Biomedical subjects

E Krause

Publications and source records attributed to E Krause.

At least 109 records · Page 6Linked to original sources

PubMed1991

[Risks of combined surgical treatment of acquired heart valve defects and coronary heart disease].

In the past years the number of patients with combined treatment of the heart valves and coronary arteries rised as well as the patients age did. In 1980-1987 the rate of patients with aortic valve replacement and simultaneous aorto-coronary bypass was 10.9% in those who underwent aortic valve replacement and 2.9% in those who had aorto-coronary bypass operation. Since 1988 the ratios changed to 18.2% and 4.9%. For the calculation of the operative risk of the combined operative treatment (AVR + CABG, MVR + CABG) we compared these groups with those patients with isolated operations (MVR, AVR, CABG). We studied all patients during 1980 and July 1989. The hospital mortality of combined procedures was significantly increased. The mortality among female patients was higher as compared to the male group. The age of patients treated by the combined procedures was higher as compared to the isolated procedures. The mean age of the patients which died was severely increased as compared to the isolated procedures. However, in the combined procedures this increase was not as pronounced as in the isolated groups. Patients with combined procedures had a higher NYHA class. The risk factors of the combined procedures were comparable to isolated CABG.

Aortic Valve↗

PubMed1990

Polyalkylenes used as stationary phases for preparative reversed-phase liquid chromatography.

Polyethylene and polypropylene were employed as stationary phases for preparative liquid chromatography and compared with LiChroprep RP-18. Polyalkylene phases are chemically stable and have homogeneous hydrophobic surfaces, but they are physically less resistant than silica-based phases. The influence of organic modifiers and salt ions on the capacity factors of aromatic hydrocarbons and peptides was determined. Peptides prepared by solid-phase peptide synthesis were purified on polypropylene. The results demonstrate the usefulness of polyalkylenes in preparative reversed-phase liquid chromatography, particularly for basic peptides.

Chromatography, Liquid↗

PubMed1990

[Effect of long-term therapy with prazosin/propranolol on blood pressure and cardiopulmonary function in essential hypertension].

In 25 hypertensives (42 +/- years), predominantly at stage I according to WHO-criteria, by the application of daily 5 +/- 4 mg prazosine and as combination of 9 +/- 6 mg with 73 +/- 31 mg propranolol the blood pressure normalized itself from on an average 183 to 148 mgHg systolically and 113 to 93 mgHg diastolically. In a long-term experiment confirmable also echocardiographically prazosine alone decreased the afterload of the heart in an unchanged high energy requirement at rest, and in a submaximal ergostasis the aerobic metabolic situation deteriorated. This could again be balanced by the combination with propranolol, whereby oxygen pulse, product of the pressure frequency and PWC 130 even improved. Function and size of the left ventricle remained echocardiographically uninfluenced in the two forms of therapy.

Adult↗

PubMed1990

Clinical evaluation of hypothermic ventricular fibrillation, multi-dose blood cardioplegia, and single-dose Bretschneider cardioplegia in coronary surgery.

37 patients undergoing coronary revascularization were randomly assigned to three protocols for intraoperative myocardial protection: hypothermic ventricular fibrillation (HF) (n = 13), multi-dose blood cardioplegia (BCP) (n = 12) and single-dose Bretschneider's crystalloid cardioplegia (CCP) (n = 12). As intraoperative markers of ischemic damage myocardial ultrastructure, ATP, and CP contents were determined in left ventricular biopsy specimens taken before and after cardiac arrest. Release of serum enzymes (CK, CK-MB, LDH, SGOT) was determined pre- and postoperatively. Hemodynamic data were assessed before, during, and after operation. The incidence of low cardiac output, positive inotropic support, intraaortic balloon counterpulsation, peri-operative myocardial infarction, rhythm disturbances, and the rate of spontaneous defibrillation was compared between groups. The results show a better preservation of high energy phosphates in the BCP group as compared to the HF and CCP groups. Myocardial ultrastructure showed moderate ischemic damage in the hypothermic fibrillation group; in contrast, only slightly deteriorated cells were seen after cardiac arrest, when cardioplegia was used. The incidence of rhythm disturbances was 25% for HF and 42% for CCP. In contrast, only 17% of new rhythm disturbances were seen in the BCP group. Functional recovery (i.e. CI and SWI) of hearts protected with BCP was generally greater as compared to HF and CCP. Release of MB-creatine-kinase isoenzyme was higher in the HF group as compared to cardioplegia. Clinical outcome in terms of incidence of peri-operative infarction, positive inotropic support and low cardiac output was superior in the BCP group but not significantly different between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardioplegic Solutions↗

PubMed1990

Results of surgical repair for 110 thoracic aortic aneurysms.

