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Biomedical subjects

E Godehardt

Publications and source records attributed to E Godehardt.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Evaluating a new, fully automated blood separator with continuous blood flow].

The AS 104 separator provides for platelet yields in agreement with given standards. The number of undesired cells (leukocytes, erythrocytes) compares favorably with other technical separation systems. Concentrate volumes, total amount of ACD-A used, extracorporal blood volume and the reduction of donor blood cells are no challenge for the donor. The number of technical problems is not unusual for a new separation system entering into the first clinical evaluation. These data, as well as the deviation of yields, recommend further optimation. The technical optimation achieved so far and an expanded evaluation using statistical procedures permit an optimal, donor-independent (using variance analysis) or individual (using regression analysis) equilibration of the machine and permit the recognition of potential differences between different separators, centers or software versions, thus allowing the calculation of the number of runs needed to recognize differences from optimal standards.

Adult↗
PubMed1990

Results of surgical treatment for atherosclerotic renovascular occlusive disease.

In this study we retrospectively examined the results of surgery for atherosclerotic renal artery lesions and analysed the factors that may affect postoperative blood pressure response, changes in renal function and late mortality. A total of 326 patients were operated on over a 15 year period and were followed up for periods from 4 to 165 months (mean follow-up time: 37.2 months). An extra renal vascular area was also involved in 91.4% of cases and in 187 (57.3%) a significant involvement of both renal arteries was found and simultaneously treated. Combined revascularisation of other arteries was performed in 50.3% of patients. The indications for surgery were the treatment of extreme hypertension in 243 patients (74.5%), the improvement of renal function in 45 with renal insufficiency, and preservation of the kidney in 38 (11.7%). The preferred method of reconstruction was transaortic endarterectomy (236 cases, i.e. 72.4%) and postoperative angiography demonstrated a normal patent renal artery in 319 of 338 studied renal arteries (94.4%). There were no deaths in the early postoperative period after isolated renal artery reconstruction. Of the 164 patients with simultaneous renal and aortic reconstruction however 14 died during the early postoperative phase. The overall early mortality was thus 4.3% (14 out of 326 patients) and correlated significantly with the extent of the atherosclerotic disease, the age of the patients, the operative technique used and the different intra- and postoperative management during the two different periods of our experience (1974-1980 v. 1981-1989).(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗
PubMed1990

["Inflammatory aneurysm" of the aorta. Diagnosis, therapy, results].

From 1970 to 1987 among 964 patients with aortic aneurysms 52 (5.4%) underwent aortic graft replacement for inflammatory aortic aneurysm. 79.2% were symptomatic, 18.9% ruptured at the time of admission. CT-scan is of main diagnostic value. The perioperative mortality rate was 15.1%. At follow-up (28 months mean) 35 of 38 living patients (92.7%) were examined clinically, by sonography and in most cases by CT-scan. The late complication rate was 20% (n = 7, atrophic kidney 3, anastomotic aneurysms 4). In contrast to abdominal aortic aneurysms inflammatory aneurysms present an elevated morbidity and mortality rate which has to be reduced by exact preoperative diagnosis and modified surgical technique.

Aged↗
PubMed1989

Winner of the ESVS Prize 1988. Effects of prostaglandin E1 (PGE1) on experimental renal ischaemia.

A persisting incidence of acute renal failure has been observed after operative treatment of thoracoabdominal aortic aneurysm, ruptured abdominal aortic aneurysm and renal artery occlusive disease in patients with preoperative impairment of renal function. Because preservation of kidney function can play an important role in the outcome of these patients, the effects of prostaglandin E1 (PGE1) to prevent ischaemic renal failure were studied in an experimental model. Twenty dogs were exposed to 3 h warm ischaemia by clamping of the supra- and infrarenal aorta and both renal arteries. In 10 dogs PGE1 was given intravenously (100 ng/kg/min) for 15 min before clamping. Ten dogs treated with normal saline served as controls. Glomerular filtration rate, renal plasma flow, plasma creatinine, blood urea nitrogen, urine volume, free water clearance and renovascular resistance were calculated before and after renal ischaemia for both groups. The dogs were followed-up for 2 weeks and radionuclide studies with Tc-99m-MAG3, I-131-OIH and In-113m-DTPA were performed on the third postoperative day to calculate global and split renal clearance, tracer extraction fraction and mean transport time. After renal ischemia 9 dogs of the control group and 3 dogs of the PGE1-group developed acute renal failure (P less than 0.05 due to Fisher's exact text). PGE1 infusion significantly attenuated the postischaemic fall in glomerular filtration rate and renal concentrating ability as well as the postischaemic increase of plasma creatinine and blood urea nitrogen induced by 3 h warm renal ischaemia (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1989

Reliability of different temporary myocardial pacing leads.

