Contact activation, heparins and cardiopulmonary bypass.
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Blood Coagulation↗
Biomedical subjects
H Wendel
Publications and source records attributed to H Wendel.
Assessment of blood pressures and gradients by automated blood pressure device compared to invasive measurements in patients previously operated on for coarctation of the aorta.
The aim of the study was to compare invasive and non-invasive blood pressure measurements and gradients. Twenty-two children and 16 adults previously operated for coarctation of the aorta were included. Invasive blood pressures were recorded proximally and distally close to the former operation site and non-invasive systolic blood pressures were recorded by an automated sphygmomanometer on right arm and leg. The adults were investigated at rest and during supine exercise. The correlation between invasive and non-invasive measurements of proximal blood pressures in adults at rest and children were the following, r = 0.92, SD 7.6 mmHg (n = 16) and r = 0.85, SD 11 mmHg (n = 22) respectively. The corresponding correlation for the distal blood pressures were the following for adults at rest 0.64, SD 11.9 mmHg and in children r = 0.82, SD 9.2 mmHg. During exercise in adults we found a low correlation when comparing invasive and non-invasive proximal and distal blood pressures and a poor correlation regarding the gradients, r = 0.50, SD 16 mmHg, r = 0.45, SD 15.9 mmHg and r = 0.30, SD 22.9 mmHg respectively (n = 16). We also measured the time interval between cessation of exercise and completion of the blood pressure recordings, which gave a mean interval of 73 sec (range 45-115 sec). During that interval the mean fall in the proximal blood pressure was 37 mmHg (range 20-80 mmHg), and the mean fall of the gradient was from 41 mmHg (range 20-76 mmHg) to 23 mmHg (range 6-56 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Doppler echocardiographic and morphologic evaluation of patients following operative repair of aortic coarctation.
Sixty-six patients operated on previously for coarctation of the aorta were included in the study. There were 50 children and 16 adults. Invasive and non-invasive gradients were recorded. Anatomical obstruction was evaluated by angiography in 54 patients and the numbers and size of collaterals were quantified. The closest correlation was found between Doppler-estimated gradients and invasive peak-instantaneous gradients (r = 0.87). The relation between anatomical obstruction and invasive peak-to-peak gradients, Doppler gradients and diastolic flow ere discouraging (r = 0.64, 0.54 and 0.35). Liberal indications for angiography or magnetic resonance tomography are recommended.
Adolescent↗
Quantification of left to right shunts by echo Doppler cardiography in patients with ventricular septal defects.
Thirty-one patients with ventricular septal defect were evaluated with Echo Doppler cardiography and colour flow mapping. The ventricular septal defect area was estimated by measurement of the jet diameter by colour flow mapping. The ventricular septal defect flow was calculated as the product of the cross-sectional area of the ventricular septal defect and the velocity time integral of flow through the defect. In ten patients the diameter obtained by colour flow mapping was compared with the diameter obtained at angiography, r = 0.88 (SD = 0.14 cm). The aortic flow was calculated as the product of left ventricular outflow tract cross-sectional area and the corresponding velocity time integral. QP/QS ratio was estimated as (ventricular defect flow + aortic flow)/aortic flow and compared to estimates by a radionuclide or oximetric method. A correlation of r = 0.95 (SD = 0.23) was found.
Adolescent↗
Estimation of Doppler gradients at rest and during exercise in patients with recoarctation of the aorta.
In patients with suspected recoarctation of the aorta the estimation of the pressure difference between the arms and legs is an important part of the examination. Because this difference is often augmented when the circulation is stressed by exercise, exercise tests are a useful part of the evaluation. Doppler echocardiography was used to estimate this pressure difference in 16 adult patients in whom simultaneous pressure and Doppler recordings were made both at rest and during exercise. There was a close correlation between the invasive peak instantaneous gradient and the Doppler gradient both at rest and during exercise. There was only a moderate correlation between the invasive peak to peak gradient and the Doppler gradient at rest and during exercise. Doppler echocardiography is recommended as an easy and accurate method of estimating the peak instantaneous gradient both at rest and during exercise in patients with suspected recoarctation.
Adult↗
Noninvasive estimation of aortic valve areas in children with aortic stenosis.
Fifteen children with aortic stenosis were examined with Echo-Doppler cardiography in order to evaluate the use of the continuity equation to calculate the aortic valve area. The results were compared to invasive estimates of valve area calculated with the Gorlin's equation. A close correlation between the two methods, r = 0.94, was found and it is concluded that even in children an accurate estimate of valve area can be expected with the use of the continuity equation.
Adolescent↗
[Diagnosis of anaerobic bacteria in bronchial secretions in pulmonary diseases].
In 50 bronchoscopic examinations the microflora of bronchial secretions has been investigated especially in order to detect anaerobic microbes with the use of the glove-box-method. In 19 patients we found the bronchial secretions steril (particularly carcinomas). Eight patients showed anaerobic gramnegative rods (Bacteroides and Fusobacteria) as predominant germs. Also in eight patients we found a mixed culture consisting in several anaerobic gram-negative rods, anaerobic gram-positive sporeless rods, anaerobic cocci, partly Clostridia and aerobes (carcinomas, pneumonias). A contamination can be excluded. In a series of patients anaerobes must be considered as infectious agent, in abscessed pneumonias particularly Bacteroides and Fusobacteria. Repeatedly an impressive clinical improvement has been established under the treatment by Metronidazol. The evidence of anaerobes especially succeeded in cases with copious mucopurulent or pure purulent secretions. The accumulation of anaerobes in bronchial secretions in alcoholics is evident.
Adult↗
Influence of phalloidin on both the nucleation and the elongation phase of actin polymerization.
