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Biomedical subjects

F Wolff

Publications and source records attributed to F Wolff.

At least 19 recordsLinked to original sources
PubMed1994

[Comparative thrombotic risk of two contrast agents in coronary angiography].

The thrombogenic risk of contrast agents in coronary angiography is still a topical issue, particularly in comparisons between ionic and nonionic contrast agents. As a complement to a preliminary study, the repercussions on sensitive markers of haemostasis were investigated in vivo in 38 patients undergoing a standard cardiac catheterisation. After randomization, an ionic low osmolality contrast agent (Ioxaglate 320) was used in 19 patients and a nonionic low osmolality contrast agent (Iopromide 370) was used in another 19 patients, according to an identical protocol. The following parameters were assayed in arterial blood samples obtained before and after the examination in each patient: platelet markers: beta-thromboglobulin (beta TG) and platelet factor IV (PF4); prethrombotic markers: thrombin-antithrombin 3 complex (TAT) and prothrombin fragments 1 and 2 (F1 + 2) as well as partial exploration of fibrinolysis: tissue plasminogen activator inhibitors (PAI). Comparison of the results demonstrated platelet activation and the presence of prethrombotic markers in both groups. No significant difference was detected between the two groups of patients. Consequently, there does not appear to be any difference in activation of coagulation between modern, low osmolality, ionic or nonionic contrast agents. This may suggest an equivalent thrombogenic risk.

Blood Coagulation Tests↗
PubMed1994

[Triple aneurysm of the Valsalva sinus complicated by right coronary occlusion: apropos of a case and review of the literature].

We report a case of aneurysm of all three aortic sinuses. The patient suffered from both cardiac failure and angina pectoris. The diagnosis, suggested by echocardiography, was confirmed by magnetic resonance imaging (MRI) which showed marqued dilatation of all three aortic sinuses. At operation, we observed dilatation of all three aortic sinuses, measuring 2 to 6 cm and partially thrombosed. We performed a Bentall operation with reimplantation of the left coronary artery ostium. The right coronary ostium was thrombosed and was revascularized by a saphenous vein bypass. Despite prolonged circulatory assistance and an intra-aortic balloon counterpulsation, cardiopulmonary bypass could not be stopped and the patient died. This is a new case of multiple aneurysms of the aortic sinuses and also a case of aortic sinus aneurysm (ASA) complicated by coronary insufficiency. This last complication has a poor prognosis, as demonstrated by a review of the 28 cases described in the literature. MRI was found to be important for the diagnosis of the ASA, in combination with echocardiography and angiography which can underestimate the aneurysm because of the frequently associated mural thrombus.

Aortic Aneurysm↗
PubMed1992

[A rare clinical manifestation of a combination tumor of cystosarcoma phylloides malignum and an intraductal cancer].

A combination of cystosarcoma phylloides and ductal carcinoma in the breast of a 47-year old woman is reported. Only few cases of this simultaneous tumour formation is described in the literature. Therapy, prognosis and follow-up are discussed. Current standard therapy is ablatio mammae, modified according to Patey, with axillary lymphnode dissection. Decision in respect of chemotherapy depends on the results of staging. Follow-up control of the patients for early detection and therapy of metastasis is recommended. The reported case underlines, that histological examination of every breast node is indicated, even if there is no sign of malignancy.

Breast↗
PubMed1991

[Contribution of imaging to the study of aortic aneurysms].

All aortic aneurysms require a positive diagnosis, a differential diagnosis and an assessment of extension. Several exploratory methods can be contemplated. In patients with warning symptoms, conventional radiology may point to the diagnosis. The reference method remains retrograde aortography which may be either conventional and seriographic or, better, radiocinematic with orthogonal projections and, if possible, digital. The site and morphology of the aneurysm, and in particular its inner channel are thus demonstrated. Computerized tomography is less invasive and usually of great value, notably for the horizontal, thoracic and abdominal aorta, not only to confirm the diagnosis but also to determine the size of the inner channel, parietal thrombi and aortic walls, as well as relations with nearby structures. Other, totally non-invasive methods are widely utilized to explore aortic aneurysms. These are ultrasonography and its variants (notably Doppler-echocardiography and the transoesophageal route), and magnetic resonance imaging which provides three-dimensional and anatomical views of the vessel. These last two examinations alone usually confirm and outline the aortic aneurysms. They must therefore be utilized as first-line examination, arteriography it is various forms being reserved for emergencies or special cases.

Aorta, Abdominal↗
PubMed1991

[Opiate analgesia in labor--use of nalbuphine in comparison with administration of the combination Dolantin/Atosil/Haldol].

