Biomedical subjects
Publications and source records attributed to U Engel.
An unusual case of metastasis of neoplasm to a benign neoplasm is reported. The initial malignancy, a small-cell bronchogenic carcinoma, was found to have metastasis to a renal oncocytoma. A review of the literature indicates, according to our knowledge, no similar case.
A controlled multicenter study has been carried out in 46 patients with ventricular tachyarrhythmias to define the antiarrhythmic effect of disopyramide phosphate. Monitoring of cardiac rhythm was performed during the whole study period by ambulatory Holter recording. The daily dose of disopyramide was 600 mg. It was found that disopyramide caused a reduction of at least 80% in the number of premature ventricular beats in 72% of the patients. Episodes of ventricular tachycardia were effectively suppressed in 65% of the patients. In 24 patients there was a reduction in the severity of the observed ventricular arrhythmias of at least one class in the classification of Lown. Analysis of the results showed a relationship between the antiarrhythmic effect and group mean plasma concentration of disopyramide.
Serious postoperative complications following thyroid surgery are to be expected in approximately 3% of cases. Intraoperative blood loss, usually in the region of the superior thyroid artery, should be minimised by careful preparation. Damage to recurrent laryngeal nerves is usually indirect due to stretching. Damage to the recurrent laryngeal nerves can be minimised by thoroughly searching for them. Permanent tetany may be avoided by demonstration and sparing of the parathyroid bodies and their blood supply. Postoperative complications of the various forms of breathing disturbance, secondary bleeding, hyperthyroid crises and hypothyroidism will be discussed in detail.
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The systolic time intervals (LVET, PEP, and ratio LVET/PEP) were determined in 53 patients presenting with signs or symptoms of thyroid dysfunction. Patients with clinical evidence of congestive heart failure, with arterial hypertension or old myocardial infarction, and patients receiving cardioactive drugs, were excluded from the study. Thyroid function was evaluated by means of T3-RIA, serum thyroxin and TRH stimulation test.
Nicotine (2 X 10(-4) M) or acetylcholine (5.5 X 10(-4) M) in the presence of 3 X 10(-6) M atropine did not increase the rate or amplitude of contraction in isolated atria or ventricular strips of the chicken heart; both drugs also did not cause an output of noradrenaline or adrenaline and did not evoke antidromic discharges in the right sympathetic nerves of isolated perfused chicken hearts. In contrast, "high K+-solutions" evoked an output of noradrenaline and adrenaline and caused a burst of antidromic discharges. Dimethylphenylpiperazine (DMPP; 3.1 X 10(-4) M), by a tyramine-like action, elicited a small output of noradrenaline and increased rate and amplitude of contraction" but did not evoke antidromic discharges. The noradrenaline output caused by DMPP was not reduced by lowering the extracellular Ca2+ concentration from 1;8 to 0.1125 mM.-Acetyl-choline (10(-5) and 10(-4) M)inhibited the noradrenaline and adrenaline outputs evoked by electrical stimulation of the right sympathetic nerves (3 HZ, 1 ms, 30 V); the inhibition was blocked by 3 X 10(-6) M atropine.-It is concluded that the terminal parts of sympathetic nerves of the chicken heart possess muscarinic inhibitory receptors but lack nicotinic excitatory receptors. Thus prejunctional nicotinic receptors are not an integral part of the terminal sympathetic neurone otherwise they would be present at this neurone in all species.
54 patients with mitral incompetence of varying origin have been studied by echocardiography. Echocardiography was usually not helpful in the diagnosis of pure mitral incompetence of mixed mitral valve lesions. However, it proved to be a sensitive method for recognition of the typical anomaly in "mid systolic click/late systolic murmur syndrome", which is ballooning of one or both leaflets toward the left atrium (17 out of 22 patients). The echo was equally useful for documentation of an abnormal systolic motion of the anterior mitral leaflet toward the septum, which was found in 7 of the 11 studied cases of hypertrophic obstructive cardiomyopathy.