Between 1974 and July 1989 110 operations for thoracic aortic aneurysms in 107 patients (69 males, 38 females) were performed, whose ages ranged from 14 to 74. 37 patients had an aortic valvular disease, 15 had Marfan's syndrome, 28 of these patients had a history of thoracic trauma or of previous aortic or cardiac surgery (14 posttraumatic aneurysms, 9 aneurysms after cardiac surgery, 5 after repair of aortic coarctation), 29 patients had hypertension. 63 patients underwent repair of dissecting aneurysms, 47 of non-dissecting (saccular or fusiform) thoracic aortic aneurysms. 67 repairs were emergency and 43 elective. The hospital mortality for the entire series was 34.5%. The analysis of multiple preoperative and intraoperative variables showed that mortality following thoracic aortic aneurysm repair is higher with increasing age (65.7% mortality for operations between the 60th and 70th year of age, 100% mortality beyond the 70th year of age) and emergency surgery (hospital mortality 52.2% compared with 6.9% for elective operations). A significant increase in mortality was noted related to the aneurysm type (poorer prognosis in DeBakey type I and II), to history of hypertension, to preoperative shock or to perforation of the aneurysm, including haemopericardium or haemothorax.

Age Factors↗

PubMed1990

Adequate flow through the internal mammary artery graft achieved by a dilatation technique.

From Jan. 1984 to Dec. 1988 941 patients had internal mammary artery grafting alone or with vein grafts. There were 1705 associated vein grafts and 957 internal mammary grafts, for a total of 2 662 grafts (2.8 per patient). Use of the internal mammary artery was indicated in patients younger than 70 years with a significant stenosis of the main stem or the proximal left anterior descending artery in elective operations. The overall operative mortality was 3.4%, 2.9% for men and 6.2% for women. It rose to 9.6% in patients who were in New York Heart Association Class IV. Incidence of bleeding requiring reexploration was 5.5% and an intra-aortic balloon pump was implanted in 3% because of low cardiac output. At cardiac recatheterization (on average after 12 months) 88.3% of the internal mammary grafts and 63.3% of the vein grafts were patent. In investigation of, reasons for operative mortality, measuring the free flow of the internal mammary artery showed flow rates of 32-208 ml/min only slightly depending on the blood pressure. A technique of dilatation is described that significantly increases the flow rate up to 85%. The technique has been used regularly since Nov. 1987: from that date the IMA is only used if it has a flow rate of at least 60 ml/min.

Coronary Circulation↗

PubMed1990

Calcium overload in human giant cell myocarditis.

Myocardial calcium overload was observed in a patient with giant cell myocarditis. The myocardial calcium content estimated by atomic absorption spectrophotometry amounted to 120 mEq/kg dry weight, and the von Kossa stain disclosed multiple foci with patchy calcifications of myocardial fibres. Cytochemical examination of the ultrastructural calcium localisation using the phosphate-pyroantimonate method showed considerable variation in the subcellular calcium distribution. In normal myocytes calcium precipitates were confined to the inner leaflet of the sarcolemma, T-tubules, intercalated disks, and sporadically to mitochondria. In contrast, extensive calcification of mitochondria and loss of sarcolemmal calcium was evident in necrotic myocytes. A number of grossly normal myocytes also showed an increase of calcium precipitates in slightly swollen mitochondria. These findings suggest that myocardial calcium overload in this case started in viable myocytes and was not merely a secondary phenomenon occurring after cell death.

Calcinosis↗

PubMed1990

[Thoracic aneurysms: criteria for surgical indications and results].

Elective operations of chronic thoracic aortic aneurysms (TAA) can be performed with low risk. In contrast, emergency repair of TAA in symptomatic patients including those with rupture is associated with a high mortality. The worst results were obtained (a) in patients who were in shock preoperatively, (b) with palliative procedures during acute dissection and (c) in patients older than 70. The results may be improved by early diagnosis and better operative technique and perioperative management.

