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  • 1
    Electronic Resource
    Electronic Resource
    Diagnosis and Therapeutic Consequences of Intramural Aortic Hematoma (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 9 (1994), S. 0 
    Details
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The classical triad of sudden devastating chest pain, electrocardiographic absence of acute myocardial Infarction, and Identification of an upstream flap in the ascending aorta by transesophageal echocardlography (TEE) Indicates aortic type A dissection requiring emergent surgery. Among 34 patients presenting with clinical signs and symptoms of an aortic dissection, three did not show the mandatory flap in the upstream aorta. The only echocardlographic finding was aortic wall thickening Indicating an intramural hematoma. Two of these patients showed early aortic ectasia and one showed a pericardial effusion. Despite the missing flap echocardiographlcally, surgery was performed in all three patients. The surgical approach was the same as that for patients with a type A dissection. Two patients are doing well after the procedure, and one patient died after reoperation. The postoperatlve histologic work-up confirmed that there was no intimal tear or dissection of the intimal layer. We conclude that the echocardiographic finding of an Intramural hematoma combined with typical clinical signs of chest pain, with myocardial infarction ruled out, requires emergent surgical intervention. (J Card Surg 1994;9:508–515)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8191.1994.tb00884.x
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  • 2
    Electronic Resource
    Electronic Resource
    Presynaptic β2-adrenoceptors on the sympathetic nerve fibres of the human saphenous vein: no evidence for involvement in adrenaline-mediated positive feedback loop regulating noradrenergic transmission (1988)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 337 (1988), S. 408-414 
    Details
    ISSN: 1432-1912
    Keywords: Presynaptic receptors ; β2-Adrenoceptors ; Sympathetic nerves ; Human saphenous vein ; Noradrenergic transmission
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Spirally cut strips of human saphenous veins preincubated with 3H-noradrenaline were superfused in the presence of corticosterone and, unless stated otherwise, of cocaine or desipramine. Tritium overflow was stimulated electrically (2 Hz). Adrenaline (in the presence of rauwolscine), isoprenaline and the preferential β2-adrenoceptor agonist procaterol concentration-dependently increased the electrically evoked tritium overflow. Prenalterol, a β-adrenoceptor agonist with moderate preference for β1-adrenoceptors, was ineffective. The concentration-response curve of isoprenaline was shifted to the right by the nonselective β-adrenoceptor antagonist propranolol and by the preferential β2-adrenoceptor antagonist ICI 118,551, but was not affected by the β1-selective antagonist atenolol. In experiments on strips preexposed to adrenaline 10 nmol/l (i. e. a concentration higher than that which normally occurs in vivo) for 32 min in the absence of cocaine or desipramine, the electrically evoked 3H overflow was not affected 12 and 44 min after withdrawal of adrenaline, irrespective of whether propranolol was absent or present in the superfusion fluid. — In veins incubated with 3H-adrenaline, a considerable amount of the radioactivity was accumulated. During subsequent superfusion with 3H-adrenaline-free solution, electrical stimulation induced tritium overflow in a tetrodotoxin-sensitive manner. Propranolol failed to modify the evoked tritium overflow. — It is concluded that the sympathetic nerve fibres of the human saphenous vein are endowed with facilitatory presynaptic β2-adrenoceptors. These receptors do not seem to play a substantial role in a local adrenaline (previously taken up)-mediated positive feedback loop regulating noradrenergic transmission, at least under the present in vitro conditions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00169532
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  • 3
    Electronic Resource
    Electronic Resource
    Human myocardial β-adrenoceptors: demonstration of both γ-adrenoceptors: mediating contractile responses to β-agonists on the isolated right atrium (1986)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 332 (1986), S. 142-147 
    Details
    ISSN: 1432-1912
