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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 58 (1980), S. 1319-1321 
    ISSN: 1432-1440
    Keywords: Demand-Schrittmacher ; Sensing-Anomalität ; akuter Myocardinfarkt ; Demand pacemaker ; Sensing abnormality ; Acute myocardial infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Trasient asynchronous pacing due to abnormal sensing function is reported in two patients with inserted demand pacemakers during the early phase of acute myocardial infarction. The hazards of the pacemaker induced parasystole with R on T phenomenon in conditions of enhanced electrical instability could be successfully overcome applying overdrive suppression of the inserted pacing system by external chest wall stimulation
    Notes: Zusammenfassung Bei 2 Patienten mit implantiertem Demand-Schrittmacher wurde in der Frühphase eines Myokardinfarktes vorübergehend asynchrone Schrittmachertätigkeit infolge gestörter Detektion beobachtet. Die Gefährdung durch schrittmacherinduzierte Parasystolie mit R auf T Phänomen unter Bedingungen erhöhter elektrischer Instabilität konnte erfolgreich unter Anwendung externer Overdrive-Stimulation beseitigt werden.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 63 (1985), S. 193-204 
    ISSN: 1432-1440
    Keywords: Suprasternal M-mode echocardiography ; Cardiovascular diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The suprasternal approach can be used to image the aortic arch, the right pulmonary artery and the left atrium. Dilatation or dissections involving the aortic arch were detected echocardiographically from the suprasternal notch. The echocardiogram of the right pulmonary artery is altered in cases of acute and chronic pulmonary hypertension. Intrapulmonary thrombi in patients with acute pulmonary embolism were visualized with this technique. A volume overloading of the pulmonary circulation due to a congenital left to right shunt, as well as a decreased pulmonary blood flow due to a congenital right to left shunt causes characteristic changes in the wall motion pattern of the right pulmonary artery. Hypoplasia or aplasia of the central pulmonary arteries can be diagnosed as well. Imaging of the left atrium from the suprasternal notch may help to differentiate between supraventricular and ventricular rhythm disturbances. The suprasternal approach is therefore recommended to be used as a routine part of each echocardiographic examination.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 64 (1986), S. 301-306 
    ISSN: 1432-1440
    Keywords: Myocardial infarction ; Fibrinolysis ; Plasminogen activators
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The early treatment of acute myocardial infarction has changed rapidly in recent years. Given the fact that an occlusive coronary thrombus can be found in most infarct patients within 4 h after clinical symptoms, the idea of instituting medical or mechanical recanalization of the occluded vessel is intriguing. However, invasive measures are time consuming, expensive and not freely available to a great number of patients. Thus, only i.v. fibrinolytic therapy of acute myocardial infarction will gain wider application in the near future. Several concepts have been worked out, one of which uses a high-dosage streptokinase or urokinase regimen. A different therapeutic alternative has been made possible by the development of selective fibrinolytic substances, such as the tissue-type plasminogen activator (t-PA) or the anisoylated plasminogen-streptokinase activator complex (APSAC). Preliminary clinical data have shown that the coronary artery patency rate achieved after i.v. administration of t-PA or APSAC is higher than that after conventional treatment with streptokinase or urokinase. The incidence of severe bleeding complications is low and comparable in these studies. However, until myocardial salvage has been demonstrated with early i.v. fibrinolytic therapy in acute myocardial infarction in a placebo-controlled randomized trial, this therapeutic concept will still be unsettled.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 61 (1983), S. 523-527 
    ISSN: 1432-1440
    Keywords: Digoxin ; Sinus node function ; Autonomic blockade
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of iv digoxin on normal sinus node function was studied after pharmacologic autonomic blockade (AB) in ten patients. Sinus cycle length (SCL), sinus node recovery time (SNRT) and sinoatrial conduction time (SACT) were determined before and after AB with propranolol (0.2 mg/kg body weight) and atropine sulfate (0.04 mg/kg body weight) iv, and 15 min, 30 min, and 45 min after 1 mg iv digoxin. AB resulted in a significant decrease (P〈0.01) in SCL (916±158 to 716±120 ms), in SNRT (1,229±221 to 871±190 ms), and in SACT (79±34 to 44±10 ms). Fifteen minutes after iv digoxin there was no significant change observed in SCL (716±120 to 708±92 ms), in SNRT (871±190 to 864±148 ms), or in SACT (44±10 to 46±15 ms). Similar results were obtained 30 min after digoxin administration. It is concluded that a single therapeutic dose of digoxin has no direct effect on electrophysiologic parameters of normal intrinsic sinus node function.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 60 (1982), S. 71-75 
