Search PubMed⌕ Search

Biomedical subjects

P Probst

Publications and source records attributed to P Probst.

At least 73 records · Page 4Linked to original sources
PubMed1991

Transient myocardial perfusion abnormalities during cold provocation test in patients with arterial hyperreactivity.

The effect of peripheral cold provocation on myocardial perfusion was evaluated utilizing thallium-201 perfusion imaging in 13 selected patients with arterial hyperreactivity (Raynaud's phenomenon: n = 8; migraine: n = 6) and angiographically documented coronary artery spasm. Eleven out of 13 subjects with coronary arterial spasm--but none of a group of patients with obstructive coronary artery disease--had transient myocardial perfusion defects during cold provocation. The localization of transient perfusion abnormalities during myocardial scintigraphy correlated with the myocardial areas distal to the spontaneous or ergonovine-induced coronary arterial spasm detected by angiography. Transient reduction of tracer uptake during cold provocation and normalization of myocardial perfusion by redistribution imaging was paralleled by areas of hypokinesia observed during the test by contrast ventriculography (n = 8). The described findings in the coronary system during peripheral cold pressor test occurred independently of the presence of Raynaud's phenomenon, and without achieving the ischemic threshold.

Adult↗
PubMed1991

[Depersonalization and déjà vu experiences: prevalences in nonclinical samples].

According to the relevant psychological and psychiatric literature, depersonalization and déjà vu experiences are usually viewed as symptoms of severe psychiatric or neurological disorders, especially in schizophrenia, depression and epilepsy. Studies of these phenomena in non-clinical populations are rate. In this article we present the results of several epidemiological investigations. On the basis of survey and interview research, quantitative and qualitative aspects of both phenomena were assessed, as well as the relations with personality variables like emotionality. The results indicate prevalence rates up to 80 percent in non-clinical populations. Based on epidemiological considerations, the question of differentiation between clinical and non-clinical forms of depersonalization and déjà vu is discussed.

Adolescent↗
PubMed1991

[Recanalization of an iliac artery occlusion from the contralateral side using "low-speed rotational angioplasty"].

This paper demonstrates the applicability of "low-speed rotational angioplasty" in antegrade direction for recanalization of the common iliac artery. After recanalization, a 4-mm PTCA balloon was used to dilate in antegrade direction using a PTCA exchange wire. After 5 weeks the femoral artery could be punctured and a residual stenosis dilated in retrograde direction.

Angioplasty, Balloon↗
PubMed1991

[Time-limited contacts with psychosomatic-psychotherapeutic ambulatory care. I. Retrospective evaluation by patients].

Despite of the relevance of psychosomatic-psychotherapeutic outpatient services there is a lack of empirical studies concerning their effectiveness and compliance from the patients' point of view. This study describes the retrospective judgements of a maximum of three outpatient consultations, given by 125 patients after a mean follow-up period of 14 months. These patients completed a comprehensive questionnaire, comparable with instruments used in follow-up studies of longterm psychotherapies. The questionnaire covered demographic data, a detailed description of the consultations (including the atmosphere of the contact and the therapeutic alliance), their consequences as well as the present life situation and -quality. The results first indicate that patients who refused their participation in the study received more unspecific recommendations by the therapist, and were more commonly referred by other clinics. The judgements of the consultations were predominantly negative. Patients criticized for example a lack of activity by the therapist and of practical advice. The overall rate of compliance (i.e. number of patients who followed the therapist's recommendations) was 49%. Compliance was higher with respect to individual therapy and lowest with respect to inpatient psychotherapy. As far as the present life situation was concerned, the patients answers indicate a slight decrease of their complaints as well as an increase of life quality as compared to the time of the consultation. Potential reasons for the negative view of time limited contacts with a psychosomatic outpatient unit are finally discussed.

Adolescent↗
PubMed1991

[Time-limited contacts with psychosomatic-psychotherapeutic ambulatory care. II. Potential determinants of compliance with therapeutic recommendations].

