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Biomedical subjects

J Vogt

Publications and source records attributed to J Vogt.

At least 163 records · Page 9Linked to original sources
PubMed1980

[Qualitative and quantitative investigations in supravalvular aortic stenosis by cross-sectional echocardiography (author's transl)].

45 patients with supravalvular aortic stenosis (SVAS) were investigated by cross-sectional echocardiography from a total number of 164 patients observed in Göttingen. In 44 cases the diagnosis of SVAS could be confirmed by this noninvasive method. There was a good correlation between the ratio of the echo-circular surface (aortic anulus and the point of maximal obstruction) and the ratio of the angio-circular surface, as well as the ratio of the echo-circular surface and the measured pressure gradient. Cross-sectional echocardiography is therefore a valuable noninvasive method for evaluating SVAS and for estimating the severity of obstruction.

Adolescent↗
PubMed1980

[Late results after Rastelli correction in transposition of the great arteries (author's transl)].

From 1974 to 1978, 11 patients underwent a Rastelli correction in transposition of the great arteries with VSD and obstruction to the pulmonary artery. 2 patients died, a mortality of 18%. All patients received a Hancock-conduit. On the average of 30 months after the operation, a complete heart catheterisation was performed. In 6 patients--55%--there was no or only a mild gradient between the RV and AP (Gradient under 40 mm Hg). 3 patients (27%) developed a considerable obstruction to the pulmonary artery (gradient over 70 mm Hg) proximal, valvular, or distal. Subaortic obstruction was not observed. 3 of the 9 patients had a residual VSD, detectable by oxymetry, 1 with a flow ratio of 1.8, which required surgery (successfully closed).

Adolescent↗
PubMed1979

[Newborn cardiotoxicity after tocolysis with fenoterolhydrobromide].

In the clinical treatment of imminent premature birth, sympathomimetic amines have greatly increased in importance as an interruptor of labor pains. The purpose of this report is to discuss the clinical findings on the basis of 30 newborns admitted to our hospital (between April 1977 and June 1978) after long-term treatment of the mother and Fenoterol (Partusisten). The predominant clinical findings were: tachycardia, paroxysmal dyspnea, cyanosis, metabolic acidosis, congestive heart failure and, in the ECG, cardiac arrhythmias and T-wave inversions in the left precordial chest leads. A high correlation was found between the clinical degree of alteration and changes in both the ECG and the VCG. In all patients these changes have normalized within 8 weeks. The histological findings of 3 deceased newborns revealed typical although not specific features such as: polyploid cells especially in the subendocardial region and a streamlined fatty degeneration of the myocardium. These findings, however, cannot prove with certainty the cardiotoxic effect of Fenoterol on the myocardium, but it appears possible that an especially high dosage of Fenoterol given i. v. can cause myocardial complications. Our findings suggest that catecholamin derivates should be applicated only with extreme caution.

Acidosis↗
PubMed1979

[Connatal leukaemia and pseudoleukaemia--two cases with cytochemical findings (author's transl)].

Two newborn infants with hyperleukocytosis and blast cells in the peripheral blood are compared. Case 1 represents a connatal leukemia, which could be characterized as monocytic by the naphthol-ASesterase reaction, which was inhibited by NaF. The child died after a few hours. Case 2 must be diagnosed as "pseudoleukemia" in mongolism. The blast cells were classified as lymphoblastic on the basis of a strong granular beta-glucuronidase reaction. The patient achieved spontaneous remission.

Diagnosis, Differential↗
PubMed1978

[Cardiomyopathy in Duchenne muscular dystrophy. Part 2: serum enzymes, vector-cardiography, and echo-cardiography in 143 patients (author's transl)].

To diagnose a possible latent or manifested cardiomyopathy, 143 male patients between 2 and 21 years of age with confirmed Duchenne muscular dystrophy were examined for serum enzymes, by electrocardiography, vector-cardiography, and echo-cardiography. The results contain information on 1. the quantitative cellular myocardial degeneration process, 2. the disturbed cellular depolarization and nerve-conduction processes in the area of the right and left ventricular myocard, and 3. the disturbed left ventricular function which, in the initial state, is only documented by a discrete decrease of contractility caused by a manifested decreased ejection output. The pathological contraction and relaxation process of the heart muscle cell and its dependency on calcium ion transport as pathogenic background is discussed.