Temporary myocardial pacing leads are routinely used for diagnosis and treatment of postoperative arrhythmias following open-heart surgery. The intention of this study is to compare five different electrodes for reliability during the postoperative period. A standardised technique of implantation was used to place 147 ventricular and 81 atrial wire electrodes in 149 patients. During operation and then daily over the next ten days, the stimulation threshold, P- and R-wave sensing, and impedance were measured with a pacing system analyser to evaluate the reliability of the pacing and sensing function. Five measurements were taken at each time; the mean values were statistically analysed. The number of failures in pacing and sensing and the course of the tested parameters during the postoperative period were compared. As a result, bipolar pacing leads (Osypka TME 64a/66a) proved to be more reliable than unipolar wires (Ethicon HD 12S, Osypka TME 60/60a), particularly in atrial sensing. Also the Medtronic 6400/6500 showed good reliability for the ventricle, so that they can be recommended for VVI-mode pacing. In conclusion, for reliable function during the postoperative course up to 10 days a specially developed bipolar temporary pacemaker electrode can be recommended for both atrial and ventricular or sequential pacing.

Differential Threshold↗
PubMed1987

[Complications of brachiocephalic catheter angiography using a non-ionic contrast medium].

In 713 patients 749 catheter-arteriographies of aortic-arch and cerebral vessels were performed using non-ionic contrast media. The patients were examined either with DSA or conventional film techniques. In 80 examinations of 76 patients complications or side-effects were noted, which resolved completely within one hour in 69 cases, showed a duration up to 7 days in 6 cases, and persisted longer than 7 days in 5 patients. Neurological complications were seen in 6.4% of the studies. There was no death. Patients, who received anti-hypertensive drugs before or during angiography and patients with a pathological angiogram had a significantly higher complication-rate. The rising number of patients with atherosclerotic cerebrovascular disease showed an unfavorable effect upon the overall complication-rate. The use of a non-ionic contrast medium did not drastically lower the rate of neurological complications.

Adult↗
PubMed1987

[Renal and adrenal function following acute administration of urapidil in hypertensive patients with normal and impaired renal function].

The effects of i.v. injection of urapidil (Ebrantil) (25 mg) on arterial blood pressure, renal function and renin-aldosterone system were studied in a group of patients with hypertension and normal renal function, in patients with hypertension and chronic renal failure and in normotensive controls. The pharmacokinetics of urapidil were evaluated simultaneously by measuring blood levels of the compound and its main metabolite. In the controls and in patients with hypertension, systolic and diastolic blood pressure were lowered few minutes after injection. Minimal blood pressure values were reached after 15-20 min. Hypotensive action was more pronounced in hypertensive patients as compared to controls. In contrast, increment in heart rate was greater in the controls. Despite the fall in blood pressure, renal plasma flow and glomerular filtration rate remained unchanged. Following the injection of urapidil, plasma renin activity increased with no change in plasma aldosterone levels. Plasma half-life of urapidil averaged 1.96 +/- 0.17 h in controls, 3.31 +/- 0.75 h in patients with hypertension and normal renal function and 2.52 +/- 0.46 h in patients with hypertension and chronic renal failure. Urapidil effectively lowers arterial blood pressure in patients with normal and impaired renal function with no deterioration in renal function.

Adrenal Glands↗
PubMed1987

Direct operations for the management of life-threatening ischemic ventricular tachycardia.

