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Biomedical subjects

E Kreuzer

Publications and source records attributed to E Kreuzer.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Age-dependent regulation of cardiac glycoside receptors].

Specific binding of cardiac glycosides to their receptors precedes their actions on the myocardium. Thus changes in the number and affinity of these membrane bound receptors will vary the response to cardiac glycoside therapy and the incidence of side-effects. Several studies have reported an age-dependent decrease in the number of cardiac glycoside receptors in animals as well as in human erythrocytes. These results may explain the increase in cardiac glycoside sensitivity with age which is not accounted for by the reduction in kidney function. Furthermore, changes in both binding affinity and capacity are known to occur in several diseases which are more common in older patients. Therefore, we have measured the number and affinity of cardiac glycoside receptors in atrial samples from 209 patients and in papillary muscle samples from 59 patients taken during coronary bypass graft surgery or mitral valve replacement. Further, the maximal increase in force of contraction was measured using papillary muscle strips from some of these patients. Our results show no significant age-dependent alteration in the characteristics of the cardiac glycoside receptors but a reduced myocardial receptor density in males (3.47 +/- 0.14 X 10(14)/g protein) compared with females (4.44 +/- 0.21 X 10(14)/g protein) (p less than 0.001) which is more pronounced in older patients. About 30% fewer cardiac receptors either per g protein or per g wet weight are present in patients with coronary heart disease or dilative cardiomyopathy. The maximal inotropic effect of ouabain in human papillary muscle strips is correlated with the number of cardiac glycoside receptors present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Quantitation of cardiac messenger RNA in heart-muscle biopsies.

A method has been developed that allows the direct quantitation of cardiac messenger RNA in heart-muscle biopsies. This provides a new tool to directly assess changes in cardiac gene expression in cardiac biopsies. Using this method, we have analyzed changes in cardiac gene expression during induction and regression of triiodothyronine-induced heart hypertrophy, during development of heart atrophy secondary to starvation and protein depletion, in adriamycin cardiomyopathy, and in patients with mitral-valve diseases.

Animals↗
PubMed1985

Progression of coronary and valvular heart disease in patients on dialysis.

Coronary heart disease and end-stage renal disease: Coronary heart disease is frequent in patients with end-stage renal disease. Without invasive procedures coronary heart disease is often not diagnosed in patients with end-stage renal disease. We have no evidence for accelerated progression of coronary heart disease under conditions of dialysis. Valvular heart disease and end-stage renal disease: Valvular heart disease shows an increasing frequency depending on the period of dialysis. Valvular heart disease is often unnoticed and constantly underestimated without invasive investigation. Valvular heart disease often indicates a bad prognosis in our patients with end-stage renal disease.

Adult↗
PubMed1984

[Plastic surgery of the mitral valve in mitral valve insufficiency - advantages of physiologic surgery].

Nine patients (mean age at the time of surgery 54.5 +/- 0.7 years), who had mitral valve reconstruction for mitral valve insufficiency were studied on an average of 15.0 +/- 7.5 months after the operation using technetium-99m-pertechnetate--or gold scintigraphy. The radionuclid ventriculograms were performed with the patient in RAO-position at rest and during mild exercise (50 watt). Looking at the results of the preoperatively performed heart catheterization with contrast ventriculography our datas showed a postoperative improved left ventricular function as well as a physiologic function of the mitral valve. Clinically the patients improved from class 3.6 to 1.6 (NYHA) on an average. The reconstructive mitral valve insufficiency is able to restore normal left ventricular function. The operation should be carried out on patients graded at class II (NYHA). Technetium-99m-pertechnetate scintigraphy (first pass technique) appears to be particularly suitable for evaluating left ventricular function and the function of the mitral valve after reconstructive mitral valve surgery.

Female↗
PubMed1984

Improvement of follicular puncture and oocyte recovery at Erlangen.

The instruments for oocyte collection for IVF developed at Erlangen as a result of experience over a period of two years are described in detail. In a consecutive series of 30 IVF attempts (30 patients), 77 oocytes were collected from 78 follicles. The advantages of our very simple and successful system are discussed, and compared to other systems. Embryo transfer was performed in the 21 patients and four progressive pregnancies resulted.

Female↗
PubMed1984

[Pregnancy following ultrasound guided transabdominal-transvesicle follicle puncture under peridural anesthesia within the scope of an IVF program].

The authors report on the case of a 28-year old married woman who was treated according to their IVF-programme after both Fallopian tubes had been removed Three embryo transfers after follicular aspiration by laparoscopy and IVF did not lead pregnancy. In a fourth attempt in May 1984 ovarian stimulation was effected via hMG (Pergonal); 10,000 IU hCG were administered on day 12 of the menstrual cycle. 35 hours later 7 oocytes were recovered via ultrasonically guided percutaneous follicular aspiration under epidural anaesthesia. 3 four-cell embryos were transferred 48 hours after insemination. 9 weeks after l.m.p. sonography showed two intrauterine gestation sacs, in each an embryo of 20 mm C-R length with heart actions and movements.