Adolescent↗
PubMed1978

[The comparative hemodynamic effects of antiarrhythmic drugs in acute myocardial infarction (comparison of propafenone and lidocaine) (author's transl)].

Hemodynamic changes after single intravenous injection of antiarrhythmic doses of propafenone (70 mg) and lidocaine (100 mg) were measured comparatively in 11 patients with acute myocardial infarction, stable cardiac rhythm and without evidence of manifest left heart failure. The effects of propafenone were characterized by a significant decrease of cardiac index by 6% and an increase in left and right ventricular filling pressures by 15% and 23%. Mean arterial pressure was significantly lowered (8%) and left ventricular stroke work index decreased by an average of 11%. Mean pulmonary artery pressure significantly increased by 7%. A fall in systemic vascular resistance by 7% was not statistically significant. Intravenous administration of propafenone at a dose of 70 mg thus caused a transitory decrease in ventricular function and acute vasodilation with a fall in systemic blood pressure. The intravenous administration of lidocaine did not result in significant changes of cardiac index or left and right ventricular filling pressures. Mean pulmonary artery pressure, systemic blood pressure and vascular resistance increased significantly.

Aged↗
PubMed1977

[Angiocardiographic and vectorcardiographic findings in Noonan's syndrome (author's transl)].

The angiocardiographic and vectorcardiographic findings in 18 patients with Noonan's syndrome are presented. The excentric hypertrophy of the left ventricle affecting the superior portion of the anterior wall, the posteroinferior portion and the septum was primarily investigated. The predominant lesion was left ventricular deformity. In one case only a hemodynamic burden was caused by the excentric hypertrophy. It could be demonstrated that angiocardiographically and vectorcardiographically differentiation between idiopathic hypertrophic subaortic stenosis and excentric hypertrophy in Noonan's syndrome is impossible. A good correlation however, existed between the morphological structures and the angiocardiographic aspect as well as the vectorcardiographic findings. If hemodynamic burden of the left ventricle is present, identical therapy is proposed for Noonan's syndrome as for idiopathic hypertrophic subaortic stenosis. Left heart catheterization is therefore indicated to prove excentric hypertrophy.

Adolescent↗
PubMed1977

Thiamphenicol in treatment of Haemophilus influenzae meningitis.

17 infants and children with pyogenic meningitis (14 Haemophilus influenzae, 2 Diplococcus pneumoniae, 1 Neisseria meningitidis) were treated with thiamphenicol, 100 mg/kg body weight/day in 4 doses i.v., as single drug. In the H. influenzae group 10 patients were cured, 4 had relapses of meningitis, 3 with documented subdural effusions. This group is compared with 14 children matched for age, initial leucocyte and CSF cell count treated with ampicillin: all of these were cured, 1 had a subdural effusion. Thiamphenicol concentrations were determined in the serum and CSF 2 h after administration. The mean serum levels were between 10-12 mcg/ml, the mean CSF levels varied from 5.4 mcg/ml at the beginning to 1-1.9 mcg/ml at the end of meningitis. The MIC of H. influenzae was 0.6-12 mcg/ml. A significant, acute, and dose related bone marrow toxicity of thiamphenicol could be documented, but was always rapidly fully reversible. We conclude that thiamphenicol cannot replace chloramphenicol in the treatment of pyogenic meningitis as single systemic antibiotic. Special indications for thiamphenicol in this disease are discussed.

Adolescent↗
PubMed1975

[Severe light dermatosis following photo therapy in a newborn infant with congenital erythropoietic urophyria].

A newborn infant with hemolytic anemia and hepatosplenomegaly was treated by phototherapy for early jaundice. After 18 h, a dark brown pigmentation of the skin was noticed, leading to the assumption of a bronze baby syndrome. Indeed, the child was suffering from a severe disturbance of liver function. 4 days later, a severe bullous dermatosis with blody imbibition developed, covering all exposed parts of the body surface and reoccurring in many bursts over several weeks despite protection against light. A severe hemolytic anemia was constantly present. The baby died on the 50th day. The diagnosis of erythropoietic porphyria was suggested immediately after the onset of the bullous exanthema and proved by laboratory data as follows: uro- and coproporphyrin in the urine were extremely high, uroporphyrin being mainly of type-I isomer. In red cells, increased amounts of uro-, copro- and protoporphyrins were detected. Massive red fluorescence of erythroblasts (so-called porphyroblasts) in the bone marrow and in the blood could be observed. At autopsy, the liver showed multiple blood-forming areas and severe diffuse hemosiderosis, which is to be explained by a long existing, i.e. fetal hemolysis. Erythropoietic porphyria is such a rare disease that there is no reason to consider it as a general contraindication for phototherapy.

