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Biomedical subjects

M Schöttler

Publications and source records attributed to M Schöttler.

At least 19 recordsLinked to original sources
PubMed2006

[On uniform social medical evaluation of performance capacity in orthopedic rehabilitation].

The need for standardized and unified performance capacity assessment in orthopedic rehabilitation has led to the attempt to use an existing standardized procedure. Graduated disease features have been defined which are relevant for work and their effects on performance capacity been formulated as rules. In this way so-called disease-conditioned performance capacities are obtained which help to identify problems in carrying out various activities. These activities can be directly assessed using tests. Appropriate tests are listed in a table.

Disability Evaluation↗
PubMed2002

Real-time influenza surveillance in Germany--results of a pilot project.

Real-time surveillance information is the prerequisite for accurate influenza diagnosis followed by appropriate treatment of acute influenza with neuraminidase inhibitors. With REALFLU trade mark Surveillance, Hoffmann-La Roche has developed an international early warning system for influenza. The feasibility of the newly developed real-time influenza surveillance in Germany was tested and the results were compared with those of the established German influenza sentinel system of Influenza Study Group (Arbeitsgemeinschaft Influenza, AGI). The evaluation of the REALFLU trade mark Surveillance was performed during the winters of 1999/2000 and 2000/2001. The percentage of influenza-like illnesses among patients seen by the reporting physicians and positives of the Roche Influenza A/B Rapid Test were reported daily by internet, evaluated and could be called up on dynamic internet web pages real-time. The group of project participants could at any time call up the evaluations of the current data on password-protected internet web pages. A retrospective comparison with data obtained by the AGI showed good agreement between the two systems. Even better agreement was obtained on comparing the data with the virus isolates of the National Reference Centers (NRZ). This confirms the reliability of the selected methodology. REALFLU trade mark Surveillance provided information about influenza outbreaks 1-2 weeks earlier than NRZ and the AGI. The results show that it is possible and reasonable to conduct influenza surveillance on a real-time basis. In an overall context of REALFLU trade mark Surveillance, the German pilot project was capable of reflecting the influenza situation on a real-time and regionalized basis during both winters. The Roche Influenza A/B Rapid test proved to be a useful surveillance tool.

Age Distribution↗
PubMed1984

[Recurring pulmonary artery embolisms and disseminated intravascular coagulation in right atrial myxoma].

A 33 year old woman presented with dyspnea and dizziness. These symptoms had recurred several times during the months preceding. At initial investigation we palpated a tumor in the upper abdomen corresponding to the sonographic finding of a 10 X 10 cm sized cystic tumor in the liver. Because of reduction of fibrinogen, prolonged thrombin time and thrombocytopenia a malignant disease involving the liver and producing pulmonary embolism and disseminated intravascular coagulation was suspected. However, during routine echocardiography a right atrial mass prolapsing in the right ventricle was detected. After normalization of fibrinogen and thrombin-time following a low dose heparin therapy a myxoma sized 6 X 5 cm was removed from the right atrium. The patient did not recover and died 20 days following surgery. At autopsy the liver tumor proved to be a benign cholangioendothelial cyst.

Adult↗
PubMed1983

Electrical and mechanical restitution of the human heart at different rates of stimulation.

Action potential duration and contractility are reduced following premature excitations, and gradually increase as the stimulus interval is lengthened. To examine these phenomena of electrical and mechanical restitution in the human heart, we simultaneously measured action potential duration and the maximum rate of left ventricular pressure in five patients undergoing electrophysiological study. Test beats were introduced at varying intervals after the last of a series of steady state intervals. By plotting action potential duration and maximum rate of left ventricular pressure as a function of the test interval, we formed electrical and mechanical restitution curves. When the rate of steady state pacing was increased, there was a decrease in action potential duration and an increase in the maximum rate of left ventricular pressure for all test intervals; i.e., a change in pacing rate affected action potential duration and maximum rate of left ventricular pressure of test responses in a reciprocal fashion. In addition, a higher steady state pacing rate allowed action potentials and contractile responses to be elicited at shorter test intervals, thereby displacing the electrical and mechanical restitution curves to the left. The magnitude of the leftward shift of both curves corresponded closely to the shortening of the steady state action potential duration induced by the increase in pacing rate. These findings confirm for the human heart that both electrical and mechanical restitution occur after membrane repolarization, i.e., as a function of the electrical diastolic interval preceding a beat, and not the stimulus interval.

Action Potentials↗
PubMed1980

Simultaneous recording of monophasic action potentials and contractile force from the human heart.

