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Biomedical subjects

F Schwarz

Publications and source records attributed to F Schwarz.

At least 199 records · Page 11Linked to original sources
PubMed1978

[Vagal tone in symptomatic sinus node dysfunction (author's transl)].

Under investigation in this study were the role of vagal tone in symptomatic sinus node dysfunction and the relationship between hypersensitive carotid sinus reflex (HCSR) and sick sinus syndrome (SSS). In 168 symptomatic patients (pts) resting heart rate (HR), maximal corrected sinus node recovery time (CSRTmax) and maximal carotid sinus pressure results (CSPmax) were determined before and after Atropine, 1 mg i.v. (A). According to test results, 103 pts had HCSR (1), 33 had HCSR + SSS (II), 30 pts had isolated SSS (III) and 20 pts with normal test results served as controls (IV). Mean age was the same in groups I--IV (p greater than 0.05). Groups I--III had a HR less than or equal to 60 bpm, rising 31% after A in groups I--IV, but absolute values were below those in group IV. In groups I--III CSP normalized after A and CSRT remained unchanged (p greater than 0.05). We conclude that increased vagal tone plays but one role in groups I--III and the combination HCSR + SSS seems rather frequent. Specific testing clearly separated HCSR from SSS.

Adult↗
PubMed1978

[The significance of electrophysiologic findings and clinical course in symptomatic sinus node dysfunction (author's transl)].

Under investigation in this study were the relationship between hypersensitive carotid sinus reflex (HCSR) and sick sinus snydrome (SSS), the significance of clinical symptomatology versus electrophysiologic test results and the natural course of both syndromes. In 186 symptomatic patients (pts) resting heart rate, maximal corrected sinus node recovery time (CSRTmax) and maximal carotid sinus pressure results (CSPmax) were determined. According to test results, 103 pts had HCSR (I), 33 had HCSR + SSS (II), 30 pts had SSS (III), and 20 pts with normal test results served as controls (IV). Mean age was the same in groups I--IV (p greater than 0.05). Groups I--III had a heart rate less than or equal to 60 bpm. There was no correlation between patients test data and the occurrence of syncopes in each of groups I--III (p greater than 0.05). In 16 pts with SSS, test results remained unchanged 16 months later (p greater than 0.05). More pts (31%) in group II died in a shorter period of time after pacer application (1.4 +/- 1 year) than pts with AV III degrees block (25%, 1.8 +/- 1.6 years) after pacer application. We conclude that the combination HCSR + SSS seems rather frequent. Specific testing separated HCSR from SSS, but failed to predict syncopes and thereby cannot aid in the indication for pacer application. The 16 months prognosis of SSS proved unfavorable. Mortality after pacer application in HCSR + SSS seems less favorable than in AV III degrees block (p less than 0.05), but depends largely on the severity of associated diseases.

Adult↗
PubMed1977

Relative binding affinity of androstane and C-19-nor-androstane-steroids for the estradiol-receptor in human myometrial and mammary cancer tissue.

The relative binding affinity of several androstane- and C-19-nor-androstane-compounds for the estradiol (E2)-receptor in human myometrial and mammary cancer tissue was studied. High speed cytosol was incubated with tritiated E2 alone as well as in the presence of increasing amounts of the compound to be tested. The highest affinity is found for steroids with two hydroxyl-groups at C-3 and C-17 in the beta-position and a double bond at C-4-5 or C-5-6. Saturation of the A-ring decreases the affinity: 5alpha-compounds have less affinity, 5-beta-compounds have less affinity; 5beta-compounds hardly any affinity. The presence of a hydroxyl-group in the 3alpha, 11beta or 16beta-position decreases the affinity, as dose a 3-oxo or 17-oxo-group. Removal of the C-19-methyl-group facilitates the binding. This data led to the concept that flatness of the A-ring in respect to the B-ring of the steroid molecule is a principal requirement for binding to the E2-receptor. The rank order of RBA is identical in myometrium and in mammary cancer tissue, indicating that estrogen-receptors are at least highly similar in both target tissues.

Androstane-3,17-diol↗
PubMed1977

[Left ventricular ejection and ejection reserve during isoproterenol infusion in hypertrophic obstructive cardiomyopathy (author's transl)].