    Keywords: Human right atrium ; Human atrial β1- and β2-adrenoceptors ; Positive inotropic effects ; ICI 118,551 ; Bisoprolol (EMD 33,512) ; Procaterol (OPC 2009)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary On the isolated electrically driven muscle strip of human right atrial appendages the β-adrenoceptor subtypes mediating the positive inotropic effects of isoprenaline, dobutamine and procaterol were characterized using the β1-selective antagonist bisoprolol and the β2-selective antagonist ICI 118,551. 1. The three agonists induced concentration-dependent increases in force of contraction with an order of potency: procaterol (pD2-value: 8.03) 〉 isoprenaline (pD2-value: 7.73) 〉 dobutamine (pD2-value: 5.44). In saturating concentrations all three agonists produced the same maximum of developed tension. 2. ICI 118,551 (10−9–10−7 mol/l) and bisoprolol (10−9–10−7 mol/l) were nearly equipotent in antagonizing the positive inotropic effects of isoprenaline and dobutamine. However, the slopes of the Schild-plots for both antagonists against both agonists were significantly less than 1.0 indicating interaction with β1- and β2-adrenoceptors. 3. On the other hand, ICI 118,551 (10−10–10−8 mol/l) was approximately 100 times more potent than bisoprolol (10−8–10−6 mol/l) in antagonizing the positive inotropic effect of the highly selective β2-adrenoceptors procaterol. In addition, the slopes of the Schild-plots for antagonism of ICI 118,551 and bisoprolol against procaterol were not significantly different from unity indicating interaction with a homogeneous class of β-adrenoceptors. The pA2-value for ICI 118,551 was 9.49, for bisoprolol it amounted to 6.99. 4. These results indicate that on the isolated electrically driven human right atrium isoprenaline and dobutamine produce increases in contractile force via stimulation of β2-adrenoceptors, while the highly selective β2-adrenoceptors procaterol induces its positive inotropic effect predominantly through stimulation of β2-adrenoceptors. It is concluded, therefore, that in human right atrium both β1- and β2-adrenoceptors functionally contribute to the cardiac responses of β-agonists.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00511404
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  • 4
    Electronic Resource
    Electronic Resource
    Inhibitory presynaptic 5-hydroxytryptamine (5-HT) receptors on the sympathetic nerves of the human saphenous vein (1986)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 332 (1986), S. 317-323 
    Details
    ISSN: 1432-1912
    Keywords: Noradrenaline release ; Presynaptic receptors ; Serotonin receptors ; 5-HT1 receptors ; Human saphenous vein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Superfused strips of the human saphenous vein preincubated with 3H-noradrenaline were used to investigate the influences of serotonin (5-HT) receptor agonists and antagonists on the electrically evoked tritium overflow. 1. 5-HT and the preferential 5-HT1A receptor agonist 8-OH-DPAT [8-hydroxy-2-(di-n-propylamino)tetralin] concentration-dependently inhibited the evoked 3H overflow. 2. The evoked 3H overflow was not affected by 0.1 or 1 μmol/l TVX Q 7821 (2-{4-[4-(2-pyrimidinyl)-1-piperazinyl]-butyl}-1,2-benzisothiazol-3(2H)one-1,1-dioxide), which selectively binds to 5-HT1A sites; TVX Q 7821 10 μmol/l produced an increase in overflow. 3. The inhibitory effect of 5-HT on the impulse-evoked 3H overflow was abolished by the nonselective 5-HT receptor antagonist metitepin, but was not attenuated by propranolol. 4. Metitepin also abolished the inhibitory effect of 8-OH-DPAT on evoked 3H overflow, whereas the 5-HT2 receptor antagonist ketanserin was inactive in this respect. There was also no antagonism of the effect of 8-OH-DPAT by the α2-adrenoceptor antagonist rauwolscine or the dopamine receptor antagonist flupenthixol. These results suggest that both 5-HT and 8-OH-DPAT inhibit noradrenaline release by activating inhibitory 5-HT receptors on the sympathetic nerves of the human saphenous vein. These receptors possess similarities to 5-HT1 recognition sites, but a further subclassification is not yet possible on the basis of the available data.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00500081
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  • 5
    Electronic Resource
    Electronic Resource
    The role of cyclic AMP in the positive inotropic effect mediated by β1- and β2-adrenoceptors in isolated human right atrium (1987)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 335 (1987), S. 561-566 
    Details
    ISSN: 1432-1912
    Keywords: Human right atrial β1-adrenoceptors ; Human right atrial β2-adrenoceptors ; Cyclic AMP ; Contractility ; Human heart
