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Biomedical subjects

W Schulz

Publications and source records attributed to W Schulz.

At least 91 records · Page 5Linked to original sources
PubMed1985

[The action of a new calcium antagonist 5,6-dimethoxy-2-(3 [(alpha-(3,4-dimethoxy)-phenylethyl)methylamino] propyl)-phthalimidine hydrochloride (AQ-A 39cl) on hemodynamics and ischemia parameters in exercise ECG of patients with coronary heart disease].

Six patients with angiographically documented coronary artery disease underwent multiple exercise tests before and after randomized double-blind crossover treatment with 200 mg 5,6-dimethoxy-2-(3[(alpha-(3,4-dimethoxy)phenylethyl)methylamino] propyl)-phthalimidine-hydrochloride (AQ-A 39 cl, in the following briefly called AQ-A 39) intravenously. Changes in ST-segment depression, angina pectoris, heart rate and blood pressure were evaluated. After AQ-A 39, the sum of ST-segment depression was significantly reduced compared with control and placebo by 48% (2p less than 0.025) and 42% (2p less than 0.05) respectively, maximal ST-segment depression by 45% (2p less than 0.025) and 35% (2p less than 0.05), respectively; the duration of angina pectoris was reduced by 50% and 33%, respectively. AQ-A 39 reduced heart rate at rest and during exercise; blood pressure, however, was not significantly altered. In conclusion, AQ-A 39 is an antianginal drug, which acts most probably by cardiac mechanisms and not by reduction of afterload. Thus, further studies about AQ-A 39 or its derivatives seem to be useful.

Adult↗
PubMed1984

[Value of computer tomography in the diagnosis of impression fractures of the cranial vault].

There are only few statements about the validity of computed tomography for the identification of impression fractures of the skull cap. The diagnostic information of roentgenograms without contrast medium and computed tomograms of a total of 15 patients were evaluated and compared. It was found that computed tomography was slightly superior to conventional X-ray examinations with respect to the diagnostic accuracy. Exact localisation, size, shape, and position of the bony impressions can be better appraised by the assessment in several axial CT section planes. The simultaneous consideration of the sequelae of the intracranial traumata by computed tomography enables a complete assessment of the craniocerebral trauma. The appropriate combination of conventional X-ray diagnosis with computed tomography should lead to an optimum diagnostic information also for these clinical pictures.

Adolescent↗
PubMed1984

[Craniocerebral injuries caused by animal anesthesia equipment].

A consequence of the rareness of bullet injuries in the GDR are the uncertainties in the recognition and assessment of injuries caused by cattle anaesthetising devices which have become evident in connection with the relevant expertises of the respective cases. In view of this situation, the design and the mode of functioning of these devices as well as selected clinical aspects of such injuries are described. Besides the local findings, the computer tomography is of paramount importance in the diagnosis for both the recognition of the typical calvarial bursting and the representation of the shot channel with a demonstration of the imprimatum. Whenever possible, the therapy should consist in an early surgical procedure according to the principles to be applied to open craniocerebral injuries.

Adult↗
PubMed1983

Percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris: analysis of early and late results.

Percutaneous transluminal coronary angioplasty (PTCA) was performed in 50 patients with stable and in 50 patients with unstable angina pectoris, each patient showing an isolated stenosis of more than 80% of the cross-sectional area of a single coronary artery. The technical success rate was 66% in the stable groups (26 of 37 patients [70%] with left anterior descending artery [LAD], 7 of 12 patients [58%] with right coronary artery [RCA]) and 74% in the unstable group (27 of 34 patients [79%] with LAD, 10 of 15 patients [67%] with (RCA). The increase in stenotic area in the unstable group exceeding that in the stable group for LAD stenoses (41.5 +/- 15.1% vs 32.3 +/- 14.5%, p less than 0.03), while in RCA stenoses the results in the stable group were better (45.1 +/- 17.6% vs 32.7 +/- 12.3%, n.s.). One acute vessel occlusion necessitating an emergency bypass operation occurred in each group (2%). The patient in the stable group died (total mortality rate 1%). Sixty-three of the successfully treated patients were routinely restudied 6 months later. According to clinical symptoms, 23% of the stable and 36% of the unstable group were in functional classes III and IV. From the anatomical viewpoint, a restenosis (greater than 85%) was found in 17% of the stable and in 24% of the unstable group. A further spontaneous decrease (greater than 10%) of the vessel obstruction was found in 47% of the stable group and in 12% of the unstable group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Anti-angina effectiveness of the calcium antagonist nifedipine in relation to coronary involvement].

