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Biomedical subjects

W Klein

Publications and source records attributed to W Klein.

At least 325 records · Page 18Linked to original sources
PubMed1989

[Current status of balloon valvuloplasty in adulthood].

The percutaneous transluminal balloon valvuloplasty has been in use for several years as part of interventional cardiology for treating acquired aortic and mitral stenosis. In spite of a high primary success rate the difficulty of this procedure lies not only in the problem of reststenosis but also in a possible development of restenosis. In aortic stenosis the indication for valvuloplasty must be restricted to special patients, such as elderly people or those with poor left ventricular function, whereas in selected patients, mitral valvuloplasty appears as a true alternative to operative commissurotomy. There can be no doubt that by intensive patient selection and progress in the technology of balloon catheters and insertion sheaths, possibly enhanced by laser application, even better results are to be achieved in the near future.

Adult↗
PubMed1989

[Do thrombocyte aggregation inhibitors modify silent episodes of unstable angina pectoris in combined anti-angina therapy?].

Pathological and clinical studies suggest that platelets play role in the pathogenesis of unstable angina. This study investigated the effect of aspirin on silent episodes of unstable angina. Patient exclusion criteria were acute infarction, left bundle branch block, and ST-depression greater than 0.1 mV in the ECG. 27 patients (pts; 20 m, 7 f; 42-72 yrs) in the CCU with unstable angina were randomized in two groups. Group A received a combination on nitrates, beta-blockers, and calcium entry blockers; in group B aspirin (500 mg/day) was added. 6 h after initiating therapy, Holter-ECG was implemented for 48 h. One pt of group A was excluded owing to infarction within these 48 h. 4 of 13 pts in group A and 5 of 13 in group B showed no ST-Segment abnormalities. 6 pts from each group displayed 2 to 5 ST-depressions greater than 0.1 mV from up to 10 min in 24 h; 3 in group A and 2 in group B had 1-5 lasting 11 to 25 min. In the second 24 h period, the number of ST-depressions decreased distinctly. Statistically, the results obtained did not differ significantly in the two groups. Furthermore, the duration of the silent ischemia did not correlate with the severity of coronary stenosis (angiography 3-8 days after admission). Thus, when combined with the aforementioned triple therapeutic regimen, aspirin does not appear to influence the silent episodes of unstable angina pectoris.

Aged↗
PubMed1989

[The inadequate status of information of interested lay persons about the educational campaign regarding risk factors for cardiovascular diseases].

181 interested individuals (75 males, 106 females; range 16 to 84 years) responded to a questionnaire issued by the Styrian Cardiovascular Lay Society. The main topic of the questionnaire concerned information gained via media, about the possible risk factors related to cardiovascular diseases and about any changes in life style consequent to this information. The results show that the general knowledge in this field especially in younger subjects is disappointing and that there is need for further intensive information and education.

Adolescent↗
PubMed1989

[Apocrine chromhidrosis].

Apocrine chromhidrosis is an extremely rare and impressive skin disorder. Primarily after emotional stress patients complain of coloured sweat secretion (black, green, blue or yellow). The deposition of lipofuscin in the apocrine glands may be the cause of this disease, the different colours of sweat being due to various oxidation stages of lipofuscin. We report two patients, one with blue and one with green axillae; the clinical features, histopathology, differential diagnosis, and pathogenesis of apocrine chromhidrosis are discussed.

Aged↗
PubMed1989

[Use of unilateral external fixation in pediatric femur shaft fracture within the scope of polytrauma].

Femoral fractures in children are mostly managed conservatively. The recommended methods are overhead traction, 90/90 degree traction on a special table (Weber) and skeletal traction in a Thomas splint or on a Brown's frame. This treatment proves cumbersome in most multiply injured children, especially in those with head injury. Due to uncooperative behaviour the fracture is difficult to hold in an acceptable position. Therefore, operative treatment has been favoured by several authors in the past. Over a period of 8 years, 167 adolescent multiple trauma victims were treated in our institution, 48% of whom had sustained femoral fractures. Since June 1985 such fractures have been stabilized with the unilateral De Bastiani external fixator as the primary and definitive treatment. Our first series consists of ten children (eight male, two female) with a total of eleven fractures, aged 3.2-15 years, mean age 8.1 years. Nine fractures were closed and two compound. Nine fractures were fixed on the day of injury and two 2 days after injury. Depending on the patient's age and the level of the fracture, controlled overriding of 10-15 mm was performed to compensate for expected overgrowth. All fractures healed in an average time of 11 weeks. Free hip and knee movement was achieved in all cases 6 weeks after removal of frame. Neither refracture nor deep infection was seen in any of these patients. Compared with internal fixation, use of this device is less invasive and requires a very short operating time. The fixator can be removed as an outpatient procedure with no need for an anaesthetic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Relevant laboratory diagnostic methods for the evaluation of the osteoinductivity of bone matrix implants].