In a detailed analysis of the data from a follow-up study with 125 patients of a psychosomatic outpatient unit, possible determinants of the utilization of therapeutic recommendations (which was seen as an indicator of compliance) have been analysed. The overall compliance-rate in the sample was 49%. Comparisons of the patients who were compliant or noncompliant (61 vs 37) revealed that demographic as well as diagnostic characteristics hardly differentiated between the two groups. The compliance-rate seems to be higher in patients who had been judged as motivated by their therapist during the time of their contacts with the unit. Besides that, the perception of the atmosphere of the contacts as well as the therapeutic alliance during a maximum of three consultations differed between both groups. Patients who were compliant assessed their life quality more positively at the time of the follow up than the other group. In a second step of the analysis, an attempt was made, by means of cluster analyses, to investigate the relationship between the compliance-rates, and the mode of referral as well as diagnostic characteristics on the one, the judgement of qualitative aspects of the consultations on the other hand. The analysis of the first relationship indicated a tendency for noncompliance in older patients and those suffering from addictions, whereas compliance seemed to be high in younger patients who came to the consultation of their own accord. Multivariate analyses further confirmed the significance of the therapeutic alliance for the prediction of compliance-rates and the importance of several other qualitative aspects of the contacts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1990

Plasminogen activator inhibitor-1 levels in patients with chronic angina pectoris with or without angiographic evidence of coronary sclerosis.

Increased plasma levels of plasminogen activator inhibitor-1 (PAI-1) have been shown to exist in 40 to 60% of patients with stable coronary artery disease and have been suggested to be responsible for the development of coronary thrombotic complications. However, it is also discussed whether PAI-1 elevation might mainly be due to variables like increased age or to reactive mechanisms caused e.g. by the chest pain itself. To exclude age dependent or pain related influences, age-matched patients with stable angina pectoris (NHYA II) and angiographically proven coronary artery disease (CAD, n = 16) or without evidence for coronary sclerosis (variant angina, n = 10; angina-like syndrome with normal coronary angiogram, n = 5; non-CAD, n = 15) have been investigated for their plasma PAI-1 activity and t-PA antigen levels. The mean PAI activity in CAD patients (17.5 U/ml) was significantly higher than in non-CAD patients (9.6 U/ml) (p less than 0.0001). In the CAD patients no significant variation in plasma PAI-1 values could be demonstrated when related to the extent of the disease or to a history of previous myocardial infarction. t-PA antigen was also elevated in CAD patients as compared to the non-CAD group (p less than 0.02). The results suggest therefore a strong correlation between coronary artery disease itself and elevated levels of components of the plasma fibrinolytic system.

Angina Pectoris↗
PubMed1989

Heparin induced increase of t-PA antigen plasma levels in patients with unstable angina: no evidence for clinical benefit of heparinization during the initial phase of treatment.

Patients with unstable coronary artery disease were randomly treated either with a combination therapy consisting of nitrates and calcium-channel blockers without or with addition of clinical grade heparin administered subcutaneously; in order to evaluate the effect of heparin treatment on the fibrinolytic system, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) plasma levels were related to the clinical course of the disease. In heparinized patients thrombin time was prolonged more than 3-fold the normal range indicating effective heparin treatment. Heparinization led to a significant increase in t-PA antigen plasma levels (p less than 0.0001) within approximately four hours while PAI-1 activities remained unaltered. However, the measurable increase of the anticoagulant and pro-fibrinolytic activities of heparin did not result in a short-term benefit for the heparinized patients because the number of further ischemic attacks per patient during the observation period of three days was not different between the two study groups.

Aged↗
PubMed1989

[Radiological methods for visualization of the urinary tract].

The methods of radiologic investigation of the urinary tract have radically altered. Sonography has established itself as the basic method of demonstrating the size and shape of the kidney. Ultrasound reliably identifies cysts among renal tumors. It is increasingly used as the primary method in the search for nephrolithiasis or ureteral stones. Urography offers the highest resolution for the delineation of pathologic changes in the renal pelvis. It is no longer available as a screening method in suspected renovascular hypertension. CT serves to clarify doubtful sonographic renal findings. It is the method of choice for staging of renal tumors and the definition of parenchymal as well as perirenal damage after trauma. Angiography, especially as regards the diagnostic value of digital subtraction angiography, is the diagnostic method of choice in suspected renovascular hypertension. The diagnostic value of magnetic resonance imaging in nephrology and urology cannot yet be finally assessed.

Angiography↗
PubMed1989

Hemodynamic effects of mexiletine and disopyramide after cardioplegic arrest.

