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Biomedical subjects

F Klinke

Publications and source records attributed to F Klinke.

35 records · Page 2Linked to original sources
PubMed1984

Morphological hazards of deuterium oxide as a cardioplegic agent.

To determine the cardio-protective effect of heavy water on the ischemic myocardium, a thoracotomy was performed on 18 mongrel dogs. The animals were connected to the extracorporeal circulation in a standardized experimental procedure. Following total cardiopulmonary bypass, 2,000 ml of a standard cardioplegic solution (LK 352) was infused at the aortic root of 10 dogs, which served as controls (group I), and the same solution containing 20% of 99.8% deuterium oxide was given at the aortic root of the remaining animals (group II). At the end of 60 minutes of ischemia, 1,000 ml of the solutions was again administered at the aortic root of the corresponding animals. Myocardial biopsies were taken from the apex of the left ventricle of each dog before cardiopulmonary bypass, immediately after the infusion of the cardioplegic solutions, following 90 minutes of ischemia, and after 30 minutes of reperfusion, and studied ultrastructurally. Whereas the ultrastructure of the myocardium of group I was well preserved at the end of the ischemic period, deuterium-oxide-treated hearts showed extensive focal and global myofilamentolysis and lysis of whole myocytes. Structural damage to glycogen, nuclear chromatin dispersal, severe intracellular edema and complete rupture of the intercalated discs were characteristic findings. At the end of ischemia, all the hearts of group I could be resuscitated. During the ischemia, all the hearts of group II developed into stone hearts. Biochemical studies on a second series showed a higher ATP depletion and a significantly higher lactate accumulation in group II than in group I.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

The influence of non-coronary collateral blood supply on the electively arrested heart during ischemia and reperfusion.

To study the influence of non-coronary collateral blood circulation (NCCBC) on the integrity of the ischemic myocardium a right-sided thoracotomy was performed on 15 anesthetized dogs. Following a total cardiopulmonary bypass (CPB), ventricular fibrillation was induced, during which 2,000 ml calcium-free cardioplegic solution LK 352 was given at the aortic root over an 8-10 min period. Precautions were taken to prevent retrograde blood flow into the coronary system via the coronary sinus. After 90 min of ischemia, ten of the dog hearts were reperfused with systemic blood for the next 30 min. Transmural biopsies were taken from the apex of the left ventricle at the following intervals: (1) before CPB, (2) immediately after the infusion of LK 352, (3) following 90 min of ischemia, (4) after 5 min, (5) after 15 min, and finally (6) after 30 min of reperfusion and were then studied ultrastructurally. The presence of NCCBC was documented by the observation of erythrocyte-filled blood vessels in the biopsies corresponding to nos. 2 and 3 of the above. To assess the degree of ischemic injury and the extent of myocardial recovery during reperfusion, a scoring system based on a semiquantitative assessment of the characteristic morphological changes was used. The average result of the separately assessed subendo- and subepicardial layers represented the score, which was plotted on the ischemic injury and the recovery scale, thus making a direct comparison of the hearts possible. All the hearts generously supplied with blood via extracoronary routes during ischemia showed minimal and reversible ischemic injuries. They recovered more quickly and more completely following reperfusion than those hearts without NCCBC. From these results we conclude that despite its warming-up effect on the myocardium and its tendency to wash out the cardioplegic solution, the NCCBC generally protects the myocardium from serious ischemic injuries and shortens the period of recuperation during the reperfusion.

Animals↗
PubMed1983

Coronary rheothermia: a quasi non-invasive method for controlling bypass patency.

A method based on the principle of thermodilution was developed for a quasi non-invasive permeability control of aortocoronary bypass. An epivascularly-attached thermistor records the cooling of the bypass wall when, following the intravenous injection of 5 to 10 ml of a NaCl solution at 4 degrees C, a bolus of cooled blood passes through the bypass. During cardiosurgical intervention, the thermistor is attached to the venous bridge by one or 2 sutures. The efferent cable goes through the thorax wall and is coupled to a subcutaneously implanted telemetric amplifier unit. The influence of the vessel wall on the perivascular temperature signal, as compared to the intravascular one, was studied in acute and chronic animal experiments. In acute experiments the perivascular peak of temperature was found to be lower than the intravascular one. Continuous measurements over 9 days showed variations in the perivascular signals which must have been due to changes in the thermal capacity of the tissue coupled to the thermistor as well as to changes in resistance caused by a variable extent of scarred area and by the varying water content of the wound bed. These variables will continue to keep rheothermia within the limitations of a method with primarily binary results (= bypass: open or closed). Given stable coupling conditions after full development of the scar around the thermistor, the signal falsification by the then constantly coupled tissue capacity becomes calculable such as to obtain semiquantitative results which, theoretically should vary predominantly with cardiac output.

Animals↗
PubMed1981

[Scoring system for indication for operative correction of funnel chest (author's transl)].

