Search PubMed⌕ Search

Biomedical subjects

H Just

Publications and source records attributed to H Just.

At least 397 records · Page 22Linked to original sources
PubMed1978

[Fully automatic computer-analysis of electrocardiograms in clinical routine (author's transl)].

A fully automated Ecg recording and interpretation system (Hewlett Packard HP 5) consisting of a central computer and two peripheral units was evaluated during a four-month period. Ecgs were transmitted via public telephone lines, as was the report from central station to peripheral recording and print-out unit. Within a few seconds after recording and print-out unit. Within a few seconds after recording and transmission a preliminary report is available in printed format. The transmitted Ecgs are stored at the central computer and are being retrieved and evaluated manually there. Three cardiologists read the tracings and furnished final reports. 468 Ecgs were thus compared in our test time of 10 days for statistical evaluation with the following results: 1. 73.1% of all statements were read correctly by the computer. 2. There is a large range of diagnostic accuracy between 0% and 100%. 3. The evaluation of Ecg changed by cardiologists reflects the individual experience of the controllers regarding the Ecg statements as well as computer-dependent possibilities like modification etc. of Ecg. 4. As an example the diagnosis "myocardial infarction" is compared with other Ecg computer programs by means of a quality index calculated from sensitivity and specificity: HP 5 with 158.5 points reaches a similar level as the Pipberger program with 162.6 and the Bonner with 159.5 points. 5. Referring to false negative results this program is acceptable in all diagnostic groups with ca. 8%, except conduction defects with 17.7%. 6. Referring to false positive results the diagnostic groups myocardial infarction/ischemia and conduction defects are not satisfactory with 36.5% and 23.4%. 7. In all the tested system seems to be very useful in routine Ecg interpretation of bigger hospitals.

Cardiology↗
PubMed1977

Coronary arteriography: current technique and standards of equipment.

Coronary arteriography has become one of the most important diagnostic procedures. It is considered indispensable prerequisite in all cases of coronary, valvular, and primary myocardial disease for definition of diagnosis as well as planning of cardiac surgical interventions. Indications seem well established today. Complications have been reviewed in detail and are well known for the different procedures being practiced today. Each examiner should have command of the Sones as well as the Judkins technique. High standards of experience and skill are demanded. Equally important is high performance technical equipment. Current status of generators, power supply, X-ray tubes, image-intensifiers and camera technique is reviewed. Cine-angiocardiography on 35 mm film with simultaneous video-tape recording can be considered standard today. Layout of the equipment should include either cradle-mount for patient rotation or better U-stands for rotation of tube-image intensifier system around the resting patient. Oblique and angulated views in multiple directions are mandatory. Bi-plane equipment seems desirable both for ventriculography as well as coronary arteriography. Future developments can be expected mainly in the field of television technology with improved camera tubes, high resolution systems, and possibly digital processing of video signals.

Angiography↗
PubMed1977

[Results of embolectomy in massive pulmonary embolism (author's transl)].

In ten patients successful embolectomy after acute massive pulmonary embolism was performed. Clinical symptoms included circulatory arrest and shock as well as collaps, syncope and dyspnoe. Pulmonary angiography regularly showed massive, bilateral emboli. In 9 patients more than one half of the pulmonary artery system was involved (perfusion defect more than 50%). Right heart catheterization demonstrated pulmonary hypertension in all cases. In 8 patients the pulmonary artery mean pressure (PAm) exceeded 30 mm Hg. In 9 patients there were signs of right heart failure (RVEDP more than 11 mm Hg). At recatheterization 6 to 30 (mean 19) days after operation using cardiopulmonary bypass there was a marked improvement of pulmonary angiograms, which were normal in 3 cases. PAm decreased from 34.3 mm Hg to 14.6 mm Hg postoperatively and RVEDP from 14.4 to 5.1 mm Hg (p less than 0.001). These results confirm, that pulmonary embolectomy leads to a good functional results.

Acute Disease↗
PubMed1977

[Cardio-pulmonary parameters after myocardial infarction in the late period of recovery. Investigation at rest and during exercise (author's transl)].

From 22 patients in the late period of recovery from myocardial infarction, cardio-pulmonary data were recorded at rest and during exercise. The physical work was increased stepwise until patients reached their individual limit of exercise. According to the different work capacity four groups of patients were formed with the aim to demonstrate the adaption processes of cardio-pulmonary parameters until reaching the peak of work capacity. In one half of the patients we still found signs of cardial insufficiency at rest. After only slight physical work signs of cardiac insufficiency appeared also in the other half of patients.

Female↗
PubMed1977

[Calcification of the mitral valve ring, a cardiac manifestation of Marfan's syndrome (author's transl)].

A 29-year-old patient with calcification of the mitral valve annulus with Marfan's syndrome and severe malformation of the chest is reported. There are 8 other cases with calcification of the mitral annulus in this syndrome in the literature. It seems to be a specific but rare cardiac manifestation of Marfan's syndrome with calcification occurring also in the younger age group. These patients, in contrast to other patients with Marfan's syndrome who mostly have mitral insufficiency of minor degree mainly in late systole, present with hemodynamically severe mitral regurgitation. Our patient died 7 weeks after implantation of a prosthetic valve in low output syndrome, probably caused by a paraprosthetic leak and newly developed aortic insufficiency. It therefore seems that indication for prosthetic replacement of the mitral valve in these patients should be made with caution, particularly in regard to the technical difficulties at operation.

Adult↗
PubMed1976

[Cardiac arrhythmias in the chronic phase of myocardial infarction (author's transl)].