Adolescent↗

PubMed1990

[Rupture and fragmentation of a polyethylene terephthalate balloon catheter in a calcified coronary artery stenosis].

We report a case of rupture and fragmentation of a PET-balloon catheter during percutaneous transluminal coronary angioplasty of a calcified LAD-obstruction. When the insufflation pressure was increased to 12 atm, the balloon ruptured. During withdrawal of the balloon catheter the tip of the shaft and a fragment of the balloon tore off and remained within the atheroma. Emergency operation was necessary to remove the fragments and to prevent a large myocardial infarction. Although this is an unusual complication of PTCA, care should be taken when PET-balloon catheters are used in calcified coronary obstructions.

Adult↗

PubMed1990

[Stress fractures from the viewpoint of occupational medicine].

A stress fracture is a typical case of an injury induced by mechanical overloading of the locomotoric system. Especially, the paper deals with aetiopathogenetic factors in connection with occupational exposures and with criteria for recognizing a stress fracture as an occupational disease. A case of a ballet-dancer who suffered from a stress fracture of the fibula illustrates the development and the course of a typical stress fracture.

Combined Modality Therapy↗

PubMed1989

Treatment of chronic knee synovitis with arthroscopic synovectomy after failure of intraarticular injection of radionuclide.

Although satisfactory results have been obtained with conventional synovectomy of the knee, there are frequent complications, and a long period of rehabilitation is necessary after this surgery. We performed arthroscopic synovectomy of the knees of 30 patients (33 knees), 22 of whom had rheumatoid arthritis. These patients underwent the procedure after failure to respond to an intraarticular injection of either osmic acid or yttrium 90. The operated knee was moved 3-5 hours after the arthroscopy, and the patients walked the next day. No rehabilitation was needed. The followup period ranged from 6 months to 36 months, with an average of 17.7 months. Except for 1 patient with severe arthritis, all patients experienced improvement. Results were rated as "good" or "very good" in 27 knees. Six months after synovectomy, the patients were asked to rate their improvement; the mean +/- SEM degree of improvement was 79.1 +/- 22.9%. All patients had significant improvement in the range of motion of the knee. One patient required manipulation of the knee (while under anesthesia) soon after the arthroscopy. There were no other complications. There was no detectable radiographic evidence of disease progression in 24 patients who were seen 1 year after the procedure or in 9 patients who were seen 2 years after the arthroscopy. Thus, arthroscopic synovectomy appears to be an effective and simple treatment for chronic knee synovitis, and has a low morbidity rate.

Adolescent↗

PubMed1989

Elastase 1 and chymotrypsin B in pancreatic juice and feces.

A chymotrypsin-like protease was detected along with elastase 1 in pancreatic secretion and stool. This enzyme was isolated from necrobiotic human pancreas, purified, partially characterized and designated as chymotrypsin B. Quantitative studies by rocket immunoelectrophoresis indicated that neither elastase 1 nor chymotrypsin B was degraded during intestinal passage. On the basis of a clinical study, both enzymes were found to reflect pancreatic function.

Chymotrypsin↗

PubMed1989

[The pharmacology of the lipoxygenase inhibitors oxphaman (1-(2,5-dihydroxybenzylidene)aminoadamantane) and oxphalin (1-(3,4-dihydroxybenzylidene)-2,4,6-trimethylaniline].

Oxphaman and particularly oxphalin, among other phenolic azomethines, have been proven as strong inhibitors of lipoxygenases (LOX) from reticulocytes, soybean, thrombocytes as well as of quasi-LOX (hemoglobin) with IC50 values which correspond with those of known LOX inhibitors. The 5-LOX is likewise strongly, the cyclooxygenase of sheep seminal vesicles only weakly inhibited. Nevertheless, antiinflammatory effectivity was found in some carrageenin-induced inflammatory models of the rat as well as in the arachidonic acid- and croton oil-induced ear oedema of the mouse. Adjuvant arthritis, experimental pain, skin permeability and allergy models (anaphylactic paw oedema, cutaneous anaphylaxis, asthma, picryl chloride ear oedema) were not, only weakly or irregularly influenced. In the guinea pig ileum a certain antihistaminic, anticholinergic and leukotriene antagonistic activity was found. An inflammation-induced vasodepression (anaphylactic shock, dextran paw oedema. UV irradiation) was dose-dependently prevented or even reversed, obviously on the basis of oxygen radical scavenging.

Adamantane↗

PubMed1989