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Biomedical subjects

H Becher

Publications and source records attributed to H Becher.

At least 145 records · Page 8Linked to original sources
PubMed1986

[Accuracy of cardiac CT and echocardiography in the diagnosis of space-occupying processes in the heart].

CT of the heart and echocardiography was performed on 107 patients with various space-occupying lesions of the heart. In addition, 27 patients were subjected to angiocardiography. A comparison of the findings has shown that cardio-CT is superior to two-dimensional echocardiography for demonstrating pericardial masses and intracavity thrombi. There was no significant difference as far as intracavity or intramural tumours were concerned. CT and sonography are superior to angiography in the diagnosis of cardiac space-occupying lesions.

Adolescent↗
PubMed1986

[Intravenous DSA of the heart: functional studies of the left ventricle in coronary heart disease at rest and following stress].

Intravenous digital subtraction angiography (i.v. DSA) of the heart is performed for demonstration of the morphologic and functional peculiarities of the left heart chamber, especially the ejection fraction and regional wall motion abnormalities. Employment of both geometric and video densitometric computation techniques resulted in a good correlation with direct ventriculography (r = 0.945), video densitometry, however, with a tendency to values up to 10% higher. Comparative DSA studies during rest and following exercise in 25 patients with coronary heart disease were suitable to discover pathologic strain reactions of the myocardium in 4 cases, typically depending on angiographic findings of the coronary arteries. In this way a simple method for better estimation of a deficit in coronary blood supply and its functional impact on myocardial performance may become useful.

Angina Pectoris↗
PubMed1986

[Echocontrast ventriculography. Determination of left ventricular functional parameters with special reference to digital subtraction echocardiography].

In 57 consecutive patients we examined whether digital subtraction echocardiography (DSE) is able to determine left ventricular function parameters, in particular the ejection fraction (LV-EF). The most important step in DSE consists of the subtraction of digitized grey level information of the original echocardiogram from a phase-identical contrast image. In addition LV-EF, end-diastolic (EDV) and end-systolic volumes (ESV) were calculated by manual definition of endocardium in the original (Na) and contrast-echocardiograms (Ko). The results were then compared with the invasive cardiac catheterisation (Hk) data. We used 5.5% oxypolygelatine (Gelifundol S) as echo-contrast material and injected 2-4 ml as a bolus directly into the left ventricle. LV-EF calculated on the basis of automatic contour definition by DSE demonstrated a better correlation with cineangiographic data (r = 0.89, SEE 5.8% in 44 patients) than the manual input of endocardial borders in original echocardiograms (r = 0.71, SEE 8.1% in 47 patients). Good correlations were also found between EF-Ko and EF-Hk with r = 0.92 and an SEE of 4.3%; because there is a good agreement between EF-Ko and EF-DSE (r = 0.91, SEE 5.3%) these calculations closely approach the results of the invasive data. The EF-Na underestimates the EF-Hk markedly as a consequence of a systematic error: as compared to the contrast image the volumes of the original echocardiograms, in particular the ESV are overestimated and the ejection fraction as a derived parameter is calculated as too small. ESV-Hk versus ESV-Na: y = 0.82x + 24.4, ESV-Hk versus ESV-DSE: y = 0.88x + 37.0.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Intravenous urokinase in acute myocardial infarction.

To achieve reperfusion early, an intravenous bolus of 2 million units of urokinase was administered in 50 patients with transmural acute myocardial infarction (AMI) 1.8 +/- 2.5 hours after the onset of symptoms. Coronary angiography performed 1.1 +/- 0.6 hours after urokinase therapy revealed patent coronary arteries in 30 patients (60%), with no significant difference between those with anterior and those with inferior AMI. Reocclusion occurred in only 1 of 24 patients restudied. Failure to achieve reperfusion was not related to the degree of systemic fibrinolytic activity, which was equally high in patients who did and those who did not achieve reperfusion, as evident from serially obtained fibrinogen measurements (77 +/- 52 vs 84 +/- 24 mg/dl, difference not significant). Plasmin activity, measured serially from 15 minutes to 24 hours after urokinase in 7 patients, was maximal at 15 minutes and undetectable after 3 hours. Wall motion at the infarct site measured from contrast ventriculograms was significantly better at follow-up only in patients in whom reperfusion was achieved and who received urokinase within 2 hours after the onset of symptoms as compared with patients in whom reperfusion was not achieved (-1.2 +/- 1.4 vs -2.4 +/- 0.9 standard deviations from normal, p less than 0.05). Peak serum creatine kinase level was significantly lower in patients in whom reperfusion was achieved than in those in whom it was not or those who had rethrombosis (802 +/- 763 vs 1,973 +/- 1,071 U/liter, p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Selective coronary angiography via flashing tomosynthesis].