    ISSN: 1432-1440
    Keywords: Pulmonary arterial pressure ; Right pulmonary artery ; Suprasternal echocardiography ; Pulmonalarteriendruck ; rechte Pulmonalarterie ; suprasternale Echokardiographie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 175 Patienten wurden innerhalb von 24 h vor der Herzkatheteruntersuchung mit Hilfe der suprasternalen M-mode Echokardiographie untersucht. Es wurde geprüft, ob sich eine pulmonale Hypertonie durch Messung der Weite der rechten Pulmonalarterie im suprasternalen Strahlengang abschätzen läßt. Gruppe I bestand aus 103 Patienten ohne pulmonale Hypertonic (enddiastclich ≤12 mm Hg; Mitteldruck≤20 mm Hg). Gruppe II umfaßte 72 Patienten mit einer pulmonalen Hypertonie. Die rechte Pulmonalarterie konnte bei 91,2% der Patienten dargestellt werden. Der enddiastolische Durchmesser der rechten Pulmonalarterie in Gruppe I betrug 17.9±0.2 mm (MW±mittlerer Fehler des Mittelwertes) und korrelierte zur Körperoberfläche der Patienten (r=0.63;p〈0.001). Die Indexweite der rechten Pulmonalarterie in Gruppe I betrug 9.9±0.1 mm/m2 und unterschied sich von der in Gruppe II mit 14.1±0.4 mm/m2 (p〈0.001). Die prozentuale systolische Erweiterung der rechten Pulmonalarterie in Gruppe I betrug 21.2±0.8%, in Grupper II 9.2±0.8% (p〈0.001). Die Indexweite der rechten Pulmonalarterie korrelierte zum enddiastolischen Pulmonalarteriendruck (r=0.82;p〈0.001). Die prozentuale systolische Erweiterung zeigte eine negative log-lineare Beziehung zum diastolischen Pulmonalarteriendruck (r=0.67;p〈0.001). Eine pulmonale Druckerhöhung kann über die veränderte Weite der rechten Pulmonalarterie und dem Bewegungsmuster des Gefäßes im suprasternalen Strahlengang diagnostiziert werden.
    Notes: Summary We studied 175 patients within 24 h before cardiac catheterization with suprasternal echocardiography to evaluate whether pulmonary arterial hypertension can be derived by measuring the size of the right pulmonary artery. Group I consisted of 103 patients without pulmonary arterial hypertension (enddiastolic≤12 mm Hg; mean pressure ≤20 mm Hg) and group II consisted of 72 patients with pulmonary arterial hypertension. The right pulmonary artery could be imaged in 91.2% of the patients studied. The size of the right pulmonary artery at the end of diastole in group I measured 17.9±0.2 mm (mean±SEM) and correlated best to the body surface area in this group (r=0.63;p〈0.001). The respective index size amounted to 9.9±0.1 mm/m2, and was different from that in group II with 14.1±0.4 mm/m2 (p〈0.001). The systolic percent expansion of the right pulmonary artery in group I was 21.2±0.8% and in group II 9.2±0.8% (p〈0.001). The index size of the right pulmonary artery for both groups correlated best to the pulmonary enddiastolic pressure (r=0.82;p〈0.001). The systolic per cent expansion showed a negative log linear relationship to the pulmonary enddiastolic pressure (r=0.67;p〈0.001). Thus, pulmonary arterial pressure can be derived by measuring the size of right pulmonary artery with suprasternal echocardiography.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 61 (1983), S. 609-615 
    ISSN: 1432-1440
    Keywords: Atrial fibrillation ; Atrial flutter ; Electrocardiography ; Electrophysiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Sixteen patients were investigated by means of programmed atrial stimulation at two different driving rates: 100 and 120/min. All patients had an increased atrial vulnerability at both driving rates. After intravenous flecainide application (1 mg/kg body weight as a bolus followed by the same amount given by infusion over a period of 20 min) the increased vulnerability was abolished in 11 and 9 patients respectively. In the remaining patients the rate of induced atrial tachyarrhythmia decreased. These findings correlate with a significant prolongation of the effective refractory period of the right atrium and a significant shortening of the relative refractory period of the right atrium. It is concluded that flecainide may be effective in the treatment of atrial arrhythmias in man.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1440
