
- F Schudt
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - V Gross
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - K Sohrabi
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - P Fischer
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - S Hofmann
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - C Noeh
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
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9
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Abstract
Pulmonary emphysema is characterised by irreversible destruction and enlargement of alveolar structure distal to terminal bronchioles. Small conducting airways < 2 mm in diameter are the major site of chronic airway inflammation and obstruction in COPD patients. 80 - 90 % of the last generation of small conducting airways, the terminal bronchioles, are destroyed in patients with very severe COPD. Recent data showing, that small airways disease is also a pathological feature in patients with COPD GOLD stage 1 and 2. Although 40 % of terminal and 60 % of transitional bronchioles were destroyed, there was no sign for emphysema. Only a significant loss of terminal and respiratory bronchioles seems to be able to induce pulmonary emphysema and respiratory symptoms.
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin,SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg
| | - O Hildebrandt
- Klinik für Innere Medizin,SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg
| | - M Dittrich
- Klinik für Innere Medizin,SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg
| | - N Koehler
- Fachbereich Gesundheit,Technische Hochschule Mittelhessen, Gießen
| | - A Weissflog
- Clinical Research, Thora Tech GmbH, Anwenderzentrum für Medizintechnik, Gießen
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Koehler U, Hildebrandt O, Koehler N, Sohrabi K. Sind die „kleinen Atemwege“ der Schlüssel zum Verständnis von Pathophysiologie und Therapieeffizienz chronisch obstruktiver Atemwegserkrankungen? Pneumologie 2018; 72:790-796. [DOI: 10.1055/a-0707-5826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
ZusammenfassungDie vorliegende Übersichtsarbeit vermittelt Informationen über die Bedeutung der „kleinen Atemwege“ hinsichtlich der Pathogenese chronisch obstruktiver Atemwegserkrankungen, insbesondere der COPD. Die Verzweigungen der Bronchien werden in Generationen eingeteilt. Bis zu den Bronchioli terminales hat das Bronchialsystem eine vorwiegende Luftleitungsfunktion (Generationen 0 – 16), mit den Bronchioli respiratorii beginnt die eigentliche Respirationszone (Generationen 17 – 23). Nach heutigem Wissen sind insbesondere die kleinen Atemwege mit einem Durchmesser < 2 mm von pathogenetischer Bedeutung, zumal die chronisch protrahiert verlaufende Inflammation hier zu morphologischen und strukturellen Veränderungen sowie zu einer Erhöhung des Atemwegswiderstandes führt. Bei schwergradiger COPD ist eine hochgradige Reduktion und Destruktion der bronchioli terminales festzustellen. Ob es bereits in einem frühen COPD-Stadium zu einem Atemwegsremodeling kommt, ist noch unklar. Hinsichtlich der In-vivo-Diagnostik morphologischer und funktioneller Veränderungen der kleinen Atemwege existiert bislang noch kein Goldstandard. Die Mikro-CT eröffnet jedoch neue Optionen der Darstellung von Mikrostrukturen im Bereich der terminalen Bronchiolen. Von therapeutischer Seite stellt sich die Frage, ob und wie eine Optimierung der inhalativen Medikamentendeposition im Bereich der „small airways“ zu erreichen ist.
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Affiliation(s)
- U. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
| | - O. Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
| | - N. Koehler
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - K. Sohrabi
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
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Guenter K, Boeselt T, Kroenig J, Hildebrandt O, Koehler N, Viniol C, Koehler U. [Asthma Control in Adults and Children Must be Improved!]. Pneumologie 2018; 72:681-686. [PMID: 30149401 DOI: 10.1055/a-0629-4242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Medication management of asthma is based on level of asthma control. GINA defined criteria for asthma control include asking about daytime symptoms, limitation of activity, nocturnal symptoms/awakenings and need for reliever treatment. Effective asthma control is necessary for preventing exacerbations and worsening of lung function. Standardized and validated questionnaires such as asthma control test (ACT) help to assess the level of asthma control. Asthma control is classified as controlled, partially controlled or uncontrolled. Multicenter studies like REALISE and AIRE give health care professionals information about effectiveness and adherence to medication over nearly 15 years. Asthma is still poorly controlled in more than 50 % of patients despite the availability of very effective drugs. Low adherence to the treatment, fear of systemic side effects related to long term treatment with inhaled corticosteroids, inadequate knowledge of the disease may be responsible factors for bad asthma control. Optimized tools for disease management and intensified education are necessary for therapeutic success.
