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Biomedical subjects

J Kaliman

Publications and source records attributed to J Kaliman.

At least 91 records · Page 5Linked to original sources
PubMed1982

Hypertension and beneficial treatment with beta-blocking agents does not change the platelet sensitivity to the antiaggregatory prostaglandins.

Recent publications have described increased vascular prostacyclin synthesis in vascular tissue from both spontaneous and experimental hypertensive animals and hypertensive humans. The only paper dealing with the platelet sensitivity reported that the cells are not abnormally sensitive to PGI2 in spontaneously hypertensive rats. In 22 patients with essential hypertension the platelet sensitivity to the antiaggregatory prostaglandins PGI2, PGE1, and PGD2 was studied on admission and two weeks after successful treatment with a beta-blocking agent. In all the age groups and in both sexes no differences in platelet sensitivity could be detected. These findings suggest that increased vascular PGI-2 synthesis is not counterbalanced by a change in platelet sensitivity in men.

Adult↗
PubMed1982

[Hemodynamics of congestive cardiomyopathy].

202 patients with congestive cardiomyopathy have been classified according to their hemodynamic, angiographic, echocardiographic and scintigraphic findings: 72 patients were in the late stage (LS), 103 patients in an early stage (ES) and 17 patients showed a latent form of the disease. 48% of the hemodynamic ES were found to be clinically in stage IV NYHA and 53% of ES fell in class III. 40% of the patients with LS showed a stationary clinical course whereas 46% could improve their classification by one grade. The mortality in hemodynamic LS was 46% within an interval of 18 +/- 14 months after the diagnosis. In ES 64% showed a stable clinical course, where a 22% were deteriorating. Mortality in this group was 10%. Sensitivity and specificity of echocardiography (93 vs 80%) and radionuclide methods (80 vs 71%) were quite good in the late stage whereas in ES specificity was only 71% vs 80%. There was a discrepancy between the degree of myocardial impairment and clinical symptoms in the late stage whereas in the early stage there was no correlation between exercise capacity and LV-hemodynamics. Non-invasive methods allow the hemodynamic evaluation of the disease; invasive methods are required for clarification of diagnosis or establishing prognosis.

Adult↗
PubMed1982

[Diagnosis and therapy of carotid sinus syndrome (author's transl)].

We investigated 76 patients with carotid sinus syndrome followed over a time period of 12-40 months (mean 24 months). In 27 patients long-term ECG were recorded over 24 hours continuously. Carotid Doppler sonography was performed in all patients. 14 patients were studied electrophysiologically. The long-term ECG examinations in patients with carotid sinus syndrome showed a significant tendency to nocturnal bradycardia, and normal heart frequency during the day. In 41% of patients extracranial obstruction of internal carotid arteries could be demonstrated. During carotid sinus massage was a significant increase of the AH time, but there was no significant changes of the HV time. 12 out of 14 patients (86%) developed an AV-block during carotid sinus massage and atrial pacing. In 31 patients pacemakers were implanted. The indication for pacemaker implantation was the clinical symptom of syncope. These patients were observed over a period of 15-40 months (mean 24 months). 15 patients were free of symptoms after the pacemaker implantation, whereas 8 patients complained of dizziness and 4 patients experienced TIA's. 45 patients without pacemaker implantation were observed over a time period of 12-24 months. 30 patients were followed over 12 months. 16 patients were free of symptoms, 14 complained of dizziness. There was no syncopy in this group and no patients died during the observation period. In patients with cardio inhibitory carotid sinus syndrome and syncopy, pacemaker implantation is the therapy of choice. In asymptomatic patients or patients with occasional dizziness pacemaker is not indicated.

Aged↗
PubMed1982

[The ECG in physiologic pacing (author's transl)].

Hemodynamic advantages led to an increasing number of implantations of so called "physiologic pacemakers", which preserve the natural sequence of atria and ventricles. The growing complexity of these systems renders ECG evaluation increasingly difficult. 85 patients had physiologic pacemakers implanted during the last 4 years and were controlled in our pacemaker outpatient clinic. Typical problems in ECG evaluation of the different pacemaking modes are discussed.

Arrhythmias, Cardiac↗
PubMed1982

[Value of the detection of arteriosclerotic lesions with labeled autologous thrombocytes].

In 44 patients with clinical signs of carotid artery stenosis a positive Doppler-ultrasound was obtained. In all patients the lesions were confirmed by angiography. In the patients labelling of autologous platelets with 111Indium-oxine-sulphate was done in order to calculate the platelet half-life. In addition we tried to visualize the verified atherosclerotic lesions under a gamma-camera. In all patients the platelet half-life was significantly shortened in comparison to the controls. In none of the patients studied a visualization of the angiographically verified atherosclerotic lesions could be obtained. These findings point out, that only in recently developed and very severe atherosclerotic lesions the number of platelets deposed on the vascular surface is enough to allow gamma-camera imaging.

