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Biomedical subjects

J Ennker

Publications and source records attributed to J Ennker.

53 records · Page 3Linked to original sources
PubMed1992

Relaxation of human coronary artery and arteria mammaria by K(+)-channel openers.

Three agents with K(+)-channel-opening activity--nicorandil, bimakalim (EMD 52692), and EMD 56431--were tested for vasorelaxation abilities in human coronary artery and human arteria mammaria. The potency orders were bimakalim = EMD 56431 >> nicorandil for relaxation in human coronary artery and bimakalim = EMD 56431 >> nicorandil in human arteria mammaria. These data demonstrate that K(+)-channel openers are effective vasorelaxant agents in human coronary artery and human arteria mammaria. Bimakalim and EMD 56431 were more potent than nicorandil, a drug that also activates guanylate cyclase.

Benzopyrans↗
PubMed1992

[Coronary revascularization in end-stage coronary heart disease in relation to assessment of myocardial vitality].

From 4/1986-12/1990, 177 pts. with endstage coronary artery disease (CAD) and left ventricular ejection fraction 10-30% received coronary artery bypass grafting (CABG). Preoperatively myocardial infarction rate was 1.5 (mean). Presupposition for CABGs was myocardial ischaemia at present demonstrated in myocardial viability test. 66.1% of the pts. had signs of ischaemia at e.c.g. after work. Additionally 97.6% of the pts. had myocardial ischaemia defined as redistribution in myocardial scintigraphy. Angina pectoris was present in 93.8% of the pts. preoperatively. 1-5 (mean 2.9) CABG per pt. were performed. 35 pts. received an internal mammaria bypass to the left coronary artery also. Operative mortality was 11.3% (1986-1990) and in 1990 alone 7.3%. Actuarial survival rate was calculated after one year to 87.4% after two years to 86.1% and after three years to 84.8%. Postoperatively all pts. were free from angina pectoris. 5 months after the operation e.c.g. after work was performed. The physical stress bearing area was increased to 82.7 Watt (mean) compared to 51.7 Watt (mean) preoperatively (p less than 0.001 s.). In conclusion pts. with endstage CAD and left ventricular ejection fraction 10-30% appeared to be good candidates for CABG with good prognosis and significant symptomatic improvement when signs of myocardial ischaemia are present preoperatively.

Aged↗
PubMed1989

[Postoperative results and follow-up of thoracic aortic diseases using magnetic resonance tomography].

Operations of the thoracic aorta for aneurysms, dissections, or congenital malformations may lead to early or late complications. Therefore, postoperative control for documentation of the surgical results, for exclusion of early changes and for comparison with later controls is mandatory. To demonstrate that magnetic resonance imaging (MRI), which we already had used with good results for preoperative studies is also able to detect postoperative abnormalities, we examined 30 patients with thoracic aortic disease (20 male, 10 female, mean age 53 +/- 13.7 years) with this diagnostic tool. There were 19 arteriosclerotic aneurysms, 10 dissections, and one aortic tumor. With MRI it was possible in all patients to visualize the results of the surgical treatment postoperatively. Early postoperative complications could be excluded, or demonstrated in one case of a retrograde aortic dissection or a hematopericardium. These pathological findings could also be shown by arterial digital subtraction angiography or echocardiography. Using MRI for follow-up of aortic dissections, the development of an aneurysm of the aortic root in a Marfan-patient could be detected. In all these patients, it was possible to differentiate true and false lumen and to detect the origin of major side branches. The diagnostic advantages of MRI, which we compared with other imaging methods, as echocardiography, computed tomography or angiography are that postoperative complications of thoracic aortic aneurysm surgery can be reliably detected and visualized in 3 different planes. Non-invasiveness, the omission of ionizing radiation and no risk of contrast media application underline that magnetical resonance imaging is an ideal method for follow-up after operation of the thoracic aorta.

Aortic Dissection↗
PubMed1986

[Replacement of the infrarenal aorta in advanced age].

Between 1975 and 1986, infrarenal aortic replacement, due to aneurysm, was performed on 80 patients (mean age 78.4 +/- 3.2 years, 63 men, 17 women). From 28 electively operated patients one died (3.6%), and from 26 urgently operated symptomatic patients, 23.1% (n = 6). Following emergency operations due to rupture, the lethality rate was 50% (13/26). The figures for patients under 75 years of age were: 4.3% (12/277), 10.6% (7/66) and 40.9% (47/125). An analysis of patients, operated in an emergency, on account of ruptured aneurysm or with symptoms, showed that significant cardiovascular and pulmonary risk factors existed. The risk of electively operated patients older than 75 years is not higher than for younger patients. In our opinion, limitation of indication for operation, due to higher age, is not justified.

Aged↗
PubMed1985

[Surgery of abdominal aortic aneurysm--results in 502 patients].

Between 1975 and 1985 502 patients (52 female, 450 male, aged 29 to 88 years, mean 66 years) were operated for abdominal aortic aneurysm (AAA). In 261 electively operated patients hospital mortality was 4.9% (group A). In 79 patients with impending rupture the rate was 12.2% (group B) and of 125 patients with a ruptured AAA 46.6% died (group C). Of 42 patients with thoraco-abdominal aneurysm (group D) 11 had a rupture. Mortality was 66%. These figures could be improved. Between November 1983 to the end of 1984 in group A lethality was 4.1% (2/49), in group B 6.25% (1/16), in group C 33% (8/24). Of the last 4 patients of group D operated electively 1 died. Reasons for this improvement were: 1. improved anesthesiological management, 2. use of graft-inclusion-technique, 3. implantation of straight tube grafts instead of bifurcated prostheses, 4. use of collagen-coated Dacron prostheses.

