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Biomedical subjects

M Langer

Publications and source records attributed to M Langer.

At least 415 records · Page 23Linked to original sources
PubMed1984

[Digital subtraction ventriculography in determining global and regional left ventricular parameters compared to left catheterization cardiography].

Since May 1982 we studied more than 150 patients with heart diseases by means of digital angiography, out of them 46 patients with a history of transmural myocardial infarction were selected. Urografin 76, 30 ml, was administered at a flow rate of 18 ml/s by means of a catheter in the superior vena cava during digital subtraction ventriculography. Results were compared with conventional contrast ventriculograms. The correlation coefficient was r = 0.93 (p less than 0.001) for determination of ejection fraction with both methods. The data in individual cases suggest that DSV is more sensitive than conventional contrast ventriculography in determination of severely reduced ejection fractions. The methods are practically identical in qualitative evaluation of disorders of regional wall motion in the anterolateral region, while DSV is more sensitive than conventional ventriculography in evaluating the apical region. Sensitivity was 85.7% when the two methods were compared in evaluation of the inferior region of the left ventricle. Both methods are identical in demonstration of severely deformed ventricles. Digital subtraction ventriculography may replace conventional contrast ventriculography in some of the situations discussed above.

Analog-Digital Conversion↗
PubMed1984

[Interference factors in sonography of the middle and lower abdomen].

Disturbing factors in diagnostic ultrasound of the mid-abdomen und lower abdomen are presented. Factors causing unsatisfactory sonographic studies were analysed in 304 sonographic studies of the middle abdomen and lower abdomen. The retroperitoneal space was not demonstrated in 31 of 304 cases (10.2%). Plain films of the abdomen and computed tomography demonstrated fat in subcutaneous tissue, the omentum and the mesenterium in 20 of 31 cases (66%) and intestinal gas in 11 of 31 cases (36%). If ultrasonic studies demonstrate diffuse accumulation of echos, then repetition of the study is not recommended, since computed tomography will provide more reliable results.

Abdomen↗
PubMed1984

[Arterial digital subtraction angiography for visualizing hemodialysis shunts].

Intraarterial application of contrast medium in digital video subtraction angiography was used to visualize chronic haemodialysis arteriovenous shunts. Patient compliance could be enhanced by the use of small volumes of non ionic contrast medium (3 ml/inj.), and the use off thin needles. The diagnostic reliability was excellent for all 25 examinations.

Adult↗
PubMed1984

[Effect of brachytherapy and teletherapy on treatment results in primary vaginal cancer].

From 1971 to 1977 99 cases of primary carcinoma of the vagina were treated at the Radiotherapy Department of the I. University Clinic for Gynecology and Obstetrics in Vienna. Radiotherapy was adapted individually as far as possible due to the different localisations and extensions of this tumor and to the vicinity of bladder and rectum, two very radiation-sensitive organs. Basically a three-phased scheme of treatment was intended: primarily a focal irradiation of the tumor by plaque-application, then combined intra-uterine and intra-vaginal radium insertion, followed by a vaginal cylinder. Thus the vaginal tissue is charged with about 32 Gy in a depth of 0,5 cm, the tumor itself with about 100 Gy. Percutaneous telecobalt irradiation was applied additionally following the method prescribed for carcinoma of the cervix uteri. A vulvo-perineal irradiation field was applied supplementarily , if the tumor was localised in the lower third of the vagina. 5-year overall remission rate amounted to 32% for the years 1971 to 1977; hence it was somewhat lower than for the total time observed (1950 to 1977), which was 39,8%. This could be explained by the sharp increase of very old patients and of progressed stages. For separate stages, the following 5-year healing rates were observed: stage I: 78%; stage II: 48%; stage III: 24% and stage IV: 19%. Recto-vaginal or vesico-vaginal fistulas occurred in 8% of the cases; less severe complications, such as cystitis or proctitis, were found in 41 and 43%, respectively. The effect of percutaneous telecobalt irradiation on the healing rate was marked in progressed cases, especially. Only 1 patient of 15 (7%), who were not treated by teletherapy, reached 5-year remission , as compared to 14 of 52 (27%), who received teletherapy. Stages I and II did not show a comparable difference. Intrauterine brachytherapy was of more importance for remission rate in early stages: 11 of 16 (69%) patients with stages I and II, who were treated with intrauterine curietherapy, survived 5 years or more; of those who did not have intrauterine insertion, only 6 of 15 (40%) reached 5-year remission . For stages III and IV, intrauterine curietherapy did not markedly change the healing rate.

