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Biomedical subjects

T Richter

Publications and source records attributed to T Richter.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Implantable pacemaker-cardioconverter-defibrillator].

The aim of this article is to introduce the automatic, implantable cardioverter-defibrillator (AICD) device in connection with the first two cases in Hungary. At present time, the indications of the AICD implantation in the European Community are as follows: recurrent sustained episodes of ventricular tachycardia ventricular fibrillation or aborted sudden cardiac (arrhythmic) death, when the treatment of the underlying heart disease and/or the application of antiarrhythmic drugs, antitachycardia surgery (or catheter ablation procedures) proved to be unsuccessful in the prevention of the ventricular tachyarrhythmias (guided by serial intracardiac electrophysiologic testing and exercise testing), Holter monitoring. On the one hand the implantation of an AICD is not a causative treatment, on the other hand the cost of an AICD is extremely expensive. On the 8th of January, 1992, the first AICD (PCD Medtronic 7217B) implantation was performed in the Hungarian Institute of Cardiology. At the first patient with dilatative cardiomyopathy, the cardioverter defibrillator discharged successfully at 16 times. Unfortunately, the implantation of this patient with AICD could prolong his life only with months due to the rapid progression of the underlying cardiomyopathy. The second patient with AICD implantation went home after the uneventful surgery. The implanted cardioverter defibrillator unit worked properly, spontaneous ventricular tachycardia was terminated successfully. The AICD treatment considerably decreases the risk of sudden cardiac (arrhythmic) deaths.

Adult↗
PubMed1995

[Not Available].

Explore the source record for details and available documents.

History of Pharmacy↗
PubMed1994

[A case of successful operation of left atrial myxoma causing cerebral embolism].

The authors describe the case report of a young woman in whom a left atrial myxoma causing cerebral embolism was diagnosed by echocardiography. On the ninth day after the development of neurologic symptoms the tumor was excised by an emergency intervention. After the operation the condition of the patient improved considerably. In connection with the case the authors underline the role of echocardiography in the detection of sources of embolism.

Adult↗
PubMed1994

[Idiopathic clubbing of the fingers. Pathogenetic mechanisms and differential etiologic diagnosis].

We report on a patient with marked clubbing of the fingers and toes with watch-glass deformity of the nails, diagnosed as idiopathic clubbing. New findings on the pathogenesis of clubbing provide evidence for the important role of cytokines, especially platelet-derived growth factor and tumor necrosis factor-alpha. The differential diagnosis includes, besides rare primary forms, clubbing in malignant neoplasias and chronic inflammatory diseases of the heart, the lung, the upper gastrointestinal tract and the liver. Clubbing can precede other symptoms of neoplasias by mouths and could be dependent on a genetic predisposition.

Adult↗
PubMed1993

[Surgical management of left cor triatriatum in adults].

Cor triatriatum sinistrum is a rare congenital cardiac anomaly in which a membrane divides the left atrium. Severity of the disease depends on the size of the opening on the membrane. The anomaly presents with severe pulmonary hypertension and prognosis is unfavourable without surgery. From 1976 through 1992, 5 adult patients were treated surgically in our institution. Cor triatriatum can be corrected surgically with a low mortality and excellent late results if an early preoperative diagnosis has been made. Clinical findings and cardiac catheterization do not provide sufficient data for the correct diagnosis. From a review of our experience it is concluded that echocardiography is superior to angiography for diagnosing cor triatriatum.

Adult↗
PubMed1993

[Experience with the implantation of the Thermos 01 rate-adaptive pacemaker].

Authors summarise their 16 patient-years experience of eight Thermos 01 rate-adaptive pacemaker systems implanted in the Hungarian Institute of Cardiology. Data collected during regular control of the patients, exercise tests and Holter investigations are presented. Five of the 8 patients had better exercise capacity, but improvement over 25 Watt workload appeared only at two patients. Thermistor-controlled rate-adaptive pacing triggered by the central venous blood (CVB) temperature appeared beneficial for patients with predominant bradycardia. The thermoregulation sensor proved to be stable and has a good correlation to diurnal rhythm but it has a delay to short and intensive workload. The setting of the Thermos 01 is very time-consuming with the present algorithm of the software. It needs regular control and re-setting because of the marked individual differences among the patient's temperature profiles.

Algorithms↗
PubMed1993

[15N liver function test in underweight infants, hypotrophic at birth].

Fifty-two infants were enrolled in the study: 23 hypotrophically born infants (birth weight < 5th percentile according to Kyank) with present body weights < 3rd percentile according to Prader (group 1), 15 patients suffering from severe liver diseases (group 2), 14 patients without liver diseases (group 3). Usual serum parameters were estimated. Additionally, the hepatic detoxification capacities were measured using the non-invasive, non-radioactive [15N]methacetin urine test. 17 of the 23 infants of group 1 showed 15N elimination rates as low as in severe liver-diseased patients (group 2) whereas their serum parameters were in the normal range, as were those of group 3. The question remains whether intra-uterine malnutrition or postnatal effects, e.g., environmental conditions, caused the functional liver damage.

