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Biomedical subjects

G Herrmann

Publications and source records attributed to G Herrmann.

At least 163 records · Page 9Linked to original sources
PubMed1988

[Combined heart and kidney transplantation in terminal myocardial and renal insufficiency].

In a 38-year-old man combined heart and kidney transplantation was performed successfully in one operation. Both organs have functioned well postoperatively: the patient was discharged from hospital on the 19th postoperative day and has remained in functional class I (New York Heart Association) eight months later. Only two episodes of cardiac rejection have been observed during this period, responding to treatment, and there was no evidence of rejection of the kidney. Such combined heart-kidney transplantation from one donor seems to be a promising form of treatment for patients in end-stage myocardial and renal failure. The frequency of cardiac rejections my be lower after combined heart-kidney transplantation than after cardiac transplantation alone.

Adult↗
PubMed1988

Evaluation of (E)-5-(2-bromovinyl)- and 5-vinyl-1-beta-D-arabinofuranosyluracil (BrVaraU, VaraU) in the treatment of experimental herpes simplex virus type 1 keratitis in rabbits: comparison with (E)-5-(2-bromovinyl)-2'-deoxyuridine (BrVUdR).

The 5-substituted 1-beta-D-arabinofuranosyl (araU) analogues, (E)-5-(2-bromovinyl)-araU (BrVaraU) and 5-vinyl-araU (VaraU), which can be considered as structural analogues of (E)-5-(2-bromovinyl)-2'-deoxyuridine (BrVUdR), are potent and selective inhibitors of herpes simplex virus type 1 (HSV-1) replication in vitro. BrVaraU and VaraU have been compared with BrVUdR for their therapeutic effect on acute HSV-1 keratitis in rabbits. Both araU derivatives applied as 0.1% eyedrops suppressed the development of keratitis as monitored by the reduced number of herpes efflorescences. The healing effect of BrVaraU and VaraU was less pronounced than that of 0.1% BrVUdR eyedrops, the difference between BrVUdR and VaraU being statistically significant at the 10th day of treatment. As a further indication of the healing effect the number of cornea with opacities seen after cessation of drug treatment were 3.3, 7.4, 27.6 and 46.9% for the BrVUdR-BrVaraU-, VaraU- and placebo-treated eyes, respectively.

Animals↗
PubMed1988

Reduced diastolic left ventricular posterior wall motion in patients with constrictive pericarditis--incidence, hemodynamic and clinical correlations.

In 24 patients with constrictive pericarditis proven by cardiac catheterization, the amplitude of diastolic left ventricular posterior wall motion was evaluated by M-mode echocardiography and compared to the results of 24 healthy volunteers. The amplitude was significantly less in constrictive pericarditis patients than in normal controls (0.3 +/- 0.2 mm versus 3.9 +/- 0.4 mm) (P less than 0.001). No constrictive pericarditis patient demonstrated a higher value than 2 mm whereas none of the healthy volunteers had an amplitude less than 3 mm. In 11 of 13 constrictive pericarditis patients who underwent pericardiectomy, an increase in amplitude was observed. In 6 patients the amplitude returned to normal limits after surgery. No significant correlation between the degree of heart failure or the level of left ventricular end-diastolic pressure and the reduction of the amplitude was found. In addition, the amplitude of left ventricular diastolic posterior wall motion did not allow a clear separation between patients who could be treated medically and those requiring pericardiectomy.

Adult↗
PubMed1988

Effects of intracoronary nitroglycerin on coronary vascular volume in man, assessed by a double-indicator dilution technique.

The effects of 0.2 mg nitroglycerin administered directly into the left coronary artery were studied in 7 patients with coronary artery disease. A multipurpose catheter designed for simultaneous measurement of coronary sinus flow and great cardiac vein flow by thermodilution and for addition recording of dye dilution curves by a fiberoptic method was introduced from a right antecubital vein into the coronary sinus and advanced with its tip to the great cardiac vein/anterior cardiac vein juncture. Coronary sinus flow and great cardiac vein flow were measured using the constant infusion technique. Selective bolus injections of indocyanine green dye were measured using the constant infusion technique. Selective bolus injections of indocyanine green dye were performed into the left coronary system via a 8 French Judkins catheter and dye dilution curves were recorded in the upper great cardiac vein. From these curves, coronary transit time was assessed and coronary vascular volume was calculated as great cardiac vein flow times coronary transit time. Intracoronary nitroglycerin led to a transient drop in regional coronary resistance that was associated with an almost parallel increase in intravascular volume. Since this increase in coronary vascular volume exceeded the well-known dilatory effect on the epicardial arteries, and lasted slightly longer than the drop in regional resistance, these data imply that the vasodilatory action of nitroglycerin is different in magnitude as well as in time course in different parts of the coronary circulation.