In 10 patients with hypertrophic obstructive cardiomyopathy (HOCM) and in 10 patients without heart disease (normals) left ventricular function and myocardial reserve under isoproterenol (Iso) infusion (0.3 microgram/kg B.W./min) were measured. From the monoplane cineangiography of the left ventricle diastolic wall thickness as well as ejection phase contractile indices, ejection fraction (EF) mean velocity of fiber shortening (VCF) and mean normalized systolic ejection rate (MNSER), were calculated. Maximum total load (TL) served as measure for afterload. Wall thickness in HOCM was higher by 73% as compared to normals (p less than 0.001). Hemodynamic values for normals at rest were as follows: EF 68.9 +/- 8.0%, VCF 1.22 +/- 0.19 circ/sec, MNSER 2.25 +/- 0.25 vol/sec and TL 228.6 +/- 37.4 dynes . 10(5). Values for HOCM at rest were as follows: EF 77.4 +/- 7.71% (p less than 0.05), VCF 1.53 +/- 0.3 circ/sec (p less than 0.05); MNSER 2.66 +/- 0.35 vol/sec (p less than 0.01) and TL 288.5 +/- 55.5 dynes . 10(5) (p less than 0.01) as compared to normals. The values under Iso in normals resulted in a significant fall of the TL (p less than 0.05), the enddiastolic volume (EDV, p less than 0.05) and of the enddiastolic pressure (EDP, p less than 0.05), VCF rose by 89% (p less than 0.001), MNSER by 66% (p less than 0.001) and EF by 23% (p less than 0.001). In HOCM under Iso TL rose by 45% (p less than 0.05), EDV and EDP did not change (p less than 0.05), VCF and MNSER rose by 23% (p less than 0.05 respectively p less than 0.01). VCF and MNSER in HOCM with Iso were reduced by 17% respectively by 13% (p less than 0.01) as compared to normals, the EDP was increased by factor 4, while EDV showed no significant difference (p less than 0.05). Our results indicate that the left ventricle in HOCM in spite of its marked hypertrophy is unable to adequately compensate for an acute gain of afterload as induced by the effect of catecholamines. Therefore, we assume stress-related congestive symptoms in HOCM to be caused--aside from other mechanisms--by diminished ejection reserve.

Adult↗
PubMed1977

Evaluation of implanted faulty demand pacemakers by magnet waving and electrical chest wall stimulation. A report of clinical experience.

15 different models of implanted demand pacemakers (61% Cordis models) in 156 patients were scrutinized owing to an announcement that had identified 3 faulty Cordis series and, as a consequence, had provoked considerable uncertainty among all pacemaker patients in the community. Malfunctions of the sensing, and reed switch mechanisms as well as changes in pacers' refractory periods were excluded by the electrical chest wall stimulation (ECWS), magnet waving (MW) or a combination of both. That those models suspected of malfunction show merely a drop in rate was verified. Established patterns of early rate drop guided the exchange for new units: no abrupt or complete rate drop occurred and no patient was lost. The application of indirect overdrive revealed that the blocking capacity for rapid rates was in Omni-Ectocor units less reliable than in Ectocor units. The characteristic reactions to MW and ECWS of the 15 demand pacemaker models were determined. Because both methods proved to be as easy to apply as they were beneficial for the follow-up, also in the uncommon situation created by the Cordis announcement, the application of both of these methods on a routine basis in pacemaker clinics is advocated.

Aged↗
PubMed1976

[The effect of the collateral circulation on the total and regional myocardial function in coronary disease].

The cinecoronarograms, ventriculograms and electrocardiograms of 164 consecutive patients (32 patients without heart disease and 132 patients with coronary artery disease) have been analyzed. Total left ventricular function was assessed by the ejection fraction. Regional myocardial function was determined by a system of hemiaxes. 89 patients with complete obstruction of the right coronary artery (RC) and/or the anterior descending branch of the left coronary artery (LAD) were divided into subgroups with good, poor and no coronary collaterals. Total and regional left ventricular function was normal in patients with well collateralized coronary occlusions. Patients with poorly collateralized or non-collateralized occlusions had impaired left ventricular function. Patients with poorly collateralized coronary occlusions showed no difference in left ventricular function when compared to patients with coronary occlusions without collaterals. Combined occlusions of the RC + LAD without collaterals were not found. Good coronary collaterals have a protective effect on total and regional myocardial function, thus improving the prognosis in complete coronary artery obstruction.

Cardiac Output↗
PubMed1976

[Roentgen diagnosis of pyelonephritis].

With the help of special literature and the results of own investigations the usability and evidence of radiological examination methods in the diagnosis of pyelonephritis are described. The high value of urography in the ascertainment of predisposing factors for pyelonephritis is emphasized. Subject of nearer considerations is the characteristic radiological feature of chronic pyelonephritis in its different developmental stages. Especially in connection with the decent radiological changes in the early forms of chronical pyelonephritis is referred to the necessity of an optimal collaboration between clinician and radiologist.

Acute Disease↗
PubMed1976

[Atrial flutter with an audible atrial sound (author's transl)].

In a case of rheumatic valve disease atrial sounds could be heard and recorded on the phonocardiogram during atrial flutter at a rate of 260/min and an atrioventricular block of 3:1 and 5:1. The atrial flutter sounds were also recorded in the apex-cardiogram and as a slight but rapid motion of the anterior mitral valve leaflet in the echocardiogram. These atrial sounds were recorded both in systole and diastole and disappeared after cardiac failure had been treated and sinus rhythm restored. This case and 19 others reported in the medical literature indicate that for atrial sounds to become audible requires high-grade atrioventricular block and increased atrial contractions with increased ventricular filling. The sounds have been proven to originate in the atrium, the characteristics of the sound being similar to those of an opening snap.

Atrial Flutter↗