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Biomedical subjects

B Eber

Publications and source records attributed to B Eber.

At least 217 records · Page 12Linked to original sources
PubMed1989

[Redilatation with the trefoil balloon catheter in 2 patients with a high degree of aortic stenosis].

Percutaneous transluminal balloon valvuloplasty (PTBV) is successfully applied in the treatment of calcified aortic stenosis. However, results following redilatation have not yet been dealt with in the literature. This method was successfully used in two patients (62a m/70a f) suffering from severe sclerotic aortic stenoses. Redilatation was undertaken in the first case after one month and after four in the second. A second redilatation by balloon catheter was done upon request of the patients after a further nine months. Following this third dilatation both patients suffered from femoral thrombosis which was treated surgically in the second case, while in the first local thrombolysis was done. In the management of the first patient valve replacement had to be performed four months after the last dilatation due to renewed complaints, while the second patient showed no evidence of recurrence within three months after the last dilatation.

Aged↗
PubMed1989

Diagnosis of hepatic hemangioma with 99mTc-labeled red cells: single photon emission computed tomography (SPECT) versus planar imaging.

This paper reports the results of a prospective study carried out to demonstrate the most important advantages of 99mTc-blood pool single emission computed tomography (SPECT) versus the established method of planar scintigraphy (PS) in the non-invasive diagnosis of liver hemangiomas. The study group comprised 40 patients in whom positive evidence of 56 hemangiomas, detected incidentally in the course of screening examinations, was established via SPECT and PS. The sensitivity of SPECT was 51/56 (91%), of PS 22/56 (39.3%); for lesions smaller than 30 mm in diameter, the sensitivity of SPECT was 31/38 (81.6%), of PS 6/38 (15.8%). All lesions with diameters of more than 30 mm were detected by both PS and SPECT. However, the SPECT method proved to be clearly superior in the identification of lesions which were smaller than 30 mm and located in unfavourable topographical sites (dorsal or subphrenic). The study proves that SPECT with 99mTc-labeled erythrocytes is the ideal complement to ultrasonography in the detection of liver hemangionas; its major advantage over TCT (transmission computed tomography) is its safe application in cases with contrast agent intolerance and hyperthyroid patients. Moreover, liver biopsies are dangerous and ill-suited for the verification of diagnosis.

Adult↗
PubMed1989

[Current status of balloon valvuloplasty in adulthood].

The percutaneous transluminal balloon valvuloplasty has been in use for several years as part of interventional cardiology for treating acquired aortic and mitral stenosis. In spite of a high primary success rate the difficulty of this procedure lies not only in the problem of reststenosis but also in a possible development of restenosis. In aortic stenosis the indication for valvuloplasty must be restricted to special patients, such as elderly people or those with poor left ventricular function, whereas in selected patients, mitral valvuloplasty appears as a true alternative to operative commissurotomy. There can be no doubt that by intensive patient selection and progress in the technology of balloon catheters and insertion sheaths, possibly enhanced by laser application, even better results are to be achieved in the near future.

Adult↗
PubMed1989

[Do thrombocyte aggregation inhibitors modify silent episodes of unstable angina pectoris in combined anti-angina therapy?].

Pathological and clinical studies suggest that platelets play role in the pathogenesis of unstable angina. This study investigated the effect of aspirin on silent episodes of unstable angina. Patient exclusion criteria were acute infarction, left bundle branch block, and ST-depression greater than 0.1 mV in the ECG. 27 patients (pts; 20 m, 7 f; 42-72 yrs) in the CCU with unstable angina were randomized in two groups. Group A received a combination on nitrates, beta-blockers, and calcium entry blockers; in group B aspirin (500 mg/day) was added. 6 h after initiating therapy, Holter-ECG was implemented for 48 h. One pt of group A was excluded owing to infarction within these 48 h. 4 of 13 pts in group A and 5 of 13 in group B showed no ST-Segment abnormalities. 6 pts from each group displayed 2 to 5 ST-depressions greater than 0.1 mV from up to 10 min in 24 h; 3 in group A and 2 in group B had 1-5 lasting 11 to 25 min. In the second 24 h period, the number of ST-depressions decreased distinctly. Statistically, the results obtained did not differ significantly in the two groups. Furthermore, the duration of the silent ischemia did not correlate with the severity of coronary stenosis (angiography 3-8 days after admission). Thus, when combined with the aforementioned triple therapeutic regimen, aspirin does not appear to influence the silent episodes of unstable angina pectoris.

