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Biomedical subjects

D Jost

Publications and source records attributed to D Jost.

17 recordsLinked to original sources
PubMed2006

Incidental diagnosis of a left ventricular thrombus through novel magnetic resonance imaging technique in a patient undergoing coronary artery bypass grafting.

Stroke after cardiac surgery is a devastating complication. We report a case of incidental diagnosis of a left ventricular thrombus in a patient scheduled to undergo coronary artery bypass grafting. The preoperative diagnosis of an apical left ventricular thrombus was assessed by a novel, whole body MRI-angiography technique (TIMRA), which led to alteration of the operative approach as an additional thrombectomy was performed through an apical left ventriculotomy.

Coronary Artery Bypass↗
PubMed2006

[Cardiovascular whole-body MR imaging in patients with symptomatic peripheral arterial occlusive disease].

PURPOSE: To examine patients with peripheral-arterial-occlusive-disease (PAOD) for systemic effects associated with atherosclerosis using a comprehensive state-of-the-art whole-body MR examination protocol. The protocol comprises the assessment of the complete arterial vasculature (except coronary arteries), the brain, and the heart. MATERIALS AND METHODS: Multi-station whole-body 3D MR angiography was performed in sixty consecutive patients with clinical suspicion for PAOD at 1.5 T (Magnetom Avanto, Siemens, Erlangen, Germany). Functional and delayed enhancement cardiac images were acquired, as well as FLAIR images of the brain and TOF angiography of intracranial vessels. MR and DSA images were assessed by independent observers for atherosclerotic manifestations and other pathology. Sensitivity and specificity for the detection of vascular pathology was calculated for MR data using conventional DSA of the symptomatic region as standard-of-reference. RESULTS: Sensitivity and specificity for the detection of significant vascular stenosis (> 70 % luminal narrowing) was 94 % and 96 % (PPV 87 %, NPV 98 %). Significant microangiopathic tissue alterations (n = 7) and/or cerebral infarction (n = 18) were diagnosed in 23/60 patients. Thirty-eight of 60 patients presented with systolic left ventricular wall motion abnormalities. In 24 patients subendocardial or transmural delayed enhancement was detected in corresponding regions, indicating prior myocardial infarction. CONCLUSION: For patients with PAOD and suspected systemic atherosclerotic disease a comprehensive diagnosis of accompanying cardiovascular pathology and therefore staging of systemic atherosclerotic disease is feasible within one MR examination.

Aged↗
PubMed2004

[Is the preoperative removal of dentures reasonable in every case?].

Traditionally, dentures are removed prior to anaesthesia. Modern techniques in dentistry and the widespread use of regional anaesthesia should lead to a more individual approach to this problem. From a legal standpoint, the information about advantages and disadvantages concerning the removal of dentures can be explained without problems to the patient without medical background.

Anesthesia↗
PubMed2003

[Morphology of gastrointestinal stromal tumors in advanced stages of the disease: baseline findings before chemotherapy with imatinib].

PURPOSE: Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal tract with an increasing detection rate due to improved differentiating methods in current diagnostic pathology. This study evaluates the radiologic characteristics of these neoplasms to discover specific signs leading to an earlier diagnosis. MATERIALS AND METHODS: As part of a randomized phase III clinical trial of the European Organization for Research and Treatment of Cancer (EORTC), 72 patients with advanced stage GIST were treated with the selective tyrosine-kinase-inhibitor imatinib (Glivec, Novartis, Switzerland). For initial staging, 60 patients underwent MRI and 12 patients underwent CT. RESULTS: GISTs are mesenchymal tumors that grow submucosally and exophytically and become multiple, nodular or ovoid in the advanced stage. The predominant findings are peripheral solid structures with strong contrast enhancement and a central necrosis. Metastases are primarily located in the liver, where they appear as oval or round, sharply delineated solitary lesions with central necrosis. CT demonstrates the primary tumors and local recurrences as nearly isodense with the liver. On MRI, the lesions are hypointense on T 1 -weighted sequences and hyperintense on T 2 -weighted sequences, compared to the liver. CONCLUSION: Immunopathology now enables the exact histologic separation of GISTs from other mesenchymal tumors. The radiological morphology is not sufficiently specific to differentiate GISTs from other mesenchymal tumors. In view of new therapeutic options, cognizance of their typical manifestations is of increasing importance for radiologists.

