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Biomedical subjects

J Schauer

Publications and source records attributed to J Schauer.

At least 55 records · Page 3Linked to original sources
PubMed1992

Screening of pulmonary hypertension in chronic obstructive pulmonary disease and silicosis by discriminant functions.

The aim of our prospective multicentric study was to develop a screening method for pulmonary hypertension in patients with chronic lung diseases. We investigated 710 patients in 10 hospitals: 315 males and 109 females with chronic obstructive pulmonary disease, and 286 males with silicosis. Manifest pulmonary hypertension was defined as pulmonary artery pressure greater than 20 mmHg (2.7 kPa) at rest. The multivariate statistical method used was a stepwise discriminant analysis. In males with chronic obstructive pulmonary disease, the diameter of the right descending pulmonary artery, forced expiratory volume in one second (FEV1) arterial oxygen tension (PaO2) at rest, and age turned out to be relevant for discrimination of groups with and without manifest pulmonary hypertension. For females the FEV1/FVC (forced vital capacity) ratio replaced the absolute value of FEV1 in the calculated discriminant function. In females, sensitivity and specificity were below 80%. In males, both were distinctly above 80%. In silicosis, the diameter of the right descending pulmonary artery was much less important, since it could frequently not be measured precisely. In these cases, precision of the prediction of about 80% could only be obtained by combined evaluation of spirometry, PaO2 during exercise, and body plethysmography. The calculated discriminant functions are appropriate for screening patients with risk of pulmonary hypertension. For different chronic lung diseases, and for both sexes, different combinations of parameters are relevant. The method is recommended to select patients who should undergo an invasive examination of pulmonary haemodynamics.

Discriminant Analysis↗
PubMed1991

[Modification of pulmonary hypertension in patients with chronic obstructive lung diseases by trapidil (Rocornal) in an acute trial].

Acute effects of Trapidil (Rocornal, Deutsches Hydrierwerk Rodleben) on pulmonary hemodynamics were studied in 47 patients. A marked decrease of pulmonary artery pressure, pulmonary vascular resistance and of right ventricular stroke work at rest and during exercise in different degrees of severity of pulmonary hypertension was shown. Especially the influence on stable pulmonary hypertension is of interest, but there was no statistical significance during exercise because of the small number of patients. Considerable objective or/and subjective side effects were not noticed. Possible multifactorial mechanisms of these effects including the left ventricular function and the role of prostaglandins are discussed. The effect of trapidil is compared with other investigated pulmonary vasodilators, such as nitrates and nifedipine. Because of hitherto there are no other studies with Rocornal in patients with COPD, further acute studies and placebo controlled long term studies with monitoring of pulmonary hemodynamic are necessary. Than it will be possible to clarify the role of trapidil in therapeutical concepts of pulmonary hypertension.

Adult↗
PubMed1990

[Differential diagnosis of syncope attack in the district hospital].

With the aim to establish a rational and effective programme for the diagnosis of syncopes for district hospitals 159 patients with previous syncopes underwent an examination programme which contained the whole specialized diagnostic spectrum of a district hospital up to the higher-frequent right-atrial stimulation. In 141 patients (88.7%) the diagnostics was successful, 18 cases (11.3%) remained unclear. At least 53% of the syncopes were of cardial, 21% of vasal, 13% of "other" and 5% of central-nervous origin. The significantly most frequent causes of the syncope were the bradycardic disturbances of the cardiac rhythm (40%) and the carotid sinus syndrome of cardioinhibitory type (22%). Apart from the analysis of the distribution of frequency and sex of the causes of the syncope as well as of the quota of the diagnostic impact of the individual examination methods on the basis of the results a diagnostic step programme is presented which renders possible a syncopal diagnostics successful in a district hospital.

Arrhythmias, Cardiac↗
PubMed1990

The influence of nifedipine (Corinfar) on pulmonary hypertension in chronic obstructive lung disease.

