[Pulsed color laser: initial experiences with vascular recanalization in patients with peripheral arterial occlusive diseases and in patients with obstructions of the dialysis shunt].
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Biomedical subjects
Publications and source records attributed to H D Weiss.
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This study demonstrates that cultivation of vascular smooth muscle cells from human artery wall is possible under completely serum-free conditions. The effects of attachment factors on cell spreading and cell proliferation are described in detail as well as routine cultivation methods under serum-free conditions (clone cultures, cell migration, subcultivation by use of an exogenous trypsin inhibitor, cryopreservation and readaptation of cells). After a careful adaptation period, only two (BMS and Ultroser G) of the four commercially available serum-free media supplements tested were used successfully for a routine cultivation of the smooth muscle cells over several passages. With both supplements cell proliferation rates were comparable with those obtained in medium containing 10% fetal calf serum. The addition of platelet-derived growth factor or transferrin to serum-free cultures had no growth-stimulating effect. The addition of endothelial cell growth factor isolated from bovine brain caused a significant increase in proliferative activity of cells cultivated with BMS, but not with Ultroser G. Moreover, we report that under the serum-free culture conditions described here, the gamma-actin content of the cells is largely reduced (51% +/- 13% (means +/- SD) for cells cultivated in Ultroser G, and 12% +/- 4% (means +/- SD) for cells cultivated in BMS) when compared with cells cultivated under serum-containing conditions (gamma-actin content = 100%). The alpha-actin content was observed to be unaltered. Even after a careful readaptation of serum-free cultured cells to serum conditions, the gamma-actin content remained reduced.
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The normal anatomy of the elbow joint is described. Diverse pathologic joint alterations, e.g. fractures and dislocations, osteochondritis, inflammatory changes, and ulnar nerve lesion are demonstrated. Particular attention is paid to three-dimensional (3D-) reconstruction of demonstrable pathologic findings.
The Simpson atherectomy device used for the recanalization of severely stenosed peripheral arteries is able to collect plaque material which can be further characterized. This study reports histological, immunohistochemical and transmission electron microscopic findings on advanced human primary atherosclerotic plaques of peripheral arteries percutaneously removed by a Simpson atherectomy catheter. Material from stenosing plaques consisted of dense connective tissue with abundant amounts of concentrically arranged elastic fibers and lamellae. This meshwork contained numerous cells, often arranged in clusters and oriented with their longer axis parallel to the direction of blood flow. The vast majority of these cells could be easily identified as vimentin-positive and desmin-negative smooth muscle cells containing lipid deposits in the perinuclear region and numerous glycogen particles. Monocytes/macrophages were observed only very infrequently. Plaque tissue contained a range of smooth muscle cell phenotypes. Most of the cells were of an intermediate phenotype, i.e. sparsely filled with myofilament bundles at the cell periphery and a high amount of organelles such as mitochondria, rough endoplasmic reticulum and Golgi cisterns. An intact lining of pieces of intimal tissue with endothelial cells was not observed. Two-dimensional gel electrophoresis of plaque tissue showed the presence of alpha-, beta- and gamma-actin isoforms with a clear predominance of the beta-isoform.
Percutaneous transcatheter embolization (PTE) in patients with life threatening bleeding carcinomas of the uterine cervix using stainless steel coils, proves to be an effective treating method. There is a low incidence of complications concerning the local cutis, nerves or arteries. PTE does not allow a causal therapy of the malignant disease, but in half of our patients (n = 13) embolization was the precondition for initial or further adequate therapeutic management.
In 94 patients the levels of plasma histamine have been measured after application of three nonionic contrast media (iopromide, iopamidol, iohexol) and after application of blood-isotonic saline solution. A significant liberation of histamine could be observed after administration of contrast media and also after administration of saline solution. Neither between the three nonionic contrast media nor between the contrast media and the saline solution significant differences could be measured. Administering contrast media after subsequently saline solution the levels of histamine were lower than in case of pure contrast media application. Psychogenically induced histamine liberation is discussed.
Diagnosis of ligament ruptures via the possibilities of conventional radiology is often insufficient. To verify CT efficiency, postmortem specimens were scanned in axial, coronal and sagittal planes and compared with anatomical findings of sections in identical planes. After the preliminary examinations we conducted a study on 32 patients. The examinations of the anterior talofibular ligament showed a correlation between CT and operative findings in 30 of 32 cases.
The series consisted of 30 patients with pulmonary emboli diagnosed by DSA. In 18 patients repeat DSA was performed using the central catheter which had been employed for the lytic therapy immediately after the end of treatment. Therapy was carried out from two to 14 days. Bleeding was observed in four of the patients. The final DSA showed complete recanalisation in five patients, partial recanalisation in 11 patients and no angiographic improvement in two.
The early differential diagnosis between transplant rejection and cyclosporin intoxication is often difficult, although it is important for treatment. We carried out dynamic CT on 48 occasions in patients with normal function, with acute tubular necrosis, rejection and cyclosporin A intoxication. Analysis of the time-density curve of the cortex showed significantly slower enhancement with cyclosporin A intoxication than during rejection. The peak and the arterial curve were also delayed in cyclosporin A intoxication. This evidence of reduced cortical perfusion during cyclosporin A intoxication can be explained by the results of modern pathophysiological studies. In principle, it is possible to distinguish between cyclosporin A intoxication and rejection by means of dynamic CT, but for its routine use the nephrotoxicity of the contrast medium must be taken into account.
MR examinations of the elbow joint of three healthy subjects and a comparison with corresponding sections of anatomical preparations show that MR tomography enables not only an excellent differentiation of muscles, tendons and of the articular capsule, but will also visualise vessels and nerve tracts. MR tomography proved superior to the conventional methods in demonstration of separate fragments and inflammatory changes in the bone on examining 11 pathological elbow joints: congenital malformation, osteochondritis dissecans, ostitis, ulnar and radial nerve lesions, completely healed radius fracture and epicondylitis of the radial and ulnar humerus. Epicondylitis could not be demonstrated by MR. Magnetic resonance tomography seems to be the only method that enables direct visualisation of the nerve paths at the elbow joint.
A rare case of oesophageal intramural pseudodiverticulosis is described. The typical radiological appearance in the oesophagogram is demonstrated and correlated with the histopathology. Review of the literature leads to the hypothesis that oesophageal pseudodiverticulosis may be the identical result of different diseases.
We studied the effect of seizures and myoclonus following cardiopulmonary resuscitation (CPR) on the outcome of all comatose adult survivors of CPR over an 8-year period. Either seizures or myoclonus occurred in 50 of 114 patients (44%): seizures in 41 patients (36%) and myoclonus in 40 (35%). Status epilepticus or status myoclonus occurred in 36 patients (32%), and 19 (17%) had myoclonic status epilepticus (MSE). Seizures and myoclonus per se were not significantly related to outcome, but status epilepticus, status myoclonus, and, particularly, MSE were predictive of poor outcome as judged by survival and recovery of consciousness.
Fourteen examinations of the tear ducts and 21 sialograms were performed using digital subtraction and conventional techniques. In nine of the former and 15 of the latter, digital subtraction produced better results, in the remainder conventional technique was equally good. The advantages of digital subtraction are due to the removal of superimposed structures of the skull. Dose measurements at the level of the lens of the eye showed a greatly reduced radiation dose when using digital subtraction, as compared with conventional dacryocystography. Digital subtraction techniques with pulsed radiation and the ability to perform pixel shift is an optimal method for performing radiological examinations of the tear ducts and salivary glands.
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