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Biomedical subjects

H J Duck

Publications and source records attributed to H J Duck.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Case report of Lyell's syndrome].

In Lyell's syndrome a toxic skin erythema is concerned which leads to the epidermal necrolysis and desquamation. An infantile and an adult form are differed; the latter is usually induced by medicaments. Two patients with apparently medicamentously induced Lyell's syndrome are presented. The evoking medicaments were penicillin and thioacetazone. The two patients showed a severe course with an extensive affection of the body surface. The therapy with glucocorticosteroids, electrolyte substitution and local treatment of the skin lesions was successful in the two cases.

Adult↗
PubMed1981

[Possibilities of electrotherapy in tachycardial rhythm disorders].

The pacemaker therapy of tachycardiac disturbances of rhythm used a great number of different methods which are applied according to the kind of disturbance of rhythm. A specialised intracardiac diagnostics is frequently necessary in order to select the suitable stimulation technique. A short survey of the different technical stimulation methods is given which are known from literature and for which own experiences are present. In the perspective a high value is ascribed to the pacemaker therapy in tachycardias.

Cardiac Pacing, Artificial↗
PubMed1980

[Myocardial scintigraphy using technetium-99m-diphosphate in combination with selective coronary perfusion scintigraphy and coronary angiography].

The findings of the scintigraphy of the myocardium with Technetium-99m-diphosphonate (Tc-99m-DP) of 45 patients with nearly exclusively ischaemic heart disease were compared with those of the selective coronary angiography and those of the selective coronary perfusion scintigraphy. 12 patients exhibited an enlargement of the activity in the myocardium (positive scintigramme). These cases were particularly described in this paper. The levocardiogramme proved disturbances of the motility of the walls in 6 patients. In 5 patients a positive scintigramme of the myocardium was registered. Therefore, the scintigraphy of the myocardium with Tc-99m-DP is regarded as a supplementing, non-invasive method for the diagnosis of more pronounced disturbances of the motility of the heart wall. Furthermore, positive scintigrammes of the myocardium were registered in angina pectoris, condition after aorto-coronary bypass-operation, cardiomyopathy and myocarditis. Since the scintigraphy of the myocardium with Tc-99m-DP is a sensitive method for the poor of cell lesions of the myocardium, it allows a judgment of the floridity of the myocardial process. From this among other results that the scintigraphy of the myocardium may be a help for the indication to the aorto-coronary bypass operation. Clear relations between the scintigraphy of the myocardium, the number of the coronary-sclerotically changed heart vessels and the development of stenosation are not to be established. An immediate connection between the size of the disturbance of the perfusion and the results of the scintigraphy of the myocardium is also not to be recognized.

Adult↗
PubMed1980

[Current therapeutic principles as well as new therapeutic aspects of idiopathic hypertrophic subaortic stenosis. II. Chemotherapeutic and direct surgical therapy].

The severity of the functional obstruction of the outflow tract of an idiopathic hypertrophic subaortic stenosis is essentially determined by the contractility of the myocardium, the left-ventricular volume and the peripheral vascular resistance. Though in the acute experiment a clear reduction of the degree of stenosis by beta-receptor-blockers may be proved the long-term results of such a therapy are unsatisfactory, particularly in patients with obstruction in rest. The use of calcium antagonists seems to promise more favourable results. The progression of the disease is, however, scarcely influencible by pharmacological measures alone. Nitrobodies are not suitable for treatment and glycosides should be used only within a manifest insufficiency of the left heart. An effective reduction or removal of the ventriculo-ventricular pressure gradient as well as a decrease of the left-ventricular telediastolic pressure may be achieved on operative way. There is an indication to this, when the complaints increase despite medicamentous therapy. At present the transaortic myotomy under use of the heart-lung-machine is regarded as most favourable method. A simultaneous or only substitute of the mitral valve should be restricted only to those cases which, apart from the functional, still show an organically conditioned insufficiency of the mitral valve. The early and late results of the palliative surgical interventions are very favourable in experienced centres. However, secure long-term prognoses may not yet be derived from this.

