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Biomedical subjects

D Heinrich

Publications and source records attributed to D Heinrich.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Hemodynamics and changes in compliance of the extra-thoracic capacity system following administration of prostacyclin (PGI2)].

Hemodynamic effects of prostacyclin (PGI2) given as an intravenous infusion at a rate of 8 ng/kg/min were assessed in 50 patients with coronary artery disease at the time of aortocoronary bypass surgery. 1. During steady-state neuroleptic anesthesia, after sternotomy and pericardiotomy, before cannulation of the aorta and vena cava PGI2 led to the following changes: decreases in mean arterial pressure (-24%), total peripheral resistance (-46%), left ventricular pressure (-12%) and left ventricular end-diastolic pressure (-48%), increases in heart rate (+9%), cardiac output (+41%), stroke volume (+30%) and dp/dtmax (+26%) as well as nonsignificant decreases in right ventricular filling pressure (-13%) and mean pulmonary arterial pressure (-9%) together with an unaltered rate-pressure product. 2. In a randomized double-blind study PGI2 was infused throughout the period from two minutes prior to, until termination of extracorporeal circulation. The effects on compliance of the extrathoracic venous system were analyzed on the basis of changes in venous pressure and oxygenator volume. As compared with controls, patients receiving PGI2 were found to have a significant increase in compliance (.157 ml/mm Hg X kg). Thus, in this setting, PGI2 can affect marked vasodilatation with reductions in peripheral resistance and mean arterial pressure together with increases in cardiac output and heart rate.

Clinical Trials as Topic↗
PubMed1983

Effects of prostacyclin during cardiopulmonary bypass in men on plasma levels of beta-thromboglobulin, platelet factor 4, thromboxane B2, 6-keto-prostaglandin F1 alpha and heparin.

A randomized double-blind study was carried out on 40 male patients requiring aorto-coronary bypass surgery. 20 patients received a constant dose of 8 ng kg-1 min-1 of prostacyclin (PGI2), beginning two minutes before extracorporeal circulation (ECC) and ending together with ECC. Compared to the placebo-treated patient group (n = 20), PGI2-treatment significantly reduced the ECC-induced release of platelet alpha-granule proteins, beta-thromboglobulin (1178 ng/ml vs. 1926 ng/ml) and platelet factor 4 (837 ng/ml vs. 1245 ng/ml) into plasma (mean of max. values). Furthermore the decrease of platelet counts during ECC was less pronounced in PGI2-treated patients. Application of PGI2 had no effect on the increase in thromboxane B2 (TxB2) plasma levels, which amounted to 0.6 ng/ml at the end of ECC. PGI2-treatment resulted in significantly elevated plasma concentrations of 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) (2.1 ng/ml) throughout the infusion off prostacyclin. 6-keto-PGF1 alpha plasma levels increased up to 1.2 ng/ml in the control group patients, indicating a stimulation of endogenous PGI2 formation during ECC.

6-Ketoprostaglandin F1 alpha↗
PubMed1983

Prostacyclin in aortocoronary bypass surgery: a double-blind, placebo-controlled study.

In a double-blind, placebo-controlled trial of 40 patients requiring aortocoronary vene transplant surgery, prostacyclin (PGI2) was infused in a dose of 8 ng/kg/min throughout cardiopulmonary bypass. When compared with the placebo-group, the patients treated with PGI2 were found to have significantly higher platelet counts 60(2) and 90 minutes after onset of extra-corporeal circulation (EC). Although this platelet preservation by PGI2 was accompanied by less degranulation of alpha-granula, total antithrombin III (AT III) as well as active AT III and factor Xa inhibitory activity did show comparable results in both treatment groups. In the early phase of EC coagulation factors (fibrinogen, prothrombin and factor VII) exhibited a trend in favour of higher plasma levels in the PGI2-treated group. The same results were found for plasminogen. F VIII-related antigen and complement factors (C3, C4, C3 activator) did not show any difference between the two treatment groups. Bleeding times, blood loss and renal function also did not exhibit any significant differences between the two groups of patients. Except for one control (60 minutes after onset of EC) hemodynamic parameters were not significantly different between the two patient groups. Whether the trend in favour of a lower mortality in PGI2-treated patients can be confirmed, will be up to further studies with greater numbers of patients.

Antithrombin III↗
PubMed1983

N-terminal peptide of pro-opiomelanocortin in human amniotic fluid.

N-terminal peptide of pro-opiomelanocortin (N-POMC) was measured in the human amniotic fluid. At the gestational age of 16 to 20 weeks, the radioimmunoassay with three different antibodies demonstrated the respective values of 2.39 +/- 0.78, 4.69 +/- 2.27, and 5.92 +/- 2.66 ng/ml. These values are approximately 10 times higher than the measurements in the plasma of women at the corresponding gestational period. The amniotic fluid collected during the delivery had significantly lower concentrations of N-POMC than the amniotic fluid at 16 to 20 weeks' gestation. However, the plasma values of N-POMC had increased approximately three times when measured at delivery and compared with the plasma values at 16 to 20 weeks' gestation. Adrenocorticotropic hormone, measured simultaneously with N-POMC in some of the samples, showed changes similar to those in N-POMC. The N-POMC immunoreactivity from the amniotic fluid has the same retention time on reversed-phase high-performance liquid chromatographic separation as the peptide purified from the human pituitary gland, thus indicating the identity of both peptides.

