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Biomedical subjects

M Gertsch

Publications and source records attributed to M Gertsch.

At least 19 recordsLinked to original sources
PubMed1992

Prevalence of the Rhesus-negative phenotype in Caucasian patients with small-cell lung cancer (SCLC).

We report that the Rhesus (Rh)-negative phenotype is more prevalent in patients with small-cell lung cancer (SCLC) than in the normal Caucasian population (SCLC: 25% Rh-negative vs. 15% expected, p less than 0.0001). This finding has been validated for a Central and a Northern European population (Switzerland and UK). In contrast, the Rh-negative phenotype is no more frequent in non-small-cell lung cancer patients or in heavy smokers with coronary heart disease than in the general population. There was a normal distribution of the ABO blood group phenotype in all patients studied. Whilst the significance of this observation is unclear, we hypothesize that a genetic predisposition to the development of SCLC may be linked to a hitherto unidentified gene on chromosome 1p near the Rh locus. Our observation may perhaps allow further progress to be made in understanding genetic mechanisms of SCLC carcinogenesis.

ABO Blood-Group System↗
PubMed1992

[Myocardial infarct without classical Q-waves in the ECG].

In this article the ECG pattern of myocardial infarction not associated with the commonly seen pathologic Q waves (greater than 0.03 s) or QS waves is discussed. In a short introduction the differential diagnosis of pathologic Q or QS waves is recalled. Thereafter, the authors insist on their experience, that the diagnosis of infarction should generally be based on the combination of RIsk factors, THOracic pain, a pathologic ECg and elevated cardiac ENzymes. Therefore, the diagnosis of a myocardial infarction should be made only, if it is 'RITHOCGENE' (abbreviation of the above-mentioned combination). The typical or possible 'non-Q-wave infarction' ECG patterns are listed, including a normal ECG.

Aged↗
PubMed1992

[Complementary information from Doppler echocardiography in the electrocardiogram in the basic assessment of chronic coronary heart disease, especially following a myocardial infarct. Observations from an ambulatory cardiology clinic].

In chronic ischemic heart disease, Doppler echocardiography (DE) at rest permits semiquantitative evaluation of scarring and remodelling processes, global ventricular function and, frequently, regional wall motion state. Late complications are detected, namely infarct expansion, true and false ventricular aneurysm, mitral insufficiency, thrombus formation, and associated valvular and aortic diseases are discovered. We studied 100 patients with known chronic coronary artery disease referred for noninvasive evaluation, including electrocardiogram (ECG) and DE. In all patients, the global left-ventricular function was satisfactorily assessable. In roughly two thirds of the documented infarctions. DE confirmed the ECG diagnosis and permitted a more precise diagnosis in the majority of them in terms of localization and/or dimension of the necrosis. In one third of the patients. DE clarified inconclusive ECG tracings. Thus, the baseline noninvasive investigation with ECG and DE is a potent tool in the management of chronic ischemic heart disease, serving as a guide to further investigation and to treatment adjustments.

Adult↗
PubMed1992

Serial chest thumps for the treatment of ventricular tachycardia in patients with coronary artery disease.

Based on excellent results of successive single chest thumping (CT) and serial chest thumping (SCT) for the interruption of ventricular tachycardia (VT) in experimental animals with subacute myocardial infarction, the SCT method was applied for the treatment of VT in patients with coronary artery disease (CAD). SCT was successful in terminating 13 of 19 episodes of VT (68%) in 8 of 14 patients (57%). Conversion of VT was immediate in 9 episodes in 6 patients and latent in 4 episodes in 2 patients. Complications were rare but significant. In one case, SCT resulted in a ventricular asystole and in another case SCT accelerated the rate of VT from 167/min to 242/min, requiring electroconversion. Neither a short duration of VT nor a preserved left ventricular function seemed to enhance conversion by SCT. For interruption of VT in patients with CAD, SCT is not as successful as in the experimental animal model and, therefore, should not be used as a routine method. It may be applied in selected patients under hospital conditions with a standby defibrillator.

Adult↗
PubMed1991

Pregnancy and delivery in a patient with Uhl anomaly.