Adrenergic beta-Antagonists↗
PubMed1980

[Current therapeutic principles as well as new therapeutic aspects of idiopathic hypertrophic subaortic stenosis. II. Pathophysiology, natural course and diagnosis].

Idiopathic hypertrophic subaortic stenosis is a noncompensatory hypertrophy of the myocardium which above all concerns the ventricular septum in its upper part near to the basis. The etiology is not yet sufficiently clarified, though a genetic component is regarded as ascertained on account of the proved familial accumulations. Haemodynamically the morphologic changes effect a systolic obstruction of the left-ventricular outflow, an insufficiency of the mitral valve and an aggravated diastolic filling of the left ventricle. Further pathophysiological symptoms of the functional subaortic stenosis are an extremely rapid ejection of blood in the early, not obstructive phase of the systole as well as a pathological forward movement of the mitral valve beginning in the midst of the systole. The disease has a bad prognosis. To be sure, the natural course is usually characterized only by a slow progression of the complaints, however, particularly in adolescents frequently sudden cases of death appear by disturbances of the cardiac rhythm or a relative coronary insufficiency. The disease which is already frequently to be diagnosed according to anamnesis, auscultation, ECG and form of the pulse curve may be ascertained using the ultrasound echocardiography as well as heart catheterization including angiography. Apart from a direct measurement of the ventriculo-ventricular pressure gradient during wuch examinations the size of the functional obstruction may further be characterized by certain pharmaca or physical methods which influence the volume of the ventricle or the afterload.

Angiocardiography↗
PubMed1979

[Abnormal myocardial blood flow distribution with a normal coronarogram in angina pectoris and after myocardial infarction].

It is reported on the selective coronary perfusion scintigraphy in 47 patients with angina pectoris and condition after myocardial infarction, which was performed simultaneously with the coronary angiography. For the paper were interesting the cases with normal coronarogram, but pathological perfusion scintigram. 3 of 25 patients with condition of infarction showed coronarographically inconspicuous vessels. In all cases the perfusion scintigram shows disturbances of regional perfusion, which corresponded with the electrocardiographic localisation of the infarction. In 3 of 22 patients with angina pectoris with normal coronarogram in the scintigram regional changes of the terminal vascular system were established. In 2 cases simultaneously a disturbance of rhythm and stimulus conduction was present, which showed a conspicuous correlation to the perfusion lesions in the septum. In the small intramural vessels haemodynamically effective changes take place which are below the coronarogram. Therefore, the only coronarography is not enough to confirm or to refuse a genuine angina pectoris or an infarction. The selecitve coronary perfusion scintigraphy gives the possibility to prove disturbances of the distribution of regional blood supply without a greater additional load of the patient as to coronary angiography. However, it cannot give evidence on the genesis of disturbances in the terminal vascular system in the normal coronarogram

Adult↗
PubMed1979

[Quantitative measurement of arterial flow by means of directional Doppler technic in hemodynamic animal experiments].

The usability of the continuous ultrasonic Doppler-method for the measurement of the blood flow in the haemodynamic animal experiment was tested. For this purpose measurements at the ascending aorta and the commune carotid artery were performed on different current conditions and compared with the electromagnetically registered blood flow. The causes for the non-conformity are discussed.

Animals↗
PubMed1979

[Clinico-diagnostic criteria for the evaluation of social aspects in acquired heart valve diseases].