To study the hemodynamic side effects of mexiletine and disopyramide when administered before cardioplegic arrest 15 dogs underwent sham cardiac surgery with a 90-min period of aortic cross-clamping. 5 dogs served as control, 5 were given 8 mg/kg/day mexiletine and another five 11 mg/kg/day disopyramide for 1 week before surgery. On the day of surgery a continuous infusion was started. After reperfusion treated animals exceeded their preischemic blood pressure and regained their preoperative cardiac output. Compared to control animals left ventricular work was higher in the treated animals after reperfusion. The two tested type I antiarrhythmics tend to add to myocardial protection when given before cardioplegic arrest and do not exhibit negative inotropic side effects.

Animals↗
PubMed1988

The inducibility of coronary artery spasm after successful PTCA.

An ergonovine test (0.2 mg ergonovine i.v.) was performed on 32 consecutive patients showing a good long-term result 3 to 6 months after successful PTCA. In seven patients (22%) a significant spasm could be induced. Six of the seven patients complained of atypical chest pain as compared to two of 25 patients with a negative test. This difference was statistically significant (P less than 0.01). These results implicate that a higher vasomotor tone at the site of previous stenosis is responsible for atypical chest pain in patients after successful PTCA and good angiographic long-term follow-up. The application of long-term nifedipine and nitroglycerin in this patient group seems to be indicated.

Adult↗
PubMed1988

The influence of nitroglycerine on the inducibility of sustained ventricular tachycardia in coronary artery disease.

To investigate the influence of nitroglycerine on the inducibility of sustained ventricular tachycardia, 11 patients with documented sustained ventricular tachycardia were studied (mean age 59 years, range 52-70 years, eight posterior wall infarctions, three anterior wall infarctions). After the induction of sustained ventricular tachycardia using a standard protocol (three ventricular premature beats triggered on the R wave, three ventricular premature beats to the refractory period during basic driving rate up to 180 beats min-1), 0.8 mg nitroglycerine was given and when the wedge pressure started dropping (after about 3 min) the EPS was repeated. The mode of the initiation of sustained ventricular tachycardia was almost identical before and after application of nitroglycerine. In addition the heart rate before (mean 186 beats min-1) and after nitroglycerine (mean 187 beats min-1) and the morphology of sustained ventricular tachycardia were the same. It is therefore concluded that anti-ischaemic interventions by nitroglycerine treating silent ischaemia and improving ventricular function respectively does not influence the initiation of sustained ventricular tachycardia during EPS. Silent ischaemia obviously does not play a role in sustained ventricular tachycardia and therefore anti-ischaemic interventions cannot be expected to influence the recurrence of sustained ventricular tachycardia.

Aged↗
PubMed1988

The effect of sotalol on exercise-induced ventricular arrhythmias.

Sotalol is a non-selective beta-adrenergic blocking agent with class III antiarrhythmic properties. Our study was intended to assess the efficacy of sotalol on exercise-inducible arrhythmias by oral administration to out patients. Thirty patients with exercise-inducible arrhythmias (80% coronary artery disease, 20% congestive cardiomyopathy) were studied after two baseline bicycle ergometric stress tests performed in upright position. Twenty-five patients (including nine crossover cases of the lower dose protocol) were given sotalol in a daily dose of 320 mg (group 1) and 14 patients in a dose of 160 mg (group 2). After 2 and 8 weeks, respectively, group 1 showed a mean reduction of the total number of inducible ventricular premature beats (VPBs) of 50% (P = 0.0042) and 61% (P = 0.0107), respectively and a significantly improved Lown score (P = 0.0002 and 0.0006, respectively). A significant antiarrhythmic response was not demonstrable for group-2 patients. Because of inefficacy, nine patients were changed from group 2 to group 1. Reduction of arrhythmias on the higher dose was significant (P = 0.0147) in this group. There was the same significant reduction of the heart rate pressure product with the low and high dosage indicating that the beta-blocker effect is achieved with the lower dosage. We conclude that sotalol is a powerful drug for reducing the number and complexity of ventricular arrhythmias in a dose of 320 mg daily. As the beta-blocking effect in both groups was the same, we assume that the reduction of arrhythmias is mainly due to class III action.

Adolescent↗
PubMed1988

Rate dependent depression of subsidiary ventricular impulse formation--cause of Stokes-Adams attacks in a patient with rate modulated pacing.

