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Biomedical subjects

W Klein

Publications and source records attributed to W Klein.

At least 235 records · Page 13Linked to original sources
PubMed1993

[Calcium antagonists and coronary heart disease. An overview].

Calcium antagonists (Ca-antagonists) have been used for 2 decades in the treatment of coronary heart disease. Their use has initially been promoted with variant angina, but soon has expanded to all forms of coronary heart disease, entailing both stable and instable angina. Based on promising experimental findings, these drugs have also been given in myocardial infarction, however, with disappointing results. The same was true for secondary prevention. The basic principle underlying Ca-antagonistic therapy of ischaemic heart disease is the improvement of myocardial oxygen balance. On the one hand, Ca-antagonists (in particular verapamil and diltiazem) reduce myocardial oxygen demand via negative inotropic and chronotropic action--on the other hand, the afterload is reduced by peripheral vasodilation. In addition, coronary dilation improves oxygen delivery, especially during exercise. Ca-antagonists inhibit transsarcolemmal Ca-influx, thus preventing deleterious myocardial Ca-overload as seen during ischaemia and atherosclerosis. Indeed, recent human studies have proven a preventive effect of Ca-blockers against atherosclerosis.

Calcium Channel Blockers↗
PubMed1993

[Genetic and immunologic studies after space flight].

The effect of spaceflight on lymphocytes of the peripheral blood was investigated in the Austrian cosmonaut flying the Austro-Soviet mission Austromir. Blood was sampled before and after flight, and the following parameters studied: quantities of lymphocytic subsets (T cells, helper cells, suppressor cells, B cells and natural killer cells); mitogenic stimulation of lymphocytes--DNA (= deoxyribonucleic acid) synthesis and expression of Interleukin-2-receptor; structural modification of DNA, unscheduled DNA synthesis and sister chromatid exchanges. Besides reducing the number of natural killer cells, spaceflight caused on impairment of lymphocyte activity and a slight modification of DNA structure. 4 weeks after flight, control values were reestablished, indicating efficient repair mechanisms.

Chromosome Aberrations↗
PubMed1993

Evaluation of the role of coronary heart disease and left ventricular contractile function in systolic mitral valve displacement.

It has been suggested that systolic bulging of the mitral valve caused by ischaemia induced left ventricular dysfunction may ultimately lead to mitral valve prolapse, making coronary heart disease the most important cause of secondary mitral valve prolapse. The influence of coronary heart disease on systolic displacement of the mitral valve was assessed in 90 consecutive patients with chest pain who were evaluated with coronary angiography and ventriculography of the left ventricle. 22 patients had coronary heart disease affecting one vessel (one vessel disease, OVD), 35 patients had coronary heart disease affecting more than one vessel (multiple vessel disease, MVD), and 33 patients had normal coronary arteries. The prevalence of mitral valve bulging was also determined in 16 patients with dilatative cardiomyopathy (CMP). Prevalence of mitral valve bulging in patients with OVD was not significantly different from normal patients. Patients with MVD and CMP had a lower prevalence of mitral valve bulging than normal patients and patients with OVD (p < 0.001). When all patients were grouped according to their ejection fraction, regardless of their underlying disease, there was a positive correlation between prevalence of mitral valve bulging and ejection fraction (r = 0.98, p < 0.001). Patients with an ejection fraction of below 50% did not have mitral valve bulging. We conclude that coronary heart disease is not a cause of mitral valve bulging and, furthermore, that systolic mitral valve bulging may serve as indicator of good left ventricular contractile function.

Adult↗
PubMed1993

[Eating behavior of patients with metabolic diseases and metabolically healthy probands in Austria. Results of a questionnaire survey at the Graz Autumn Fair 1991].

Malnutrition as the cause of developing atherosclerosis is undoubtedly of major importance. For that reason, proper nutrition and eating habits among the population is of specific significance in preventive medicine. In order to establish a more pronounced food consciousness among the population of Styria, a questionnaire was issued to 1.354 persons attending the Graz Autumn Fair in 1991. The results showed above all that approximately 40% of the subjects investigated presented a disease due to malnutrition and metabolic disorder, mainly hyperlipidemia. The choice of various foods varied according to male and female tastes; roasted pork was more often a men's favourite dish (p < 0.001) while women had a prediction for vegetarian food (p < 0.001). There was, however, no difference in the choice of eating habits in persons with or without metabolic disorders. Thus, women in general do pursue a healthier consciousness was not so pronounced in man. Yet, it could not be established by means of the questionnaire that subjects with metabolic disorders showed different eating habits with respect to their disease.

