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J C Reidemeister

Publications and source records attributed to J C Reidemeister.

At least 37 records · Page 2Linked to original sources
PubMed1991

[The concept of lung and heart-lung preservation within the scope of multiple organ procurement].

Preservation of the lung is still one of the most challenging problems, because due to limited procurement time not all organs available can be used. The most common procurement technique is flush perfusion of the pulmonary artery system. Alternative methods in clinical use are either the autologous working heart-lung preparation or donor core-cooling (DCC). The own concept presented here, modified to the special demands of multi-organ-procurement, combines DCC and interstitial equilibration adapted to intracellular ion concentration. DCC is induced by extracorporeal circulation (ECC) using a transportable heart lung machine including a highly effective cooling system: cooling circuit based on two parallel heat exchangers with ice-water cooling produced by a high-pressure overflow of a low-temperature ice block (-40 degrees C). While cooling by ECC stepwise hemodilution is achieved by priming volume and incorporation of the cardioplegic solution (Bretschneider-HTK). The aim of equilibration is to lower the extracellular levels of sodium and calcium, and to increase the level of potassium. Additionally, the buffer capacity of donor blood is increased by the incorporated histidine-buffer system (alpha-stat). To avoid donor organ edema the time of ECC should be as short as possible. Using our system donor organ temperatures below 10 degrees C are reached within less than 30 min. In addition to ECC, lung surface cooling is achieved by external overflow with cold arterial blood (internal mammary artery). Besides lung preservation the main advantage of this concept is the profound precooling of all visceral organs before their individual flush perfusion.

Animals↗
PubMed1991

[Interdisciplinary management of perforating heart injuries].

Penetrating cardiac injuries are being observed in urban regions with increasing frequency; due to improved advanced trauma life support ascending numbers of trauma victims are reaching the trauma centers still alive. The main pathophysiological determinant is acute pericardial tamponade. The time course of the patients' circulatory state cannot be predicted due to the nonlinear course of the pressure-volume relationship. Thus only after clinical diagnosis is made and if the circulation is poor should on-the-spot emergency subxiphoidal pericardiocentensis be considered and endotracheal intubation is indicated restrictively. The concept of clinical emergency room management is as follows: (1) Under stable circulatory conditions urgent exploratory pericardiotomy should be performed following sonographic confirmation; (2) in compensated state of shock and with clinical signs of tamponade immediate pericardiotomy should be done simultaneously with induction of anesthesia, abstaining from any diagnostic procedures; (3) in life-treating situations or under resuscitation emergency sternotomy should be performed by the surgeon present, aiming to control bleeding. Reconstruction can be done in cooperation with the cardiothoracic surgeon. The operative techniques used may extend from simple suturing of the myocardial injury to emergency aortocoronary bypass grafting. By quick interdisciplinary emergency management including basic cardiac surgical techniques (performed ideally by the trained general or trauma surgeon) even penetrating cardiac injuries can be treated with acceptable prognosis.

Cardiac Tamponade↗
PubMed1990

[Diagnosis and therapy of acute traumatic aortic rupture].

Aortic transection is defined as complete or partial dehiscence of the aortic wall layers. Aortic transections are seen in 16% of all lethal traffic accidents. The quality of the first emergency care outside hospital and the organization of rescue systems result in an increasing number of patients (espec. with life-threatening multiple injuries incl. atypical aortic lesions) reaching a trauma-center. Guide-lines for surgical indications are: 1. emergency-operation in case of symptomatic transection incl. simultaneous surgery of concommitant lesions. 2. Urgent operation following primary hemodynamic stabilisation in cases of isolated or asymptomatic transection. 3. In cases of concommitant lesions with surgical priority, delayed operation of asymptomatic transection. The perioperative letality claims up to 20%. Next of operative complication paraplegia remains the most deleterious problem. Despite different methods of protection on the spinal cord the incidence of paraplegia persists in the range of 5-10%.

Aorta, Thoracic↗
PubMed1988

[The vena cava superior syndrome in sarcoidosis].

We report the first observation of clinical manifestations of vena cava superior syndrome (VCSS) associated with sarcoidosis. Twenty-four years after the first signs of the disease had been noted, mediastinal lymphomas penetrating the wall of the vena cava superior caused complete obstruction. It is most unusual for the vessel wall to be destroyed in this way, which explains why VCSS is often missed in sarcoidosis. The obstructed vessel was resected and successfully replaced by a Gore-Tex prosthesis. The importance of VCSS for the differential diagnosis is pointed out. Two further peculiarities are the simultaneous occurrence of elevated intraocular pressure and VCSS, and the familial incidence.

Female↗
PubMed1986

Human beta-adrenoceptors: relation of myocardial and lymphocyte beta-adrenoceptor density.