Aged↗
PubMed1989

[The endothelium and antithrombotic substances].

Thrombin is a component of the coagulation cascade which leads to the formation of fibrin. In platelets, thrombin promotes aggregation. Thrombin not only interfers with hemostasis, but also exerts profound vascular effects. In canine coronary arteries, thrombin leads to endothelium-dependent relaxations via the production of endothelium derived relaxing factor. Higher concentrations, however, lead to contractions. Without endothelium the relaxations are abolished whereas the contractions may be augmented. In ischemic coronary arteries same reactions could be observed. Antithrombotic substances like heparin or hirudin inhibit the vascular effects of thrombin. Heparin binds in the proximity of the catalytic sites, whereas the bindings sites for hirudin can be found in the anionic group of the enzyme. Furthermore, heparin interacts with platelets and fibrinolytic substances and may be inactivated. Recombinant hirudin, however, is a selective thrombin antagonist, does not influence vascular smooth muscle tonus and does not lead to bleeding. Thus, hirudin may be an ideal substance for treating thrombin-induced vasospasm in coronary heart disease.

Animals↗
PubMed1989

[The inadequate status of information of interested lay persons about the educational campaign regarding risk factors for cardiovascular diseases].

181 interested individuals (75 males, 106 females; range 16 to 84 years) responded to a questionnaire issued by the Styrian Cardiovascular Lay Society. The main topic of the questionnaire concerned information gained via media, about the possible risk factors related to cardiovascular diseases and about any changes in life style consequent to this information. The results show that the general knowledge in this field especially in younger subjects is disappointing and that there is need for further intensive information and education.

Adolescent↗
PubMed1989

[Myocardial damage following lightning injury].

In a 27-year-old woman, struck by lightning behind the left ear, the ECG showed signs of an acute posterior-lateral myocardial infarction after 1 h of unconsciousness and loss of memory. Her serum enzymes were increased as is typical of myocardial infarction, but the patient did not complain of cardiac symptoms. Besides clear signs of lightning injury, the patient showed a hemorrhage throughout the left breast and transient pericardial effusion was observed by echocardiography. In the course of two months, the ECG revealed a regression to unspecific ST-T-deviations and serum enzymes became normal. TI-201-myocardial-scintigraphy (SPECT), done six days and two months after lightning injury, excluded reversible and irreversible perfusion defects.

Adult↗
PubMed1988

[Status of information of interested lay persons: results of a questionnaire survey by the Styrian Heart Association].

181 interested individuals (75 males, 106 females; range 16 to 84 years) responded to a questionnaire issued within the information and instruction courses of the Styrian Cardiovascular Non-professional Society. The main topic of the questionnaire concerned information gained via media, possible risk factors leading to cardiovascular diseases and any changes in living conditions due to such facts. The results show clearly that the general knowledge in this field especially in younger subjects is disappointing and further intensive information and instruction would be urgently required.

Adolescent↗
PubMed1988

Comparison of different methods of ST measurement for evaluation of myocardial ischaemia in Holter monitoring.

Long-term ambulatory electrocardiographic monitoring [AEM] of the ST segment is clinically the most practical test for the documentation and quantification of myocardial ischaemia. However, there is still some controversy about the validity of ST measurements in Holter monitoring. Therefore, in the present study, in a series of 26 patients with angiographically proven (greater than 70%) coronary heart disease and a positive exercise electrocardiogram, the number, duration and the severity of symptomatic and asymptomatic ischaemic episodes were measured by (1) the ST change at the J point, (2) the ST change 0.07-0.10 s after the J point (immediately before the T wave), (3) the change of the slope of the ST segment, and (4) the area under the ST segment, with a Reynolds Pathfinder III and compared with visual analysis. At the J point (1) there were a total of 264 episodes with a duration of 3947 min and a maximum of 0.35 mV, before the T wave (2) 276 episodes with a duration of 3440 min and a maximal change of 0.40 mV; looking at the slope of the ST segment (3) the figures were 118, 1041 min and regarding the area under the ST segment they were 198, 2385 min. In conclusion, ST deviations are safely detected by automated analysis of the ST segment. Compared with visual analysis (220 episodes), deviation of the ST1 (J point) and ST2 point (80 ms thereafter) overestimate the incidence of true ischaemic ST depression by about 20%.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1987

[Pathologic enzyme patterns in sonographically verified liver metastases].