    Keywords: Levodopa ; Inotropic drugs ; Congestive heart failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate the long-term effects of orally administered levodopa, 11 patients with chronic congestive heart failure (NYHA III–IV) were studied during maintenance therapy (30±1 days) and after withdrawal from levodopa. The daily levodopa dose was 4 g in six patients; because of side effects the levodopa dose was reduced to 2–3 g in the remaining patients. After withdrawal of levodopa, mean pulmonary capillary wedge pressure and mean right atrial pressure increased significantly (from 19±2 to 24±3 and from 7±2 to 9±2 mmHg, respectively). Effective renal plasma flow was 329±57 during levodopa therapy and decreased significantly to 252±27 ml/min after withdrawal of levodopa. The number of ventricular premature contractions and couplets increased during levodopa therapy and decreased again significantly after withdrawal of levodopa. No significant differences between on and off levodopa were observed in resting heart rate, arterial blood pressure, cardiac index, stroke work index, systemic vascular resistance, sodium and water excretion, or creatinine clearance. Seven patients improved on levodopa therapy by one NYHA class; four of these seven patients deteriorated again by one NYHA class after withdrawal of levodopa. Regarding both clinical and hemodynamic changes after withdrawal of levodopa, three patients were classified as responders to long-term levodopa therapy. All three responders received 4 g levodopa per day. Average dopamine plasma level was 5.3±0.8 ng/ml in the responder group and 2.0±0.5 ng/ml in the nonresponder group. Long-term administration of oral levodopa is associated with beneficial clinical and hemodynamic response in only a minority of patients with chronic congestive heart failure.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 18 (1980), S. 461-465 
    ISSN: 1432-1041
    Keywords: antiarrhythmic drugs ; lorcainide ; haemodynamic effects ; i.v. dose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The cardiovascular effects of a single i.v. dose (2 mg/kg over 5 min) of lorcainide were studied in 14 patients with heart disease. In the haemodynamic part of the study (6 patients), the aortic and pulmonary systolic, diastolic and mean pressures, left ventricular systolic and end-diastolic pressures, cardiac output and the rate of rise of left ventricular pressure were measured before and for 30 min after administration of the drug. Lorcainide produced a slight and short-lasting decrease in the aortic and pulmonary systolic pressures, and all other pressure values remained unchanged. The cardiac output and systemic vascular resistance were not altered by lorcainide. It consistently depressed the rate of rise of left ventricular pressure (maximum mean decrease 19%). In the angiographic part of the study (8 patients), the ejection fraction and the mean velocity of circumferential fiber shortening were measured before and 5 min after lorcainide. In all but one patient, lorcainide decreased the ejection fraction (mean decrease 11.6%), and the mean velocity of circumferential fiber shortening was uniformly diminished by lorcainide (mean decrease 29.7%). Thus, lorcainide moderately impaired myocardial performance in patients with normal and reduced left ventricular function without producing hypotensive side effects.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 100 (1967), S. 101-112 
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Severe allergic reactions by incompatibility of medicaments in four children were found. The socalled Lyellsyndrome was found in three cases, once the sulfonamid-encephalopathia was observed. One child with Lyell-syndrom died. The treatment consisted in giving cortisone and ACTH, the local treatment with nebacetin-spray. Very important are little transfusions of blodd and albumine. The sensibility to medicaments may disappear, but it may persist for the whole life. The incompatibility to medicaments is severe; the incompatible medicaments should'nt be given nor more.
    Notes: Zusammenfassung Es wird ausführlich über vier Kinder berichtet, bei denen schwere allergische Reaktionen bei Arzneimittelunverträglichkeit festgestellt wurden. Zweimal konnte das sog. Lyell-Syndrom und einmal die Sulfonamid-Encephalopathie beobachtet werden. Ein Kind mit schwerer Epidermolysis acuta toxica (Lyell) verstarb, die anderen beiden Kinder konnten gerettet werden. Die Behandlung bestand in Gaben von ACTH und Cortison sowie Infusionen; der lokalen Behandlung mit Nebacetin-Spray muß größte Sorgfalt gewidmet werden. Kleine Blut- bzw. Albumininfusionen ergänzen die Therapie sehr gut. Eine genaue Anamnese, vor allem eine exakte Arzneimittelanamnese sollte bei allen Kindern erhoben werden. Die Sensibilisierung, die durch das Arzneimittel gesetzt wurde, kann zwar spontan verschwinden, aber andererseits auch lebenslang bestehen bleiben. Die einmal unverträglichen Medikamente dürfen nicht wieder verabreicht werden.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Journal of Chromatography B: Biomedical Sciences and Applications 223 (1981), S. 238-242 
    ISSN: 0378-4347
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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