Blood Volume↗
PubMed1988

[Fibrosing alveolitis after combined radio- and chemotherapy. A case report].

A nineteen year old female patient with Hodgkin's disease of the mixed type was treated with sequential radio- and chemotherapy according to the ABVD-regimen. Following this treatment, symptoms of fibrosing alveolitis developed which were resistant to treatment and led to death. The analysis of clinical and pathological findings revealed a causal relation between the combination of polychemotherapy and irradiation of the thorax. This underscores the necessity of strong selection and supervision of patients in the case of combined radiotherapy of the thorax and chemotherapy, especially with adriamycin and bleomycin.

Adult↗
PubMed1988

[Therapeutic occlusion of an erroneously implanted aortocoronary venous bypass using transluminal balloon embolization].

Today, therapeutic occlusion of blood vessels can be performed not only by surgical ligation, but also by various transluminal embolization techniques. The use of hardly steerable emboli (e.g. metal coils or gel foam) is, however, associated with the risk of embolic displacement into the circulation. The present case describes the embolization of an ACVB-graft erroneously implanted to a cardiac vein, by means of a catheter system with a detachable silicone-rubber balloon (Bard-Parker mini-balloon system).

Angina Pectoris↗
PubMed1987

[Management of rejection following heart transplantation using oral steroid medication].

After 47 orthotopic heart transplantations with long-term immunosuppression (cyclosporin A, 3-10 mg/kg; azathioprine, 1-2 mg/kg; prednisolone 0.1 mg/kg) there were 306 episodes of acute rejection. In 44 of these (14.8%) the oral prednisolone dosage was increased, from a mean of 10.8 +/- 2.95 mg/d to 36.6 +/- 7.2 mg/d, followed by stepwise reduction to the original maintenance dose. Compared with the customary intravenous bolus administration (1.0 g/d for three days: success rate 89%), the oral schedule was successful in 33 of the 44 episodes of rejection (75%). It is concluded that in selected patients acute rejection episodes after heart transplantation can be successful treated by an increase in the oral dose of steroids without changing the dosage of the other two immunosuppressive drugs.

Adolescent↗
PubMed1987

Therapeutic effect of (E)-5-(2-bromovinyl)-2'-deoxyuridine, caffeic acid oxidation product, and trisodiumphosphonoformate on cutaneous herpes simplex virus type 1 infection in guinea pigs.

The influence of (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU), caffeic acid oxidation product (KOP), and trisodiumphosphonoformate (TPF) on the course of the primary cutaneous herpes simplex virus infection was investigated by means of a guinea pig test model. The antiviral substances were applied in an ointment with 10% urea as a penetration mediator. When the treatment was initiated 15 minutes after virus inoculation, 3% BVDU effectively inhibited the development of herpetic vesicles and 0.1% BVDU prevented the appearance of herpetic satellites. Under the same conditions 1% and 3% KOP ointments inhibited the appearance of satellites; and 0.5% TPF ointment completely inhibited the development of cutaneous herpes lesions. Prophylactic drug administration given 24, 20, and 4 hours before virus inoculation was without any protective effect.

Animals↗
PubMed1987

Results of orthotopic heart transplantation for ischaemic cardiomyopathy.

From July 1983 to May 1987, 172 orthotopic heart transplantations were performed in 165 patients. Of these, 46 recipients (39 male, 7 female), aged between 26 and 56 years (mean age 47), suffered from ischaemic cardiomyopathy. Postoperative immunosuppression consisted of a triple drug regimen of cyclosporine A, azathioprine and, in the last 31 patients, low-dose steroids. The actuarial survival in this group of patients at 1 year and at 2 years was 71.9%. There were five early deaths: three due to acute rejection and two from multiple-organ failure and sepsis. Of the eight late deaths, two could be attributed to acute cardiac rejection and four to bacterial infections. In two patients, sudden death occurred in the presence of accelerated graft atherosclerosis. Mild-to-moderate coronary artery lesions were seen in five other patients undergoing angiography one year after transplantation. Apart from the well-known postoperative risk factors in cardiac transplant recipients, accelerated graft atherosclerosis appears to be an additional hazard in the subgroup surgically treated for ischaemic cardiomyopathy.

