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Biomedical subjects

B Eber

Publications and source records attributed to B Eber.

At least 199 records · Page 11Linked to original sources
PubMed1990

[Correlation between late potentials, left ventricular function and coronary heart disease].

By signal averaging it is possible to registrate late, fragmented low amplitude signals (late potentials, LP's) from the bodysurface 26 patients (21 males, 5 females) with a mean age of 57 years were investigated by signal averaging, Holter-monitoring and cardiac catheterization. 11 patients had a dilative cardiomyopathy (group A), 10 patients a coronary heart disease (group B), 5 of them with an ejection fraction greater than 50%, 5 of them with a reduced ejection fraction, whereas the control-group with 5 patients (group C) showed no coronary stenosis or reduced ventricular function, 6 out of 11 patients with dilative cardiomyopathy showed LP's; all of these with Lown IVb had LP's. In 2 patients with coronary heart disease and good left ventricular function late potentials were found, and in all 5 patients with disturbed left ventricular function. The control-group revealed no late potentials although 4 patients had Lown IVa or more in Holter-ECG. In conclusion, late potentials show a good correlation to malignant ventricular ectopic beats in patients with dilative cardiomyopathy and coronary heart disease, especially when the left ventricular function is reduced.

Adult↗
PubMed1990

Anticardiolipin antibodies are no marker for survived myocardial infarction.

Antiphospholipid antibodies--both the lupus anticoagulant and anticardiolipin antibodies--are closely associated with arterial and venous thrombosis. In this prospective trial the IgM- and IgG-anticardiolipin antibodies in serum were determined in acute and chronic coronary artery disease. Seventy-four unselected males (34-87 years, mean 60) were included in the study. All patients underwent coronary angiography; infectious and autoimmune diseases were exclusion criteria. Sixteen patients had coronary artery disease (group A), 34 showed coronary stenoses with prior infarction (B), and 14 had survived an acute myocardial infarction (C), whereas 10 patients revealed no significant coronary narrowing (D; controls). The major risk factors were the same for all groups. Neither the IgM- nor the IgG-anticardiolipin antibody levels showed any significant difference in the four groups. The severity of coronary artery disease did not correlate to these antibodies. Furthermore, no correlation was found between elevated anticardiolipin antibodies and thrombocyte levels. Thus, a higher anticardiolipin level does not appear to be a marker for recurrent cardiovascular events.

Adult↗
PubMed1990

[The patient following PTCA].

Diagnostic measures after PTCA consist of history, clinical findings, after 3 months and thereafter in 6 months intervals as well as ergometry in case of recurrency of complaints of after 3 months and then in 6 months intervals. A thallium-scintigraphy is done eventually. A repetition of a coronarography is indicated only in cases of typical symptoms or registration of ischemia. Therapy consists of lifelong ASS and calcium channel blockers for 3 months and treatment of risk-factors. Repetition of a PTCA, atherectomy, stent-implantation, laser-angioplasty or bypass-surgery varies from case to case; the decision has to be made individually.

Angioplasty, Balloon, Coronary↗
PubMed1990

Localization of mediastinal parathyroid adenoma by T1-201 scintiscan and SPECT.

A 64-year-old female patient was admitted to our department for fatigue, pain in the right upper abdomen, obstipation, and meteorism. The laboratory findings showed total calcium and ionized calcium elevated, phosphate close to lower limit, and parathyroid hormone increased. T1-201/Tc-99m subtraction scintiscan of the neck and upper mediastinal region did not give any evidence of isolated enhanced uptake suggesting the presence of parathyroid adenoma. After further increases in calcium and parathyroid hormone level T1-201 whole-body scan and single photon emission computed tomography of the thoracic region were performed. These revealed a circumscribed T1-201 uptake in the mediastinum immediately cranial ventral to the heart base. The postcontrast transmission computed tomography of this area confirmed the finding of the T1-201 scintigraphy with a 4 x 3 x 2 cm tumor. After sternotomy and surgical removal of the mediastinal parathyroid adenoma (chief cell adenoma), calcium and parathyroid hormone levels returned to normal values.

