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Biomedical subjects

H Bergmann

Publications and source records attributed to H Bergmann.

At least 145 records · Page 8Linked to original sources
PubMed1983

Angioplasty in stenosis of the innominate artery.

We describe a successful percutaneous transluminal dilatation (PTD) of an innominate artery stenosis in a 40-year-old patient with aortic arch syndrome. Five years earlier both a left central carotid artery occlusion and an innominate and left subclavian artery stenosis were treated by grafting from the aorta to the distal vessels. At recurrence of the neurological symptoms, reocclusion of the graft to the innominate artery and subtotal stenosis of the left carotid anastomosis were noted. To prevent the hazards of a reoperation, the innominate artery stenosis was dilated by means of PTD via the right brachial artery. Success of the procedure was demonstrated by Doppler sonography and angiography. It appears that PTD serves as an excellent method of treating stenoses of the aortic arch branches in aortic arch syndrome.

Adult↗
PubMed1983

[Clinical relevance of microaggregates in stored blood].

A survey is given on the clinical relevance of microaggregates in stored blood. Initially the pathophysiology of aggregation led by electrostatic and humoral changes on the surface and membrane of the platelets is presented, and the well known pathomechanisms of embolization as well as the functional pulmonary impact of these emboli are discussed. The ever increasing importance of humoral factors is stressed, the mechanic obstruction of pulmonary capillaries by microaggregates having not that clinical importance as the general opinion in earlier days has been. New therapeutic aspects therefore are mentioned: The blockade of aggregation and the release syndrome by adding aspirin, aprotinin or prostaglandin E 1 to the stored blood, pharmacologically influencing the metabolism of arachidonic acid by inhibiting negative effects of prostaglandins (injecting ibuprofen as inhibitor of thromboxane-synthesis) and stimulating positive prostaglandin effects (infusion of prostacyclin), and finally the application of fibronectin (cryoprecipitates) for increasing the RES-function thus also enhancing the clearance of microaggregates, fibrinogen/fibrin complexes and intestinal serotonin. The latter way only, however, is also clinically feasable. The purely mechanical microfiltration should therefore still be used (3 pints of blood at least, pulmonary damage by trauma, shock or sepsis) and the methods of giving aggregate-poor red cell preparations (buffy coat free or saline washed) should be remembered. For the future one could speculate that more or less complete humoral block might be used in conjunction with a "midi-filtration" (Eckert: 40-100 mu diameter standard blood filter).

Blood Preservation↗
PubMed1982

[Variant angina non-invasive assessment of coronary morphology].

The predictability of coronary morphology was investigated in 28 patients with variant angina using clinical symptomatology, effectiveness of nifedipine an appropriate ECG changes. Using coronary angiography seven patients had shown normal or not significantly stenosed coronary arteries (group 1), 21 had significant coronary stenoses (greater than 70%) (group 2). Six patients of group 1 showed resting angina only, 11 out of group 2 had in addition exertional angina and 4 had to be assigned clinically to threatening infarct enlargement. Treatment with nifedipine was successful in 6 patients of group 1, however, only in 6 out of 17 patients in group 2. In no case did treatment with nifedipine lead to success in multiple vascular involvement. Normal control ECGs were present in 6 patients of group 1, a pathologic ECG with Q spikes or T inversions was seen in 20 patients of group 2. Results indicate good diagnostic accuracy for normal coronary vessels in the presence of angina at rest, effective treatment with nifedipine and normal control ECGs. Significant coronary stenoses may be assumed when angina at rest and during exertion, ineffective treatment with nifedipine and pathologic control ECGs are demonstrable. Using these parameters prediction of coronary morphology with non-invasive methods was possible in 14 of the 28 patients with variant angina.

Angina Pectoris, Variant↗
PubMed1982

[Transluminal dilatation of innominate stenosis in aortic arch syndrome].

