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Biomedical subjects

A Moritz

Publications and source records attributed to A Moritz.

At least 181 records · Page 10Linked to original sources
PubMed1989

Leaflet fracture in Edwards-Duromedics bileaflet valves.

Two cases of leaflet fracture in the Edwards-Duromedics valve at 36 and 38 months after implantation are reported. Both patients were immediately reoperated on and recovered well. In one valve an older housing fracture with partial tissue ingrowth was noted beside a recent transverse leaflet fracture. In the other valve the leaflet was fractured near the pivot mechanism. All larger embolized parts were detected in the iliac artery region by computed tomographic scan and were subsequently removed. Problems in diagnosis and the importance of immediate reoperation, even without exact diagnosis, are discussed. Technical evaluation of the valve revealed crack growth and arrest, giving evidence of fatigue fracture. Scanning electron microscopic examination revealed several areas of pitting and erosion. Although the exact cause of mechanical disruption remains speculative, pyrolytic carbon seems to have the characteristic of fatigue fracture as well as erosion damage. A connection between the two might exist.

Adolescent↗
PubMed1989

Radionuclide assessment of the natural heart ejection fraction before and after LVAD implantation.

Complete pressure unloading of the ventricles can preserve ischemically damaged myocardium. Most clinical left heart assist device (LVAD) systems used after ischemic injury of the heart apply atrial cannulation which does not ensure pressure unloading. In order to assess the effect of the implantation of an intracorporeal LVAD on the function of the natural heart, we determined the ejection fraction (EF) in four male Holstein calves (90-105 kg) before and after insertion of a Cleveland Clinic pneumatic LVAD. A gated blood pool scan was obtained with a gamma camera after injection of 40 mCi Tc-labelled albumin. The animals were restrained in a sling to avoid movement artifacts. All animals showed a drop of 65 +/- 12% to 42 +/- 14% EF in the first postoperative (p.o.) week. Left ventricular output did not maintain sufficient blood pressure as assessed by pump-off tests. Systolic blood pressure dropped from 122 +/- 6.5 mm Hg to 81 +/- 6 mm Hg without pump support on the morning of the first p.o. day. Apical coring and possible restrained heart movement by the implanted LVAD may lead to impaired myocardial function that renders the individual LVAD dependent until adaptative corrections take place.

Animals↗
PubMed1988

[Clinical use of the artificial heart, indications and results].

Clinical experience with the artificial heart now comprises 520 cases. 390 patients had to be supported mechanically when they could not be weaned off cardiopulmonary bypass. 177 (45%) subsequently had their assist devices removed and 100 (25.4%) were discharged. Good functional results were achieved, since 30 of 36 long-term survivors are in NYHA class I or II. 140 underwent two-stage cardiac transplantation. Of 63 patients implanted with a ventricular assist device (VAD) 71% were transplanted and 51% survived. A total artificial heart (TAH) was used in 77 cases, 81% were transplanted and 47% survived. Five patients received TAH implantations as a permanent replacement of the failing heart. Though the clinical courses were complicated by strokes and infections and the patients were tethered to bulky drive units, it was proven that the TAH may sustain human life for up to 622 days, much longer than so far achieved in animal experiments. Improvements of the atrial connectors and valve holding components and of the biocompatibility of the blood contacting surfaces should overcome the complication of thromboembolism. Fully implantable devices which are currently being developed will avoid the problem of drive-line infections and provide fuller mobility to the patient.

Assisted Circulation↗
PubMed1988

Voluntary control of an ileal pouch by coordinated electrical stimulation. A pilot study in the dog.

Ileal reservoirs were constructed in four dogs under general anesthesia and stimulated by means of a constant current generator that produced pulse trains at frequencies between 6 Hz and 1.67 kHz. Stimulation at 6 Hz with 50 ms pulses between amplitudes of 15 and 25 mA uniformly produced pouch contraction and reservoir emptying. Stimulation at other frequencies did not cause pouch emptying although pressure increases were sometimes observed. Such electrical stimulation may be useful for voluntary control of intestinal reservoirs when used as replacement for urinary bladder or colon. The mechanism by which the intestinal contraction is produced appears to be different than that produced by slow wave pacing.

