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Biomedical subjects

F Wolff

Publications and source records attributed to F Wolff.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Clinical aspects and therapy of trophoblastic tumors].

Over a period of ten years 14 women with trophoblast tumours (rarely seen in Europe) underwent diagnosis, treatment and follow-up, appropriate for the time. The high specificity of human beta-chorionic gonadotropin as marker in the recognition and follow-up of this tumour contributed to the good prognosis, as well as the cytostatic treatment, varied according to risk factors. Twelve of the 14 women are either cured or free of recurrences for a long time.

Adult↗
PubMed1985

[Clinical value of thallium-201 myocardial scintigraphy with dipyridamole performed before and after aortocoronary bypass].

In addition to preoperative coronary angiography, 63 patients undergoing coronary bypass surgery also had myocardial scintigraphy with dipyridamole 1 to 2 days before surgery, resting scintigraphy 10 after bypass and a repeat scintigraphy with dipyridamole 3 to 6 months later. The myocardium was divided into 5 segments. In each segment the perfusion was classified as: normal, presence of a reversible defect (redistribution), presence of a permanent defect (no redistribution). A comparison of pre-and postoperative scintigraphies led to the following conclusions. Three to six months after bypass, improved perfusion was observed in 65.6% os ischaemic segments, showing that surgery was very effective. On the other hand, the immediate postoperative control (10 days) only showed improved perfusion in 42.5% of the ischaemic segments: this interval was too short to appreciate the benefits of coronary bypass. There was a good correlation between the scintigraphic improvement after surgery and the reversibility of the zones of hypofixation of Thallium before surgery. When the defect was reversible, 80% of the revascularised segments were improved. Fifty-eight per cent of non-reversible defects before surgery were unchanged by the revascularisation procedure. However, the absence of redistribution during preoperative scintigraphy was not synonymous with definitive myocardial lesions and does not represent a contra-indication to coronary bypass surgery; in fact, improved perfusion was observed in 42% of these constant defects. The quality of recovery depends on the condition of the muscle: only segments with normal motion can be improved. Degradation of the clinical condition of patients was always related to aggravation(lack of improvement in 1 case) of scintigraphy.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Artery Bypass↗
PubMed1985

[Redistribution of 201 Tl after myocardial scintigraphy with dipyridamole: value in the detection of coronary stenosis and ventricular kinetic anomalies].

One hundred and eight-four patients suspected of having coronary artery disease underwent coronary and left ventricular angiography and Tl 201 myocardial scintigraphy with dipyridamole including images of redistribution after 3-4 hours. The results of scintigraphy were assessed visually in all cases and by quantitative analysis in 91 patients. Comparison of early (DIP) and late (REDIS) images showed three types of response: 1) no hypofixation on either (10 patients), 2) a constant defect (59 patients), 3) a reversible defect (115 patients, including 21 cases of "paradoxical" redistribution). The value of the redistribution images was assessed in the diagnosis of coronary stenosis and in the evaluation of ventricular wall function in post-stenotic zones. The following results were obtained: Visual analysis of the DIP scintigraphy alone gave 17 false positive and 8 false negative results (sens: 95%, spec: 41%). The false negative results were all observed in patients at high risk. The DIP/REDIS scintigraphy (considered normal if both images were normal) gave 20 false positive but only 1 false negative result (sens: 99%, spec: 32%). In addition, the negative predictivity increased from 60 to 90%. The considerable reduction in the number of false negative results was due to the detection of "paradoxical" redistribution. The finding indicates that late films must be taken systematically even if the early scintigraphy is normal. Quantitative analysis of DIP scintigraphy was less sensitive and more specific than visual analysis (sens: 82.7%, spec: 68.7%; NVP: 46%). The same was observed when the redistribution films were processed (DIP/REDIS): significantly increased sensitivity and negative predictive value at the cost of a lower specificity (sens: 96%, spec: 41%; NPV: 70%). No significant differences were observed between the type of scintigraphic defect (constant or reversible) and the probability of coronary stenosis (positive predictive value 93 and 86% respectively). "Paradoxical" redistribution corresponded to a pathological situation (PPV: 85%). A correlation was found between the reversible or permanent nature of the hypofixation and left ventricular function. Out of 142 segments showing reversible defects, 112 (79%) had normal or subnormal motion (moderate hypokinesia). Reversibility therefore usually indicated conservation of the viability of post-stenotic zones. Significant wall abnormalities were found in 62% of 140 segments with constant defects, mostly corresponding to infarction; however, in 38% there was no abnormality of wall motion or electrical changes of necrosis.(ABSTRACT TRUNCATED AT 400 WORDS)

Angiocardiography↗
PubMed1984

[Risks in pregnancy after kidney transplantation].