Phalloidin, a heptapeptide from the mushroom Amanita phalloides, increased the velocity of actin polymerization, but slightly decreased the velocity of elongation (polymerization onto sonicated F-actin). A plot of log polymerization velocity vs. log actin concentration was less steep in the presence of phalloidin than in its absence, suggesting that the filament nucleus is smaller in the presence of phalloidin than in its absence.
Actins↗
Influence of phalloidin on ATP hydrolysis during actin polymerization.
The influence of phalloidin on the ATP hydrolysis associated with actin polymerization was investigated. Whereas in the absence of phalloidin actin-bound ATP was totally hydrolyzed during polymerization, ATP hydrolysis was not complete after actin polymerization in the presence of phalloidin: 5-10% of ATP remained unhydrolyzed and disappeared only after 2 days.
Actins↗
Kinetics of actin depolymerization: influence of ions, temperature, age of F-actin, cytochalasin B and phalloidin.
Actin, labelled with the fluorescent dye N-(3-pyrenyl)maleimide, was diluted below its critical concentration and depolymerization was followed by measuring the declining fluorescence intensity. The time courses of depolymerization were fitted to a sum of three exponentials. In most cases there was a fast initial phase followed by one or three slower ones. Increasing MgCl2 concentration slowed down depolymerization velocity, as did substitution of Tris-maleate buffer by phosphate buffer. Older F-actin preparations depolymerized more slowly than younger ones. Phalloidin strongly decreased depolymerization velocity even after sonication. In the presence of cytochalasin B depolymerization was more uniformly exponential than in the absence of cytochalasin B; overall depolymerization velocity was decreased by cytochalasin B. The results are discussed on the assumption that depolymerization kinetics reflect the length distribution of actin filaments during depolymerization.
Actins↗
[Anesthesiologic problems in endoscopic interventions of the respiratory organs].
In 28 patients--16 normotensive and 12 hypertensive patients--anaesthetized with hexobarbitone, halothane, nitrous oxide/oxygen and intermittent doses of suxamethonium we examined the influence of diagnostic bronchoscopy on arterial blood pressure, heart frequency, rate pressure product as well as acid-base balance and arterial oxygen partial pressure. Both groups of patients showed a remarkable and highly significant increase in these hemodynamic parameters during intubation, extubation and bronchial lavage. Clinically relevant changes of acid-base balance and arterial oxygen partial pressure which could be responsible for these hemodynamic reactions did not occur. Sympathicotonic reflexes caused by the bronchoscopy are considered to be the main causes for the increase in blood pressure, heart frequency and rate pressure product. They can only be prevented by a sufficient narcosis depth.
Acid-Base Equilibrium↗
[Results, complications and controlled after-care in thoracoscopic pleural and lung biopsy].
Report on 546 transthoracic forceps biopsies from pleura and lung, selected under thoracoscopic observation. After inducing a diagnostic pneumothorax the biopsy is performed in general anaesthesia with a forceps introduced beside the thoracoscope. In 60%, the endoscopic-bioptic examination resulted in a definitive diagnosis. In the remaining cases too, the results of biopsy were usefull for further diagnostic and clinical conclusions. The number of complications is small. Main risks are bleeding, tension pneumothorax, and cutaneous emphysema. In diseases of pleura and in cases of disseminated small-size lung processes, the method permits in a high proportion a corroborated diagnosis.
Aftercare↗
[Indications for the use of a wound adhesive in pneumothorax treatment].
With the aim to improve the results of treatment of pneumothorax, experience has been gathered using tissue glues (Akutol-Spofa, Ankerplast-Spray). Using these preparations, it is possible to tighten small defects and porous regions of the pleura, and to induce circumscribed obliterations of the pleural fissure. The technique is simple (intubation, thoracoscopy, circumscribed application of glue to visceral pleura, insufflation of the lung, drainage of the thorax, permanent suction if necessary). The method is used only, if spontaneous resolution of pneumothorax is failing. Using this method, the relapse rate is significantly reduced as compared with the results of pure drainage with suction. Late results of pulmonary function are good.
Adhesives↗
[Diagnosis of Wegener's granulomatosis].
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Adult↗
[Goodpasture's syndrome--confirmation of diagnosis and value of lung x-ray findings].
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Adult↗
[Clinical studies of the differentiation of macrobullous and rarefying lung diseases].
For the purpose of macrobullous and rarefying pulmonary diseases according to clinical criteria an own examination group of 32 patients with rarefications of the lung parenchyma is analyzed. From the clinical point of view above all two characteristic forms of the course are to be demarcated. On the one hand, vast grotesque tissue defects in the sense of the progressive pulmonary dystrophy with only an insignificant component of bronchitis are found. On the other hand, relatively "small" lesions of the parenchyma are opposite to a distinct obstructive bronchitis. Thus the bronchitis syndrome may in a certain way be helpful differential-diagnostically. The importance of the protease inhibitors for the pathogenesis of such pictures of a disease and the indication of further diagnostic interventions are discussed.
Adult↗
[Pleural asbestosis in dock workers].
During the last three years 29 patients with asbestosis of the pleura were examined. 21 of them were exposed to dust on wharfs as joiners, locksmiths, transport workers, isolators and in other trades. The beginning of the exposition was at least 15 years age, the duration of the exposition was 5 to 25 years. Two bronchial carcinomas and one mesothelioma of the pleura among our patients emphasize the increased risk for malignoma of the patients with asbestosis. For this reasons an early recognition and a regular medical control of the patients as well as a reducthe long time of latency between the beginning of the exposition and the appearance of morphologic changes it is recommended to employ older colleagues in the working places with dust exposition.
Adult↗