Search PubMed⌕ Search

Biomedical subjects

H J Kaiser

Publications and source records attributed to H J Kaiser.

At least 73 records · Page 4Linked to original sources
PubMed1992

Lupus anticoagulants/anticardiolipin antibodies in patients with normal tension glaucoma.

Ocular vascular occlusive disease resulting in severe retinopathy and/or post-thrombotic glaucoma has been extensively discussed in patients with lupus anticoagulant and/or anticardiolipin antibodies (LA/aCL). Inadequate circulation plays an important role in the pathogenesis of another ophthalmic entity--the normal tension glaucoma. We studied 22 patients with normal tension glaucoma (group I) and 23 with chronic open-angle glaucoma (group II) and compared them with a control group (n = 25, group III). LA, aCL, the aCL cofactor beta 2-Glycoprotein I, and other haemostatic parameters including factor VIII:C, von Willebrand factor, factors II, V, VII and plasminogen activator inhibitor were measured. Five out of 22 (22.7%) in group I, five out of 23 (21.7%) in group II and three out of 25 (12.0%) in group III had positive LA and/or aCL. These prevalences were not statistically significantly different. beta 2-Glycoprotein I was normal in all groups. No other parameters were significantly different between groups. These findings do not support the contribution of ocular microvascular occlusive disease, due to elevated aCL, in the pathogenesis of glaucomatous damage.

Aged↗
PubMed1991

Systemic hypotension: a risk factor for glaucomatous damage?

Four glaucoma patients with rapid progression of visual field damage and excavation of the optic nerve head despite normal or well-controlled intraocular pressure had one factor in common: low systemic blood pressure. Furthermore, when monitored during 24 h, a sustained blood pressure drop during sleep was always observed. Systemic hypotension, therefore, might be a significant risk factor for glaucomatous damage. The authors recommend measuring the blood pressure frequently in such patients, especially at night.

Adrenergic beta-Antagonists↗
PubMed1991

[A comparison of MRT and SPECT findings in patients with cerebral microangiopathy].

Lacunar infarctions and periventricular hypodensity are assumed to be typical CT patterns of cerebral microangiopathy (MA). In 17 patients with such findings and in 6 controls without any signs of central nervous system disease cranial CT, MRT and 99mTc-HMPAO-SPECT were employed. Seven patients with CT findings of minor MA demonstrated in comparison to controls no significant difference. In 10 cases with CT findings of pronounced MA periventricular rCBF was significantly reduced compared to controls. rCBF of temporal and parietal cortex was not diminished compared to controls. In 14 patients studied with MRT deep white matter lesions were found which appeared solitary, multiple or confluent. Employing 99mTc-HMPAO-SPECT, cerebral MA revealed rCBF reduction in periventricular brain tissue by cerebellar standardization.

Aged↗
PubMed1990

Methoxyisobutylisonitrile (MIBI) Tc 99m SPECT to establish a correlate to coronary flow reserve, the perfusion reserve, from global and regional myocardial uptake after exercise and rest.

With 99mTc-MIBI SPECT and a 4 h exercise (E: 150 MBq iv) and rest (R; 800 MBq iv) protocol, global and regional left ventricular (LV) myocardial uptake was determined in 70 patients with angiographically confirmed coronary heart disease (CHD) and in 10 controls. The aim was to establish an E/R ratio as a correlate to coronary vascular reserve, representing perfusion reserve (PR). E/R ratios, obtained from total LV myocardium or from normal or impaired regions, were greater than 1.19 under all conditions, indicating the presence of higher flow during exercise than at rest (even in areas of low flow). Global PR separated (P less than 0.01) controls (1.63 +/- 0.21; mean +/- SD) from severely diseased patients (1.29 +/- 0.14 in 2- or 3-vessel disease) only. Improved differential diagnosis was gained from calibrating the regional E/R ratio to regional differences (E minus R) of uptake. For the left ventricle regional PRs (RPR) for 25 ROIs of the target, framing the myocardium, were determined. RPR at the regional maximum of 99mTc-MIBI uptake was similar in both controls (1.66) and patients (1.63), indicating a high probability of meeting some areas with functionally normal perfusion in patients with CHD. RPR allowed sufficient separation (P less than 0.025) concerning the degree of coronary artery stenosis (RPR in occlusion, 0.26; stenosis greater than 75%, 0.39; less than 75%, 0.56). In controls, the overall value for RPR was 1.14 +/- 0.28 (P less than 0.001). LV global PR and RPR were useful in separating patients with CHD vs controls and in classifying the severity of vascular stenosis.

