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Biomedical subjects

B Henkel

Publications and source records attributed to B Henkel.

At least 37 records · Page 2Linked to original sources
PubMed1985

Combined medical and mechanical recanalization in acute myocardial infarction.

A technique of combined medical and mechanical recanalization was employed in 96 patients with acute transmural myocardial infarction. The mean time between onset of symptoms and admission to hospital was 170 +/- 65 min (X +/- SD). After 10 +/- 16 min, 250,000 U streptokinase was administered intravenously for 20 min. Intracoronary thrombolysis was commenced within 38 +/- 14 min. First coronary angiograms demonstrated reperfusion, an open vessel in 25/96 patients (26%). In 15/71 patients (21%) reperfusion occurred during thrombolysis therapy, before mechanical recanalization could be performed. Recanalization was achieved mechanically in 37/71 patients (52%) with occluded coronary vessels. In 8/71 patients (11%) mechanical recanalization failed but the vessel opened during thrombolysis. In 12/96 patients (12%), the coronary vessel remained occluded. Thus, reperfusion could be achieved in 88% of the patients. Reperfusion rate was 76% in the first 38 patients and 95% subsequently. After reperfusion, coronary thrombi were found in 25/96 patients (26%) but dissolved during thrombolysis in 16/25 patients (64%). Peripheral coronary embolism was observed in 3/25 patients (12%). For the whole group, reocclusion occurred in 8/84 patients (10%). By combined medical and mechanical recanalization, the recanalization rate could be increased with low reocclusion rate. Trends showed an improvement in regional and global left ventricular function in patients with anterior myocardial infarction.

Aged↗
PubMed1985

Hemichorea associated with varicella-zoster reinfection and endocarditis. A case report.

A 20-year-old woman developed transient right-sided hemichoreatic movements after household exposure to varicella-zoster. Some days before the appearance of involuntary movements a vesicular rash had occurred. About 6 months later an elevated IgG serum titer against varicella virus was found and two-dimensional echocardiography showed signs of an endocarditis. During the following 2 months the IgG value returned to within the normal range and the choreatic movements disappeared almost totally. The possibility is discussed that endocarditis had been caused and maintained by serum antibodies to varicella-zoster virus which cross-reacted with valvular tissue. Embolization to the region of the left striatum and/or postinfectious encephalitis in this region are assumed to be the most plausible causes of the transient hemichorea.

Adult↗
PubMed1985

Percutaneous transluminal coronary angioplasty (PTCA) following thrombolysis.

After successful intracoronary and intravenous thrombolysis in acute myocardial infarction in about 90% of all cases highgrade organic stenoses of the diseased vessels can be found. These obstructions may impede coronary blood flow and be the reason for recurrent angina in the rehabilitation phase. In a prospective, controlled, randomized study with 127 patients (pts) with acute myocardial infarction 64 pts were treated with streptokinase (group I) and 63 pts were treated with streptokinase and additional PTCA procedures (group II). The patients of both groups did not differ with respect to age, distribution of sex and diseased vessels, time between onset of symptoms and start of lysis or time to maximum of CPK-curve. In group I 59 out of 64 pts had recanalized vessels (92%), in group II 56 out of 63 pts (89%). In 55/56 pts PTCA was attempted (success rate 65%) with an artificial reocclusion in two pts (4%). After four weeks in group I 47 pts were controlled angiographically. The stenosis rate did not differ between the acute phase and the control study (78.6 +/- 11.8% vs. 78.0 +/- 15.2%). Five reocclusions had occurred. In group II the resting stenosis after thrombolysis (81.7 +/- 6.6%) was diminished by PTCA to 33.0 +/- 18.2%. In the control study the remaining stenosis was 31.9 +/- 24.4%. The difference between groups I and II at the four week control was highly significant (p less than 0.001). In group I there were ten deaths during the hospital phase, nine of them of cardiac origin. In group II nine pts died, three from shock lung and five from cardiac causes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

[Detection of aneurysms of the atrial septum using transesophageal echocardiography].

In 7/340 patients (2.1%) examined by transesophageal echocardiography, aneurysms of the intraatrial septum were observed. In no patient were additional shunts present. In 3/7 patients mitral valve and in 2/7 patients tricuspidal valve prolapse was found. Intraatrial septum aneurysms seem to have a higher frequency than that indicated by transthoracical echocardiography. The incidence observed by transesophageal echocardiography corresponds to the incidence of pathological findings.

Adolescent↗
PubMed1985

[Brain abscess in a bidirectional atrial septal defect in adulthood].

