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  • 1
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Social Science & Medicine 17 (1983), S. 1827-1830 
    ISSN: 0277-9536
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Social Science & Medicine 17 (1983), S. 1743-1750 
    ISSN: 0277-9536
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Congestive heart failure ; PDE inhibition ; Positive inotropic action
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Enoximone, a phosphodiesterase-inhibitor, is a potent inotropic vasodilator agent that causes a marked improvement in hemodynamics in patients with congestive heart failure. The acute effects of oral enoximone on rest and exercise hemodynamics, ejection fraction, aerobic metabolism, exercise capacity, and arrhythmias were studied in 11 patients with moderate to moderately severe dilative cardiomyopathy after 8 days of enoximone (100 mg tid) in addition to baseline therapy (diuretics and digitalis). The cardiac index increased from 2.44±0.45 to 2.72±0.50 l/min/m2 (p〈0.01) at rest and from 4.00±0.96 to 4.75±0.95 l/min/m2 (p〈0.005) during exercise. Pulmonary wedge pressure decreased from 16.8±7.3 to 12.5±6.5 mmHg (p〈0.005) at rest and from 28.2±8.0 to 24.5±10.3 mmHg (p〈 0.05) during exercise. Systemic vascular resistance decreased from 1608±243 to 1495±300 dynes*sec*cm−5 (p〈0.05) at rest and from 1152±155 to 1027±236 dynes*sec*cm−5 (ns) during exercise. The anaerobic threshold, which was recorded simultaneously, increased from 13.2±2.7 to 15.5± 2.5ml/kg/min VO2 (p〈0.02). The radionuclide ventriculography ejection fraction improved from 21.7±5.0 to 28.1±9.1% (p〈0.01) during exercise; the changes at rest were not significant (20.8±6.2 vs 25.8±8.4%). Exercise tolerance showed an increase of 16% (492±133 to 573±135 sec, p〈 0.005). The resting heart rate remained unchanged (81.8±13.4 vs 81.8±11.9). Interestingly, 24-h Holter monitoring revealed more or new repetitive arrhythmias in 9/11 patients. Short-term therapy with oral enoximone enhances ventricular performance by increasing cardiac contractility and lowering vascular resistance, both of which extend exercise tolerance and improve aerobic metabolism. Potential proarrhythmic effects need further evaluation, however.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 72 (1994), S. 985-991 
    ISSN: 1432-1440
    Keywords: Cell volume ; Na+/H+ antiporter activity ; Human mononuclear leukocytes ; Angiotensin-converting enzyme inhibitor ; Diuretic therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies in patients with congestive heart failure (CHF) treated with diuretics and/or digoxin have shown abnormalities of cellular volume and electrolytes in biopsies of skeletal muscle. These abnormalities seem to play an important role with regard to the dysregulation of peripheral vascular resistance and characteristic clinical features of CHF, for example, muscular weakness. This study assessed the effect of angiotension-converting enzyme (ACE) inhibitor therapy on cell volume and cell volume regulation in patients with CHF. Cell diameters of human mononuclear leukocytes (HML) were determined electronically by a Coulter Counter. Cell diameters for 19 patients with decreased left ventricular ejection fraction (determined via levocardiography) on therapy with ACE inhibitors (group 1) were compared to those of HML from patients on diuretics alone (group 2,n = 16). The activity of the Na+/H+ antiporter was determined by cell swelling in isotonic propionate. The control group consisted of 20 normal, age- and sex-matched volunteers. HML diameters were significantly increased from 7.16 ± 0.07 in normals to 7.24 ± 0.08 μm (group 1;P 〈 0.01) and 7.23 ± 0.11 μm (group 2;P 〈 0.05), indicating an abnormal regulation of cell volume. There were no statistically significant correlations between the individual ejection fraction or digoxin therapy and average cell diameters. In both patient groups ethylisopropylamiloride-sensitive swelling rates were normal compared to the control group indicating a normal activity of the Na+/H+ antiporter. In conclusion, increased cell sizes reflect a structural change in HML rather than a rapidly reversible functional abnormality which was not affected different by ACE inhibition and diuretic therapy. The pathomechanisms underlying abnormal cell sizes in CHF patients remain to be determined but could be similar to those responsible for muscular changes in CHF. Further studies should show whether HML, being easily accessible, are a valid cell model to reflect these muscular abnormalities in CHF, and whether a normal cell size can be achieved therapeutically by normalized neurohumoral activities.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1433-0423