Adenoma↗
PubMed1990

Coronary revascularization: influence on ventricular arrhythmias.

Myocardial ischemia may cause severe cardiac arrhythmias. In the present study, the influence of revascularization on ventricular arrhythmias was investigated. A total of 68 patients (61 male, 7 female; mean age 53 years) with coronary artery disease was divided into three groups: Group A (21 patients) underwent percutaneous transluminal coronary angioplasty (PTCA); Group B (37 patients) had coronary artery bypass grafting (CABG); and Group C were 10 patients who served as controls, who had simple coronary angiography. All patients had a Holter ECG on the day before angiography. PTCA patients and controls were restudied on the day after the procedure, while in Group B, Holter ECG was repeated three weeks after surgery. Groups A and B were again studied 18 months after the first Holter ECG. The PTCA group showed a slight reduction in complex arrhythmias immediately following PTCA, which increased again after 18 months; the CABG group, however, revealed a significant increase in complex arrhythmias three weeks after bypass surgery, but a decrease after 18 months. There was no significant change in the control group before or after angiography. Thus, successful revascularization has no influence on ventricular arrhythmias after 18 months.

Adult↗
PubMed1990

4'-O-tetrahydropyranyl-doxorubicin in advanced breast cancer: a phase II study.

In a phase II study, 35 patients with advanced breast cancer were treated with 4'-O-tetrahydropyranyl-doxorubicin (THP-DXR) (70 mg/m2 i.v. on day 1); treatment was repeated every 3 weeks. Eight patients had failed prior chemotherapy for advanced disease. A total of 34 patients were evaluable for response. After a median of 10 treatment courses (range, 3-15), objective tumor response was seen in 59% (20 of 34 patients) (95% confidence limits, 42%-75%). In all, 17 partial remissions and 3 complete remissions were observed; stable disease occurred in 13 patients. The median duration of response was 42+ weeks (range, 21 - 77+ weeks). The dose-limiting side effects were leukopenia (26 patients, WHO grade III-IV) and thrombocytopenia (9 patients, WHO grade II-IV). Nausea/vomiting was experienced by 34 patients; in 18, it reached WHO grade II-III. Other treatment-related side effects included alopecia (WHO grade II-III) in 26 patients and stomatitis and diarrhea (WHO grade I-III) in 9 patients. At cumulative doses of THP-DXR of at least 700 mg/m2 (range, 700-1,050 mg/m2), no signs of congestive heart failure were observed. We conclude that THP-DXR is effective for first- and second-line chemotherapy in advanced breast cancer and that side effects are manageable.

Adult↗
PubMed1990

Effects of benazepril and metoprolol OROS alone and in combination on myocardial ischemia in patients with chronic stable angina.

The efficacy of benazepril, metoprolol OROS and their combination was evaluated in 29 patients (42 to 74 years of age) with chronic stable angina and documented coronary artery disease in a placebo-controlled, double-blind, crossover trial using serial quantitated exercise testing and ambulatory electrocardiographic (ECG) monitoring. The mean (+/- SEM) exercise time was 8.5 +/- 0.7 min with placebo, 8.3 +/- 0.6 min (95% confidence interval [CI]-1.06 to 0.54) with benazepril, 9.4 +/- 0.5 min (95% CI -0.32 to 2.14) with metoprolol OROS and 9.6 +/- 0.5 min (95% CI -0.25 to 2.47) with the combination of benazepril and metoprolol OROS. The mean exercise time to the development of 1 mm ST segment depression was prolonged from 6.0 +/- 0.6 min with placebo to 6.3 +/- 0.6 min (95% CI -0.93 to 1.45) with benazepril, 7.9 +/- 0.5 min (95% CI 0.83 to 3.0) with metoprolol OROS and 8.1 +/- 0.6 min (95% CI 0.88 to 3.29) with the combination of benazepril and metoprolol OROS. Benazepril did not alter the rest or maximal heart rate, whereas metoprolol OROS alone and in combination significantly lowered the heart rate at rest and during maximal exercise. Systolic blood pressure at rest was nonsignificantly reduced, whereas diastolic blood pressure was lowered significantly by all treatments in comparison with placebo. At maximal exercise, only metoprolol OROS, whether given alone or in combination with benazepril, was able to blunt significantly systolic blood pressure and rate-pressure product.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Noninvasive and invasive diagnosis of a huge congenital aneurysm of the left atrium: a case report.

