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Biomedical subjects

M Hoffman

Publications and source records attributed to M Hoffman.

At least 235 records · Page 13Linked to original sources

[Early results of surgical treatment of patients with Wolff-Parkinson-White syndrome].

Successful dissection of accessory pathways (AcP's) was performed in 19 of 20 patients. 15 pts had single, 4 double and 1 patient had 3 accessory pathways (AcP's). The patient with 3 AcP's was operated twice. During the first operation two AcP's were eliminated. The third one was revealed during the postoperative electrophysiologic study. Verapamil facilitated its manifestation and localisation. No patient had syncope or atrio-ventricular tachycardia after the operation. In 3 of 10 patients who had atrial fibrillation before the operation, episodes of AF occurred in the early postoperative period. Conduction to the ventricles was through the normal conduction system. Dissection of AcP's prevented extremely fast ventricular response and syncope. After discontinuation of amiodarone more frequent ventricular premature beats occurred in patients with long history of cardiac arrhythmias, on drugs for a long time and in patients who had heart dilatation. Several months after the operation VEB were less frequent, probably because tachycardias did not occur, left ventricle geometry improved, and cardiodepressant drugs were discontinued. Previously these patients had been treated usually with combination of 2-3 such drugs. After the successful dissection of AcP's the patients lost the feeling of illness and do not feel being imperilled. Children can attend schools normally and some adult patients resumed their professional activities.

Adolescent↗

[Electrocardiography of high resolution in the diagnosis of arrhythmogenic dysplasia of the right ventricle].

UNLABELLED: To assess the diagnostic value of high resolution ECG in ARVD which is a rare and diagnostically difficult disease, cardiac micropotentials were evaluated in 32 pts with ventricular arrhythmias with LBBB pattern and right axis deviation. Typical ECG-, ECHO-, angiographic features of ARVD were found in 9 pts (mean age 36 y, VT 8 pts, MAS-5). Normal right ventricle (NRV) (Echo, Tc99) was seen in 23 pts (mean age 36 y, VT-14 pts, MAS-6). 25 healthy man (mean age 28 y) served as control (C). RESULTS: [table: see text] Morphology of total QRS complex in pts with ARVD, comparing to NRV pts and C, was exceptionally characteristic: it was composed of high frequency notches seen not only as prolonged LP but also within fundamental QRS complex. CONCLUSION: In pts with ARVD beside presence of LP, significantly prolonged TVAT and characteristic notches within QRS complex are observed, therefore the high resolution ECG is a promising method in noninvasive diagnosis of ARVD.

Adult↗

[Clinical and electrophysiological indications for surgical treatment in patients with Wolff-Parkinson-White syndrome].

20 patients with WPW syndrome and recurrent tachyarrhythmias were studied clinically and electrophysiologically. The localization and electrophysiological properties of accessory pathways and other heart structures were estimated before the surgical treatment. 13 patients (pts) suffered syncope in the course of atrial flutter or atrial fibrillation with heart rate greater than 300/min, often proceeding into ventricular fibrillation or atrioventricular tachycardia greater than 260/min, which sometimes proceeds into atrial/ventricular fibrillation. 6 pts experienced dizziness or fainted during tachyarrhythmias or rhythm changes. In 15 pts antiarrhythmic drugs in monotherapy or various combinations did not prevent recurrence of tachyarrhythmias. In 4 of 5 other pts only amiodarone was effective but the drug was discontinued due to serious adverse effects. The lack of good effect of antiarrhythmic drug therapy can be based on mutually unfavorable electrophysiologic properties of the accessory pathways and other heart structures. Pts who experienced syncope had a particularly short effective refractory period (ERP) of the accessory pathways in ante- and retro-grade direction and short ERP of the ventricle muscle. Additionally, there were multiple accessory pathways, heart muscle impairement and frequent ventricular premature beats--factors triggering the tachyarrhythmias.

Adolescent↗

The effects of heparin cofactor II-derived chemotaxins on neutrophil actin conformation and cyclic AMP levels.

The serine proteinase inhibitor heparin cofactor II (HC) can be cleaved by polymorphonuclear leukocyte (PMN) elastase (LE) to yield potent chemotactic activity for PMN and monocytes. In contrast to the bacterially-derived chemotaxin formyl-Met-Leu-Phe (fMLP), the HC-derived chemotaxin does not stimulate PMN degranulation or oxidative burst activity. We compared the effects of HC-derived chemotaxins to the effects of fMLP on PMN actin conformation and on the cAMP levels. Both the HC chemotaxins and fMLP rapidly induced an increase in F-actin which was similar in magnitude and time-course. However, in contrast to fMLP, HC-derived chemotaxins did not elevate cAMP levels. HC-derived chemotaxins may be useful probes of chemotactic responses, since they do not have the mixed biological activities of fMLP.

Actins↗

Pain management in the opioid-addicted patient with cancer.

Two patients with an active or recent history of opioid abuse had painful complications of cancer that required narcotic analgesic therapy. Initial pain management was difficult due to issues of distinguishing tolerance from disease progression, concurrent methadone maintenance, and drug-seeking behavioral patterns. Pain control was achieved with psychological support, medication contracts, and attention to proper dosing of opioids. Suggested guidelines for management of these cases are offered.

Adult↗