Two women had four supervised pregnancies after renal transplantation. A striking feature was that the children had fetal growth retardation which led to premature termination of pregnancy by section. Likely causes of the growth retardation are, in the first instance, long-term treatment with corticosteroids and increased incidence of toxaemia. There is no evidence for a significant rise in the risk of teratogenicity for the embryo by the immunosuppressive treatment. However, an increased mutagenicity risk must remain a possibility in view of the one case of Turner's syndrome. Close interdisciplinary control of mother and child makes it possible to reduce risks to a reasonable level in case of pregnancy after renal transplantation.

Cesarean Section↗
PubMed1982

Perinatal pharmacokinetics of acetylsalicylic acid.

Pregnant women were treated with infusions of acetylsalicylic acid (ASA). The plasma concentrations of total salicylate or those of ASA and salicylic acid (SA) were determined. The ASA steady state was reached after 2 h of infusion whereas 3 days seemed necessary to reach the steady state of SA. In a further study during the late phase of cervical dilatation (12 min - 2 h before birth) healthy pregnant women were given 1 g ASA as a single i.v. bolus injection. The resulting plasma levels of ASA and SA in the mothers during delivery, the plasma concentrations in umbilical cord blood and in blood obtained from the newborn several hours after birth were measured. With increasing time the SA concentrations in the umbilical cord blood plasma approached those of the mothers. On the other hand, the umbilical cord blood concentrations of ASA did not approach the maternal concentrations, probably because of the ASA esterase activity at the placental barrier. The plasma concentrations in the newborn indicated that the newborn is able to degrade ASA and to excrete SA. However, the velocities are lower than the respective velocities in adults.

Aspirin↗
PubMed1982

[Incidence and causes of fetal and neonatal macrosomy].

Amongst the 7486 babies born at the Department of Gynecology and Obstetrics in Cologne from 1974 to 1978, 536 neonates displayed a birthweight of more than 4000 g. The obstetrically relevant data from 523 deliveries were evaluated retrospectively. We compared and contrasted the results with a reference group of 511 neonates with a normal weight (2500-3999 g) according to the matched pair principle. The incidence of macrosomic neonates amounted to 7.2% of total deliveries in the observation period. On comparing the average age of the mothers, we found a rise from 27.4 years (mothers of the reference group) to 29.4 years in mothers of babies weighing 4000-4499 g and 30.3 years in mothers with babies weighing 4500 g and more. The proportion of the pregnant mothers over 40 years old was 4.6% as compared to 2% in the reference group in macrosomic babies. The parities show a decrease of the primiparae and an increase of the multiparae amongst mothers of macrosomic babies. The rate of primiparae was 49.3% in the group of babies of normal weight as compared to 33.3% in moderately overweight (4000-4499 g) and 23.4% in the highly overweight babies (4500 g and over). The large proportion of adipose mothers in neonatal macrosomy was also striking. The average weight of the women at the end of pregnancy was 71.4 kg in the reference group and rose to 78.6 or 86.8 kg, respectively, in the mothers of macrosomic neonates. In 453 puerperal mothers who had delivered a macrosomic baby, an oral glucose tolerance test (oGTT) was performed in the first 72 hours after delivery. This was pathological in 25.8% of mothers of moderately overweight children, and was pathological in 29.7% of mothers of distinctly overweight babies. This thus confirmed the correlation between diabetogenic metabolic stress and macrosomy. Evaluation of the course of birth revealed a distinctly raised risk of asphyxia with restriction of the vitality index and increase of abnormal internal and neurological features especially for the neonates with a weight of 4500 g and more. Our goal must therefore be to diagnose macrosomy better than so far by foetal biometry in order to counteract the risks described by prospective control of pregnancy and delivery.

Adult↗
PubMed1982

[Coronary lesions in myocardial infarction].

The authors analyse the coronary lesions in 285 patients with primary myocardial infarction (164 anterior, 121 inferior infarcts) undergoing coronary angiography an average of 4 months after infarction. The statistical study of the analytical table of the lesions according to severity and site, demonstrated a significant difference in each group (p less than 0,001): --there was a very clear dominance of occlusion of the LAD artery in anterior infarction but severe narrowing (greater than or equal to 70%) was observed mainly on the right coronary and left circumflex arteries; --in inferior infarction, the incidence of occlusion was higher on the right coronary artery and severe narrowing was divided between the LAD and left circumflex arteries. Controlateral, double or triple vessel disease was present in 74% of anterior and 85% of inferior infarcts. There were many more patients with double and triple vessel lesions than with single vessel disease. Residual angina gave no indication of the extension of the lesions in anterior infarction but patients with this complication after inferior infarction had a higher rate of triple vessel disease. Stress testing is exploitable in inferior infarction but did not give any discriminating results. In this series, angina and stress testing only allowed triple vessel disease to be suspected in patients with inferior infarction. A coronary arteriographic study, by showing the severity and controlateral extension of the lesions, comparable in primary anterior and inferior infarction, gives important prognostic information and allows assessment of surgical possibilities.

Angina Pectoris↗