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Affiliation(s)
- K Guenter
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - T Boeselt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - J Kroenig
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - N Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - C Viniol
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
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Kroenig J, Hildebrandt O, Cassel W, Gross V, Sohrabi K, Fischer P, Weissflog A, Koehler U. Longterm-recording of night-time symptoms in patients with stable COPD. Pneumologie 2018. [DOI: 10.1055/s-0037-1619170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J Kroenig
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - O Hildebrandt
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - W Cassel
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - V Gross
- Faculty of Health Sciences, University of Applied Sciences, Gießen
| | - K Sohrabi
- Faculty of Health Sciences, University of Applied Sciences, Gießen
| | - P Fischer
- Faculty of Health Sciences, University of Applied Sciences, Gießen
| | | | - U Koehler
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
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Fischer P, Kroenig J, Weissflog A, Hildebrandt O, Koehler U, Sohrabi K, Gross V. Discrimination of night-time cough in patients with stable COPD. Pneumologie 2018. [DOI: 10.1055/s-0037-1619169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- P Fischer
- Faculty of Health Sciences, University of Applied Sciences, Gießen
| | - J Kroenig
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | | | - O Hildebrandt
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - U Koehler
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - K Sohrabi
- Faculty of Health Sciences, University of Applied Sciences, Gießen
| | - V Gross
- Faculty of Health Sciences, University of Applied Sciences, Gießen
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Koehler U, Hildebrandt O, Sohrabi K, Gross V, Weissflog A. Diagnostische Perspektiven der akustischen Langzeitregistrierung von Atem- und Atemnebengeräuschen. Pneumologie 2018. [DOI: 10.1055/s-0037-1619398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- U Koehler
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg; Schlafmedizinisches Zentrum Marburg
| | - O Hildebrandt
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg; Schlafmedizinisches Zentrum Marburg
| | - K Sohrabi
- Faculty of Health Science, University of Applied Sciences, Gießen
| | - V Gross
- Faculty of Health Science, University of Applied Sciences, Gießen
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15
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van Dam P, Tomatis M, Marotti L, Heil J, Mansel R, Rosselli del Turco M, van Dam P, Casella D, Bassani L, Danei M, Denk A, Egle D, Emons G, Friedrichs K, Harbeck N, Kiechle M, Kimmig R, Koehler U, Kuemmel S, Maass N, Mayr C, Prové A, Rageth C, Regolo L, Lorenz-Salehi F, Sarlos D, Singer C, Sohn C, Staelens G, Tinterri C, Audisio R, Ponti A, Badbanchi F, Catalano G, Cretella E, Daniaux M, Emons A, van Eygen K, Ettl J, Gatzemeier W, Kern P, Schneeweiss A, Stoeblen F, Van As A, Wuerstlein R, Zanini V. Time trends (2006–2015) of quality indicators in EUSOMA-certified breast centres. Eur J Cancer 2017; 85:15-22. [DOI: 10.1016/j.ejca.2017.07.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/31/2017] [Accepted: 07/25/2017] [Indexed: 12/21/2022]
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16
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von Heydebrand M, Hildebrandt O, Cassel W, Schäfer A, Kesper K, Weissflog A, Taher N, Sohrabi K, Gross V, Koehler U. [Apnea Detection by Means of Respiratory Sound Recordings and Polysomnography - A Comparative Study]. Pneumologie 2017; 71:594-599. [PMID: 28759934 DOI: 10.1055/s-0043-112888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Introduction In this study, recognition of apnoeas by means of polysomnography (PSG) and nocturnal respiratory sound recordings in patients with obstructive sleep apnoea (OSA) was analyzed and compared. Methods In 45 patients with OSA requiring treatment (AHI > 15/h), concomitant polysomnographic recordings and long term respiratory sound recordings by means of LEOSound were performed. Patients' average age was 58 ± 12 years (mean ± standard deviation), average BMI was 33 ± 7 kg/m2. Audio-visual apnoea detection by LEOSound was compared to polysomnographic apnoea detection. Increased artifact rate due to dislocation of microphones led to rejection of 11 out of 45 recordings for detailed analysis. Results Comparison of apnea detection by audio-visual analysis and polysomnography yielded a median of 164 apneas for LEOSound recordings and 158 apneas for PSG. Median apnoea index (AI) was calculated to be 20/h for respiratory sounds recording and 21/h for PSG. The correlation of apnea indices from acoustic long term registration and PSG was 0.939 (p < 0.001). Discussion Acoustic long term registration of primary and secondary respiratory sounds is also capable to recognize apnoeas. Exact differentiation between apnoeas and hypopnoeas is only possible in a limited fashion.