Incidence and type of arrhythmia, using continuous ECG monitoring, were examined in 79 patients six weeks to 24 months after acute myocardial infarction, the findings being compared with arrhythmias at rest and on exercise, and correlated with signs of heart failure and coronary insufficiency. Arrhythmias were revealed in 16% (n = 13 at rest) and 19% (n = 10 of 52) on exercise. But continuous ECG monitoring revealed it in 86% (n = 68). On the other hand, arrhythmias may occur in the resting ECG but be rare on continuous monitoring. Ventricular extrasystoles were the most common arrhythmia, often multifocal and giving rise to bigeminy, only rarely as a result of exercise. Such extrasystoles usually showed right or right and left bundle conduction delays. Their frequency increased with increasing age of the patient. They were particularly frequent in patient who already had cardiac symptoms at rest, in patients with a large heart, and those who could not easily be exercised. Arrhythmias were more frequent a year after infarction than shortly before discharge from hospital or six months after infarction.

Adult↗
PubMed1976

[The prodromal phase of myocardial infarction (author's transl)].

The prodromal phase was studied retrospectively in 101 patients who had sustained acute myocardial infarctions. Only in a few did the infarction occur suddenly. Prodromal symptoms occurred in 80%: angina pectoris of various forms, especially change in type of complaint, signs of heart failure and non-specific general symptoms. With approaching infarction, approximately from the third week onwards, there was a crescendo course of anginal symptoms and of heart failure. Especially typical was change in the form of the angina, with occurrence of spontaneous or resting angina or recumbent angina. Such anginal symptoms, without previous angina on effort, only occurred during the last seven days before the infarction. Angina with manifest or latent signs of heart failure in the course of increasing symptoms (crescendo course) was typical for the last three to four days before infarction. There was an increased incidence of prodromal signs in anterior-wall infarction. A crescendo course implied a worse prognosis. Prodromal symptoms are frequent and prognostically less favourable also in women.

Adult↗
PubMed1976

[Plasma level studies of quinidine retard, their significance for dosage and onset of effect].

A new sustained-action preparation of quinidine-bisulfate (BM-Chinidin Retard) was investigated in 21 patients. After a single oral dose of 1 g peak plasma levels are reached within 3-4 hours with an unsubstantial decrease during the following 4 hours. After 2 g in three divided doses within 12 hours maximal plasma levels are found after 14-16 hours, but an effective level is reached as early as 4 hours after the first dose. With 1 g Chinidin retard given in two doses within 24 hours, varying plasma concentrations are reached after 24 hours, reaching a maximum after 48 hours and decreasing to a medium level thereafter. The minimal concentrations measured were 23 percent lower than the maximal concentrations suggesting that during longterm application rather stable plasma levels are achieved. The effectiveness of the preparation was demonstrated in patients with atrial fibrillation and flutter, supra-ventricular and ventricular premature beats. Longterm treatment was attempted in all patients. Quinidine effectiveness and plasma concentrations were constant throughout the observation period. Side effects were rare: inappetence, vertigo, and headache were observed transiently in 4 patients without necessitating a change in medication. ECG-alterations occurred as described for quinidine-prepartions in general.

Administration, Oral↗
PubMed1976

[Antiarrhythmic treatment of ventricular ectropic arrhythmies with Disopyramide].

Disopyramide (D.) is a new antiarrhythmic agent, which is not related chemically to any of the known substances. Animal experiments have shown a close similarity to quinidine action. Side effects are mainly due to anticholinergic effects. Pharmacokinetic studies with radioactive labelled D. have demonstrated that 80 per cent are elimated via the kidneys and 15 per cent through the gut. Gastrointestinal reabsorption in 90 per cent. We have studied the antiarrhythmic properties of D. in ventricular ectopic arrhythmias in twenty male patients. There were 13 myocardial infarctions, 5 cardiomyopathies, one severe oartic regurgitation with prosthetic valve replacement, one case with VPB of unknown aetiology. In ten cases the influence of D. on ventricular excitation threshold in implanted pacemakers was studied. The effects were correlated with Disopyramide-plasma levels. D. was effective in suppressing VPB. It was successful in 67 per cent, in 30 per cent the effect was unsatisfactory. Pacemaker-threshold remained unaltered. Side effects included constipation. Two deaths were observed. Their relationship to the adminstration of D. is not definitely proved. Nevertheless should the drug because of its negative inotropic action be employed with caution in cases with congestive heart failure.

Administration, Oral↗
PubMed1976

[Pulmonary gas exchange after myocardial infarction in the late period of recovery. II. Investigations during exercise (author's transl)].

After myocardial infarction in the late period of recovery (13-25 months p. infarctum) pulmonary gas exchange in 23 patients was measured besides as hemodynamic parameters during exercise. The parameters take a course similar to that of subjects without lung and heart diseases. Arterial blood gas tensions (Pa02, Paco2) remain unchanged compared to resting values. Alveolar ventilation did show no difference in any of the patients. Minute ventilation VE, the various dead spaces, alveolar-arterial gas differences (AaDo2, aADco2) and ventilation-perfusion ratios of the whole lung VA/Q suggest however that these parameters show different courses according to the physical capacity of the patients. As the physical capacity of each patient is due to different cardiac functions taken by cardiac output and mixed venous blood gas tensions alterations of pulmonary gas exchange seemed to be dependent on the respective left ventricular function of the heart. Of the twenty-three patients, twelve with cardiac failure under exercise showed the most pronounced alterations in pulmonary gas exchange. Therefore, the different physical work capacity of the patients are determined only by cardiac function. No limitation of the productivity due to impeded lung function could be proved.

Carbon Dioxide↗