Adult↗
PubMed1987

Late increase in luminal diameter of aortocoronary venous bypass grafts associated with an increase in the vascular region under supply.

In a previous study, a significant inverse relation was found between the luminal size of aortocoronary venous bypass grafts and the vascular resistance of the coronary region that was perfused by the bypass graft in late stages after bypass surgery. This observation suggested that changes in the graft-dependent vascular area could influence the luminal size of the vein graft, even when they occurred several years after operation. Whereas it is well established today that aortocoronary vein grafts often decrease in luminal diameter after implantation, an increase in the bypass lumen has so far not been reported. Therefore, changes in luminal diameter of 27 vein grafts in 21 patients who underwent at least two postoperative angiographic studies (first study 8 +/- 5 months after surgery, second study 58 +/- 32 months after surgery) were compared with the size of the vascular region supplied by the bypass. The graft diameter was found to be unchanged between the two studies (3.3 +/- 0.6 versus 3.4 +/- 0.7 mm, p = NS) when the dependent vascular area was unchanged. A significant increase in graft diameter from 2.8 +/- 0.8 to 3.9 +/- 0.9 mm (p less than 0.001) was observed in nine patients in whom the area of perfusion had increased between the two studies because of the development of occlusion or obstruction of major coronary branches that were now perfused from the grafted vessel by way of collateral vessels. These data support the contention that the luminal size of aortocoronary vein grafts can adapt to the needs of the dependent myocardial vascular region even late after operation rather than being the result of a nonreversible degenerative process as commonly assumed.

Adult↗
PubMed1987

Pneumocystis carinii pneumonia following heart transplantation.

Pneumocystis carinii pneumonia represents a rare complication that is associated with a high mortality following heart transplantation. The cases of two heart transplant recipients who developed Pneumocystis pneumonia within the first 3 postoperative months are reported. Both patients had severe clinical symptoms of the disease; the diagnosis was confirmed by bronchoalveolar lavage, and the patients were treated with a combination of trimethoprim and sulfamethoxazole. Both patients recovered and are well at the time of this report.

Adult↗
PubMed1987

Efficacy of 5-vinyl-1-beta-D-arabinofuranosyluracil (VaraU) against herpes simplex virus type 2 strains in cell cultures and against experimental herpes encephalitis in mice: comparison with acyclovir and foscarnet.

The sensitivity of different herpes simplex virus type 2 (HSV-2) strains to inhibition by 5-vinyl-1-beta-D-arabinofuranosyluracil (VaraU) was evaluated in comparison to 9-(2-hydroxyethoxymethyl)guanine (ACV; acyclovir) and trisodiumphosphonoformate (Na3PFA; foscarnet), using a plaque inhibition assay in primary rabbit testes (PRT) cells as well as in human embryonic lung fibroblast (HELF) cell cultures. The order of decreasing activity found was ACV much greater than VaraU greater than Na3PFA in PRT cells and ACV greater than VaraU much greater than Na3PFA in HELF cells, with 50% inhibition doses (ID50) of 1.8, 8.8, and greater than 110 microM for the three drugs in HELF cells, respectively. After 72hr of drug treatment, inhibition of HELF cell proliferation by VaraU (ID50, greater than 1000 microM) was less than that by ACV and Na3PFA, resulting in high selectivity indexes of greater than 100 against HSV-2 for VaraU and ACV. Their in vivo efficacy was assessed in a mouse encephalitis model. Using a treatment schedule of three daily intraperitoneal (ip) doses over a period of 5 days, only the survival times of mice were considerably prolonged by VaraU (150 or 300 mg/kg per day; P less than 0.05 or P less than 0.001, respectively). In contrast, ACV treatment (150 mg/kg per day) led to a nearly complete prevention of encephalitis and death (P less than 0.001). Similar therapy results with VaraU application through the drinking water were obtained using only one-sixth of the high ip dose (approximately 50 mg/kg per day) but over a prolonged period of treatment. Under similar conditions no therapeutic effect of oral Na3PFA was observed.

Acyclovir↗