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Biomedical subjects

H Kuhn

Publications and source records attributed to H Kuhn.

At least 217 records · Page 12Linked to original sources
PubMed1976

[Bypass operations in reconstructive vascular surgery, using prosthetic material (author's transl)].

Age and accumulation of risk factors in patients with arterial occlusive diseases in Fontaine's Stages III and IV do not always permit direct vascular reconstruction. A further indication for prosthetic bypass procedures is given by local infections following vascular surgical interventions, severe damage to soft parts after traumata and radiotherapy, and anus praeter in the pelvic region. In the supra-aortic region carotido-subclavian, subclavio-carotid and the carotido-carotid bypasses are already routine operations. The indications for axillo-femoral, carotido-femoral, femoro-femoral, iliaco-femoral and obturator bypasses are described and discussed with reference to our own experiences.

Aortic Diseases↗
PubMed1976

[Hypertrophic obstructive cardiomyopathy (author's transl)].

The course of hypertrophic obstructive cardiomyopathy is characterized by a slow progressiveness. The degree of clinical severity can therefore not seldom be unchanged over 10 years and more. Even today, no therapy is known that will guarantee a confirmed improvement in the prognosis of the disease. The symptoms and discomforts can be favorably influenced in many cases by conservative measures. Compared with the conservatively treated patients the favorable results are in the surgically treated group.

Adolescent↗
PubMed1976

[Hereditary neuropathic Portuguese type of amyloidosis (author's transl)].

Report of a 35 year old male with hereditary neuropathic amyloidosis of the portuguese type, the second known case in Germany. There are extensive nodular Congo red positive amyloid deposits in the endoneurium of the peripheral nerves which lead to displacement, compression atrophy and interruption of the endoneural fascicles. The amyloid fibril structure is specially noted by interference contrast microscopy. It can also be documented in unstained microscopic sections. Further extensive nodular deposits are present in the mesangium of the glomerula. The remaining organs show preponderantly affected vessel walls and collagen fibres.

Adult↗
PubMed1976

Model consideration for the origin of life. Environmental structure as stimulus for the evolution of chemical systems.

In an attempt to understand the origin of living systems we encounter the following problems: How can we conceive the origin of the first self-reproducing forms, and by means of what stimuli could a constant increase in the complexity of such forms commence? How can a translation apparatus for genetic information develop? One cannot imagine that such an apparatus for the synthesis of enzymes can function alone without the interference of enzymes themselves, which, however, could only become available after the construction of the apparatus itself. What stimulus mechanism is conceivable that leads to the division of the genetic apparatus into a replication system, and an enzyme-synthesis system? The main problem therefore, is not the search for basic theoretical concepts. It is not a question which can be answered by means of specific experiments. One should rather explore the principal possibilities of how molecules combine to produce more and more complicated functional units. We look for the fundamental structural changes in the organizational systems and the driving forces initiating these developments. Questions concerning the detailed chemical realization are of secondary importance. In trying to solve the puzzle of how the genetic apparatus is gradually built up as complex aggregates of molecules, we consider a consistent causal chain of simple and transparent physiochemical model steps. The driving force for the self-organization of matter is seen in a specific environmental structure to be found on the surface of the earth. By this structure, which is periodic in time and heterogeneous in space, evolution is initiated and driven towards a continuously increasing degree of complexity correlated with a continuous expansion of the accessible living space. This process is a necessity under proper environmental conditions. Accidental events initiate each step but do not determine the general course of evolution which is determined by the selection mechanism.

Adenosine Monophosphate↗
PubMed1976

[Cardiodepressive effect of alcohol in low doses in normal persons and patients with coronary disease].

To study the effect of small amounts of ethanol 1 ml whisky (43 vol. %) per kg body weight was given to normal subjects (n = 11) and patients with coronary heart disease (n = 11) and the systolic time intervals (STI) PEP (preejection period), LVET (left ventricular ejection time), QS2 (total electromechanical systole) and PEP/LVET were measured. A control group consisted of five patients with coronary heart disease. The following results were obtained: Already at rest PEP/LVET was significantly higher in patients with coronary heart disease. After the ingestion of alcohol, significant changes of the STI were observed; mainly an increase of PEP and PEP-LVET was found. In patients with coronary heart disease the effect began earlier, was significantly higher and lasted significantly longer than in normal subjects. According to invasive correlation-studies of different authors, these results indicate an impairment of left ventricular function, especially of ejection fraction and contractility. These alterations seem to be more pronounced in patients with coronary heart disease. The results of this study should be considered in advising patients with coronary heart disease.

Adult↗
PubMed1976

[Possibilities of surgical treatment of the postthrombotic syndrome (author's transl)].

