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Biomedical subjects

U Kaufmann

Publications and source records attributed to U Kaufmann.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Spontaneous left atrial echo contrast in trans-esophageal echocardiography].

Left atrial spontaneous contrasts (LASC) are found almost exclusively with transesophageal echocardiography (TEE), usually in patients with mitral stenosis or mitral prosthetic valves. The prevalence of LASC was examined in 143 consecutive patients undergoing TEE and transthoracic echocardiography (TEE). LASC of variable intensity were observed in 31 patients (22%) with TEE, in contrast to none with TTE. There was a significant correlation between the presence of LASC and atrial fibrillation (p less than 0.001), left atrial dilatation (p less than 0.005) and presence of mitral valve prosthesis or mitral stenosis (p less than 0.02). In 48% of patients with LASC the mitral valve was entirely normal. Multivariance analysis showed atrial fibrillation and left atrial dilatation to be independent predictors for the presence of LASC. There were significantly more ischemic strokes in patients with LASC (35% vs 12% in patients without LASC). LASC are a frequent observation with TEE. As sensitivity of the echocardiography instruments steadily improves, LASC are also found in increasing numbers of patients with minimal structural change of the heart. LASC may indicate the presence of microthrombi and thus be involved in the pathogenesis of thromboembolic complications; their clinical relevance and prognostic significance needs to be further investigated.

Adult↗
PubMed1991

Long-term follow-up of the first 56 patients treated with intracoronary self-expanding stents (the Lausanne experience).

Fifty-six patients treated with the self-expanding intracoronary stent for acute occlusion during percutaneous transluminal coronary angioplasty (PTCA) or restenosis were followed for 24 to 43 months (mean 34). Successful deployment and positioning were achieved in 55 of 56 patients. Occlusion of the stent was documented in 8 patients, the earliest occurring 30 minutes and the latest 8 months after implantation. Three of the occluded stents were recanalized by PTCA. Coronary artery bypass grafts (CABG) were required in 4 patients: 1 for symptomatic restenosis, 1 for left main stenosis adjacent to the stent and 2 for acute ischemia during the in-hospital stay (less than 7 days). Myocardial infarction occurred in the territory of the stented vessel in 8 patients. Seven patients died between 1 day and 19 months after implantation. Local bleeding complications occurred in 10 patients, with 5 requiring blood transfusion. Restenosis within the stent was angiographically documented in 5 patients (9%). A new lesion in the treated vessel was found in 10 patients, followed by implantation of a second stent in 5 and a third stent in 1 patient. Medical treatment was instituted in the remaining 4 patients. Forty-nine patients (88%) are alive. Twenty-nine patients (51%) remained asymptomatic, and 44 (78%) are in a better functional class than before the implantation. Eleven of 15 (79%) major complications (acute occlusions or deaths) occurred in patients who received a stent in the left anterior descending coronary artery. In conclusion, implantation of the self-expanding intracoronary stent appears to be a new therapeutic option for treating acute occlusion or restenosis after PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1991

The porcine PGD gene is preferentially lost from chromosome 6 in pig x rodent somatic cell hybrids.

The 6-phosphogluconate dehydrogenase (PGD) and glucose phosphate isomerase (GPI) genes are both located on chromosome 6 in the pig (Sus scrofa domestica). Nonetheless, the PGD gene was absent in a total of 17 GPI-positive cell lines found in three independently derived panels of pig x rodent somatic cell hybrids. In most of these cell lines we found an apparently normal pig chromosome 6 at cytogenetic analysis. These results suggest instability of the porcine PGD gene region in interspecies hybrid cells.

Animals↗
PubMed1991

Relative risk analysis of angiographic predictors of restenosis within the coronary Wallstent.

