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Biomedical subjects

H Klein

Publications and source records attributed to H Klein.

At least 289 records · Page 16Linked to original sources
PubMed1982

["Malignant hyperthermia" following NLA and spinal anaesthesia (author's transl)].

A 51 years old patient underwent 3 urological operations within a short space of time. The anaesthetic procedures (NLA and spinal anaesthesia) caused a rise of temperature, hyperventilation and tremor, suggesting a malignant hyperthermia. The patient refused a muscle bioptical investigation. Biopsies were performed in the patient's children. In the daughter, some "whorled fibres" and single fibre necrosis, interpreted as signs of myopathy, were detected. The clinical syndrome of the father and the histological results of the daughter point out to the possibility that in this family a predisposition to malignant hyperthermia is present.

Anesthesia, Spinal↗
PubMed1981

Direct surgical therapy of ventricular arrhythmias in coronary heart disease.

The aim of surgical therapy for ventricular arrhythmias is to eliminate the areas of diseases myocardium from which ventricular tachycardias originate. According to the results of endocardial mapping a 2 to 3 mm deep endocardial incision is performed around the identified arrhythmogenic area. Within the past 12 months, 19 patients with coronary heart disease and complex ventricular arrhythmias were operated upon. In 16 cases an endocardial incision was performed. In 5 a left ventricular aneurysm was resected as well, 4 patients received one to 4 coronary vein grafts, and in 7 patients aneurysmectomy and bypass grafting were combined. Except for one relapse, no ventricular tachycardia has reappeared since the operation. Ventricular tachycardia could not be initiated by intracardiac stimulation postoperatively in any of the cases restudied. Four patients died from causes unrelated to ventricular arrhythmias. Direct surgical therapy was proven a promising new approach in patients with ventricular tachycardia or complex ventricular arrhythmia refractory to medical treatment. Our technique of endocardial incision appears to be effective and less traumatic to the myocardium than the original transmural encircling incision.

Adult↗
PubMed1981

The young Jewish revivalist: a therapist's dilemma.

This article presents and discusses: (a) some of the diagnostic and psychotherapeutic problems which emerged when dealing with extremely religious Jewish young men; and (b) conscious ethical questions and unperceived counter-transference reactions to religion and religious patients which may overburden the therapist's helping capacity, thereby curtailing the beneficial extent of his intervention. The setting of the therapeutic process is an open intensive care unit. The possible implications and effects of carrying out institutional therapy with this particular kind of patient are also analysed.

Adolescent↗
PubMed1981

[Virological and morphological results in patients with congestive cardiomyopathy (author's transl)].

In 30 patients with congestive cardiomyopathy, right ventricular biopsies were performed. The biopsy material was investigated by virological and morphological methods. In all cases it was impossible to isolate viruses from the right ventricular myocardium, corresponding to the lack of infiltrative changes as shown by morphology. Results point against a direct causative role of viruses in the genesis of congestive cardiomyopathy.

Adult↗
PubMed1981

[Resorption of 2-phenylphenol from washing hand disinfectants (author's transl)].

2-phenylphenol may be applied as active agent in hand disinfectants which have a simultaneous cleaning effect. Such a preparation (Primasept M, Schülke & Mayr GmbH, Norderstedt) which is also suited for the inactivation of Hepatitis B viruses was applied according to prescription and the intake of the active agent by the skin was determined indirectly by the quantity separated in the urine. After 10 minutes successive application of the preparation a mean value of 6.2 mg was observed. Compared with the ADI-value, admitting significantly higher values, no particular risk has to be expected by application of the preparation.

Absorption↗
PubMed1981

Selective isolation of young erythrocytes for transfusion support of thalassemia major patients.

Transfusion-induced hemochromatosis remains a major therapeutic complication in the management of thalassemia major patients. Using available blood cell component separators, a system has been devised to selectively harvest young red cells from transfusion support of these subjects. Red cell units isolated by this method have an average estimated mean cell age of 30 days, compared to 60 days for unfractionated blood, and contain 80% of the hemoglobin content of standard red cell units. Radiochromium half-life for young cells measured in 7 asplenic thalassemia major patients averaged 47.4 days compared to 29.5 days for routine frozen red cells. The enhanced survival is not due to reticulocyte enrichment alone, but represents a true cohort of younger red cells. Although costly, this modality could theoretically halve the transfusion requirement in transfusion-dependent patients. When combined with modern iron chelator regimens, it may be possible to achieve consistently negative iron balance prior to the onset of hemochromatosis.

Cell Separation↗
PubMed1980

[Reciprocal changes of triiodothyronine and reverse triiodothyronine in the early stage of myocardial infarction (author's transl)].

The changes of thyroid hormones and TSH in plasma of males in the early stage of myocardial infarction are described. Already on admission T3 was diminished and went on falling. On admission rT3 was elevated and reached its maximum after 19 hours. T4 and TSH did not show essential alterations. The results suggest that in the early stage of myocardial infarction a rapid shift of the monodeiodination of T4 to rT3 occurs instead of T3 with a quick decrease of T3 and increase of rT3 in the blood.

Aged↗
PubMed1980

Results after resection of postinfarction left ventricular aneurysms.

Although left ventricular aneurysmectomy (LVA) is a common surgical procedure, the late functional and hemodynamic results have not been well defined. This presentation describes our results with LVA in 135 patients operated between 1969 and 1979. Associated procedures were performed in 57 (42%) including coronary bypass grafting in 50, valve replacement in 5, closure of ventricular septal defect in 2, or combinations of these in 3 patients. One hundred four of the 122 hospital survivors were followed from 2 to 107 months (mean = 37 months). There were 13 hospital deaths (9.6%), 12 late deaths (9.8%) and an actuarial 5-year survival rate of 77%. Clinical improvement of preoperative heart failure occurred in 82%, and of angina in 70%. Only 33 patients (30%) returned to normal work. Bicycle exercise testing in 70 patients showed normal working capacity in 41 (59%). Recatheterization in 49 patients showed no significant changes in left ventricular end-diastolic pressure or cardiac index, and a borderline reduction of the total ejection fraction. Ventricular arrhythmias were detected by long-term ECG in 70% of all patients after surgery. Of those with preoperative life-threatening arrhythmias, rhythm improvement was noted in 50%, but only 2 of 13 patients were free of arrhythmias after operation. This study demonstrates a greater frequency of postoperative symptomatic and functional improvement as compared to hemodynamic and ECG improvement. Ventricular tachyarrhythmias originating from post-infarct scars increased intra- and postoperative risk and aneurysmectomy alone is considered insufficient for treatment of these disturbances. Further electrophysiologic investigations are needed and additional surgical measures may be necessary to improve the subset of patients with life-threatening arrhythmias.

Adult↗