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Biomedical subjects

E Köhler

Publications and source records attributed to E Köhler.

At least 91 records · Page 5Linked to original sources
PubMed1982

[Mitral valve prolapse and platelet activity in young patients with cerebral ischaemia (author's transl)].

In 47 patients under 45 years of age (average age 35.4 years) with more or less localised cerebral ischaemia without evidence of arteriosclerosis echocardiography showed mitral valve prolapse in 13 cases. This was slightly more frequent than in an age and sex-matched control group. The difference was not statistically significant. In three quarters of the patients (n = 35) a significantly raised beta-thromboglobulin level was found indicating increased platelet activity. No definite conclusions can be drawn as to the cause of cerebral ischaemia which is probably due to embolism. However, treatment with platelet aggregation inhibitors should be considered.

Adult↗
PubMed1982

[Exercise echocardiography in dilatative cardiomyopathy].

Using M-mode echocardiography under 2-D control at rest and during ergometer exercise (ex), we examined 15 patients (pat) with angiographically moderate diffuse left ventricular (LV) contraction impairment (mean enddiastolic volume index 115 ml/m2, mean ejection fraction 58%) (group DCM I). The aim of the study was to look for differences in LV behavior under exercise within this patient group, with a view to aiding diagnosis. These pat were compared to 10 normal subjects (N) and 10 pat with advanced dilatative (congestive) cardiomyopathy (enddiastolic volume index 135 ml/m2, ejection fraction 44%) (DCM II). Even at rest, the LV diameters and the fractional shortening (FS) in the group DCM I differed significantly from those in N, and in the case of the mean FS the difference increased on ex (rest p less than 0.05, exertion p less than 0.0005). In none of the three groups did the enddiastolic diameter undergo any significant change on ex. The endsystolic diameter decreased in N by an average of 5.2 mm (p less than 0.0005); at 2.8 mm (p less than 0.005), the decrease (DCM I vs N p less than 0.005) was distinctly slighter to be observed in DCM I; in DCM II it was no longer significant. Within the group DCM I, 4 pat showed a behavior on ex that was not what the values at rest would have suggested. 2 pat showed a physiological reaction on ex despite a restricted function at rest; however, in 2 patients with relatively good values at rest, the FS decreased on ex. According to these findings, a restriction of LV function is to be recognized echocardiographically more clearly on ex than at rest, especially in low-level dilatative cardiomyopathy (DCM). In individual cases, a varying increase in LV functional impairment is to be observed during ex, or even generalized physiological reaction, which would not be expected from the echocardiogram at rest. Thus the results of the examination present a differentiated basis for the observation of the course of the disease, especially in pat with a moderate DCM.

Adult↗
PubMed1982

[Abnormal findings of cardiac function in patients with systemic lupus erythematosus (author's transl)].

To find out the rate of cardiac involvement among patients with systemic lupus erythematosus (SLE), 34 patients with SLE were examined by ECG, x-ray of the chest, body plethysmography, one- and two-dimensional echocardiography In addition, in 23 patients with SLE a microcatheterization of the right heart side was undertaken with measuring of the mean pulmonary artery pressure and cardiac index during exercise. Echocardiography revealed moderate abnormal findings in 62% of the patients. In particular, there was a thickening of the interventricular septum (31%), an enlargement of the right ventricle (23%), a diminution of the left ventricular fractional shortening (16%), an augmentation of the left atrium (10%) and of the left ventricle (6%). A small pericardial effusion was observed in 6% and a thickening of the left ventricular posterior wall in 3%. At micro-catheterization in 19 out of 23 patients with SLE, there was an increase of the mean pulmonary artery pressure up to abnormal values. In 5 patients, mean pulmonary pressure rose over 40 mm Hg. Most of the patients also showed an increase of the arterial pressure up to pathological values. Furthermore, most of the patients finished exercise because of muscular insufficiency or dyspnoea. Only 4 of 23 patients with SLE reached 90% of the age-corresponding maximal heart rate. The results indicate that with about 80% of all patients with SLE the cardiac capacity is reduced. In about 20% of the patients with SLE, this diminution of cardiac capacity is severe, and the necessity of medical treatment has to be discussed.

Adolescent↗
PubMed1982

[The effect of disopyramide, mexiletine and propafenon after intravenous and oral administration on left ventricular function in the M-mode echocardiogram].

The effects of the antiarrhythmic drugs disopyramide (D), mexiletine (M), and propafenone (P) on left ventricular function after intravenous injection and after oral therapy of at least 48 hours, and of the combined oral application of D and M, were studied by M-mode echocardiography in patients with ventricular arrhythmias in whom antiarrhythmic therapy was indicated. The drugs were given in doses comparable in terms of clinical efficacy. The results showed that the three drugs had varying negative inotropic power. The intravenous injection resulted in a more pronounced cardiac depression than the oral therapy. The most significant decrease in left ventricular wall motion after intravenous and oral application was seen after D, the smallest negative inotropic effect after M. P caused a cardiac depression between these extremes. After the combined oral application of D and M the impairment of left ventricular function was more pronounced than after therapy with the single drugs.

Administration, Oral↗
PubMed1981

Impaired hormonal regulation of adenosine 3',5'-monophosphate release in adipose tissue from hyperglycemic sand rats in vitro.