36 patients with chronic stable or the variant form of angina pectoris were subdivided according to their coronary angiogram into 4 groups: Group A with a single highgrade stenosis in one coronary artery, Groups B, C and D with different patterns of occluded, but collateralized coronary arteries supplying noninfarcted myocardium. All patients underwent multiple exercise step tests before (K) and after randomly assigned crossover treatment with 20 mg nifedipine (N), 20 mg isosorbiddinitrate (I), the combination of both (I + N) and Placebo (P). Peak and mean ischemic ST-segment depression, the occurrence of angina pectoris and heart rate were evaluated. The mean ischemic ST-segment depression decreased significantly after N in group A by -28% (p less than 0.01), but was not significantly altered in the groups B, C and D (B: -12%, C: +7%, D: +2%). After I, mean ST-segment depression decreased significantly in all groups (A: -36%, p less than 0.001; B: -27%, p less than 0.001; C: -22%, p less than 0.01; D: -29%, p less than 0.05). The combination of I + N was not better than I alone. Peak ST-depression and angina pectoris paralleled the results of mean ST-depression. The resting heart rate increased significantly after N only in group A (+9%, p less than 0.01) and increased after I in the groups A, B and C (A: +11%, p less than 0.05; B: +12%, p less than 0.05; C: +12%, p less than 0.01). During exercise, heart rate was not significantly different in any group or after any type of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Active and passive coronary vasodilation after intracoronary and sublingual nitroglycerin.

Nitroglycerin is known to dilate epicardial coronary arteries. It is not known, however, to what extend pressure-dependent passive vasoconstrictive effects may counteract active vasodilation. Therefore, repeated coronary angiograms were performed in 100 patients under standardized conditions before (C) and after 0.16 mg nitroglycerin intracoronarily as well as after an additional 1.6 mg nitroglycerin sublingually. Coronary diameters were determined in stenotic and nonstenotic coronary artery branches. Aortic blood pressure and heart rate were monitored continuously. Aortic blood pressure decreased slightly after intracoronary injection from 146/70 mmHg (C) to 142/77 mmHg and decreased markedly after additional sublingual administration to 129/70 mmHg. Heart rate increased from 78 beats/min (C) to 79 beats/min after intracoronary injection and to 81 beats/min after sublingual administration. Diameters in nonobstructed coronary segments increased in proximal (+7%), medial (+10%), and distal (+12%) segments after intracoronary injection; after sublingual administration a more pronounced diameter increase was observed in all segments (proximal +12%, medial +13%, distal +14%). In obstructed coronary arteries, a stenotic dilation of more than 10% was found in 73% (58/80) after intracoronary injection, but only in 50% (40/80) of the patients after sublingual administration of nitroglycerin. The average diameter increase within coronary stenoses in all patients was 24% after intracoronary injection, but only 10% after additional sublingual administration. In conclusions dilation of epicardial coronary arteries occurs in nonstenotic and stenotic segments. In nonstenotic coronary arteries, there are additive vasodilative effects after intracoronary and sublingual nitroglycerin; in coronary stenoses, however, a maximal effect is achieved after intracoronary injection which is diminished after sublingual administration.

Adult↗
PubMed1983

[Diameter changes of epicardial coronary arteries and coronary stenoses after intracoronary application of SIN 1, a molsidomine metabolite].