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Affiliation(s)
- M von Heydebrand
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - W Cassel
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - A Schäfer
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - K Kesper
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | | | - N Taher
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - K Sohrabi
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - V Gross
- Fachbereich Gesundheit, Technische Hochschule Mittelhessen, Gießen
| | - U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
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17
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Koehler U, Hildebrandt O, Krönig J, Grimm W, Otto J, Hildebrandt W, Kinscherf R. [Chronic hypoxia and cardiovascular risk : Clinical significance of different forms of hypoxia]. Herz 2017; 43:291-297. [PMID: 28474128 DOI: 10.1007/s00059-017-4570-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 03/13/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Abstract
It is of fundamental importance to differentiate whether chronic hypoxia occurs intermittently or persistently. While chronic intermittent hypoxia (CIH) is found typically in patients with obstructive sleep apnea (OAS), chronic persistent hypoxia (CPH) is typically diagnosed in patients with chronic lung disease. Cardiovascular risk is markedly increased in patients with CIH compared to patients with CPH. The frequent change between oxygen desaturation and reoxygenation in patients with CIH is associated with increased hypoxic stress, increased systemic inflammation, and enhanced adrenergic activation followed by endothelial dysfunction and increased arteriosclerosis. The pathophysiologic consequences of CPH are less well understood. The relationship between CPH and the development of pulmonary hypertension, pulmonary heart disease as well as polycythemia has been established.
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Baldingerstraße 1, 35043, Marburg, Deutschland.
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Baldingerstraße 1, 35043, Marburg, Deutschland
| | - J Krönig
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Baldingerstraße 1, 35043, Marburg, Deutschland
| | - W Grimm
- Klinik für Innere Medizin, SP Kardiologie, Intensivmedizin und Angiologie, Philipps-Universität, Marburg, Deutschland
| | - J Otto
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität, Marburg, Deutschland
| | - W Hildebrandt
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität, Marburg, Deutschland
| | - R Kinscherf
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität, Marburg, Deutschland
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18
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Koehler U. [250 Years "Inventum novum" - Leopold Auenbrugger]. Pneumologie 2016; 70:S144-S148. [PMID: 27926958 DOI: 10.1055/s-0042-118084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität, Marburg
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Koehler N, Goubeaud M, Hildebrandt O, Sohrabi A, Koehler U. Die Geschichte des Sauerstoffs – von der Entdeckung bis zur medizinischen Anwendung. Pneumologie 2016; 70:S149-S154. [DOI: 10.1055/s-0042-118369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier) Philipps-Universität Marburg
| | - M. Goubeaud
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier) Philipps-Universität Marburg
| | - O. Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier) Philipps-Universität Marburg
| | - A. Sohrabi
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier) Philipps-Universität Marburg
| | - U. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier) Philipps-Universität Marburg
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20
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Koehler U, Hildebrandt O, Kerzel S, Urban C, Hoehle L, Weissflog A, Nikolaizik W, Koehler J, Sohrabi K, Gross V. [Normal and Adventitious Breath Sounds]. Pneumologie 2016; 70:397-404. [PMID: 27177168 DOI: 10.1055/s-0042-106155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Auscultation of the lung is an inexpensive, noninvasive and easy-to-perform tool. It is an important part of the physical examination and is help ful to distinguish physiological respiratory sounds from pathophysiological events. Computerized lung sound analysis is a powerful tool for optimizing and quantifying electronic auscultation based on the specific lung sound spectral characteristics. The automatic analysis of respiratory sounds assumes that physiological and pathological sounds are reliably analyzed based on special algorithms. The development of automated long-term lungsound monitors enables objective assessment of different respiratory symptoms.