Acetamides↗
PubMed1992

[Determination of exocrine pancreatic function in childhood with the pancreozymin-secretin test].

Pancreatic function can only be determined exactly via the pancreozymin-secretin test. We conducted this test in two versions: (1) under conditions of continuous perfusion with the possibility of volume correction and (2) as a simple tubing. We compared the results of 86 tubings with the results of 87 examinations under perfusion. For that purpose all patients were classified into four groups: group a) with 46 and 10 examinations, respectively, in patients suffering from cholestasis in early infancy, group b) with 7 and 12 examinations, respectively, in older patients with liver diseases, group c) with 8 and 17 examinations, respectively, in patients suffering from cystic fibrosis or Shwachman's syndrome and group d) with 25 and 48 examinations, respectively, in children with normal pancreatic function. Both examination methods nearly identical mean values of the enzyme activities in all four patient groups. However, mean variations were found to be higher in case of tubing. Therefore the lower limits (x - 2s) of this test were defined at a lower level than those of the tests under perfusion.

Amylases↗
PubMed1992

[Rate of intrauterine growth retardation at the Leipzig Perinatal Center comparing the years 1982 to 1984 with 1987 to 1989].

Referring to the number of all live-born children, hypotrophic newborn (IUGR) were classified at the Centre for Perinatal Care in Leipzig into two periods of time. Based on the 5th Kyank-percentile 6.5% hypotrophic newborn were classified into period A (1982-1984) and 5.0% hypotrophic newborn were classified in period B (1987-1989). The proportion of hypotrophic newborn with a birth weight < 2500 g amounted to one quarter of all infants (except multiple birth) with low birth weight in period A and to one fifth (20.7%) in period B. The decrease in the rate of hypotrophy in these infants affected nearly exclusively the mature ones. The number of infants with extreme intra-uterine growth retardation amounted to 29% (99 in 329) in period A and to 24% (58 in 238) in period B. The rate of hypotrophy in stillbirths decreased from 44% to 33%. In this process the proportion of extremely hypotrophic stillbirths amounted to 47% in period A, whereas it decreased to only 26% in period B.

Cross-Sectional Studies↗
PubMed1992

[Failure to thrive in young children--disorders of carbohydrate absorption?].

We examined 31 formerly hypotrophic newborn children (birth weight < 5th Kyank percentile) with failure to grow in infancy (weight < 3th Prader percentile). The rates of digestion and absorption of carbohydrates were determined by segmental perfusion of the small intestine and compared to the results of 21 patients with florid coeliac disease. Despite the normal structure of the mucous membrane of the small intestine, the rates of absorption of glucose in 14 formerly hypotrophic children and, additionally, in 12 and 10 of these children, respectively, the rates of hydrolysis of lactose and sucrose were nearly as low as in patients with florid coeliac disease. The reduced absorption and digestion of carbohydrates, respectively, could be a cause of subsequent failure to grow in some of the hypotrophic newborn children.

Celiac Disease↗
PubMed1991

Cystic fibrosis with three mutations in the cystic fibrosis transmembrane conductance regulator gene.

Three mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene were discovered in a pancreas-insufficient patient with cystic fibrosis (CF) who displayed an uncommon combination of almost normal chloride concentration in sweat tests and typical symptoms of gastrointestinal and pulmonary disease. The R553Q mutation was found on the maternal delta F508-CFTR gene. Codon 553 is located within a consensus motif of the ATP-binding cassette transport proteins at a less conserved position. Other members of this protein superfamily contain a glutamine instead of arginine at the homologous position, suggesting a modulating rather than disease-causing role of the R553Q mutation in CFTR. The amplification refractory mutation system did not detect the R553Q mutation in a further 65 normal, 113 delta F508, and 91 non-delta F508 CF chromosomes. The index case carried the R553X nonsense mutation on the paternal chromosome. The R553X mutation was present on a further 9 out of 86 German non-delta F508 CF chromosomes linked with the XV2c-KM19-Mp6d9-J44-GATT haplotypes 2-2-2-1-1 and 1-1-2-1-2. The location of R553X on separate haplotypes including both alleles of the intragenic GATT repeat suggests an ancient and/or multiple origins of the R553X mutations. The association of the genotype of the CFTR mutation and the clinical phenotype was assessed for the patients carrying the related genotypes delta F508/delta F508 (n = 80), delta F508/R553X (n = 9) and delta F508-R553Q/R553X (n = 1). In compound heterozygotes, the median chloride concentration in pilocarpine iontophoresis sweat tests was significantly lower than in the delta F508 homozygotes (P less than 0.01). The patient groups were significantly different with respect to the distributions of the centiles for height (P less than 0.001) and weight (P less than 0.01) as the most sensitive predictors of the course and prognosis in CF. Growth retardation was more pronounced in the compound heterozygotes.