Adult↗
PubMed2003

[Use of SPIO-enhanced T1- and T2-weighted images for the differentiation of liver lesions: an ROC analysis].

PURPOSE: The superparamagnetic iron oxide (SPIO) Resovist is a contrast media with shortening of both T(1) and T(2) relaxation time. This study evaluates the impact of SPIO-enhanced T(1)- and T(2)-weighted images for the differentiation of liver lesions. MATERIALS AND METHODS: SPIO-enhanced MRI examinations (1.5 T, Symphony Quantum) of 61 patients were analyzed. Thirty-seven patients had malignant liver lesions (metastases n = 32, HCC n = 5) proven by biopsy or laparotomy, 11 patients had benign liver lesions (FNH n = 2, hemangiomas n = 4, benign cysts n = 5, normal liver on laparoscopy n = 13). After unenhanced T(1)- and T (2)-weighted imaging, a bolus injection of 1.4 ml SPIO (Resovist) was given, followed by T(1)-weighted imaging at 20 s, 60 s, and 5 min and T(2)-weighted imaging at 10 min post injection. A score from 1 (benign) to 5 (malignant) was used by three blinded radiologist for the ROC analysis of the unenhanced T(1)-/T(2)-weighted images (set 1) and of the combinations of unenhanced T(1)/T(2)-weighted and SPIO T(1)-weighted images (set 2), unenhanced T(1)/T(2) and SPIO T(2)-w images (set 3) and all images (set 4). RESULTS: The accuracy of plain MRI (set 1: 56 %) was increased by SPIO-enhanced T(1)-weighted images (set 2: 81 %) and SPIO-enhanced T(2)-weighted images (set 3: 90 %). Best results were obtained using unenhanced T(1)-weighted, unenhanced T(2)-weighted and both SPIO T(1)-weighted and T(2)-weighted images (set 4: 93%). The accuracy of predicting histopathologic diagnosis was 91%. CONCLUSION: For the differentiation of liver lesions, SPIO-enhanced T(2)-weighted images had a greater impact on the accuracy of MRI than T (1)-weighted images, but SPIO-enhanced T(1)-weighted images provided additional information in some patients and should not be deleted.

Adult↗
PubMed2001

Preliminary results on the prediction of countershock success with fibrillation power.

In a study of artifact-free ventricular fibrillation episodes in 54 patients, 28 of whom experienced return of spontaneous circulation (ROSC), the power of different indicators to predict the ROSC was compared. Taking the average of sensitivity, specificity and positive and negative predictive value, the dominant frequency reaches 76%, the mean amplitude 72% and fibrillation power 71%. There is little correlation between the three indicators.

Electric Countershock↗
PubMed1996

Finger pad tophi in gout.

OBJECTIVE: To determine frequency and prevalence of finger pad tophaceous deposits in patients with chronic tophaceous gout. METHODS: We examined 36 consecutive patients with chronic tophaceous gout for intracutaneous tophaceous urate deposits in the fingers pads. Subjects were patients of outpatient clinics at 2 large university hospitals, Emory and the University of Pennsylvania Affiliated Hospital Systems. RESULTS: Finger pad tophaceous deposits were found in 30.5%, which was surprising, given how few cases are reported. CONCLUSION: Finger pad tophi may be more common than generally believed.

Adult↗
PubMed1992

New nuclide 263Ha.

Explore the source record for details and available documents.

Journal Article↗
PubMed1988

Differential effects of potassium channel blockers on neurohypophysial release of oxytocin and vasopressin. Evidence for frequency-dependent interaction with the endogenous opioid inhibition of oxytocin release.