Since July 1, 1990, Nalbuphine has been used as an obstetric analgesia at the Municipal Women's Hospital in Cologne-Holweide. The following differences were found between 2 groups of 122 patients each, one of which received Nalbuphine and the other a socalled cocktail, a combination of dolantin, haldol, and atosil. The number of spontaneous births in the Nalbuphine group was higher and the number of Caesarean sections and vagino-operative births were lower in comparison to the cocktail group. The pH-level of the arterial umbilical cord was higher in the Nalbuphine group, which can be explained by less stress on the child during birth. Overall, the post partum irregularities were less in the Nalbuphine group, whereas 6 children in the cocktail group had respiratory adaptation disturbances.

Analgesia, Obstetrical↗
PubMed1990

[Ambroxol versus betamethasone for the promotion of antepartum lung maturity in pathological pregnancies].

Although glucocorticoids have been universally implemented to stimulate fetal lung maturity, their effectiveness and side effects are still widely contested. In search of alternative drugs a double-blind study was conducted between June 1981 and June 1984 comparing betamethasone, a conventional corticoid, and ambroxol, a bromhexine metabolite for efficacy and tolerance in prenatal prevention of the respiratory distress syndrome (RDS) in premature infants and full-term neonates. The therapeutic efficacies of betamethasone and ambroxol for this indication proved to be comparable. Since the possible risks of corticoid therapy in abnormal pregnancies are repeatedly discussed in the literature and in daily clinical practice. 137 patients with EPH gestosis, placental insufficiency, diabetes mellitus, and premature rupture of the membranes were selected from the original group of 308 patients. Only minor side effects (e.g. nausea) were present in a few of the 137 cases undergoing treatment with the 2 test substances. No side effects were observed in the neonates. The incidence of fetal RDS was comparable in both groups (2.9% with ambroxol, 2.2% with betamethasone). Transient and mild RDS cases were slightly more frequent in the ambroxol group than in the betamethasone group. To date, contraindications to ambroxol treatment in abnormal pregnancies are unknown and since generally the rate of potential side effects is considered to be lower in comparison with corticoid treatment, the use of ambroxol especially in abnormal pregnancies corresponding indication can be recommended.

Ambroxol↗
PubMed1990

[The status of prenatal lung ripening].

Morbidity and mortality of low-weight infants depend mainly on the respiratory-distress syndrome (RDS) and its complications, such as neonatal asphyxia and intraventricular haemorrhage. This underlines the importance of prenatal prevention of RDS. The results of the present multicentre studies demonstrate successful acceleration of fetal lung maturation by glucocorticoids and ambroxol. Both agents lower the RDS-rate two to threefold. The effectiveness in accelerating fetal lung maturation is comparable. In contrast to glucocorticoids, ambroxol seems to have no severe potential maternal or fetal side effects. We believe that prenatal prevention of RDS remains the treatment of choice even if neonatal surfactant therapy is expected to open up new aspects for the future.

Animals↗
PubMed1990

[Pregnancy outcome with intensified insulin therapy in manifest diabetes].

In 1981, the intensified insulin therapy for achievement of euglycaemia in pregnant diabetics was introduced at the University Department of Obstetrics and Gynaecology in Cologne. This study compares the results of 112 pregnancies in women with overt diabetes monitored before (1971-1980) or after (1981-1988) changing the therapeutic regimen. In the period from 1981 to 1988, the proportion of euglycaemic patients (preconceptionally 19%, before delivery 79%) was clearly higher than from 1971 to 1980 (n = 42; 7% and 9%, respectively). The tight blood glucose control resulted in a doubling of hypoglycaemic episodes during pregnancy. The proportion of preterm deliveries was reduced from 47% to 24%. The rate of caesarean sections was nearly constant (1971-1980: 38%, 1981-1988: 34%). The marked success of therapy was the decrease of perinatal mortality from 20.9% to 2.9%. The perinatal morbidity also diminished, as shown by the decreasing rates (30-90%) of foetopathy, macrosomy, respiratory distress syndrome, birth trauma, hypoglycaemia, hypocalcaemia and polycythaemia. The malformation rate, however, remained high (1971-1980 = 7%, 1981-1988 = 11%). The results demonstrate the necessity of a strict blood glucose control during pregnancy, beginning before the time of conception.

Adult↗
PubMed1990

[Pregnancy-induced hypotonia. A prospective study of fetal development, labor and morbidity of newborn infants].

Maternal and foetal risk of hypotension in pregnancy were examined in a prospective study, comprising a total of 770 pregnant women i.e. 700 normotensives and 70 hypotensives. We conducted a minimum of 5 pressure controls beginning after the 20th week of gestation. All pressure controls were conducted by the same person and in each control 4 pressure values were taken (left and right arm, lying, standing). No difference was discovered in the statistical analysis of our data of pregnancy, delivery and foetal outcome. Our special interest was in the frequency of preterm delivery and foetal growth retardation. The rate was similar in the hypotensive group (6.7/3.1%) compared to the normotensive group (6.8/2.8%). From our results we conclude, that maternal hypotension is not a risk factor in pregnancy, and that no therapy is needed.

Acidosis↗
PubMed1989

[Electronic data processing of the patient record for computer-assisted evaluation of pregnancy and labor].

