Search PubMed⌕ Search

Biomedical subjects

H Zeitler

Publications and source records attributed to H Zeitler.

31 records · Page 2Linked to original sources
PubMed1992

Counteraction of the vasodilator effects of enalapril by aspirin in severe heart failure.

OBJECTIVES: This study was undertaken to determine if a standard dose of aspirin interacts relevantly with the circulatory effects of enalapril in severe heart failure. BACKGROUND: The frequent association of heart failure with coronary artery disease confers potential for combined treatment with an angiotensin-converting enzyme inhibitor and the prostaglandin synthesis inhibitor aspirin, the pharmacodynamic actions of which are, in part, mutually opposed. METHODS: In 18 patients, on 3 consecutive days, hemodynamic measurements were performed at baseline and 4 h after administration of a double placebo, enalapril (10 mg) plus placebo and enalapril plus aspirin (350 mg) according to a double-blind, randomized, crossover protocol. RESULTS: Enalapril given before aspirin led to significant decreases in systemic vascular resistance, left ventricular filling pressure and total pulmonary resistance together with a significant increase in cardiac output. When given with or on the day after aspirin, enalapril did not elicit significant changes in any of these variables. There was a clear tendency to lower values for pulmonary artery pressure on all regimens, and slowing of the heart rate was incurred whether or not aspirin had been given. Chi-square analysis of the individual responses showed that the probability of effecting a decrease in systemic vascular resistance > or = 300 dynes.s.cm-5 was six times greater when enalapril was given without aspirin (p < 0.01). CONCLUSIONS: In severe heart failure, the prostaglandin synthesis inhibition by aspirin counteracts the systemic arterial vasodilation of angiotensin-converting enzyme inhibition with enalapril and substantiates its dependence on the integrity of prostaglandin metabolism. Trends toward reductions of pulmonary artery pressure and slowing of the heart rate were still observed, presumably subsequent to lowered norepinephrine concentrations indicating maintenance of prostaglandin-independent actions of angiotensin-converting enzyme inhibition.

Adult↗
PubMed1992

[The value of tumor volumetry as opposed to bidimensional determination of tumor size during follow-up of hepatic metastases from colorectal carcinoma].

36 patients with liver metastases due to colorectal carcinoma under treatment with arterial perfusion chemotherapy of the liver with 5-fluoro-2-desoxyuridine (FUDR) via a subcutaneous pump were investigated by axial liver CT at 6-monthly intervals. In all examinations a dynamic CT scan with intravenous bolus injection of contrast medium was carried out following a native scan. Changes in tumour size were documented by means of 1. volumetry and 2. bidimensional measurement according to WHO criteria. Since we were not able to assess small newly developing lesions within the liver using the volumetric classification, the WHO-classification showed much higher sensitivity in cases of progressive disease. In addition, volumetric determination of tumour size by means of region-of-interest technique proved to be rather impracticable in clinical routine compared to bidimensional measurement.

Aged↗
PubMed1992

[The place of portangiography in the follow-up control of locoregional chemotherapy].

101 portangiographies in patients with liver metastases from colorectal primaries who underwent hepatic intraarterial or intraperitoneal chemotherapy were performed and studied between January 1991 and February 1992. 81% of the examinations did not involve complications. In 19% of the angiographies abnormalities of the arterial perfusion of the liver, like occlusion, dissection or narrowing of hepatic arteries, were found. We conclude that portangiography is a very important investigation before regional chemotherapy.

Angiography↗
PubMed1992

[Malignant fibrous histiocytoma: productive use of imaging procedures].

Malignant fibrous histiocytoma (MFH) of soft tissue is a rare tumor. We present a case of MFH in the bicipital muscle. Local muscle hypertrophy or lesions of the long tendon of the bicipital muscle may be a difficult differential diagnosis. This case is used for outlining advantages of ultrasound, computed tomography and magnetic resonance imaging. In conventional radiography MFH is seen as a soft-tissue tumor sometimes involving the bone. CT is the best way to test bone involvement. Tumor extension will be assessed with great accuracy by means of ultrasonics and magnetic resonance imaging (MRI).

Arm↗
PubMedDate not supplied

MRI of the breast in the differential diagnosis of mastitis versus inflammatory carcinoma and follow-up.

PURPOSE: Our goal was to evaluate the potential of dynamic MRI in differentiating mastitis and inflammatory breast carcinoma. Furthermore, we evaluated the potential of breast MRI to follow up mastitis patients under antibiotic treatment. METHOD: Twenty-one cases of dynamic breast MR (11 mastitis, 10 inflammatory carcinomas) were reviewed. All patients had a history consistent with either mastitis or inflammatory breast carcinoma. The final diagnosis was histologically confirmed. RESULTS: Ninety percent of the inflammatory carcinomas were found to enhance > 100% in the first minute compared with 55% for mastitis. There is no significant difference between mastitis and inflammatory carcinoma. CONCLUSION: While breast MR cannot currently be used definitively to distinguish inflammatory carcinoma from mastitis, the differences in dynamic enhancement may prove to be useful in follow-up of presumed mastitis in problematic cases. If after biopsy the diagnosis remains unclear, breast MR may help to (a) demonstrate the success of the antibiotic treatment and (b) diagnose coexisting or confounding inflammatory carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Value of MR mammography in the detection and exclusion of recurrent breast carcinoma.

PURPOSE: This is a study of 140 patients undergoing MR mammography (MRM) for evaluation of possible local recurrent disease following breast-conserving surgical treatment of mammary carcinoma. MRI was performed 1-228 months (mean 28.3 months) postoperatively. METHOD: MRM and interpretation of the dynamic measurements were performed in a standardized manner after positioning the patient in a double breast coil. A GRE sequence (Flash 3D, TE 5 ms, TR 12 ms, FA 25 degrees) was acquired before and 1, 2, 3, and 8 min after intravenous injection of Gd-DTPA in a dose of 0.15 mmol/kg body wt. RESULTS: Recurrent disease was excluded in 82.8% of cases with MRM. In another 13.6% of patients, MRM was able to reliably detect recurrence of malignancy. In five cases (3.6%), MRM returned false-positive results. CONCLUSION: MRM is a sensitive method for detecting or excluding recurrence of malignant disease. It remains to be determined whether early detection of recurrent disease can contribute significantly to improving the prognosis in these patients.

Adult↗