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Biomedical subjects

H Oster

Publications and source records attributed to H Oster.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Capillary hemangioma of the heart: a case report].

In a 52-year-old man, within the left ventricle, a globular mass 1.5 cm in diameter was detected incidentally by echocardiography. Selective coronary angiography showed a mobile patch of hypervascularity suggesting the vascular nature of the cardiac mass. The patient was operated and a pedunculated tumor originating from the anterolateral papillary muscle was removed. Histological examination revealed a benign capillary hemangioma. Six months after surgery the patient was reevaluated by echocardiography. There was no evidence of tumor recurrence.

Coronary Angiography↗
PubMed1994

[Reopening of chronic coronary occlusions--initial references for prognostic indications].

Today indication for percutaneous transluminal coronary angioplasty is based on typical chest pain and objective signs of myocardial ischemia during exercise. Especially in chronic coronary occlusions, however, prognostic implications may play an increasing role in the future. The case report describes long-term follow-up of a patient in whom a chronic complete occlusion of the right coronary artery could be reopened successfully back in September 1988. At this time, the peripheral part of the occluded RCA was filled retrogradely by septal collaterals from the LAD. After reopening the patient remained symptom-free for more than two years. In January 1991 again severe angina recurred and ECG showed a non-transmural anterior myocardial infarction. The LAD was occluded proximal and the peripheral part was filled retrogradely by septal collaterals coming from the right coronary artery which was still open (flow reversal). Left ventricular function was only slightly impaired and the LAD occlusion could be reopened successfully too. The case suggests that prognostic implications should be taken into consideration in addition to symptoms especially in complete coronary occlusions.

Aged↗
PubMed1993

Olfactory identification deficits in Down's syndrome and idiopathic mental retardation.

We investigated olfactory identification in children and adults with Down's syndrome (DS) and idiopathic mental retardation (IMR) and in age-matched normal controls (NC). Identification was assessed with a four alternative-forced-choice task modified from the University of Pennsylvania Smell Identification Test (M-UPSIT) and a yes/no task yielding measures of discrimination and response bias for the same stimulus material. Control tactile identification tasks were also administered. Results were that odor identification performance on both tasks was specifically impaired in DS compared to IMR and NC. Accuracy of identification on the M-UPSIT correlated inversely with age in DS only. When uncertain, DS and IMR subjects guessed "yes" more often than "no" on the Yes/No task (liberal decision bias) and guessed the last response alternative on the M-UPSIT (recent position bias), whereas the normal subjects had neutral decision bias on the Yes/No task and matched the objective position presentation probabilities on the M-UPSIT. Decision bias correlated with accuracy of identification in both tasks for the DS subjects only.

Adolescent↗
PubMed1991

[Coronary bypass with arteries].

The internal mammary artery (IMA) and the right gastroepiploic artery are increasingly used for myocardial revascularization. The postoperative results are much better than those of the saphenous vein regarding mortality, patency rate, and relief of symptoms. The IMA can be used as an in-situ-graft or as a free transplant, either as a single graft or using sequential anastomoses. Ten years postoperative 90% of the IMA-bypasses are patent and risk of reoperation is significantly lower in patients with IMA-grafts. From August 10, 1989 until January 31, 1991, 1515 patients were operated for coronary artery disease in our center. There were 1219 men and 296 woman with a mean age of 58.9 years (26-83 years). In 1050 patients (69.3%), either one or both IMA-arteries were used. 75% of the men and 47.7% of the women received an IMA-graft. 981 patients had an in-situ-graft, and in 69 patients the IMA was used as a free transplant. In 74 cases both IMAs were used. In 315 patients sequential anastomoses with one IMA and several coronary arteries were performed. According to our experience, the IMA is an ideal bypass conduit and should be used predominantly.

Coronary Angiography↗
PubMed1990

Multiple-dose safety study of ibuprofen/codeine and aspirin/codeine combinations.

