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Biomedical subjects

J Cyran

Publications and source records attributed to J Cyran.

At least 37 records · Page 2Linked to original sources
PubMed1987

Placebo-controlled study of lisinopril in congestive heart failure: a multicentre study.

A double-blind randomised, parallel, placebo-controlled study was performed in patients with congestive heart failure, at 13 centres in 10 countries, to assess the efficacy and safety of lisinopril, a new angiotensin-converting enzyme inhibitor. After a 2-week run-in period, 130 patients receiving digoxin and/or diuretics were randomised to 12 weeks of treatment with lisinopril 5 mg daily (87 patients) or with placebo (43 patients), with an option to increase lisinopril dosage to 10 or 20 mg. Patients treated with lisinopril improved significantly more than placebo-treated patients (p less than 0.05) for all clinical parameters except oedema and paroxysmal nocturnal dyspnoea. Left ventricular ejection fraction rose by 8% in lisinopril patients compared to 2% in the placebo group, while the cardiothoracic ratio and echocardiographic end systolic diameter fell in the lisinopril group (p less than 0.01) but not in the placebo group. Exercise duration was greater in the lisinopril group at all timepoints, and the increase in exercise duration at 12 weeks was greater by more than 2 min in the lisinopril group as compared to the placebo group (p less than 0.01). Changes in clinical and noninvasive parameters such as the New York Heart Association status, were well correlated with changes in exercise duration. Four patients in the lisinopril group and three in the placebo group died in this study, and there were 31 adverse clinical experiences in the 87 lisinopril-treated patients compared to 13 in the 43 placebo-treated patients. We conclude that lisinopril in doses of 2.5-20 mg/day is well tolerated and effective in patients with heart failure who are receiving digitalis and diuretics.

Adolescent↗
PubMed1986

[Typing of amyloidoses intra vitam by tissue biopsy using antibodies. Report on 2 patients].

The value of the immunohistochemical classification of amyloid-syndromes has been illustrated in two patients with generalized amyloidosis. Chemical types and exact diagnosis were recognized in biopsies (and later necropsies) using antisera against different purified amyloid fibril proteins and the indirect immunoperoxidase technique. The first case, originally diagnosed as "perireticular" amyloid, was diagnosed as "Ak-amyloidosis with kappa-Bence-Jones-proteinuria without apparent B-cell malignoma", the second case as "AA-amyloidosis reactive to periodic fever". The diagnosis and possible therapeutic measures are discussed in the light of the new classification of amyloid syndromes.

Aged↗
PubMed1981

Computed tomography in constrictive pericardial disease.

Thirteen patients with pericardial abnormalities and a question of constrictive hemodynamics underwent contrast enhanced cardiac computed tomography (CT). Those with clinical and catheterization evidence of restricted cardiac filling demonstrated three CT signs: a dilated IVC, a deformed ventricular contour, and an angulated interventricular septum. Patients with pericardial fluid, thickening, or calcification but without evidence of constriction showed none of these signs. Cardiac CT also defined sites of particular constriction for subsequent resection.

Adult↗
PubMed1981

[End-diastolic volumes of the left ventricle in computer tomography in comparison to heart catheter ventriculography].

In 47 patients the authors calculated the volume at the end of a diastole according to both the cardiac catheter ventriculogram and the CT ventriculogram, comparing the results obtained with each of these methods. A linear regression was found. The correlation coefficient was approximately r = 0,96; n = 47. Cardiological examination revealed that of the examined patients (including the cardiac catheter finding) 18 patients had coronary heart disease, whereas 9 had cardiomyopathy, 6 arterial hypertension, 9 had various cardiac abnormalities and 5 did not show any organically manifest heart disease. The article discusses CT determination of the volume at the end of the ventricular diastole, and discusses the results.

Cardiac Catheterization↗
PubMed1980

Enzymatic analysis and collagen content in endomyocardial biopsy samples of patients with congestive cardiomyopathy of unknown etiology.