UNLABELLED: Between June 1978 and 1986, 93 consecutive patients underwent electrophysiologically guided operations for life-threatening recurrent sustained ventricular tachycardia mostly associated with other surgical procedures, such as left ventricular resection (aneurysmectomy) and coronary artery bypass grafting. DATA: Eighty-seven percent of the surviving patients were free of spontaneous ventricular tachycardia return or sudden death 1 year after the operation and 77% at 5 years. The instantaneous risk of ventricular tachycardia return was highest immediately after operation, declined rapidly, and by 2 weeks postoperatively had merged with the constant hazard phase, which persisted as long as the patients were observed. Endocardial resection, rather than encircling endocardial myotomy, increased the risk of spontaneous ventricular tachycardia return/sudden death. Survival rates, including hospital deaths, were 95% at 30 days, 89% at 1 year, and 70% at 5 years after operation. The most prevalent mode of death was heart failure. The absence of anterolateral left ventricular aneurysms and the use of more extended encircling incisional techniques for ventricular tachycardia ablation increased the risk of early and late death. Survival was particularly poor in that subset of patients in whom recurrent sustained ventricular tachycardia returned after operation; the most prevalent mode of death in this group was also progressive left ventricular failure. Inferences: (1) Complete and partial encircling endocardial myotomy incisions are the most effective surgical techniques for malignant ventricular tachycardia ablation. (2) Because of their adverse effects on left ventricular structure and function, the arrhythmogenic tissues have to be localized as precisely as possible, and the encompassing incisions should be kept as limited as possible. (3) The late return of ventricular tachycardia may be more related to a progressive ischemic left ventricular cardiomyopathy than to an inadequate operation.

Cardiac Pacing, Artificial↗
PubMed1985

[Animal experiment studies of suture material and suture technic of the stomach].

The aim of these examinations was a comparison of the tensile strength and the histology of single and two-layer sutured gastrotomies applied to rats. Independent of the applied suture material and suture technique all experiments resulted in the same tensile strength of the suture between the 5th and 7th postoperative day as in the control group. Differences of anastomotic dehiscence did not exist. The single-layer can be loaded as well as the two-layer suture. Any difference of the tensile strength of anastomosis depending on the suture material does not exist.

Animals↗
PubMed1984

Tryptophan-induced lowering of blood pressure and changes of serotonin uptake by platelets in patients with essential hypertension.

Oral tryptophan loading and serotonin (5-HT) uptake by platelets were investigated as an approach to the study of central serotonergic mechanisms in patients with essential hypertension. Single oral doses of L-tryptophan (50 mg/kg body weight) lowered blood pressure significantly 90-120 min after administration in 14 patients with essential hypertension, but not in normotensive controls. Baseline measurements (without tryptophan loading) of 5-HT uptake by platelets did not differ between hypertensive and normotensive persons. Whereas L-tryptophan changed the uptake kinetics and increased 5-HT uptake in normal controls, these effects were not observed--or occurred to a much lesser degree--in hypertensive patients. It is suggested that in human essential hypertension central serotonergic mechanisms are involved in pathogenetic mechanisms. The tryptophan-induced lowering of blood pressure could be attributable to the enhancement of central 5-HT synthesis.

Adult↗
PubMed1984

Effect of haemodynamic changes during rapid atrial pacing on determination of sinus node recovery time.

Arterial blood pressure was continuously monitored during rapid atrial pacing in 31 patients with different types of heart disease to determine sinus node recovery time and corrected sinus node recovery time. Pacing was initiated at 70 beats/min and increased stepwise to 160 beats/min. One to one atrioventricular conduction was maintained throughout the one minute stimulation period. Blood pressure fell initially during at least one stimulation period in 21 of our patients and at pacing rates up to 130 beats/min in 18. Once blood pressure had fallen during overdrive pacing maximal sinus node recovery time and maximal corrected sinus node recovery time could not be prolonged by increasing the pacing rate. Sinus node recovery time and corrected sinus node recovery time during the pacing induced fall in blood pressure was significantly shorter than those during stimulation runs with constant blood pressure. No pacing induced fall in blood pressure and no relation between changes in blood pressure and sinus node recovery time were evident in 10 of the 31 patients. Sinus node recovery time is therefore influenced by alterations in autonomic tone due to pacing induced haemodynamic changes.

Aged↗
PubMed1984

Surgical treatment of ventricular tachycardias. Complete versus partial encircling endocardial ventriculotomy.