Bone Marrow Diseases↗
PubMed1975

[Congenital mitral stenosis. Report on 33 patients].

Thirty-three patients with congenital mitral stenosis are presented. Congenital mitral stenosis occurs as an isolated malformation and in combination with additional cardiac lesions. A new classification into 5 groups is suggested. It is possible to classify congenital mitral stenosis with and without additional lesions according to these 5 groups. This is of particular clinical advantage. Isolated congenital mitral stenosis is a rare malformation. In combination with additional obstructive left-sided cardiac malformations mitral stenosis occurs more frequently. In infancy and early childhood the so-called parachute valve is a stenotic lesion. According to our experience the parachute valve tends to the development of additional mitral incompetence in older children. This observation is of clinical and diagnostic importance. In patients with additional valvular aortic stenosis the mortality is very high. The operative treatment of congenital mitral stenosis with a parachute valve in combination with other obstructive lesions of the left ventricular outflow tract and the aorta without removal of the parachute valve seems to be unable to improve the hemodynamic situation and the prognosis of these patients. There is not enough experience with artificial valves in congenital mitral stenosis in early childhood.

Adolescent↗
PubMedDate not supplied

Discrete subaortic stenosis: the value of cross-sectional sector echocardiography in evaluating different types of obstruction.

The value of cross-sectional sector echocardiography in the visualization of discrete subaortic stenosis (DSS) was investigated using an 80 degrees phased-array sector scanner with simultaneously derived M-mode outputs. Thirty-three patients (including 22 postoperative patients) with proven DSS were investigated and divided into two groups: group I--discrete membranous type; and group II--diffuse fibromuscular type. In group I (15 patients), two isolated subaortic ridges were identified as discrete linear echoes in the long axis of the outflow tract in five patients. A single distinct and isolated linear echo was observed in three patients, whereas in another five the ridges appeared to be attached to the ventricular septum and/or to the base of the anterior mitral leaflet. In two patients with mild DSS, a false-negative diagnosis was made. Only 2 out of 12 patients in this group showed a short remnant of the ridge after surgical revision. In group II, a more generalized or long-segment narrowing was present in 18 patients; in 14 of them the ridges were continuous with the walls of the outflow tract. Eight out of ten patients reexamined following resection of fibromuscular tissue still had residual obstruction. Analysis of the simultaneous M-mode recordings revealed that the transient appearance of the ridge in the outflow tract depended on the normal movement of the heart within the chest, on the lengthening of the membrane itself, and on the angle between the ultrasound beam and the membrane during different cardiac cycles. Our study shows that a spectrum of one- and two-dimensional patterns exists depending on the nature of the obstructing lesion. Cross-sectional sector echocardiography provides more direct visualization and characterization of various types of DSS than M-mode echocardiography does.

Adolescent↗
PubMedDate not supplied

A decade of staged Norwood palliation in hypoplastic left heart syndrome in a midsized cardiosurgical center.

Hypoplastic left heart syndrome (HLHS) is a challenge for the pediatric cardiologist and the surgeon. It is generally assumed that the postoperative outcome after surgery for congenital heart disease is influenced by the institutional size. We present the results of 43 patients with true HLHS (situs solitus and atrioventricular and ventriculoarterial concordance) referred for operation between 1992 and 2002 in our center. Two children had atrioseptostomy: one died soon after the operation, and the other one was transplanted successfully but died at the age of 6 months following acute rejection. The remaining 41 underwent Norwood I palliation, 21 stage II palliation, and 10 stage III palliation. Early mortality was 29% after stage I operation, 4.7% after stage II palliation, and 0% after stage III operation. Overall mortality was 39% after stage I, 9.5% after stage II, and 10% after stage III operation. Low birth weight was associated with a higher mortality (p < 0.05). Mortality declined with increasing experience, comparable to the results of very large cardiosurgical centers with many more patients. The quality of surgery and perioperative management in smaller pediatric cardiosurgical centers can reach the level of very large centers.

Germany↗