For the valuation of the osteoinductive efficacy of different bone grafts bears upon increasing the determination of the alkaline phosphatase, the content of calcium, hydroxyproline and protein. We could prove the quantitative differentiation of different prepared bone matrix implants being possible, nevertheless the histological examination is an unavoidable, full of good sense completion.

Alkaline Phosphatase↗
PubMed1988

[Status of information of interested lay persons: results of a questionnaire survey by the Styrian Heart Association].

181 interested individuals (75 males, 106 females; range 16 to 84 years) responded to a questionnaire issued within the information and instruction courses of the Styrian Cardiovascular Non-professional Society. The main topic of the questionnaire concerned information gained via media, possible risk factors leading to cardiovascular diseases and any changes in living conditions due to such facts. The results show clearly that the general knowledge in this field especially in younger subjects is disappointing and further intensive information and instruction would be urgently required.

Adolescent↗
PubMed1988

Cyclosporin A treatment in children with minimal change nephrotic syndrome and focal segmental glomerulosclerosis.

In a pilot study 23 children with nephrotic syndrome were treated with cyclosporin A (Cs) for 6-45 months. 8 children suffered from steroid dependent minimal change nephrotic syndrome (MCNS) and had experienced at least one course with cytotoxic drugs, but had relapsed thereafter. 2 children had diabetes mellitus type I with nephrotic syndrome and 13 children had steroid resistant focal segmental glomerulosclerosis (FSGS). Cs was started with 100 mg/m2/day in two doses and increased stepwise to obtain a Cs whole blood trough level of 200-400 ng/ml. In steroid dependent MCNS treatment with Cs reduced relapse rate significantly, and prednisone therapy could be stopped completely. After discontinuation of Cs, relapses reoccurred as frequently as before. Renal function remained unimpaired despite repeated Cs treatment courses up to 38 months. In cases of nephrotic syndrome with diabetes type I Cs treatment led to complete remission without changing the insulin requirement. However, after discontinuation of Cs relapses reoccurred. In steroid resistant FSGS 6 children benefited from Cs treatment: 4 went into complete remission, 2 into partial remission. The 2 children with complete remission relapsed but remained Cs responsive. The remaining 7 children with FSGS did not respond to Cs but continued the course of their disease, with two patients rapidly progressing to terminal renal failure. Side-effects of Cs treatment were mild. It is concluded that Cs is an effective agent in steroid dependent MCNS and can be used as an alternative drug in specific cases like steroid toxicity or diabetes mellitus. In steroid resistant FSGS a trial with Cs seems to be warranted since some cases do respond favorably. To avoid nephrotoxicity treatment with Cs should always be monitored closely by determination of blood levels and renal function.

Biopsy↗
PubMed1988

Fura-2 detected myoplasmic calcium and its correlation with contracture force in skeletal muscle from normal and malignant hyperthermia susceptible pigs.

Fura-2 was used to estimate myoplasmic [Ca2+] in intact intercostal muscle fibers from normal and malignant hyperthermia susceptible (MHS) pigs. Small muscle bundles (20-50 fibers) were loaded with the membrane-permeant form of the dye. Resting myoplasmic [Ca2+] were not significantly different in normal and MHS muscles. Halothane produced increases in myoplasmic Ca2+ with associated contractures in MHS muscles, but not in normal muscles. These halothane effects were reversible. Caffeine produced increases in myoplasmic Ca2+ and contractures in both MHS and normal muscles. The threshold concentrations were lower in the MHS muscles. The correlations between myoplasmic [Ca2+] and force in MHS and normal muscles were similar.

Animals↗
PubMed1988

Arthroscopic synovectomy of the knee joint: indication, technique, and follow-up results.

Between 1981 and 1986, at the Orthopaedic Clinic of the University of Düsseldorf, arthroscopic synovectomy of the knee was performed on 59 joints in 56 patients. The follow-up examination covered 45 knee joints in 43 patients (18 female and 27 male patients). The follow-up results, taken at an average of 2.7 years after the arthroscopic synovectomy, have up to now been good and equal to those achieved using the conventional technique. In this experience, arthroscopic synovectomy is a surgical procedure that places less strain on the patient in the early postoperative healing period. An arthrotomy was no longer required in the hypertrophic synovial diseases treated during this time. Fibroarthrosis, not uncommon after conventional arthrotomy, did not occur. Only a few stab incisions were necessary to reach all--in particular the posterior--knee-joint cavities. Postoperative pain was markedly reduced from a preoperative level of 16.6 points (47%) (35 maximum points possible, or 100%) to a level of 29.5 points (84%) at follow-up. Patients who experienced an open synovectomy previously in the other knee now favor the arthroscopic procedure. The majority of the patients had a range of motion between 0 and 120 degrees within the first 2 weeks after surgery. Swelling disappeared from a preoperative score of 2.9 points (19%) (15 maximal points possible, or 100%) to 12.2 points (81%). Subjectively, 78% of the patients were satisfied with the result of arthroscopic synovectomy, 7% considered the procedure a partial success, and 15% were dissatisfied.

