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Biomedical subjects

B Meier

Publications and source records attributed to B Meier.

At least 199 records · Page 11Linked to original sources
PubMed1996

[Acute dyspnea].

A 75 year old patient was hospitalized because of acute dyspnea. For two weeks she suffered from a flu-like illness with low-grade fever, cough, and fatigue. On auscultation systolic and diastolic murmurs were found whose intensity changed depending on the position assumed by the patient. Transthoracic and transoesophageal echocardiography showed a tumor in the left atrium obstructing the left ventricular inflow tract. The tumor was removed surgically because of this obstruction and the imminent danger of embolism to the peripheral arteries. The diagnosis of an atrial myxoma was confirmed intraoperatively and by histology.

Acute Disease↗
PubMed1996

[Lipoprotein(a) and plasma lipids in 429 elderly and very old subjects: significance as risk factor, effect of nutrition and life style].

Lipoprotein(a) [Lp(a)] was discovered in 1962. Lp(a) consists of an LDL particle linked to apolipoprotein(a). The latter shows large genetically determined interindividual variation in size. The close relationship of apo(a) to plasminogen suggests interactions with coagulation. Epidemiological studies established Lp(a) as an independent cardiovascular risk factor. In a follow-up to the Basel Study, we measured Lp(a) in 429 healthy men and women aged 65-95. The influence of nutrition and lifestyle and correlation with plasma lipids and other cardiovascular risk factors was analyzed. The mean concentration was 416 +/- 266 mg/l (median 320 mg/l). Lp(a) concentration did not differ between men and women. In contrast to the simultaneously determined lipid fractions, Lp(a) concentration is lower with increasing age. The correlation with plasma cholesterol is low but statistically significant (p < 0.01). Higher Lp(a) values were associated with a history of myocardial infarction and anticoagulant medication (p < 0.01). Other risk factors did not correlate with Lp(a). There was a low but statistically significant correlation between low Lp(a) and regular intake of vitamin pills. Our results confirm the association of longer life expectancy with low Lp(a) concentration, which are to a large extent independent of external factors. Thus, Lp(a) could be a true longevity gene.

Aged↗
PubMed1996

[Catheter closure in atrial septal defects and open foramen ovale using the Sideris buttoned device].

Percutaneous nonsurgical closure is an alternative to surgical repair of a significant atrial septal defect (ASD) or a patent foramen ovale (PFO) associated with systemic embolism without other cause. We report the results of the first 35 patients (19 ASDs, 16 PFOs) in whom transcatheter closure was attempted. Diagnosis and follow-up were based on transesophageal echocardiography in the majority of cases. In all patients the "Sideris buttoned device" was used. A total of 19 patients (13 women) were treated for symptomatic ASD of the secundum type. The mean defect size before the intervention was 17 mm by echocardiography and 24 mm measured by balloon in the catheterization laboratory (stretched diameter) with a reduction to 4 mm after treatment measured by echocardiography. A total of 16 patients (5 women) underwent transcatheter closure of a PFO; 14 patients had had cerebral embolic events and 2 peripheral. During follow-up of 104 patient months, only one patient had a recurrent embolic event. He had at that time no occluder protecting the PFO after early embolization and extraction of the device.

Adolescent↗
PubMed1996

[Risks in diagnostic and therapeutic invasive cardiological procedures].

The risk of invasive cardiologic interventions being associated with morbid and mortal events is substantially related to the absolute numbers in whom these procedures are performed and this, in turn, is due to the epidemiologic significance of diseases of the cardiovascular system in industrialized countries. Diagnostic cardiac catheterization with coronary angiography is an invasive procedure with a relatively low risk of complications ( approximately 1%) or death (approximately 0.1%). Percutaneous transluminal coronary angioplasty (PTCA), on the other hand, carries a risk of complications of approximately 4% and has a mortality of approximately 1%. The major source of complications with intracoronary stent implantations relates to their thrombogenicity with acute or subacute closure of the vessel (rate of complications 6-15%, mortality approximately 2%). In vessels of < or = 3 mm in diameter, the restenosis rate of a stenotic lesion treated with a stent approximates that of conventional PTCA (one third). Patients with reduced left ventricular ejection fraction are at substantial risk if treated with drugs instead of bypass surgery (better long-term survival in the latter group.

Angioplasty, Balloon, Coronary↗
PubMed1996

[Coronary fistula in adults. Review with reference to personal experience].