Based on 50 consecutive patients whom we operated for funnel chest, we tried to work out the indications for operative correction by developing a scoring system. In this scoring system we considered not only the depth of of the funnel respectively the depth of the impression, but also all the other disturbances of the organs of the chest resulting from the malformation. The possible accompanying deformities of the thoracic cage were taken into account too. The scoring system demands a more stringent indication.

Adolescent↗
PubMed1981

[The behaviour of the granular alveocytes in chronic pulmonary congestion, pulmonary fibrosis and after extracorporeal circulation (author's transl)].

The granular alveocytes, known to be the site of the production of the surfactant, undergo characteristic changes following chronic pulmonary congestion and the succeeding fibrosis, and after extracorporeal circulation. Congestion is accompanied by cell edema and the breakdown of the lamellar bodies. With fibrosis the cells are shrunken and present with little if any lysosomes. The nuclei are pyknotic or demonstrate karyolysis. Vacuolar degeneration of the lamellar bodies and progressive degeneration of the mitochondria are observed. The extracorporeal circulation damages many granular alveocytes. The degree of damage correlates with the duration of the cardiopulmonary bypass and with the degree of the prepump pathological changes present in the lungs. On the other and the extracorporeal circulation induces in the intact cells enhanced surfactant production, during which the different developmental stages of the lamellar body increasingly accumulate within the cell. In conclusion, pulmonary congestion and fibrosis reduce the activity of the granular alveocytes. The extracorporeal circulation enhances structurally favourable conditions in the granular alveocytes for the increased release of the surfactant in the immediate post-operative phase - a process which could be regarded as an autoregulatory mechanism.

Adult↗
PubMed1980

[beta-Thromboglobulin in plasma in patients with heart-valve diseases and with prosthetic heart valves (author's transl)].

In each 50 patients with rheumatic heart valve diseases and after implantation of prosthetic heart valves and in 20 patients with bioprostheses, beta-thromboglobulin (beta-TG) in plasma was determined. In all cases beta-TG was significantly elevated above the normal range. The levels of beta-TG lay in patients with bioprostheses lower than in the other groups. Bioprostheses are less damaging the thrombocytes than prosthetic heart valves.

Beta-Globulins↗
PubMed1979

[Problems of sigmoid diverticulitis in the female and its differential diagnostic delineation from the left-sided adnexal tumor].

In the last three years 42 patients with complicated diverticulitis were treated surgically. There were 18 women in all. Nine of these women were believed to have gynecologic disease because of the palbable pelvic tumor and were hospitalized at the Gynecologic Department. 2 patients underwent an exploratory operation by gynecologic surgeons based upon preoperative diagnosis of ovarian mass. The diagnosis at operation in all two cases was perforated sigmoid diverticulitis. Another three of the nine patients had initally emergency exploratory operations by gynecologic surgeons based upon diagnosis of pelvic mass. Also here the diagnosis at operations were perforated sigmoid diverticulitis and they underwent emergency primary resection of the perforated sigmoid by surgeons. In all the cases of complicated diverticulitis the surgical proceature was the primary resection; the anterior resection was combined with a temporare transverse colostomy.--Diverticulitis is an important differential diagnosis of a left pelvic tumor in women with or without clinical and laboratory indications of infections and history of diverticulitis.

Adnexa Uteri↗
PubMed1978

[Value and reason for routine rectosigmoidoscopy (author's transl)].

Routine rectosigmoidoscopy was undertaken in 700 patients under surgical treatment for disease in other parts of the body. Pathological changes were found in 39 patients (5.6%): 24 with adenomatous polyps, 5 with adenopapillary polyps, 7 with infiltrating growing "carcinomatous" polyps without involvement of the muscularis mucosae, and three with carcinoma. The polyps were removed with an electric loop or haemoclip in 28, by transanal submucous excision in eight. One of the carcinoma cases was treated by resection, the other two by abdominoperineal rectal resection. The results indicate that routine rectosigmoidoscopy is of value.

Adult↗
PubMedDate not supplied

Analysis of long-term survival in patients with locally advanced non-small cell lung cancer.

Neoadjuvant combined radiochemotherapy followed by definitive tumor resection improved survival in patients with locally advanced non-small cell lung cancer (NSCLC). Fifty-four patients (NSCLC IIIa + IIIb) were treated with combined radiochemotherapy within a phase I/II study. Twenty-six patients had been resected after combined neoadjuvant treatment and this group was evaluated concerning long-term survival. The median survival for patients with stage IIIa tumor was calculated to be 26 months and 13 months for patients with IIIb status. Patients with no viable tumor cells in the mediastinal lymph nodes had a significantly better survival probability than patients with residual microscopic lymph node disease (p=0.038). Patients with no viable tumor cells had a 1-year (2-year) survival rate of 100% (60%) versus 58% (42%) for patients with residual microscopic tumor in the mediastinal nodes. No significant difference between the N1- and the N2-status was seen. Hence, response to neo-adjuvant radiochemotherapy seems to be an additional important prognostic factor in patients with advanced NSCLC.

Adult↗