This multiple-dose, double-blind, placebo-controlled, randomized, normal volunteer study compared formulations of ibuprofen/codeine and aspirin/codeine for systemic safety. Vital signs, hematologic, biochemical and urinary parameters, side effects, mood and mental alertness, were monitored. The placebo group had less gastrointestinal side effects and more frequent stools than the active treatment groups. There was statistical evidence for greater adverse effects of aspirin/codeine on mood and mental alertness in comparison to ibuprofen/codeine and placebo. Ibuprofen/codeine had a more favorable adverse effect profile than aspirin/codeine. A mild respiratory and cardiac depressant effect attributable to codeine was evident in all active treatment groups after 7 days of frequent therapy. More work needs to be done to elucidate the factors regulating the development of tolerance to the respiratory and cardiovascular depressant effects of opiates in general, and for codeine in particular.

Adult↗
PubMed1988

Differential facial responses to four basic tastes in newborns.

The distinctiveness and recognizability of taste-elicited facial expressions in newborns were examined in 2 studies. Sucrose, sodium chloride, citric acid, and quinine hydrochloride solutions were presented to 12 infants at 2 hours of age. In Study 1, the anatomically based Facial Action Coding System adapted for infants (Baby FACS) was used to obtain detailed, objective descriptions of the infants' videotaped facial responses to each solution. Facial responses to sucrose were characterized primarily by facial relaxation and sucking. The responses to salty, sour, and bitter solutions shared the same hedonically negative upper- and midface components but differed in the accompanying lower-face actions: lip pursing in response to sour and mouth gaping in response to bitter. There was no distinctive facial expression for sodium chloride. These findings demonstrate that newborns differentiate sour and bitter from each other and from salt, as well as discriminating sweet versus nonsweet tastes. In Study 2, untrained adults viewing videotapes of the infants' facial reactions made forced-choice judgments identifying the stimuli presented and rated the hedonic tone of the infants' responses. While the judges accurately identified the newborns' responses to sucrose, there were systematic errors in their judgments of the 3 nonsweet stimuli. The judges' hedonic ratings, on the other hand, clearly differentiated between the infants' responses to the bitter stimulus and the other 3 tastes. The findings are discussed in terms of the possible functional origins and communicative value of taste-elicited facial expressions in infants.

Discrimination Learning↗
PubMed1988

[Coronary spasm immediately following coronary revascularization].

Of 2,600 coronary operations performed from August 1983, to December 1988, two ischemic reactions of the inferior wall immediately after operation were observed. In both patients the right coronary artery was either dissected or revascularized intraoperatively. Under the diagnosis of postoperative spasm both patients had reangiography three hours after surgery. Right coronary artery spasm was demonstrated in both patients. After intracoronary injection of calcium channelblockers the spasm resolved completely. Patient 1 demonstrated a small inferior infarction during control angiography, patient 2 remained free of a myocardial infarction. The possible causes of coronary spasm during or after surgery are discussed. The diagnosis and an approach to therapy are outlined.

Coronary Artery Bypass↗
PubMed1987

Use of the left internal thoracic artery to correct a left main coronary atresia.

Dyspnea with a slightly enlarged heart was noticed in a five year old girl at a checkup. The cardiological investigation revealed an enlarged left ventricle with slight mitral regurgitation. The right coronary artery was enlarged and filled the entire left arterial system via collaterals. The left main coronary artery could not be detected. In addition, outflow of contrast medium into the large vessels was absent. With the diagnosis of left main coronary atresia, the left internal thoracic artery was implanted on to the proximal left anterior descendent in October 1985. In the control angiogram, the anastomosis conditions were normal, the left ventricle had decreased in size and contracted almost normally. The collaterals from the right could no longer be demonstrated. The child (now six years old) has full exercise tolerance today. In the ultrasonogram, the ventricle shows normal contraction behavior. Up to know, four cases with congenital main coronary atresia have been reported in the literature.

Child, Preschool↗
PubMed1986

[Use of the mammary artery in coronary revascularization].