This article describes an EDP-adequate data collection system which can also be used in the conventional way. The relational data base system used is PROFESSIONAL ORACLE, Revision 5.1.; the requisite hardware consists of 3 IBM-AT-compatible personal computers with a main storage comprising 4 MB, system MS/PC-DOS, and a hard disk of at least 20 MB. The standardized case history compiles the user to collect the data carefully and completely. Besides formulating research problems the system automatically prepares the discharge report. By means of statistical analysis a continuous internal quality assessment was realized.

Electronic Data Processing↗
PubMed1987

[Induction of fetal lung maturation using ambroxol and betamethasone. Results of an open multicenter study].

In a randomized open multicenter study the results of antenatal prophylaxis against neonatal RDS by administration of betamethasone were compared with those obtained with the bromhexine VIII metabolite Ambroxol. Ambroxol was administered for a maximum of 5 days - 1000 mg in an infusion solution; betamethasone was injected intramuscularly in 2 daily doses of 8 mg. One of these two substances was given to 123 pregnant women for pulmonary maturation in the fetus, in accordance with a randomization plan. The patients were either being treated for premature labor or pregnancy was terminated on the basis of indication between the 28th and 36th week. Therapy had to be discontinued in 4 cases in each group, because of continued labor and birth, and in one case because of an amniotic infection syndrome. A full analysis of the treatment records of 57 pregnancies in the Ambroxol group was carried out; the corresponding figure for the betamethasone group was 58. In 39 patients the duration of pregnancy was 37 weeks or more, so that no assessment on the basis of neonatal pulmonary maturity was possible. In the remaining pregnancies, RDS morbidity was estimated on the basis of clinical and radiological findings and blood gas analysis. Related to a maximum duration of pregnancy of 34 weeks, RDS morbidity after Ambroxol therapy was 18.2% (2 out of 11), as opposed to 35.7% (5 out of 14) after betamethasone treatment. The results confirm that antenatal administration of Ambroxol can bring about a reduction in neonatal RDS corresponding to that achieved with betamethasone therapy. However, with Ambroxol the occurrence of side-effects is potentially lower; it therefore has advantages over betamethasone while being equally efficacious.

Ambroxol↗
PubMed1987

Capgras delusion and seizures in association with therapeutic dosages of disulfiram.

We have described a patient in whom EEG abnormalities, a seizure disorder, and Capgras syndrome developed two weeks after she started taking disulfiram. That disulfiram has been shown to inhibit dopamine beta-hydroxylase in vitro suggests an etiologic role for dopaminergic pathways in at least some cases of Capgras syndrome. Our experience with this patient suggests that convulsions and psychosis may occur as a side effect of standard dosages of disulfiram in patients with no previous history of psychosis or brain disease. Furthermore, the symptoms may resolve spontaneously without the long-term use of antipsychotic or anticonvulsant medication.

Adult↗
PubMed1987

[Coronarography-scintigraphy comparison of the effects of trinitrin-spray in 15 patients with coronary disease].

15 patients with coronary disease underwent a dual investigation, angiographic and scintigraphic, first without treatment and after administration of 0.8 mg of sub-lingual trinitrin-spray. The radiocinema angiography enables to explore variations of the coronary and stenosic diameter, the duration of the opacification (inverse of circulatory velocity) and the tonality of the network. Plane scintigraphy with T1201 enables to quantify the regional fixation in 9 myocardiac territories, as well as the global fixation with the myocardium/background noise ratio and the index of mean perfusion deficit. The diameter of healthy arteries and the pre- and post-stenotic segments of the diseased arteries are uniformly dilated after trinitrin (11.5-12.5%) while the stenoses are on an average unchanged (+ 1.2% NS). 4 cases of stenotic dilatations were observed, but without any decrease of the degree of stenosis (the pre-stenotic diameter increasing in the same proportions), nor any scintigraphic improvement. On scintigraphy, no difference of the myocardium/background noise ratio nor the mean deficit index was observed after trinitrin, which demonstrates the non-variation of the total coronary output. On the contrary, a redistribution of the regional activity (and therefore of the regional coronary flow) is observed in 10 patients. In comparing the stenotic areas which improve on scintigraphy (group I) and those which do not improve or deteriorate (group II) with the modifications of the arterial diameters under trinitrin, a correlation does not appear to be present. Also, the tonality is uniformly increased in both groups. The circulatory velocity is, however, significantly decreased in group II.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗
PubMed1987

[Diastolic coronary prolapse in partial left pericardial agenesis].

A few rare cases of coronary artery stenosis and occlusion have been reported in partial left pericardial agenesis. The authors report a privileged observation of partial left pericardial agenesis associated with an atrial septal defect in which diastolic collapse of the left marginal artery was demonstrated; this chronology was confirmed by synchronous analysis. The peroperative findings may explain the pathogenesis of the coronary disease encountered in this type of malformation, providing a new diagnostic sign of partial left pericardial agenesis.

Adult↗