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Biomedical subjects

H Saner

Publications and source records attributed to H Saner.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Significance of trans-esophageal echocardiography as an adjunct to transthoracic echocardiography].

We describe our experience with the first 103 patients undergoing transesophageal echocardiography at our institution. The procedure was well accepted by most patients and associated with no major complications. The clinical indications for this procedure have included endocarditis, prosthetic cardiac valve dysfunction, detection of intracardiac source of embolism, atrial septal defect and thoracic aortic dissection. Transesophageal echocardiography proved to be useful in all of these diagnostic categories, especially if standard transthoracic echocardiography did not provide a complete assessment.

Adult↗
PubMed1990

[The current status of cardiac rehabilitation in Switzerland].

The aim of this study was to investigate the present situation of institutionalized cardiac rehabilitation in Switzerland. In 1989, there were 21 rehabilitation clinics and 21 ambulatory cardiac rehabilitation programs in Switzerland. All programs include physical activity and risk factor intervention. There is a wide variety of program selection and intensity. The medical care, the physical activity program, the strategy for risk factor intervention, the technical equipment and the emergency concept can be regarded as good in most rehabilitation clinics and in the ambulatory rehabilitation programs. However, a search for quality criteria for further activities in cardiac rehabilitation in Switzerland seems desirable.

Cardiac Rehabilitation↗
PubMed1989

Local cooling test for clinical capillaroscopy in Raynaud's phenomenon, unstable angina, and vasospastic visual disorders.

A local cooling test produces a typical flow stop reaction in nailfold capillaries in 88% of patients with Raynaud's phenomenon, but only in 15% of healthy controls. A stop reaction occurred in 9 of 12 patients with Prinzmetal variant angina, exceeding significantly that in 2 of 12 matched control subjects. Also in patients with reversible visual disorders presumably due to vasospasm, the test resulted in a stop reaction in 16 of 25 cases exceeding that in control. In both of these patient groups the cooling test as well as the symptoms reacted favorably to nifedipine. Thus, the local cold exposure test appears to be useful for objective clinical examination not only of patients with Raynaud's phenomenon but also of patients with vasospastic syndromes such as variant angina and visual disorders.

Adult↗
PubMed1988

[Practical importance of capillary microscopy].

Vital capillaroscopy has been successfully used for many years to study the microcirculation of human skin capillaries. The presence of typical capillary abnormalities is helpful in distinguishing scleroderma from other connective tissue diseases. Application of a local cold exposure test to finger nailfold capillary microscopy reveals the functional difference between normal subjects and patients with Raynaud's syndrome on the level of the microcirculation. Transcutaneous intravital fluorescence videomicroscopy may be helpful in the sometimes difficult differential diagnosis of lower limb edema. Microlymphangiography offers a new approach to depiction of the intravital anatomy of human lymphatic skin capillaries. Further the technique of intravital fluorescence videomicroscopy provides a noninvasive method of studying morphologic and functional abnormalities in diabetic microangiopathy.

Capillaries↗
PubMed1987

[Comparison of 3 ECG computer programs with interpretation by physicians].

Three ECG computer programs-Hewlett Packard analog program (HP), Telemed analog program (T) and Marquette 12 SL digital program (MAC)-were evaluated and their accuracy of ECG reading compared with the reading of 4 experienced interpreters on 140 ECGs of patients with various clinical abnormalities. Major disagreement with effect on patient management, and minor disagreement were defined at a joint session with a senior (consensus). The computers identified all normal ECGs correctly (sensitivity 100%). The percentage of major agreements (full agreements and minor disagreements) between consensus and computer was 79% for HP, 90% for T and 93% for MAC. The number of disagreements varied widely between readers and in relation to the different computers. Major problems for the computers were the interpretation of rhythm disturbances and the diagnosis of myocardial infarction, T-wave changes and ventricular hypertrophy: major diagnoses missed by the readers were first degree AV block, QT prolongation, and myocardial infarction. Although there was a considerable difference of accuracy between the 3 computer systems, all of them are sufficiently accurate to be useful to most clinicians. However, every ECG should be over-read by a physician, particularly if a clinical decision is based on the ECG diagnosis.

