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Biomedical subjects

P Probst

Publications and source records attributed to P Probst.

At least 127 records · Page 7Linked to original sources
PubMed1982

[Hemodynamics of congestive cardiomyopathy].

202 patients with congestive cardiomyopathy have been classified according to their hemodynamic, angiographic, echocardiographic and scintigraphic findings: 72 patients were in the late stage (LS), 103 patients in an early stage (ES) and 17 patients showed a latent form of the disease. 48% of the hemodynamic ES were found to be clinically in stage IV NYHA and 53% of ES fell in class III. 40% of the patients with LS showed a stationary clinical course whereas 46% could improve their classification by one grade. The mortality in hemodynamic LS was 46% within an interval of 18 +/- 14 months after the diagnosis. In ES 64% showed a stable clinical course, where a 22% were deteriorating. Mortality in this group was 10%. Sensitivity and specificity of echocardiography (93 vs 80%) and radionuclide methods (80 vs 71%) were quite good in the late stage whereas in ES specificity was only 71% vs 80%. There was a discrepancy between the degree of myocardial impairment and clinical symptoms in the late stage whereas in the early stage there was no correlation between exercise capacity and LV-hemodynamics. Non-invasive methods allow the hemodynamic evaluation of the disease; invasive methods are required for clarification of diagnosis or establishing prognosis.

Adult↗
PubMed1982

[CT-staging of renal carcinoma].

In 38 cases of renal cell carcinoma computed tomographic (CT) findings concerning local tumour invasion (T), regional lymphnode involvement (N) and that of large veins (V) are compared with the pathological tumour staging (pT, pN, vein involvement). The local tumour invasion was correctly diagnosed with CT in 84% of the cases. Our experience is that CT finding, in regards to tumour infiltration into neighbouring organs, is more accurate the more dorsal these infiltrations lie. In the N-category, there is a tendency to overstage. For tumour involvement of the V. cava and V. renalis, CT findings are inaccurate; there angiography will be necessary to obtain important preoperative information and to determine the arterial blood supply of the tumour. After urographic and sonographic diagnosis of a solid renal parenchymal mass, CT comes next as diagnostic assessment. Angiographic examinations are not necessary with T 1/2-tumours, but with large renal tumours (T 3/4), abdominal aortography, selective renal arteriography and cavography are essential.

Adenocarcinoma↗
PubMed1982

[Selective thrombolysis in acute myocardial infarction: evaluation of functional result by metabolic studies and perfusion imaging (author's transl)].

The effects of selective thrombolysis with intra-coronary streptokinase in regard to myocardial protection are still debated. In 25 patients with acute myocardial infarction we evaluated regional metabolism with 123 radio-iodinated heptadecanoic acid and segmental 201 thallium scintigraphy in the distribution of the recanalized coronary vessel. Lysis was successful in 11/16 occlusions of LAD-, 4/7 RCA- and 1/2 CX-vessels. In this group (A) the average defect size on TI-scintigrams was 19 +/- 6% 24 hours after the intervention, whereas unsuccessful recanalisation (group B) resulted in a defect size of 38 +/- 7% (p less than 0.01). There was good concordance between thallium defect size and fatty acid metabolism in group B. However, in group A 6 of 11 patients showed significantly smaller fatty aid accumulation than the thallium defect size reflected. These data suggest that successful reperfusion does result in protection of myocardium in the majority of infarct patients reflected in the smaller TI infarct size. Successful reperfusion, however, does not always immediately restore metabolic dysfunction. This discrepancy will have to be analyzed by further follow-up studies of these patients.

Coronary Vessels↗
PubMed1982

[Diagnosis and therapy of carotid sinus syndrome (author's transl)].

We investigated 76 patients with carotid sinus syndrome followed over a time period of 12-40 months (mean 24 months). In 27 patients long-term ECG were recorded over 24 hours continuously. Carotid Doppler sonography was performed in all patients. 14 patients were studied electrophysiologically. The long-term ECG examinations in patients with carotid sinus syndrome showed a significant tendency to nocturnal bradycardia, and normal heart frequency during the day. In 41% of patients extracranial obstruction of internal carotid arteries could be demonstrated. During carotid sinus massage was a significant increase of the AH time, but there was no significant changes of the HV time. 12 out of 14 patients (86%) developed an AV-block during carotid sinus massage and atrial pacing. In 31 patients pacemakers were implanted. The indication for pacemaker implantation was the clinical symptom of syncope. These patients were observed over a period of 15-40 months (mean 24 months). 15 patients were free of symptoms after the pacemaker implantation, whereas 8 patients complained of dizziness and 4 patients experienced TIA's. 45 patients without pacemaker implantation were observed over a time period of 12-24 months. 30 patients were followed over 12 months. 16 patients were free of symptoms, 14 complained of dizziness. There was no syncopy in this group and no patients died during the observation period. In patients with cardio inhibitory carotid sinus syndrome and syncopy, pacemaker implantation is the therapy of choice. In asymptomatic patients or patients with occasional dizziness pacemaker is not indicated.

Aged↗
PubMed1982

[A new method for quantification of 2-dimensional echocardiographic images of the left ventricle (author's transl)].