From August 1983 through December 1985 1088 patients underwent coronary surgery. 406 (37%) received a single or bilateral internal mammary artery (IMA) graft with single or sequential anastomoses. The youngest patient was 6 years old, the oldest 75, with a mean age of 55.7 years. A total of 672 IMA anastomoses was constructed. In addition 348 patients received 610 saphenous vein grafts. 83% of the IMA were anastomosed to the LAD and its branches, 12% to the circumflex and 5% to the right coronary artery. 4 patients (0.98%) died postoperatively, 402 survived and are free of angina. In our experience the IMA can be used routinely with low operative risk and good results.

Adolescent↗
PubMed1986

The child's conception of food: differentiation of categories of rejected substances in the 16 months to 5 year age range.

Children (N = 54) ranging in age from one year four months to five years were offered over 30 items to eat. The items included normal adult foods and exemplars of different adult rejection categories: disgust (e.g. grasshopper, hair), danger (liquid dish soap), inappropriate (e.g. paper, leaf) and unacceptable combinations (e.g. ketchup and cookie). We report a high to moderate level of acceptance (item put into mouth) of substances from all of these categories in the youngest children. Acceptance of disgusting and dangerous substances decreases with increasing age, while acceptance of inappropriate substances remains at moderate levels across the age range studied. Although the youngest children accepted more disgust items, the majority rejected most of the disgust choices. Almost all children at all ages tested accept combinations of foods which, although individually accepted by adults, are rejected in combination. No significant differences were observed between 'normal' children and those with a history of toxin ingestion, although there was a tendency of ingesters to accept more inedible items. In general, the results suggest that a major feature of the development of food selection is learning what not to eat.

Adult↗
PubMed1983

Thermographic evaluation of myocardial temperature during infusion of cold cardioplegia.

Delay in myocardial cooling during an infusion of cold cardioplegic solution may occur in patients with coronary artery disease. Forty patients with significant stenosis of the left anterior descending coronary artery (LAD) were divided into 3 groups according to the extent of the LAD stenosis. Group A consisted of 12 patients with 70% stenosis. Group B included 23 patients with 90% stenosis, and in group C there were 5 patients with LAD occlusion. Myocardial temperature was measured with a thermocamera during infusion of 2000 ml 8 to 10 degrees C cold Bretschneider's cardioplegic solution and compared to 10 other patients without coronary artery disease undergoing mitral valve replacement (group D). In group A the myocardium cooled to 15 degrees C after 4 1/2 minutes and to 12 degrees C after 10 minutes. In group B the myocardial temperature was 15 degrees C after 5 minutes and 12 degrees C after 10 minutes. In group C the temperature reached 18 degrees C after 5 minutes and 14 degrees C after 10 minutes. In group D the myocardial temperature was 12 degrees C after 3 minutes and 10 degrees C after 7 minutes. This study shows far better myocardial cooling rates in patients with unobstructed coronary arteries.

Body Temperature↗
PubMed1981

Surgical correction of an atherosclerotic coronary artery aneurysm. Case report.

A 56-year-old male patient became symptomatic with angina pectoris. Selective coronary angiography revealed an aneurysm of the stem of the circumflex artery and a subtotal stenosis of the left anterior descending coronary artery (LAD). At cardiac surgery the anterior wall of the aneurysm was resected and the resulting defect closed with a venous patch. Bypass grafts to the LAD and the first marginal branch were also implanted. Three months later both grafts were shown to be patent, and flow through the reconstructed stem of the circumflex artery was undisturbed.

Aneurysm↗
PubMed1980

Combined medical and surgical procedure in acute myocardial infarction--a preliminary report.

