Domain-wall lattices in the Te-W(211) system.
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Journal Article↗
Biomedical subjects
E Bauer
Publications and source records attributed to E Bauer.
[Long-term results of surgical coronary vessel intervention in patients with reduced left ventricular function].
From 1975 to 1980, 112 patients with an ejection fraction below 45% underwent coronary artery bypass grafting (CABG) in the Cardiovascular Surgery Unit, University Hospital Zürich. The mean age was 35 years and the mean ejection fraction 32% (21-44%). The vast majority of patients had severe symptoms (angina pectoris or congestive heart failure). Elective surgery was performed in 62 patients (55%) and emergent or urgent in 50 (45%). All were operated on in mild hypothermia (26-30 degrees C). An average of 2.9 bypasses per patient were performed; in 57, internal mammary artery bypass was carried out for revascularization of the left anterior descending branch. - Early postoperative mortality (within 30 days of operation) was 3.6%; all deaths were of cardiac origin. Perioperative myocardial infarction occurred in 7.5% of all patients. Cumulative survival was 83% at 5 years and 68% at 9 years. Mean mortality rate/year was 3.8% with a maximum of 6.5% in the first year after operation. The incidence of angina pectoris and congestive heart failure was significantly lower after revascularization. Cumulative survival was significantly enhanced in patients with complete revascularization (91% at 5 years vs 71% for incomplete revascularization). Early postoperative mortality was especially high in urgent and emergent cases, and was higher after revascularization with internal mammary artery bypass than with venous graft. Postoperative ejection fraction was assessed in 20 patients (12 with 2- or 3-vessel disease and 8 with left main coronary artery stenosis). Ejection fraction was significantly increased only in the patient group with left main coronary artery stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
[Long-term performance of mitral valve bioprosthesis].
Long-term clinical performance of mitral tissue valves was analyzed in a consecutive series of 250 patients (131 men, 118 women; mean age 51 years) over a 13-year period. Mean follow-up was 71 months (range 1-141 months). The total cumulative follow-up period was 1466 years. The late mortality was 2.0% per patient-year, whereas thromboembolism occurred in 1.4% per patient-year, prosthetic valve endocarditis in 1.0% per patient-year, periprosthetic leaks in 0.3% per patient-year and structural valve deterioration in 3.0% per patient-year. The rate of reoperation was 3.4% per patient-year. Actuarial analysis showed the following results (1 year/5 years/10 years): Survival rate: 97 +/- 1%/89 +/- 2%/82 +/- 5%; free of embolisms: 98 +/- 1%/96 +/- 1%/86 +/- 5%; free of endocarditis: 99 +/- 1%/95 +/- 2%/90 +/- 3%; free of valve deterioration: 99 +/- 1%/96 +/- 1%/60 +/- 8%; no reoperation: 98 +/- 1%/94 +/- 2%/57 +/- 8%; free of late complications: 92 +/- 2%/77 +/- 4%/41 +/- 10%. On the basis of our statistical evaluation the probabilities are that, 11 years after implantation of a mitral bioprosthesis: (a) only 35% of patients are free of late complications (including thromboembolisms, prosthetic valve endocarditis, structural valve deterioration and death); (b) and only 50% of patients have not needed reoperation.
Actuarial Analysis↗
[Injuries of the large brain-feeding arteries].
Among 2923 severely injured patients in the period 1980-1988, 17 had injuries or large supraaortic arteries. The incidence was 0.58%, with an overall mortality of 53%. In 75% of survivors there was a persistent neurological deficit. We treated 5 penetrating (A. carotis 4, A. vertebralis 1) and 12 nonpenetrating (A. carotis 11, A. vertebralis 1) injuries. In all penetrating carotid injuries (4) repair was performed on admission and mortality was 50%; 1 of 2 survivors has postoperative hemiparesis. Localization of nonpenetrating carotid injuries (11) was intrathoracic (2), in the neck (7) and intracranial (2). Main complication of nonpenetrating extracranial carotid injuries is neurological deficit (7/9) due to thrombosis (3) or stenosis (4) with embolism (2). Surgery was performed in 3 cases comprising pseudoaneurysm in 2 and concomitant aortic rupture in 1. Mortality was 44%, and 80% of survivors had persistent neurological deficits. Extracranial carotid injuries (n = 13) carried a mortality rate of 83% in occluded and 29% in nonoccluded vessels (p less than 0.05). Location of carotid injury in the neck (n = 11) carried a mortality of 55%, and intracranial (n = 2) of 100% respectively. Duplex-Doppler scanning of carotid arteries is a safe, noninvasive method which is essential in blunt carotid artery trauma. Prognosis is dependent upon the size of cerebral infarction. Once neurologic deficit has been established for more than 24 hours, reconstruction of the artery should be postponed and performed only for complications (pseudoaneurysm or embolization). Clamping of arteries without hypothermic circulatory arrest or shunt should be avoided. The danger of rupture in dissection and pseudoaneurysm is slight.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Electronic properties of ultrathin nickel films on W(110).
