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Biomedical subjects

H D Bolte

Publications and source records attributed to H D Bolte.

At least 19 recordsLinked to original sources

[Thrombolysis therapy and coronary angiography in acute myocardial infarct in the Augsburg region: results of the Augsburger Heart infarct register 1985-1987].

In the years 1985-87, the Augsburg Coronary Event Register registered 1333 hospitalized patients who had survived an acute myocardial infarction (AMI) for at least 24 h. In 953 patients, data on time intervals in the prehospital phase were documented in addition to the medical records data in a standardized nurse interview. The time from onset of AMI until the patient called for medical attention constituted most of the prehospital time delay. Of the interviewed male and female patients, 67% were hospitalized within 6 h (= time limit). The differences, both in the number of thrombolyses and the number of coronary angiographies performed in men and in women are statistically significant. Thrombolysis was performed in 27% of the male and 12% of the female AMI patients who were admitted to hospital within the time limit. The rate of thrombolytic therapy decreased with increasing age and was less in patients with recurrent AMI (men: 20%, women: 0%) than in patients with first AMI (men: 29%, women: 15%). There was some time-of-day variation in the percentage of thrombolytic therapy which may be attributable to hospital organization. From 1985 to 1987, the coronary angiography rates performed in the medical center doubled, independent of the thrombolytic therapy rates. In this time, angiography rates in thrombolyzed patients increased from 49% to 75%, and from 14% to 31% in patients without thrombolysis. The 28-day case fatality was 4.8% in patients with thrombolysis and 13% in patients without thrombolytic therapy. Controlling for age, sex, and recurrent AMI, this difference is not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Increase of force of concentration under hypoxic conditions by glucose-insulin. Experiments in isolated papillary muscles of the guinea pig (author's transl)].

The minimally remaining force of contraction under the influence of hypoxia was measured in isolated right-ventricular papillary muscles of the guinea-pig, incubated in hypoxic (pO2 90 mm Hg) and oxygenated (pO2 630 mm Hg) buffer solution. With insulin (0.05 IE/ml) and elevated glucose (300 mg% compared to 100 mg%) the force of contraction fell to only 70 +/- 9% minimally instead of 38 +/- 11% (control, p less than 0,001). Elevated glucose or insulin alone had less pronounced effects which were not statistically significant for insulin. The results show an increase of tolerance against hypoxia of isolated papillary muscles under the influence of glucose and insulin.

Animals

[Sensitivity of the haemoccult test in colorectal tumours (author's transl)].

157 patients with histologically investigated colorectal tumours from 5 hospitals of the University of Munich were tested with the Haemoccult test. In 30 (35.7%) of 84 patients with malignancy of the colon and in 31 (58.5%) of 53 patients with adenomas or polyps the correctly performed test was negative. The test result showed no dependency on age or sex of the patient, nor on size, stage or localisation of the tumour. A problem-orientated history lowered the rate of false negative tests to 2.4%. The high rate of false negative results was not attributable to organisational or technical errors.

Adenoma

[Results of employing single crystal gammacamera and minicomputer in the first tracer passage to determine left-ventricular ejection fraction and wall motion (author's transl)].

Single crystal gammacamera and minicomputer were employed in 71 patients to determine left-ventricular ejection fraction (EF) (17 mCi 99mTc-HSA; 30 degrees RAO projection) by means of the first tracer passage. In 30 out of these patients, ventricular wall motion could be analyzed additionally because later on the gammacamera was equipped with a converging collimator. Comparison with cineventriculographically determined EF values revealed a good correlation (r = 0.91), not depending on left-ventricular wall motion pattern. Hereby, with first transit, high EFs were computed somewhat lower and low EFs were found somewhat higher. This non-limiting discrepancy is closely related to the influence of paracardiac "background"-radioactivity. Comparative analysis of segmental wall motion demonstrated agreement in 83% of the 90 segments examined. Therefore, it can be confirmed that performance of the first tracer passage for a evaluating segmental wall motion must not mandatorily be done with a multicrystal camera.

Adult

[Therapy with beta-blocking-agents (author's transl)].

Within the last 10 years the indications for a therapeutic regimen with beta-blocking-agents have been differentiated: coronary heart disease with angina pectoris (interval regimen), essential hypertension, especially in younger persons; hyperkinetic heart syndrome; thyreotoxikosis, symptomatic therapy; heart rhythm disorders, extrasystolic or tachysystolic; neurologic-psychiatric diseases. The development of the newer beta-blocking-agents has effected different kinetic data (f.i. long acting effects of Tenormin) and a increased cardioselectivity. The recommendations for the therapeutic regimen have to be outlined to the underlying diseases. The sensitivity against the drugs depends on remarkable individual differences, with the consequence of a careful and low dosage in the beginning in each case. The side-effects of beta-blocking-agents are presumably: bradycardia, bronchospasm, fatigue, adynamia, myocardial insufficiency, gastrointestinal symptoms, hypoglycemia, hypotension.

Adrenergic beta-Antagonists

Immunological results in myocardial diseases.

Immunological studies have shown new diagnostically important changes in alcoholic and viral myocarditis, as well as in congestive cardiomyopathy. Increased heart size correlated with the degree of congestive heart failure, as well as with negative immunofluorescence and an increased IgA concentration in the serum. These findings may serve as a diagnostic aid in patients with myocardial disease due to alcohol abuse. Viral heart disease is characterized by a variety of symptoms and nuclear antibodies (IgM) can be of help in the differential diagnosis. Heart muscle tissue of patients with congestive cardiomyopathy preferentially binds IgG and IgA. In addition to the other changes these findings are of diagnostic importance. It seems likely that results similar to those obtained for humoral antibodies in congestive cardiomyopathy will apply in the correlation of the haemodynamic status of the patients. The pathophysiological implication of these findings is not clear at present, but the evolution of congestive cardiomyopathy appears to be associated with binding of immunoglobulin to the myocardium, as well as with humoral antiheart antibodies.

Adult

[Cardiac effects of antikaliuretic diuretics-clinical and biochemical investigation (author's transl)].

Recently direct myocardial effects of antikaliuretic diuretics with respect to contractility parameters and prevention of digitalis-induced arrhythmias were published. In order to test the value of these reports we measured the effect of potassium-canrenoate and triamterene on cardiac output and on digitalis-induced arrhythmias in patients during diagnostic and the therapeutic flow directed right heart catheterization (Swan-Ganz) in our intensive care unit. In addition the influence of these drugs on (Na+ + K+)-ATPase and on (3H)g-strophanthin binding to human cardiac cell membranes was investigated to gain information on the mechanism of their action. Triamterene (100-200 mg p.o.) was without any effect on cardiac output, the same was found true for potassium-canrenoate given in a single dose (200-1000 mg intravenously). However, when applied in two doses (200 mg i.v. and 60 min later 400 mg i.v.), potassium-canrenoate increased cardiac output by 11 percent (p less than 0.05). Only in 2 out of 14 patients potassium-canrenoate (200-400 mg i.v.) suppressed digitalis-induced ventricular ectopic beats. Canrenone, the active metabolite of potassium-canrenoate displaces [(3H)]g-strophanthin from its binding sites in human cardiac cell membranes and inhibits (Na+ + K+)-ATPase activity. These in vitro effects were measured at the same concentrations as found in vivo after "therapeutical" doses. The effects of triamterene in this respect were found only in extremely high concentrations. Our results imply that canrenone has cardiac glycoside-like effects in human cardiac cell membranes.

Adenosine Triphosphatases