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Biomedical subjects

J Thormann

Publications and source records attributed to J Thormann.

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

[Complications in the venous system in patients with transvenous implanted pacemakers].

There is a little account in the literature regarding early and late thrombotic complications in connection with permanent pacer application (PPA), although, clinically this is of relevance. Therefore, upper thoracic phlebography (UTP) was carried out 44 +/- 10 months after PPA in 100 consecutive pts with a mean age of 62 years. Sixty-one UPTs were normal, 15 UTPs showed occlusions of the axillary and/or subclavian vein and 24 presented with minor thrombotic changes. Reliable clinical diagnoses had been made in 10 pts only prior to UTP. In addition, 12 pts had UTPs 19 +/- 12 months after malfunctioning electrodes had been severed and each proximal stump left within the venous cavity on occasion of the repeated PPA. Clinical complications in these pts consisted of total occlusion of the superior caval vein in 2 and multiple pulmonic embolism (clinically and scintigraphically) in 3 pts. With the mobile part of the retained electrode above the left brachiocephalic vein inflow in 8 pts, occlusion had taken place in this very region. In addition, the free floating stump of the electrode was found in the pulmonary artery, in the right atrium and the right ventricle, in one pt each.

Adult↗
PubMed1981

[Clinidine-induced bradycardia: studies of the effect on the human sinus node (author's transl)].

Heart rate, atrioventricular conduction, sinus-node recovery time and effectiveness of carotid-sinus massage on heart rate were measured before and every five minutes after intravenous injection of 0.15 mg clonidine (Catapresan) in 11 patients (averaged age 60 years) with symptomatic bradycardia (dizzy spells, syncope, palpitations). Th results indicated the following significant (P less than 0.05) mean maximal effects: heart rate fell by 12% (from 59 to 52/min), capacity of atrioventricular conduction by 9% (from 132 to 121/min), while maximal sinus-node recovery time ("over-drive suppression") doubled (from 1704 to 3562 ms), heart rates of 120, 150 and 200/min being used for diagnostic atrial overdrive stimulation at each five-minute period after clonidine. During clonidine administration three patients developed a so-called hypersensitive carotid sinus reflex, in two patients the effectiveness of carotid sinus massage decreased, in three if increased, while in three it remained normal. It is concluded that (1) during bradycardia, initiated or increased by sympatholytic drugs, tests should be undertaken to exclude latent sinus-node syndrome and (or) hypertensive carotid-sinus reflex; (2) clonidine should not be used in patients with signs of sinus-node dysfunction.

Aged↗
PubMed1981

Skin reactions to a urea-containing cream.

Patch tests with a cream (Calmuril) containing 10% urea were performed on 79 patients with eczematous skin disease; seven (9.9%) had positive tests. Patch tests with the ingredients of the cream were negative. It is suggested that the positive patch test reactions are toxic, due to hypertonicity and acidity of the cream.

Adolescent↗
PubMed1981

Hemodynamics alterations induced by isoproterenol and pacing after aortic valve replacement with the Björk-Shiley or St. Jude medical prosthesis.

Stress evaluation was carried out in 26 patients approximately 7 months after aortic valve replacement with Björk-Shiley valves (13 patients) and St. Jude medical valves (13 patients). During isoproterenol infusion (0.3 micrograms/kg/min), cardiac output increased by a factor of 1.5 and aortic valve area decreased by 50% for both valve groups, while transvalvular gradients (rest: 7 +/- 2 vs 10 +/- 5 mm Hg, p greater than 0.05) increased by 42 +/- 18 vs 51 +/- 18 mm Hg (p greater than 0.05), i.e., to levels of moderate aortic stenosis. However, during pacing stress these values progressively decreased with rising heart rates. In other postoperative evaluations that included ergometric stress with isoproterenol and pacing, induced hemodynamic changes after aortic valve replacement were predictable and consistent with regard to both direction and magnitude, and they differed characteristically according to the type of stress used. We conclude that no functional differences between Björk-Shiley and St. Jude medical valves can be claimed. Standardized evaluation with isoproterenol is a sensitive stress test of prosthetic valvular hemodynamics. Because of the apparent magnification of residual obstruction after aortic valve replacement, it has advantages over pacing.

