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Biomedical subjects

W Rudolph

Publications and source records attributed to W Rudolph.

At least 127 records · Page 7Linked to original sources
PubMed1980

[The technetium-99-m-pyrophosphate scintigram in the assessment of the size of acute myocardial infarction: comparison with CK-(MB) curves mortality (author's transl)].

While the technetium-99m-pyrophosphate scintigram enables diagnostic proof of acute myocardial infarction, its use in the evaluation of the extent of infarction has not been clearly established. This study, in 30 patients with acute myocardial infarction was, thus, undertaken to assess the relationship between the findings of the technetium-99m-pyrophosphate scintigram, with respect to infarct area and uptake pattern, the infarct size, as determined from the total CK an CK-MB curves, and the mortality. The scintigraphically determined infarct areas ranged between 1.7 and 29.3 cm2; the 20.2 plus or minus 6.0 cm2 average for anterior wall infarction (n=18, range 7.4 to 29.3 cm2) was significantly greater (p smaller than 0.005) than the 8.3 plus or minus 5.3 cm2 average for inferior infarction (n=12, range 1.7 to 15.8 cm2). Correlation coefficients between the scintigraphically and enzymatically determined infarct sizes for the entire patient population ranged from 0.71 to 0.80. Anterior infarctions correlated more closely (0.66 to 0.84) than inferior infarctions (0.46 to 0.66). The technetium-99m-pyrophosphate uptake pattern was focal in 20 patients and ring-shaped (doughnut) in ten. Infarcts with focal uptake patterns were significantly smaller than those displaying a doughnut pattern (12.2 plus or minus 6.4 vs. 24 plus or minus 4.0 cm2, p smaller than 0.005). The infarct weight calculated from the CK-MC curve with application of individually determined disappearance rate for those infarcts displaying a focal uptake pattern was 34 plus or minus 29 grams while that associated with a doughnut uptake pattern was significantly greater at 86 plus or minus 25 grams (p smaller than 0.005). During the 18 -month observation period there were six deaths; the average scintigraphic infarct area of 22.8 plus or minus 3.6 cm2 in those who died was significantly greater (p smaller than 0.005) than that of the 13.8 plus or minus 8.2 cm2 of the survivors. Of the non-survivors, five had a doughnut uptake pattern and one displayed focal uptake. In the 24 survivors, a focal uptake pattern was found in 19 and a doughnut pattern in five. Conversely, 19 of the 20 patients with a focal uptake pattern survived while only five of the ten patients with a doughnut pattern were alive after 18 months. Thus, comparison with the enzymatically determined infarct weight as well as the mortality indicate that the technetium-99m-pyrophosphate scintigram yields clinically relevant data with regard to infarct size. Since no patient with an infarct area of less than 17 cm2 died within the 18-month observation period, designation of scintigraphically determined infarct size as small (smaller than 17 cm2) and large (larger than 17 cm2) was enabled. The corresponding cut-off point between large and small infarctions as determined enzymatically has been designated at 65 grams. Accordingly, agreement was found in 70% (14 of 20 patients) with scintigraphically small infarcts and in 80% (8 of 10 patients) with scintigraphically large infarcts...

Acute Disease↗
PubMed1980

Red blood cell aggregation in men with coronary artery disease.

The red blood cell aggregation value (AW) in a group of 39 patients with coronary artery disease (CAD) was measured and compared with that of an age- and sex-equivalent group of normals and a group of 12 patients with suspected CAD, whose coronary arteries were found to be normal by coronary arteriography. The AW was significantly higher in CAD patients than in both normal groups (2P < 0.01 and 2P < 0.02 respectively). The AW in a group of 12 CAD-patients treated with the aggregation lowering drug clofibrate was significantly lower than in the untreated CAD-group. The predictive value of AW was calculated by means of mathematical methods. Measurement of AW could be a useful aid in the study of detection of CAD.