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The time course of the effects of isoprenaline (3 × 10−7 mol/l) on contractile force and on the cyclic AMP level was studied in the electrically driven isolated muscle strip of the human right atrium. Isoprenaline produced a rise in cyclic AMP content (maximum increase after 60 s) preceding the increase in contractile force. The effects of isoprenaline on contractile force and on the intracellular level of cyclic AMP were enhanced in the presence of the phosphodiesterase inhibitor papaverine (10−5 mol/l). On the other hand, the β-adrenoceptor antagonist propranolol (10−7 mol/l) suppressed isoprenaline-induced cyclic AMP increases, but reduced the increase in force of contraction by only 35%. In addition, both the β1-selective antagonist bisoprolol (3 × 10−9 × 10−8 mol/l) and the β2-selective antagonist ICI 118,551 (3 × 10−9 × 10−8 mol/l) inhibited the isoprenaline-induced cyclic AMP increase concentration-dependently; ICI 118,551 produced more pronounced inhibition than bisoprolol. It is concluded that cyclic AMP is involved in the positive inotropic action of isoprenaline evoked by β1- and β2-adrenoceptor stimulation in isolated human right atrium; however, an additional cyclic AMP independent mechanism cannot be ruled out.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00169125
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  • 6
    Electronic Resource
    Electronic Resource
    Muscarinic cholinoceptors in the human heart: demonstration, subclassification, and distribution (1990)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 341 (1990), S. 14-21 
    Details
    ISSN: 1432-1912
    Keywords: Human cardiac muscarinic cholinoceptors ; Muscarinic cholinoceptor subtypes ; Human right atrium ; Human left papillary muscle ; Negative inotropic effect ; [N-Methyl-3H]-scopolamine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In human atrial and ventricular myocardium, the muscarinic cholinoceptor (M-cholinoceptor) populations were characterized by means of radioligand binding (with [N-methyl-3H]-scopolamine ([3H]-NMS) as the ligand) and functional experiments (negative inotropic effect of carbachol on isolated electrically driven right atrial and left papillary muscle preparations). (1) Binding of [3H]-NMS to human atrial and ventricular membranes was rapid, reversible and saturable (KD-values: 0.5–1.0 nmol/l). The maximal number of [3H]-NMS binding sites, however, was approximately 2.5-fold higher in right and left atrial membranes (200–250 fmol[3H]-NMS specifically bound/mg protein) than in right and left ventricular membranes (80–100 fmol/mg protein). (2) M-cholinoceptor antagonists inhibited [3H]-NMS binding to right atrial and left ventricular membranes with steep, monophasic competition curves indicating interaction with a single class of binding sites. In both tissues the order of potency was: atropine 〉 AF-DX 116 〉 hexahydro-siladifenidol (HHSiD) 〉 pirenzepine. (4) It is concluded that, in the human heart, functional M-cholinoceptors mediating negative inotropic effects exist that belong predominantly (if not exclusively) to the M2-subtype. However, the atrial regions of the human heart are more densely endowed with these M2-cholinoceptors than the ventricular myocardium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00195052
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  • 7
    Electronic Resource
    Electronic Resource
    Multimodality evoked potentials and EEG in brain death. Clinical experiences and animal investigations (1989)
    Springer
    Neurosurgical review 12 (1989), S. 357-362 
    Details
    ISSN: 1437-2320
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01790674
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  • 8
    Electronic Resource
    Electronic Resource
    230. Operative Technik und Ergebnisse bei 36 Thymektomien (1983)
    Springer
    Langenbeck's archives of surgery 361 (1983), S. 755-755 
    Details
    ISSN: 1435-2451
    Keywords: Thymoma ; Thymectomy ; Myasthenia gravis ; Thymone ; Thymektomie ; Myasthenia gravis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über 36 Thymektomien bei 24 Frauen und 12 Männern in 10 Jahren berichtet. Hauptsymptome waren Myasthenia gravis, Luftnot, Gewichtsverlust, thorakale Schmerzen, Husten, obere Einflußstauung und Heiserkeit. Histologisch fanden sich 4 benigne Thymome, 7 Hyperplasien, 7 Thymus-CA., 2 thymogene Cysten und 16mal normales Gewebe. Der Rö-Thorax war in 1/3 der Fälle positiv. Op-technisch ist die mediane Sternotomie erforderlich, da dem intra-op. Befund bzw. Dignität und Prognose wesentliche Bedeutung zukommt. Zur Senkung der Rezidivgefahr wird das perithymische Fett mitreseziert. Die Thymektomie bewirkte in 1/3 der Myasthenie-Fälle eine Besserung.
