Biomedical subjects
Publications and source records attributed to M Fuchs.
The hypothesis is promoted that the arterial vessel can modulate the response to atherogenic factors. Patients with the same index of atherogenic factor may have different degrees of arteriosclerosis. The verification of this thesis needs a prospective study. The second fact described is the diminished experimental arteriosclerosis after treatment with the calcium antagonist Nifedipine (Corinfar).
In twelve patients with coronary heart disease and hemodynamically significant coronary artery stenoses (LAD: 11, LAD plus RCA: 1) the effect of intracoronary nifedipine, 0.2 mg, on PTCA-related myocardial ischemia was evaluated. The severity of angina pectoris during balloon inflation was not significantly reduced by nifedipine, whereas the sum of ST segment alterations in Einthoven and Goldberger leads on inflation was significantly decreased by the drug. Before inflation intracoronary nifedipine lowered the systolic arterial blood pressure significantly, whereas diastolic and mean aortic pressure and heart rate remained unchanged. At the end of the inflation period heart rates were significantly faster after nifedipine, and the heart rate-blood pressure product higher with nifedipine. No significant correlations could be calculated between the extent of ST segment alterations and any of the hemodynamic parameters. From our results we conclude that, besides the possibility of ventricular afterload reduction, the beneficial cardioprotective effect of intracoronary nifedipine may mainly be attained by the local "cardioplegic" action of this substance.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
72 patients with supraglottic carcinomas were stratified into two groups with similar cancerological data. 36 underwent horizontal and 36 total laryngectomy. Both groups were radiated postoperatively. In N0, elective neck dissection was omitted. Superior survival was achieved in patients after total laryngectomy. Recurrence rate in the neck for both groups was 6%. There was considerable morbidity after horizontal laryngectomy with aspiration being the main factor. 30.6% of the patients were unable to swallow at all and 30% had a permanent tracheostomy because of laryngeal stenosis. Technical modifications of horizontal laryngectomy including a change in postoperative radiotherapy as described seem to provide better functional results.
The influence of adenoidectomy, myringotomy and lavage of the middle ear was studied in children suffering from secretory otitis. The children were controlled by audiograms and tympanograms over a one-year period of time. 89 percent of all children showed normal values one year following surgery, 11 percent had still high negative middle ear pressures and conductive hearing loss. We think that these children only are candidates for ventilating tubes (grommets).
In 17 anaesthetized open-chest pigs, experiments were performed to determine if a myocardial protective effect can be obtained by intracoronary perfusion through the dilatation catheter during balloon inflation for percutaneous transluminal coronary angioplasty. Placement of the catheter such that the balloon lay in the middle third of the left anterior descending coronary artery caused a significant deterioration in haemodynamic status prior to balloon inflation, and on 5 occasions led to the development of ventricular fibrillation (VF). Balloon inflation without perfusion for periods of up to 5 min produced further haemodynamic deterioration, and culminated in VF in 4/14 cases. Simultaneous perfusion during balloon inflation (proximal perfusion pressure 900-1200 mmHg), with flow rates of 14.5 ml min-1 for arterial whole blood and 21 +/- 7 ml min-1 for blood diluted with 0.90% NaCl (haematocrit approx. 25%), not only prevented the haemodynamic deterioration but resulted in an improvement compared with values obtained with the catheter in position prior to balloon inflation. In no case did VF occur during 5 min of balloon inflation plus perfusion. The use of diluted blood as the perfusate was not associated with intracatheter thrombus formation, which was sometimes seen as a complication of whole blood perfusion.
Explore the source record for details and available documents.
Palpebral fissure length and head circumference were measured in 170 black and 170 Hispanic normal children aged 1 month to 16 years. Eye measurement values were compared with those for white children. It was found that black children have longer palpebral fissures than whites and in certain age groups, than Hispanics. A statistically significant correlation between palpebral fissure length and head circumference was established in black children.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Changes of collateral perfusion pressure (CPP) and segmental coronary resistances during reactive hyperemia were studied in nine chloralose-urethan-morphine anesthetized open-chest dogs. Coronary perfusion pressure was controlled by a cannula in the left main coronary artery and inflow measured by an electromagnetic flowmeter. The first or second diagonal branch of the left anterior descending coronary artery was cannulated and perfused from a carotid artery; inflow was abolished by embolization with latex microspheres (diameter: 25 +/- 5 mu) and peripheral coronary pressure was assumed to represent CPP. Segmental coronary resistances were defined as follows: Proximal coronary resistance (R1) was calculated from the difference between coronary perfusion pressure and CPP divided by coronary inflow. Distal coronary resistance (R2) was calculated from CPP divided by coronary inflow. Reactive hyperemia was produced by interruption of coronary inflow for 15 s and analysed at 30 s and 60 s of reperfusion when cardiac function had recovered. At baseline, R1 was 0.52 +/- 0.04 mm Hg X min X 100 g/ml (RU) and R2 0.63 +/- 0.07 RU. At 30 s, R1 was reduced by 19 +/- 3% (P less than 0.01) this was less (P less than 0.05) than R2 which was reduced by 32 +/- 3% (P less than 0.01). At 60 s R1 and R2 were reduced by 11 +/- 2% and 13 +/- 2%, respectively; this was not significantly different. Accordingly, CPP (baseline: 59 +/- 4 mm Hg) at 30 s was reduced by 7 +/- 2% (P less than 0.03), at 60 s the reduction was not significant. The data suggest that reactive hyperemia, as a model of metabolic coronary dilatation, may reduce CPP equivalent to a coronary steal phenomenon.
Explore the source record for details and available documents.