An intrapericardial aneurysm of the left atrium in a twenty-eight-year old asymptomatic woman is reported. The aneurysm was diagnosed by two-dimensional echocardiography and the specific intraaneurysmatic flow pattern was described by color blood flow imaging. To the authors' knowledge such a noninvasive diagnosis of a left atrial aneurysm has never been reported in the literature before. The diagnosis was confirmed by angiocardiography. The aneurysm was successfully resected. The patient was discharged without medication and continues to do well.

Adult↗
PubMed1990

Transient prealbumin-associated hyperthyroxinemia in TSH-producing pituitary adenoma.

This case report describes a 38-year-old male who was hospitalized for further clarification of clinically mild hyperthyroidism. His increased total hormone levels, the elevated free thyroid hormones and the elevated basal TSH with blunted response to TRH strongly suggested a pituitary adenoma with inappropriate TSH incretion. Transmission computed tomography showed an intrasellar expansion, 16 mm in diameter. The neoplastic TSH production was confirmed by an elevated alpha-subunit and a raised molar alpha-sub/TSH ratio. However, T4 distribution on prealbumin (PA, TTR), albumin (A) and thyroxine binding globulin (TBG) showed a clearly increased binding to PA (39%), indicating additional prealbumin-associated hyperthyroxinemia. The absolute values of PA, A and TBG were within the normal range. After removal of the TSH-producing adenoma, basal TSH, the free thyroid hormones and T4 binding to prealbumin returned to normal. Therefore, the prealbumin-associated hyperthyroxinemia had to be interpreted as a transitory phenomenon related to secondary hyperthyroidism (T4 shift from thyroxine binding globulin to prealbumin) rather than a genetically conditioned anomaly of protein binding.

Adenoma↗
PubMed1990

Ketanserin prevents early restenosis following percutaneous transluminal coronary angioplasty.

In the treatment of coronary artery stenoses restenosis represents the main problem in 25-35% of cases following successful percutaneous transluminal coronary angioplasty (PTCA). In the present trial the effect of the 5HT2-serotonergic receptor antagonist ketanserin on the rate of restenosis after 24 h ('early restenosis') or 4-9 months ('late restenosis') was investigated. Preliminary studies demonstrated that ketanserin infused at the dose of 0.1 mg/min inhibited platelet aggregation without evidence of side effects. In the restenosis study, 43 patients (37 males, 6 females; mean 55 years) were randomized into two groups. After PTCA, 22 patients were treated with conventional therapy (group A), whereas 21 received additionally ketanserin (0.1 mg/min for 24 h, group B). The angiograms (prior to, after, 24 h after, and 4-9 months after PTCA) were examined in a blind manner using a computer-based quantitative angiographic system. After 24 h, 3 patients of group A, but none of group B showed restenosis (more than 50% decrease in diameter stenosis). In total, the diameter at the site of stenosis prior to PTCA decreased by 11% in the controls, but remained unchanged in the ketanserin-treated patients. After 4-9 months, 26% of group A (5 out of 19 patients examined) and 22% of the controls (4 out of 18 patients examined) developed restenosis of more than 50%; there was no statistical difference in the degree of residual stenosis between both groups. These findings suggest that a 24-hour infusion of ketanserin following PTCA may prevent early restenosis, but does not influence the incidence of late restenosis.