Cardiac monophasic action potentials (MAPs) and contractility have been simultaneously measured in man while the heart rate was being changed by right atrial pacing. A new non-suction electrode was used for safe and long-term recording of MAPs from the endomyocardium. Abrupt changes in cycle-length were followed first by a fast, then a slow response in the adaptation of MAP-duration and of contractility (LV dp/dt max) to the new steady state. After increasing the heart rate then slow phase of MAP shortening appears to be related to the slow staircase of contractility, whereas after the step decrease of frequency no such a relation could be observed. The consistency of these results with those obtained in corresponding in-vitro experiments indicates that this methodical approach may be suitable for assessing the process of E-C coupling in the human heart.

Action Potentials↗
PubMed1977

[Artrial septal defect in the adult (author's transl)].

The clinical and hemodynamic findings of 96 adult patients with ostium secundum defect are presented. There are no interrelationships between the extent of symptoms and clinical state on one side and heart size, shuntvolume and other hemodynamic parameters on the other hand. Our observations do not allow firm conclusions as the the natural course of the affection. It can be stated however, that this congenital cardiac malformation can be associated with a normal life exspectancy and without severe symptoms for decades. Hence we see problems as to the indication of the surgical closure of the defect, since not much is known about the longstanding usefulness of surgery in respect to a possible prolongation of life exspectancy and diminuition of morbidity. We therefore are of the opinion that - until such data are available - the indication for surgery should not be guided by prospective nonproved assumption but by the clinical state of the patient and the severity of his symptoms.

Adolescent↗
PubMed1976

[The effect of sudden changes in the stimulation rate of the heart on peak systolic pressure (author's transl)].

The changes in systolic pressure were studied in 48 patients during artificially (by electrical stimulation) induced sudden increases and consecutive decreases in heart rate. Various patterns could be separated respective to phase A (sudden switch from low (80-120 impulses/min) to higher heart rate (140-180 impulses/min)) and to phase B (sudden switch-back from high to lower (control) beating rate): AI) The systolic peak-pressure of the first contraction after the shortened stimulation interval is very low and often stays ineffective (below the aortic opening pressure). The second contraction develops already a higher pressure than the first one, during the consecutive beats the systolic pressure increases gradually until a new steady state is reached, which is usually lower than the systolic pressure during the foregoing lower beating rate. Sometimes however it can be equal or even higher. Accordingly after an elevation of heart rate arterial mean pressure can drop, stay constant or increase. AII) The systolic peak-pressure of the first contraction after the shortened stimulation interval stays relatively high and drops continuously with the succeeding contractions until a new steady state is reached according to the higher heart rate, it is however always lower than the one at a lower stimulation rate. Therefore arterial mean pressure is always decreased. AIII) Finally we observed changes in arterial systolic pressure in some patients that could not be grouped according to one or to the other pattern described above.- BI) The systolic peak of the first contraction after the switch-back from the high to the lower (control) rate is much higher than that of the last at the higher rate. The peak pressures of the consecutive contractions are then dropping continuously to the new steady-state, that can be higher, equal or lower than that at the higher stimulation rate. BII) ....

Adolescent↗
PubMed1976

[The treatment of excessive arterial hypertension by a permanent cardiac pacemaker system: a case report concerning the possibility to influence the disturbed harmonization between the heart and the arterial system (author's transl)].

In a 63 year old female patient with a history of longstanding arterial hypertension the implantation of a permanent cardiac pacemaker system resulted in a drastic reduction of the elevated blood pressure values, allowing to reduce the formerly necessary high dosage of antihypertensive drugs. It can be assumed that in the case presented the insertion of the permanent pacemaker leads to several hemodynamic changes: firstly, the heart rate is elevated slightly, secondly, the course of the ejection of the stroke volume is changed and consequently the contour of the pulse wave. Especially the latter factor may have an influence on various regulating mechanisms of the circulatory system and thereby on the lowering of the arterial blood pressure and the consecutive reduction of the hypertrophy of the left ventricle. Most probably the baroreceptor reflex system may be of additional great importance. In addition the "desynchronization" of the spread of excitation by the cardiac pacer might be assumed to change the action of the heart in the beginning of the ejection phase into a "softer" way of pumping. The alteration of a rather "rigid" pump (during normal excitation) into a "soft" pump (during desynchronized excitation) thus may lead to a lowering of the arterial pressure a) by decreasing the speed of ejection of the stroke volume and b) by improving the matching between the heart and the arterial "Windkessel".

Blood Pressure↗