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Biomedical subjects

H Kaiser

Publications and source records attributed to H Kaiser.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Influence of minimum current for peripheral nerve stimulation on the latency and success rate of sciatic blockade].

UNLABELLED: The efficacy of conduction anesthesia depends to a great extent on accurate application of the local anesthetic solution (LA) in close proximity to the nerve trunk. The problem with most peripheral nerve stimulators available in the past was that they did not provide a small enough electrical stimulus. Correct positioning of the needle could not be guaranteed if muscle contractions occurred. New current-controlled stimulators have recently been developed with low currents from 0.1 mA upwards. We studied the intensity of stimulus currents eliciting just-visible muscle contractions in the lower leg (m. triceps surae) to see how this influenced the latency and success rate of sciatic nerve block. METHOD: In a randomized study, 35 patients (18-68 years, ASA I and II) undergoing elective surgery were investigated. The block was performed by posterior approach using 30 ml 1% prilocaine. The stimulator was switched on with a frequency of 1 impulse/s and a stimulus current of 1 mA when the insulated needle was at a depth of 4 cm. In group 1 (n = 5) LA was injected when the first visible muscle contractions occurred at a current of 1.0 mA, but vanished if the current was diminished. In group 2 (n = 10) the needle was placed if a minimum current of 0.5 mA just triggered a muscular response. In group 3 (n = 10) the threshold current was 0.3 mA and in group 4 (n = 10) 0.1 mA. In all cases direct contact between the needle tip and the nerve was avoided.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Rhabdomyolysis as a complication of chronic alcoholism. Observations in 19 cases].

In 19 chronic alcoholics with rhabdomyolysis the clinical picture demonstrated markedly different degrees of severity of myolysis. Muscle pain, muscle swellings and brown-coloured urine were rare. But symptoms of delirium, at times with cerebral seizures, were frequent at the onset. Renal failure of different degrees was common; five patients had to be dialysed. Two patients died in irreversible shock. Respiratory insufficiency and hypercalcaemia were other complications. Early recognition of the disease is important, because early treatment can prevent acute "myoglobinuric" renal failure.

Adult↗
PubMed1985

Long-term follow-up after intracoronary streptokinase therapy for acute myocardial infarction.

This article describes the effects on patients treated with intracoronary streptokinase during acute myocardial infarction and long-term follow-up. The mortality and the incidence of cardiac events were assessed during a follow-up period of 35 +/- 5 months. Coronary artery bypass grafting was undertaken in 37% of the patients. Hospital mortality was 11%, (n = 8); none of these deaths was due to myocardial rupture. The postdischarge mortality was 10%; three of these patients experienced sudden death. Serial assessment of left ventricular function in 35 patients showed an increase of angiographic ejection fraction prior to intervention from 50 +/- 4% to 58 +/- 12% (p = 0.005) 36 +/- 53 days later. Gated-blood pool imaging after 16 +/- 7 months (n = 35) and 32 +/- 9 months (n = 31) revealed no change in ejection fraction. Angina pectoris recurred in four of the 35 patients. We studied a historical comparison group, that consisted of 66 patients, who were treated at the same institution prior to the advent of intracoronary intervention techniques; this group was followed for 48 +/- 9 months. Baseline clinical and angiographic parameters were comparable in the two groups. Coronary artery bypass grafting was performed in only 18 of these patients. Mortality during hospitalization and postdischarge was not significantly different in the two groups. Ejection fraction decreased significantly in the comparison group from the first to the second evaluation and remained unchanged during the follow-up period. We conclude that no major adverse effects were associated with intracoronary streptokinase infusion over a long follow-up period. This may be related to the high frequency of coronary artery bypass surgery following reperfusion.

Aged↗
PubMed1984

[Bezafibrate-induced myolysis and myoglobinuria in patients with impaired renal function].

A muscular syndrome has been described in patients on clofibrate and fenofibrate therapy. The present paper describes four patients with impaired renal function in whom symptoms and signs of skeletal muscle damage developed during treatment with another clofibrinic acid derivative, bezafibrate. The syndrome was characterized by variable degrees of muscular cramps and paresis, excessive elevation of muscle enzymes in serum, myoglobinemia and myoglobinuria. Transient deterioration of renal function was also common. All patients had been overdosed with bezafibrate with regard to their renal function. It is concluded that bezafibrate like other lipid lowering agents of the clofibrate type may induce muscle damage, at least if doses are not adjusted to renal function. Extreme caution is warranted when treating patients with renal impairment with bezafibrate and strict dose adjustment to kidney function is necessary to avoid muscle damage.

Aged↗
PubMed1984

Patterns of creatine kinase release during acute myocardial infarction after nonsurgical reperfusion: comparison with conventional treatment and correlation with infarct size.

Coronary arteriography and biplane ventriculography were performed in 51 patients during the acute (mean of 6.6 hours after onset of symptoms) and chronic (1 to 3 months after admission) phase of myocardial infarction. Twenty-four patients were treated in a conventional manner. In 27 patients, reperfusion was achieved with intracoronary streptokinase after 24 +/- 20 minutes of infusion. Peak creatine kinase and cumulative creatine kinase release were derived from serial creatine kinase measurements. Ejection fraction and the length of the akinetic or dyskinetic segments were calculated in the chronic phase. The time interval between onset of symptoms and peak creatine kinase was significantly shorter for the streptokinase-treated patients as compared with the conventionally treated patients (13.5 +/- 5.3 versus 22.9 +/- 7.4 hours, p = 0.0001). Significant linear correlations were obtained for both streptokinase-treated and control patients, relating: 1) peak creatine kinase value to both length of the noncontracting segment and ejection fraction in the chronic phase, and 2) cumulative creatine kinase release to both length of the noncontracting segment and ejection fraction in the chronic phase. Patients treated with streptokinase experienced a relatively greater release of enzyme for a given infarct size as compared with those treated in a conventional manner. The difference in enzyme release between the two groups increased as infarct size increased. These observations may be explained by enhanced washout of enzyme from the infarct zone, secondary to reperfusion after intracoronary streptokinase therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Circulation↗
PubMed1984

[Scintigraphy with 99mTc-methylene diphosphonate for the detection and localization of rhabdomyolysis].

In 24 patients with biochemically proven rhabdomyolysis 34 scans with 99mTc-MDP were performed to detect regional as well as generalized myolysis. When performing the scan within 10 days after the maximum of myolysis, scintigraphic detection was possible in 95% of the patients, but after 20 days in none. Regional tracer accumulation in muscles was more frequent (89%) than generalized diffuse accumulation (31%). Predominantly muscles of the thigh, the buttocks and the upper arm were involved. Diffuse tracer accumulation in both kidneys occurred in 75% of patients with significant renal dysfunction. The results show that in addition to regional muscle damage generalized myolysis may be detected by scintigraphy with 99mTc-MDP. In cases of regional muscle damage scintigraphy proved to be more sensitive than clinical signs.

Alcoholism↗
PubMed1983

[Muscular carnitine-palmityl-transferase deficiency].

Deficiency in carnitine-palmityl-transferase (CPT) was demonstrated in a 20-year-old man with paroxysmal myoglobinuria, after failure to discover another cause. It is concluded that muscular CPT deficiency must be excluded before a recurrent myoglobinuria is classified as "idiopathic".

Acyltransferases↗