Forty consecutive patients underwent electrophysiologically guided encircling endocardial ventriculotomy as treatment for recurrent sustained ventricular tachycardia resulting from coronary artery disease and previous myocardial infarction. Twelve patients (30%, Group I) had a complete encircling endocardial ventriculotomy and 28 (70%, Group II) had a partial encircling endocardial ventriculotomy (54.4% +/- 2.2% of the left ventricular endocardial circumference) at the earliest electrical activation during ventricular tachycardia. There were no significant differences between the two groups in age, sex ratio, New York Heart Association class, coronary disease, aneurysm location, concomitant bypass grafting, and left ventricular function. One patient of Group I and two patients of Group II did not survive the perioperative period (8% versus 7%, not significant). The survivors were restudied electrophysiologically about 3 weeks after the operation. Eight patients of Group I and 19 patients of Group II were free of ventricular tachycardia (no spontaneous or inducible ventricular tachycardia) without antiarrhythmic drugs (73% versus 73%, not significant). The mean follow-up period in Group I is 22.6 months and in Group II, 15.2 months. Five patients of Group I and of Group II developed severe left ventricular dysfunction (46% versus 8%; p = 0.025). Also, congestive heart failure was a significant cause of death in Group I patients (p = 0.036). In conclusion, electrophysiologically guided partial encircling endocardial ventriculotomy is highly efficient as a surgical treatment of recurrent sustained ventricular tachycardia. Complete encircling endocardial ventriculotomy offers no better ablation of arrhythmias and should be avoided because of its apparent hazards to left ventricular performance.

Coronary Disease↗
PubMed1982

[Postoperative radiotherapy of astrocytomas grade 3 and 4 with the radiosensitizer misonidazole. -End results of a multicentric controlled German study].

102 patients entered a multicentric randomized study from May 1978 till December 1980. After an operative removal of a supratentorial astrocytoma grade 3 or 4 all patients were treated by radiotherapy of the whole brain with 40 Gy, and after a rest of 1 to 2 weeks with a boost dose of 20 Gy to the tumor region. By randomization the patients got misonidazole (400 mg/m2) to each of the 30 fractions or a placebo. The overall tolerance was good. A mild transient peripheral neuropathy was seen only in 2 patients. The median of survival time was not significantly different for both groups with 16 months (grade 3) and 10 months (grade 4). Thus a radiosensitizing effect of misonidazole was not proven.

Adolescent↗
PubMedDate not supplied

Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study.

A large prospective long-term study with users of natural family planning (NFP) methods has been conducted to analyze the relation between unintended pregnancy rates and sexual behavior with special reference to barrier method use in the fertile phase. Seven hundred and fifty eight NFP beginners, 19-45 years of age, 14870 cycles, 28 unintended pregnancies were studied. Of the couples, 54.2% use NFP only or predominantly and 45.9% use mixed methods (additional barrier method use in the fertile phase in 55.7% of the cycles). The overall pregnancy rate after 12 cycles of exposure is 2.2% according to the actuarial method. There is no significant difference between NFP users and mixed methods users and also no significant effect of duration of use in the first 5 years of exposure. During "perfect use" the pregnancy rate at 12 months is 0.63%. When only protected intercourse takes place in the fertile phase the pregnancy rate is 0.45%. The symptothermal method of NFP is most unforgiving for imperfect use (unprotected intercourse in the fertile phase). However, it is extremely effective when either abstinence or protected intercourse is used in the fertile phase.

Adult↗
PubMedDate not supplied

[Dose-effect relation in therapy of cytostatic-induced leukopenia with lithium carbonate].

Lithium is used increasingly for attenuation of chemotherapy induced leukopenia in infants and adolescents. Thus, pharmacological data are needed. The purpose of this study was to give recommendations for oral dosage yielding efficient serum levels. Furthermore, two methods of serum level determination were compared. Flame emission photometry using microsamples gave results comparable to atomic absorption photometry. The correlation of oral dose and serum level was investigated in a phase I study. A wide range of serum levels related to an identical oral dose was found. Therefore, frequent serum level determinations are needed to realize efficacy and to avoid toxicity. The correlation between increasing serum levels and leucocyte count was investigated in the first part of a phase II study. No significance was found; i.e. a linear progressing dose-effect relation does not exist. The time course of leukocyte count was analysed for two different serum level groups in the second part of the phase II study. A significant correlation was found in the group with a serum level greater 0,7 mmol/l.

Adult↗