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Biomedical subjects

P Schweizer

Publications and source records attributed to P Schweizer.

At least 127 records · Page 7Linked to original sources
PubMed1980

[The diagnostic value of echocardiography in coronary artery disease--1. M-mode echocardiogrpahy (author's transl)].

The hallmarks of coronary artery disease are wall motion abnormalities. If the disturbances of wall motion are located in the septum and the posterior wall near the basis of the heart, they can be detected by M-mode echocardiography. Isolated asynergies of the left ventricle in the anterior wall and the apex of the heart are missed. The amplitude, the change in wall thickness during contraction, and the velocity of wall motion can be analysed for quantitative evaluation of regional function. Only pathological findings can be used for diagnostic purposes. Stress-tests increase the sensitivity of the method. Left ventricular volume determinations are not possible in patients with coronary artery disease by M-mode echocardiography because of methodical problems. Only left ventricular dimensions and fractional shortening should be measured. An altered closure of the mitral valve reflects a significant increase in left ventricular filling pressure.

Cardiac Volume↗
PubMed1980

[Disturbed postoperative course in the treatment of necrotizing enterocolitis (NEC) (author's transl)].

The necrotizing enterocolitis (NEC) is marked by three stages, each of which has characteristic clinical symptoms and radiological findings. The management and prognosis are different in each stage. The experiences we got from 27 patients, seen in 5 years, are demonstrated and the typical postoperative complications are analysed. The conclusion can be reached that NEC has the best prognosis by a conservative treatment in stages I and II, and that a surgical approach is indicated when stage III turns into stage IV.

Child↗
PubMed1980

[Mediastinal complications following retropleural operation for oesophageal atresias (author's transl)].

Serious acute complications can occur in relation to anastomotic insufficiency or re-opening of the fistula in patients with tracheo-oesophageal fistula and atresia, even if the repair has been carried out extra-pleurally. For this reason the patient should not be nursed flat and the important life-threatening signs to watch for are increasing tachypnoea and dyspnoea with respiratory acidosis and a central air shadow in the mediastinum.

Esophageal Atresia↗
PubMed1980

[The postoperative course following antireflux operations for vesico ureteral reflux (author's transl)].

The authors report 779 ureters related to vesico-ureteric reflux. 602 were treated by the method of Politano-Leadbetter and 177 by the method of Grégoir. Follow-up observations in these patients showed lesions requiring further surgery in relation to bleeding, stone-formation in the urinary tract and lesions of the bladder wall. The question of postoperative urinary obstruction and recurrent reflux was stressed and the problems related to the indication for surgery for vesico-ureteric reflux in infancy are discussed.

Child↗
PubMed1979

[Ventricular arrhythmias in mitral valve prolapse syndrome (author's transl)].

Long-term ECG monitoring over 22 hours and exercise ECGs were performed in 72 patients with mitral valve prolapse syndrome. 70% of the patients had ventricular arrhythmias. In 28% severe arrhythmias in the form of multifocal atopic beats and ventricular runs were demonstrated. Long-term ECG monitoring was a suitable method for detection of these arrhythmias and superior to exercise ECG. Clinical, electrocardiographic and echocardiographic findings could not be correlated to the severity of ventricular arrhythmias.

Adolescent↗
PubMed1979

[A new method of pericardiocentesis and quantification of pericardial effusions by echocardiography (author's transl)].

With a new method for safe and complete evacuation of pericardial effusions it was possible to check the quantification of pericardial fluid is was possible to check the quantification of pericardial fluid by echocardiography. Using a formula based on the assumption that in systole the pericardial fluid is distributed equally around the contracting heart (like a coat enveloping a sphere), it was demonstrated that pericardial effusions ranging from 250 to 600 ml could be fairly accurately measured. Smaller effusions were not so readily determined. Effusions over 600 ml could be only roughly measured, usually being underestimated.

Echocardiography↗
PubMed1979

Efficacy of propranolol versus placebo in long-term treatment in patients with mitral valve prolapse.

In 60 patients with mitral valve prolapse syndrome a randomized controlled interindividual double-blind study of propranolol (p) was performed. Patients received p 80 mg (A), 160 mg (B) and placebo (C) orally for 4 weeks. Prior to and after treatment, heart rate (HR) and blood pressure (RR) as well as systolic time intervals (STI) were measured and corrected for heart rate--electromechanical systole (QS2I), left ventricular ejection time (LVETI), and preejection period (PEPI). The ratio PEP/LVET was calculated. Plasma levels were measured by an optimized fluorimetric method. 1. STI lay in the upper part of the normal range, indicating that some patients had a hyperkinetic cardiac function. 2. P had no influence on QS2I and LVETI in A and B. PEPI was prolonged (A: +13.2 ms, B: +14.2 ms) and PEP/LVET was increased (A: +0.040, B: +0.050). 3. As indicated by the changes in HR, RR, PEPI, and PEP/LVET p showed in B compared to A only minor additional effects. 4. Plasma levels of p were in B three times higher than in A (A: 89.2 +/- 10.0 nmol/l B: 246.7 +/- 30.5 nmol/l). With a dose of 80 mg propranolol a point close to the plateau of maximum efficacy was reached, where a higher dose resulted only in small additional negative inotropic effects.

Clinical Trials as Topic↗
PubMed1979

Malformations of the urinary tract.