5% of the working population of the Federal Republic of Germany are suffering from a postthrombotic syndrome. Reconstructive venous surgery is only beginning to make progress as regards technique and number of cases. Over a period of four years and among a total of 2,000 cases of vascular surgery, there were only 112 operations on the venous system. Unilateral occlusions of the iliac vein are reconstructed by Palma Operation. The results of such interventions can be improved by creating a temporary arteriovenous fistula (14 observed cases, 12 of them functionning). In cases of thrombotic occlusion of the femoral vein, the equilateral saphenous vein can be implanted into the popliteal vein, thus providing an unimpaired runoff for the pump of the calf muscles (May-Operation). In this procedure, better haemodynamic conditions for the permeability of the graft can also be created by a temporary arteriovenous fistula established between the distal saphenous vein and the posterior tibial artery behind the ankle (9 observed cases, 8 of them functionning).

Acute Disease↗
PubMed1976

[Course observations of hypertrophic obstructive myocardiopathy].

The course of HOCM is characterized by a slow progression. Symptoms can often be influenced favourably by medical treatment. Altogether there is some difference between the course of untreated and the propranolol-treated patient groups which is, however, not statistically significant. Furthermore, the rate of sudden death is uninfluenced. Comparing clinical and haemodynamic results in medicically treated patients we find a reduction of the outflow tract obstruction in case with clinical improvement but not a reduction of the enddiastolic pressure. Independent on the clinical course there was a significant increase of the enddiastolic pressure after 5.5 years. We may conclude that there is a progredient process of hypertrophy which is uninfluenced by the obstruction and by conservative management. The best results are obtained in the operated group. According to our results a surgical intervention should possibly be considereed more generously.

Adolescent↗
PubMed1975

[Diagnostic and prognostic value of endomyocardial biopsy in patients with congestive cardiomyopathy (author's transl)]rdiomyopathy(author.

Endomyocardial biopsies were obtained from the right ventricle in 25 patients with the clinical diagnosis of congestive cardiomyopathy. The biopsies were subjected to virological and histological studies (light and electronmicroscopy) and the findings correlated with clinical data. Abnormal morphological findings were present in all patients. The presumed clinical diagnosis was confirmed in 19, the morphological changes not being consistent with the clinical diagnosis of CCM in six patients. Electronmicroscopy revealed cardiac storage disease in one patient and pathological changes secondary to previous myocarditis in the other five. Clinical follow-up studies of the five patients apparently confirmed the morphological results, because in no case was there clinical deterioration, three patients in fact being in a fairly normal cardiac state at present. Using a morphological scoring system, the 19 patients with morphologically confirmed diagnosis of CCM were subdivided into two groupds, those with four points or less (group I, n equal to 9), and those with five pints or more (group II, n equal to 10). During a mean follow-up period of nearly 12 months the first group had a low mortality rate (n equal to 2), while the other had a high one (n equal to 6). The occurrence of signs of degeneration and mitochondrial alterations, in particular, was associated with a poor clinical prognosis. This differentiation into two groupds could not be achieved by clinical means alone. Type B3 Coxsackie virus was isolated from one biopsy, but no patient had significant serological evidence of virological infection.

Adult↗
PubMed1975

Degeneration and regeneration of adrenergic nerves in mesenteric blood vessels, iris and atrium of the rat after 6-hydroxydopamine injection.

Degeneration of adrenergic axons after 6-hydroxydopamine (6-OH-DA), 2 times 68 mg kg-1 i.v. within 6h, and the subsequent regeneration process over the following 205 days were studied in rat mesenteric vessels, wight atria and irides, using the histochemical fluorescence method of Falck and Hillarp. The objective of the study was to determine why noradrenaline is less depleted and recovers much more rapidly in the mesentery than in other tissues after 6-OH-DA (Finch et al., 1973). The mesentery was further studied by electron microscopy and noradrenaline content analyses, until day 29 after 6-OH-DA treatment. Virtually all adrenergic terminal axons in these tissues were destroyed one day after 6-OH-DA. The large nonterminal axon bundles which occur along the mesenteric vessels and rarely in the heart survived and revealed an intensified catecholamine fluorescence; correspondingly, the mesenteric noradrenaline content was only reduced to 29% of control values. In contrast, such large nonterminal axon bundles were not observed in control iris preparations, and no adrenergic fibres survived in the irides, as suggested by fluorescence microscopy. Regenerating axons were observed in all organs after 3-8 days. The number of nerve terminals along the circumference of the external elastic lamina, as observed in ultrathin cross sections of mesenteric vessels, appeared virtually normal 4 weeks after treatment. Meanwhile, the noradrenaline content of the mesentery returned to approximately 85% of control values. As suggested by fluorescence microscopy, complete adrenergic regeneration occurred in mesenteric vessels between days 46 and 105, while regeneration in atrium and iris was incomplete even at day 205; The density of adrenergic axons in the iris, morphometrically determined, was only 76% and 88% of controls on days 160 and 205, respectively. The survival of the many large nonterminal axon bundles in the mesentery with increased NA content explains the relatively small NA depletion of the mesentery; The rapid recovery of the mesenteric NA content is due to faster regeneration of adrenergic terminal axons in the mesentery as compared with iris and atrium. This is tentatively explained in terms of sprouting from the large axon bundles surviving close to the destroyed terminal axons of the mesenteric vessels, whereas in the other tissues no (iris) or only a few (atrium) large nonterminal axon bundles occur and persist to act as a source of quickly regenerated terminal axons.

Animals↗