Adult↗
PubMed1983

[lst report: Alternatives to cortisone therapy. lst clinical experiences with a carnitine-betamethasone combination for the stimulation of fetal lung maturity].

In the recent past criticism has been voiced with regard to the efficacy and possible side effects of corticosteroid prophylaxis of fetal respiratory distress syndrome (RDS). Apparently the efficacy of this treatment has been over-estimated and the spectrum of possible side effects has not received enough critical attention. In view of the multiple indications that the fetal metabolism, above all, may be altered by this type of therapy, it seems necessary to search for other methods of surfactant stimulation. This paper presents the first clinical study on the use of carnitine (4 g for 5 days in combination with twice 8 mg beta-methasone versus twice 8 mg betamethasone alone). The patients on combination therapy showed a more marked increase in surfactant content of the amniotic fluid. Lung compliance determination in infants born within 72 hours of completion of therapy also revealed better results in the combination therapy group. There were also fewer clinically demonstrable RDS cases in this group. More research will be necessary to definitely establish the value of this new form of therapy.

Animals↗
PubMed1983

The TRH induced PRL release in patients with autonomous thyroid nodules before and after surgical treatment.

Total and free thyroid hormones (T3, T4, FT3, FT4), TSH and PRL were determined in basal conditions and after stimulation with TRH in 32 patients affected by autonomous thyroid nodules before and after nodulectomy and in 24 control subjects. Only 7 patients were clinically thyrotoxic and thyroid hormone concentrations were slightly elevated in most cases. In untreated patients the increment (delta) in PRL after TRH was significantly lower than in normal subjects but was not as severely depressed as that of TSH. After nodulectomy both delta PRL and delta TSH increased and were not significantly different from those found in normal subjects. Thus PRL responsiveness to TRH is depressed by prolonged though moderate increases in thyroid hormone concentrations but is not as sensitive to their action as TSH.

Adult↗
PubMed1983

[Clinical course and radiotherapy of primary vaginal cancer (362 cases)].

362 cases of primary vaginal carcinoma were treated at the Irradiation Department of the University Clinic for Obstetrics and Gynaecology, Vienna, from 1950 to 1977. As method of choice an individually dosed, fractioned and protracted radium-telecobalt therapy was employed. An overall 5-years' survival rate of 39.8% could be achieved, a value which is above the average reported in world literature. Comparing the last period analysed in the present study (1971 to 1977) with another period 20 years earlier (1951-1956), the following differences can be observed: the fraction of stages III and IV rose markedly from 57.2% to 68.7%; associated with this change was an increase of the percentage of older patients (greater than 60a) from 53.6% to 70.7%. These two developments had an impact on the survival rate: in the total population, it was 39.8% as compared to 32% for the period from 1971 to 1977. The 5-year-survival rate in stage I (n = 60) was 75%, in stage II (n = 95) 45.3%, in stage III (n = 145) 30.3% and in stage IV (n = 62) 19.3%. The incidence of rectovaginal or vesico-vaginal fistulas amounted to 8%. The importance of gynaecological screening for old age patients is emphasized being the only possibility for reducing the high percentage of progressed stages.

Adult↗
PubMed1983

[Importance of oxytocin sensitivity for the spontaneous onset of human labor].

