Biomedical subjects

H Trenckmann

Publications and source records attributed to H Trenckmann.

At least 55 records · Page 3Linked to original sources

PubMed1978

[Removal of a foreign body from the superior vena cava by means of a urinary calculus remover].

It is reported on a successful removal of torn off or knotted parts of a heart catheter, which were extracted without difficulties from the superior vena cava and from the right atrium via the vena saphena magna by means of the catcher of ureteroliths after Dormia. One case in question was a 27-year-old male patient with pentalogy of Fallot, in whom was the danger of embolisation into the greater circulatory system on account of the torn off catheter conducting wire. In the other 57-year-old patient with acute myocardial infarction after knotting of a subclavian catheter a mechanical irritation of the endocardium with repeated appearance of ventricular fibrillation developed. Before deciding on a thoracotomy for the removal of parts of a catheter from the central vessels and the heart it should be tried before a transvasal extraction with the help of special catheters.

Adult↗

PubMed1978

[Alternating ECG changes in dystrophia myotonica (Curschmann-Steinert)].

It is reported on a 39-year-old patient who revealed pathological ECG-findings of the most different kind during several years. Since there were no clues to a myocarditis, later on, however, pareses of atrophical skeletal muscles developed and a distropia myotonica could be diagnosed, the cardiological disturbances are to be regarded as a symptom of this disease. When also a participation of the myocardium in the distrophia myotonica is not unknown, so even in our case the frequently changing disturbances of the nervous impulses of the heart, of the ventricular stimulus conduction and of the replolarisation of different expression as well as the pronounced hypersensitivity to heart glycosides are remarkable individual findings. The interpretation of these findings is problematic. Morphologic and dystrophic changes of the myocardium as well as functional myotonic disturbances on the membraneous system may influence the process of stimulation and may cause the clinical appearances.

Adult↗

PubMed1977

[Circulating tissue antigens in inflammatory heart disease].

Experiments with an antipericardium immune serum of the goat resulted in the proof of two not identical with serum proteins antigens in the pericardium. By means of the same antiserum with the help of the gel diffusion technique after Ouchterlony and immunoelectrophoresis the sera of patients with carditis or myocardial infarction, respectively, were examined for the presence of circulating tissue antigens. In 20 out of 23 patients with carditis 1 or 2 antigens were found which were not identical with normal serum proteins. In 27 cases of myocardial infarction their proof was successful only in 4 patients, in complication by a post-myocardial infarction syndrome in 2 out of 3 cases. In comparative investigations of sera of 100 healthy persons only 4 test persons showed a positive result. There was no clue for the identity of one of the antigens proved with C-reactive protein.

Animals↗

PubMed1977

[The antistreptolysin reaction with and without dextran sulfate addition in various diseases].

It is reported on the results of determinations of the antistreptolysin titre in patients with infectious hepatitis, renal and essential hypertension, mitral stenosis, acute tonsillitis, scarlet fever, rheumatic fever as well as rheumatoid arthritis according to the usual and the dextran sulphate absorption method in altogether 739 patients. Here as in a former publication in 1,700 normal persons partly considerable significant differences between the antistreptolysin titre with and without dextran sulphate were found. The two techniques are discussed, also the influence of the beta-lipoproteins with their proportion of phosphatide on the result of the antistreptolysin titre. It is possible to absorb beta-lipoproteins and perhaps also phosphatides with the help of the addition of dextran sulphate. The present investigations show unequivocally that the absorption the dextran sulphate is a necessary demand which saves the clinician from diagnostic and therapeutic errors. The antistreptolysin reaction is to be regarded only as one constituent for the clinical diagnosis and must not be overvalued in its importance.

Antigen-Antibody Reactions↗

PubMed1976

[Long-term results in electric pacemaker therapy].

