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Biomedical subjects

W Hemmer

Publications and source records attributed to W Hemmer.

99 records · Page 6Linked to original sources

[Heart transplantation--2 years' experience in the Grosshadern Clinic of the University of Munich].

Between August 1981 and August 1983 11 heart transplantations were carried out at the Klinikum Grosshadern of the University of Munich. The recipients were 10 men and 1 women. The age of the patients at the time of the operation ranged from 20 to 45 years. The diagnosis was: congestive cardiomyopathy (4 cases), coronary heart disease (5 cases), Uhl's disease (1 case), valvular heart disease (1 case). Cyclosporin A was used as the main immunosuppressive agent in all cases. 3 patients died (1., 10. and 73. postop. day). 8 patients survived now since 2 to 25 months. The survival time exceeds 0.5 years in 5 cases and 1 year in 3 cases.

Adult↗

[Cortisone in non-hemorrhagic stroke. An anterospective comparative study (author's transl)].

In an open, randomized anterospective, comparative study on encephalomalacias it was shown that with regard to the parameter of rehabilitation progress in the degree of paralysis, the patients treated with cortisone had a significantly better performance at the 5% level. The main point of attack of cortisone appears to be in the early phase of the insult (first 5 days). It seems unlikely that edema control is the only active principle. More probably this is an additional effect on cell metabolism. From these results it seems logical to continue to follow up the acute treatment of cerebral insult with cortisone and search for an optimal dosage and better confirmation.

Aged↗

Creatine kinase in non-muscle tissues and cells.

Over the past years, a concept for creatine kinase function, the 'PCr-circuit' model, has evolved. Based on this concept, multiple functions for the CK/PCr-system have been proposed, such as an energy buffering function, regulatory functions, as well as an energy transport function, mostly based on studies with muscle. While the temporal energy buffering and metabolic regulatory roles of CK are widely accepted, the spatial buffering or energy transport function, that is, the shuttling of PCr and Cr between sites of energy utilization and energy demand, is still being debated. There is, however, much circumstantial evidence, that supports the latter role of CK including the distinct, isoenzyme-specific subcellular localization of CK isoenzymes, the isolation and characterization of functionally coupled in vitro microcompartments of CK with a variety of cellular ATPases, and the observed functional coupling of mitochondrial oxidative phosphorylation with mitochondrial CK. New insight concerning the functions of the CK/PCr-system has been gained from recent M-CK null-mutant transgenic mice and by the investigation of CK localization and function in certain highly specialized non-muscle tissues and cells, such as electrocytes, retina photoreceptor cells, brain cells, kidney, salt glands, myometrium, placenta, pancreas, thymus, thyroid, intestinal brush-border epithelial cells, endothelial cells, cartilage and bone cells, macrophages, blood platelets, tumor and cancer cells. Studies with electric organ, including in vivo 31P-NMR, clearly reveal the buffer function of the CK/PCr-system in electrocytes and additionally corroborate a direct functional coupling of membrane-bound CK to the Na+/K(+)-ATPase. On the other hand, experiments with live sperm and recent in vivo 31P-NMR measurements on brain provide convincing evidence for the transport function of the CK/PCr-system. We report on new findings concerning the isoenzyme-specific cellular localization and subcellular compartmentation of CK isoenzymes in photoreceptor cells, in glial and neuronal cells of the cerebellum and in spermatozoa. Finally, the regulation of CK expression by hormones is discussed, and new developments concerning a connection of CK with malignancy and cancer are illuminated. Most interesting in this respect is the observed upregulation of CK expression by adenoviral oncogenes.

Animals↗

High-dose diltiazem prevents migration and proliferation of vascular smooth muscle cells in various in-vitro models of human coronary restenosis.

BACKGROUND: Restenosis after coronary angioplasty is considered to be caused mainly by increased migration and proliferation of smooth muscle cells (SMC). The concept of local, site-specific delivery of pharmacologic therapies has opened the door for new, high-dose drug regimes. METHODS AND RESULTS: SMC were isolated by enzymatic disaggregation with collagenase/elastase from human coronary plaque tissue of 29 patients (pSMC) and post mortem from the coronary media of 33 corpses (mSMC). Endothelial cells were isolated from human umbilical veins by enzymatic disaggregation with collagenase/dispase. By positive reaction with antibodies against smooth muscle alpha-actin and von Willebrand factor cells were identified as SMC or endothelial cells. In proliferation studies 5-150 micrograms/ml diltiazem was added to the culture media of pSMC, mSMC and endothelial cells. After 5 days there was a significant dose-dependent inhibition of cell proliferation (for pSMC with > 50 micrograms/ml, for mSMC with > 25 micrograms/ml, and for endothelial cells with > 5 micrograms/ml). In migration studies the effect of 5-150 micrograms/ml diltiazem on the velocity of migration of pSMC was investigated over a period of 48 h. Administration of diltiazem at concentrations of 100 and 150 micrograms/ml caused a significant inhibition of the migration of pSMC. The cytoskeletal components smooth muscle alpha-actin, vimentin, and alpha-tubulin of pSMC and the expression of von Willebrand factor of endothelial cells were investigated after an incubation period of 5 days with 50 and 150 micrograms/ml diltiazem. In the transfilter coculture model the effect of 50 micrograms/ml diltiazem on mSMC was investigated after mechanical injury of cocultured endothelial cells. Administration of diltiazem at a concentration of 50 micrograms/ml inhibited the development of a neointimal proliferate in the transfilter coculture model significantly (P < 0.001). CONCLUSIONS: A high dose of diltiazem inhibited the migratory and proliferative activities of coronary SMC significantly. In further experimental studies the effect of locally applied high doses of diltiazem on postangioplasty restenosis should be elucidated.

Actins↗

Background and early results of a modified left atrial radiofrequency procedure concomitant with cardiac surgery.

With the introduction of the maze operation Cox was able to show that the surgical treatment of atrial fibrillation (AF) is feasible. However, the maze operation remains surgically demanding and time-consuming as it requires multiple incisions in both atria. This has led to the development of various modifications. With new ablative technology and the acceptable results of an exclusively left atrial maze procedure in combination with mitral valve surgery, it has become possible to simplify the maze operation radically. Thirty-one patients ( mean age 62.3 years) with chronic or intermittent AF underwent a modified radiofrequency procedure in combination with some other cardiac surgical operation. Mitral valve disease coexisted in 17 patients, aortic valve disease in 9, coronary heart disease in 4 patients and 1 had an atrial septal defect (ASD). After left atriotomy and with the use of the Thermaline radiofrequency ablator probe, bilateral pulmonary vein isolation was carried out. An additional ablation line was directed from the left pulmonary veins to the posterior mitral valve annulus, and finally the left atrial appendage was resected. The complete procedure added an average of only 18.2 minutes to the operation. In the early postoperative course AF or atrial flutter recurred in 12 patients but at discharge only 8 patients (24%) still had an arrhythmia. We concentrated on the first 26 patients of our series who had received a follow-up examination 3 months postoperatively. At discharge 18 of the 26 patients were in sinus rhythm (69,2%), and at 3 months after surgery 23 of 26 patients were in sinus rhythm (88.5%), with recovery of atrial contraction confirmed echocardiographically. Only 4 patients still required medication for arrhythmias. The modified radiofrequency ablation procedure of the left atrium proved to be simple to perform, quick and reliable. It offers the possibility of a surgical cure for AF when performed together with another cardiac operation, and the early results indicate a high rate of success for this simple procedure.

Adult↗