In human right atria obtained from 21 patients during open-heart surgery, beta-adrenoceptor density [assessed by iodine-125-labeled (-)-cyanopindolol binding] and responsiveness (positive inotropic responses to isoprenaline) were linearly related to the beta-adrenoceptor density in the corresponding circulating lymphocytes. This direct relation of human myocardial and lymphocyte beta-adrenoceptor alterations, therefore, makes it possible to monitor drug- or disease-induced beta-adrenoceptor changes in tissues not easily accessible in humans.

Female↗
PubMed1986

Human myocardial beta-adrenoceptors: demonstration of both beta 1- and beta 2-adrenoceptors mediating contractile responses to beta-agonists on the isolated right atrium.

On the isolated electrically driven muscle strip of human right atrial appendages the beta-adrenoceptor subtypes mediating the positive inotropic effects of isoprenaline, dobutamine and procaterol were characterized using the beta 1-selective antagonist bisoprolol and the beta 2-selective antagonist ICI 118,551. The three agonists induced concentration-dependent increases in force of contraction with an order of potency: procaterol (pD2-value: 8.03) greater than isoprenaline (pD2-value: 7.73) greater than dobutamine (pD2-value: 5.44). In saturating concentrations all three agonists produced the same maximum of developed tension. ICI 118,551 (10(-9)--10(-7) mol/l) and bisoprolol (10(-9)--10(-7) mol/l) were nearly equipotent in antagonizing the positive inotropic effects of isoprenaline and dobutamine. However, the slopes of the Schild-plots for both antagonists against both agonists were significantly less than 1.0 indicating interaction with beta 1- and beta 2-adrenoceptors. On the other hand, ICI 118,551 (10(-10)--10(-8) mol/l) was approximately 100 times more potent than bisoprolol (10(-8)--10(-6) mol/l) in antagonizing the positive inotropic effect of the highly selective beta 2-agonist procaterol. In addition, the slopes of the Schild-plots for antagonism of ICI 118,551 and bisoprolol against procaterol were not significantly different from unity indicating interaction with a homogeneous class of beta-adrenoceptors. The pA2-value for ICI 118,551 was 9.49, for bisoprolol it amounted to 6.99.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗
PubMed1984

Acquired aortic coarctation due to posttuberculotic gibbous formation.

This is a report on a rare case of acquired stenosis of the descending thoracic aorta resulting from an extreme posttuberculotic gibbous formation. The unusual anatomical relationship precluded conventional alleviation of the stenosis which was bridged ultimately with a graft producing a satisfactory functional result.

Adult↗
PubMed1984

[Superior vena cava syndrome--clinical aspects, etiology and case reports].

The so-called superior-Cava Syndrome is caused by obstructions by centrally localized tumors by thrombosis or by inflammations of the mediastinum. In cases of tumorous infiltration a graft can be inserted. The different phenomena of thrombosis caused by nutritial catheters and pace makers are of clinical importance. Acute thrombosis of the brachio-cervical veins and the Vena Cava can be treated successfully by means of thrombolysis. Besides CT bilateral brachial phlebography communicates optimal information concerning localization of vascular obstruction and collateral circuits.

Adult↗
PubMed1983

Coexistence of beta 1- and beta 2-adrenoceptors in human right atrium. Direct identification by (+/-)-[125I]iodocyanopindolol binding.

The highly specific beta-adrenoceptor radioligand, (+/-)-[125I]iodocyanopindolol, has been used to subclassify beta-adrenoceptors in membranes from human right atrial appendage obtained during open heart surgery. Binding of (+/-)-[125I]iodocyanopindolol was saturable (Bmax = 86.4 +/- 7.4 fmol (+/-)-[125I]iodocyanopindolol bound/mg protein, n = 4), of high affinity (KD = 53 +/- 6 pM, n = 4), rapid, reversible, and stereospecific. The relative potencies of isoprenaline, adrenaline, and noradrenaline for inhibition of (+/-)-[125I]iodocyanopindolol binding and activation of adenylate cyclase were 1:10:10, indicating a population composed mainly of beta 1-adrenoceptors. Inhibition of (+/-)-[125I]iodocyanopindolol binding by beta 1- (practolol, metoprolol, betaxolol) and beta 2- (IPS 339, ICI 118,551, zinterol, procaterol) selective drugs, however, resulted in biphasic displacement curves with slope factors (nH, pseudo Hill coefficients) significantly less than 1.0. Nonlinear regression analysis of these curves revealed a beta 1: beta 2 ratio of 80:20 in human right atrial appendage. Nonselective beta-adrenergic drugs (propranolol, isoprenaline, and adrenaline), on the contrary, inhibited binding with monophasic displacement curves and nH = 1.0. Binding of agonists to the beta-adrenoceptors in human right atrial appendage seems to be regulated by guanyl nucleotides. In the absence of GTP, isoprenaline binds to high and low affinity state of the beta-adrenoceptors. GTP (10(-4) M) converts this heterogeneous binding into a homogeneous one of low affinity. It is concluded that, in human right atria, beta 1- and beta 2-adrenoceptors coexist; however, beta 1-adrenoceptors predominate. The physiological function of beta 2-adrenoceptors in human right atrium remains to be elucidated.