Adult↗
PubMed1979

ECG changes during long-term minoxidil therapy for severe hypertension.

A prospective assessment of the effects of minoxidil on the ECG was carried out in a series of 80 patients with severe hypertension, representing an observation of 139.6 patient years. In combination with beta-adrenergic blocking agents and diuretics, minoxidil resulted in substantial reductions in blood pressure at rest and during exercise. Concomitant with the initiation of minoxidil treatment, ECG changes consisting of flattening or inversion of the T waves, ranging from slight to very marked, were observed in 90% of the patients. While these changes may be potentially disconcerting, the observations of this study show that they are not related to changes in heart rate or other clinical criteria associated with myocardial ischemia. They are not influenced by exercise or beta-blockade and they generally revert to control appearance during chronic treatment, at which time accompanying improvement in preexisting abnormalities of the T wave was frequently seen. During long-term treatment, a substantial reduction of increased QRS voltages was observed.

Adolescent↗
PubMed1979

[Compatibility of antihuman lymphocyte globulin (AHLG). Possible side effects and complications].

The results in the antihuman lymphocytic globulines (AHLG) therapy of 25 patients with predominantly haematological and neurological diseases are reported. Extent and scope of the side-effects observed are discussed. A careful clinical, clinico-chemical and immunological observation of the patients during the AHLG therapy is indispensable for performing this biological immunosuppression and a strict selection of patients is also required. Under these conditions there are no higher risk and responsibility in an AHLG therapy than in other intensive kinds of therapy.

Anemia, Hemolytic, Autoimmune↗
PubMed1979

[Medical management of tachycardias (author's transl)].

Guidelines for a step-wise plan of treatment of tachycardias have been compiled based on clinical empirical experience and with the aid of surface electrocardiograms, intracardial electrograms and stimulation techniques. The plan is primarily with the aid of surface electrocardiograms, intracardial electrograms and stimulation techniques. The plan is primarily oriented with respect to the antiarrhythmic efficacy, the adverse reactions and the practicability of the respective agents. Any type of tachycardia, including premature atrial or ventricular contractions, may be regarded as indication for treatment. Treatment is not indicated only in those asymptomatic patients with rare and evanescent tachycardias and in those with less than 300 premature contractions per hour. Beta-adrenergic blockers are the drugs of choice for the persistent sinus tachycardia. Should the latter agents be contraindicated, propafenon, amiodarone or aprindine may be administered. Verapamil and/or digitalis are indicated only for suppression of paroxysmal sinus tachycardias. Atrial premature contractions are best managed with guinidine or disopyramid. An acute reduction of rapid ventricular rates associated with atrial tachycardias, atrial flutter or fibrillation can best be attained through the administration of verapamil prior to digitalis or beta-adrenergic blockers. Re-establishment of sinus rhythm and prophylactic suppression of the latter should be undertaken with quinidine or disopyramid in combination with digitalis and/or either a beta-adrenergic blocker or intravenously-administered verapamil. Verapamil is the drug of choice for initial management of AV-junctional tachycardia for which a combination with digitalis may be considered. An alternative combination is that of a beta-adrenergic blocker and digitalis. For the acute treatment of ventricular tachycardias, lidocain has proved most effective. Although ajmaline and/or propafenon may be given should no response be obtained, electrical cardioversion would be more appropriate. To prevent ventricular tachycardia or when treatment is indicated for ventricular premature beats, ajmaline, propafenon, quinidine, disopyramid or mexiletine, occasionally in combination with a beta-adrenergic blocker should be employed. Verapamil and/or ajmaline, are usually very effective for termination of reciprocal tachycardias. Ajmaline or propafenon in combination with a beta-adrenergic blocker is recommended for the prophylactic treatment of reciprocal tachycardia. In patients who additionally have bradycardia, prolonged QT-intervals or pre-excitation syndromes, the guidelines should be modified accordingly.

Anti-Arrhythmia Agents↗