Adrenocorticotropic Hormone↗
PubMed1982

Clinical evaluation of the hepatitis safety of a beta-propiolactone/ultraviolet treated factor IX concentrate (PPSB).

The association of viral hepatitis, type B, with the use of prothrombin complex concentrates (PPSB) has been well documented. PPSB prepared from cold-sterilized plasma (beta-propiolactone treated and UV irradiated) has been shown not to induce hepatitis in chimpanzees. 500 U of cold-sterilized PPSB were infused into 5 healthy male volunteers. Previous to, and up to 6 months after, PPSB-application in addition to careful clinical investigations, the following hepatitis parameters were determined: SGOT, SGPT, y-GT, alkaline phosphatase, total serum bilirubin, HBsAg, HBcAb and HBsAb. On the basis of all of the above parameters there was no indication of induction of viral hepatitis following the application of PPSB prepared from beta-propiolactone/UV treated plasma.

Adult↗
PubMed1982

[Carcinomatous meningeosis during cis-platinum treatment of gynaecological cancers (author's transl)].

Two cases of carcinomatous meningeosis are reported. One occurred during cis-platinum combination treatment (PAC-scheme) for advanced ovarian carcinoma and one during the same treatment for a carcinoma of the cervix. Both patients showed no neurological problems prior to chemotherapy. The central nervous symptoms developed rapidly following the administration of small doses of cis-platinum (total dose 160 or 300 mg) and could not be controlled. In one case tumour cells were found in the cerebral spinal fluid. The cause of death could have been an unusually toxic reaction to cis-platinum. A thorough neurological examination prior and during chemotherapy with cis-platinum is necessary in order to recognize toxic side effects of the drug as soon as possible.

Adult↗
PubMed1981

[The direct fetal electrocardiography following intra-uterine fetal death (author's transl)].

During labor the maternal cardiogram was traced through the dead fetus. The technical prerequisites for this phenomenon are described. The concomitant intra-uterine tracings of the contractions showed decelerations during the contractions in the maternal cardiogram obtained from the dead fetus. Similar observations have been described by other authors. The etiology of maternal cardiographic decelerations during the contractions is discussed. Decelerations in the maternal cardiogram traced from the dead fetus during labor may result in misinterpretations which lead to inappropriate obstetric management.

Adult↗
PubMed1981

[Preliminary results using the histocan needle biopsy for the microscopic evaluation of gynaecologic tumours (author's transl)].

In a preliminary study the new "Histocan"-needle was tested in respect of its diagnostic value in patients with palpatory findings suspicious for recurrent cancer in the pelvis and in patients with breast tumours. Initially there were some difficulties in handling the biopsy needle. Furthermore we saw some haematomas after breast biopsy, which could be avoided, however, by compression of the biopsy wound. From the morphological point of view the fine structures of tissue specimen were without the gross needle-conditioned artifacts and in some respect could be interpreted better than in Silverman-biopsies. Statistical data can only be given after finishing our cooperative studies.

Biopsy, Needle↗
PubMed1981

[Maternal mortality in the Rheinische Landesfrauenklinik Wuppertal from 1917 to 1979 (author's transl)].

From 1917 to 1979, the maternal mortality in the Rheinische Landesfrauenklinik Wuppertal has been investigated on the basis of 136084 live births. From 1917 to 1921, it was 10.1% and decreased to 0.16% in the period from 1973 to 1979. The maternal mortality in association with caesarean section, which was 11.8% in the period from 1917 to 1921 with a frequency of caesarean sections of 2.5%, decreased to zero since 1973 with a frequency of 6.3%. A caesarean section preceded more than 50% of the deaths since 1962. Most of the decreased (24.4%) were in the group of 30-34 years of age and 48.3% aged more than 30 years. 51.5% were primiparas and 14.6% of the women were at least para 4's. From 1917 to 1936, infection was the main cause of maternal mortality with 39.6%; from 1957 to 1966, however, thrombo-embolism advanced to the leading cause with 27.3%. Since 1960, 4 of 35 deaths were anaesthetic deaths. During all the examined periods, non-specific reasons of maternal mortality were an important factor with more than 30%.

Age Factors↗
PubMed1981

[Ultrasonographic diagnosis of a combined malformation syndrome - hydrocephalus - evisceration and dysplasia of the extremities (author's transl)].

The article reports on the ultrasonographic criteria in a complex malformation syndrome (hydrocephalus, evisceration and phocomelia of the lower extremities). Additional examination methods which are suggested whenever there is a suspicion of foetal malformation, are described. The majority of severe congenital malformations can be discovered antenatally via thorough sonographic examination of the foetus in the longitudinal and transverse axes.

Abnormalities, Multiple↗
PubMed1980

Post-transfusion thrombocytopenic purpura: immunological and clinical studies in two cases and review of the literature.

Two patients with post-transfusion thrombocytopenic purpura are described, the first cases recognized in Austria and Germany. Both patients were female, 51 and 60 years of age. The purpura was evoked by blood transfusions with a latent period of 2 and 7 days. The thrombocytopenic episode lasted for 22 and 60 days. In one case, thrombocytopenia was associated with agranulocytosis due to transient bone marrow failure. Both patients were negative for the platelet-specific antigen PlA1 (= ZWa). Their sera contained PlA1 as well as potent HLA antibodies. Detailed clinical and serological data are presented. The literature with a total of 25 cases so far reported is surveyed.

Agranulocytosis↗