Endomyocardial biopsy samples from patients suffering from congestive cardiomyopathy of unknown etiology (COCM) were analyzed for lactate dehydrogenase (LDH) isoenzyme distribution by microisoelectric focusing. In addition, the concentration of collagen in the biopsy samples was estimated by determination of hydroxyproline and proline. The results were correlated with the clinical and hemodynamic data of the patients. Increased activities of total LDH and LDH5--the worse the hemodynamic parameters, the higher the concentration of LDH5--indicate an enhanced anaerobic glycolysis in the myocardium of COCM patients. The close correlation between the hemodynamic data and the LDH isoenzyme pattern suggests an association between severity of COCM and impairment of aerobic metabolism. The results of the alteration in the LDH isoenzyme pattern were not influenced by the collagen content in the myocardial biopsy samples. Varying isoenzyme patterns in the different parts and wall layers of the normal heart show the necessity of analyzing biopsy samples only from comparable localizations.

Biopsy↗
PubMed1980

[Assessment of left ventricular performance by single crystal gamma camera and first pass radionuclide angiography (author's transl)].

Employment of a single crystal gamma camera in first pass radionuclide angiography yields essential parameters of left ventricular performance. These are: global ejection fraction, end-diastolic, end-systolic and stroke volumes, regional wall motion and regional ejection fractions. Since the right anterior oblique (30 degree RAO) projection is used, results of this noninvasive method are comparable to findings from invasive contrast ventriculography. A critical evaluation of the comparative results (correlation r = 0.84 to 0.97 in global ejection fraction; r = 0.87 to 0.95 in end-diastolic volume; agreement in segmental wall motion analysis of 72 to 90%) justifies the use of a single crystal gamma camera in first pass radionuclide angiocardiography. At elevated heart rates, e.g. during exercise, the single crystal system yields information of limited value as compared with that of the multiple crystal system. As compared to other methods (e.g. equilibrium methods), short examination times (30 s) of first pass are advantageous. First pass radionuclide angiocardiography may directly precede equilibrium examinations. Within this sequence, it may be used to assess right ventricular function and lung circulation.

Angiography↗
PubMed1979

[Results of employing single crystal gammacamera and minicomputer in the first tracer passage to determine left-ventricular ejection fraction and wall motion (author's transl)].

Single crystal gammacamera and minicomputer were employed in 71 patients to determine left-ventricular ejection fraction (EF) (17 mCi 99mTc-HSA; 30 degrees RAO projection) by means of the first tracer passage. In 30 out of these patients, ventricular wall motion could be analyzed additionally because later on the gammacamera was equipped with a converging collimator. Comparison with cineventriculographically determined EF values revealed a good correlation (r = 0.91), not depending on left-ventricular wall motion pattern. Hereby, with first transit, high EFs were computed somewhat lower and low EFs were found somewhat higher. This non-limiting discrepancy is closely related to the influence of paracardiac "background"-radioactivity. Comparative analysis of segmental wall motion demonstrated agreement in 83% of the 90 segments examined. Therefore, it can be confirmed that performance of the first tracer passage for a evaluating segmental wall motion must not mandatorily be done with a multicrystal camera.

Adult↗
PubMed1978

[Lactacidosis in biguanide therapy: diagnosis and therapy. 4 cases compared to 179 cases in the world literature].

In 4 out of 9711 (= 1:2400) patients, lactice acidosis due to biguanides was diagnosed. Serum lactate concentration averaged 18.2 mmol/l and the pH value 6.87. All patients showed signs of renal insufficiency and three had congestive heart disease. In addition to treatment with biguanides, other factors might have contributed to the lactice acidosis in these patients: prolonged fasting, severe dehydration due to persistent vomiting, acute bronchopneumonia, and acute pyelonephritis. On addmission, two patients were in shock and all patients were semi-conscious or comatose. All patients were treated with bicarbonate and glucose/insulin. One patient was hemodialysed. Two of our four patients died. Oour four patients are compared with 179 patients in the literature with respect to mortality and prognosis of lactic acidosis due to biguanides.

Acidosis↗