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Biomedical subjects

W Klein

Publications and source records attributed to W Klein.

At least 415 records · Page 23Linked to original sources

[Complications following mediastinoscopy. Prevention and therapy].

Mediastinoscopy, being practised since 20 years, is a research method giving a high degree of information and during this time has become indispensable in diagnosis of diseases of the chest. The close neighbourhood of vital organs, small and easily vulnerable blood vessels and nerval tissues of functional importance first seemed to burden this method of investigation with an incalculate risk. But subtle operative technique with its instruments by Carlens and others let the number of complications remain remarkably small even in great collective statistics. The number of lethal complications ranged below 0.2%, more severe ones about 1%. But in these latter ones one almost always succeeds in achieving a restitutio ad integrum bei performance of consequent after-treatment. The more frequent mediastinoscopic investigations are performed in regions of marked pathologic changes, the higher is the number of described complications. But it must be considered that in many cases the more perilous and functionally straining thoracotomy can be avoided using mediastinoscopy. Complications occurring most frequently are described and possibilities of therapy are discussed.

Abscess↗

Haemodynamic effects of dopamine and dopamine combined with nitroglycerin in patients subjected to coronary bypass surgery.

The haemodynamic effects of dopamine and dopamine with nitroglycerin were evaluated in eight patients with coronary heart disease who underwent aortocoronary bypass surgery. The study was performed under anaesthesia and before surgery. Dopamine 8 micrograms kg-1 min-1 alone produced a marked increase of the cardiac index from 2.47 to 3.47 litre min-1 m-2 but only small changes in heart rate (from 65 to 68 beat min-1). This improvement in cardiac performance was accompanied by an increase of the mean pulmonary artery pressure from 10.9 to 21.3 mm Hg and in the left ventricular filling pressure from 6.1 to 13.8 mm Hg with unchanged systemic and pulmonary vascular resistance. Mean arterial pressure increased from 72 to 103 mm Hg. Simultaneous infusion of dopamine (8 micrograms kg-1 min-1) and nitroglycerin (mean dose 0.5 microgram 21.3 to 14.4 mm Hg) and of left ventricular filling pressure (from 13.8 to 7.9 mm Hg). Cardiac index (from 3.47 to 3.34 litre min-1 m-2) and mean arterial pressure (from 103 to 95 mm Hg) were not reduced to the same extent by the addition of nitroglycerin. The combined treatment of dopamine with nitroglycerine seems to be of value in patients with pre-existing high left ventricular filling pressure or with pulmonary hypertension.

Adult↗

Fate of 2,5,4'-trichlorobiphenyl in rats.

1. Following the administration of daily oral doses (1 mg/kg) of 2,5,4'-trichloro-[14C]biphenyl to rats for 14 days, the compound was rapidly excreted, only small amounts (3--4%) being stored in the organs. 2. The majority of the biphenyl was metabolized (greater than 85%) and the major metabolites excreted were identified as hydroxy-, dechloro- and conjugated derivatives.

Animals↗

[Is there a characteristic constellation of findings in esophageal functional diagnosis after antireflux operations?].

The significance of the finding esophagitis (grade I) in 23 patients was evaluated by manometry, measurement of pH and acid clearance test 18 months after the antireflux procedure (Lortat-Jacob). The provocation of pathological reflux was impossible (reflux provocation test). The acid clearance test demonstrated a low grade delay of the emptying rate. From these results it is supposed that the antiflux procedure only produces a pressure barrier but not a digestive sphincter. According to the pressure barrier in the functional analysis of the esophagus, three typical findings appeared: esophagitis (grade I), normal pH-monitoring, and delayed acid clearance.

Biopsy↗

[Angioma like dysplasia of synovial membrane with phlebectasia causing palindromic joint swelling in childhood (author's transl)].