Adult↗
PubMed1993

A physiological oral magnesium supplement does not influence total serum magnesium, left ventricular ejection fraction and prognosis in patients with dilated cardiomyopathy.

It has been postulated that patients with congestive heart failure (CHF) benefit from physiological oral magnesium supplements. In order to study the effect of such supplements upon patients with idiopathic dilated cardiomyopathy (IDC) we studied a group of 23 patients with the salient characteristics of IDC (18 male, 5 female; mean age 51 +/- 13 years [range: 23-72]; Mg group), who received oral magnesium supplements (15 mmol/day). All patients received oral ACE inhibitors and 22 were receiving digitalis and diuretics. A control group of 27 patients, matched for age, sex, symptoms, and additional treatment (22 male, 5 female; mean age 52 +/- 13 years [range 22-71]) were not given oral magnesium supplements. All these patients also received oral ACE inhibitors, 25 were receiving digitalis, and 23 were receiving diuretics. Mean serum magnesium concentration (total serum Mg) in the Mg group was 0.83 +/- 0.06 mmol/litre [mean +/- SD, range 0.69-0.99], while in the control group it was 0.83 +/- 0.07 mmol/litre [range 0.70-0.96], P = NS. Left ventricular ejection fraction (LV-EF) improved from 32 +/- 11 per cent [range 13-51] to 42 +/- 14 per cent [range 15-66] in the Mg group and from 30 +/- 13 per cent [range 10-52] to 42 +/- 11 per cent [range: 25-64] in the control group. We found that physiological oral Mg supplements did not influence serum magnesium, LV-EF, or prognosis. Furthermore, we found that 56 per cent of all patients improved when subjected to strict guidance and therapy with ACE inhibitors, digitalis, and diuretics.

Adult↗
PubMed1993

[Free, vascularized, folded fibula transplantation].

A free vascularized folded fibula as possibility for reconstruction of segmental bony defects up to 9 cm is described. Preserving its vascularisation, the fibula is osteotomized and folded into two equal or two vascularized bone transplants of different length with only one arterial and venous pedicle. Folding of the fibula leads to a biomechanically superior stabilisation. This technique was used in a posttraumatic osteomyelitic defect of the tibia after a Pilon tibiale fracture.

Adult↗
PubMed1993

[Revision operations in carpal tunnel syndrome].

From 1975 to 1990, 1133 carpal tunnel releases were performed. Of these operations, 81 were secondary procedures, suggesting that repeat surgery for carpal tunnel syndrome is not uncommon. Of the 50 repeat procedures during the last six years, 37 were operated on due to persistent or early recurrent symptoms within fifteen months of their first operation. Technical errors and complications due to traumatic technique were found to be the underlying causes. The most frequent finding was an incompletely divided retinaculum flexorum. Twelve out of thirteen patients with an operation interval longer than fifteen months had been relieved of their complaints for months after the first operation. Some of these cases are considered to be true recurrences. In cases of persistent or recurrent symptoms after carpal tunnel release, operative revision is indicated without hesitation.

Adult↗
PubMed1993

[Results of dorsal pelvic ring stabilization].

Complete disruptions of the posterior pelvic ring are rotationally and vertically unstable [type C according to the Tile/AO (ASIF) classification (1991)]. Usually operative treatment is required. The data on 24 patients over a 5-year period were analyzed. Thirteen patients were female (54.2%) and 11 male (45.8%); the average age was 32.8 years. Multiple trauma was present in 20 patients (83.3%). In most cases operative stabilization of the posterior pelvic ring was performed by lag screws from the ilium into the body of the sacrum. The mortality in this series was 16.7% (4 patients). One patient had a thrombosis of the femoral and pelvic veins. In 2 patients we had to perform a second operative procedure because of lag screws that had not been precisely placed or had dislocated. Two incisions healed secondarily. On the postoperative radiographs in 3 patients a slight deformity of the pelvic ring was visible; in another patient the reduction of the injured hemipelvis was not sufficient. The 20 survivors had a clinical and radiological examination on average 27.5 months after their injury. Eleven patients were without pain, while 9 complained of low back pain. Gait disturbances were found in 8 patients; in 2 of them this was due to associated injuries. Five patients were unable to work. Eight patients had neurological deficits, some of them minor. Additional complications were impotence (3 patients), urinary (2 patients) or fecal incontinence (1 patient), and dystocia requiring a cesarean section (1 woman) [multiple entries].(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Clinical aspects, morphology and therapy of an unusual case of bilateral macrodactyly].