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - S Kerzel
- Klinik für Pädiatrische Pneumologie und Allergologie, Universitäts-Kinderklinik Ostbayern am KUNO-Standort St. Hedwig , Regensburg
| | - C Urban
- Alpenklinik Santa Maria, Bad Hindelang-Oberjoch
| | | | | | - W Nikolaizik
- Klinik für Kinder- und Jugendmedizin, Philipps-Universität, Marburg
| | | | - K Sohrabi
- Fachbereich GES, Technische Hochschule Mittelhessen, Gießen
| | - V Gross
- Fachbereich GES, Technische Hochschule Mittelhessen, Gießen
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Koehler U, Weissflog A, Nikolaizik W, Hildebrandt O, Scholtes M, Sohrabi K, Gross V. Objektives Monitoring von chronischem Husten mit dem ambulanten Lung-Sound-Monitoring-System LEOSound. Pneumologie 2016. [DOI: 10.1055/s-0036-1572012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sohrabi K, Scholtes M, Mursina L, Weissflog A, Hildebrandt W, Hildebrandt O, Gross V, Koehler U. Bestimmung der hyperkapnischen Atemantwort bei Patienten mit COPD. Pneumologie 2015; 69:662-6. [DOI: 10.1055/s-0034-1392998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- K. Sohrabi
- Technische Hochschule Mittelhessen, Gießen, Fachbereich Gesundheit
| | - M. Scholtes
- Technische Hochschule Mittelhessen, Gießen, Fachbereich Gesundheit
| | - L. Mursina
- Technische Hochschule Mittelhessen, Gießen, Fachbereich Gesundheit
| | | | - W. Hildebrandt
- Institut für Anatomie und Zellbiologie, Philipps-Universität Marburg
| | - O. Hildebrandt
- Technische Hochschule Mittelhessen, Gießen, Fachbereich Gesundheit
| | - V. Gross
- Technische Hochschule Mittelhessen, Gießen, Fachbereich Gesundheit
| | - U. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
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23
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Koehler U, Hildebrandt O, Walliczek U, Höhle L, Weissflog A, Heselhaus J, Kerzel S, Urban C, Sohrabi K, Gross V. Was ist für die Diagnostik und Therapieverlaufskontrolle von chronischem Husten wichtig? Pneumologie 2015; 69:588-94. [DOI: 10.1055/s-0034-1392616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- U. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | - O. Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | | | | | | | | | - S. Kerzel
- Klinik für Pädiatrische Pneumologie und Allergologie, Universitäts-Kinderklinik Ostbayern am KUNO-Standort St. Hedwig, Regensburg
| | - C. Urban
- Klinik für Pädiatrische Pneumologie und Allergologie, Universitäts-Kinderklinik Ostbayern am KUNO-Standort St. Hedwig, Regensburg
| | - K. Sohrabi
- Fachbereich GES, Technische Hochschule Mittelhessen, Gießen
| | - V. Gross
- Fachbereich GES, Technische Hochschule Mittelhessen, Gießen
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24
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Mursina L, Groß V, Librizzi D, Luster M, Sohrabi A, Seifert O, Hildebrandt O, Heverhagen JT, Koehler U, Sohrabi K. [Pilot Project: Improved Lung Deposition via a New Nasal Inhalation Procedure]. Pneumologie 2015; 69:469-76. [PMID: 26258421 DOI: 10.1055/s-0034-1392444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Inhaled drugs can only be effective if they reach the middle and small airways. This study introduces a system that combines a trans-nasal application of aerosols with noninvasive pressure support ventilation. METHODS In a pilot study, 7 COPD patients with GOLD stages II and III inhaled a radiolabeled marker dissolved in water via a trans-nasal route. The mean aerosol particle size was 5.5 µm. Each patient took part in two inhalation sessions that included two application methods and were at least 70 hours apart. During the first session ("passive method"), the patient inhaled the aerosol through an open tube system. The second session ("active method") included pressure support ventilation during the inhalation process. A gamma camera and planar scintigraphy was used to determine the distribution of aerosol particles in the patient's body and lung. RESULTS The pressure supported inhalation ("active method") results in an increased aerosol lung deposition compared to the passive method. Above all, we could demonstrate deposition in the lung periphery with relatively large aerosol particles (5.5 µm). DISCUSSION The results prove that the combination of trans-nasal inhalation with noninvasive pressure support ventilation leads to significantly increased particle deposition in the lung.
