Search PubMed⌕ Search

Biomedical subjects

J Hasse

Publications and source records attributed to J Hasse.

At least 91 records · Page 5Linked to original sources
PubMed1987

[Dipyridamole and low-dose aspirin in patients with aortocoronary bypass--comparison with anticoagulation].

The effects of antiplatelet therapy (AP; dipyridamole 400 mg [beginning 2 days preoperatively] + aspirin 50 mg/day) and anticoagulation (AC) were compared prospectively in 251 patients with coronary artery bypass grafting (CABG). Two weeks postoperatively, 85.2% of AP and 81% of AC patients had all grafts patent with graft patency rates of 93.6% and 91.3% respectively (p = n.s.) Significant differences in favour of AP therapy were found in subgroups with multiple grafts and with low intraoperative graft flow. Up to 3 months postoperatively, severe complications occurred in 22 AC patients (11 bleedings) but only in 9 patients on AP therapy (p less than 0.01). Overall, AP therapy should therefore be preferred to AC in patients with CABG surgery.

Anticoagulants↗
PubMed1987

[Thoracic trauma with injuries of the thoracic spine].

From a major series of surgically treated patients with fractures and fracture dislocations of the thoracic spine 4 cases are presented exhibiting different trauma mechanisms and presenting with a variety of associated acute and chronic intrathoracic lesions. Surgical stabilisation and treatment of additional intrathoracic injury (vascular, lymphatic duct, empyema, posttraumatic fibrothorax) necessitated a transpleural approach, effective for the spine as well. Diagnostic radiology was restricted to minimal requirements due to urgency and/or difficulties of exposure.

Adult↗
PubMed1985

[Relation between intraoperative blood flow measurements and graft patency afer aortocoronary bypass surgery].

During aorto-coronary bypass surgery, electromagnetic flow measurements of venous grafts were performed in 50 consecutive patients at rest and after stimulation with papaverine (2 mg) to assess whether early postoperative patency was predictable. The overall patency rate at day 9-11 was 95.4% (145/152 distal grafts; 118 proximal grafts). Flow in all bypass grafts averaged 52.5 +/- 31.4 ml/min and increased after papaverine stimulation by 46.9 +/- 32.2 ml/min (p less than 0.01). 5 of 6 grafts with a flow of less than 30 ml/min and without adequate flow increase after papaverine (less than 80%) were occluded. Grafts with a flow of greater than or equal to 30 ml/min or an increase of greater than or equal to 80% after papaverine, had a high short-time patency rate (98%). Thus, perioperative flow measurements combined with papaverine stimulation predicted early patency of single grafts with an accuracy of 95%.

Coronary Artery Bypass↗
PubMed1985

[Invasive pulmonary aspergillosis--a diagnostic and therapeutic problem in patients with severe aplastic anemia].

Three young patients with severe aplastic anemia undergoing intensive immunosuppressive therapy developed fever and pulmonary infiltrates during longlasting severe granulocytopenia, despite multiple broad spectrum antibiotic combinations and granulocyte transfusions. Invasive pulmonary aspergillosis was diagnosed only by thoracotomy. In conjunction with high dose amphotericin-B therapy complete resolution of aspergillosis was achieved in two cases, paralleled by slow recovery of bone marrow function, whereas in the third case only a partial remission was possible together with transient amelioration of granulopoiesis. We suggest early aggressive surgical methods to establish the diagnosis of aspergillosis in these severely menaced patients, so that antifungal therapy with high dose amphotericin-B can be initiated at an early stage.

Adolescent↗
PubMed1985

Mediastinal staging of bronchial carcinoma: can computed tomography replace mediastinoscopy?

In bronchial carcinoma the assessment of operability requires an accurate evaluation of the regional and mediastinal lymph nodes. For this, both mediastinoscopy and computed tomography are often used on a routine basis today. The present work considers the relative value of these two methods of investigation. Fifty-seven patients with bronchial carcinoma, in whom both investigations were carried out prior to surgery, were included in this prospective study. In the computed tomogram, lymph nodes with a diameter of more than 1 cm were defined as positive (i.e. suspected malignant infiltration). Sixteen of the 57 patients had histologically confirmed lymph node metastases; in 13 cases the metastases were detected by computed tomography, in 12 cases also by mediastinoscopy and in 3 cases only at thoracotomy. In 41 of the thoracotomized patients, no mediastinal metastases were found. As was to be expected, mediastinoscopy also proved negative in these cases. In 9 of these cases, however, the preoperative computed tomography findings were false-positive. For computed tomography the specificity was 78% and the sensitivity 81%; for mediastinoscopy, on the other hand, the specificity was 100% and the sensitivity 75%. The specificity of computed tomography is too low. Also, lymph nodes which are only inflamed may be considerably enlarged and cannot be differentiated in the computed tomogram from those with malignant infiltration. Mediastinal lymph nodes which appear enlarged in the computed tomogram therefore have to be further investigated by mediastinoscopy. However, in this prospective study, mediastinoscopy provided no additional information in those cases in whom the computed tomography findings were negative (lymph node diameter less than or equal to 1 cm); it did not detect the metastases in the 3 patients with false-negative computed tomography findings. Therefore, in the case of a negative computed tomogram, thoracotomy may be performed immediately, without previous mediastinoscopy.