    Keywords: Key words Chagas disease •Trypanosoma cruzi• Romaña's sign • Retinal pigment epithelium ; Schlüsselwörter Chagas-Krankheit •Trypanosoma cruzi• Romaña-Zeichen • Retinales Pigmentepithel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Fragestellung: Die im Vorjahr präsentierte Pilotstudie, die erstmals eine größere Gruppe von Patienten mit Chagas-Krankheit augenärztlich untersuchte, zeigte, daß bei dieser Parasitose auch Veränderungen am Augenhintergrund in Gestalt von Defekten des retinalen Pigmentepithels zu erwarten sind. Die Fortsetzung dieser Studie soll nun durch ein vergrößertes Patientenkollektiv weitere Hinweise auf die Art und das Ausmaß der Fundusveränderungen geben. Material und Methode: Nach serologischer Bestätigung der Infektion schloß sich eine komplette ophthalmologische Untersuchung mit Beurteilung der vorderen und hinteren Augenabschnitte an. Ergebnisse: Bei den 23 neu untersuchten Patienten war der Fundus in 21 Fällen unauffällig, während 1 Patient Fibrae medullares, 1 weiterer deutliche Pigmentverschiebungen am hinteren Pol zeigte. Zusammen mit der Pilotstudie wurden mittlerweile 102 Patienten mit Chagas-Krankheit untersucht. Bei insgesamt 8 Patienten (7,8 %) lagen Defekte des retinalen Pigmentepithels vor, welche in keinem Fall eine signifikante Visusbeeinträchtigung zur Folge hatten. Schlußfolgerung: Wir können davon ausgehen, daß es sich hierbei um seltene und harmlose postentzündliche oder immunologisch bedingte Veränderungen bei der Amerikanischen Trypanosomiasis handelt.
    Notes: Background: Last year's pilot study, which examined for the first time a representative group of patients with Chagas disease, showed that in this parasitosis changes in the ocular fundus can be expected in the form of defects of the retinal pigment epithelium. Examination of more patients in this study should give further information about the character and extent of the alterations found. Materials and methods: After serological confirmation of the disease, we performed an ophthalmological examination of the anterior and posterior segments. Results: In 21 out of 23 patients the fundus was unobtrusive; 1 patient showed fibrae medullares and 1 patient clear pigment dispersion on the posterior pole. Together with the pilot study, a total of 102 chagasic patients were examined. In 8 patients (7.8 %) defects of the retinal pigment epithelium were found, which did not cause any significant loss of vision. Conclusions: We presume that the described defects are a matter of rare and harmless postinflammatory or immunological changes in the American type of trypanosomiasis.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Der Ophthalmologe 97 (2000), S. 433-436 
    ISSN: 1433-0423
    Keywords: Schlüsselwörter Dengue-Fieber ; Okuläre Manifestation ; Key words Dengue-fever ; Ocular manifestation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Dengue-Fever is a mosquito transmitted viral disease. It is endemic mainly in South-East Asia and Afrika. The clinical manifestation is divided into different stages. Ocular manifestations in travellers have been rarely reported. Patients: We present the cases of two patients, having just returned from a trip to Thailand. During their trip they had fallen ill with symptoms of classic dengue-fever. Findings: On examination visual acuity had decreased in both patients. In one patient we detected a relative central scotoma in perimetry and reduced amplitudes in VEP. In indirect ophthalmoscopy we found intraretinal haemorrhages, foveal lesions in the pigment epithelium, cotton-wool spots and a maculopathy. The fluorescein angiographic findings included extravasation in the macular region and block fluorescence. The diagnosis was confirmed by a rise in Dengue-fever antibody titre and the detection of flavivirus IgM antibodies. Conclusion: Dengue-fever and its ocular manifestation in Europeans is a rare condition. Expanding tourism to tropical countries may lead to an increasing number of cases.