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Affiliation(s)
- L Mursina
- Technische Hochschule Mittelhessen, Fachbereich Gesundheit, Gießen
| | - V Groß
- Technische Hochschule Mittelhessen, Fachbereich Gesundheit, Gießen
| | - D Librizzi
- Klinik für Nuklearmedizin, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - M Luster
- Klinik für Nuklearmedizin, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - A Sohrabi
- Klinik für Nuklearmedizin, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - O Seifert
- Technische Hochschule Mittelhessen, Fachbereich Gesundheit, Gießen
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - J T Heverhagen
- Departement Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie (DIPR), INSELSPITAL, Universitätsspital Bern
| | - U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg
| | - K Sohrabi
- Technische Hochschule Mittelhessen, Fachbereich Gesundheit, Gießen
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25
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Koehler U, Hildebrandt O, Koehler J, Nell C. [The pioneer of bedside teaching - Herman Boerhaave (1668-1738)]. Dtsch Med Wochenschr 2014; 139:2655-9. [PMID: 25490755 DOI: 10.1055/s-0034-1387399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, Philipps-Universität Marburg
| | - O Hildebrandt
- Klinik für Innere Medizin, Philipps-Universität Marburg
| | - J Koehler
- Medizinische Fakultät, Comenius Universität Bratislava
| | - C Nell
- Klinik für Innere Medizin, Philipps-Universität Marburg
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26
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Koehler U, Weissflog A. [The discovery of the capillary system by Marcello Malpighi (1628-1694) as a completion of Harvey's theory of blood circulation]. Dtsch Med Wochenschr 2014; 139:2662-5. [PMID: 25490757 DOI: 10.1055/s-0034-1387270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- U Koehler
- Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - A Weissflog
- Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
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27
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Koehler U, Hildebrandt O, Nell C, Alakhras R, Nikolaizik W, Weissflog A, Hoehle L, Sohrabi K, Totta L, Gross V. Akustisches Langzeit-Monitoring von Atem- und Lungengeräuschen im Schlaf. Somnologie 2014. [DOI: 10.1007/s11818-014-0685-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Koehler U, Koehler Y. „Burnout“ – Krankheit oder Folge von Stress? Dtsch Med Wochenschr 2014; 139:1731-4. [DOI: 10.1055/s-0034-1370293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- U. Koehler
- Klinik Innere Medizin, Schwerpunkt Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
| | - Y. Koehler
- Frankfurt School of Finance and Management Frankfurt/Main
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Koehler U, Hildebrandt O, Nell C, Thiem K, Sibai E, Gross V, Grimm W. [Cheyne-Stokes respiration in patients with chronic heart failure: only a diagnostic marker or also a cardiovascular risk factor?]. Dtsch Med Wochenschr 2014; 139:1009-14. [PMID: 24782155 DOI: 10.1055/s-0034-1369809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Sleep disordered breathing with predominant obstructive or central apnea is an under-recognized but highly prevalent comorbidity in patients with chronic heart failure. As the severity of heart failure increases the prevalence of central sleep apnea (CSA) and Cheyne-Stokes respiration (CSR) is also much more frequent. Cheyne-Stokes respiration is characterized by alternating periods of crescendo and decrescendo respiration followed by central apnea. Present data indicate that CSA-CSR is not only a compensatory response to severe heart failure but also a predictor of worse prognosis. However the results on long-term mortality are not consistent. The prognostic importance of night- and daytime CSR has to be further elucidated. Increased sympathetic nervous activity has been proposed to play a mayor role concerning progression and outcome of chronic heart failure by CSA-CSR.
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Intensiv- und Schlafmedizin
| | - O Hildebrandt
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Intensiv- und Schlafmedizin
| | - C Nell
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Intensiv- und Schlafmedizin
| | - K Thiem
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Intensiv- und Schlafmedizin
| | - E Sibai
- Klinik für Innere Medizin, Schwerpunkt Pneumologie, Intensiv- und Schlafmedizin
| | - V Gross
- Biomedizinische Technik, Fachbereich KMUB (Krankenhaus- und Medizintechnik, Umwelt- und Biotechnologie), Technische Hochschule Mittelhessen, Gießen
| | - W Grimm
- Klinik für Innere Medizin, Schwerpunkt Kardiologie und Angiologie, Philipps-Universität Marburg
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Koehler U, Brandenburg U, Weissflog A, Sohrabi K, Groß V. [LEOSound, an innovative procedure for acoustic long-term monitoring of asthma symptoms (wheezing and coughing) in children and adults]. Pneumologie 2014; 68:277-81. [PMID: 24615666 DOI: 10.1055/s-0034-1365156] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Particularly in young children the diagnosis of asthma is difficult and mostly based on clinical symptoms like wheezing, cough and dyspnea. Children with nocturnal wheezing often suffer from a low quality of sleep and impaired sense of well-being during the day. Physicians recommend that parents record the frequency of asthma attacks or symptoms to help manage their children's disease. The lack of an appropriate method for standardized and objective monitoring makes asthma management difficult. The aim of this paper is to present a new method for automated wheeze and cough detection and analysis. The mobile LEOSound recording and analysing system described here should help improve diagnosis and monitoring of asthma symptoms in children.