Calcium antagonists may provide an effective approach to the treatment of pulmonary hypertension disorders. Under this aspect we examined 44 patients by right heart catheterisation at rest and at exercise before and after sublingual application of a single dose of 20 mg nifedipine (Corinfar) as well as under continuous dosage of 30-60 mg daily. In patients with latent pulmonary hypertension we ascertained an efficient significant decrease of PAP, 15 of 18 patients were responders. This protective effect persists in the longterm studies after 1 year as well as after 2 years at equal magnitude. In patients with manifest pulmonary hypertension the influence on pulmonary hemodynamics was not so efficient. This behaviour is caused by morphological fixation of pulmonary hypertension. Therefore the determination of magnitude of pulmonary hypertension by right heart catheterisation is necessary for evaluation of nifedipine therapy.

Adolescent↗
PubMed1989

[Modification of pulmonary hypertension in patients with chronic obstructive lung diseases using calcium antagonists in an acute trial].

Since the life expectancy of the patients with chronic obstructive lung diseases (COLD) is essentially determined by the size of the pulmonary hypertension, today the efforts are directed to an early and effective therapy of the precapillary hypertension. Apart from a treatment of the pulmonary basic disease the therapy with vasodilators stands in the centre of interest. The influence on mean pressure of the pulmonary artery and vascular resistance of the lung by verapamil (39 patients) and nifedipine (21 patients) was investigated. In patients with latent pulmonary hypertension the two calcium antagonists showed a reduction of the pressure of the pulmonary arteries and vascular resistance of the lungs, which was more distinct when nifedipine was given. An influence on the haemodynamic parameters in patients with manifest pulmonary hypertension could not be ascertained. In correspondence with the findings in literature the results show that the use of calcium antagonists for part of the patients with precapillary hypertension appears as an enrichment of the therapeutic possibilities. At present a prerequisite for this, however, are still individual haemodynamic investigations. The question of the effectivity of a long-term therapy is not yet satisfactorily clarified.

Administration, Sublingual↗
PubMed1987

[Effect of secondary bronchopulmonary diseases on the performance and course of rehabilitation of patients with myocardial infarct].

On the one hand, the results of the study show a relatively large number (44%) of bronchopulmonary secondary diseases in a non-selected number of patients with condition after myocardial infarction, on the other hand, partly considerable respiratory functional reductions with clear decrease in vitality and delayed and restricted professional rehabilitation are to be proved. Of particular significance was the arterial hypoxaemia as an important functional determinant in the pathophysiology of the chronic coronary heart disease. From this results the necessity of a complex cardiopulmonary diagnostics in the dispensary care of patients with condition of myocardial infarction, a differentiated medication. In particular becomes evident the balanced application of beta-receptor blockers and glycosides.

Exercise Test↗
PubMed1986

[Noninvasive roentgen diagnosis of right heart function in patients with recirculation disorders and chronic nonspecific lung changes].

The non-invasive x-ray functional diagnostic electroradiographic method at the large vessels near the heart may enrich the radiological preliminary diagnostics of recirculation abnormalities. In chronic unspecific pulmonary diseases it can characterize the load of the right heart. Our studies should serve as a pilot study for the in future possible, simply to be handled non-invasive video-densitometry of the vessels near the heart in the preliminary diagnostics of cardiovascular diseases.

Cardiac Output↗
PubMed1985

[Results of long-term conditioning in patients with myocardial infarction during phase III rehabilitation].

The active kinesitherapy is an essential constituent of the whole rehabilitation process of patients with infarction. Despite the decrease due to the physiology of ageing and the progression of the coronary disease the physical functional capacity can be kept relatively constant also over many years. Thus the quality of the patients' lives can be favourably influenced. Whether the life expectancy alone can be improved at long date by the active conditioning, further on remains unclarified. Aimed differentiated medication, psychosocial measures, the consideration of secondary bronchopulmonary diseases and the well-timed selection for the coronary-surgical intervention must be included into the process of complex rehabilitation of patients with myocardial infarction. In these cases diagnostics and therapy of the somatic risk factors must particularly be taken into consideration during the whole process of rehabilitation in order to decrease the progressing of the basic disease.

Adult↗
PubMed1984

[A new isotope technic for the determination of residual volume].