The serum enzyme pattern, consisting of GOT, GPT, lactate dehydrogenase, gamma glutamyl transpeptidase and alkaline phosphatase, was investigated in 128 patients with sonographically verified liver metastases. Gamma glutamyl transpeptidase and alkaline phosphatase turned out to be the most sensitive enzymes, being elevated in 89% and 88%, respectively. The GOT was elevated in 45% GPT in 37.5% and lactate dehydrogenase in 56% of all cases. The enzyme elevation did not correlate with the degree of liver involvement. In conclusion, pathological serum enzyme patterns are useful for the detection and follow up of liver metastases. Normal serum enzyme levels do not rule out the presence of liver metastases.

Enzymes↗
PubMed1987

[A 42-year-old patient with a metastasizing insulinoma].

We report the case of a patient suffering from a rapidly metastasizing insulinoma who after a period with noncharacteristic symptoms suddenly fell into confusional states leading to initial misinterpretation.

Adenoma, Islet Cell↗
PubMed1987

[Is sonography superior to enzyme diagnosis in the detection of hepatic steatosis?].

In order to evaluate the diagnostic value of sonography in steatosis of the liver, liver biopsies were performed in 52 patients with sonographically diagnosed steatosis of the liver. 27 of 28 patients with normal serum enzymes showed an estimated steatosis of 10 to 40% on histological examination. In the other 24 patients with increased serum enzyme levels histological steatosis was found in 20 patients. 8 further patients with presumed systemic disorders had both normal sonographic findings and normal serum enzyme levels and when subjected to liver biopsy showed an estimated steatosis in the range of 5 to 10%. Reliable sonographic diagnosis of steatosis of the liver can be made only if the degree of steatosis exceeds 10% at least. Normal serum enzyme levels do not exclude steatosis of the liver.

Enzymes↗
PubMed1986

[Sonographic comparative studies of the portal vascular system before and following endoscopic sclerosing of esophageal varices].

On the occasion of 35 episodes of oesophageal injection therapy in which partly the intravascular and partly the perivascular injection technique were used, real time sonographic measurements were performed on the veins of the portal system immediately before and after sclerotherapy. In the case of intravascular injection, both the portal and the splenic vein and the confluens of the splenic and the superior mesenteric vein showed an increase in diameter, whereas in the cases of perivascular injection such changes were minimal or absent. The practical applicability of such sonographic calibrations could possibly lie in certain conclusions that could be drawn concerning the degree of vascular compression or obliteration during each session of sclerotherapy.

Esophageal and Gastric Varices↗
PubMed1984

[Modification of the FT4-level and the nonspecific peripheral thyroid parameter by heparin].

Heparin produces changes in FT4-levels both in vivo and in vitro as determined by commercial kits. Methods utilising the principle of equilibrium dialysis show significant increases whereas methods using T4-tracer analogue techniques reveal marked decreases in FT4-values. Possible clinical side-effects of heparin administration such as heparin-induced hyperthyroidism and tachyarrhythmias are discussed. The present results confirm the FT4-decreasing effect of in vivo and in vitro administration of heparin with FT4-RIAs based on the tracer analogue technique; however, the unspecific peripheral thyroid parameter of systolic time-intervals did not reveal any tendency towards hyperthyroidism. Also the discrepant results dependent on the method used, indicate that, following heparin administration FT4-levels do not reflect that hormone concentration is relevant to the metabolism of the whole body.

Adult↗
PubMedDate not supplied

Serum neopterin and activity of coronary artery disease.