An abscess of the brain is a serious complication in patients with congenital heart malformation. The great majority of cases are limited to cyanotic congenital heart disease and a peak in the age distribution can be seen in childhood. We report on a 40-year-old man with progressive right hemiparesis due to an abscess in the left basal ganglia. Clinical aspects and additional diagnostic assessment are described. By cardiologic examination including transoesophageal cross-sectional echocardiography a bidirectional sinus-venosus defect could be detected. This finding supported the diagnosis of a so-called 'paradoxical' brain abscess.

Adult↗
PubMed1984

Atrioventricular dissociation detected by suprasternal M-mode echocardiography: a clue to the diagnosis of ventricular tachycardia.

Twenty-two patients were studied by suprasternal M-mode echocardiography during ventricular tachycardia (VT). Adequate echocardiograms were obtained from 19 patients. Thirteen patients showed atrioventricular (AV) dissociation and 6 patients a ventriculoatrial contraction pattern according to the left atrial (LA) contraction obtained from the suprasternal notch. In 1 of these 6 patients, a 2:1 block retrograde was found by echocardiography. In another patient, an intermittent block occurred in the retrograde direction. In 4 patients, a constant relation between the QRS complex and LA contraction soon after the beginning of the QRS complex was seen, demonstrating a 1:1 ventriculoatrial conduction. According to the LA contraction obtained from the suprasternal echocardiogram, 13 patients showed AV dissociation and 6 patients a retrograde conduction to the LA. From the analysis of the 12-lead standard electrocardiogram obtained simultaneously during VT, AV dissociation could be recognized in only 3 patients. Thus, AV dissociation during VT is more easily diagnosed with suprasternal M-mode echocardiography than with the standard electrocardiogram.

Adult↗
PubMed1984

[Amniocentesis under permanent sonographic surveillance].

81 amniocenteses were carried out during the second trimenon for the purpose of prenatal diagnosis under permanent sonographic surveillance without any complications. Sonographic surveillance means that a sectorial scanner was used (RA1 and Combison 202 R) by the real-time process with a 110 degrees or 60 degrees sectorial field soundhead for closely observing the movements of the amniocentesis needle already in the subcutis. The progress of the needle through the individual layers can be observed continuously. As a matter of fact, the gradual progress of the needle from the extra-amnial to the intra-amnial area can be followed step by step and millimetre by millimetre. If the site of puncture is occupied by the foetus, the procedure can be stopped or interrupted. Depth of penetration of the needle into the amnion can be limited to a few millimetres. This puncture technique will usually eliminate anyl risk of injury to the foetus. Any danger of infection which may be attributed to the needle touching the soundhead or contact jelly, is also eliminated since the amniocentesis needle (sternal puncture needle 0.8 X 90 mm, preferably CSF puncture needle 20 G 3 1/2") is entered into the cutis at a distance of 8 cm from the soundhead. Hence, the only risk involved in amniocentesis which cannot be predicted in advance, would be haemorrhage due to injury to a vessel, mainly in the myometrium or, if transplacental puncture becomes necessary, a possible formation of a haematoma leading to abortion. This possible complication, however, had not been observed by us so far.

Abortion, Spontaneous↗
PubMed1984

[Transluminal angioplasty--unstable angina, fresh infarct].

Transluminal coronary angioplasty is successfully used in stable and unstable angina. Out of 107 patients admitted with unstable angina 28% were treated medically, 24% operatively and 48% by angioplasty. In a total of 116 patients the stenosis diameter was enlarged from 75.0 +/- 11.0% obstruction to 25.1 +/- 16.4% (improvement 49.9 +/- 16.5%) without differences between concentric and eccentric or right and left coronary stenosis. In 11 out of 22 patients with total coronary occlusion of recent origin the vessel was reopened by the balloon and enlarged to a resting stenosis of 22.3 +/- 16.4%. There were no differences in the success- and the complication rate between stable and unstable angina. After successful thrombolysis residual stenoses greater than 50% are dilated during the same session. In a randomized prospective study 51 patients were dilated immediately (group I) and 48 patients (group II) treated conservatively. In group I the reinfarction- and the cardiac death-rate was two patients compared to seven patients in group II. After four weeks there was one reocclusion (3%) compared to five (17%) and a residual stenosis of 31.9 +/- 24.4% versus 78.0 +/- 15.2%. Angioplasty can be used with good results and a low complication rate in unstable angina and following successful thrombolysis.

Aged↗
PubMed1984

[Successful transvenous electric ablation of the AV conduction system in therapy-refractory atrial flutter].