Adenosine Diphosphate↗
PubMed1990

201Tl myocardial SPECT and beta-endorphin levels in patients with suspected silent ischemia.

Today silent myocardial ischemia (SMI) is a well-recognized phenomenon. However, in the absence of clinical signs suggesting coronary artery disease (CAD), a streamlined diagnostic approach for precise clarification has proved to be difficult. Sensitivity and specificity of ergometric results are rather poor in symptom-free patients. Thus the question arises, whether the necessity of coronary angiography can be established more precisely by 201Tl myocardial SPECT in these patients. Treadmill exercise according to the Bruce protocol, 201Tl myocardial SPECT and coronary angiography were performed in a total of 106 patients with suspected SMI. In group I (high probability of ischemia; n = 46), reversible defects detected by SPECT correlated well with significant stenoses and irreversible defects with subtotal stenoses or complete occlusions. SPECT sensitivity in the detection of ischemia was 91%, its specificity 96%. In group II (low probability of ischemia; n = 60), SPECT sensitivity was as high as in group I (94%) but due to a high number of false-positive results (e.g. cardiomyopathy) specificity was only 75%. However, SPECT was superior to exercise ECG (sensitivity 70%; specificity 56%) in the detection of SMI. In addition, beta-endorphin levels were determined in 180 healthy subjects, 37 patients with symptomatic CAD and in 34 patients with SMI before and during maximum exercise. Exercise values in patients with SMI were significantly higher than in healthy subjects or in patients with symptomatic CAD.

Adult↗
PubMed1990

[A 58-year-old woman with unstable angina pectoris and restenosis after PTCA: successful therapy with ketanserin].

This case report describes a 58-year-old female suffering from unstable angina pectoris showing two-stem disease with occlusion of the left anterior descending artery at angiography. Due to continuous symptoms and ECG-deviations, percutaneous transluminal coronary angioplasty of the occlusion was performed twice with primary success. However, acute re-occlusion with angina and ECG-changes developed after 6 and 2 h, respectively. For technical reasons, immediate bypass surgery was impossible and thus, patient underwent a third dilatation followed by infusion of ketanserin (0.1 mg/min), a S2-serotonergic receptor antagonist, for 24 h. During this period, patient was without complaints and showed normal ECG. Hematocrit fell and viscosity as well as elasticity improved markedly by ketanserin. Renewed angina and ECG-deviations developed 2 h after discontinuation of ketanserin therapy and patient had to undergo coronary artery bypass grafting.

Angina, Unstable↗
PubMed1990

[The role of anticardiolipin antibodies in the pathogenesis of arterial and venous thromboses].

Antiphospholipid-antibodies such as the anticardiolipin-antibodies may lead to a biological false positive test for syphilis. Numerous clinical studies have shown an augmented incidence of both arterial and venous thrombosis in patients with increased serum levels of these antibodies. Most of the trials were case reports of patients with lupus erythematodes. The results of prospective studies on the importance of these antibodies in patients with thrombosis but without autoimmune disorders were, however, somewhat contradictory. In vitro, several explanations for the development of thrombosis by the antibodies exist: inhibition of prostacyclin, prekallikrein, thrombomodulin, interaction with coagulation factors and/or antithrombin III and damage of thrombocytes. In contrast, experimental studies on isolated blood vessels show that IgM-anticardiolipin-antibodies evoke endothelium-independent relaxations and therefore may prevent vasospasm and thrombosis.

Autoantibodies↗
PubMed1990

Serum selenium levels in distinct manifestations of coronary artery disease.