Aorta, Abdominal↗
PubMed1985

[Diagnostic and therapeutic procedures in primary small intestinal tumors].

Between 1975 and 1985 37 patients (23 men, 14 women, 34.3-88 years, mean age 59.5 years) with a primary tumor of the small intestine (7 benign, 8 carcinoids, 22 malign neoplasms) were operated. Preoperative diagnosis could be improved by sonography and computed tomography. In dubious cases explorative laparotomy is recommended. 1 patient died postoperatively. During the mean follow-up period of 32.7 months 19 patients (57%) died with a mean survival time of 19.7 month. An improvement of prognosis of small intestinal tumors may be possible by an early diagnosis and a radical surgical approach, according to the health status of the patient.

Adult↗
PubMed1985

Risks and benefits of cardiac pacing in children.

Forty-nine patients aged 2 days to 14 years (30% below 1 year of age) required implantation of a permanent pacemaker system. Surgically induced bradyarrhythmia was the main indication for treatment (84% of patients). In the follow-up period (ranging from 2 to 140 months) 16 reoperations became necessary for complications in 12 children. Twelve of these were caused by problems related to function of the epicardial electrode (threshold rise 9, lead fracture 2, dysfunction 1). Four patients died, but pacemaker function had remained intact in all. Our experience confirms that artificial cardiac stimulation has become a reliable instrument for improving quality of life and life expectancy of children endangered by postsurgical, congenital and acquired rhythm disorders.

Adolescent↗
PubMed1985

[Recurrent ileus in jejunal diverticulitis].

Jejunal diverticula are in most cases acquired lesions of the intestinal wall, which are caused by abnormalities of smooth muscle or myenteric plexus. They may lead to more complications than previously expected. The described patient developed an acute abdomen 8 years after an ileus due to jejunal diverticulitis with enterolith formation and resection of two jejunal diverticula. Immediate laparotomy had demonstrated again an ileus, partly induced mechanically by an obstruction due to 2 enteroliths, partly induced paralytically due to local peritonitis. The surgical significance of jejunal diverticula is discussed.

Cholelithiasis↗
PubMed1984

False aneurysm of the femoral artery due to an osteochondroma.

Two cases of primary misdiagnosis of a posttraumatic false aneurysm are reported. In the first case a twenty-year-old patient was hospitalized under the diagnosis of a malignant soft tissue tumor five weeks after a kick against the right distal thigh. Diagnostic procedures performed in our clinic, however, led to the expectation of a false aneurysm of the femoral artery, caused by perforation of the wall of the vessel by an osteochondroma. Intraoperative findings confirmed this and led to the supposition of a connection with the mechanical trauma. The postoperative course was uneventful. The second case had a similar history. Prophylactic excision of osteochondromas in areas with increased risk of perforation, as in the region of the femoropopliteal junction, is recommended.

Adult↗
PubMed1983

Surgical experience with left atrial myxomas.

Between 1974 and 1982, 16 patients (four men, twelve women, mean age 50.5 years) underwent surgery for left atrial myxoma at the Hannover Medical School. Clinical features encompassed cardiac murmurs (100%) and findings compatible with mitral stenosis (87%), chest pain (37%), arrhythmias (37%), syncope (18%) and malaise (37%). Arterial tumor embolism (to the right leg) occurred in one case. The sedimentation rate was consistently elevated. Sinus rhythm was present in 14 and atrial flutter in two patients. In all but one case, the diagnosis was documented through cardiac catheterization. In recent years, however, noninvasive methods such as echocardiography and computer tomography have proved to be accurate and reliable diagnostic methods such that cardiac catheterization would now appear indicated primarily for patients with additional heart disease and for those over the age of 40 years to rule out the presence of asymptomatic coronary artery disease. Surgery was performed with cardiopulmonary bypass and all patients survived the procedure. In 13 cases the tumor was removed through a right atrial approach with septal incision, in two through the left atrium and in one case both approaches were used. Complete removal of the tumor was achieved in all patients. The tumors were found to arise from the atrial septum in 15 and from the inferior wall of the left atrium in one patient. The size of the tumors ranged from 30 mm in diameter up to 100 mm X 60 mm X 40 mm with weights between 4.8 and 125 grams. Although no residual tumors have been seen during an average observation period of 29.2 months (range nine to 56 months), long-term follow-up, readily accomplished with noninvasive methods, is warranted for such patients.

Adult↗
PubMed1979

Immunoprophylactic anti-Rho(D) treatment after mismatched transfusions.

80 cases of anti-Rho(D) treatment after mismatched transfusions are reviewed to compare the intramuscular (i.m.) and intravenous (i.v.) route of treatment. No severe reactions such as renal failure occurred with either method of anti-D treatment. If the Rh-immune globulin is injected i.m., 20 micrograms anti-D per ml red cells are used. For i.v. anti-D administration, 10-12 micrograms anti-D are suggested. The i.v. method of anti-D treatment is recommended for the future. Furthermore, a scheme of treatment for after mismatched transfusions is described.

Blood Grouping and Crossmatching↗
PubMedDate not supplied

Off-pump myocardial revascularisation in an octogenarian patient with dextrocardia and situs inversus.

Dextrocardia associated with situs inversus totalis is a rare condition and there are few reports of myocardial revascularisation in such patients. An 82-year-old woman with dextrocardia and situs inversus totalis underwent successful off-pump coronary artery bypass grafting using internal mammary arteries. The operative technique was similar to that of off-pump coronary artery bypass grafting for situs solitus. However, for a right-handed surgeon the operation was easier standing on the left side of the patient.

Aged, 80 and over↗