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D Metz

Publications and source records attributed to D Metz.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Diagnostic and prognostic value of continuous Doppler in pulmonary embolism].

A prospective study of 18 patients admitted to hospital for acute pulmonary embolism confirmed the reliability of continuous wave cardiac doppler as a non-invasive method of evaluating systolic pulmonary artery pressures. These pressures were calculated by applying the simplified Bernoulli equation to the maximal velocity of regurgitant tricuspid flow and compared with the results of cardiac catheterisation and angiography, the percentage of vascular obstruction being assessed using Miller's index. The correlations between the two methods were good, r = 0.96; p less than 0.001, with a standard error of +/- 5.2 mmHg. The correlations between the velocity of tricuspid flow and the percentage of obstruction were less significant (r = 0.65; p less than 0.005) but improved when patients with pre-existing cardiopulmonary disease were excluded. This technique of non-invasive assessment of haemodynamic parameters also helps in evaluating the underlying pathology; tricuspid regurgitation with velocities greater than 3.5 m/s is associated with pre-existing chronic cor pulmonale, information of prognostic interest which would guide therapeutic management.

Acute Disease↗
PubMed1988

[Validation of a method for measuring the area of aortic stenosis using only continuous Doppler. Value for the surveillance of transluminal aortic valvuloplasties].

Forty patients with aortic valve stenosis underwent continuous wave doppler-echocardiographic exploration followed by catheterization within 24 hours on average. Three methods of aortic functional area calculation, based on the continuity equation principle, were tried and compared with the haemodynamic data. The results of the reference equation (continuity through the whole systole) gave a correlation coefficient r = 0.77 with a standard error (SE) of 0.17 cm2. The continuity equation using only maximum velocity values was less satisfactory: r = 0.69; SE = 0.19 cm2. The simplified equation with an arbitrary 2 cm subaortic diameter and a subaortic velocity obtained by continuous wave doppler recording yielded results that were very similar to those of the reference equation: r = 0.78; SE = 0.16 cm2. It is suggested that this third equation should be used in the follow-up of transluminal aortic valvuloplasties, since its calculation is based only on aortic velocity, which reflects the degree of stenosis, and subaortic velocity, which indirectly reflects left ventricular function.

Adult↗
PubMed1988

[Comparison of 3 methods of calculating valve surface by continuous Doppler in the quantitative evaluation of 42 cases of aortic stenosis in adults].

42 patients with a tight, symptomatic aortic stenosis, underwent a Doppler test followed, within approximately 5 days, with catheterization. Non-invasive measurement of the maximal aortic gradient is obtained by applying Bernouilli's formula to the maximum speed. Three methods of evaluation of the valvular areas are compared. The first method derives from Gorlin's formula. The second corresponds to the ratio aortic flow/mean velocity. The third method uses the continuity equation. The results compared with haemodynamic data are as follows: the correlation factor regarding the gradients is: r = 0.72 (EA: 22 mmHg), going from r = 0.74 (EA: 0.11 cm2) for the first method, r = 0.76 (EA: 0.15 cm2) for the second method and r = 0.81 (EA: 0.10 cm2) for the third method. In conclusion, the calculation of the maximum gradients is of good predictive value to differentiate minimal and tight aortic stenoses. Regarding moderate or decompensated aortic stenoses, it is advisable to follow the Doppler with the measurement of the valvular areas. The first two methods are characterized by their practicality and easy realization; the third method is preferable when there is an associated mitral valve disease.

Adult↗
PubMed1988

[Aortic dissection with normal aortography and x-ray computed tomography. A diagnostic trap not to be ignored].

We are reporting the case of a 63 y.old patient whose initial clinical examination and ultrasonographic data had led to the diagnosis of acute aortic dissection. Only an emergency surgical procedure was able to confirm the diagnosis, after failure of angiography and CT-scan to do so. In the light of this example, we are presenting a reminder of the sensitivity of various paraclinical examinations, classically accepted to establish this diagnosis.