    Notes: Zusammenfassung Hintergrund. Dengue-Fieber ist eine virale Infektionskrankheit, die überwiegend im südostasiatischen Raum und in Afrika auftritt. Mit Blick auf den klinischen Verlauf unterscheidet man verschiedene Grade. Okuläre Manifestationen bei Dengue-Fieber wurden in der Literatur bisher vereinzelt bei Patienten in Endemiegebieten, aber kaum bei Reisenden beschrieben. Patienten: Wir berichten über zwei bis dahin augengesunde Patienten, die kurz nach einer Thailandreise eine Augenklinik in Deutschland aufsuchten. Während ihres Auslandaufenthalts litten beide unter Symptomen des klassischen Dengue-Fiebers. Ergebnisse: Bei Erstvorstellung erhoben wir folgende ophthalmologische Befunde: Reduzierte zentrale Sehschärfe, relatives Zentralskotom, Amplitudenreduktion im VEP, Blutungen im Bereich der Netzhaut, “cotton-wool spots”, Makulopathie, foveale Pigmentepithelverschiebungen sowie Hyperfluoreszenzen und Blockaden in der Fluoreszensangiographie. Die Diagnose wurde anhand des serologischen Befundes gesichert. Im Verlauf kam es zu einer vollständigen restitutio ad integrum ohne spezifische Therapie. Schlussfolgerung: Dengue-Fieber ist bei Europäern bisher selten beobachtet worden. Bei Zunahme des Ferntourismus muss jedoch mit steigenden Fallzahlen auch bei uns gerechnet werden.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 142 (2000), S. 215-217 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Archives of gynecology and obstetrics 255 (1994), S. 173-180 
    ISSN: 1432-0711
    Keywords: Idiopathic subfertility ; Infertility ; Intrauterine insemination ; In vitro fertilization ; Ovarian stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract 650 couples with idiopathic subfertility (mean duration: 5.7 year, range 2–21 years) were treated during 2870 cycles by three assisted conception methods (each involving mild ovarian stimulation): I timed intercourse (TI), II intrauterine insemination (IUI), III in vitro fertilization/embryo transfer (IVF/ET). Treatment started with TI in most cases and then changed to IUI after three to six cycles. Couples who failed to conceive were treated after another 3–9 cycles by IVF/ET. An overall cumulative pregnancy rate of 80.2% was reached after 18 treatment months. The pregnancy rates per treatment cycle were: TI 5.3%, IUI 6.9%, IVF/ET 15.8% (per oocyte retrieval)
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Archives of gynecology and obstetrics 255 (1994), S. 173-180 
    ISSN: 1432-0711
    Keywords: Key words: Idiopathic subfertility ; Infertility ; Intrauterine insemination ; In vitro fertilization ; Ovarian stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract.  650 couples with idiopathic subfertility (mean duration: 5.7 year, range 2–21 years) were treated during 2870 cycles by three assisted conception methods (each involving mild ovarian stimulation): I timed intercourse (TI), II intrauterine insemination (IUI), III in vitro fertilization/embryo transfer (IVF/ET). Treatment started with TI in most cases and then changed to IUI after three to six cycles. Couples who failed to conceive were treated after another 3–9 cycles by IVF/ET. An overall cumulative pregnancy rate of 80.2% was reached after 18 treatment months. The pregnancy rates per treatment cycle were: TI 5.3%, IUI 6.9%, IVF/ET 15.8% (per oocyte retrieval).
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1440
    Keywords: HIV-1 ; Endothelins ; Endothelin-1 ; Cytokine ; Retinal microangiopathic syndrome ; Vascular disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Endothelin-1 is a recently identified cytokine with potent vasoconstrictor activity which is associated with various diseases involving blood vessels. HIV-1 related retinal microangiopathic syndrome is a frequent finding in patients with AIDS or AIDS-related complex, presenting predominantly with retinal cotton-wool spots. We investigated 55 HIV-1 infected patients by ophthalmoscopy and for endothelin-I immunoreactivity in plasma and an additional 76 HIV-1 infected patients only for endothelin-1 levels. For reference values 13 age-matched healthy subjects were studied. In 18 of 55 patients (33%) investigated ophthalmoscopically we found evidence of microangiopathic syndrome. Overall, the mean endothelin-1 immunoreactivity in plasma of HIV-1 infected patients was significantly elevated as compared to controls (4.28 ± 3.62 versus 2.72 ± 0.67 fmol/ml, P 〈 0.0001). HIV-1 infected patients with retinal microangiopathic syndrome had significantly higher plasma levels of endothelin-1 immunoreactivity (4.59 ± 1.38 fmol/ ml) compared to HIV-1 infected patients without microangiopathic syndrome (3.18 ± 1.64 fmol/ml, P = 0.003). Correlation analysis revealed that endothelin-1 immunoreactivity in plasma had no significant association with disease progression, CD4 cell count, β2-mi-croglobulin, neopterin, or age. Endothelin-1 immunoreactivity in plasma was correlated exclusively with retinal microangiopathic syndrome in one or both eyes (r = 0.45, P = 0.0006) and with the number of cotton-wool spots (r = 0.50, P = 0.0001). In conlusion, HIV-1 related retinal microangiopathic syndrome is associated with elevated plasma levels of endothelin-1. By virtue of its potent vasoconstrictor activity endothelin-1 may be involved in the pathogenesis of HIV-1 related vascular disease.
    Type of Medium: Electronic Resource
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