Adult↗
PubMed1988

Comparison of different methods of ST measurement for evaluation of myocardial ischaemia in Holter monitoring.

Long-term ambulatory electrocardiographic monitoring [AEM] of the ST segment is clinically the most practical test for the documentation and quantification of myocardial ischaemia. However, there is still some controversy about the validity of ST measurements in Holter monitoring. Therefore, in the present study, in a series of 26 patients with angiographically proven (greater than 70%) coronary heart disease and a positive exercise electrocardiogram, the number, duration and the severity of symptomatic and asymptomatic ischaemic episodes were measured by (1) the ST change at the J point, (2) the ST change 0.07-0.10 s after the J point (immediately before the T wave), (3) the change of the slope of the ST segment, and (4) the area under the ST segment, with a Reynolds Pathfinder III and compared with visual analysis. At the J point (1) there were a total of 264 episodes with a duration of 3947 min and a maximum of 0.35 mV, before the T wave (2) 276 episodes with a duration of 3440 min and a maximal change of 0.40 mV; looking at the slope of the ST segment (3) the figures were 118, 1041 min and regarding the area under the ST segment they were 198, 2385 min. In conclusion, ST deviations are safely detected by automated analysis of the ST segment. Compared with visual analysis (220 episodes), deviation of the ST1 (J point) and ST2 point (80 ms thereafter) overestimate the incidence of true ischaemic ST depression by about 20%.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1988

Cellular location of glutamine synthetase and lactate dehydrogenase in oligodendrocyte-enriched cultures from rat brain.

Glial cells were isolated from 1-week-old rat brain and cultured in a serum-free medium supplemented with the hormones insulin, hydrocortisone, and triiodothyronine. After 1 week in culture the cell population consisted mainly of galactocerebroside-positive cells (GC+; oligodendrocytes), the remainder of the cells being positive for glial fibrillary acidic protein (GFAP+; astrocytes). Oligodendrocytes were selectively removed from the cultures by complement-mediated cytolysis. The activities of glutamine synthetase and of various marker enzymes were measured in the nonlysed cells remaining after complement treatment of the cultures and in the culture medium containing proteins of the lysed cells. We found that the cellular activity of glutamine synthetase decreased in parallel with the lysis of GC+ cells and that the activity of glutamine synthetase in the supernatant increased. The activity of glycerol-3-phosphate dehydrogenase, a marker enzyme for oligodendrocytes, was no longer detectable in complement-treated cultures and the activity of glutamine synthetase was markedly lowered, whereas the activity of lactate dehydrogenase was as high as in untreated cultures. The location of glutamine synthetase both in oligodendrocytes and in astrocytes was confirmed by double-label immunocytochemistry with antisera against glutamine synthetase, GC, and GFAP. We conclude that in this culture system glutamine synthetase is expressed in both types of glial cells and that the activity of lactate dehydrogenase is at least one order of magnitude higher in astrocytes than in oligodendrocytes.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗
PubMed1988

[Percutaneous transluminal coronary angioplasty (PTCA) in the therapy of coronary heart disease].

Percutaneous transluminal angioplasty (PTCA) has been performed worldwide since 10 years and in Graz since 1980. 1977 6 procedures were performed, 1987 about 100,000 will be done worldwide. PTCA today represents a standard treatment of coronary heart disease in addition to pharmacological and surgical therapy. At the present time about one third of patients with coronary heart disease are treated by PTCA. Primary success rate ranges between 80 and 90%, complication rate has dropped under 4%. Besides patients with one-vessel-disease also those with multi-vessel-disease, reduced left ventricular function and patients with unstable angina and acute myocardial infarction are dilated. The "achilles" heel of PTCA is restenosis, which develops in 25 to 35% of cases within 6 months. At present, research is devoted to avoid or prevent this complication.

Angioplasty, Balloon↗
PubMed1988

[The use of CT in meniscopathy].

The results of CT examination of meniscopathies in 54 patients, most of them competitive athletes, are presented. CT has an overall accuracy of about 90 per cent and can hence be used for diagnosing a lesion of the meniscus with a reasonable amount of safety, while being rapid and avoiding unnecessary exposure to stress. This method, therefore, should be a focal point of the imaging methods and thus be placed between the specialist doctor's findings and possible surgery. The pros and cons of CT compared with other imaging methods are discussed.

Athletic Injuries↗