Macrodactyly, originally described by von Klein in 1824, is one of the rarest congenital anomalies of the hand. It displays a wide variety of manifestations, and its association with other congenital defects and syndromes has been discussed by many authors. A rare case involving an adult with bilateral, hyperostotic macrodactyly of the hands is presented. The hands were not treated in childhood. Clinical findings, pathology, and treatment are discussed.

Adult↗
PubMed1992

Stereoselective release of (S)-atenolol from adrenergic nerve endings at exercise.

In-vitro studies have shown that atenolol, a beta-blocking agent, is stereoselectively taken up by and released from adrenergic nerve endings by membrane depolarisation. To investigate the potential importance of these findings, blood samples were taken at rest and after exercise testing from 10 patients (mean [SE] age 60 [3] years) receiving long-term treatment with racemic atenolol. At rest, mean plasma concentration of (R)-atenolol was higher than that of (S)-atenolol (ratio 1.14, p less than 0.01), but after exercise there was a stereoselective increase in (S)-atenolol concentration, which changed the ratio to 0.66 (p less than 0.01). Since (S)-atenolol but not (R)-atenolol causes clinically relevant beta-blockade, our findings may have importance for the management of patients receiving beta-blocking drugs.

Adrenergic Fibers↗
PubMed1992

Frequency of magnetic resonance signal abnormalities of the brain in patients aged less than 50 years with idiopathic dilated cardiomyopathy.

Twenty patients with idiopathic dilated cardiomyopathy (IDC) aged less than 50 years (mean 41) and an age-matched group of 20 healthy volunteers were studied. All subjects were free of cerebrovascular symptoms and risk factors for stroke. Magnetic resonance imaging of the brain, extracranial Doppler ultrasonography, heart catheterization and echocardiography were performed. In patients with IDC, a higher frequency of ventricular enlargement (p less than 0.02), cortical atrophy (p less than 0.01) and white matter lesions (p less than 0.05) was observed. Cerebral infarcts were found in 4 patients (p less than 0.05) who showed clinically severe limitation of functional capacity (New York Heart Association class III or IV). The extent of cortical atrophy, and the duration of clinical evidence of IDC showed a significant correlation (p less than 0.04). The data indicate a high incidence of parenchymal abnormalities of the brain in young, neurologically asymptomatic patients with IDC.

Adolescent↗
PubMed1992

Increased IgM-anticardiolipin antibodies in patients with restenosis after percutaneous transluminal coronary angioplasty.

Increased anticardiolipin antibodies (acL) are often associated with arterial thrombosis in patients with autoimmune diseases. A mural thrombus at the site of percutaneous transluminal coronary angioplasty (PTCA) has been suggested as the initial cause for restenosis after primarily successful PTCA. In this study, IgM- and IgG-acL were determined in 65 men with coronary artery disease treated by PTCA; patients with infectious and autoimmune diseases were excluded from the study. Follow-up coronary angiography was performed 12 months after PTCA; restenosis was defined as greater than or equal to 50% reduction in diameter of the coronary vessel. The series comprised 2 groups: 34 patients (mean age 56 +/- 8 years) with (group A) and 31 (mean age 55 +/- 9 years) without (group B) restenosis. Medical history and laboratory findings were comparable in both groups. In patients with restenosis, IgM-acL were more often increased (9 of 34) than were those in patients without restenosis (2 of 31; p less than 0.05); IgG-acL values did not differ in both groups. Furthermore, there was no correlation between any vascular risk factors or laboratory findings, or both, with both IgM- and IgG-acL levels. Thus, IgM-acL appear to be independent indicators for an increased risk for restenosis after PTCA. Our observations suggest that an autoimmune mechanism may have a role in restenosis.

Adult↗