Adult↗
PubMed1990

[Determination of regional cerebrovascular perfusion reserve (rCPR) using quantitative flow/volume (F/V)-SPECT. Results in patients with subcortical ischemic brain lesions with or without neuropsychological symptoms].

NPS (aphasia or neglect) are a regular concomitant symptom of cortical, and, occasionally, subcortical ischemic lesions. In 19 patients with subcortical lesions (eight with NPS, 11 without NPS), F/V-SPECT was employed to search for changes in rCPR in both, lesions and ipsilateral cortex. Results were correlated with NPS and MRI findings. Compared to the unaffected hemisphere, all subcortical lesions showed reduced regional cerebral blood flow (rCBF) (-16 to -23%), increased regional cerebral blood volume (rCBV) (+34 to +62%), and decreased or missing rCPR (-27 to -28%). Compared to MRI, there was no difference in lesion size in the thromboembolic lesions. Hemodynamic low-flow infarcts, however, were greater with SPECT than in MRI. In patients without NPS, the adjacent cortex was normal in SPECT and MRI. In addition, patients with NPS revealed reduced rCBF (-18%), increased rCBV (+19%), and decreased rCPR (-22%) in the adjacent cortex. MRI was normal in the same cortical area. These results indicate that NPS in subcortical lesions may be caused by a hemodynamic mechanism causing reduction of rCPR in the adjacent cortex.

Adult↗
PubMed1990

99Tcm-methoxy-isobutyl-isonitrile SPECT to evaluate a perfusion index from regional myocardial uptake after exercise and at rest. Results of a four hour protocol in patients with coronary heart disease and in controls.

In 70 patients with angiographically confirmed coronary heart disease and in 10 controls, a 4 h exercise (E) (injection of 150 MBq 99Tcm-MIBI) rest (R) (800 MBq) protocol was employed. Of these, 10 patients with 21 myocardial defects after E received a third injection 24 h after. SPECT was used to image myocardial distribution, and visual findings separated three patterns of perfusion defects after E v. R (reversible [REV], partial reversible (PREV), irreversible (IRR)). Relative regional uptake was obtained from a target-like (33 ROIs) evaluation of short-axis cuts, establishing a perfusion index (PI) by relating the defect uptake to individual maximum uptake (100%) after exercise (PIE), at rest (PIR) and the respective differences Delta PI (PIR-PIE, i.e. filling in by the second 99Tcm-MIBI injection). Visually, the sensitivity was 86% in patients or 69% in involved vessels (stenoses of greater than 33%). Vascular supply areas revealed minimal PIE values of 74.7 +/- 10.6% (control), 62.4 +/- 9.2% (REV), 46.1 +/- 7.7% (PREV) and 33.5 +/- 9.9% (IRR) (p less than 0.01). Delta PI was +13.2% or +10.1% in REV or PREV (n.s.) and +2.1% in IRR (p less than 0.01) or -0.2% in controls. PIE values did not correlate to the degree of stenosis. In areas with old myocardial infarction, the same sequence of significant decrease of PIE with reversibility occurred, independent of the patency of the supplying vessel. 33 of 35 IRR defects (94.3%) revealed PIE of less than 45%, thus predicting IRR already after the E examination. PIR values from the 4 h protocol correlated to PIR values 24 h thereafter with r = 0.94 (n = 21). 99Tcm-MIBI may be employed in a short one day E-R protocol in clinical routine. Evaluation of PI seems to be a promising tool to quantify visual defects aimed at describing the perfusional state of the terminal vascular supply area.

Adult↗
PubMed1990

[A method of adjusting and evaluating MRT and SPECT tomograms for comparing cerebral morphology with cerebrovascular regulation].

A method is introduced which yields computerized correlations of topographically identical morphological and functional orbito-meatal slices of the brain by employing the specific local resolutions and a simple adaptation algorithm. In addition, a ROI-overlay method is described which may be used to evaluate semiquantitatively (interhemispherical ratios or ratios hemisphere/cerebellum) identical planes to assess rCBF, rCBV and regional vascular regulation. It appears to be advantageous that ROIs can be superimposed on MRI images as well as on SPECT images.

