PubMed Health⌕ Search

Biomedical subjects

H Diederichs

Publications and source records attributed to H Diederichs.

2 recordsLinked to original sources

[Angiographically unexplained myocardial ischemia in high grade coronary stenosis with main stem involvement in intravascular ultrasound].

HISTORY AND ADMISSION FINDINGS: For seven weeks a 57-year-old man had been complaining of recurrent non-radiating retrosternal pain and pressure on slightest exertion. Admission physical examination was unremarkable except for evidence of peripheral vascular disease. Cardiovascular risk factors were hypertension, hyperlipoproteinaemia and obesity. INVESTIGATIONS: The resting ECG was unremarkable. Objective signs of myocardial ischaemia were produced in the exercise ECG (angina at 100 Watt, negative T waves in V2 to V6 and borderline S-T depression in V4). Myocardial scintigraphy showed reversible reduced perfusion of the anterior wall near the apex and also of the apex and septum. Left ventricular (LV) angiography demonstrated a normally contracting LV, while selective coronary angiogram revealed a 20% reduction in caliber of the proximal branch of the anterior interventricular branch (AIVB), with otherwise normal coronary arteries. Subsequent intravascular ultrasound (IVUS) showed a circular echo-poor 80% stenosis at the origin of the AIVB with extension to the main stem. TREATMENT AND COURSE: A bypass from the internal mammary artery to the AIVB and an aortocoronary venous bypass to the intermediate branch were performed. The patient was free of symptoms postoperatively. CONCLUSION: If cases where there is a discrepancy between clinical and coronary angiographic findings--the latter being unclear or inconsistent, especially in the area of the left main stem, bifurcations or vessel origin--IVUS may contribute decisively to demonstrating coronary anatomy or pathology, and to indicating the type of revascularizing measures.

Coronary Angiography↗

Rapid decrease in cellular sodium and chloride content during cold incubation of cultured liver endothelial cells and hepatocytes.

Hypothermia, as used for organ preservation in transplantation medicine, is generally supposed to lead to an intracellular accumulation of sodium, and subsequently of chloride, via inhibition of the Na+/K+-ATPase. However, on studying the cellular sodium concentration of cultured liver endothelial cells using fluorescence microscopy, we found a 55% decrease in the cellular sodium concentration after 30 min of cold incubation in University of Wisconsin (UW) solution. To confirm this surprising result, we set up a capillary electrophoresis method that allowed us to determine the cellular contents of inorganic cations and of inorganic anions. Using this method we measured a decrease in the cellular sodium content from 104+/-11 to 55+/-4 nmol/mg of protein, accompanied by a decrease in the chloride content from 71+/-9 to 25+/-5 nmol/mg of protein, after 30 min of cold incubation in UW solution. When the endothelial cells were incubated in cold Krebs-Henseleit buffer or in cold cell culture medium instead of UW solution, similar early decreases in cellular sodium and chloride contents were observed, thus excluding the possibility of the decreases being dependent on the preservation solution used. Furthermore, experiments with cultured rat hepatocytes yielded a similar decrease in sodium content during initiation of cold incubation in UW solution, so the decrease does not appear to be cell-specific either. These results suggest that, contrary to current opinion, sodium efflux predominates over sodium influx during the early phase of cold incubation of cells.

Adenosine↗