Inflammation plays a key role in the pathogenesis of atherosclerosis. In coronary artery disease (CAD), the release of different cytokines activates cellular defense. Infiltration of neutrophils and monocytes/macrophages is detected in the vessel wall in patients with CAD. Macrophages activated by interferon gamma synthesize metalloproteinases and neopterin, a pteridin derivative that has been used as an immune marker. To determine neopterin levels in patients with chronic CAD and acute coronary syndromes, the authors studied 116 subjects: 1) 25 consecutive patients (18 men, 7 women; mean age 68.5 +/- 14.3, range 40 to 86 years) with unstable angina or acute myocardial infarction (AMI); 2) 31 consecutive patients (25 men, 6 women; mean age 64 +/- 12.7, range 47 to 83 years) with signs and symptoms of clinically stable CAD; and 3) 60 consecutive healthy blood donors (38 men, 22 women; mean age 54.4 +/- 6.23, range 44 to 66 years). Neopterin levels were determined with a commercially available enzyme-linked immunosorbent assay method. In patients with unstable angina and AMI before thrombolytic therapy, neopterin levels were not significantly different from levels in patients with stable CAD (5.97 +/- 1.4 versus 7.84 +/- 3.56 nmol/L; P = 0.15). Neopterin levels in both patient groups did not significantly differ from levels in control subjects (P > 0.1). Neopterin levels in patients with unstable angina and AMI were measured four times during a 72-hour period. The lowest value was observed at baseline and differed significantly from values after 72 hours (P < 0.001; 5.97 +/- 1.4 versus 9.25 +/- 2.36). Neopterin levels after 72 hours were also significantly different from initial values in patients with stable CAD (P < 0.001). There was no correlation between neopterin and creatine kinase (CK) levels, CK-MB isoenzyme, or troponin I as markers for the extent of the myocardial injury during the observation period. These data do not support previous reports of higher baseline levels of serum neopterin in patients with unstable angina or AMI compared with patients with chronic, stable CAD and healthy controls. Neopterin as a marker of macrophage activation is significantly increased in patients with AMI and unstable angina shortly after the onset of symptoms (after a period of 72 hours), supporting the hypothesis of monocyte and macrophage activation in patients with an acute coronary syndrome or AMI.

Adult↗
PubMedDate not supplied

Syncope in dilated cardiomyopathy is a predictor of sudden cardiac death.

Fifty percent of patients with dilated cardiomyopathy die within 5 years of diagnosis. Syncope is known to be a predictor of poor outcome in patients with advanced heart failure. To assess the risk of patients with dilated cardiomyopathy with a history of syncope during standard medical treatment we compared this group to similar patients without syncope. Twenty-three patients with angiographically proven dilated cardiomyopathy and syncope were followed prospectively and compared to 201 patients without history of syncope. All patients showed a left-ventricular ejection fraction of less than 45%. Both groups did not differ in left-ventricular ejection fraction at baseline (30 +/- 7% in the syncope group, 30 +/- 8% in the no syncope group). Mean follow-up was 2.6 years in the syncope group and 2.4 years in the no syncope group. At baseline, syncope patients used more often amiodarone (p < 0.04), while there was no statistically significant difference between the two groups regarding the intake of digitalis, diuretics and angiotensin-converting enzyme inhibitors. Twenty-six percent of patients in the syncope group and 20% in the no syncope group died during follow-up (non significant). The striking difference, however, was the type of death: 5 out of 6 patients in the syncope group died suddenly compared to 13 of 41 patients in the no syncope group (p < 0.025). Patients with dilated cardiomyopathy and a history of syncope are at high risk of sudden death.

Aged↗
PubMedDate not supplied

Subclinical thyroid disorders in patients with dilated cardiomyopathy.

UNLABELLED: Severe thyrotoxicosis can cause irreversible congestive heart failure. To investigate the coincidence of subclinical thyroid disorders and idiopathic dilated cardiomyopathy (IDC) we investigated these patients with respect to their morphological and functional thyroid status. Thyroid sonography as well as thyroid hormone levels were measured in all patients. RESULTS: Sixty-one patients (50 male, 11 female) with chronic stable IDC were included. Two out of 61 patients showed completely normal thyroid morphology and function. The other 59 patients showed either morphological or functional abnormalities or both. Of the 53 patients with morphological abnormalities 23 patients (all male) showed diffuse goiter as opposed to 29 nodular enlarged organs (24 male, 5 female). No clinically significant hypothyroidism or thyrotoxicosis was seen. A good correlation was found between the duration of IDC and thyroid volume (r = 0.44; p < 0.001). Two patients died during the study period, 1 from sudden death and 1 from progressive heart failure. CONCLUSION: Subclinical thyroid disorders are frequently seen in patients with long-standing IDC when they live in an area of chronic iodine deficiency. This can be explained by chronic salt restriction as basic treatment for congestive heart failure. Therefore we conclude that examination of the thyroid gland should be done routinely in patients with IDC, especially when restriction of salt intake is recommended by the treating physician.

Adult↗