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität, Marburg
| | | | | | - K Sohrabi
- Kompetenzzentrum für Informationstechnologie (KITE), Technische Hochschule Mittelhessen, Gießen
| | - V Groß
- Biomedizinische Technik, Fachbereich KMUB, Technische Hochschule Mittelhessen, Gießen
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Koehler U, Hildebrandt O, Jerrentrup L, Koehler KI, Kianinejad P, Sohrabi K, Schäfer H, Kenn K. [Long-term oxygen therapy (LTOT)--what should physicians, homecare-providers and health insurance companies know?]. Pneumologie 2014; 68:193-8. [PMID: 24595853 DOI: 10.1055/s-0033-1359198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Long-term oxygen treatment (LTOT) has been demonstrated to improve prognosis in patients with chronic respiratory insufficiency. In terms of pathogenesis, improved oxygenation, reduction of pulmonary artery pressure as well as reduction of respiratory work are important. Since there are considerable differences between the LTOT systems, individually tailored therapy is needed. In particular, the mobility aspects of the patients must be taken into consideration. It is important to distinguish between stationary/mobile devices with a liquid oxygen system and stationary/mobile devices with oxygen concentrator. Oxygen titration should be performed in relation to rest and activity phases (e. g. 6 minute walk test) as well as in relation to the sleep phase. Employing devices with demand-controlled valves should be critically examined. This can be undertaken only under physician orders and requires continuous monitoring.
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
| | - O Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
| | - L Jerrentrup
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
| | - K-I Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
| | - P Kianinejad
- Medizinische Informatik, Fachbereich MNI (Mathematik, Naturwissenschaft, Informatik), Technische Hochschule Mittelhessen, Gießen
| | - K Sohrabi
- Medizinische Informatik, Fachbereich MNI (Mathematik, Naturwissenschaft, Informatik), Technische Hochschule Mittelhessen, Gießen
| | - H Schäfer
- Medizinische Klinik II, Innere Medizin und Pneumologie, Lungenzentrum Saar, SHG-Kliniken Völklingen
| | - K Kenn
- Schön Klinik Berchtesgadener Land, Schönau
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Koehler U, Cassel W, Hildebrandt O, Kesper K, Kianinejad P, Nell C, Mayer G, Ohl G. Obstruktive Schlafapnoe bei neurologischen Erkrankungen. Nervenarzt 2013; 85:35-42. [DOI: 10.1007/s00115-013-3890-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Würfel W, Suttner R, Shakeshaft D, Mayer V, Schoen U, Sendelbach K, Locher M, Koehler U, Fiedler K, Krüsmann G, Holinski-Feder E. Pregnancy and Birth After a Two-Step PGD: Polar Body Diagnosis for Hemophilia A and Array CGH on Trophectoderm Cells for Chromosomal Aberrations. Geburtshilfe Frauenheilkd 2013; 73:812-814. [PMID: 24771936 DOI: 10.1055/s-0033-1350705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 07/05/2013] [Accepted: 07/16/2013] [Indexed: 12/12/2022] Open
Abstract
Objective: To demonstrate that a PGD program can be successfully established after the 2011 verdict of the German Bundestag concerning PGD. Material and Method: Eight years previously, the couple had had a daughter who suffered from clinically manifest hemophilia A due to an unbalanced X-inactivation, as well as microdeletion syndrome resulting in severe physical and mental disability. The couple wished to have a second child but refused the idea of a "trial" pregnancy. Given the indications for both, it was necessary to carry out polar body diagnosis (PBD) to rule out hemophilia A and, during the same cycle, a subsequent PGD on the blastocysts to rule out genetic aberrations. The PBD and PGD (trophectoderm biopsy, TEB) were performed after high-dosage ovarian stimulation and ICSI fertilization of the oocytes. A blastocyst was successfully transferred on day 6. Results: The patient conceived immediately. The pregnancy developed normally and the patient gave birth to a girl in the 40th week of pregnancy. Post-natal examinations showed that the baby is free from hemophilia A and is developing normally both physically and mentally. Conclusion: Establishment of a PGD program is now possible after legalization of PGD in Germany. It is possible to apply two investigative techniques in a single treatment cycle if multifactorial diagnosis is required.