It is reported on experiences and results in 317 patients with altogether 690 implantations of pacemakers from 1963 to 1974 and under comparison and with reference to the up to now existing long-term results published in literature state and tendency of the medical and technical development of the electric heart stimulation are discussed. The average age of outpatients was 62.9 years with a peak of age of 46% in the 7th decade of life. 60% were male patients, 40% female ones. With about 50% the constant total atrioventricular block was the most frequent indication. 63% of the familiar types of pacemakers were biotronic apparatuses, 36% of them with fixed frequency. The average duration of the function of all apparatuses was calculated with 20.1 months. Hereby the biotronic types had the longest average function times of 26.7 months (frequency fixed) or 26.3 months (regulated). In 373 reimplantations is shown that 2.17 apparatuses were implanted in each patient. The total number of complications was 21.2% related to the total number of implantations. With 8.9% breaks of the cable were in the first place in myocardial electrodes. Dislocations of transvenous electrodes were observed only in 4.5% of our cases. With 5.8% pressure necroses and infections were the cause of complications stood in the second place concerning frequency. The total lethality was 23.7% with an age peak of 38% in the 8th decade of life. 13.4% of the cases of death belong to an early lethality with a prevailing part of epicardial implantations. In our patients the cumulative survival rate was after 1 year 89.3%, after 5 years 62.3% and after 8 years 47.7%. The 50% survival rate was ca. 7.3 years. In comparison to the population of the same age the average expectance of life is transgressed by about 6 years. The prolongation of the survival time by electrostimulation compared with the conservative treatment of the total atrioventricular block with Adams-Stokes-syndrome is the essential result of the pacemaker therapy.

Adams-Stokes Syndrome↗

PubMed1976

[Problems of idiopathic congestive cardiomyopathy].

It is reported on the course of an idiopathic congestive cardiomyopathy in a younger man which could be observed during three years. After a longer period free of symptoms acutely appeared the signs of a myocardial failure, in which case disturbances of cardiac rhythm at length caused death. In detail the clinical fingings, pathologo-anatomical changes as well as the differential-diagnostic considerations are discussed, which are important for the demarcation of the other forms of the idiopathic and secondary cardiomyopathies.

Adult↗

PubMed1975

[Misplaced implantation of a pacemaker electrode in a coronary vein].

The wrong implantation of pacemaker electrodes into a coronary vein is in most cases accidentally diagnosed when thoracic X-ray pictures are made in two planes. It is to be excluded not with certainly in the sagittal ray-path of the thoracic X-ray picture and in the ECG of the extremities. The diagnostic criteria for the recognition of a false position are the end of the electrode which is in the frontal ray-path directed dorsally to the spine and a right bundle branch block in the ECG existing since implantation. Pacemaker-synchronous contractions of the diaphragm as well as an increased already at the time of implantation stimulus threshold may be references. Description of an own observation with an up to now long-term stimulation through a coronary vein without complications lasting 15 months, in which a correction of the position is not regarded as necessary due to the regular function of the pacemaker.

Aged↗

PubMed1975

[Cardiomypathies].

Heart insufficiency, cardiomegaly and pathological changes of the ECG after exclusion of coronary heart disease, congenital or acquired vitia cordis and hypertension of the greater or lesser circulatory system result in the diagnosis cardiomyopathy with the liability of further differential-diagnostic demarcation. If causes of a secondary cardiomyopathy can be detected, a causal therapy is often possible, as to the remaining group of the idiopathic cardiomyopathies one must for the time being limit to an exclusively symptomatic treatment (protective therapy, limitation of the fluid supply, glycosides, diuretics, medicamentous and electric therapy of disturbances of the rhythm).

Cardiac Glycosides↗

PubMed1975

[Complications of cardiac pacemakers].

Since the number of patients with pacemakers increases and the further decentralisation of the care of these patients is planned the survey has the purpose to inform as many physicians as possible about the complications of the pacemaker therapy. In the several paragraphs the problems of the regular and anticipated exhaustion of the battery, defects of the electronic constituents of the pacemaker, fracture of the cable, dislocation of the electrodes, disturbances of the transmission between endocardium and myocardium, disturbances of rhythm under pacemaker-therapy, disturbing influences by intra- and extracorporal causes, surgical complications and implantations in the false place are reported on. Knowledge and early recognition of the complications in the pacemaker-therapy will furthermore favourably influence the long-term prognosis of this group of patients.

Cardiac Surgical Procedures↗

PubMed1975

[Antistreptolysin-titre under the use of traditional methods and after saturation with dextran sulfate].