BACKGROUND: Late angiographic narrowing has been observed following coronary implantation of the Wallstent. To identify the angiographic variables that predict restenosis within the stented segment, a retrospective study of data from the European Wallstent core laboratory was performed. METHODS AND RESULTS: Follow-up angiograms (excluding patients with in-hospital occlusions) were analyzed for 214 lesions in 176 patients (78% restudy rate). The incidence of restenosis within the stented segment was 35% by lesion and 35% by patient for criterion 1 (greater than or equal to 0.72 mm loss in minimal luminal diameter) and 24% by lesion and 24% by patient for criterion 2 (diameter stenosis greater than or equal to 50% at follow-up). The association between 16 variables and restenosis was determined by a relative risk ratio assessment. Variables with significant risk ratios for restenosis with criterion 1 were use of multiple stents/lesion (relative risk, 1.56; 95% confidence interval [CI], 1.08-2.25) and oversized (unconstrained stent diameter exceeding reference diameter greater than 0.7 mm) stents (relative risk, 1.64; 95% CI, 1.10-2.45), and for criterion 2, oversizing by more than 0.70 mm (relative risk, 1.93; 95% CI, 1.13-3.31), bypass grafts (relative risk, 1.62; 95% CI, 0.98-2.66), use of multiple stents/lesion (relative risk, 1.61; 95% CI, 0.97-2.67) and residual diameter stenosis more than 20% post stenting (relative risk, 1.51; 95% CI, 0.91-2.50). CONCLUSIONS: It is concluded that several angiographic variables are significantly associated with late angiographic narrowing after stenting in the coronary arteries. We suggest that stent operators avoid excessive oversizing in the selection of stent diameter and the use of multiple stents per lesion to lessen the risk of late restenosis.

Blood Vessel Prosthesis↗
PubMed1991

[Therapy of sleep apnea with theophylline (Uniphylline) administration every evening].

Sleep apnoea (SA) has a prevalence of 1-10% in men. The physiological sleep is disturbed. SA is associated with cardiopulmonary disease (systemic arterial hypertension, cardiac arrhythmics, cor pulmonale) and the quality of the patient's life is reduced. Thirty male patients participated in a study to investigate the influence of an oral dose of theophylline on sleep apnoea. Under theophylline a significant reduction of apnoea events and of the apnoea index was seen.

Adult↗
PubMed1991

[Long-term follow-up of sleep apnea therapy with sustained-release theophylline administered every evening].

Sleep apnoea increases mortality and morbidity. The physiological sleep profile is disturbed and functional capacity is decreased. At present nasal CPAP breathing (continuous positive airway pressure) seems to be the best treatment method in obstructive sleep apnoea. However, this therapy is expensive, imposing a strain on the patient, and hence some patients will not tolerate it. Medical treatment of sleep apnoea with theophylline has proved effective. In 40 patients suffering from sleep apnoea, long-term treatment with sustained-release theophylline was investigated. Responders show a significant reduction of apnoeic phases and of apnoea index at the beginning and after long-term treatment. Using an individual theophylline dosage with morning theophylline concentration between 5 and 8 micrograms/ml, only few side-effects occurred. Positive effects on cardiopulmonary capacity could be detected. The Broca index does not change significantly. Sustained-release theophylline applied in the evening showed a positive effect on sleep apnoea in responders.

Adult↗
PubMed1991

[Hemodynamic changes with and without CPAP-ventilation in patients with sleep apnea].

In 21 patients suffering from severe sleep-apnoea syndrome we measured continuously haemodynamic parameters, blood gases, ECG, EEG, respiratory rate and ultrasonic cardiogram before and under treatment with nasal CPAP-breathing. All patients (male, age 29 to 58 yrs) had normal blood gases, heart-minute-volumes pulmonary artery pressures and left ventricular end-diastolic wedge pressures, when they were awake. During sleep all developed a decrease of pO2 and severe pulmonary artery hypertension with mean pulmonary artery pressures of 64 mmHg. In 10 patients an enlargement of the right ventricular diameter up to 13 mm difference could be seen. Treatment with nasal CPAP-breathing could reduce or even prevent changes in blood gases and in the haemodynamic system. The pulmonary artery pressures normalised in all patients. No right ventricular enlargement could be seen during nasal CPAP-breathing. Treatment with CPAP-breathing could normalise haemodynamic disorders in patients with severe SAS and may perhaps prevent development of cor pulmonale.

Adult↗
PubMed1990

[Coronary restenosis 6 months following transluminal atherectomy].