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Journal Article↗
Direct observation of scaling by high-resolution low-energy electron diffraction: O on Mo(110).
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Journal Article↗
Liver transplantation with atrioatrial anastomosis for Budd-Chiari syndrome.
We report the case of a young woman with Budd-Chiari syndrome in whom mesentericoval shunt was first performed, followed by transcaval liver resection and hepatoatrial anatomosis 3 years later. Liver transplantation became necessary 5 years later because of deterioarating liver function with portal hypertension and bleeding. Successful transplantation was performed with atrioatrial anastomosis with help of cardiopulmonary bypass, simplifying considerably the technical procedure and reducing dramatically blood loss.
Adult↗
Significance of microbiological and biochemical analyses in empyema thoracis.
Following the indifferent results of a retrospective analysis, a prospective study was undertaken to analyse the causative organisms in 51 cases of empyema. Cultures were positive in 44/51 (= 86.3%) cases. 2 bacterial species were recovered for each empyema. The aerobic gram-positive cocci represented the largest group (57%), followed by aerobic gram-negative bacteria (18.6%), anaerobic bacteria (18.6%), and fungi (5.8%). Polymicrobial empyema accounted for 59.1% of the cases. Anaerobic bacteria were cultured from 36.4% of empyema. Anaerobic bacteria were more frequently isolated from pleural effusions than from other specimens. Swabs were found to be of minor value for anaerobics. Analyses of glucose and pH value in pleural effusions have been reported to be useful in differentiating complicated from uncomplicated effusions in cases where the aspirated fluid is not purulent and is negative on gram stain, but clinical as well as radiological findings point to an empyema. Our results have shown that pH-values less than 7.30 and Glucose less than 60 mg/dl were not absolutely specific for empyema. In contrast, PMN-elastase in pleural effusion and HI-30 in urine showed a statistically significant differentiation of empyema from exudates of other origin.
Anti-Bacterial Agents↗
Different mobilization of calcium in endothelin-1-induced contractions in human arteries and veins: effects of calcium antagonists.
We studied the role of extra- and intracellular Ca2+ in endothelin-1-induced contractions of the isolated human internal mammary artery and vein. Veins were more sensitive to the peptide than arteries (concentration shift:3.2-fold; n = 4-10, p less than 0.05). The Ca2+ antagonists darodipine, verapamil, and diltiazem (10(-7)-10(-6) M) did not prevent the response to endothelin-1 in both vessels. In contrast, darodipine (10(-8)-10(-6) M), added after the contraction had developed, partially reversed the response in the artery (26 +/- 7%) and particularly in the vein (67 +/- 5%; n = 4, p less than 0.005 compared to the artery). Removal of extracellular Ca2+ reduced the contractions to endothelin-1 (10(-8) M) in the artery (control: 89 +/- 4% of 100 mM KCl; Ca2(+)-free: 68 +/- 4% n = 4-6, p less than 0.01), but not in the vein except at low concentrations (10(-9) M) of the peptide. After removal of intracellular Ca2+ with caffeine in the artery, endothelin-1 still evoked a contraction (17 +/- 3%, n = 3; p less than 0.005 vs. control), while in the vein the response was abolished. Thus, mobilization of Ca2+ during endothelin-1-induced contractions differs in the human internal mammary artery and vein. In the artery, the contraction depends on extracellular Ca2+, intracellular caffeine-sensitive Ca2+ stores, and a caffeine-insensitive component, while in veins, mobilization of intracellular Ca2+ is most important. Ca2+ antagonists do not prevent, but partially reverse, endothelin-1-induced contractions indicating that voltage-operated Ca2+ channels do not initiate but contribute to the maintenance of the response.