Adult↗
PubMed1984

[The Erlangen in-vitro fertilization program--results to date].

The authors describe the development of the Erlangen in-vitro fertilisation programme during the past 2 1/2 years. Details of the instrumentarium and of the individual steps are described, such as stimulation and control of cycle, follicle puncture and embryo transfer. By 31. 3. 1984 the number of attained pregnancies increased to 43 and that of delivered infants to 27. 32 pregnancies were achieved with 226 embryo transfers. 12 healthy children have already been born. In one of the most recent series, 33 consecutive transfers resulted in 9 pregnancies. Details of the instrumentarium and technique which have contributed to obtaining the best results, are compared with the technique and results obtained by other work teams.

Embryo Transfer↗
PubMed1984

Gene expression in cardiac hypertrophy in rat and human heart muscle.

Changes in the cardiac contents of microsomal RNA and poly(A)-containing mRNA have been examined during induction and regression of heart muscle hypertrophy in rat hearts, as well as possible changes in the subcellular distribution and protein-synthetic activity of cardiac mRNA. In addition, cardiac biopsies from patients with mitral valve diseases were evaluated for their mRNA contents. Induction of heart muscle hypertrophy was accompanied by substantial increases in cardiac microsomal RNA (30-60%) and cardiac mRNA (20-80%). During regression of hypertrophy increased levels of cardiac microsomal RNA and mRNA returned to normal values within 10-16 days. In general, cardiac mRNA levels were lower in human heart muscle than in rat heart muscle. Since the subcellular distribution of the microsomal RNA and of the mRNA as well as the protein-synthetic activity of the mRNA were not changed in the hypertrophied animals as compared with normal animals, and since the cardiac contents of most specific cardiac mRNA species (mRNAs for MHC, MLC1 and MLC2, actin, tropomyosin, troponin-T, myoglobin) increased proportionately, it is concluded that during induction of hypertrophy activation of gene expression occurs and affects the genes coding for the major cardiac proteins to a similar extent. This does, however, not exclude the possibility of more specific shifts in isoprotein patterns and in the levels of their corresponding mRNAs. It is proposed that changes in cardiac mRNA levels are the major regulatory factor in causing changes in cardiac protein synthesis rates leading to the induction and regression of cardiac hypertrophy.

Animals↗
PubMed1983

[Advantages in the therapy of bradycardiac rhythm disorders by physiologic pacemaker systems].

A review of the recent development in cardiac pacing is given, based on the experience of the Department for Cardiac Surgery of the University of Munich. Meanwhile the frequency of physiological pacemaker systems has increased to more than 30 percent of all implantations. Basical informations about physiological stimulation, indications, techniques of implantation--particularly via the subclavian vein and patient's follow-up--are discussed.

Bradycardia↗
PubMed1983

[Heart transplantation--2 years' experience in the Grosshadern Clinic of the University of Munich].

Between August 1981 and August 1983 11 heart transplantations were carried out at the Klinikum Grosshadern of the University of Munich. The recipients were 10 men and 1 women. The age of the patients at the time of the operation ranged from 20 to 45 years. The diagnosis was: congestive cardiomyopathy (4 cases), coronary heart disease (5 cases), Uhl's disease (1 case), valvular heart disease (1 case). Cyclosporin A was used as the main immunosuppressive agent in all cases. 3 patients died (1., 10. and 73. postop. day). 8 patients survived now since 2 to 25 months. The survival time exceeds 0.5 years in 5 cases and 1 year in 3 cases.

Adult↗
PubMed1983

[Plastic and reconstructive surgery of the mitral valve].

The mitral valve replacement is a common and live-saving procedure, many complications may occur as therefore: endocarditis, thromboembolism, and bleedings because the lifelong coumarin medication. Therefore, reconstruction the patient's own mitral valve may cut many problems afrementioned. Mitral valve is composed by 6 anatomic elements. For each, mitral stenosis, incompetence or combination of both, typical patho-anatomical changes exist. Before surgical correction these lesions want be recognized during surgery and appropriate correction selected. The correction may preserve the physiologic entity and function of mitral valve for long time.

Humans↗
PubMed1982

[Report on a successful orthotopic cardiac transplantation in Germany].

The first successful heart-transplantation carried out in the Department for Cardiovascular Surgery of the University of Munich, Klinikum Grosshadern is reported. The recipient, 32 years old at the time of operation, had sustained a large antero-lateral-septal myocardial infarction in June 1980; thereafter the left ventricular ejection fraction was severely impaired (e.f. = 19%). Yet, the operation was definitely planned some year later, after the patient had survived an embolus to the right lung, an acute left heart failure and a small ulcer of the stomach. The operation was performed on 8-19-1981. The donor was a 23 year old young man, who had met a fatal motorcycle accident 10 days ago. The man was pronounced dead in the afternoon of the preoperative day according to the criterions of the German Society for Surgery by means of a carotid angiogram. Donor and recipient were well matched in regard to blood group, HLA-A2-System and finally cross-match-test. Transplantation was carried out according to the technique of Lower and Shumway. Immediately p.o., immunosuppressive therapy was started using azathioprine, cortisone and antihuman thymocyte globulin. Two acute rejections were noted, the first from p.o. day 6 to 15, the second from p.o. day 22 to 34. The second acute rejection was complicated by a pneumatosis cystoides intestinii, which caused a change of the immunosuppressive therapy to Cyclosporin A. No further complications were registered in the following p.o. course, the patient is discharged since Christmas 1981.