Anastomosis, Surgical↗
PubMed1988

[Experimental bile duct replacement using deep seromuscular stomach wall grafts].

Numerous materials and experimental designs were tested hitherto concerning their usefulness as a substitute of the ductus choledochus. However, an ideal substitute to discover failed. We had tested a serous muscular stomach wall patch, flapped at the gastroepiploic vasa, in 6 pigs. Choledochus epithelium did not grow in every case. A scarred shrinking with following stenosis of the transplant resulted in all cases with a longer observation period. We concluded from that a serous muscularly flapped stomach wall transplant does not suit as a bile duct substitute.

Animals↗
PubMed1987

Implantation of the Duromedics bileaflet cardiac valve prosthesis in 400 patients.

From September, 1983, to April, 1986, 451 Duromedics bileaflet cardiac valve prostheses were implanted in 400 patients at our institution in Vienna. Aortic valve replacement was done in 190 patients, 157 underwent mitral valve replacement (1 patient also underwent tricuspid valve replacement), 52 underwent double valve replacement, and 1 patient underwent isolated reoperation for tricuspid valve replacement. Concomitant procedures were performed in 86 patients (21.5%). Sixty-one patients (15.2%) had undergone previous cardiac surgery; 32 (8%) had undergone earlier valve replacement. The early mortality rate (within 30 days) was 6.25% (25 patients). Follow-up was done on 337 surviving Austrian citizens; this represents 429 patient-years. The late mortality rate was 2.1% per patient-year (9 patients). We observed paravalvular leak in 3 patients (0.7% per patient-year), thromboembolism in 4 (0.9%), prosthetic valve endocarditis in 5 (1.2%), and anticoagulant-related hemorrhage in 10 (2.3%). Valve failure occurred in 8 patients (1.8%). We conclude, therefore, that good clinical results and a low complication rate can be achieved with this new type of valve.

Anticoagulants↗
PubMed1985

Characterization of the 7S RNA and its gene from halobacteria.

The 7S RNA is an abundant nonribosomal RNA in H. halobium and other halobacteria. A specific 7S RNA gene probe shows high homology to genomic DNA of all halobacteria tested but not to those of several other archaebacteria, eubacteria and eukaryotes. All halobacterial genomes seem to carry a single copy of the 7S RNA gene. The coding region of the 7S RNA gene is highly G+C rich whereas the 5'- and 3'-noncoding regions possess a rather low G+C content. An extended double stranded structure for the 7S RNA is deduced from its nucleotide sequence. The 7S RNA of H. halobium (304 nucleotides) resembles in size and structure the 7S-L RNA from mammalian cells and shares with it a sequence homology of about 50% when arranged in a colinear fashion. The similarities in sequence are found particularly at the 3'- and 5'-termini. No similarity was detected between the 7S RNA from H. halobium and the nonribosomal 6S RNA from Escherichia coli.

Animals↗
PubMed1985

Common structural features of the genes for two stable RNAs from Halobacterium halobium.

The genes coding for the 5S rRNA and another stable RNA, termed 7S RNA, in Halobacterium halobium were isolated from a genomic library of this archaebacterium and their nucleotide sequences determined. Both genes are colinear with their transcripts (5S rRNA and 7S RNA), but 5S rRNA and possibly also 7S RNA isolated from other halobacteria carry additional nucleotides within the RNA transcript. Both genes are located in the G + C rich chromosomal fraction I of H. halobium. Comparison of the 3' non-coding regions of both genes shows a 20 bp sequence of high homology immediately at the 3' ends which is almost symmetrically flanked by two stem-loop structures, one being situated close to the 3' end but within the coding region and the other downstream of the common 20 bp sequence.

Base Sequence↗
PubMed1985

Two years' experience with the duromedics bileaflet heart valve prosthesis.