1,700 blood samples of healthy test persons without clinically and paraclinically provable streptococcal diseases were examined for their content of antistreptolysin. Beside the usual method parallel determinations were carried out after addition of dextran sulfate. Thus increases of unspecific antistreptolysin titres shall be in most cases excluded, above all by the influence of the lipoproteins. The absorption of dextran sulfate led to the decrease of the antistreptolysin titre by 12.33%. Furthermore could be proved that the average antistreptolysin titre of female test persons is ca. 20 antistreptolysin units below the titre of male test persons, that seasonal variations of the antistreptolysin titre with the highest titres appear in the first and third quarter which may be explained by a bad unspecific defensive condition, that, furthermore, the antistreptolysin titres increase to the 14th year and then continuously decrease and that in new-born children the arithmetic mean value of the antistreptolysin units is significantly higher than in their mothers. Hereby an active influence of the placenta on the transmission of antibodies seems to be possible. Though a slightly increased financial expenditure is necessary for dextran sulfate, temporarily and concerning working technique, however, no larger loads appear, it is justifiable to perform the determination of antistreptolysin titres only by means of dextran sulfate-absorbed sera, since in this way a considerable number of unspecific and misleading reactions can be excluded.

Adolescent↗

PubMed1975

[Thoracic gunshot-injury with penetration of the pericardium in a 15-year-old student].

On account of the exceptionality is reported on a 15-year-old adolescent who suffered a gunshot into the thorax by a device which was built by himself. More than 12 hours after the accident for the first time a physician was consulted. Then the patient was transported to Leipzig for operation. The missile had penetrated the anterior wall of the pericardium, had passed through the cleft between exterior layer of the myocardium and the pericardium and lodged at the trangression into the adjacent lung. The postoperative course was without complications. The patient could be dismissed without any complaints.

Adolescent↗

PubMed1975

[Drug therapy of myocardial infarct in ambulatory practice].

For the practicing physician the medicamentous treatment of the patients with infarction is the main problem of the secondary prevention in the prehospital phase as well as in the after-treatment. In these cases in the acute phase not the myocardial insufficiency is in the centre of the out-patient care, but the therapy of the disturbances of cardiac rhythm, which mainly cause the high lethality in the early phase. Therefore, uncomplicated infarctions, in whch care must be taken only for a sedation of sympathico-adrenergic reactions and a volume reduction of the heart, should be differed from complicated cases. However, an immediate transport to the hospital must be guaranteed. If there appear a contraction insufficiency of the left ventricle or threatening disturbances of the rhythm, additionally glycosides and saluretics must be administered as well as an aimed antiarrhythmic therapy must be initiated. The necessary medicamentous measures are described dependent upon the diagnosis of brady- and tachycardiac disturbances of the rhythm. The author enters briefly the problems of volume substitution, treatment of acidosis as well as the administration of beta-sympathicolytics and gluco-corticoids. - In the after-treatment of infarctions anticoagulants are the only medicaments to be prescribed, when findings completely without complications are present. If, however, there are signs of activity of the coronary heart disease in the post-infarction phase, a basic therapy with a glycoside and anticoagulants as well as an individually to be varied additive therapy with nitro-preparations, beta-sympathicolytics, saluretics, anti-hypertensive agents and antiarrhythmic agents are necessary.

Acidosis↗

PubMed1975

[Diagnosis and therapy of arteriovenous lung fistulas].

On the basis of 6 own cases, 5 of which were observed during one year, the clinical picture, the diagnostics and the therapy of the arteriovenous pulmonary fistula are described. Of decisive diagnostic importance is the angiography of the pulmonary artery which should always be used for the clarification of unclear pulmonary foci as well as clinically unclear cyanosis. For the removal of this shunt connection in the lesser circulatory system therapeutically only the operation comes into question. On account of the threatening complications and the inclination to the dilation of the fistula with growing age it is indicated also in cases with only slight haemodynamic effect. Dependent on the anatomical position of the fistula the ligature of the afferent artery is recommended.

Adult↗

PubMed1975

[Fundamental problems on the care of patients with permanent artificial pacemaker therapy].

In the GDR the number of patients with pacemakers increases with about 900 new implantations each year. The further decentralisation of the care of patients with pacemakers proposed by the team pacemaker therapy demands the inclusion of more physicians into the care of these patients. The pacemaker systems used at present in the GDR are described as well as the practical approach in the control of the function of the pacemakers is discussed. In the figures typical electrocardiographic pictures of various models of pacemakers are demonstrated.

Germany, East↗

PubMed1974