Adult↗
PubMed1984

[Prosthesis endocarditis--a surgical indication!].

The authors summarize their experience of the management of 26 patients with prosthetic valve endocarditis. Out of 11 patients who did not undergo surgery, 8 were treated medically, with 9 early deaths (mortality 75%). 15 patients were treated surgically with 3 deaths caused by resistant infection (mortality 20%). Prosthetic valve endocarditis remains a dangerous complication of valve replacement, and the authors recommend immediate valve replacement in all patients with infected mechanical valves.

Adolescent↗
PubMed1984

Clinical evaluation of the St. Jude Medical heart valve prosthesis. A two-year follow-up of 150 patients.

To evaluate the clinical performance of the St Jude Medical bileaflet heart valve prosthesis, we followed 150 consecutive patients (95 male and 55 female patients, mean age 54 years, range 1 to 74 years) for an average of 24 months. These included 74 patients with aortic, 56 patients with mitral, and 20 patients with multiple valve replacement. During the 2 year follow-up, there were a total of four perioperative and seven late deaths, two of which were prosthesis related. Reoperation was necessary in four patients, because of paravalvular leaks in two patients with mitral and one patient with aortic prostheses and because of leaflet dislodgment in one patient with a mitral prosthesis, a postoperative complication that has not been reported previously. The thromboembolic rate per 100 patient-years was 2.6 in aortic and 2.9 in mitral valve replacement, the symptoms being reversible in all patients. All patients were receiving anticoagulant therapy. A total of four complications of anticoagulant therapy (three minor and one fatal) were observed. Significant hemolysis was observed in none of the patients. In patients with dyspnea, the New York Heart Association functional classification was 2.7 +/- 0.8 preoperatively versus 1.3 +/- 0.6 postoperatively. In patients with angina, it was 2.6 +/- 0.6 preoperatively versus 1.03 +/- 0.2 postoperatively. Noninvasive Doppler measurements revealed excellent flow characteristics, values being close to those obtained in natural valves (mean +/- standard deviation of maximal flow velocity: 1.5 +/- 0.5 versus 0.9 +/- 0.1 m/sec in the aortic position; 1.1 +/- 0.3 versus 0.8 +/- 0.3 m/sec in the mitral position).

Adolescent↗
PubMed1984

Traumatic pulmonary pseudocysts and paramediastinal air cyst: two rare complications of blunt chest trauma.

Traumatic pulmonary pseudocysts and paramediastinal air cysts due to closed chest trauma are very uncommon. Minor clinical symptoms and major radiologic signs are characteristic of this form of injury to the lung parenchyma. Treatment of combined pseudocysts and pneumatocele in a 17-year-old girl is described. Chest X-ray and computed tomography provided the diagnosis. No surgical treatment was required. Intensive bronchial toilet and PEEP-assisted respiration by mask were followed by recovery. This condition must be differentiated from lung abscesses after infected hematomas, specific cavities, or congenital pulmonary cysts.

Adolescent↗
PubMed1983

[Atypical and ischemic chest pain more than a year after aortocoronary bypass].

215 consecutive patients were followed up for more than a year (22 +/- 9 months) after aortocoronary bypass. Recurrence of ischaemic (anginal) and atypical chest pain was assessed: 54% of all patients were completely without pain postoperatively, 76% free of angina and 93% improved by at least one NYHA class. The frequency of severe atypical chest pain was similar pre- and postoperatively (11% and 13%, respectively), but nearly double that of postoperatively severe angina (13% vs 7%, P less than 0.05). Limiting atypical chest pains in patients with pre-operative atypical chest pain was much more frequent postoperatively than in patients who pre-operatively had only angina (30% vs 11%, P less than 0.005). These two patient groups did not differ with respect to age, sex, degree of vessels disease, exercise-induced ischaemia or number and patency of bypasses. Thus, exercise-limiting atypical chest pain can influence the surgical results in up to 30% of patients with pre-operative atypical chest pain (with or without typical angina).

Adult↗
PubMed1983

Traumatic aneurysm of the thoracic aorta simulating bronchogenic neoplasms.

A 70-year-old man was examined in 1977 because of hoarseness and a central opacification in the left hilus. At that time, the diagnosis of a central bronchogenic carcinoma was made based on roentgenographic findings. The patient's condition was reevaluated five years later, when an examination disclosed a chronic posttraumatic aortic aneurysm. Despite severe chronic obstructive pulmonary disease, the patient was successfully operated on.

Aged↗