Aged↗
PubMed1981

Sensitivity of platelets to prostaglandins in cornary heart disease and angina pectoris.

The platelet sensitivity to the antiaggregatory prostaglandins (PGI2, PGE1 and PGD2) was studied in patients with angiographically verified coronary heart disease. The sensitivity was tested in vitro by inhibiting the ADP-induced platelet aggregation by various concentrations of these prostaglandins. Beside the age dependent alterations of platelet sensitivity reported earlier, there is a statistically significant decrease in sensitivity for PGI2 and PGE1 in patients with coronary heart disease. In contrast, no significant change for the PGD2-sensitivity could be observed. In angina pectoris a further significant decrease in sensitivity (again only for PGE1 and PGI2) was found which returned back to the starting values within a few hours. In patients with maturity onset diabetes and coronary heart disease the sensitivity was always lower than in those patients with coronary heart disease alone. Changes in platelet sensitivity might play a key role in initiating and progressing atherosclerosis by an immediate disturbance of hemostatic balance. The studies further support the hypothesis that PGI2 and PGE1 share the same receptor on the platelet surface.

Adult↗
PubMed1981

Value of platelet sensitivity to antiaggregatory prostaglandins (PGI2, PGE1, PGD2) in 50 patients with myocardial infarction at young age.

Based upon earlier findings of our group that not only the synthesis of antiaggregatory prostaglandins by the vessel wall is altered in atherosclerotic vascular tissue of patients, but also the sensitivity of their platelets to these prostaglandins is changed, we examined a well defined group of 50 patients with myocardial infarction before the age of 40 years. In all patients the coronary heart disease was verified by angiography. The sensitivity of the platelets was examined in relation ot the smoking habit, the type and presence of hyperlipoproteinemia, one, two and three vessel disease and familial history. Except for hyperlipoproteinemia and smoking, all the patients were free of any additional risk factor. It is demonstrated that the platelet sensitivity to the antiaggregatory prostaglandins is significantly diminished in hyperlipoproteinemics in comparison to a control group.

Adult↗
PubMed1980

Platelet proteins (beta-TG and PF4) in atherosclerosis and related diseases.

The mean plasma concentrations of beta-TG and PF4 were significantly elevated in patients with diabetes mellitus, peripheral vascular disease and coronary artery disease reflecting enhanced in vivo platelet activity in some of these patients. No correlations could be observed between state of metabolic control and concentrations of platelet specific proteins in diabetic subjects. High mean beta-TG levels were noticed in diabetic patients with increasing severity of retinopathy. Raised beta-TG values decreased significantly after two weeks of treatment with dipyridamole in 10 type-I diabetics. In patients with peripheral vascular disease the WU-test, but not the ADP- or collagen induced platelet aggregation was significantly different between patients and controls, but there were no correlations between the mentioned platelet function tests.

Arteriosclerosis↗
PubMed1980

Serum lipoproteins in patients with clinical signs of atherosclerosis: peripheral vascular and coronary heart disease.

Lipid and lipoproteins were examined in 7 males patients with coronary heart disease, 10 males with coronary heart and peripheral vascular disease, 25 males with peripheral vascular disease and 10 females with peripheral vascular disease aged between 50-60 years. In general our results demonstrate that in all patients with different locations of atherosclerosis elevated concentrations of total cholesterol, LDL-cholesterol and triglycerides can be found. However low HDL-cholesterol levels measured in all groups should be pointed out. From our data it is concluded that there does not exist a typical lipid or lipoprotein pattern in patients with different locations of atherosclerosis. Only minor differences exist concerning the concentrations of the major lipids and lipoproteins.

Arteriosclerosis↗
PubMed1979

[Surgery of extracranial carotid artery occlusion (author's transl)].

A report is given on the results achieved in 197 procedures undertaken for extracranial cerebrovascular insufficiency in 186 patients. Patch angioplasty of the common carotid and internal carotid artery were performed in 162 cases, whilst in 30 patients kinking or looping of the internal carotid artery was corrected by means of arteriopexy, segmental resection of the common carotid artery or by means of reimplantation of the transected internal artery proximal to its origin. Neurological deficits with incomplete recovery were observed in 2 cases (1%). The mortality rate was 3%.

Arterial Occlusive Diseases↗
PubMed1979

[Femoro-crural reconstruction in preference to amputation (author's transl)].

22 cases of arterial occlusion below the branching of the popliteal artery and 1 case of traumatic subtotal amputation of the calf were revascularized by autogenous femoro-crural vein bypasses. All patients had pain at rest and/or gangrene. So far, with an average bypass patency of 15 months in two of three equal parts of the operated legs, the decision to try reconstruction instead to amputate has met with successful results. The operative technique is described in detail and the speical problems of this group of patients and the particular difficulties of this technically sophisticated bypass procedure are discussed.

Adult↗