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Biomedical subjects

G von Schulthess

Publications and source records attributed to G von Schulthess.

At least 19 recordsLinked to original sources
PubMed1992

Improvement of severely reduced left ventricular function after surgical revascularization in patients with preoperative myocardial infarction.

In recent years, two pathophysiological conditions--stunned and hibernating myocardium--have been described showing how function may be depressed in myocardium that remains viable. The aims of the present study were postoperative assessment of LV function at rest and during exercise after CABG in patients with established previous myocardial infarction and impaired preoperative LV function and evaluation of preliminary experience with positron emission tomography (PET) in the preoperative identification of reversible ischaemic myocardium and its predictivity in postoperative functional improvement. We studied 23 patients with preoperative LV function under 45%. Echocardiography and complete heart catheter were performed pre- and postoperatively. PET was performed in all patients preoperatively. In 21 patients with patent grafts, CABG significantly improved systolic and diastolic function during exercise and at rest. EF improved from 34% +/- 14% to 52% +/- 11% at rest and from 31% +/- 14% to 58% +/- 13% during exercise (P less than 0.01). Time constant of diastolic relaxation was significantly reduced after revascularization. In 2 patients with pathological findings on postoperative coronarangiography, EF remained unchanged. Both global and regional contractility improved following surgery. Regional analysis indicated that improved EF at rest occurred in regions developing ischaemia during exercise before CABG and in regions showing typical mismatch in 82Rubidium-2-fluoro-2-desoxyglucose suggesting the presence of hibernating myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Artery Bypass↗
PubMed1991

Accuracy of magnetic resonance imaging compared to computerized tomography and renal selective angiography in preoperatively staging renal cell carcinoma.

During 1986 and 1987, 47 patients with renal cell carcinoma were evaluated preoperatively with CT, angiography and MRI. The preoperative tumor stage (T), lymph node metastases and venous involvement determined with the three methods were compared to the operative and histopathological findings. For T stage, angiography proved less accurate (54%) than CT (64%) or MRI (63%). MRI was found to be superior to CT in assessing lymph nodes, with an overall accuracy of 89% and sensitivity of 100% compared to 77 and 60%, respectively, of CT. For venous involvement CT was overall more accurate (74%) than angiography (65%) or MRI (63%). All three methods expressed a low sensitivity (between 31 and 41%) and a high specificity (between 95 and 100%) for detecting venous involvement. The minimal advantages of MRI compared to its high cost do not justify its routine use. CT remains the method of choice in staging preoperatively renal cell carcinoma.

Angiography↗
PubMed1990

Magnetic resonance imaging in malignant bone tumours.

Complete removal of the tumour without leaving microscopic disease is vital in the management of bone sarcomas. Magnetic resonance imaging now seems to be the best method of depicting the changes produced by the tumour within the bone and surrounding soft tissues. In order to define its reliability, five cases of primary bone sarcomas (Ewing's sarcoma, osteosarcoma, chondrosarcoma) are described where radiographs, bone scans and magnetic resonance images are directly compared to the pathological findings after resection. We conclude that surgical margins should be redefined with respect to the extent and borders of the tumour as depicted by magnetic resonance imaging. This will allow improvement in salvage procedures, but further experience is needed so as not to jeopardize the prognosis by incomplete removal of the tumour.

Adolescent↗
PubMed1988

[1.5 T MRI, arthrography and arthroscopy in the evaluation of knee lesions].

It has been previously demonstrated that MRI can show the knee joint non-invasively and without radiation. Forty-two patients with lesions of the knee were examined using 1.5 Tesla and flexible surface coils. The findings were compared with those of arthroscopy, arthrography and, where possible, with those at surgery. For the evaluation of cruciate ligament injuries, MRI proved to have a sensitivity of 100% and a specificity of 82% with an overall accuracy of 92%. Thirty-nine cruciate ligaments were correctly evaluated. Three times a false positive diagnosis was made. Examination of the menisci was less reliable. Sensitivity was 88% and specificity was 83% with an overall accuracy of 94%. Fifteen meniscus lesions were correctly diagnosed. Three times a false positive and twice a false negative diagnosis was made. Four of the five incorrect diagnoses concerned the posterior horn of the meniscus and three were situated laterally.

Adolescent↗
PubMed1983

Turnover of autologous alpha 1-antitrypsin in a patient with congenital analbuminemia.

Despite very low amounts of albumin (1.7 mg/100 ml) the total plasma protein concentration of a patient with congenital analbuminemia was only slightly reduced to 6.3 g/100 ml. The lack of albumin is compensated by high concentrations of many other plasma proteins. Among the plasma proteins measured, alpha 1-antitrypsin showed a particularly high level. To investigate the underlying mechanism of this increase we purified plasma alpha 1-antitrypsin from the patient, labelled it with 125I, and studied its turnover in the analbuminemic patient and two normal volunteers. A half-life of 15 days in the patient compared with 7.5 and 8 days in the normal volunteers was found. The calculated synthesis rate of alpha 1-antitrypsin was about twice as high in the patient as in the controls. Therefore, both a longer half-life and an increased synthesis rate contribute to the high level of alpha 1-antitrypsin in the plasma of the analbuminemic patient.

Blood Protein Disorders↗
PubMed1978

[A clinical report of luetic hearing loss (author's transl)].

Three patients with syphilitic hearing losses are reported. In these patients, the impairment of cochleovestibular function progressed rapidly and quite often with fluctuations. The prognosis of inner ear damage is generally poor. However, in one 24-year old patient, treatment with penicillin and cortisone was successful in arresting hearing loss. This loss began early in the second stage of the disease so that its luetic origin could be recognized at the onset of the otological symptoms.

Adult↗