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Biomedical subjects

J Thormann

Publications and source records attributed to J Thormann.

At least 127 records · Page 7Linked to original sources
PubMed1977

Effects of nitroglycerin, postextrasystolic potentiation, and pacing-induced ischaemia on wall motion in patients with ischaemic heart disease.

The influence of nitroglycerin, postextrasystolic potentiation, and rapid ventricular pacing on total and regional ventricular function was studied in 32 patients with normal ventricular function and in 44 patients with left ventricular asynergy caused by obstructive coronary artery disease. Total ventricular function was assessed by ventriculography and regional ventricular function was analysed by use of 7 hemiaxes. Nitroglycerin increased ejection fraction and decreased left ventricular systolic and end-diastolic pressures in the normally functioning ventricles; apical wall motion increased, while basal wall motion remained unchanged after nitroglycerin in these ventricles. Pressures fell significantly in ventricles with asynergy after nitroglycerin; ejection fraction decreased while wall motion in asynergic areas was inconsistently influenced. Postextrasystolic potentiation augmented ejection fraction by a powerful and homogeneous increase of wall motion in normally functioning ventricles. Asynergic areas and normal areas in diseased ventricles showed identical augmentation of wall motion after a premature beat. Rapid venticular pacing produced a significant increase in end-diastolic pressure and a fall in ejection fraction in patients with obstructive coronary artery disease. Wall motion in normal areas perfused by arteries with critical stenoses was dramatically depressed after pacing, while asynergic areas and normal areas perfused by normal arteries remained unchanged. The results show that normal contractile behaviour can be detected by postextrasystolic potentiation in asynergic areas, suggesting that some normally perfused muscle exists in these areas. Pacing stress does not further deteriorate function in asynergic areas, which suggests the presence of viable and well perfused muscle (within scar tissue) whose function may not profit from revascularization. Pacing-induced asynergy identifies the functional significance of coronary stenoses and suggests that bypass surgery might be beneficial.

Cardiac Volume↗
PubMed1977

[Left ventricular ejection and ejection reserve during isoproterenol infusion in hypertrophic obstructive cardiomyopathy (author's transl)].

In 10 patients with hypertrophic obstructive cardiomyopathy (HOCM) and in 10 patients without heart disease (normals) left ventricular function and myocardial reserve under isoproterenol (Iso) infusion (0.3 microgram/kg B.W./min) were measured. From the monoplane cineangiography of the left ventricle diastolic wall thickness as well as ejection phase contractile indices, ejection fraction (EF) mean velocity of fiber shortening (VCF) and mean normalized systolic ejection rate (MNSER), were calculated. Maximum total load (TL) served as measure for afterload. Wall thickness in HOCM was higher by 73% as compared to normals (p less than 0.001). Hemodynamic values for normals at rest were as follows: EF 68.9 +/- 8.0%, VCF 1.22 +/- 0.19 circ/sec, MNSER 2.25 +/- 0.25 vol/sec and TL 228.6 +/- 37.4 dynes . 10(5). Values for HOCM at rest were as follows: EF 77.4 +/- 7.71% (p less than 0.05), VCF 1.53 +/- 0.3 circ/sec (p less than 0.05); MNSER 2.66 +/- 0.35 vol/sec (p less than 0.01) and TL 288.5 +/- 55.5 dynes . 10(5) (p less than 0.01) as compared to normals. The values under Iso in normals resulted in a significant fall of the TL (p less than 0.05), the enddiastolic volume (EDV, p less than 0.05) and of the enddiastolic pressure (EDP, p less than 0.05), VCF rose by 89% (p less than 0.001), MNSER by 66% (p less than 0.001) and EF by 23% (p less than 0.001). In HOCM under Iso TL rose by 45% (p less than 0.05), EDV and EDP did not change (p less than 0.05), VCF and MNSER rose by 23% (p less than 0.05 respectively p less than 0.01). VCF and MNSER in HOCM with Iso were reduced by 17% respectively by 13% (p less than 0.01) as compared to normals, the EDP was increased by factor 4, while EDV showed no significant difference (p less than 0.05). Our results indicate that the left ventricle in HOCM in spite of its marked hypertrophy is unable to adequately compensate for an acute gain of afterload as induced by the effect of catecholamines. Therefore, we assume stress-related congestive symptoms in HOCM to be caused--aside from other mechanisms--by diminished ejection reserve.

Adult↗
PubMed1977

Pachyonychia congenita Jadassohn-Lewandowsky: a disorder of keratinization.

A 15-month-old boy with pachyonychia congenita is described. The patient also had follicular keratosis, leukokeratosis of the tongue, and blisters on the soles. Histopathological examination of the follicular keratosis showed hyperkeratosis and acanthosis. Horny plugs were located in sweat pores. By electron microscopy abnormal keratinization was demonstrated.