Egyptian sand rats (Psammomys obesus) developed under laboratory holding conditions and in dependence of different food intake various states of hyperglycemia and hyperinsulinism. Associated with the development of this syndrome insulin resistance of muscle- and adipose tissue appears. The question arose as to whether hyperglycemia and hyperinsulinism generally leads to hormone resistance. Therefore, we selected sand rats with different degrees of hyperglycemia and various stages of hyperinsulinism. Two groups of sand rats were investigated: normoglycemic and hyperglycemic animals. In these sand rats the catecholamine action on cAMP production adipose tissue was studied in vitro. There was a significant reduction of hormone responsiveness in adipose tissue of the hyperglycemic group compared with the noradrenaline response of adipose tissue of the normoglycemic sand rats. In no case had insulin significantly inhibited the noradrenaline stimulated cAMP production. By means of adenosine deaminase studies the interference of the eventual release of adenosine with the hormone action on adipose tissue in vitro could be excluded. In the sand rats correlations between IRI levels in the decapitation blood and noradrenaline stimulated cAMP release associated with simultaneous occurrence of insulin- and catecholamine resistance in adipose tissue seem to indicate that hormone resistance could be a general phenomenon during the development of hyperinsulinism.

Adipose Tissue↗
PubMed1981

[The diagnostic value of M-mode-, two-dimensional echocardiography, and computed tomography in comparison to the results of cardiac catheterization in the diagnosis of tumors of the heart (author's transl)].

12 patients with cardiac tumors (7 myxomas of the left, 2 of the right atrium, 2 ventricular, 2 intramural tumors and 1 epicardial cyst) were examined by M-Mode-(ME) and two-dimensional (2DE) echocardiography, computertomography (CT) and heart catheterization (HK) with angiography (A). The results were compared with intraoperative findings. There were no false negative results with 2DE and CT, but in 1 case the size of an intramural tumor was underestimated by 2DE. With ME all atrial myxomas were diagnosed, but 2 ventricular and 2 intramural tumors as well as the epicardial cyst were overlooked. Also with HK and A, the 2 intramural tumors and the epicardial cyst were not recognized well. The results indicate that the diagnosis of cardiac tumors can be made with great accuracy by noninvasive methods. The sensitivity of the single methods depends on the location of the tumors.

Adolescent↗
PubMed1981

A specific method of high sensitivity for the determination of adenosine in the incubation medium of fat tissue.

A suitable method for the measurement of adenosine in the incubation medium of fat tissue (200-500 mg) has been developed. The method is based on the specificity of the adenosine deaminase reaction and on the high sensitivity of a fluorescent method for adenine derivatives. The decrease of fluorescence in a sample after treatment with this enzyme is used for measuring adenosine in the range of 50-500 pmoles/tube. This method is highly specific and is not affected by other adenine derivatives present in the sample. Instead of acetic acid, perchloric acid was used in the fluorescent reaction, thus increasing the amount of adenosine dependent fluorescence. With this modification of the original fluorescent method, perchloric acid extracts can be used without further processing after deproteinization of the samples. Using this method, we could measure the adenosine release of fat pads of Wistar rats incubated in Krebs-Ringer-albumin buffer without concentration or purification procedures.

Adenosine↗
PubMed1981

[Electron microscopical investigations on islets of Langerhans in sand rats (Psammomys obesus) before manifestation of diabetes mellitus (author's transl)].

Electron microscopical investigations of islets of Langerhans are carried out in "protodiabetic" sand rats. In the B-cells and beta-Granules (2 to 5) aggregated. Mitochondrias, Golgi apparatus and rough endoplasmic reticulum are increased. These B-cells are stimulated. The A-cells are degranulated, and lipofuscin-granules are in the cytoplasm present. These cells were stimulated too. The D-cells are not stimulated.

Animals↗
PubMed1981

Significance of adenosine for the hormone responsiveness of adenylate cyclase in adipose tissue of normoglycemic and hyperglycemic sand rats.

In young sand rats, bred in our colony, the metabolism was directed from the normoglycemic state by means of feeding conditions. The noradrenaline action on adenylate cyclase is impaired in hyperglycemic, hyperinsulinemic sand rats. Generally, addition of adenosine to the in vitro system eliminates the responsiveness of the adenylate cyclase to noradrenaline in adipose tissue. The presence of adenosine deaminase in the incubation medium abolished this inhibition effect of added adenosine. The interference of released adenosine with the hormone action in vitro was excluded by addition of adenosine deaminase to the incubation medium. In both groups of sand rats adenosine deaminase did not increase the noradrenaline effect on adenylate cyclase. Investigations were carried out as a part of the research project "Diabetes mellitus and diseases of fat metabolism". These results along with the others on the measured adenosine release exclude adenosine as a reason for the disturbed hormone action on adenylate cyclase in hyperglycemic, hyperinsulinemic sand rats.

Adenosine↗
PubMed1981

[Holosystolic mitral valve prolapse and "SAM" after surgical treatment of hypertrophic obstructive cardiomyopathy (author's transl)].

In a 49-year-old male patient surgical treatment of hypertrophic obstructive cardiomyopathy (HOCM, clinical grade III, NYHA) by means of transaortic myotomy and myectomy was performed in November 1979. 6 months later the M-mode-echocardiogram revealed a distinct systolic anterior motion of parts of the mitral valve apparatus (SAM) as well as a marked holosystolic mitral valve prolapse (MVP). The two-dimensional echocardiographic examination demonstrated that the "SAM"-phenomenon was caused solely by chordae tendineae of the anterior mitral leaflet, while the prolapse was due to the posterior mitral leaflet itself.

Cardiomyopathy, Hypertrophic↗