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C Hellekant

Publications and source records attributed to C Hellekant.

At least 19 recordsLinked to original sources
PubMed1994

Anomalous origin of the right coronary artery from the main pulmonary artery. A case report.

A fifty-nine-year-old, asymptomatic woman with anomalous origin of the right coronary artery from the main pulmonary artery is presented. The diagnosis was established by catheterization and angiocardiography. The indications for surgery in this condition are discussed, with special reference to asymptomatic patients. In this patient, surgery was not undertaken, because of the absence of signs of impairment of left ventricular perfusion and function. The patient remains asymptomatic after eight years of observation.

Coronary Vessel Anomalies↗
PubMed1992

Haemodynamic significance of the atrioventricular plane displacement in patients with coronary artery disease.

Echocardiographic quantitative assessment of the atrioventricular plane displacement (AVPD) in systole towards the apex has been used to estimate global left ventricular (LV) function. The study population consisted of 106 patients with coronary artery disease (CAD) with or without previous myocardial infarction and 40 age-matched healthy subjects. The AVPD was recorded from the apical four- and two-chamber views at four sites corresponding to the septal, lateral, anterior and posterior walls of the left ventricle. A mean displacement (AVmean) was calculated from the above sites. AVmean was significantly decreased in patients with CAD compared to healthy subjects (P less than 0.001). In patients in whom the left ventricular ejection fraction (LVEF) was calculated from cineangiograms a good correlation between AVmean and LVEF was found (r = 0.89, P less than 0.001, SEE = 6.4). Selecting an AVmean of 10 mm or more to define a normal LVEF (greater than or equal to 55%) resulted in a sensitivity of 92% and a specificity of 87% in predicting a normal versus abnormal left ventricular systolic function. It is concluded that the ease of recording the AVPD by echocardiography provides a simple and valuable noninvasive method to assess global left ventricular function in patients with CAD.

Adult↗
PubMed1988

Intraaortic balloon tamponade during hemorrhagic shock in sheep.

Two groups (n = 10 in each) of adult sheep were exposed to hemorrhagic shock resulting in mean arterial pressure (MAP) below 25 mmHg for 10 min. Following that, group A received crystalloids (8% of body wt) during one hr together with supraceliac intraaortic balloon tamponade during the first 30 min, while group B (controls) received crystalloids only. The central circulation was rapidly restored in group A, as indicated by increased MAP and increased systemic vascular resistance (SVR). After deflation of the balloon MAP dropped to the same value as in the control group, while cardiac index increased gradually with volume replacement and was significantly higher at the end of the resuscitation period (60 min) than in the control group (P less than 0.05). Despite a more rapid restoration of central hemodynamics in group A, lactic acidosis was more severe, acute renal failure and neurological complications more frequent, and mortality higher than in the control group. It was concluded that continuous supraceliac aortic occlusion for 30 min had deleterious effects on organs dependent on aortic blood flow distal to the aortic tamponade and may contribute to the development of multiple organ failure after resuscitation from hemorrhagic shock. Further studies are needed to evaluate the effects of intermittent intraaortic balloon tamponade in hemorrhagic shock.

Animals↗
PubMed1986

Intra-arterial mitomycin C and intravenous bleomycin as induction chemotherapy in advanced head and neck cancer--a phase II study.

Fifty-six patients with previously untreated, unresectable squamous cell carcinomas of the head and neck region were treated with repeated intra-arterial chemotherapy with mitomycin C using a selective or super-selective angiographic technique, and bleomycin given i.v., followed by radical radiotherapy. In addition, restricted tumour-reductive surgery was done in 18 of these patients. The response rate (CR + PR) after completion of the integrated treatment was 89%, with 63% of the patients showing CR. The toxicity of this regimen was, however, far from negligible. The median survival for this series of patients with advanced head and neck cancers is 19 months, and 17 are still alive after 16 + -66 + months.

Aged↗
PubMed1985

Scintigraphy and chest radiography in the screening of pulmonary embolism after total hip replacement.

210 patients were screened for pulmonary embolism after total hip replacement with chest radiography and perfusion-ventilation scintigraphy using a new, dry 99mTc-microaerosol and a detailed system for coding scintigraphic abnormalities. Chest radiography did not contribute significantly to the diagnosis of pulmonary embolism. In spite of careful evaluation, false-negative and false-positive scintigraphic diagnoses of PE are still possible.

Evaluation Studies as Topic↗
PubMed1984

Percutaneous transluminal angioplasty of arteriosclerotic lesions in the pelvis and lower extremities.

The experience of percutaneous transluminal angioplasty (PTA) in 66 patients (71 stenoses) with arteriosclerotic lesions in the pelvic and lower extremity arteries is reported. The PTA was technically successful in 70 stenoses. Complications were seen in eleven patients. The follow-up time was 19 months (2-44). The frequency of recurrencies was clearly related to the location of stenosis, the more distal the lesion the higher the recurrency rate. The immediate roentgenologic result had no prognostic value to protect recurrencies. To conclude PTA is an alternative to surgery in patients with short stenoses in the iliac arteries, but very strict indications should be used when lesions are localized below the inguinal ligament.

Adult↗
PubMed1983

Pre- and postoperative lung function in sitting and supine position related to postoperative chest X-ray abnormalities and arterial hypoxaemia.

