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Biomedical subjects

H Beran

Publications and source records attributed to H Beran.

11 recordsLinked to original sources
PubMed1999

Aortic valve replacement: is the stentless xenograft an alternative to the homograft? Midterm results.

BACKGROUND: This study was performed to assess the midterm clinical results after aortic valve replacement (AVR) with stentless xenograft (SX) compared with cryopreserved aortic or pulmonary homografts (HX). METHODS: In 139 patients (<60 years) undergoing elective AVR, 59 HX and 80 SX were inserted. All patients were followed clinically and by color flow Doppler echocardiography for 45+/-12 months (range 31-58 months). RESULTS: There were 5 in-hospital deaths (3.5%): 4 HX and 1 SX (p = NS). The mean gradient was 6+/-2 mm Hg in HX versus 13+/-6 mm Hg in SX (p<0.001) and remained unchanged during follow-up. Actuarial survival (HX 77%, SX 80%), freedom from endocarditis (HX 91%, SX 99%), freedom from thromboembolic events (HX 98%, SX 90%), and freedom from reoperation (HX 98%, SX 100%) were comparable between groups after 58 months. CONCLUSIONS: Despite slightly higher transvalvular gradients, the stentless aortic valve achieved excellent midterm results, when compared with homografts.

Actuarial Analysis↗
PubMed1995

Aortic valve replacement: is the stentless xenograft an alternative to the homograft? Early results of a randomized study.

From November 1992 to October 1993 we randomized 101 patients over 60 years of age undergoing elective aortic valve replacement, with or without concomitant coronary artery bypass grafting, to receive either a cryopreserved aortic or pulmonary homograft (n = 38) or a stentless porcine aortic valve xenograft (Edwards Prima 2500) (n = 63). The majority of all valves (92%) were inserted freehand in the subcoronary position. Six homografts (16%) were implanted as a free-root replacement and two xenografts (3%) were used as a mini root. There were four in-hospital deaths (4%), three in the homograft group and one in the xenograft group (homograft, 7.9% versus xenograft, 1.6%; p = not significant). Forty-one patients were followed at 3- to 6-month intervals for 9 +/- 2 months (3 to 14 months) and valve pathology was assessed routinely by means of color flow Doppler echocardiography. Two patients in the homograft group developed new aortic insufficiency grade II; all others remained with trivial or no valve incompetence. The mean gradient remained unchanged to immediate postoperative measurements (homograft, 5 +/- 1 mm Hg versus xenograft, 11 +/- 4 mm Hg; p < 0.001). Despite a slightly higher transvalvular gradient, xenografts achieved excellent initial results when compared to homografts. Ease of implantation and freedom from thromboembolism indicate that xenografts can be an acceptable alternative to homografts, particularly in older patients with small aortic annuli. Long-term studies assessing the durability of the xenograft are necessary for final evaluation.

Aged↗
PubMed1994

Non-concordance by gender for schizophrenia and related disorders in sibships.

We analysed gender-concordance rates among 29 prospectively sampled schizophrenic probands and their 39 affected and 71 unaffected siblings. We did not find any unusual concordance rates. We found no same-gender concordance particularly in siblings affected by schizophrenia and related disorders. We considered unaffected siblings in an additional attempt to make valid and unbiased comparisons between genders, but this reduced the number of informative sibships to 20. We stratified the siblings of probands by sibship and by the proband's gender in order to check gender distribution within families. The data do not support hypotheses that schizophrenia is pseudo-autosomal or male-female chromosomally transmitted.

Adult↗
PubMed1994

The season of birth of schizophrenics and schizoaffectives.

We examined the birth distribution of 2,450 schizophrenic and 682 schizoaffective patients first admitted between 1971 and 1992 to the University Hospital for Psychiatry in Vienna. Our data showed an excess of schizophrenic births in the first quarter of the year and a deficit in the third quarter compared with expectation from census data. The quarterly distribution of schizophrenic births seemed to be different from the one of of schizoaffective patients. In schizoaffectives an excess of births in the first quarter of the year was present, but no other deviation from expectation.

Adult↗
PubMed1993

Peri-operative elastase-alpha-1 proteinase inhibitor in patients with postoperative intervertebral discitis.

In a prospective study of 251 patients operated upon for lumbar disc herniation it has been investigated whether the preoperative and early postoperative values of Elastase-alpha-1 Proteinase Inhibitor (EPI)-an indicator of inflammatory processes-and C-reactive Protein (CRP)-a well known predictor of some postoperative complications-were correlated to the later development of discitis. Postoperatively discitis developed in 14 patients. A randomly chosen group of 15 complication-free patients out of the total of 251 cases was used as control group. Elevated EPI plasma values, especially in the pre-operative and first postoperative days, turned out to be significantly related to the likelihood of later discitis development, but no such relation for the CRP plasma values could be established. Thus and early prediction of patients at risk for this complication seems to be possible by pre- and postoperative measurement of EPI. It could be justified-but its usefulness has yet to be proven-to give antibiotics prophylactically and other anti-inflammatory medication in patients with elevated pre- and postoperative EPI values.

Acute-Phase Reaction↗
PubMed1993

No proof of linkage between schizophrenia-related disorders including schizophrenia and chromosome 2q21 region.