To assess the value and significance of short-term tomosynthesis in judging the pathological condition of coronary vessels, the authors examined 34 patients with coronary heart disease. In comparison with 35 mm cinecoronary angiography, all angiographically determined vascular occlusions and stenoses were identified via short-term tomosynthesis. Comparison of the degrees of stenoses yielded good correlation (r = 0.85). Short-term tomosynthesis offers the advantage of employing smaller amounts of contrast medium to be injected; furthermore, the examination period is shorter, and exposure to radiation is also significantly less.

Cineangiography↗
PubMed1985

[Morphometric and densitometric assessment of left ventricular function in the digital subtraction angiocardiogram].

The paper deals with the early clinical experience, using a new DSA installation with a specially programmed cardiological module. DSA provides very good contrast and special resolution and morphometric estimation of the ejection fraction and regional movement of the left ventricular myocardium derived from DSA. This is as good as the results of the left cardiogram. The significant advantage of DSA ist the ability to make a rapid and simple diagnosis. In addition, it is possible with densitometric methods to calculate ventricular volume curves and to provide phasic indications of the amplitude to contraction of the left ventricle. These investigations have so far proved valuable and provide new scope for the radiological evaluation of left ventricular function.

Absorptiometry, Photon↗
PubMed1985

Coronary angiography with flashing tomosynthesis.

Thirty-four patients with coronary artery disease were studied with standard 35 mm coronary cineangiography and flashing tomosynthesis, to assess the value of the latter technique to detect stenotic coronary arteries. All occluded vessels and all coronary stenoses seen by cineangiography were also found by flashing tomosynthesis. A correlation coefficient of r = 0.85 (P less than 0.001) was determined between the degrees of stenosis obtained by the two techniques. With flashing tomosynthesis, less contrast medium was needed, the investigation time was shorter, and the radiation exposure markedly reduced. At present, dynamic events, such as collateral blood flow, cannot be evaluated. We conclude that coronary arterial stenoses and occlusions can be reliably evaluated by flashing tomosynthesis. Further technological developments are necessary for the technique to gain clinical acceptance.

Adult↗
PubMed1984

Correlation of echocardiographic and surgical findings in acute bacterial endocarditis.

From January 1979 to April 1983, 72 patients (pts) with bacterial endocarditis were treated. During their first stay in hospital 36 of them (age range: 23-67 years) underwent cardiac surgery because of severe congestive heart failure, unsuccessful antibiotic treatment of the infection and/or embolic events. In all these cases cardiac surgery was performed without preoperative catheterization. Surgery was recommended on the basis of clinical as well as M-mode and 2D echocardiographic findings. In 32 of the 36 pts the echocardiographic study completely predicted the surgical findings (23x the aortic valve, 1x the mitral valve, 1x the tricuspid valve, 5x the mitral and aortic valve, 1x the aortic valve and a VSD and 1x the triscuspid valve and a VSD were involved). The preoperative echocardiographic diagnosis was incomplete in 4 of the 36 pts. One aortic aneurysm, one aortic root abscess and 2x vegetations on the mitral valve were not detected by echocardiography. Surgery was recommended in these 4 pts because of additional aortic valve endocarditis proven by echocardiography. We conclude that combined M-mode and 2D echocardiography allows the accurate prediction of morphological alterations of the heart in the setting of acute bacterial endocarditis. Thus cardiac surgery can be recommended in pts with acute bacterial endocarditis without preoperative heart catheterization and coronary angiography.