Adrenal Cortex Hormones↗
PubMed1982

Regional left ventricular function in the three main coronary artery territories at rest and during exercise.

Twenty consecutive patients (mean age 51.6 years) with persistent severe angina pectoris underwent aorto-coronary bypass surgery receiving an overall of 60 anastomosis. On an average, 9.4 +/- 1.5 months p.o. first pass radionuclide ventriculograms (18 to 24 mCi 99m Technetium-Pertechnetate i.v.) were performed at rest and after exercise. Besides measurement of global ejection fraction (GEF), regional ejection fraction (REF) was assessed employing for the first time a new technique: each RAO-view of p.o. radionuclide left ventriculogram was subdivided into three regions according to supply of the three main coronary arteries and their branches as visualized on pre-operative coronary angiogram. GEF improved after maximum exercise in 13 cases by 8.1% points (from 50.4 to 58.5%), remained unchanged three times and decreased four times by 7.1 points (from 51.6 to 44.5%; all changes p less than 0.05). In completely revascularized regions (n = 35) REF improved 24 times by 9.7 points (from 51.1 to 60.8%), did not differ from rest REF six times and decreased in three case by 7.3 points (from 48.6 to 41.3%; all changes p less than 0.05). completely revascularized regions responded to exercise like normally perfused areas (increase 7.8 points (from 50.6 to 58.4%; n = 7; p less than 0.05). REF deteriorated in incompletely revascularized regions (n = 9) six times by 12.8 points (from 58.0 to 45.2%), remained unchanged twice and improved once by 4.5 points. Total group's REF decreased by 7.3 points (from 56.8 to 49.5%; p less than 0.05). Exercise REF of incompletely revascularized regions was highly significant inferior to that of completely revascularized regions (49.5 to 58.4%; p less than 0.01). GEF is a weighted balanced of the three regional ejection fractions. The most important parameter is REF of LAD territory.

Adult↗
PubMed1982

Stenosis of the supraaortic branches combined with coronary artery disease: one-stage surgical treatment.

Combined one-stage surgery of the supraaortic branches and the coronary arteries was performed on 17 consecutive patients, 13 men and 4 women, having a mean age of 56.7 +/- 8 years. Angina pectoris was the primary symptom in all patients. Signs of cerebro-vascular insufficiency were present in 4 cases, 2 with syncopies, one with amaurosis fugax, and one with drop-out symptoms. All patients were invasively examined. Coronary angiogram verified triple vessel disease in 13 cases, double vessel disease in 3 and single vessel disease in one. Angiography of the carotid artery proved unilateral disease in 11 patients, in 5 both sides were either stenosed or occluded. One patient had a left-sided proximal 80% lesion of the subclavian artery. In all cases, the supraaortic branches were done first, followed by revascularization of the coronary artery system. All patients survived the early postoperative course; one died suddenly 33 months after operation. After 16.8 +/- 14 months, 11 out of 15 patients felt much better. Signs of cerebro-vascular insufficiency were not present. Our conclusion: one-stage surgery of the supraaortic branches and the coronary arteries would seem justified. A list of indications is presented.

Adult↗
PubMed1982

Valve replacement for chronic mitral insufficiency; long-term follow up using technetium pertechnetate scintigraphy.

Technetium Pertechnetate Scintigraphy was performed in 12 patients (9 men and 3 women, average age 48 +/- 13 years) on an average 19.8 +/- 11 months after valve replacement for chronic mitral insufficiency. Preoperative conventional ventriculography had revealed increased enddiastolic and endsystolic volumes (230.9 +/- 66 resp. 73.5 +/- 26 ml). 59.4 +/- 9% of the stroke volume (157.5 +/- 47 ml) regurgitated into the left atrium. Ejection-fraction (67.7 +/- 6%) was normal in all cases. Postoperative first pass technique was employed using a fast multicrystal camera (Baird Atomic, system 77). Volumes were assessed measuring normalized total count rate (count integral of the left ventricle divided by the maximum count density). 19.8 +/- 11 months after valve replacement enddiastolic and endsystolic volumes revealed normal at rest (121.8 +/- 38 resp. 52.8 +/- 35 ml) and after maximum exercise (122.0 +/- 29 resp. 37.6 +/- 22 ml). Ejection fraction responded physiologically to exercise by rising from 57.7 +/- 12 to 69.7 +/- 10%.

Adult↗