Adolescent↗
PubMed1987

[Calculation of intracardiac shunt using Doppler echocardiography].

The purpose of this study was to assess the accuracy of a quantitative two-dimensional Doppler echocardiographic method for estimation of intracardiac shunts. The ratio of pulmonary to systemic flow (Qp/Qs) was evaluated by duplex Doppler echocardiography in 20 patients with various intracardiac shunts. Right and left ventricular stroke volumes (RSV, LSV) were determined from the recordings of ejection blood flow velocity and diameter at the level of the pulmonary and aortic orifices in each ventricular outflow tract. The ratio RSV/LSV, determined by duplex Doppler echocardiography, was compared with Qp/Qs by oxymetry. The Doppler echocardiograms were of sufficient quality for shunt calculation in 15/20 patients (75%). The RSV/LSV for ten normal subjects was 0.99 +/- 0.05 (mean +/- SD), whereas the RSV/LSV for 15 patients with intracardiac shunts, 2.6 +/- 0.5, was significantly higher than that for normal subjects (p less than 0.01). In 12/15 patients, the Doppler study estimated the severity of intracardiac shunting correctly. The presence of complex anatomic situations, a wide pulmonary artery or significant semilunar regurgitation seem to have a negative impact on the Doppler echocardiographic shunt calculation. Our findings indicate that, with a few limitations, the Doppler index RSV/LSV is clinically useful in the estimation of the magnitude of the shunt flow in patients with intracardiac shunts.

Adolescent↗
PubMed1986

Polymorphic debrisoquine and mephenytoin hydroxylation in patients with pulmonary hypertension of vascular origin after aminorex fumarate.

During the period 1967 to 1971 an increase in the incidence of pulmonary hypertension of vascular origin (PHVO) was observed in Austria, Federal Republic of Germany, and Switzerland. Most patients had been given aminorex fumarate and a possible link was suspected. We therefore investigated the possibility of genetically-determined drug hydroxylation deficiencies (debrisoquine or mephenytoin type) in these patients as an explanation for the development of PHVO. Seventeen patients took 10 mg debrisoquine and 100 mg mephenytoin orally. Sixteen PHVO patients were classified as extensive metabolizers of debrisoquine with logarithmic metabolic ratios of -0.35 +/- 0.11 (mean +/- SEM), whereas one patient was a poor metabolizer with a logarithmic metabolic ratio of 1.82. For the mephenytoin hydroxylation sixteen patients with PHVO were extensive metabolizers, with logarithmic hydroxylation indices of 0.27 +/- 0.05. One poor metabolizer of mephenytoin had a logarithmic hydroxylation index of 1.59. Deficient hydroxylation of debrisoquine and mephenytoin was found in two different patients. The prevalence of poor metabolizers among patients with PHVO after aminorex fumarate was therefore approximately 9% for both debrisoquine and mephenytoin. This corresponds closely to the data of our reference population study where genetic debrisoquine and mephenytoin hydroxylation deficiencies occurred independently, with a prevalence of 10% and 5% respectively. Thus, the normal prevalence of extensive drug hydroxylation phenotypes in patients with PHVO is not consistent with the hypothesis that the development of PHVO after aminorex fumarate might be related to a pharmacogenetically determined impairment of polymorphic drug oxidation.

Adult↗
PubMed1983

Cardiogoniometry: a new noninvasive method for detection of ischemic heart disease.

Cardiogoniometry is a new vectorcardiographic method. The vector-loops are constructed from three orthogonal ECG leads and registered on-line by a microprocessor. The angle between the maximal QRS and T vectors, as well as the spatial orientation of these vectors are very constant in healthy individuals. Deviations of these vectors and angles are sensitive indicators for changes in repolarization occurring, for instance, during coronary insufficiency. The changes in these variables were evaluated in 50 patients with suspected coronary artery disease and correlated with angiographic findings. Cardiogoniometry showed a sensitivity of 79% and a specificity of 82%, which is comparable to exercise testing. In contrast to the latter cardiogoniometry can be performed at rest, is free of risk, and therefore also suitable for elderly patients.