Aortic Valve↗
PubMed1981

Effects of clonidine on sinus node function in man.

Drugs interfering with sympathetic tone may result in depression of the function of the sinus node, especially in patients with disease of the sinus node. In 11 patients presenting with palpitations, vertigo, or syncope, the heart rate, the recovery time of the sinus node, the carotid sinus pressure slowing, and the atrioventricular conduction capacity were assessed before and every five minutes up to 30 minutes after intravenous administration of 0.15 mg of clonidine. The following significant maximal mean effects were noted at about 15 minutes after the administration of clonidine: the heart rate decreased 12 percent (59 vs 52 beats per minute); and the atrioventricular conduction capacity (ie, paced heart rate at second-degree atrioventricular block) decreased by 9 percent (132 vs 121 beats per minute), while the maximal recovery time of the sinus node increased by a factor of two (1,704 vs 3,562 msec) when atrial overdrives of 120, 150, and 200 beats per minute were used for each five minute period. In analyzing maximal carotid sinus pressure slowing after administration of clonidine, three of 11 patients developed hypersensitive carotid sinus reflex de novo, and two patients showed a decrease and three patients an increase of carotid sinus pressure slowing, while three patients had no carotid sinus pressure slowing both before and after administration of clonidine. We conclude that caution should be taken in administering clonidine to patients with signs indicative of dysfunction of the sinus node.

Aged↗
PubMed1981

A new non-glycoside, non-adrenergic cardiotonic agent AR-L 115 BS. Hemodynamic proof of its efficacy after both i.v. and oral administration.

In 11 patients with New York Heart Association (NYHA) functional class III-IV symptoms we monitored the effect of 2-[(2-methoxy-4-methylsulfinyl)phenyl]-1H-imidazo[4.5-b]pyridine (AR-L 115 BS). Heart rate (HR), pulmonary arterial mean pressure (PAM), aortic systolic pressure (AoSP) and thermodilution cardiac output (CO) were measured before and up to 25 min after a bolus of AR-L 115 BS, 3 mg/kg body weight, i.v. The oral effect of AR-L 115, 200 mg, 3 times daily, was monitored in 18 patients with congestive cardiomyopathy (CC) over a period of 4 days. AR-L 115 BS is also orally active and thus is a very promising inotropic agent for the treatment of chronic heart failure in man.

Administration, Oral↗
PubMed1981

[Hemodynamics and metabolic-energetic expenses of the influence of AR-L115 in patients with coronary artery disease (author's transl)].

AR-L115 has been shown to substantially improve myocardial pump function in patients (pts) with advanced congestive cardiomyopathy by i.v. and by p.o.-route. Since AR-L115 effects on myocardial oxygen consumption (MVO2) and coronary blood flow (CSF) are unknown, the hemodynamic myocardial metabolic and ECG-responses to AR-L115 (2 mg/kg BW bolus) were monitored at the 9, 14 and 19-min interval in 7 patients coronary 3-vessel disease, exhibiting ischemia during pacing stress only. Maximal responses occurred at the 14th min after AR-L115. THere were (average) increases in cardiac index by 30%, in heart rate by 19%, in CSF by 39%, in MVO2 by 34%, and in dp/dt max by 27%. There were (average) decreases in peak systolic pressure by 13%, in PCW by 30%, in LVEDP by 42%, in systemic vascular resistance by 34%, and in coronary vascular resistance by 37%. All changes were significant (p less than 0.05). Unchanged (p greater than 0.05) remained myocardial lactate extraction, stroke work index, and stroke-index. The only moderate increase in MVO2 is possibly explained in that the increase in contractility was a least partially offset by the reductions in pre- and after load. The AR-L115-induced improved pump function was accompanied by moderate increases in MVO2 and CSF, but without evidence of myocardial ischemia.