A consecutive series of 5384 coronary arteriograms was retrospectively investigated for the presence of coronary artery fistulas. 15 fistulas were found in 14 patients, corresponding to a prevalence of 0.26%. All the fistulas were small and hemodynamically insignificant. There were no fistula-associated complications. Most of the fistulas were discovered as incidental findings during an otherwise indicated coronary angiography (8 patients). In the 6 patients without other cardiac pathology, the investigation was performed because of a systolo-diastolic murmur in 2 cases, myocardial ischemia caused by a "coronary-steal phenomenon" in 2 cases, and chest pain in 2 cases. With the exception of a fistula between two coronary arteries and a postoperative fistula, all of them originated from the proximal part of the coronary arteries (9 from the right, 6 from the left). Most of the fistulas drained into the main pulmonary artery (73%).

Adult↗
PubMed1996

Ultrasound-guided compression repair for treatment of femoral artery pseudoaneurysm: acute and follow-up results.

Femoral artery pseudoaneurysm is a significant problem in patients undergoing arterial diagnostic or therapeutic catheterization. The aim of this investigation was to report the incidence of pseudoaneurysm after arterial catheterization and the success rate of ultra-sound-guided compression repair. During a 3-year period (11/91-11/94) 9,051 patients underwent 7,312 cardiac catheterizations and 1,739 peripheral percutaneous transluminal coronary angioplasty procedures. Patients suspect of pseudoaneurysm were referred for a color Doppler ultrasound examination. All patients with pseudoaneurysm were considered for ultrasound-guided compression repair. Pseudoaneurysm occurred more frequently after interventional procedures with new devices (valvuloplasty 2.3%, stent 3.2%) than after conventional catheterization diagnostic cardiac catheterization 0.2%, electrophysiology 1.3%, percutaneous transluminal coronary angioplasty 0.2%). The incidence of pseudoaneurysm after peripheral percutaneous coronary transluminal angioplasty, including intra-arterial lysis and stent, was 1%. Ultrasound-guided compression repair was successfully performed in 37 of 41 cases with pseudoaneurysm (90%). Ultrasound-guided compression repair was successfully performed in 30 of 31 patients (97%) without anticoagulation and in 7 of 10 patients (70%) receiving anticoagulants (P < 0.05). There was no correlation between mean diameter of the pseudoaneurysm, age of the lesion, or antiplatelet therapy. Color Doppler ultrasound re-examination at up to 3 months indicated successful treatment in all patients. The use of complex interventional catheterization procedures leads to an increased frequency of pseudoaneurysms compared with conventional angiography and percutaneous transluminal coronary angioplasty. Ultrasound-guided compression repair is a non-invasive, efficient, safe and cost-effective therapy for post-catheterization pseudoaneurysm.

Adult↗
PubMed1996

EXAFS investigation of the active site of iron superoxide dismutase of Escherichia coli and Propionibacterium shermanii.

The local structure of the iron site in ferric superoxide dismutase from P. shermanii was analyzed by X-ray absorption spectroscopy. The metal-ligand cluster of the enzyme is found to be similar to the crystallographically investigated ferric superoxide dismutase from E. coli. At pH 6.4 the enzyme is five-fold coordinated with three histidines, an aspartate and a water molecule. The average bond lengths between the metal and the histidines are about 2.10 A, between metal and aspartate they are about 1.86 A and between metal and water 1.96 A. With an increase in pH a change in the coordination number from five to six is observed both in pre-edge peak and EXAFS spectra analysis. However, the bond lengths of the ligands do not change dramatically, they are conserved for the aspartate and increase slightly to 2.13 A for the average metal-histidine distance at pH 9.3. The observation of the increase in coordination number is correlated with a decrease in enzymatic activity which occurs in the high pH range. The zinc EXAFS spectra of P. shermanii superoxide dismutase have shown that zinc can be incorporated in the active center instead of the iron.

Amino Acid Sequence↗
PubMed1996

Occlusion of large atrial septal defects with a centering buttoned device: early clinical experience.

A feasibility clinical study was conducted for the transcatheter occlusion of large ostium secundum atrial septal defects with the centering buttoned device. The centering buttoned device is a modification of the regular buttoned device in which a centering counter-occluder is sutured at the central 40% portion of the occluder. During centering it is stretched, forming a parachute-shaped structure and pulling the occluder over the center of the defect. During buttoning, the counter-occluder forms a double figure eight, opposing the right atrial side of the atrial septum. Occlusion was performed in 12 patients aged 6 to 56 years. All had been rejected for transcatheter occlusion by the regular buttoned device, because of either their defect size or the lack of adequate septal rim. The defect size varied between 23 and 31 mm, and the device size varied between 45 and 60 mm. Nine had immediate effective occlusions of their defects and three residual shunts. One patient with unbuttoning had hemolysis at 2 weeks and underwent surgery. Early results of the transcatheter occlusion of large atrial septal defects are promising, and larger clinical trials are justified.