Acute Disease↗
PubMed1983

[Value of echocardiography in the preoperative diagnosis of acute bacterial endocarditis].

Open-heart surgery was performed in 26 of 56 patients with acute bacterial endocarditis seen in three years. Non-controllable infection, cardiac failure or embolism were the indications for operation. In all instances pre-operative invasive angiographic diagnosis was dispensed with, indications being based entirely upon clinical findings plus the results of M-mode or cross-sectional echocardiography. In 22 of the 26 patients the pre-operative echocardiographic diagnosis coincided with the intra-operative one. In the other four patients the pre-operative echocardiographic findings were incomplete, but no surgically important information had been missed.

Adult↗
PubMed1982

The reliability of echocardiography in preoperative diagnostics of bacterial endocarditis.

During a period of 4 years, 32 patients with acute bacterial endocarditis were admitted for cardiac surgical intervention. Uncontrollable infections, heart failure or embolism presented indications for the operation. In all cases, a preoperative, invasive angiography diagnostic was abandoned. The indication for surgical intervention was based on clinical criteria as well as the findings of one-dimensional or two-dimensional echocardiography. In 26 out of 32 patients who underwent surgical intervention, the preoperative echocardiography findings were in agreement with the intraoperative findings. In the remaining 6 patients, the preoperative echocardiographic findings were incomplete; in 2 cases particularly, it is important to note that an aneurysm of the ascending aorta had been missed. In view of these findings and results, we think that in acute bacterial endocarditis, the combined use of one- and two-dimensional echocardiography together with clinical findings can replace preoperative hemodynamic diagnostics.

Adult↗
PubMed1978

[Purine nucleotide synthesis in human liver an its influence by benzbromarone (author's transl)].

5-Phosphoribosyl-1-pyrophosphate amidotransferase and the hypoxanthine-guanine phosphoribosyltransferases (H-PRT, A-PRT) were assayed in human liver cells and some of the properties of these enzymes were determined. The Michaelis-Menten constants of both H-PRT and A-PRT for phosphoribosylpyrophosphate are at least an order of magnitude lower than for human PP-ribose-P amidotransferase. At the enzyme level the higher specific activities of phosphoribosyltransferases would, in effect, give precedence to purine salvage in human liver. In addition, no effect of benzbromaronum on enzyme activities could be demonstrated.

Amidophosphoribosyltransferase↗
PubMed1978

Purine nucleotide synthesis in normal and leukemic blood cells.

The present study was undertaken to obtain more precise information about the purine biosynthetic pathway in human blood cells. 5'phosphoribosyl-l-pyrophosphate (PP-ribose-P) amidotransferase was found in cell-free extracts from all leukemic cells and normal lymphocytes and therefore these cells could synthesize the first intermediate of the purine-de-novo-synthesis. Normal leucocytes, erythrocytes and bone marrow cells lack this enzyme system and have an absolute requirement for externally supplied purines via salvage pathway. Leukemic blast cells show different enzyme activities independent of their cell count. Kinetic studies with the crude enzymes showed sigmoidal substrate velocity curves for PP-ribose-P, whereas glutamine shows hyperbolic kinetics. The leukemic cell enzymes from all four donor types (ALL, CLL, AML and CML) are rapidly saturated with low concentrations of PP-ribose-P and less inhibited by the physiological feedback inhibitor, adenosine 5'monophosphate. The crude enzymes of normal spleen lymphocytes and leukemic cells were further purified (10 to 15-fold) and substrate velocity curves for PP-ribose-P and glutamine show now hyperbolic kinetics and double reciprocal plots were linear with and apparent Km for PP-ribose-P of 0.14 mM and for glutamine 2.0 mM. In the presence of different concentrations of AMP, the PP-ribose-P substrate velocity plot changed from a hyperbolic to a sigmoidal curve; no difference in the degree of the inhibition between both partially purified enzymes (normal spleen lymphocytes and leukemic cells from all four donor types) could now be observed.

Adenosine Monophosphate↗