The purpose of this investigation was to evaluate a new therapeutic approach, by which acutely ischemic human myocardium could be reperfused. The procedure was as follows: intracoronary application of nitroglycerine, intraluminal recanalization by catheters and intracoronary application of streptokinase. Before and after these interventions coronary angiograms were made. Surgical coronary revascularization was performed 1--64 days after reestablishment of flow through the occluded vessels. Seven patients with acute myocardial infarction were treated in this manner. The mean preoperation ejection fraction was 48.6%, the mean enddiastolic pressure was 17.5 mmHg and the mean maximal CPK activity was 616 units/liter (u/l). By the conservative regimen outlined, reopening of the occluded vessels was achieved in all cases. Critical stenoses of 80--85%, however, persisted. But, reperfusion appeared sufficient since in none of the patients hemorrhagic myocarditis was produced intra-operatively. There was no hospital mortality. The mean post-operative ejection fraction was 60% and the mean enddiastolic pressure was 10.6 mmHg. It is concluded that ischemic myocardium can be reperfused by the active conservative regime tested. Emergency revascularization performed after induced reperfusion appears to carry a low operative risk.

Aged↗
PubMed1980

Recanalization of an acutely occluded aortocoronary bypass by intragraft fibrinolysis.

Acute thrombotic occlusion of an aortocoronary bypass graft to the left anterior descending coronary artery (LAD) was successfully dissolved by selective infusion of streptokinase into the graft at 2000 U/min for 1 hour via catheter. There was partial recanalization of the graft and complete filling of the LAD within 15 minutes. After 1 hour of lysis, the graft was completely patent, although high-degree narrowing at the site of the proximal anastomosis was still present. Follow-up angiography 16 days later revealed persistent patency of the graft and disappearance of narrowing at the site of proximal anastomosis. The relatively low total dose of streptokinase (140,000 U) did not result in a systemic hyperlytic state. There were no complications. The technique may prove useful in acute graft occlusion but needs further evaluation.

Acute Disease↗
PubMed1979

[Reopening of infarct-occluded vessel by transluminal recanalisation and intracoronary streptokinase application (author's transl)].

Coronary angiography was performed 2 hours after onset of complaints in a 57-year-old patient with acute anteroseptal infarction. Using a wire spiral in the coronary catheter the acutely occluded anterior interventricular branch was reopened. With intracoronary streptokinase (120 000 units in 50 minutes) the recanalisation canal was enlarged. The clinical picture and electrocardiographic findings improved under the influence of treatment. An aorto-coronary bypass operation was performed on the following day. The post-operative angiogram showed marked improvement of left ventricular function. The results indicate that this intervention prevented widespread necrosis.

Angiography↗
PubMed1979

Acute myocardial infarction: intracoronary application of nitroglycerin and streptokinase.

In five patients with acute myocardial infarction, the effects of both intracoronary nitroglycerin (NTG) and subsequent intracoronary streptokinase application were evaluated. In addition, transluminal recanalization was performed in one of these patients. Injection of NTG into the infarct-related coronary artery resulted in improved distal filling of the subtotally occluded left circumflex artery in one patient, and in transient patency of the completely occluded right coronary artery in a second patient. In a third patient patency of the totally occluded left anterior descending artery (LAD) was achieved by transluminal recanalization with a guide wire. In a forth patient with occulsion of the LAD, there was no response to intracoronary NTG and mechanical recanalization was not attempted. Subsequent intracoronary infusion of streptokinase (1,000--2,000 U/min for 15--60 min) resulted in a further and long-term reduction of narrowing at the site of acute occlusion in patients I-III and in opening of the completely occluded LAD in patient IV. Improvement of lumen was paralleled by alleviation of symptoms. In a fifth patient, in whom the LAD was subtotally occluded, the degree of coronary obstruction could not be changed by intracoronary application of NTG or by lysis. In this patient, symptoms and ECG changes improved with reduction of pathologically elevated blood pressure values. The findings suggest that myocardial infarction had been caused by thrombotic occulsion in four patients, and that spasm of the infarct vessel could have been an additional factor in two of these patients. In the fifth patient, an increase of afterload in the presence of a subtotal lesion might have caused the critical imbalance between oxgen supply and demand, resulting in cell death.

Cardiac Catheterization↗