The vasodilating effects of intracoronary injections of 0.4 mg SIN 1, the active metabolite of molsidomine, on epicardial coronary arteries and coronary stenoses were evaluated in 14 patients with coronary artery disease in a double-blind randomized fashion versus placebo. 9 additional patients with well-definable coronary stenoses received 0.4 mg SIN 1 as well. Diameter changes of nonstenotic coronary arteries in proximal, medial and distal coronary segments as well as changes of the residual luminal diameters within coronary stenoses were determined before (K), immediately after (M1) and 10 minutes after (M2) intracoronary application of SIN 1; in addition, aortic pressure and heart rate were monitored continuously. Aortic pressure and heart rate did not change after SIN 1 or placebo. After SIN 1, the diameter of nonstenotic coronary arteries increased in proximal segments by + 9% (M1) and + 11.7% (M2), in medial segments by + 17.6% (M1) and + 17.6% (M2), in distal segments by + 26.4% (M1) and + 28.8% (M2). Within coronary stenoses, the residual luminal diameters showed a mean increase by 31.5% (M1) and 48.3% (M2). Placebo did not alter coronary diameters significantly. SIN 1 effectively dilates nonstenotic and especially stenotic epicardial coronary arteries, as it is already known for nitrates and calcium-channel blockers. By intracoronary injections, the direct effects on coronary vessels can be detected without interference with systemic effects. The increase in residual luminal diameters within dynamic coronary stenoses after SIN 1 is most likely an important antianginal mechanism also for molsidomine.

Coronary Disease↗
PubMed1983

[Influence of cold-stimuli on hemodynamics and coronary diameters. Provocation of coronary artery spasm].

In 32 patients with coronary heart disease the influence of different cold-stimuli on hemodynamic parameters and coronary artery diameter was examined during left heart catheterization. The cold pressor test (CPT) and the cold air inhalation test (CAIT) were applied to 16 patients in random sequence. 16 patients served as control group. Systolic and diastolic blood pressure increased more under CPT (by 15 and 10 mm Hg respectively) than under CAIT (by 10 and 3 mm Hg). Heart rate and left ventricular enddiastolic pressure did not change. Proximal and distal coronary segment diameters showed a slight, not statistically significant increase under cold-stimuli. All 4 patients with a history of angina pectoris at rest developed coronary spasm, some with ischemic ECG changes; spasm and symptoms disappeared spontaneously when the cold-stimulus was withdrawn. Patients with a history of angina pectoris under cold conditions showed no pathological reactions. It is concluded that two different mechanisms may cause angina pectoris under cold-stimuli. First, the oxygen-consuming effect of an increase in blood pressure, and secondly, an immediate coronary vasospastic reaction. The combined use of CPT and CAIT seems to be an effective and safe means of identifying patients with a tendency to coronary artery spasms.

Adult↗
PubMed1983

The garland type of acute postinfectious glomerulonephritis: morphological characteristics and follow-up studies.

Among 44 patients with acute post-infectious GN, we found 11 cases (10 male, 1 female) displaying an immunohistologically and electron microscopically characteristic "garland pattern". Numerous sub-epithelial deposits of the "hump" type with characteristic patchiness correspond in the electron micrograph to densely packed deposits (IgG, always combined with C3, more rarely also with IgM) demonstrable immunohistologically on the peripheral loops. On the other hand, sub-endothelial, mesangial and intramembranous deposits are less prominent. Clinically, the patients have a strikingly high proteinuria. Follow-up studies have revealed that in a proportion of the patients both the clinical and the morphological findings can regress after a month long course. These are mainly younger patients. On the other hand, in another group of cases (mainly older patients) both the clinical and the morphological findings persist even after months. Within acute post-infectious GN, the "garland type" appears to form a particular group in which a large proteinuria (with or without nephrotic syndrome) and a tendency to chronicity or at least to a protracted course is present in a relatively high percentage.

Adolescent↗