The significance of oxytocin for the onset of labour in humans is disputed, mainly because there is no increase in oxytocin concentration in the peripheral maternal blood before onset of labour. However, Fuchs et al. have recently shown that the concentration of oxytocin receptors in the myometrium is significantly higher directly before onset of labour than at the onset of spontaneous contractions. To establish a correlation with the clinical sensitivity to oxytocin, the authors determined the oxytocin sensitivity by means of intravenous administration of 3 X 10 m I.U. of oxytocin with continuous tocographic recording. Parallel to this determination, the cervical score was measured according to Bishop. The patients were 26 healthy pregnant women in whom both parameters were determined daily until onset of spontaneous labour pains. The sensitivity to oxytocin increased significantly during the last few days before spontaneous onset of labour. On the day before onset of pains, almost all of the pregnant women showed maximum sensitivity to oxytocin. Parallel to this, the cervical, scores also increased; on the day before onset of labour pains, almost all pregnant women had a cervical score of 5 or more than 5. On the basis of these results, which concur accurately with the results of measurement of oxytocin receptor concentrations, it is definitely possible to refute the arguments that oxytocin is irrelevant for the onset of labour because its concentration in the maternal plasma does not increase before the pains begin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

Protein sparing and protein replacement in acutely injured patients during TPN with and without amino acid supply.

The metabolic effects of TPN were studied in a selected group of trauma patients. Nineteen patients were randomly divided into two groups: the first was treated with glucose and insulin, the second with glucose, insulin and amino acids. Each patient in both groups received TPN isocaloric with respect to daily energy output and the treatment lasted five days. Each group was further divided into two subsets (severe or moderate catabolism) according to fasting energy output with respect to the expected energy expenditure. During the acute flow phase, both in moderate as well as in severe catabolism, glucose and insulin were effective for protein sparing; the maximum protein sparing effect was reached when giving a caloric intake equal to 130% of daily energy output. Glucose, insulin and amino acids were effective in replacement of nitrogen losses. In moderately catabolic patients nitrogen balance was significantly better than in severely catabolic patients. This study shows that early and short-term TPN is effective in controlling the flow phase of trauma. Glucose and insulin appear to be the determinants of the protein sparing effect when given in amounts equal to those needed; amino acids provided protein replacement when given in amounts equal to about 20% of energy output. Energy supply higher than 120-130% of daily energy output does not increase protein sparing and protein replacement, the only effect being a further increase in metabolism, which is possibly dangerous in critically ill patients.

Adolescent↗
PubMed1982

[Radiologic aspects of the congenital arteriovenous malformations, Klippel-Trenaunay type, and Servelle-Martorell type (author's transl)].

In our study 13 patients with a Klippel-Trenaunay type and 7 patients with a Servelle-Martorell type of arteriovenous malformations were analyzed. The results demonstrate that these 2 entities can be differentiated by routine radiography. The Klippel-Trenaunay type of angiodysplasia does not need arteriography, whereas arteriography as well as phlebography are necessary in the Servelle-Martorell type of angiodysplasia, in order to show ectatic regions of the involved vessels. The differentiation between the above mentioned arteriovenous malformations and the F. P. Weber type of angiodysplasia is easy. In the F. P. Weber type of angiodysplasia a lengthening of the involved extremity, arteriovenous shunts, as well as alterations of the bone are characteristic.

Angiography↗
PubMed1982

[Contrast enhancement of the gyral pattern in herpes simplex encephalitis].

A case of herpes simplex encephalitis was examined by computer tomography. Both cerebral hemispheres showed contrast enhancement of the gyri. The cause of this is considered. The increased contrast medium accumulation in the affected areas is probably due to the marked vascular proliferation which can be demonstrated anatomically, and to the rapid escape of contrast from the capillaries into the interstitial spaces. The findings of other authors, which differ somewhat, are discussed.

Adult↗
PubMed1982

[Congenital angiodysplasias of types F.P. Weber, Klippel-Trénaunay and Servelle-Martorell].

Basing our observations on a study of 47 cases of angiodysplasia of types F.P. Weber, Klippel-Trénaunay and Servelle-Martorell, we attempted to demonstrate that differentiation of these 3 syndromes is possible if criteria obtained from a non-invasive investigative method are used. This involves taking standard X-rays of the extremities (both sides) which are examined under direct magnification (0.1-01 mm) thus allowing the most exact possible analysis of the skeletal changes. In this way, the Weber syndrome should be suspected if bone prolongation is seen in association with loss of substances from the skeleton. In the Klippel-Trénaunay syndrome, the bone lengthening is not accompanied by bony lesions. In the Servelle-Martorell syndrome bony lesions go hand in hand with limb hypertrophy.

Angiomatosis↗