Isolated rat neurohypophyses were fixed by their stalks to a platinum wire electrode and superfused with Krebs-HEPES solution. Vasopressin and oxytocin released into the medium were determined by specific radioimmunoassays. Hormone secretion was increased by electrical stimulation of the pituitary stalk at different frequencies. The effects of several potassium channel blockers, tetraethyl-ammonium (TEA) ions, 4-aminopyridine (4-AP) and 3,4-diaminopyridine (3,4-DAP) were tested. The release of vasopressin and oxytocin evoked by electrical stimulation with 900 pulses at 15 Hz (about 900 and 1,000 microU, respectively) was about 10 times higher than that evoked by 900 pulses at 3 Hz. Both 10 and 30 mmol/l TEA enhanced the release of vasopressin evoked by stimulation at 3 and 15 Hz, by 25- and 2-fold, respectively, to attain a maximum release of about 1,800 microU per stimulation. The stimulated release of oxytocin attained a maximum of about 9,000 microU at 15 Hz in the presence of 10 mmol/l TEA or at 3 Hz with 30 mmol/l TEA. Thus, in the presence of maximally effective concentrations of TEA both stimulation frequencies (3 and 15 Hz) were equieffective in evoking release of vasopressin and oxytocin. 4-AP or 3,4-DAP enhanced the release of vasopressin evoked by 15 Hz stimulation maximally to about 1,600 microU. In the presence of 4-AP or 3,4-DAP the release of oxytocin evoked by stimulation at 15 Hz increased maximally to about 8,000 microU and that evoked by stimulation at 3 Hz to about 1,500 microU.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Aminopyridine↗
PubMed1988

Effects of tetraethylammonium ions on frequency-dependent vasopressin release from the rat neurohypophysis.

1. Isolated rat neurohypophyses were fixed by their stalks to a platinum wire electrode and superfused with oxygenated Krebs-HEPES solution. Vasopressin release into the medium was determined by radioimmunoassay. Vasopressin secretion was increased by electrical stimulation at different frequencies (3-30 Hz) and different train lengths (75-900 pulses). The effects of tetraethylammonium (TEA) ions and of enhanced calcium were tested. 2. Electrical stimulation at 7.5 or 15 Hz evoked a markedly larger release of vasopressin than stimulation at 3 Hz. During continuous stimulation at 7.5 and 15 Hz the evoked vasopressin release per pulse declined rapidly, but with similar time constants for both frequencies indicating that the fatigue of the release process was strongly time dependent. The kinetic analysis showed also that the initial release per pulse was identical for 7.5 and 15 Hz stimulation. Nevertheless, with increasing duration, stimulation at 7.5 Hz became less efficient (in terms of release per total stimulus) than stimulation at 15 Hz and this was due to the time-dependent fatigue. 3. TEA (10 mM) increased the release of vasopressin evoked by 3 Hz stimulation much more than that evoked by 15 Hz stimulation resulting in an equieffective activation of release by both stimuli. On the other hand, elevation of the extracellular calcium from 1.2 to 3 mM did not alter the different efficiency of stimuli of 3 and 15 Hz. In the presence of TEA the time-dependent fatigue of the release during continuous stimulation was prevented, but an additional, slower component of the fatigue became apparent which was release or impulse dependent. 4. As prolongation of the action potential by TEA facilitates preferentially the hormone release evoked by low (ineffective) frequencies, it is suggested that a frequency-dependent broadening of action potentials which reportedly occurs on neurosecretory neurones may play an important role in the frequency-dependent facilitation of hormone release from the rat neurohypophysis.

Animals↗
PubMed1987

Tetraethylammonium ions and 4-aminopyridine prevent opioid inhibition of neurohypophysial oxytocin release.

Naloxone increased the electrically (15 Hz, 1 min) evoked release of oxytocin from isolated neural lobes of rats 3-4-fold. In the presence of 4-aminopyridine or tetraethylammonium ions the evoked release of oxytocin was increased 8-9-fold and remained unaffected by naloxone. Increasing the calcium concentration in the medium from 1.2 to 3 mM caused only a marginal increase of the evoked oxytocin release. In conclusion, blockade of potassium channels and/or the resulting prolongation of the action potential can surmount the opioid inhibition of oxytocin release.

4-Aminopyridine↗