Following His bundle ablation and implantation of a rate adaptive pacemaker (Vitatron TX 911) a 52-year-old gentleman experienced several presyncopal attacks while driving a car. On examination pectoralis muscle contraction caused temporary pacemaker inhibition. Incremental overdrive stimulation demonstrated progressive depression idioventricular automaticity and was associated with similar symptoms following overdrive at high pacing rates. Following appropriate pacemaker programming the patient remained symptom free.

Adams-Stokes Syndrome↗
PubMed1988

Subsidiary pacemaker function in complete heart block after His-bundle ablation.

To investigate the electrophysiological properties of ventricular impulse formation after His-bundle ablation in 11 patients, incremental ventricular overdrive stimulation studies were performed. The studies, which were spread over a follow-up period of up to 601 days, were carried out invasively with temporary leads as well as noninvasively with the implanted pacemakers and chest wall inhibition. The overdrive pacing rate was increased in steps of 10 beats/min, and the pacing duration was 2 minutes at each level. Ten out of 11 patients had a reliable ventricular escape rhythm; in the remaining patient, consistently no subsidiary pacemaker function was observed up to 10 seconds. In 83% of the studies, incremental ventricular overdrive stimulation caused progressive suppression of ventricular impulse formation with exponential increase in ventricular recovery time and progressive postrecovery subsidiary pacemaker depression. In the remaining 17%, ventricular recovery time showed a heterogeneous response to overdrive stimulation--as possible cause alterations in the sympathetic tone and limitations attributable to the method used are discussed. The results of this study demonstrate a rate-dependent overdrive suppression of subsidiary ventricular pacemaker tissue. This can be of clinical importance in patients with complete heart block and rate-adaptive pacemakers because sudden pacemaker failure or temporary pacemaker inhibition at high stimulation rates may cause Stokes-Adams attacks not reproducible at lower pacing rates.

Aged↗
PubMed1987

[Myocardial ischemia with normal coronary vessels. Indication of a vasospastic etiology].

In a 43-year-old woman with ECG changes of an acute anterior and posterior wall infarct, associated symptoms and biochemical findings, coronary angiography demonstrated normal coronary arteries and a normal variant in the course of the left coronary artery. Vasospasms in another vascular bed (migraine) and highly positive 201-Thallium scintigraphy during acral cold provocation speak for coronary spasm as cause of the myocardial ischaemia in this patient.

Adult↗
PubMed1987

R-wave amplitude changes during exercise stress testing: patients with dilative cardiomyopathy compared to patients with coronary artery disease.

R-wave amplitude (RWA) depends to a large extent on the left ventricular filling volume. Changes of RWA are attributed to the Brody-effect. Exercise has been shown to induce a decrease of RWA in a healthy population and an increase in patients with coronary artery disease (CAD). No clear data exist for cardiomyopathy (CMP). Controls (n = 12), patients with CMP (n = 32) and CAD (n = 58) were compared. Alterations of RWA (Wilson lead V5) were correlated with parameters of a bicycle exercise test including resting and exercise hemodynamics and parameters of LV-function including EF, LVEDV and LVEDP. CMP compared to CAD had smaller RWA at rest (0.78 +/- 0.47 vs 1.32 +/- 0.72 mV, P less than 0.01). During comparable levels of exercise CMP (EF 35 +/- 14%) showed no significant changes of RWA. CAD (EF 57 +/- 16%) presented an increase of RWA by +0.11 +/- 0.23 mV (P less than 0.01), while controls showed a straight decline of RWA (-0.31 +/- 0.24 mV). In patients with CAD delta RWA (RWA max exercise - RWA rest) was a more sensitive parameter for detection of disease (assuming delta RWA greater than or equal to +0.1 mV, 36/58 patients) than maximal ST-segment changes (ST-segment-depression in lead V5 greater than or equal to 0.2 mV at 0.08 sec after J-point, 22/58 patients). Precordial leads V2, V4, V5 and V6 showed similar changes. This paper supports the theory that changes of wall thickness or changes in the amount of air respective to the amount of fluid in the lungs are responsible for RWA changes. These changes are clearly dependent on the severity of the disease and on left ventricular function. Therefore measurement of RWA changes during exercise may offer additional information in patients with CAD as well as in patients with CMP.

Adult↗