The new Duromedics Bileaflet Cardiac Valve prosthesis has a special moving hinge mechanism for its two leaflets to wash the critical articulation area and thus reduce thrombus formation. Between October 1983 and June 1985, we implanted 278 of these prostheses in 254 patients. We did 114 aortic valve replacements, 109 mitral valve replacements, 34 double valve replacements, and two tricuspid valve replacements. Nearly 20% of the patients had had previous cardiac procedures. The hospital mortality was 5.9%. Follow-up was started with 214 surviving Austrian patients, and up to the present time, we have a follow-up period of 1704 patient months. Five patients died late after the operation (3.5 per 100 patient years). We observed 10 valve-related complications in nine patients (7 per 100 patient years). There were three cases of prosthetic endocarditis (2.1 per 100 patient years), two paravalvular leaks, and four bleeding episodes (2.8 per 100 patient years). The mechanical hemolysis was minimal, and the postoperative hemoglobin value averaged 15 g%. The LDH increased from 230 IU to 307 in the aortic valve replacements, 406 in the mitral valve replacements, and 435 in the double valve replacements. Intraoperative pressure gradients and postoperative Doppler echocardiography showed good hemodynamic performance. We conclude that good clinical results and a low complication rate can be achieved with the Duromedics Valve.

Journal Article↗
PubMed1984

[The problem of scars in heart surgery with special reference to the use of static magnetic fields].

An attempt is made to survey the pathophysiology of wound healing, as well as the aetiological factors involved and the possibilities of therapeutic intervention to prevent the formation of hypertrophic scars and keloid after cardiac operations. Several prophylactic measures are discussed, with special reference to the use of static magnetic fields. Their application to scars after cardiac operations was carried out by energy pak foils. Patients treated with these foils showed slightly improved results as compared with a control group. The results, however, were not statistically significant.

Adult↗
PubMed1982

Studies in man with a cold-recombinant live influenza B virus vaccine.

A cold recombinant live influenza B virus vaccine was tested in man. In comparison to a placebo, reactogenicity attributable to virus infection was slight or moderate. No revertant viruses were shed, and there was no evidence of transmission to the placebo group who were housed in close contact with the vaccinees. Serological responses to initial inoculation were moderate; 60% of vaccinees showing twofold increases in serum hemagglutination inhibition (HAI) titers gave a geometric mean titer (GMT) of 1:13. Three weeks after the first vaccination, both the vaccine and the placebo group were revaccinated with homologous live virus vaccine. The group previously given vaccine was resistant to reinfection as judged from clinical reactions and virus shedding and the GMT increased only slightly to 1:16.3. In contrast, the former placebo group responded; mild symptoms were seen, the majority shed viruses and 50% showed twofold increases in serum HAI titers to a geometric mean titer of 1:17.4.

Adult↗
PubMed1980

Studies in man with cold-recombinant influenza virus (H1N1) live vaccines.

Two cold-recombinant influenza A (H1N1) viruses were tested in several groups of human volunteers. Only minor clinical symptoms were seen and no febrile reactions occurred. With serologically primed individuals virus shedding was low, but a high proportion showed rises in serum antibody levels after vaccination and mean titres were high. With serologically unprimed volunteers shedding was high, about 75% yielding viruses but only at low titres and for a short duration. No revertant viruses were found and there was no evidence of transmission to potentially susceptible individuals housed in close contact to the vaccinees. Serum antibody responses with unprimed volunteers were, however, low. Only about one half showed increases in serum antibody titres after vaccination and mean titres were low. Nevertheless, challenge with live attenuated virus indicated a high degree of protection based on virological evidence of infection.

Adult↗
PubMed1978

[A new influenza subunit vaccine: hemagglutinating antibodies one year after vaccination (author's transl)].