A computer-supported system was designed for processing of 2-dimensional echocardiographic images of the left ventricle. The purpose of the method is to improve quantitative analysis of regional contraction patterns of the ventricle, using a 3-dimensional reconstruction technique. The definition of the spatial position of the transducer and a computer assisted outlining of the ventricle are the main features of the system. The usefulness of this method was demonstrated in a preliminary study.

Computers↗
PubMed1982

[The ECG in physiologic pacing (author's transl)].

Hemodynamic advantages led to an increasing number of implantations of so called "physiologic pacemakers", which preserve the natural sequence of atria and ventricles. The growing complexity of these systems renders ECG evaluation increasingly difficult. 85 patients had physiologic pacemakers implanted during the last 4 years and were controlled in our pacemaker outpatient clinic. Typical problems in ECG evaluation of the different pacemaking modes are discussed.

Arrhythmias, Cardiac↗
PubMed1982

[Cavography and CT for demonstration of canalicular spread of renal neoplasms into the inferior vena cava ].

The venous and lymphogenic tumor extension (Robson, Stage III) was assessed in two patient collectives with renal neoplasms: in the first (n = 47), only cavography, in the second (n = 45), only computerized tomography was performed. For both groups there were no false negative diagnoses. False positive readings can occur with CT. Thus, ambiguous findings in CT should be clarified by cavography. CT was superior to cavography regarding the detection of pathologic lymph nodes. However, lymph node enlargement was caused in 10% of these cases by inflammatory hyperplastic reaction without evidence of metastatic tumor spread.

Adolescent↗
PubMed1982

[Follow-up studies in 64 patients with WPW syndrome after electrostimulation].

In 65 out of 79 patients with WPW syndrome who had extensive electrostimulation studies, a follow-up evaluation (mean follow-up period 2.5 years) was performed. The patients were divided into 2 groups: Group 1: No therapy or therapy only during tachycardia. Group 2: Continuous oral drug therapy. There was no difference of antegrade and retrograde refractory periods, but there was a significant difference in the initiation of tachycardias. In group 1, the typical reentry tachycardia using the AV node antegradely and the accessory pathway retrogradely was predominant, while in group 2, complex arrhythmias (atrial fibrillation + reentry tachycardia, tachycardias using the accessory pathway in both directions, reentry tachycardia + AV-nodal tachycardia, isolated atrial fibrillation) during electrostimulation could be induced. all except 1 patient in whom no tachycardia could be initiated were in group 1 (statistically significant difference). Thus the type of tachycardia which can be initiated during electrostimulation is a better predictor for the condition in the follow-up period than the refractory period. As concomitant disease there were 4 cases with Ebstein disease (2 had additional mitral valve prolapse syndrome) and 3 cases with mitral valve prolapse syndrome. 3 of the 4 patients with Ebstein disease were in group 2. 1 of the 64 patients died during the follow-up period suddenly, but the cause of death is not known and possibly due to medical therapy. The mortality in a non-selected group of patients with WPW syndrome seems to be very low.

Adolescent↗
PubMed1981

Value of platelet sensitivity to antiaggregatory prostaglandins (PGI2, PGE1, PGD2) in 50 patients with myocardial infarction at young age.

Based upon earlier findings of our group that not only the synthesis of antiaggregatory prostaglandins by the vessel wall is altered in atherosclerotic vascular tissue of patients, but also the sensitivity of their platelets to these prostaglandins is changed, we examined a well defined group of 50 patients with myocardial infarction before the age of 40 years. In all patients the coronary heart disease was verified by angiography. The sensitivity of the platelets was examined in relation ot the smoking habit, the type and presence of hyperlipoproteinemia, one, two and three vessel disease and familial history. Except for hyperlipoproteinemia and smoking, all the patients were free of any additional risk factor. It is demonstrated that the platelet sensitivity to the antiaggregatory prostaglandins is significantly diminished in hyperlipoproteinemics in comparison to a control group.

Adult↗
PubMed1981

Comparison of various quantization methods of segmental ventricular wall motion in ischemic heart disease.

Numerous methods of measuring regional myocardial wall motion are in use. A critical comparison is needed to assess the strengths, weaknesses, accuracy, and precision of these methods. This paper reports the evaluation of five methods using computer-assisted interactive graphics. Fifty cines were selected: 16 from normal subjects, and 34 from patients with proven cardiovascular diseases. Tracings were made of the opacified left ventricle in end systole and diastole and digitized. All fifty cines were analyzed by five methods using computer-implemented graphic techniques. The results included a display of the silhouettes, which were translated and rotated according to various methods. In addition, the percent contraction for eleven myocardial regions was tabulated and displayed. The sixteen cines from normal subjects were used to derive a range of "house" normal values for region contraction patterns with which the measurements from the 34 abnormal patients were compared. The five methods were evaluated by comparing results from the computer-aided analysis with the visual assessment of two experienced radiologists. One method was found, the results from which agreed with the radiologists' visual impression for every case. This computer-aided method was quantitative and reproducible. Consequently, it can give information which supplements the visual impression.

Coronary Angiography↗