Brain↗
PubMed1983

[Relevance of an iodine allergy to commercial polyvidone-iodine preparations].

Patch testing with Iodine/potassium-iodide (3%) and commercialized povidone (PVP)-iodine preparations (Betaisodona-ointment and solution, Polyvidon-Jod-ointment "Braun", Braunol-solution "Braun", Traumasept-ointment, and Traumasept solution--not marketed--, were carried out in 104 patients of the Department of Dermatology of the Municipal Hospital Kassel. In addition, the according ointment and solution-bases were tested. 22 tests were patients with ulcera crurum, 82 patients with infectious skin diseases or skin tumors. 35 out of the 104 patients showed positive reactions to iodine/potassium-iodide. Hyperreactivity to one or more PVP-iodine-ointments was found in 12 patients, to one or more PVP-iodine solutions in 29 patients. If there was no positive reaction to iodine/potassium-iodide, PVP-iodine ointments were always tolerated, while PVP-iodine-solutions produced positive reactions in 9 cases even then. Our results show that allergic skin reactions must be expected in 2-9% of all patients using PVP-iodine ointments, and in 12-20% of all patients using PVP-iodine-solutions. If iodine-allergy is known the rate of positive reactions to PVP-iodine ointments is 6-25% to the solutions 34-60%.

Drug Hypersensitivity↗
PubMed1982

[Topical antimicrobial therapy: the efficacy of clioquinol- and tribromphenolbismuth- zinc oxide preparations].

Clioquinol- and tribromphenolwismut zinc oxide preparations were tested in vitro in order to investigate their bactericidal and bacteriostatic efficacy against strains of staphylococcus aureus, E. coli, pseudomonas as well as against the fungi candida albicans and trichophyton rubrum. The results show that there was both a bacteriostatic and a bacteriocidal effect of clioquinol except against pseudomonas. Tribromphenolwismut has less efficacy. In spite of some suggestions in the literature our results confirm that the efficacy of clioquinol is not impaired if combined with zinc oxide. The use of this well tolerated preparation is recommended in the treatment of infectious dermatoses even today.

Administration, Topical↗
PubMed1980

[A new antihypertensive agent used in a clinical setting].

In a multicenter study with 54 patients with essential and renal hypertension (WHO I to III) the antihypertensive efficacy and safety of guanfacine were evaluated against clonidine in a double blind cross-over design. The treatment period for each drug lasted five weeks. There was a two week's wash-out period with placebo between the application of the respective preparations. During the first two weeks of treatment a daily dose of 3.3 mg guanfacine and 0.5 mg clonidine led to a significant fall in blood pressure from 187/103/138 mm Hg (s/d/m) to 152/86/113 mm Hg and from 186/101/136 mm Hg to 156/91/118 mm Hg respectively. During the following time blood pressure and dosage remained almost unchanged. In contrast to clonidine the guanfacine group showed a smaller fall in blood pressure in upright than in supine position. Both drugs showed a decrease of heart rate by approximately 4 beats per minute. Side effects such as dry mouth and tiredness were more pronounced under treatment with clonidine than with guanfacine (p less than or equal to 0,08). Guanfacine is well tolerated as a potential antihypertensive drug with relatively few side effects of mild nature.

Adult↗
PubMedDate not supplied

Short-term effect of dipyridamole on blood flow velocities in the extraocular vessels.

Dipyridamole is known to inhibit platelet aggregation and to induce vasodilatation. It has been shown that dipyridamole increases blood flow in various tissues in humans as well as in the eyes of animals. We studied the influence of dipyridamole in a prospective open trial in 23 patients with impaired ocular circulation due to different causes, based on experienced clinical judgement, such as anterior ischemic optic neuropathy, vasospastic syndrome, glaucoma, or central retinal vein occlusion. Blood flow velocities in the ophthalmic artery, central retinal artery and vein, one lateral and one medical posterior ciliary artery were measured using a Siemens Quantum 2000 color Doppler device. Blood flow velocities were measured before and under treatment. Dipyridamole increased blood flow velocities significantly in all vessels measured. Therefore, it seems promising to evaluate the effect of dipyridamole over a longer period in patients with impaired ocular blood flow.