The antibody response to a new influenza subunit vaccine was compare d one year after vaccination with the responses induced by two other influenza vaccines. The subunit vaccine was given either in a high dose form containing 2100 IU, or in a low dose form containing 700 IU. As comparison a split vaccine was used containing 800 IU and AI(OH)3 as adjuvant and a whole virus vaccine containing 2100 IU. Of the 399 vaccinated subjects which had taken part in this study 151 were available for hemagglutination inhibiting (HAI) antibody determinations one year after vaccination. Protection rates assessed for the respective groups on the assumption that serum HAI titers of 1 : 32 or greater confer protection. With the high dose of subunit vaccine 85% of volunteers were considered still to have protective titers one year after vaccination, compared with 77% of those who received the whole virus vaccine. Although the high dose subunit vaccine and whole virus vaccine induced similarly high protective levels lasting at least one year, the reactions observed on vaccination were significantly less with the subunit preparation. The lower dose of subunit vaccine induced lower levels of protection (60%) after one year, and lower mean HAI titers than the high dose subunit vaccine. Nevertheless protection was superior to that of the split virus adjuvant vaccine. The addition of adjuvant thus does not seem materially to improve the immune response to influenza virus antigens. An increase of antigen content can however be seen as a practical alternative for achieving higher antibody levels. The subunit vaccine would appear to be particularly suitable in this respect as even with a higher dose there is no increase in reactogenicity.

Adjuvants, Immunologic↗
PubMed1978

[Vaccination of infants and schoolchildren with an influenza subunit vaccine (author's transl)].

A new influenza subunit vaccine which contains only hemagglutinin and neuraminidase antigens was investigated for reactogenicity and immunogenicity in children aged between three and 15 years. Children under six years of age received either 500 IU or 1000 IU of the commercial vaccine, those aged from six to 15 years either 1000 IU or 2000 IU. The vaccines contained the virus strains recommended by the World Health Organisation for the vaccination season 1976/77. In a double blind study the vaccinees were allocated at random to the different dosage groups. The children were examined for reactions by the vaccinating physician 24 hours after vaccination. Serum hemagglutination inhibiting antibody titers were determined before vaccination and four weeks after vaccination. In the younger age-group additional antibody determination was made two weeks after a booster injection. A very low rate of side-reactions was observed in all dosage groups. The increase of the antigen content was not associated with a higher rate of side reactions. After the first vaccination a significant rise of antibody titers could be observed in all children. After the booster injection a further increase of these antibody titers was observed. The response of the younger age group to the dosages 500 and 100 IU did not different significantly. In contrast, in the older age group the increase of the dosage from 1000 to 2000 IU was connected with a better immune response. This was especially marked in the antibody titers against the influenza B-strain virus.

Adolescent↗
PubMed1976

[A new influenza subunit vaccine: reactogenicity and antigenicity in comparison to split and whole virus vaccines (author's transl)].

The reactogenicity and immunogenicity of a new influenza subunit vaccine essentially containing only haemagglutinin and neuraminidase was studied in man. The vaccine was compared to commercially available vaccines, an adjuvant containing tween-ether split vaccine (800 IU per dose), and a fluid whole-virus vaccine (2100 IU per dose). Two dosages (700 and 2100 IU) of the fluid subunit vaccine were compared. All vaccines contained the virus strains recommended by the WHO for the 1975/76 season. In a double-blind study 399 volunteers were randomly selected to receive one of the four vaccines. The volunteers were examined for side-effects 24 and 48 hr after vaccination. Antibodies inhibiting haemagglutination were determined prior to and four weeks after vaccination. The sudunit vaccine at 700 IU per dose caused significantly fewer local side effects than the comparable split vaccine, and resulted in significantly higher antibody titers against both influenza A strains. A comparison of the subunit and whole virus vaccines containing high dosages (2100 IU) showed striking differences in reactogenicity. Subunit vaccine was very well tolerated. whereas whole virus vaccine caused systemic reactions, including fever and headache, in 15% of the volunteers. No significant reactogenicity was seen with a high dosage of subunit vaccine (2100 IU) although this is a three-fold increase on the currently used European dosage. Antibody titers were significantly enhanced however.

Adolescent↗