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Affiliation(s)
- W Würfel
- KCM (Kinderwunsch Centrum München), Munich
| | - R Suttner
- KCM (Kinderwunsch Centrum München), Munich
| | | | - V Mayer
- MGZ (Medizinisch-Genetisches Zentrum), Munich
| | - U Schoen
- MGZ (Medizinisch-Genetisches Zentrum), Munich
| | | | - M Locher
- MGZ (Medizinisch-Genetisches Zentrum), Munich
| | - U Koehler
- MGZ (Medizinisch-Genetisches Zentrum), Munich
| | - K Fiedler
- KCM (Kinderwunsch Centrum München), Munich
| | - G Krüsmann
- KCM (Kinderwunsch Centrum München), Munich
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Gothwal M, Nakamura L, Hainmann I, Koehler U, Schilling F, Rost S, Oldenburg J, Zieger B. Molecular genetic analysis of a patient with moderate hemophilia A and psychomotor developmental delay. Klin Padiatr 2013; 225:175-6. [PMID: 23709133 DOI: 10.1055/s-0033-1341490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Koehler U, Greulich T, Gross V, Hildebrandt O, Redhardt F, Sohrabi K, Weissflog A, Koczulla R. Die akute Exazerbation der COPD. Dtsch Med Wochenschr 2013; 138:837-41. [DOI: 10.1055/s-0032-1332982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- U. Koehler
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - T. Greulich
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - V. Gross
- SP Biomedizinische Technik, Fachbereich Krankenhaus- und Medizintechnik, Umwelt- und Biotechnologie (KMUB), Technische Hochschule Mittelhessen, Gießen
| | - O. Hildebrandt
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - F. Redhardt
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
| | - K. Sohrabi
- Fachbereich MNI, Medizinische Informatik, Technische Hochschule Mittelhessen, Gießen
| | - A. Weissflog
- SP Biomedizinische Technik, Fachbereich Krankenhaus- und Medizintechnik, Umwelt- und Biotechnologie (KMUB), Technische Hochschule Mittelhessen, Gießen
| | - R. Koczulla
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg
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Schudt F, Seifert O, Scholtes M, Koehler U, Sohrabi K, Gross V. Klinische Evaluierung eines akustischen Verfahrens zur nächtliche Bestimmung der Atemstromstärke. Pneumologie 2013. [DOI: 10.1055/s-0033-1334672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sohrabi A, Seifert O, Sohrabi K, Librizzi D, Scholtes M, Koehler U, Gross V. Verbesserung der thorakalen Partikeldeposition bei druckunterstützter nasaler Langzeit-Inhalation (NLI). Pneumologie 2013. [DOI: 10.1055/s-0033-1334678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lewerenz T, Heselhaus J, Seifert O, Scholtes M, Sohrabi K, Koehler U, Gross V. Bewertung eines neuen Gerätes zur automatischen Detektion nächtlicher Wheezing-Ereignisse. Pneumologie 2013. [DOI: 10.1055/s-0033-1334786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Koehler U, Hildebrandt O, Redhardt F, Sibai E. [Was the discovery of the systemic circulation exclusively due to William Harvey?]. Dtsch Med Wochenschr 2012; 137:2700-5. [PMID: 23233300 DOI: 10.1055/s-0032-1327347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- U Koehler
- SP Pneumologie, Intensiv- und Schlafmedizin, Klinik für Innere Medizin, Philipps-Universität Marburg.