We examined linkage between schizophrenia and schizophrenia-related disorders and five genetic markers on chromosome 2 in fourteen families ascertained through affected probands in St. Louis and Vienna. The chromosomal region 2q21 was considered a candidate locus for schizophrenia because of a report of a balanced translocation 2;18 (q21;q23) in a schizophrenia family. Linkage analyses were conducted for three disease models: a narrow model including schizophrenia only; an intermediate model including a spectrum of schizophrenia-related disorders; and a broad model including major affective disorders. Multipoint linkage analyses excluded linkage across the region (about 50 cM) for the intermediate disease model. The same was generally true for the broad affection status model. None of the two-point and multipoint analyses showed definite linkage of schizophrenia to any marker. The most prominent positive association was between D2S44 and a broad affection status model, giving a two-point lod score of 1.71 at 0.20 recombination fraction.

Adult↗
PubMed1993

[Whiplash trauma of the cervical spine from the neurosurgical, traumatologic and psychologic viewpoint].

Since the early 50's, whiplash injury has been a subject of intensive study in order to find out the genesis of this disease. Unfortunately, most of the studies were planned retrospectively and were based on inhomogeneous groups of patients. In our prospective study, we tried to keep the patient group homogeneous. 62 patients were examined neurologically and radiologically immediately after the accident. Furthermore, they underwent a psychological test, the so-called Freiburg personality profile. 6 months later the patients were checked again. On the basis on our findings, the suspected psychological influence has to be confirmed. Preexisting degenerative lesions of the cervical spine, also, are undoubtedly prognostic for longer-lasting symptoms.

Adult↗
PubMed1993

[Supratentorial glioma: analysis of clinical and temporal parameters in 163 cases].

163 cases of supratentorial astrocytomas and glioblastomas were evaluated retrospectively after close-meshed observation and treatment. We attached the greatest importance to the reevaluation of already known prognostic parameters and to the temporal analysis of the course of gliomas. We could confirm the influence of the histologic grade on the survival time. Histologic grading by means of immunohistochemistry proved to be more precise than grading only by means of HE staining. Furthermore, the patient's age was one of the most important prognostic variables for survival time after operation. Other factors were the first preoperative Karnofsky rating, the preoperative diameter of the tumour, the duration of preoperative symptoms and the interval between operation and diagnosis of tumour recurrence as well as between tumour recurrence and reoperation. Epileptic seizures as preoperative symptoms were found to be far less prognostic for survival time. Localisation of the tumour, other preoperative symptoms, Karnofsky rating before reoperation and the extent of tumour resection proved to be of no importance for survival time.

Adolescent↗
PubMed1990

The prognostic value of somatosensory evoked potential monitoring and tumor data in supratentorial tumor removal.

The aim of this study was to find appropriate somatosensory evoked potential (SSEP) and tumor data that would predict immediate postoperative outcome. Seventeen patients were evaluated, all with supratentorial mass lesions. Intraoperative SSEP monitoring was carried out, and central conduction time, N20 amplitude, and N20 to N13 amplitude ratio were recorded throughout the operation. The differences between the end and the start of the procedure and between the end of the operation and the most substantial changes during tumor removal were calculated for statistical evaluation. Tumor location and extent were carefully determined and calculated by computed tomographic reconstructions in the axial and sagittal planes. Several tumor parameters were measured: the distances from the midpoint of the tumor to the central sulcus, midline, and base of the skull and the longitudinal and cross-sectional diameters. The electrophysiologic and tumor data sets were correlated with the immediate postoperative neurologic deterioration. For this purpose, patients were divided into two groups: group 1 = no neurologic deterioration after operation (13 patients); group 2 = neurologic deterioration after operation (4 patients). The difference in central conduction times between the end and the start of the procedure was the only variable that exhibited a significant influence on the immediate postoperative condition (P = 0.007), as determined by analysis of variance. The other electrophysiologic data as well as the tumor data failed the significance threshold of P = 0.05. Discriminant analysis was applied to test the classification capacity of the measured variables. Involving all measured variables (electrophysiologic and tumor data), discriminant analysis allowed a correct classification of all 17 patients to their proper neurologic deterioration group. Discriminant analysis for SSEP data alone led to 15 correct classifications. Tumor data, used alone for discriminating procedures, revealed 14 correct classifications. When each variable was analyzed separately, only the difference in central conduction times between the end and the start of the procedure gave significant predictions, namely, 15 correct classifications. This was the same number as achieved by all electrophysiologic variables together. No other variable could on its own yield any valid prognosis for assessment of immediate postoperative neurologic deterioration. The data confirm the importance of central conduction time recovery before the end of the operation on the patient's immediate postoperative neurologic condition.

Adult↗
PubMed1989

[Brain abscess. Prognostic factors].

Thirty-eight cases of cerebral abscess were analysed retrospectively for any factors that might influence outcome. Using the "Glasgow outcome score", age, history, level of consciousness, as well as various computed tomography findings (cisternal swelling, compression of the ventricular system, degree of oedema and size of abscess) were considered for their prognostic value. It was found that age over 40 years and clouded consciousness exerted a statistically significant unfavourable effect (P less than 0.05). Outcome was also unfavourable in half the patients with multiple abscesses, but the number of cases (six) was too small to be statistically significant. All other variables had no statistically significant influence on prognosis.

Adolescent↗