The technique of closed-chest ablation of the atrioventricular (AV) conduction system was used in 3 patients (53-62 years of age) with atrial flutter not responding to medical management. A persistent third-degree AV block was induced in all patients. Moderate increases in CK and CKMB enzymes but not in Tc-pyrophosphate uptake were observed in these patients. 5 days after the procedure a permanent pacemaker was implanted in each case. We conclude that closed-chest ablation of the AV conduction system is a safe and efficient procedure in selected patients with drug-resistant supraventricular arrhythmias.

Adult↗
PubMed1983

[Is tubal sterilization with the Tupla-clip a reversible method?].

Between 1976 and 1981 402 tubal sterilizations were performed with Tupla-clip most of them by laparoscopic application. 11 tubes were removed between 15 and 47 months following the sterilization with the Tupla-clip. The local changes both macroscopically and microscopically to the tupla-clip were evaluated. The possibility of tubal patency following removal of the clips was tested by carbon dioxide pertubation. The tubal-occlusion with the tupla-clip is definitive since all tubes had a fibrous tissue strand where the clip had been applied which still carried blood vessels. No tube was patent with the carbon dioxide pertubation. The intra-operative testing of correct application of the clip and the documentation of this correct application is again mentioned. This is especially important in view of the recent judgements of the federal supreme court regarding liability in failed tubal sterilizations. The excellent chance of reversal by tubal anastomosis and the 100% success rate of this method of sterilization within the 6 years under observation will increase the acceptance of the tupla-clip as a method for tubal sterilizations.

Female↗
PubMed1983

Improved ischemic tolerance during percutaneous transluminal coronary angioplasty by intracoronary injection of nitroglycerin.

Intracoronary injection of nitroglycerin increases ischemic tolerance in 70% of patients with unstable angina during PTCA, thus delaying development of angina pectoris and/or ventricular arrhythmias. Intracoronary injection of nitroglycerin thus seems to be a suitable way of prolonging dilation time in PTCA, an important factor of success rate. Combination with calcium-antagonists may be more effective than injection of nitroglycerin alone.

Adult↗
PubMed1982

[Ultrasound diagnosis of pathologic changes of the uterine tube].

The possibilities of sonographic diagnosis of pathologic changes in the uterine tube are examined by means of a computerised automatic real-time scanner with a statistical B-scan of high resolution. It is not possible to isolate sonographically the anatomically unchanged tube or the tube obliterated as a result of salpingitis. Nevertheless, it is possible to effect an indirect diagnosis if the tube is at least unilaterally patent or if it is bilaterally occluded, by means of an extended form of sonography within the scope of a sonographically controlled hydropertubation via a phenomenon which the author describes an "positive" or "negative" "phenomenon of Douglas". Hence, sonographically monitored hydropertubation, together with hysterosalpingography or laparoscopic chromopertubation--with reservations--is a valuable diagnostic tool to help in clarifying the cause of sterility. Pathological changes of the tubes in the sense of a sactosalpinx of different contents (retained secretions) can be differentiated by sonography. A characteristic sonographic echo pattern is also seen if the tubes are conglutinated with an extremely low amount of liquid collected in the tube. Various pathological changes of the tube can be recognised sonographically directly and indirectly by means of sonography extended in this manner.

Diagnosis, Differential↗
PubMed1979

[The intra-operative proof of occlusion of the tubes in tubal sterilizations (author's transl)].

In tubal sterilization operations with a plastic clip failures with subsequent pregnancies become only known by misplacement of the clips. Failures are more frequent when the clips are placed through a posterior colpotomy. In 163 laparoscopic tubal sterilization with the Tuplar-clip during the last 2 1/2 years no subsequent pregnancy was observed. The carbon-dioxide pertubation or the chromo-pertubation after occlusion of the tubes with a clip permits an immediate intra-operative proof of secure bilateral tubal occlusion. A pregnancy due to faulty placement of the clip is then no longer possible. Other advantages of this method of tubal sterilization are mentioned.

Female↗
PubMed1976

Ionic interactions in eukaryotic ribosomes: splitting of the subunits of rat liver ribosomes by treatment with monovalent cations.

Proteins of rat liver ribosomal subunits were successively split off by stepwise treatment of the particles with various concentrations of LiC1 (0.4--1.0 M) or KC1 (0.6--1.5 M). Split proteins and core particle proteins were analyzed by two-dimensional polyacrylamide gel electrophoresis. The LiC1 concentrations were estimated at which the individual proteins are split off. The proteins of 40S and 60S subunits were classified in 4 and 5 groups, respectively, according to their splitting behavior. The effect of LiC1 and KC1 is similar, but higher concentrations of KC1 than of LiC1 are required to obtain comparable split protein patterns. Evidence for structural changes of the core particles during the split procedures was obtained.

Animals↗