Cardiac Pacing, Artificial↗
PubMed1981

Echocardiographic identification and analysis of function of the St. Jude medical heart valve prosthesis.

The St. Jude medical (SJM) heart valve prosthesis presents a new bi-leaflet design which in preclinical evaluation exhibited favourable haemodynamic characteristics. Therefore clinical trials started in February 1978. The entire valve is made of pyrolytic carbon which has a poor X-ray visibility and therefore an alternative for the noninvasive routine control of valvular function and postoperative follow-up had to be found. Experimental studies in a left heart simulator provided adequate echovisualisation of both leaflets, however, depending on the direction of their motion in relation to the echobeam. Identification of both leaflets and an analysis of their motion was possible with a transducer at right angles to the leaflet axis. The experimental data were confirmed by clinical observations after implantation of the SJM prosthesis in patients. Based on the information obtained, we are providing recommendations for the implantation of the SJM prosthesis in order to achieve optimal echocardiographic visualisation of the valve and its moving parts in the postoperative follow-up.

Echocardiography↗
PubMed1980

Oral sodium cromoglycate in chronic urticaria.

Fifteen patients were included in a double-blind cross-over trial to investigate the efficacy of oral sodium cromoglycate in the treatment of chronic urticaria. Only patients with positive oral provocation tests were entered into the study. The challenging agents were food additives or antirheumatic agents. Treatments were taken for 4 weeks and the dose of sodium cromoglycate was 200 mg four times daily. No significant differences were found between active and placebo treatment periods for diary card symptom scores. Six patients preferred the active treatment, two preferred placebo and seven had no preference. The clinician showed no preference for either treatment.

Administration, Oral↗
PubMed1980

Contact allergy to idoxuridine. Sensitization following treatment of herpes zoster.

A total of 45 of 60 patients with herpes zoster previously treated with topical idoxuridine 5-40% in dimethylsulfoxide were patch tested 2 years later with idoxuridine 0.5% and 5% in petrolatum. Three (7%) showed positive reactions. Idoxuridine is considered a weak sensitizer, but in strong concentrations and in active solvents, which increases absorption, there seems to be a risk of sensitization.

Adolescent↗
PubMed1980

Aquarium-borne Mycobacterium marinum granulomas.

Mycobacterium marinum was isolated for the first time in Denmark from skin granuloma of a 37-year-old man. The skin lesion was provoked by an injury from the broken glass of an aquarium used for tropical fish. Treatment with rifampicin and ethambutol was successful. At the time of diagnosis, M. marinum was also isolated from a dead fish; but in no case was skin granuloma found among purchasers of fish supplied by the patient.

Adult↗
PubMed1980

[Reproducibility of sinus node recovery time in relation to the time of the day and the overdrive stimulation rate (author's transl)].

Corrected sinus node recovery time (CSRT) was tested in 9 patients with (CSRTI) and 6 patients without sick sinus syndrome = SSS (CSRTII) at 6 constant time intervals each, on 3 consecutive days using 5 rates of atrial overdrive stimulation (AST) via a stable loop mounted atrial electrode. From the results presented it can be concluded: CSRTI is reproducible with high rates when corresponding time periods and the same AST rate are used. A stepwise CRST increase by 60% is consistent up to AST 140 bpm only; up to AST 200 bpm the pattern varies within maximal pathological CSRT ranges for each of the 6 time periods measured, as an expression of influences unidentified in this study. The implication is: For an optimal diagnostic yield in CSRT testing several AST rates above 140 bpm are required and the time intervals of 17 and 8 hours represent a "high" and at 14 hours a "low" for CSRT testing; there are factors, other than the sinus node dysfunction, that added to the pathologic significance of the CSRT.

Adult↗
PubMed1979

Urinary histamine in severe atopic dermatitis.

Urinary histamine was studied in 11 patients with severe atopic dermatitis and 17 controls, as well as in seven atopics prior to and 6 months following hyposensitization. No statistically significant differences were found between the groups. Urinary histamine seems to be of no value as an indicator of disease activity in atopic dermatitis.

Adolescent↗