Darier Disease↗
PubMed1977

Evaluation of implanted faulty demand pacemakers by magnet waving and electrical chest wall stimulation. A report of clinical experience.

15 different models of implanted demand pacemakers (61% Cordis models) in 156 patients were scrutinized owing to an announcement that had identified 3 faulty Cordis series and, as a consequence, had provoked considerable uncertainty among all pacemaker patients in the community. Malfunctions of the sensing, and reed switch mechanisms as well as changes in pacers' refractory periods were excluded by the electrical chest wall stimulation (ECWS), magnet waving (MW) or a combination of both. That those models suspected of malfunction show merely a drop in rate was verified. Established patterns of early rate drop guided the exchange for new units: no abrupt or complete rate drop occurred and no patient was lost. The application of indirect overdrive revealed that the blocking capacity for rapid rates was in Omni-Ectocor units less reliable than in Ectocor units. The characteristic reactions to MW and ECWS of the 15 demand pacemaker models were determined. Because both methods proved to be as easy to apply as they were beneficial for the follow-up, also in the uncommon situation created by the Cordis announcement, the application of both of these methods on a routine basis in pacemaker clinics is advocated.

Aged↗
PubMed1976

[The effect of the collateral circulation on the total and regional myocardial function in coronary disease].

The cinecoronarograms, ventriculograms and electrocardiograms of 164 consecutive patients (32 patients without heart disease and 132 patients with coronary artery disease) have been analyzed. Total left ventricular function was assessed by the ejection fraction. Regional myocardial function was determined by a system of hemiaxes. 89 patients with complete obstruction of the right coronary artery (RC) and/or the anterior descending branch of the left coronary artery (LAD) were divided into subgroups with good, poor and no coronary collaterals. Total and regional left ventricular function was normal in patients with well collateralized coronary occlusions. Patients with poorly collateralized or non-collateralized occlusions had impaired left ventricular function. Patients with poorly collateralized coronary occlusions showed no difference in left ventricular function when compared to patients with coronary occlusions without collaterals. Combined occlusions of the RC + LAD without collaterals were not found. Good coronary collaterals have a protective effect on total and regional myocardial function, thus improving the prognosis in complete coronary artery obstruction.

Cardiac Output↗
PubMed1976

[Atrial flutter with an audible atrial sound (author's transl)].

In a case of rheumatic valve disease atrial sounds could be heard and recorded on the phonocardiogram during atrial flutter at a rate of 260/min and an atrioventricular block of 3:1 and 5:1. The atrial flutter sounds were also recorded in the apex-cardiogram and as a slight but rapid motion of the anterior mitral valve leaflet in the echocardiogram. These atrial sounds were recorded both in systole and diastole and disappeared after cardiac failure had been treated and sinus rhythm restored. This case and 19 others reported in the medical literature indicate that for atrial sounds to become audible requires high-grade atrioventricular block and increased atrial contractions with increased ventricular filling. The sounds have been proven to originate in the atrium, the characteristics of the sound being similar to those of an opening snap.

Atrial Flutter↗
PubMed1976

Clinical trial comparing hydrocortisone 17-butyrate to betamethasone 17-valerate in a series of patients with eczematous skin diseases.

A randomized, double-blind, left-right comparative study was carried out to compare the value of hydrocortisone 17-butyrate with that of betamethasone 17-valerate in the treatment of eczematous skin disorders. In a series of 23 patients with such disorders, no differences between the two preparations was demonstrated with regard to effectiveness.

Administration, Topical↗
PubMed1976

Long-term observations of cardiac arrhythmias during and after cardiac surgery. I. Acquired heart disease.

Twelve arrhythmias that occurred during and following surgery for acquired heart disease were studied in a group of 52 randomly selected patients. In cases of aortic and mitral valve replacement, Björk-Shiley prosthetic valves were used, and procain-magnesium-aspartate solution was applied for cardiac arrest. Registration and analysis of rhythm disturbances were carried out at 10 different time intervals, spaced narrowly in the intra-and early postoperative phases, then more widely up to the 96th hour of observation. Arrhythmic incidence and occurrence per case and phase are given, thereby allowing an account of transient arrhythmias as well. The peak occurrence of serious rhythm disturbance was found, intraoperatively, at about the time of aortic cross-clamping and release (ischaemic effect) with the exception of the mitral-commissurotomy group. The 1st-6th postbypass hours showed an arrhythmia trough, followed by a 2nd peak (9th-96th postoperative hour) made up of less serious arrhythmias (electrolyte- and acid-base disturbances; digitalis effects). All 12 arrhythmia types, as well as the five separately considered ventricular arrhythmias of the "first arrhythmia peak", did not reveal any significant relation to: patients' age, N.Y.H.A. criteria, pre-operative PAm or the duration of anaesthesia, surgery and bypass time.

Adult↗