Caffeine↗
Threshold concentrations of endothelin-1 potentiate contractions to norepinephrine and serotonin in human arteries. A new mechanism of vasospasm?
Endothelin-1 is an endothelium-derived vasoconstrictor peptide. Its circulating levels are below those known to evoke direct vascular effects. To study whether low concentrations of endothelin-1 potentiate the effects of other vasoconstrictor hormones, we suspended isolated human internal mammary and left anterior descending coronary artery rings in organ chambers for isometric tension recording. In mammary artery rings, the contractions to norepinephrine (3 x 10(-8) M) were potentiated by threshold (3 x 10(-10) M) and low concentrations (10(-9) M) of endothelin-1 (96 +/- 35% and 149 +/- 58% increase from control; p less than 0.01 and 0.001; n = 6). The inhibitor of endothelial nitric oxide formation L-NG-monomethyl arginine did not affect the potentiating effects of the peptide. The calcium antagonist darodipine (10(-7) M) prevented the potentiation of the response to norepinephrine evoked by endothelin-1. Similarly, contractions to serotonin (10(-7) or 3 x 10(-8) M) were amplified by endothelin-1 (3 x 10(-10) M) in the mammary (30 +/- 9%) and in the coronary arteries (59 +/- 25%). Endothelin-1 (10(-9) M) further potentiated the response (57 +/- 23% in mammary and 87 +/- 26% in coronary arteries; p less than 0.05; n = 7 and 3). The sensitivity of mammary arteries to calcium chloride was markedly enhanced in the presence of endothelin-1 (3 x 10(-10) M; concentration shift, eightfold; p less than 0.01; n = 5).(ABSTRACT TRUNCATED AT 250 WORDS)
Arteries↗
[Indications and results of surgical treatment of bronchial cancer including small-cell carcinoma].
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Carcinoma, Bronchogenic↗
Angioimmunoblastic lymphadenopathy with trisomy 3: the cells of the malignant clone are T cells.
A method involving simultaneous demonstration of the immunophenotype and the karyotype was applied to a case of angioimmunoblastic lymphadenopathy (AILD), in which the standard chromosome preparation revealed an aberrant clone with trisomy 3 and additional changes. The aberrant mitoses showed a positive reaction with the monoclonal T-cell antibody Leu 4 (CD3). This new method thus provides definite evidence that the malignant clone with trisomy 3, a characteristic finding in AILD, belongs to the T-cell population. Nevertheless, cytogenetically normal T cells were also found. Moreover, a cell from the same clone was found in the phytohemagglutinin-stimulated blood lymphocytes. This finding demonstrates that AILD may have a leukemic variant.
Chromosomes, Human, Pair 3↗
Permeation of the human skin by heparin and mucopolysaccharide polysulfuric acid ester.
Punched samples of different specimens of human skin were treated with 5 mg/cm2 of commercially available topical preparations of heparin (50,000 IU/100 g, i.e. 0.35% w/w) or mucopolysaccharide polysulfuric acid ester (MPS, 1.4 and 0.45% w/w, respectively; active ingredient of Hirudoid). Heparin and MPS were labelled with tritium. The skin samples were fixed into a perfusion chamber. Perfusion fluid and skin were analysed 180 to 360 min later. The concentrations found in the corium varied from 0.005 to 0.1 IU heparin per g (i.e. 0.03 to 0.64 micrograms/g) and from 1.05 to 3.14 micrograms/g of MPS. While in normal skin the single administration of heparin and MPS resulted in levels of the same relative magnitude, skin with thinner epidermis and decreased horny layer (keloids) absorbed MPS to a higher degree. Repeated administration of a 1.4% MPS cream (0 and 90 min, measurement after 180 min) resulted in markedly enhanced levels, which were out of proportion especially in the deeper skin layers. This effect was confirmed with a 0.45% MPS cream. The direct comparison to the heparin cream resulted in higher heparin levels in the epidermis but higher MPS levels in all deeper skin layers, when calculated to the same concentration in the cream. The heparin in the dermal layers and in the perfusion chamber fluid was determined by molecular binding to protamine loaded sepharose 4B.