Successful percutaneous transluminal dilatation of an anonyma stenosis is reported. The patient was a 40 year-old male with the aortic arch syndrome. Five years before an occlusion of the central carotid artery, as well as anonyma and left subclavian stenoses were treated by means of vascular grafts. On recurrence of the neurological symptoms, reocclusion of the right graft to the anonyma artery and subtotal stenosis of the left carotid bifurcation was noted. The anonyma stenosis was dilated by means of PTD. Haemodynamic success was demonstrated by Doppler sonography.

Adult↗
PubMed1982

Substitution therapy with an antithrombin III concentrate in shock and DIC.

In 15 patients admitted to the Intensive Care Unit for shock and with signs of DIC, Antithrombin III (AT III) was substituted. Immediately after the first blood sampling, 1,000 units of AT III was given. This was followed by 500 units AT III after 24 h and after 48 h. A continuous dose of heparin of between 250 and 500 I.U./h was simultaneously given. The following results were obtained: The activity of AT III on admission of 63 +/- 19% increased to 83 +/- 17% 30 min after the initial substitution. There was a clear difference between the recovery of the substituted AT III in acute DIC and in patients in a steady state. AT III recovered in circulation was 47 +/- 15% in the former group but 83 +/- 16% in the latter cases. One unit of AT III per kg body weight increased AT III activity in circulation by 1% in acute DIC but by 1.8% in a steady state. The average half life of the substituted AT III was 4.4 +/- 1.6 h in acute DIC and was 20.2 +/- 4.1 h when the patients were in a steady state.

Adult↗
PubMed1982

[Noninvasive flow measurement of Cimino-shunts by ultrasonics ].

A duplex scanner is used for noninvasive and semiquantitative flow measurement of Cimino-shunts. Normal venous shunt flow was in 12 chronic shunts 15.2 +/- 3.9 ml/sec and 3 fresh shunts 7.3 +/- 1.8 ml/sec. A noninvasive diagnosis of hemodynamically significant shunt stenoses seems to be possible. Therefore an early and routinely examination of shunts by means of a duplex scanner ist recommended.

Arteriovenous Shunt, Surgical↗
PubMed1982

Effects of oral pirenzepine on gastric emptying and antral motor activity in healthy man.

UNLABELLED: Pirenzepine (PIR), in contrast to classical antimuscarinic drugs, shows heterogeneity of binding that corresponds with the pharmacological activity: gastric secretion is inhibited by low doses, whereas higher doses are needed to inhibit gastrointestinal motility. This study investigated the effects of oral PIR on gastric emptying and antral motor activity. 20 healthy men (mean age 24.9 yr) participated in two experimental sessions, one week apart. According to a cross-over double blind design they received, three and a half days prior to the studies, either 50 mg PIR twice daily or placebo (PLA). A semisolid test meal labelled with 150 MBq 99mTc hSA was administered. A gamma camera coupled to a computer monitored modulation depth (MD), frequency (FR), and propagation velocity (PV) of antral contractions together with gastric emptying rate (GE) according to a modification of Akkerman's technique. PIR decreased MD (PLA: 21.2 +/- 1.7 SEM%; PIR: 17.2 +/- 1.5%; P less than 0.005) and increased FR (PLA: 3.12 +/- 0.05 cycles/min; PIR: 3.29 +/- 0.07 c/min; P less than 0.005) significantly whereas PV was accelerated (PLA: 2.9 +/- 0.2 mm/sec; PIR: 3.1 +/- 0.3 mm/sec; n.s.) and GE delayed only slightly (PLA: 50.4 +/- 8.5 kcpm; PIR: 35.5 +/- 6.0 kcpm; n.s.). PIR produced more frequent stools in three and accommodation difficulties and a dry mouth in each two subjects. PLA caused no side effects. CONCLUSION: PIR delays GE insignificantly despite of considerable effects on antral motility.