UNLABELLED: Directional coronary atherectomy was developed to decrease the incidence of restenosis. Among the first 61 patients treated with directional atherectomy at Mayo Clinic, 50 have been considered a success. Half of the patients had had one or more previous PTCA performed on the target lesion. Patients were followed during 6 months. Coronary angiogram was performed 6 months after atherectomy or earlier if ischemia appeared. Restenosis was defined as a greater than or equal to 50% luminal narrowing or loss of greater than or equal to 50% of the initial gain. Ischemia was documented in 23 patients. Control angiogram demonstrated restenosis in 24 patients (48%). Among those 24 patients, 18 had ischemia documented during stress test or at rest, and underwent a second procedure (second atherectomy in 4, PTCA in 8 and bypass surgery in 6 patients). Neither previous procedures nor the type of vessel significantly influenced restenosis rates. CONCLUSIONS: coronary restenosis was not less frequent after directional atherectomy, than after conventional balloon angioplasty. Previous procedures or type of vessel did not influence restenosis incidence.

Adult↗
PubMed1990

Assignment of the porcine calcium release channel gene, a candidate for the malignant hyperthermia locus, to the 6p11----q21 segment of chromosome 6.

Several studies point to the possibility that malignant hyperthermia (MH) in pigs is caused by a defect in the calcium release channel (CRC) of skeletal muscle sarcoplasmic reticulum. The locus for MH is closely linked to the glucosephosphate isomerase (GPI) locus, near the centromere of chromosome 6. We demonstrate synteny of the genes for CRC and GPI using somatic cell hybrid lines, and assign the CRC gene to chromosome 6p11----q21 by in situ hybridization.

Amino Acid Sequence↗
PubMed1990

[Current problems of pharmacotherapy--heart failure].

Cardiac muscle cell hypertrophy, hyperplasia of connective tissue, abnormal peripheral circulation and metabolic changes in the cardiac fibre and in the smooth muscle cell as a consequence of mechanic overload are described in variable proportions in heart failure. These changes in turn are essential factors for progression of the disease. Results of early drug intervention in patients with few or no symptoms suggest that decrease of mechanic overload by vasodilator therapy slows down the progression of the disease. In late stages, treatment with diuretics and vasodilators improves the symptoms and the outcome of heart failure. Diuretics alone and inotropic positive substances bring about some improvement of symptoms and maximal oxygen consumption, but they have no favourable effect on the outcome. Positive inotropic substances remain restricted to late forms of heart failure, in which they seem to ameliorate symptoms but have a rather unfavourable effect on the outcome. The role of diuretics, ACE inhibitors and digoxin is well defined. This is not the case for newer calcium-channel blockers from the dihydropyridine group, of beta blockers, of phosphodiesterase inhibitors and of substances with partial beta agonist and partial beta blocking activity. These drugs must still be classified as experimental agents for the treatment of heart failure.

Adrenergic beta-Antagonists↗
PubMed1990

[Importance of psychometric studies in gynecological tumor follow-up care].

100 patients successfully treated for gynecological tumors and 100 females who never had suffered from a malignant disease were investigated for neurosis by means of a special questionnaire according Höck and Hess. 52% out of the tumours patients and 42% of the control group demonstrated symptoms and signs of neurosis. The difference was not significant. Patients with tendency to depression or neurosis can be detected with psychometric methods and treated accordingly.

Adult↗
PubMed1989

[Immediate and late complications secondary to the implantation of a coronary endoprosthesis].

The incidence of acute and late complications after coronary stenting has been studied in 95 consecutive patients. A total of 113 stents were implanted: 23 cases for acute occlusion of the dilated vessel and 72 for restenosis. After 16 months of follow-up, minor complications had occurred in 22 patients (23%). They consisted of transient occlusion of the prosthesis in 7 patients (7.3%), non-Q wave infarction in 4 patients (4.2%) and 10 hemorrhages (11%). During the following period major complications were observed in 11 patients (12%) with myocardial infarction in 7 instances and acute occlusion in 7 patients. 5 patients (5.3%) underwent coronary artery bypass graft and 6 (6.3%) died (one in-hospital death). Two deaths were related to the stent, but in the other four no definite correlation between the prosthesis and the death could be demonstrated. Restenosis at 12 months was present in 4 cases: in 3 patients (4.7%) where the stent had been implanted for restenosis and 1 (4.7%) where it had been implanted for acute occlusion. We conclude that for selected patients, coronary stenting is a promising new technique, especially for acute occlusion after PTCA; moreover, at 12 months restenosis is less frequent than after PTCA. However, technical improvement is necessary to diminish the rate of complications, particularly thrombosis and hemorrhage.

Aged↗