A new isotope method for the determination of the residual volume of the lungs by means of stable, non-radioactive nitrogen isotope 15N is described. Normal air is breathed in a closed system. One part of the air nitrogen is replaced by 15N labelled molecular nitrogen. 15N2 physiologically acts like normal nitrogen so that the so-called secondary effects by using He or H2 are eliminated. By combination of a spirograph and an emission spectrometric 15N analyser the residual volume can be determined and mixing curves can be obtained. The determination of the residual volume in 10 healthy persons gives a range of normal values from 19 to 31% of the total capacity. In three persons with emphysema values from 45 to 50% of the total capacity are found. The analysis of mixing curves leads to additional informations concerning the intrapulmonary gas mixing conditions in the lungs. The relative error of the residual volume determination is about 8%.

Adult↗
PubMed1982

[Physical exercise in patients with angina pectoris of effort].

Results of physical training in 37 patients with the ischaemic heart disease with angina of effort are given, 31 one them had had myocardial infarction. Training on bicycle ergometer lasted 2 1/2 to 10 months. After exercise 75% of patients showed enhanced threshold capability, the "double product" (the heart rate x systolic AP) decreased at the expense of the pulse deceleration and decrease of the systolic AP with the standard exercise of 50 W. The maximum size of the "double product" under exercise and also with the appearance of angina remained unchanged. The heart volume after exercises did not change. Changes in haemodynamics depended on the initial functional state of the myocardium, which was evaluated by the degree of rise of the diastolic pressure in the pulmonary artery (DPPA) with 50 W exercise and according to the functional curves of the left ventricle traced by comparing DPPA and the minute volume. In patients with "good" myocardial function (DPPA not lower than 30 mm Hg) after exercises the stroke and minute volumes increased with the threshold exercise, DPPA decreased with 50 W, functional curve of the left ventricle approached the functional curve of healthy individuals. Patients with "bad" function (DPPA over 30 mm Hg and higher did not show) changes in haemodynamics and in the functional curve of the left ventricle.

Adult↗
PubMed1981

[Myocardial scintigraphy with Tc-99m-diphosphonate in patients with coronary heart disease: a comparison with ECG and hemodynamic examinations at rest and during exertion].

In 67 patients, 61 of whom underwent a myocardial infarction and 6 suffered from angina pectoris, myocardial scintigraphy was performed using the technetium-99m-diphosphate (Tc-99m-DP). In 51 patients the ECG and left pulmonary end-diastolic pressure (LPEDP) were investigated additionally at rest and during exercise (bicycle ergometre). A significantly higher occurrence of positive scintigrams was found in cases with marked coronary insufficiency, whereas with the normal ECG findings the negative scintigrams were significantly more often. Increased LPEDP values occurred more often with positive than with negative myocardial scintigrams, especially during exercise. The authors recommend the myocardial Tc-99m-DP scintigraphy for the assessment of the activity of pathologic process after acute myocardial infarction.

Angina Pectoris↗
PubMed1980

[Surface and electrokymography of the ventricular wall of the heart in a comparison of myocardial function in patients with myocardial infarct].

We examined 21 patients with infarction of the anterior or lateral wall and 29 patients with infarction of the posterior wall at an average age of 48.3 years in rehabilitation stage II by means of kymographic methods. By reason of our results the surface kymogramme is a valuable screening method for the recognition of a pathological movement of the ventricular wall in myocardial infarction. The simultaneously performed electrokymographic examinations on patients with myocardial infarction referred to a relatively high proportion of clinically insignificant surface-kymographic findings. Except from this is the surface-kymographic motion paradoxis, which in every case also electrokymographically showed a considerable disturbance of the movement of the ventricular wall in the sense of a dynamic aneurysm of the heart wall after Heckmann with a decreased heart function. A pathological electrokymogramme of the heart wall was to be found only from stage II of the heart function after Roskamm, i.e. with reduction of the contractility of the heart in rest. From this results the clinical significance of the pathological electrokymogramme as reference to a considerable functional disturbance of the myocardium, partly without any subjective complaints present at the time of examination or clinical symptoms of heart insufficiency. The importance of these findings for rehabilitation will be possible only after longitudinal investigations of many years. As preliminary examination for electrokymography in chronic ischaemic heart disease a surface kymogramme is to be demanded, since in an unconspicuous surface kymogramme no indication to electrokymography is given.

Coronary Disease↗