Amino Acid Sequence↗
PubMed1991

[Development of body weight and height of small-for-gestational-age infants in relation to the degree of intrauterine retardation].

The increase of weight of 238 hypotrophic and 31 eutrophic newborns is analyzed and assigned to 4 clusters in the course of their first 21 months. It is compared with body weight curves by Prader. Cluster 1 Increase in weight about the 50th percentile Cluster 2 Increase in weight between the 50th and 3rd percentile Cluster 3 Increase in weight just below the 3rd percentile Cluster 4 Increase in weight clearly below the 3rd percentile More than a half of all hypotrophic newborns had a body weight below the 3rd percentile by Prader (cluster 3 and 4) on attaining the age of 21 months. The appearance of hypotrophy in the newborns is subdivided into 4 groups by means of gestational age and relative birthweight: Group 1 eutrophic and moderate hypotrophic (n = 77) Group 2 premature and moderate hypotrophic (n = 46) Group 3 eutrophic and distinct hypotrophic (n = 62) Group 4 premature and distinct hypotrophic (n = 53) We found that the increase of weight correspond to cluster 4 in 4% of group 1, in 22% of group 2, in 32% of group 3, and in 43% of group 4. At last the increase of body weight is hard influenced in the first 3 years of life by hypotrophy and degrees of maturity of the newborns.

Birth Weight↗
PubMed1991

[Care of patients with celiac disease in adolescence and young adulthood].

60 patients suffering from coeliac disease were continuously cared for during a longer period. In these patients the diagnosis was established on the basis of the commonly used ESPGAN criteria in their childhood. Another biopsy was performed in adolescence and early adulthood. In 26 patients the diagnosis coeliac disease was confirmed. These patients are recommended to carry on keeping to a strict diet. 4 patients show a normal mucosa (type I) while following normal nutrition for more than 2 up to 5 years in adulthood although in their childhood the diagnosis of coeliac disease was established. While being put an a diet or following a short lasting normal nutrition, respectively, 17 patients have a morphologically intact mucosa of the small intestine, which is, however, in nearly all cases functionally damaged. In these patients the diagnosis is to be clarified definitely by means of a final biopsy of the small intestine after an at least 2-year-lasting exposition to gluten. 13 patients refused a biopsy in adulthood.

Adolescent↗
PubMed1991

[Comparative studies of the activity of disaccharidases in the mucosa of the small intestines in dystrophic, formerly hypotrophic-born young children and of patients with flat mucosa of various etiology].

The disaccharidase activities of the mucous membrane of the small intestine were determined in formerly hypotrophic children who showing a dystrophy with a morphological normal mucosa (n = 36), patients with a flat mucosa caused by enteral protein intolerances of different genesis (n = 27), patients with a morphologically and functionally normal mucosa (n = 51). In about half of the former small-for-date children were shown activities lower than the simple standard deviation of the normal value, for lactase n = 17, for sucrase n = 14, for maltase n = 12. Some children showed pathologically reduced activities even below the double standard deviation for the normal value: lactase n = 8, sucrase n = 5, maltase n = 3.

Birth Weight↗
PubMed1991

[Acute circulatory disorders of the eye. Clinical findings and results of Doppler sonography of the internal carotid artery].

Clinical and Doppler sonographic findings on the internal carotid artery of 218 patients with acute central retinal artery obstruction (42), branch retinal artery obstruction (43), anterior ischemic optic neuropathy (AION) (51), amaurosis fugax (AF) (21), and retinal vein occlusions (61) were evaluated. The most prominent finding was that only 1 out of 51 patients with AION and none of 61 patients with retinal vein occlusions showed a relevant stenosis or occlusion of the internal carotid artery. In contrast, however, patients with acute central retinal artery obstruction and branch retinal artery obstruction and those with AF revealed stenoses or occlusions of the internal carotid artery in approximative one-third to one-fourth of the cases. No excavation of the optic disc (cup) occurred in patients' eyes affected by AION or in the other eye. Fourteen of 51 patients with AION showed a "stuttering progression" of their visual function. The patients with progressive loss of vision were significantly younger on average than patients with permanent visual loss due to AION. Some of these cases with progressive field defects revealed an increase in edema of the optic discs and in hemorrhages. Patients with acute central retinal artery obstruction showed very high blood pressure values more often than patients with AION. Retinal emboli (Holenhorst plaques) were very often seen in patients with branch retinal artery obstruction (in 29 of 43 patients; 67%). However, they rarely occurred in patients with acute central retinal artery obstruction (5 of 42 patients). Only 1 of 51 cases with AION showed retinal emboli.

Adult↗