In spite of the retrogression of the acute rheumatic fever the acquired valvular defects still play an essential role for the morbidity and mortality above all for the younger and middle decenniums of life. In the preliminary diagnostics it is the task of the family doctor to diagnose the valvular defect, to differentiate it from non-organic findings and to estimate its degree of severity. The diagnosis of a carditis renders special difficulties, particularly in its chronic recurrent form. Certain situations of life do not demand only an actual analysis of the findings, but also an individual prognostic estimation. For the choice of profession, the ability for military service and driving a car general references and regularities must be taken into consideration. The indication to operation of the valvular defect is generally given in degree of severity and with restriction also in stage IV. A mitral stenosis is operated already in stage II, when stronger complaints and haemodynamic changes are present. Patients with degree of severity III and IV should avoid a pregnancy, in stage I and II under common control by the internist and obstetrician the pregnant patient may not have any scruples to carry to full term.

Abortion, Therapeutic↗
PubMed1978

[Foundations and indications for selective coronary perfusion scintigraphy].

By means of coronarography in the most favourable case only the morphology and function of the vessels up to a diameter of 0.1 mm may be established. By the selective coronary perfusion scintigraphy this gap is closed, for it allows a judgment also of the terminal vascular system of the myocardium. The basis of this method is an occlusion of the arterioles and capillaries by radioactively labelled microspheres, in which case, however, only every 10,000th to 20,000th vessel is embolized for a short time. Thus the proper selective perfusion scintigraphy is for the patient a procedure which is not stressing, which, however, demands a sounding of the coronary vessels. On the basis of our own previous results this investigation method is indicated in the diagnostics of the ischaemic heart disease also in its atypical form, in the indication to the vascularisation operation with aortocoronary bypass and its postoperative control as well as in the cardiomyopathies. Also in load examinations and in pharmacological tests by their use as double nuclide method an enlarged information can be got. The importance of the perfusion scintigraphy is among others shown in patients with normal coronarogramme, but with perfusion disturbances which can be proved by means of this method. The most comprehensive invasive diagnostics in the diseases mentioned is at present achieved by the combination of coronarography, ventriculography and selective perfusion scintigraphy.

Cardiomyopathies↗
PubMed1975

[Drug therapy of myocardial infarct in ambulatory practice].

For the practicing physician the medicamentous treatment of the patients with infarction is the main problem of the secondary prevention in the prehospital phase as well as in the after-treatment. In these cases in the acute phase not the myocardial insufficiency is in the centre of the out-patient care, but the therapy of the disturbances of cardiac rhythm, which mainly cause the high lethality in the early phase. Therefore, uncomplicated infarctions, in whch care must be taken only for a sedation of sympathico-adrenergic reactions and a volume reduction of the heart, should be differed from complicated cases. However, an immediate transport to the hospital must be guaranteed. If there appear a contraction insufficiency of the left ventricle or threatening disturbances of the rhythm, additionally glycosides and saluretics must be administered as well as an aimed antiarrhythmic therapy must be initiated. The necessary medicamentous measures are described dependent upon the diagnosis of brady- and tachycardiac disturbances of the rhythm. The author enters briefly the problems of volume substitution, treatment of acidosis as well as the administration of beta-sympathicolytics and gluco-corticoids. - In the after-treatment of infarctions anticoagulants are the only medicaments to be prescribed, when findings completely without complications are present. If, however, there are signs of activity of the coronary heart disease in the post-infarction phase, a basic therapy with a glycoside and anticoagulants as well as an individually to be varied additive therapy with nitro-preparations, beta-sympathicolytics, saluretics, anti-hypertensive agents and antiarrhythmic agents are necessary.

Acidosis↗
PubMed1975

[Diagnosis and therapy of arteriovenous lung fistulas].

On the basis of 6 own cases, 5 of which were observed during one year, the clinical picture, the diagnostics and the therapy of the arteriovenous pulmonary fistula are described. Of decisive diagnostic importance is the angiography of the pulmonary artery which should always be used for the clarification of unclear pulmonary foci as well as clinically unclear cyanosis. For the removal of this shunt connection in the lesser circulatory system therapeutically only the operation comes into question. On account of the threatening complications and the inclination to the dilation of the fistula with growing age it is indicated also in cases with only slight haemodynamic effect. Dependent on the anatomical position of the fistula the ligature of the afferent artery is recommended.

Adult↗