Adolescent↗
PubMed1996

Interventional cardiology in Europe 1993. Working Group on Coronary Circulation of the European Society of Cardiology.

An annual survey on cardiac interventions in Europe is performed by the working group on Coronary Circulation of the European Society of Cardiology with the help of the national societies of cardiology. A questionnaire about cardiac interventions in 1993 was mailed to a representative of the national societies of 35 members of the European Society of Cardiology. The data collection of coronary interventions was delayed by slow backreporting and from 10 of the 35 national members data were missing or grossly incomplete. They were excluded from the analysis. CORONARY ANGIOGRAPHY: A total of 756,822 coronary angiograms were reported resulting in an incidence of 1146 +/- 1024 per 10(6) inhabitants, ranging from 24 (Romania) to 3499 (Germany). This represents an increase of 12% compared to 1992. Germany (279,882 cases), France (157,237), the United Kingdom (77,000), Italy (44,934) and Spain (37,591) registered 79% of all the coronary angiograms performed. PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY: A total of 183,728 percutaneous transluminal coronary angioplasty cases were reported in 1993, 24% more than in 1992. On average, they accounted for 18 +/- 7% (range 8 (Romania) to 35% (Sweden) of the coronary angiograms. Most of these percutaneous transluminal coronary angioplasties (82%) were confined to a single vessel. In 13% only, percutaneous transluminal coronary angioplasty took place immediately after the diagnostic study. Adjusted per capita. Germany ranks first with 873 percutaneous transluminal coronary angioplasties per 10(6) inhabitants, followed by France (737), Holland (725), Belgium (713), and Switzerland (665). The European mean of percutaneous transluminal coronary angioplasties per 10(6) inhabitants was 270 +/- 279, representing an increase of 14% compared with 1992. A major in-hospital complication was reported in 3.8% of the patients undergoing percutaneous transluminal coronary angioplasty: 0.6% hospital deaths, 1.5% emergency coronary artery bypass grafting, and 1.7% myocardial infarctions. NEW DEVICES: In 1993 stents were implanted in 6444 patients (3.5% of all percutaneous transluminal coronary angioplasty patients), equally distributed between bail-out situations (53%) and elective procedures. The 14 stent implanting countries showed a mean increase in incidence of coronary stenting of 53% compared with 1992. Other interventional devices were applied in 7045 cases, 3.8% of all percutaneous transluminal coronary angioplasty cases. Coronary ultrasound (2194 cases) and coronary angioscopy (380 cases) were performed infrequently. NON-CORONARY INTERVENTIONS: Valvuloplasties were most frequently performed non-coronary interventions European countries performed more than 300 valvuloplasties each in 1993. Most of them were mitral valvuloplasties in southern countries. CONCLUSIONS: Although partial backreporting might conclusions, several findings of this survey are noteworthy for the participating countries: The number of percutaneous taneous transluminal coronary angioplasties is universally increasing. There is an extremely wide range of coronary angiography and percutaneous translumina, coronary angioplasties performed per population. The most common additional procedure is a stent implantation while other new devices are only rarely applied. Mitral valvuloplasty is the most frequently performed non-coronary intervention.

Angioplasty, Balloon, Coronary↗
PubMed1996

Familial hypercholesterolaemia with severe cardiac involvement in a boy: successful management and mid-term follow-up.

A 13-year-old boy with double heterozygosity for familial hypercholesterolaemia with a 90% left coronary artery main stem stenosis is reported. The patient's cholesterol levels were effectively controlled with weekly sessions of selective low-density lipoprotein cholesterol removal through immunoadsorption by use of an extracorporeal system. Left main coronary artery stenosis was successfully treated with percutaneous transluminal balloon dilation. At 30 months after the intervention and still under treatment with weekly sessions of low-density lipoprotein apheresis the patient is free of cardiac symptoms. He shows normal exercise capacity and normal myocardial perfusion. It is concluded that aggressive management is justified in such patients and may result in a near-normal quality of life.

Angiography↗