Adult↗
PubMed1982

[Study of principles in pathogenesis and therapy of fat embolism. IV. In vivo studies of drug-induced mobilization of embolized lung fat].

Pluronic F 108 added to serum in a concentration of 1 g/dl proved as the optimal means to increase the fat emulgatory capacity. Similar concentrations were achieved in living rabbits by infusing 4.5 g per kg body weight. In spite of this higher dosage we failed to mobilize 131 J labelled fat, embolized into the lungs of the animals. It is concluded that also in humans there exists no possibility to mobilize fat emboli from the lungs by the application of tensides (non-ionic detergents, lecithin-preparations, bile salts) or of organic solvents (alcohol, ether). All these agents are capable to emulsify fat in vitro, however, only under vigorous shaking.--Because of the side effects of those agents their application on patients, suffering from posttraumatic fat embolism seems not to be justified.

Animals↗
PubMed1982

[Substitution of antithrombin III in shock patients].

In 15 patients admitted to the operative intensive care unit of the Institute of Anesthesiology for shock and with signs of DIC, antithrombin III (AT III) was substituted together with a continuous infusion of heparin. 1,000 units AT III were given after the first blood sampling. This was followed by 500 units after 24 h and after 48 h. 14 out of the 15 cases could be evaluated. The activity of AT III prior to substitution was below 75% in 10 cases and above 75% in 4 cases. The mean increase after substitution was 16%. The recovery was below 50% in cases with acute DIC whilst it was 90% in cases in a comparatively steady state. One unit AT III per kg body weight increased the activity of AT III in circulation by an average of 1% in acute DIC whilst the increase was 2% in cases without signs of acute DIC. The average half disappearance of the increase of AT III in circulation was 4.25 h in acute DIC but was 19.0 h when acute DIC was not detectable.

Adult↗
PubMed1981

[Clinical, angiographic and therapeutic aspects of variant angina (author's transl)].

A report is given on seven patients with Prinzmetal's variant angina. Rest angina occurred in all patients. In contrast, exertional angina was observed only on patients with significant (greater than 70%) coronary stenosis. Likewise, electrocardiographic changes (negative T) were only demonstrable in patients with severe coronary obstruction. The coronary angiogram was normal in one patient, demonstrated insignificant lesions in two and significant stenosis in four cases. In patients with insignificant coronary lesions obstructive coronary spasm was provoked by ergonovine maleate and this group responded well to a combination of nifedipine and isosorbide dinitrate therapy. The patients with significant coronary stenosis were free from pain after coronary bypass surgery; one of these suffered a perioperative anterior myocardial infarction. On the basis of these observations promising therapy is possible if the coronary morphology is known.

Adrenergic beta-Antagonists↗
PubMed1981

[General anesthesia in eye operations (author's transl)].

This retrospective study reports on ten years' experience of general anesthesia in ophthalmosurgery (4080 cases) at the General Hospital in Linz, Austria. The majority of patients in ophthalmosurgery are infants, children and geriatric patients confronting the anesthesiologist with specific problems. Anesthesiologic techniques and complications are discussed. Cooperation and continuous qualified anesthesiologic care are essential for good results. In bulb-opening procedures Valium-Neuroleptanalgesia is preferred, as it involves less stress, especially for the geriatric patient, and insures optimal operating conditions for the ophthalmologist. In the Linz General Hospital general anesthesia has become the method of choice in eye surgery.

Adolescent↗
PubMed1981

[Barbiturates].

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Anesthesia, General↗
PubMed1980

[Effects of Imolamin on hemodynamics and pacing induced angina pectoris (author's transl)].

10 patients with exertional angina pectoris were examined to evaluate the hemodynamic effects of 100 mg parenteral applied Imolamin. In 4 out of 7 patients the pacing-induced angina was improved after Imolamin. No significant changes were found in heart rate, mean pulmonary artery pressure, left ventricular systolic and enddiastolic pressure. The compatibility of Imolamin was good.

Angina Pectoris↗