We followed throughout pregnancy and delivery a 26-year-old woman suffering from a severe form of Uhl anomaly (congenital arrhythmogenic right ventricular dysplasia with severe enlargement and hypokinesis of the right ventricle, tricuspid valve insufficiency, and mild pulmonary valve insufficiency). Despite severely impaired cardiac function, the patient tolerated pregnancy surprisingly well. At 37.4 weeks' gestation, prophylactic low-dose heparin was started. Three days later she delivered a healthy 2700-g girl by elective cesarean performed under intensive cardiac surveillance.

Adult↗
PubMed1990

Myocardial infarction during a football game: empiric estimation of the contribution of skeletal muscle damage to the serum creatine kinase activity.

A 40-year-old untrained participant of a competitive football game experienced chest pain after 20 minutes of playing time. An acute anterior myocardial infarction was diagnosed by electrocardiographic criteria and the creatine kinase rose to its maximum of 3900 U/l (normal range less than 125 U/l) by 24 h with a CK-MB fraction of 6.1%. In order to estimate the contribution of skeletal muscular work to CK activity, the course of CK activity was prospectively measured in 11 untrained participants of a competitive football game, who had normal electrocardiographic findings on exercise testing. Individual peak values of CK correlated positively (p less than 0.01) with the time spent in play. Based on this observation we could estimate that, at most, 14% of the total CK was contributed by skeletal muscle damage in our patient. When total CK was elevated above 125 U/l, the percentage of CK-MB activity did not exceed 6% of total CK in any case. 3-methylhistidine, methylhistidine, an indicator of contractile protein turnover and creatinine were prospectively determined in spot urine samples before the game and for up to 48 h after the game. 3-methylhistidine/creatinine ratios did not change from baseline after the game and no correlation with CK was found. Urine 3-methylhistidine/creatinine, measured within 48 h after a football game, does not contribute to the quantification of skeletal muscle damage.

Adult↗
PubMed1990

[Transitory subclavian steal induced by abnormal position of the arm and producing dangerous myocardial ischemia after mammary artery bypass].

Literature reports only eleven cases of subclavian steal syndrome after CABPG through a left internal mammary artery (LIMA). In 2 asymptomatic patients the diagnosis was established at routine control angiography. In all cases some degree of stenosis of the subclavian artery (SCA) proximally to the emergence of the LIMA was demonstrated and quickly corrected by means of a left carotido-subclavian bypass graft. We report the observation of a patient who presented already at the 11th postoperative day recurrent instable angina with typical ECG changes. This case is absolutely exceptional for two reasons: Postoperative angina appeared exclusively during sleep but never under exercise. Careful interrogation revealed that the patient always slept with his hands crossed under the neck, in a position comparable to the Adson test. In this critical position of the arms, typical attacks of angina and ECG changes could be easily and repetitively induced. A steal syndrome though the LIMA bypass could be demonstrated at coronary angiography and simultaneous measures of the systolic blood pressure on both arms revealed a difference over 20 Torrs which became apparent exclusively in upright position of the arms. All the symptoms disappeared spontaneously within a few months. Six months postoperatively the ECG was normal even in the upright position of the arms and no blood pressure difference could be evidenced anymore. A control coronary angiography showed a patent and well-functioning LIMA graft on the LAD and the absence of any retrograde perfusion of the LIMA graft. These different transitory symptoms have probably to be related to a postoperative compression of the proximal SCA by hematoma or by oedematous reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[ECG and cardiac changes in acute brain injury].

Two case reports and a review of the literature on ECG changes and myocardial damage (subendocardial hemorrhages and focal myocytolysis) in patients with acute brain lesions are presented. The implications and problems associated with these changes are discussed, particularly in relation to the evaluation of potential cardiac transplant donors.

Adult↗
PubMed1989

Conversion of induced ventricular tachycardia by single and serial chest thumps: a study in domestic pigs 1 week after experimental myocardial infarction.