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Sohrabi K, Basu D, Schudt F, Scholtes M, Balzer B, Hildebrandt O, Koehler U, Gross V. Bestimmung der Atemstromstärke mithilfe des ThorAKUSTIK-Verfahrens bei Mund- und Nasenatmung. Pneumologie 2012; 66:669-73. [DOI: 10.1055/s-0032-1325692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- K. Sohrabi
- ThoraTech GmbH, Anwenderzentrum Medizintechnik, Gießen
| | - D. Basu
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
| | - F. Schudt
- Biomedizinische Technik, Fachbereich KMUB, Technische Hochschule Mittelhessen, Gießen
| | - M. Scholtes
- Biomedizinische Technik, Fachbereich KMUB, Technische Hochschule Mittelhessen, Gießen
| | - B. Balzer
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
| | - O. Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
| | - U. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
| | - V. Gross
- Biomedizinische Technik, Fachbereich KMUB, Technische Hochschule Mittelhessen, Gießen
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Koehler U, Hildebrandt O, Koehler K, Gross V, Weissflog A, Sohrabi A. Ist die telemedizinische Versorgung von Patienten mit COPD sinnvoll? Pneumologie 2012; 66:302-4. [DOI: 10.1055/s-0031-1291827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- U. Koehler
- Klinik für Innere Medizin; SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
| | - O. Hildebrandt
- Klinik für Innere Medizin; SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
| | - K. Koehler
- Klinik für Innere Medizin; SP Pneumologie, Intensiv- und Schlafmedizin (Direktor: Prof. Dr. C. Vogelmeier), Philipps-Universität Marburg
| | - V. Gross
- Technische Hochschule Mittelhessen, Fachbereich KMUB, Biomedizinische Technik, Gießen
| | - A. Weissflog
- Thora Tech GmbH, Anwenderzentrum Medizintechnik, Gießen
| | - A. Sohrabi
- Thora Tech GmbH, Anwenderzentrum Medizintechnik, Gießen
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Suttner R, Shakeshaft D, Koehler U, Schon U, Harasim T, Wagner A, Holinski-Feder E, Rost I, Wurfel W. P8 First experiences with PGD after trophectoderm biopsy at Kinderwunsch Centrum Munich (KCM), Germany. Reprod Biomed Online 2012. [DOI: 10.1016/s1472-6483(12)60225-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rix M, Valks P, Hao N, Loyola D, Schlager H, Huntrieser H, Flemming J, Koehler U, Schumann U, Inness A. Volcanic SO2, BrO and plume height estimations using GOME-2 satellite measurements during the eruption of Eyjafjallajökull in May 2010. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2011jd016718] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sohrabi K, Leiche L, Weissflog A, Schneider H, Koehler U, Gross V. Telemedical monitored training for patients with chronic pulmonary disease. BIOMED ENG-BIOMED TE 2012; 57 Suppl 1:/j/bmte.2012.57.issue-s1-N/bmt-2012-4223/bmt-2012-4223.xml. [DOI: 10.1515/bmt-2012-4223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sohrabi K, Sohrabi A, Librizzi D, Mursina L, Koehler U, Gross V. Nasal long-term inhalation facilitates enhanced thoracic particle deposition. BIOMED ENG-BIOMED TE 2012. [DOI: 10.1515/bmt-2012-4224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Koehler U, Reinke C, Sibai E, Hildebrandt O, Sohrabi K, Dette F, Grimm W. [Autonomic dysfunction and cardiac arrhythmia in patients with obstructive and central sleep apnea]. Dtsch Med Wochenschr 2011; 136:2622-8. [PMID: 22160956 DOI: 10.1055/s-0031-1292852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Obstructive sleep apnea and central sleep apnea with Cheyne-Stokes respiration are associated with an increased risk of cardiac arrhythmia. Apnea- associated arrhythmia may contribute to sudden cardiac death and premature mortality in those patients. Both forms of sleep apnea excert strong modulatory effects on the autonomic system with a special autonomic profile. Profound vagal activity is leading to bradyarrhythmias, and sypathico-excitation to tachyarrhythmias. Atrial fibrillation and ventricular arrhythmias in obstructive and central sleep apnea patients are mainly found in combination with cardiovascular comorbidity (coronary heart disease, hypertensive heart disease, chronic heart failure). Bradyarrhythmias in OSA are induced by a cardioinhibitory vagal reflex due to obstructed airway. CPAP-therapy has been demonstrated to reduce arrhythmias.
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Affiliation(s)
- U Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg.
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Nell C, Kehr K, Hildebrandt O, Sohrabi K, Cassel W, Greulich T, Koehler KI, Koehler U. Chronische Lungenerkrankung: Sicht der Partner und deren Einschätzung bezüglich der Effekte von Lungensport. Pneumologie 2011; 65:751-5. [DOI: 10.1055/s-0031-1291437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- C. Nell
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
| | - K. Kehr
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
| | - O. Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
| | - K. Sohrabi
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
| | - W. Cassel
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
| | - T. Greulich
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
| | - K-I. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
| | - U. Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg (Direktor: Prof. Dr. C. Vogelmeier)
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Koehler N, Goubeaud M, Hildebrandt O, Sohrabi AK, Koehler U. [The history of oxygen--from its discovery to its implementation as medical therapy]. Pneumologie 2011; 65:736-41. [PMID: 21901664 DOI: 10.1055/s-0030-1256779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- N Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg
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Koehler U. 250 Jahre „Inventum novum” – Leopold Auenbrugger. Pneumologie 2011; 65:532-6. [DOI: 10.1055/s-0030-1256480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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