Computers↗
PubMed1983

In vivo comparison of the nailfold capillary diameter as determined by using the erythrocyte column and FITC-labelled albumin.

The diameter of nailfold capillaries in conventional intravital microscopy is estimated by measuring th width of the erythrocyte-columns. We determined the diameter of the fluorescence-marked microscopy in 33 capillary loops in the nailfold of 12 subjects and compared it with that of the ec-columns. 400-500 mg FITC-albumin were injected into the brachial artery through cannulas inserted for bloodgas analysis. The FITC-marked capillary lumen exceeded the width of the ec-columns of 10.8 +/- 3.0 microns by 4.2 +/- 0.7 microns or by 38% on the arteriolar side, and that of 12.0 +/- 2.7 microns by 4.6 +/- 0.8 microns (p less than 0.01), on the venular side. Venous occlusion produced a significant enlargement of the ec-columns by 13% (p less than 0.01), but no significant increase in the FITC-marked capillary lumen. The difference of 405 microns between the full capillary lumen as represented by the fluorescent plasma space and the width of the ec-columns corresponds presumably to the plasmatic zone between red cells and the vessel wall. No extravasation of FITC-HA was observed neither before nor after venous occlusion.

Adult↗
PubMed1981

[Modified Wright-spirometer for babies and small children (author's transl)].

We were able to increase the sensitivity of the Wright Spirometer five fold by a slight technical modification. Respiratory volumes as low as 5 ml could be measured accurately and corresponded will with the bell spirometer. Because most respirators include a considerable compression volume during expiration, we prefer to take measurements directly at the tube. The dead space could be reduced from 34 to 20 ml and we therefore take measurements only during 30 s with infants and 20 s with premature babies and give a higher oxygen concentration during this period. The modified spirometer has been tested clinically with success. It is of great help to determine initial tidal volumes. Subsequent controls can be done easily and allow a correlation with blood gases and if necessary a change of the respiratory volume.

Blood Gas Analysis↗
PubMed1980

[Virologic diagnosis of rubella. Findings in a rubella epidemic in a military training camp].

During a minor rubella epidemic in a Swiss army recruit training camp (Spring 1978), recent rubella infection was proved in 20 out of 22 investigated cases. In 18 cases virus replication could be shown by means of indirect immunofluorescence (IIF). Due to its higher sensitivity and easier performance in comparison with conventional echo interference, we believe IIF should be the method of choice for rubella virus isolation. In 2 out of 22 cases, the possibility of a secondary infection was discussed. A chceklist is given showing the necessary steps for virological investigations we think should be carried out to define immunity status, confirm or rule out a rubella infection, particular weight being attached to the embryopathy question. This article is therefore intended to provide the clinician interested in virological problems with a total to enable him to take the necessary measures for detection of rubella infection and interpretation of laboratory findings.

Adult↗
PubMed1980

[The dignity and rights of the patient].

In his treatment of the patient, the doctor must be guided not simply by concern for the patient's biological existence but ultimately by concern for the dignity and integrity of his person. These qualities are founded in the patient's innate human freedom, which equally underlies his entitlement to life and to proper treatment without sacrifice of his right to self-determination, his inviolability and his human dignity. Self-determination presupposes the right to information and communication, and this in turn an obligation on the part of the doctor to talk in terms which the patient understands and to devote sufficient time to his needs. Respect for the inviolability of the patient's person implies not only his right to the security of confidentiality and discretion, but also his right, when receiving any form of treatment, to be acknowledged as a physiological, psychological and social entity with a concrete individuality. Human dignity, finally, implies the right of each individual to be the real "raison d'être" for any treatment to which he is subjected. Beyond this, a right to health can only exist in the negative sense of the right not to be made avoidably ill by the social order, and a right to sickness only in the restricted sense of not being put at a social disadvantage as the result of a medically diagnosed illness.

Attitude of Health Personnel↗