A single chest thump (CT) is widely accepted in the emergency treatment of ventricular asystole, whereas there exists controversy about this method for the interruption of ventricular tachycardia (VT). Hitherto, delivering serial chest thumps (SCTs) has been described only once for the treatment of VT. A systematic analysis for interruption of VT by CT or SCTs (or both) is lacking. We have therefore investigated this subject in five domestic pigs after experimental myocardial infarction. Manual conversion was attempted in 20 induced VTs. Six VTs were converted by CT, seven VTs were converted by the first SCTs, and six VTs were converted by the last of multiple (two to seven) SCTs. The overall success was 95%. There were no serious complications. The rate of successful SCTs exceeded the rate of VT by 10% to 126%. The technique of SCTs, the mechanisms of manual conversion, and the controversial opinions regarding the value of precordial thumping in asystole, VT, and ventricular fibrillation are discussed. SCTs should be practiced only very cautiously in patients until further experience is available.

Animals↗
PubMed1988

Electrocardiographic detection of left ventricular hypertrophy in the presence of left anterior fascicular block.

The hitherto available electrocardiographic indexes for the detection of left ventricular hypertrophy in the presence of left anterior fascicular block do not provide a reliable diagnosis. Consequently, a new index based on the behavior of the QRS complex in left anterior fascicular block in the frontal and horizontal plane was constructed and its value assessed by echocardiographic measurements. The new index SIII + (R + S) maximal precordial greater than or equal to 30 mm was applied to the electrocardiograms of 50 patients without myocardial infarction and without right bundle branch block, showing a specificity of 87%, a sensitivity of 96%, a positive predictive value of 89% and a negative predictive value of 95%. Echocardiographic measurements were used as reference. Compared with the electrocardiographic indexes used so far (which were also applied to the 50 electrocardiograms), the new index showed a comparable high specificity and a distinctly superior sensitivity. The apparent paradox--why the electrocardiographic diagnosis of left ventricular hypertrophy is easier in the presence rather than in the absence of left anterior fascicular block--is discussed.

Adult↗
PubMed1987

[ECG diagnosis of left ventricular hypertrophy associated with a left anterior fascicular block].

The hitherto available ECG indices for the detection of left ventricular hypertrophy in the presence of left anterior fascicular block do not provide a reliable diagnosis. We have therefore constructed a new ECG index, based on vectorcardiographic considerations, and assessed its value by echocardiographic measurements. The new ECG index SIII + (R + S)max precordial greater than or equal to 30 mm, applied to the ECGs of 50 patients without myocardial infarction and without right bundle branch block, showed a specificity of 87.5%, a sensitivity of 96.1% and a positive predictive value of 89.2%.

Bundle-Branch Block↗
PubMed1979

[Echocardiography].

Explore the source record for details and available documents.

Echocardiography↗
PubMed1978

[Ventricular arrhythmias in the acute stage of experimental swine myocardial infarct; effect of the beta blocker pindolol and the calcium antagonist Ro 11-1781].

A study was designed to examine ventricular arrhythmias in the acute phase of experimental myocardial infarction in the pig and to evaluate possible antiarrhythmogenic influence of the beta-adrenergic blocking drug pindolol (Visken) and the calcium antagonist Ro 11-1781. Ventricular fibrillation (VF) occurred in 17 of 18 animals, in 4 almost immediately after coronary occlusion and in 12 with a delay of about 17 min. VF was almost always induced by episodes of ventricular tachycardia (VT) which were started by single ventricular premature beats (VPBs). VPBs occurred in 3 phases, whereas VT and VF coincided only with phase 1 and phase 3. The prematurity index QR/QT of single VPBs decreased significantly with time after coronary occlusion. The beta-adrenergic blocking drug pindolol and the calcium antagonist Ro 11-1781 did not prevent VT or VF.

Acute Disease↗
PubMed1977

[Experimental myocardial infarct in the pig: effect of temporary ligation and revascularization on the ST segment in the epicardial ECG and on the incidence of ventricular fibrillation].

A short period of myocardial ischemia induced by temporary ligation of 2 min duration prior to occlusion of the left anterior descending branch of the left coronary artery (LAD) in the pig does not have a beneficial effect on epicardial ST-segment alterations or on the incidence of ventricular fibrillation. One-stage ligation therefore seems to be the procedure of choice in occluding the porcine LAD. In 14 of 24 animals an isolated alternans of the ST-T segment was observed during the first few minutes of occlusion. Reperfusion after 60 min caused temporary increase of the ST-segment alterations, in contrast to the findings in the dog, where revascularization causes prompt return of the ST-segment to the pre-occlusion level. In addition, ectopic rhythms were frequently observed after removal of ligation.

Animals↗