    Notes: Summary The paper reviews 36 thymectomies in 24 women and 12 men in a 10-year period. The main symptoms were myasthenia gravis, dyspnoea, loss of weight, thoracic pain, coughing, superior vena cava syndrome, and hoarseness. Histology revealed 4 benign thymomas, 7 hyperplasias, 7 thymus carcinomas, 2 thymic cysts, and 16 with normal tissue. Chest roentgenograms were positive in 1/3 of the cases. The operative technique requires median sternotomy because of the importance of the intra-operative finding as to malignancy and prognosis. To diminish the rate of recurrence perithymic fat is also removed. Thymectomy showed improvement in 2/3 of the cases of myasthenia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01276055
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  • 9
    Electronic Resource
    Electronic Resource
    Konzept zur Lungen- und Herz-Lungen-Präservation im Rahmen der Multiorganentnahme (1991)
    Springer
    Langenbeck's archives of surgery 376 (1991), S. 102-107 
    Details
    ISSN: 1435-2451
    Keywords: Multi-organ-procurement ; Lung preservation ; Donor core-cooling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Lungenpraservation ist ein noch weitgehend ungelöstes Problem, das die Ischämie-/Transportzeit und somit die Ausschöpfung von Spenderresourcen limitiert. Das derzeit am häufigsten angewendete Verfahren beruht auf Flush-Perfusion des pulmonalen Funktionskreislaufes. Weitere Verfahren sind autolog arbeitende Herz-Lungenpräparation oder tiefe Spenderganzkörperhypothermie. Die vorgestellte Konzeption verbindet Ganzkörperhypothermie mit Aquilibrierung des Extrazellularraumes mit dem Ziel intrazellulärer Adaptation und ist modifiziert auf die Anforderungen der Multiorganentnahme. Durch Anschluß des Spenders an eine für these Zwecke entwickelte transportable Herz-Lungenmaschine wird das Kühlverfahren eingeleitet und parallel zur Temperaturabsenkung eine Hämodilution durch Inkorporation der protektiven HTK-Lösung nach Bretschneider induziert. Die schrittweise Äquilibrierung zielt auf eine extrazelluläre Senkung des Na+-Gehaltes, Anhebung des K+-Gehaltes and Ca++-Absenkung. Gleichzeitig wird die Kapazität der bluteigenen Puffersysteme durch das inkorporierte Histidin-Puffersystem verstärkt. Zur Vermeidung von Ödembildung wird eine möglichst kurze Phase der extrakorporalen Zirkulation angestrebt; die tiefe Hypothermie his unter 10°C Organtemperatur wird durch parallelgeschaltete Wärmeaustauscher mit Hochdrucküberflutung eines Tieftemperaturcisblockes in weniger als 30 min erreicht. Zusätzlich wird zur weiteren Oberflächenorgankühlung arterielle Blutüberströmung der Lungen eingesetzt. Die Vorteile erstrecken sich nicht allein auf die Lungenpräservation, sondern auch auf die Vorbehandlung aller weiteren zur Multiorganentnahme vorgesehenen Organe.
    Notes: Summary Preservation of the lung is still one of the most challenging problems, because due to limited procurement time not all organs available can be used. The most common procurement technique is flush perfusion of the pulmonary artery system. Alternative methods in clinical use are either the autologous working heart-lung preparation or donor core-cooling (DCC). The own concept presented here, modified to the special demands of multiorgan-procurement, combines DCC and interstitial equilibration adapted to intracellular ion concentration. DCC is induced by extracorporeal circulation (ECC) using a transportable heart lung machine including a highly effective cooling system: cooling circuit based on two parallel heat exchangers with ice-water cooling produced by an high-pressure overflow of an low-temperatured ice block (−40°C). While cooling by ECC stepwise hemodilution is achieved by priming volume and incorporation of the cardioplegic solution (Bretschneider-HTK). The aim of equilibration is to lower the extracellular levels of sodium and calcium, and to increase the level of potassium. Additionally, the buffer capacity of donor blood is increased by the incorporated histidine-buffer system (α-stat). To avoid donor organ edema the time of ECC should be as short as possible. Using our system donor organ temperatures below 10°C are reached within less than 30 min. In addition to ECC, lung surface cooling is achieved by external overflow with cold arterial blood (internal mammary artery). Besides lung preservation the main advantage of this concept is the profound precooling of all visceral organs before their individual flush perfusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01263467
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  • 10
    Electronic Resource
    Electronic Resource
    Non-lethal penetrating cardiac injury from a crossbow bolt (1998)
    Springer
    International journal of legal medicine 111 (1998), S. 88-90 
    Details
    ISSN: 1437-1596
    Keywords: Key words Penetrating cardiac injury ; Emergency ; thoracotomy ; Suicide ; Crossbow wounds
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract Crossbow injuries to the thorax are nowadays uncommon. The type of arrowhead used determines not only the form of entrance wound but often the outcome of these injuries. We report the case of a 38-year-old man who attempted to commit suicide by firing a bolt from a sport crossbow into his heart. Although the bolt penetrated the mediastinum causing a deep intraseptal myocardial lesion and the pre-operative diagnostic procedure delayed the necessary operation, the patient survived.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004140050121
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