Glycosaminoglycans↗
[Surgical and perioperative problems of heart transplantation].
Orthotopic heart transplantation is an established treatment for terminal cardiac diseases. Close cooperation and coordination with other clinics and laboratories is mandatory to transplant a good organ with minimal ischemic time. Accurate donor evaluation and treatment is essential for fast recovery after operation. Our series is 79 orthotopic heart transplantations form 9/85 to 10/89 in 78 patients. Average ischemic time is 38 minutes in organ procurement from table to table and rises distinctly in distal heart procurement (n = 33), but is usually under 120 minutes at organ procurement from any place in Switzerland. The transplantation is performed in the technique from Lower and Shumway. Immunosuppression with triple therapy (Cyclosporin A, Azathioprim, Prednisone) and initial cytolytic therapy is well tolerated. Consequent diagnosis and treatment for rejection and infections lead to good short and medium term survival. Prophylactic treatment is indicated in high risk constellation for cytomegalovirus and toxoplasmosis infection. Early mortality (less than 30 days) was two out of seven and caused by bacterial infections. Actuarial survival is 91% at one and two years and 85% at three years with good quality of life and NYHA class I.
Heart Diseases↗
Gluteal necrosis after acute ischemia of the internal iliac arteries.
Ligation of the internal iliac artery mostly remains without consequences because of the well established collateral network. In patients with compromised collateral circulation however, acute interruption of both hypogastric arteries during aorto-iliac surgery or transluminal embolisation can lead to necrosis of the gluteal muscles and other adjacent organs (rectum, bladder, lumbosacral plexus). Experience with 3 similar cases after aorto-iliac surgery demonstrates two main intraoperative mechanisms: 1. Embolisation, 2. Ligature of both internal iliac arteries in patients with compromised arteriosclerotic collaterals. Despite of adequate therapy, mortality is over 70%. The most important feature during aorto-iliac operations is to preserve at least one internal iliac artery by either reimplantation of the main stem or by an additional bypass to this artery.
Aged↗
Pharmacokinetics of auranofin a single dose study in man.
Three days after cholecystectomy 7 patients were given a single dose of auranofin (5 tablets Ridaura = 4.35 mg gold). Gold was detected in samples of blood, plasma, urine, bile and feces. The determinations were carried out using instrumental neutron activation analysis. The mean gold concentrations reached maximum in blood and plasma after 2 h and in urine and bile after 16 h. The mean terminal half-lives were 7.6 days (blood), 15 days (plasma) and 6.5 days (bile). Cumulative amounts of gold excreted in bile, urine, and feces were 1.6, 4 and 40%, respectively.
Aged↗
[Ventricular septal defect following myocardial infarct].
Surgery was performed for postinfarction ventricular septal defect (VSD) in 25 consecutive patients (14 men, 11 women; mean age 68 +/- 8 years). 9 patients were preoperatively in cardiogenic shock and required mechanical circulatory support by intra-aortic balloon pump (IABP) before surgery, whereas 11 acute patients underwent surgery without use of the IABP beforehand. The following procedures were performed: VSD patch closure in 25/25 patients, resection of infarct in 15/25, and patch enlargement of the left ventricle in 3/25. The overall 30-day mortality was 6/25 (24%). However, mortality was higher (4/9 [44%]) in the group with IABP support versus the group of acute patients without it (2/11 [18%]: p less than 0.05). In patients with significant postinfarction VSD, surgical closure appears to be mandatory.
Aged↗
[Heparin and mucopolysaccharide polysulfuric acid ester permeate human skin].
After topical application of commercial preparations containing heparin and heparinoids (MPS) in concentrations of 30,000 up to 150,000 IE/100 g, the individual layers of the skin show more or less increased heparinization, which can be traced by means of the permeation chamber technique. The average concentration of heparin and MPS in the dermal layers containing capillaries is about 0.1-0.5 IE/ml and 400-40,000 ng/ml, respectively, depending on the quality of the horny layer. We did not find any evidence for the permeation being activated either by DMSO, urea, or other accelerators. Repeated exposition to the preparation within 4 hours, however, resulted in increased permeation of heparin and MPS. The amount of the gel or ointment applied was of no significance.
Fibrinolytic Agents↗