Adenylyl Cyclases↗
PubMed1983

[Congenital aneurysms of the left atrium with intact pericardium--value of diagnostic methods for recognition, prognosis and therapy].

An intrapericardial aneurysm of the left atrial appendage in a 7-year-old girl is reported. Review of the 36 cases described up to now reveals that there is no specific age for this disease. It is therefore questioned whether this defect is really congenital in origin. Systemic embolism and serious rhythm disturbances are the most common complications; the younger the patient, the less likely they are to occur. Systemic embolism has only been described in the case of aneurysms located at the left atrial appendage, not in aneurysms of other parts of the left atrial wall. The risk of the development of rhythm disorders, however, is independent of the location within the left atrium. Clinical findings (including ECG) are nonspecific. Cardiomegaly and unusual configuration of the heart are constantly found, but are not pathognomonic. The diagnosis is usually confirmed by angiocardiography. Operation seems always to be indicated if complications are to be avoided. Operative deaths or complications during the follow-up after operation are not described. Nothing is known about the etiology of the disease.

Angiocardiography↗
PubMed1983

[Left coronary artery originating from the pulmonary artery as a syndrome found in infancy, childhood and adulthood].

The cases of two patients with Bland-White-Garland-Syndrome are reported. A 13 year old girl had been operated during infancy (ligation of the left coronary artery at its origin from the pulmonary artery) and showed reopening of the ligation with marked collateral circulation between the right and left coronary artery. She was operated again, successfully. A second critically ill patient with a typical pattern of anterolateral infarction in his ECG recovered so well that only five years later he was readmitted; then he showed the adult-type ECG with good collateral circulation between the right and left coronary artery. He underwent an equally successful operation. In both cases there is good evidence for the development of a sufficient collateral circulation after ligation of the coronary artery to pulmonary artery connection. Spontaneous formation of anastomoses between the right and left coronary artery enables even infants with this anomaly to survive. These findings confirm the suggestion that the "infancy-type" and "adult-type" of the Bland-White-Garland-Syndrome represent only different stages of the same disease.

Adolescent↗
PubMed1982

[Primary cardiac tumours: diagnosis and surgical treatment (author's transl)].

A teratoma of the cardiac skeleton, a rhabdomyoma of the right ventricle and an intramural fibroma in the left ventricle were observed in three children, aged eight weeks, eight months and eight years, respectively. Atrial myxoma was found in a 42-year-old and a 49-year-old patient. History and symptoms showed no particular common features in the various patients, merely signs of flow obstruction in four of the five patients. Amongst specific cardiological diagnostic methods only angiocardiography was reliable in the demonstration of intra- or paracardiac space-occupying lesions. All five patients were successfully operated on under cardiopulmonary bypass. The surgical technique varied according to localisation, extent of the tumour and its site in relation to essential cardiac structures. Follow-up examination indicated that the patients were free of symptoms and recurrence.

Adult↗
PubMed1980

Stimulation by adrenaline and dopamine but not by noradrenaline of myocardial alpha-adrenoceptors mediating positive inotropic effects in human atrial preparations.

In isolated electrically driven right auricular strips of human hearts (1 Hz at 37 degrees C) the ability of the endogenous catecholamines noradrenaline, adrenaline, and dopamine to mediate positive inotropic effects by stimulation of myocardial alpha-adrenoceptors was investigated. 1. The concentration-response curve for the positive inotropic effect of noradrenaline was shifted to the right by pindolol, 10(-8)M, whereas the additional blockade by phentolamine, 3 x 10(-6)M, was without further effect; therefore, the positive inotropic effect of noradrenaline is mediated by beta-adrenoceptors only. 2. In contrast, the positive inotropic effects of adrenaline as well as of dopamine are caused by stimulation of both, beta- and alpha-adrenoceptors. 3. These results are discussed with respect to the possible physiological and pathophysiological function of myocardial alpha-adrenoceptors.

Catecholamines↗
PubMed1980

Conduit-integration in correction of right ventricular outflow obstruction.

A new method for correction of right ventricular flow tract obstruction is described. The method combines the advantages of patch-plasty-procedure and external valved conduit by conduit integration into the right ventricular and pulmonary arterial wall. Good results had been achieved in 3 cases (2 cases of Fallot's tetralogy and one case of double outlet right ventricle).

Abnormalities, Multiple↗