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Biomedical subjects

B Heyden

Publications and source records attributed to B Heyden.

12 recordsLinked to original sources
PubMed1982

[Pro and contra profundaplasty (author's transl)].

The profundaplasty has recently advanced to a widely used surgical approach for revascularisation of the lower extremities, both for claudication and limb salvage. The effectiveness of this simple time saving procedure depends on a critical selection of patients and the use of an improved surgical technique. Main prerequisites are the simultaneous aorto-iliac inflow repair, using thromboendarterectomy or bypass, the patency of the so-called "receptor segment" of the popliteal artery and a sufficient run- off in the distal arterial tree. An additional lumbar sympathectomy has proved as a protective adjunct which results in an additional increase of flow in the restored deep femoral artery. In combined occlusive lesions of the aorto-iliac and femoro-popliteal segment the late results of a proximal inflow repair in combination with profundaplasty and lumbar sympathectomy are significantly superior to the total repair of both arterial segments. A profundaplasty is contraindicated if this artery is seriously diseased or in the presence of total occlusion of the popliteal artery (receptor segment) and of more than two main arteries below the knee. This is the place where long distal grafts are still justified for limb salvage. In over 80% of patients with arterial occlusive disease of the leg arteries the profundaplasty (with or without aorto-iliac inflow-repair) has proved as an effective alternative to time-consuming extensive arterial reconstructions with equivocal outcome.

Arterial Occlusive Diseases↗
PubMed1981

[Quantitative hemodynamic studies in finger reimplants using intraoperative flow measurement and postoperative phlebemphraxis plethysmography (author's transl)].

1. Clinical and haemodynamical checking has shown that no negative influence on the result of re-implantation is exercised by safeguarding the venous flow via a single anastomosis at the back of the finger (success quota 82%). 2. One venous thrombosis only occurred as a result of the surgical procedure mentioned above, in 18 reimplanted fingers (5,5%); hence, the quota of venous thromboses is definitely lower than with other reported groups of patients (2, 6). 3. Anastomosing of one dorsal vein only in the reimplantation of long fingers and thumb can, therefore, be recommended as a simplified routine method.

Amputation, Traumatic↗
PubMed1980

Principles of operation for combined aortoiliac and femoropopliteal occlusive lesions.

In combined chronic occlusive lesions at the aortoiliac and femoropopliteal level, partial repair of the central vessels in combination with profundaplasty and lumbar sympathectomy represents a more simple and shorter procedure than does the previously preferred total correction of both segments. In a retrospective study of 403 limbs, Stages II, III and IV, the triad procedure results in a cumulative patency rate of 77 versus 39 percent for total repair. In limb salvage operations, Stages III and IV, the corresponding figures for the amputation rate were 8 versus 36 per cent and for reoperation, 7 versus 23 per cent. Prerequisites for this type of repair are an improved technical approach and a critical selection of patients with a receiving segment of the popliteal artery and a sufficient runoff below the knee.

Aorta↗
PubMed1979

[Vascular replacement with plastics (author's transl)].

The plastic substitution of the aorta and its large branches may be considered largely solved today. For this purpose preference is given to highly porous, thin-walled double velour prostheses. The search for a biocompatible plastic substitute for small caliber arteries and the large veins of the body (portal vein, vena cava, iliac veins) is proceeding in two directions at the present time: on the one hand towards optimized bioprostheses and on the other hand towards plastics which apply the principle of microporosity or impermeability with the creation of antithrombogenic inner surfaces. In this respect expanded polytetrafluoroethylene and coating with carbon are very promising.

Biocompatible Materials↗
PubMed1979

[Surgery in combined aorto-iliac and femoro-popliteal occlusive lesions (author's transl)].

In combined chronic occlusive lesions at the aorto-iliac and femoro-popliteal level the partial repair of the central vessel in combination with profundaplasty and lumbar sympathectomy ("triad procedure") represents a simpler and shorter procedure than the previously preferred total correction of both segments. In a retrospective study of 403 limbs (stage II-IV) the triad procedure shows a cumulative patency (life table analysis) of 77% vs. 39% in total repair. The amputation rate in triad procedure--for stage III/IV--was 8% vs. 36% and the frequency of reoperation 7% vs. 23% in total repair. Prerequisites for this type of repair are an optimal technique and a correct selection of patients presenting patient "receiving segment" of the popliteal artery and a sufficient run-off below the knee.

Aortic Diseases↗
PubMed1975

Initiation of transcription within an RNA-polymerase binding site.

1. The 5'-terminal sequence of the RNA transcribed from bacteriophage fd replicative form DNA under the control of promotor region I has been determined to be ppp(Gp)nUpApApApGpApCpCpUpGpApUpUp. . . 2. This sequence is complementary to the 5'-terminal sequence of the minus strand of the corresponding RNA polymerase binding site I, the starting point for RNA synthesis lying approximately in the middle of the binding site. 3. This initial sequence is also transcribed faithfully from isolated complexes of RNA polymerase and binding site I, obtained by DNase digestion of complexes between RNA polymerase and fd replicative form DNA. These highly stable complexes can not be reconstituted from binding site and enzyme. 4. It is concluded that RNA polymerase binding site and initiation site are identical parts of a promoter region, and that no "drift" between these sites is required as a step in RNA chain initiation. An additional non-transcribed outside region is implicated as essential for full promoter function.

Base Sequence↗
PubMedDate not supplied

Thoracic outlet-syndrome with vascular complications.

1. In thoracic outlet-syndrome arterial lesions--such as poststenotic aneurysm with or without peripheral arterial emboli--are mostly caused by permanent compression of the vessel. In 48% of cases arterial emboli show to be the first clinical manifestation of a subclavian artery lesion. 2. Venous lesions usually classified as "spontaneous axillar vein thrombosis" are probably initiated by intimal lesions of the axillary vein caused by compressionof this vessel in the costoclavicular space. 3. Unilateral ischemia of fingers or hand--especially in young patients--should be considered first of all as a peripheral manifestation of a cervical rib-syndrome. Surgical correction should include besides rib resection, lumen control of the poststenotic dilated artery, disobliteration of occluded main arteries and thoracic sympathectomy in cases with several distal arterial embolic occlusions. 4. Venous thrombectomy for acute thrombosis of the axillary and subclavian vein should be combined with the resection of the first rib in order to prevent any further compression to the vein in the costoclavicular space. The use of a temporary a.v.-fistula may be used as an additional mens for keeping the disobliterated vein patent. 5. In the thoracic outlet-syndrome neurological signs and complaints caused by intermittent or permanent mechanical nerve irritation represent the most frequent clinical findings (i.e. 90%). On the other hand in two thirds of patients with arterial or venous complications neurological signs are missed and therefore do no help for diagnosis.

Adult↗