Between 1967 and 1977, 1500 children with malformations of the urinary tract were operated upon at the paediatric surgical department of the University of Tubingen. Ten children died in the early postoperative period or later on: Two patients died after operative correction of bladder extrophy following pneumonia and pyelonephritis and uraemia and urinary infection respectively. One child with a myelomeningocele had an ileal conduit performed and died two days after operation of peritonitis and urinary ascites. Two older children with reflux died in spite of successful ureteroneocystostomy, one following a cerebral haemorrhage and the other because of hypertension and uraemia. Five children with mechanical urinary obstruction died after discharge of uraemia and urinary infection. The following reasons for the deaths could be found: -- In two cases wrong indication for operation. -- In one case a technical fault at operation. -- In two cases the diagnosis was made too late. -- In five cases the wrong type of operation was used.

Adolescent↗
PubMed1979

[Pressure-dimension analysis of the poststimulation potentiation--influence of heart rate and ventricular function (author's transl)].

The mechanism of poststimulation potentiation (PSP) was studied in 17 patients with coronary artery disease by simultaneous pressure-dimension analysis. The left ventricular pressure (LVP) was measured by catheter-tip-micromanometer and LV diameter by M-mode echocardiography. The pressure signals were digitised and analysed on line by 400 Hz. The pressure-dimension tracings were additionally analysed half-automatically. Measurements were done during right atrial pacing at 80, 120, 140 beats/min and during the poststimulation period. 1. Right atrial pacing increased the rate of LV pressure development (dp/dt max), the rate of pressure fall (dp/dt min), the velocity of circumferential fiber shortening (VCF mn), and fiber dilatation (vcf mx) dependent on heart rate and cardiac function. 2. LV enddiastolic diameter (LVEDD) reached during the first poststimulation period the starting point independent on pacing rate and cardiac function. LV enddiastolic pressure (LVEDP) showed a slight overshoot. PSP resulted in an increase of LVP, dp/dt max, VCF mn, and the velocity of posterior wall motion, dp/dt min, VCF mx, and the velocity of posterior wall relaxation decreased, however, with the first post-stimulation beat. 3. The PSP was dependent on atrial pacing rate. The higher the pacing rate the higher the PSP. dp/dt max increased after cessation of 120/min for +29% and after 140/min for +38%. The PSP for the preload independent parameter of contractility, V-40, was, however, equal for both heart rates +25% and +28% respectively. 4. Another determinant of PSP was cardiac function. The PSP was relatively higher in patients with reduced ejection fraction than in patients with a normal ejection fraction: dp/dt max +55% and 25%, VCF mn +18% and +7% respectively. From the derived ventricular function curves, it could be shown, that atrial pacing reflected an increase in LV contractility (Bowditch effect), whereas PSP reflected an increase in LV performance by the Frank-Straub-Starling (Woodworth staircase) effect on a new left ventricular function curve, which was shifted to the left by atrial pacing.

Adult↗
PubMed1979

[Pharmacodynamic studies in suicidal digoxin poisoning (author's transl)].

In two patients with suicidal digoxin poisoning the correlations between serum digoxin concentration and changes in the duration of QTc and the flattening of the T-waves were studied. The digoxin serum half-life following suicidal digoxin poisoning was in the first patient (10 mg beta-acetyl derivative of digoxin) 77 h, prolonged cause of renal insufficiency, and in the second patient 39.6 h. (20 mg beta-acetyl derivative of digoxin). In both patients the digoxin induced flattening of the T-wave reached a plateau of maximum efficacy at a serum level of 2-3 ng/ml with no further change up to a serum level of 13.2 ng/ml and 9.6 ng/ml respectively. A linear correlation, however, was found between the digoxin serum concentration and the digoxin induced shortening of QTc, r = 0.88 and r = 0.92 respectively. A plateau maximum efficacy was not found. The regression equations were y = -12.0 chi + 430.8 and y = -8.0 chi + 391.9 respectively. The shortening of QTc is therefore an important parameter for the diagnosis of digoxin poisoning. It can be determined very quick with no methodical problems.

Digoxin↗
PubMed1979

[Pathomorphology and therapy of bile duct hypoplasia and -atresia: - lymphodigestive bile drainage (author's transl)].

In the treatment of extrahepatic biliary atresia Kasai's hepatic-porto-enterostomy brought an important improvement. A bile drainage from the liver into the bowel can be achieved in about 40% of the children suffering from extrahepatic bile duct atresia. Long-term results are nevertheless disappointing because cholangitis and the progression of fibrosis and the original disease aggravate the final results. Supported by the results of animal experiments and clinical findings we studied the possibility of bile drainage together with the hepatic lymph into the bowel. In the animal experiments we succeeded in developing a successful method. The method of operation is described and reasons are mentioned. The first clinical results achieved with a small number of patients are reported and some open questions are put up for discussion.

Animals↗
PubMed1979

[Surgical treatment of congenital obstructive biliary disease (author's transl)].

The results of surgical treatment of bile duct atresia and hypoplasia are disappointing; no improval of long-term survival could be observed. With Kasai's hepato-jejuno-enterostomy which is not suited for the management of complete atresia. A new surgical procedure was evaluated in animal experimentation and in some patients: the bile was drained through the lymph system of the liver into the intestinal tract. Morphology, surgical procedure and indications as pertinent to this new approach are described and discussed. On the basis of the data available at present no conclusions can as yet be drawn, if the good results obtained in animal experimentation will be achieved in man as well. Surgical treatment of choledochus cysts is discussed. The procedure chosen depends upon the site of the cyst. Surgery is aimed at extirpation of the cyst and reconstruction of bile flow through the papilla Vateri. Curative and palliative procedures are discussed.

Bile Ducts↗