Spirometry in both sitting and supine position was performed before and 3-5 days after elective upper abdominal surgery in 53 men, aged 41-72 years. The results were related to postoperative respiratory complications as defined by chest radiography and to measurements of the arterial oxygen tension. Preoperative total lung capacity (TLC), functional residual capacity (FRC) and wash-out volume (WOV) were lower in both positions among patients who were to develop major chest X-ray abnormalities than among patients with normal chest radiographs postoperatively. All patients who developed major chest X-ray abnormalities had a negative value for FRC - closing capacity (CC) in the supine position preoperatively, indicating 'airway closure' during tidal breathing. Preoperative WOV and lung clearance index (LCI) were higher in both sitting and supine positions in patients who developed postoperative hypoxaemia than in patients who did not. The postoperative decrease in TLC, FRC and WOV in the sitting position was greater among patients with major X-ray abnormalities and/or arterial hypoxemia postoperatively than among patients without these complications. According to our results, conventional spirometry in the supine position is not superior to conventional spirometry in the sitting position as part of pre- or post-operative assessment of patients. On the other hand, both preoperative 'airway closure' and arterial oxygen tension, measured in the supine position, showed a correlation with postoperative chest X-ray abnormalities.

Adult↗
PubMed1982

Vincristine, Adriamycin, cyclophosphamide, and etoposide (VP16-213) in small-cell anaplastic carcinoma of the lung.

Twelve patients with small-cell anaplastic carcinoma of the lung were treated with vincristine 1 mg/m2 i.v. day 1, adriamycin 50 mg/M2 i.v. day 1, cyclophosphamide 1,000 mg/m2 i.v. day 1, and etoposide 80 mg/m2 i.v. day 2, 4, 6 given on an outpatient basis and repeated at 3-week intervals. As consolidation therapy seven patients received two courses of BCNU median 29 mg/m2 (range 24-73 mg/m2) short term intraarterial infusion in the bronchial artery with 2 to 3-weeks intervals. One patient with limited disease had no evidence of disease for 13+ months and one patient complete remission for 3+ months. Four of ten patients with extensive disease had complete remission for median 5 months (range 2+ to 5+ months) and four patients had partial remission for median 5 months (range 4 to 5+ months). Despite side effects the chemotherapy was well tolerated by the patients. The results correspond to those obtained with other effective regimens in small-cell anaplastic carcinoma of the lung.

Adult↗
PubMed1982

Remission by chemotherapy of the Eaton-Lambert myasthenic syndrome in a patient with small cell bronchogenic carcinoma.

A 70-year-old man developed symptoms compatible with the Eaton-Lambert syndrome, and a small cell bronchogenic carcinoma was diagnosed. During treatment with cytostatics his muscular strength was restored and the lung tumour as well as the electrophysiologic findings characteristic of the Eaton-Lambert syndrome disappeared. To our knowledge, it has not been reported before that chemotherapy alone of a small cell bronchogenic carcinoma has resulted in clinical, roentgenologic, and electrophysiologic remission of the Eaton-Lambert syndrome.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1982

Intravenous arteriography in the preoperative evaluation of advanced atherosclerosis.

Intravenous arteriography may be used as an alternative to translumbar or transaxillary angiography in cases with occlusion or severe stenosis of the aorta or iliac arteries, to determine the extension of the disease. During a 10-year period the method was used in 117 patients. For the examination, 80 to 100 ml of contrast medium was injected into the right atrium and after a delay of 10 to 20 seconds the lumbar aorta, iliac and femoral arteries were demonstrated. The quality of the examination was excellent or good in 92 per cent. No complications occurred. In 19 patients a continuous pressure recording was made in the main pulmonary artery. The pulmonary artery pressure increased to a significantly higher degree after contrast medium injection than after injection of the same amount of isotone saline. In all patients the pressure returned to normal within 4 minutes.

Adult↗
PubMed1982

The clinical significance of postoperative chest X-ray abnormalities, arterial hypoxemia and clinically recorded respiratory complications.

The clinical consequences of postoperative complications as defined by signs and symptoms, chest radiography and measurements of the arterial oxygen tension were studied in 53 men, aged 40-75, who were electively operated for peptic ulcer or gallbladder disease. Clinical signs of a respiratory complication were detected in 4 patients. Of the 28 patients with chest X-ray abnormalities and 23 with arterial hypoxemia only 2 had clinical signs of a disordered pulmonary function. None of the remaining patients with arterial hypoxemia and/or chest X-ray abnormalities required any specific treatment. Hospital stay was not prolonged in patients with respiratory complications. Arterial hypoxemia and chest X-ray abnormalities in patients without clinical signs of a disordered pulmonary function had no influence on postoperative course or rehabilitation and were in all cases reversible without treatment.

Adult↗
PubMed1981

Double blood supply of bronchogenic carcinoma from multiple arteries.

Angiography was performed in connection with intra-arterial chemotherapy in 110 patients with bronchogenic carcinoma. All tumors were supplied from at least one ipsilateral bronchial artery. A double systemic arterial supply was found in 12 patients, the additional blood supply coming from a second ipsilateral bronchial artery in 3 patients, from the ipsilateral internal mammary artery in 4, from intercostal arteries in 4 and from the subclavian artery in one patient. All patients with tumor supply from a non-bronchial artery had direct tumor spread to the chest wall or to the mediastinum. A complete angiographic examination may therefore be of prognostic significance and necessary before intra-arterial chemotherapy, which mainly has a local effect.

Adult↗