Aortic Dissection↗
PubMed1988

[Floating thrombus of the right atrium in acute pulmonary embolism. Clinical, echocardiographic aspects and therapeutic sequelae].

The performance of a systematic sonocardiography in all our patients hospitalized since January 1985 for pulmonary embolism, has enabled to discover five cases of floating thrombus of the right atrium. Three patients presented an abnormal auscultation, with one of them presenting a tricuspid wedge syndrome. On the sonogram, the aspect of the thrombus, "coil or ball-shaped", floating in the atrial cavity, sometimes prolapsed through the tricuspid valve, associated with the signs of a pulmonary heart, enables to rule out other right intraatrial masses. Pulmonary angiography seems contra-indicated because of the risk of embolus of this thrombus, the migration of which may be fatal. Embolectomy, under extra-corporeal circulation (heart-lung pump) with examination of the right cavities appears to be the treatment of choice.

Acute Disease↗
PubMed1987

[Evaluation of pulmonary systolic arterial pressures by continuous Doppler in tricuspid regurgitation in adults. Apropos of 43 cases].

Forty-three hospital patients with tricuspid regurgitation were prospectively explored by continuous wave Doppler ultrasound to determine their pulmonary systolic arterial pressure. In the absence of pathology of the pulmonary orifice this value corresponds to the sum of the right atrioventricular systolic gradient calculated by Bernoulli's equation DP = 4V2 from the tricuspid regurgitation and the right atrial pressure evaluated by clinical examination. The values obtained are compared with the results of right heart catheterization. Our study showed good correlation (r = 0.90) with a standard error of 8.2 mmHg, the main source of effort being the clinical quantification of right atrial pressure. These results confirm that pulmonary systolic arterial pressure can reliably be measured by this method in the presence of tricuspid regurgitation. The method is of considerable interest in permanent pulmonary hypertension or in emergencies.

Adolescent↗
PubMed1983

[Psoriasis therapy with the aromatic retinoid Ro 10-9359 (Tigason)].

At three University Departments of Dermatology (Berlin, Leipzig, Erfurt) of the GRD, 63 psoriatics (46 men, 17 women) were treated with aromatic retinoid Ro 10-9359 (Tigason) up to a maximum of 84 weeks. In 34 of these cases, photochemotherapy was additionally applied. This combination resulted in a more rapid healing than Tigason alone. The average initial dose amounted to 1 mg per kg body weight. Only in cases of psoriatic erythroderma, the treatment started with a daily rate of 25 mg Tigason. The maintenance dose came to 50 to 25 mg daily. On account of deterioration of the cutaneous condition and/or heavy itching, the treatment had to be discontinued in 4 cases. Side effects as cheilitis, rhagades, loss of hair, and onycholysis disappeared after reduction of the dose. Our study confirmed the good therapeutical effect of Tigason with the various forms of psoriasis.

Adolescent↗
PubMed1981

Incorporation of 14C-linoleic acid in cerebrosides of psoriatic and normal human skin.

Psoriasis is marked by loss of glycoalyx. Glycocalyx is composed of glycoproteins and glycolipids such as cerebrosides. It was shown that the incorporation of 14C-linoleic acid in cerebrosides of normal and psoriatic human skin is different. In psoriatic epidermis and corium the turnover of this fatty acid is significantly elevated. It is suggested that in psoriasis the epidermal cell is not able to build up a regular carbohydrate sequences of lipids because the false carbohydrate chain activates the degradation of glycolipids and in compensating for the increased degradation raises the synthesis rate of glycolipids.

Carbon Radioisotopes↗
PubMed1981

Brainstem-evoked response audiometry: normative data from the preterm infant.

Brainstem-evoked response audiometry (BERA) was performed on 40 preterm infants who had low neonatal risk scores. Mean latencies for waves I and V were obtained from four age-groups, 33-34, 35-36, 37-38 and 39-40 weeks conceptional age. The results indicate that BERA is a valuable and reliable tool in assessment of auditory function in the preterm infant. Also for classification of abnormality it is recommended that 2 standard deviations from the mean latency of wave V be used.

Audiometry↗