Adult↗
PubMedDate not supplied

Cardiac stress-rest single-photon emission computed tomography with technetium 99m-labeled tetrofosmin: influence of washout kinetics on regional myocardial uptake values of the rest study with a 1-day protocol.

BACKGROUND: The purpose of this study was to evaluate (1) the washout kinetics of 99mTc-labeled tetrofosmin, separately for myocardium with normal and reduced perfusion, and (2) its influence on quantitative analysis in a 1-day stress-rest protocol. METHODS AND RESULTS: Twenty-five patients with angiographically proved coronary artery disease underwent bicycle exercise stress testing with injection of 200 MBq 99mTc-labeled tetrofosmin and first single-photon emission computed tomographic (SPECT) imaging 40 minutes after injection. A second SPECT was acquired 2.3 +/- 0.4 hours after the first one immediately before rest injection of 800 MBq 99mTc-labeled tetrofosmin. The rest (third) SPECT was acquired 15 minutes thereafter. The relative washout fraction per time (WOFt) was calculated assuming linear washout kinetics. Thirty-three regional uptake values per study were calculated, normalized to the perfusion maximum (100%) in either the postexercise SPECT and the rest SPECT, for the latter with and without correction of remaining counts from stress injection. In regions with normal perfusion, WOFt was 11.5% +/- 3.5% per hour. In regions with markedly reduced perfusion (relative uptake < 50%, WOFt was 8.3% +/- 9.9% per hour. The highest variation of the relative uptake values between rest SPECT with and without correction of remaining counts from stress injection was 5.4% +/- 3.5% in regions with stress-induced ischemia. CONCLUSION: To use a 1-day protocol with a stress-rest radioactivity ratio of 1:4 and an interval of more than 2 hours between the examinations, a correction for remaining counts from stress injection seems not to be necessary for the quantitative analysis of rest SPECT.

Adult↗
PubMedDate not supplied

Systemic blood pressure and capillary blood-cell velocity in glaucoma patients: a preliminary study.

Systemic hypotension and vasospasm have both been suggested as risk factors for glaucomatous damage. Furthermore, a relationship between the incidence of vasospastic disorders and systemic hypotension has been reported. This preliminary study investigated the relationship between these two risk factors. In 20 glaucoma patients suspected to have vascular risk factors, time of blood-flow standstill was measured under cold provocation in nailfold capillaries and 24-hour blood pressure was monitored. Nine were high-tension glaucoma patients but progressing despite medically well-controlled intraocular pressure, and 11 had normal-tension glaucoma. Thirteen patients were vasospastic, and seven were not. Patients without vasospasm had a significantly lower mean systolic blood pressure during the daytime (113.4 +/- 7.1 mmHg) than vasospastic patients (122.6 +/- 12.8 mmHg), p = 0.026. The time of blood-flow standstill in vasospastic patients, however, correlated with the lowest individual systolic blood pressure reading (r = -0.56; p = 0.049). These low readings occurred mostly during the night ("deepers").

Blood Flow Velocity↗
PubMedDate not supplied

A new angiotensin-II- receptor blocker, CGP 48933: local tolerance and effect on intraocular pressure. A pilot study.

CGP 48933, a new angiotensin-II-receptor antagonist, has been shown to lower intraocular pressure (IOP) in two different rabbit glaucoma models in a dose-dependent manner after local application. As a further step a pilot study was performed in human eyes. The trial consisted of three parts. Parts 1 and 2 comprised a double-masked intraindividual trial between CGP 48933 and its vehicle (saline) in five healthy volunteers (Part 1) and five patients with early stages of primary open-angle glaucoma (Part 2), to assess local tolerance and the effect on IOP. Part 3 was a single-masked intraindividual trial between CGP 48933 and saline, to find the effective dose range of the new compound. Local tolerance was assessed as excellent in all subjects. No conjunctival hyperemia burning or itching occurred. There were no significant changes in IOP from baseline in drug or vehicle-treated eyes. In addition, there was no dose-dependent (200 micrograms to 1 mg) effect of CGP 48933 on IOP. Systemic blood pressure, heart rate and pupil size did not change during the observation period. Topical application of CGP 48933 in its present formulation is thus not suitable for lowering IOP in humans.

Administration, Topical↗