In a five year old boy who had intermittent knee joint swelling, angioma like venous dysplasia of synovial membrane was diagnosed by arthroscopic examination. The arthroscopic diagnosis was the indication for arthrotomy. The suprapatella pouch of the knee joint contained a blue grape like tumor. Angiomalike venous dysplasia of the synovialmembrane can histologically be separated from other angiomas of the inner joint capsule and angiomalike alterations in other joint diseases. Arthroscopy should be performed if within half a year monarticular intermittent joint swelling in childhood can not be diagnosed.

Child, Preschool↗

[Echocardiographic and hemodynamic studies on the influence of verapamil in hypertrophic obstructive cardiomyopathy (author's transl)].

15 patients with obstructive hypertrophic cardiomyopathy were studied by m-mode echocardiography and 9 of them also by left heart catheterism before and after 10 mg Verpamil. The following results were obtained: 1. The systolic anterior movement (SAM) of the mitral valve was reduced (p less than 0.005), 2. the enddiastolic and endsystolic diameter were increased (p less than 0.02 and 0.05 respectively), 3. the EF-slope remained unchanged. 4. The left ventricular systolic pressure was reduced (p less than 0.025) and the gradient diminished from an average value of 58 to 34 mmHg (p less than 0.02), 5. heart rate and left ventricular enddiastolic pressure remained constant. The results of this acute study suggest a beneficial effect of Verpamil in patients with hypertrophic obstructive cardiomyopathy.

Blood Pressure↗

The influence of some prostaglandins on DNA synthesis and DNA excision repair in mouse spleen cells in vitro.

In vitro experiments were performed on mouse spleen cells to establish possible influences of some naturally occurring prostaglandins on DNA synthesis and DNA excision repair. The prostaglandins A1, B1, E1, E2 and F2alpha were tested in concentrations of lopg, 5ng and 2.5microgram per ml cell suspension. DNA synthesis was significantly increased by PgF2alpha in all the three concentrations tested, while the other tested prostaglandins were essentially ineffective. DNA excision repair was significantly inhibited by PgE1 and PgE2 at 5ng/ml and at 2.5microgram/ml but increased by PgF2alpha in the two lower concentrations. The rejoining of DNA-strand breaks after gamma-irradiation was slightly reduced by PgE1, PgE2 and PgF2alpha at 2.5microgram/ml.

Animals↗

The synovial changes in post-traumatic synovitis and osteoarthritis.

The histopathologic appearances of post-traumatic synovitis and synovitis of osteoarthritis cover a limited range of changes and have features in common. Electron microscopy yields information complementary to that given by light microscopy. With these techniques, based on sufficient material, histological analysis linked with clinical observation will permit some degree of differentiation between the two conditions.

Adolescent↗

[Investigations of the influence of radiation therapy upon the course of the DNA repair in peripheric lymphocytes and tumorous tissues from patients with malignant disease (author's transl)].

The influence of radiation therapy upon the capacity of DNA repair in peripheric lymphocytes and tumorous tissues was studied in eleven patients with malignant manifestations. A comparison was made between the effects of short-term and of long-term irradiation. The individual cases presented differing results. An enhancement of DNA repair as well as a diminution was observed in peripheric lymphocytes as a response to irradiation. In tumorous tissues, on the contrary, a total inhibition of DNA repair was generally found.

Aged↗

[Possibilities and significance of computer tomography in non-tumorous space-occupying intracranial lesions (author's transl)].

Based on the experience collected in 108 patients from a series of more than 7500 CT examinations, the possibilities and limitations of computed tomography in non-tumorous space-occupying lesions are discussed. Serious problems of differential diagnosis are encountered mainly in the case of cerebral abscesses and acute demyelinization, as well as granulomas. Cystic processes are usually easier to classify. Anamnesis will often be helpful in the case of parasites. Old intracerebral hemorrhages can simulate tumors and calcifications. The same applies to giant angiomas and giant aneurysms. In cerebral infarction, too, an occasional confusion with a tumor in the blood-brain barrier disturbance phase cannot be excluded.

Blood-Brain Barrier↗