The trace element selenium plays an important role in the oxidation of lipids and is therefore closely associated with atherosclerosis. In a series of 49 unselected male patients having undergone coronary angiography, the serum selenium level was determined using flameless atomic absorption spectrometry (Zeeman technique), and compared to a standard (Seronorm; Nycomed). In the whole series the serum selenium levels were markedly decreased with no significant difference between patients with or without coronary artery disease. The severity of the coronary artery disease (CAD) did not correlate with the selenium level. However, patients with prior myocardial infarction had a significant higher selenium level than those without. Thus, the level of selenium does not appear to be a marker or a risk factor for coronary artery disease.

Aged↗
PubMed1989

[Tl-201 myocardial SPECT in silent myocardial ischemia and angiographically proven coronary heart disease].

Silent myocardial ischemia is defined as true myocardial ischemia without angina pectoris in patients with angiographically detected coronary artery disease. In this study 52 patients (46 male, 8 female: mean age 53 years) with a pathological exercise test but no symptoms were investigated. They showed stenosis of 75% or more of the diameter in at least one coronary segment on angiography. Prior to or after catheterization (within 14 days) Tl-201 SPECT was done and evaluated independently of angiography. A clear correlation between angiographically confirmed stenosis and reversible perfusion defects with Tl-201 SPECT was established (62 out of 76 lesions). Furthermore, there was a significant relation between angiographically detected subtotal or total occlusions of coronary vessels and irreversible perfusion defects using Tl-201 SPECT (35 in 44 lesions) (p less than 0.001). In patients with ST depression but without angina pectoris during the exercise test, the Tl-201 SPECT is highly suited to determine the hemodynamic effect of coronary stenoses.

Angina Pectoris↗
PubMed1989

[Management of acute intrathoracic aortic dissection].

At the intensive care station of the Internal Medicine Department, University Clinic Graz, all patients admitted were promptly and carefully examined in case of suspected acute intrathoracic aortic dissection and immediately treated. In 1987 a total of 4446 patients were referred to this CCU, 893 suffered from acute thoracic pain. In 21 patients of the latter a clinical suspicion of aortic dissection was observed. In 9 patients of these, diagnosis could be established within 5 hours by echocardiography, CT and angiography. 11 patients had no dissection while one positive finding could only be determined by postmortem exam. Retrospectively, these figures for 1982 were 3908 admitted patients, 790 suffering from acute thoracic pain of which only 5 showed suspected dissection. In 3 cases dissection could be confirmed using the same diagnostic procedures, but 2 were without finding. Further 3 patients out of the total series were affected with dissection which could only be determined postmortem. Out of the 9 patients with positive diagnosis, 6 showed Typ I, 1 Typ II and 2 Typ III dissection according to DeBakey (8m, 1f, range 46-78 years). 2 patients underwent surgery immediately after diagnosis, 1 after 12 hours, while 4 cases were conservatively treated. These 7 patients have survived by controlled hypotension up to now (10 to 22 months). Two patients died 2 and 10 hours, respectively, after admission with positive diagnosis. In spite of the severity of this disease prompt and efficient diagnosis and rapid therapeutic management are the key to survival.

Aged↗
PubMed1989

[Metastatic thyroid cancer: sudden death following aclarubicin therapy].

We report on a 62-year-old patient with a metastasising, only poorly differentiated follicular thyroid carcinoma, who was subjected postoperatively to chemotherapy with Aclarubicin. Aclarubicin (Aclaplastin) is a new cytostatic agent, from the group of anthracyclines, with fewer side effects and clearly diminished cardiotoxicity. The patient died suddenly after two treatment cycles with clinical symptoms of cardiac insufficiency; the post-mortem examination, however, revealed that two metastases in the myocardium might have been the cause of death; toxic myocardial damage could be excluded histologically. Upon occurrence of cardial symptoms and signs during therapy with cytostatic agents of thyroid carcinoma with Aclarubicin, whose cardiotoxic side effects are known, the possibility of metastatic spread in the myocardium should, nevertheless, also always be considered in the differential diagnosis.

Aclarubicin↗