PubMed Health⌕ Search

Biomedical subjects

J H Müller

Publications and source records attributed to J H Müller.

At least 19 recordsLinked to original sources
PubMed1990

[Follow-up of surgical therapy in patients with threatened and acute myocardial ischemia for an average of 5 years].

Out of a total group of 300 patients after local intracoronary fibrinolysis, systemic ultra-high short-term fibrinolysis and instable angina pectoris 73 (24% out of 300) patients, in whom acutely or in the course of the treatment a surgical therapy of their coronary heart disease was performed, were analysed. Constellations of the findings of the coronary heart disease, when according to this connection with an adequate conservative therapy on the basis of a diagnostic and therapeutic step programme in 44% of the patients an improvement of the load capacity and in 73% an improvement of the subjective well-being is to be stated. In patients with diseases of one vessel compared with patients with diseases of several vessels significantly more frequently an intraindividual increase of the bicycle-ergometric performance develops.

Angioplasty, Balloon, Coronary↗
PubMed1990

[Diagnostic value of digital subtraction angiography in chronic venous insufficiency].

The first 117 investigations in chronic venous insufficiency by means of the technique of digital subtraction angiography (DSA) are reported. According to our experiences hitherto made this technique with peripheral intravenous injection of contrast remedies is excellently suited for the phlebography of the pelvic and vena cava regions as well as of the region of upper arm and shoulder, not so much, however, for the phlebography of the leg. By decrease of the concentration of the contrast remedy and the total quantity of the contrast remedy a reduction of the patient's stress and the risk of the examination is the result.

Angiography, Digital Subtraction↗
PubMed1990

[Phlebodynamometry studies in patients with chronic venous insufficiency and phlebography verified insufficiency of muscle veins].

23 patients with complaints in the sense of a chronic venous insufficiency were examined by means of phlebodynamometry, who phlebographically did not show any postthrombotic changes of the deep conducting veins, but had clear signs of an insufficiency of the muscle veins stage I-III. Cases with isolated insufficiency of the muscle veins (n = 5) and combination forms with additional insufficiency of the conducting veins and/or superficial varicosis (long and short saphenous veins) were found. Measured at the decrease of pressure (delta-p) after exercise in the combined forms the epifascial varicosis has the greatest haemodynamic effects. The isolated findings of an insufficiency of the muscle veins with or without additional insufficiency of the conducting veins has apparently only smaller haemodynamic effects. For the isolated insufficiency of the muscle veins normal limit values for delta-p could still be measured, which also could only insignificantly be bettered by application of a tourniquet. This knowledge is important for therapy planning.

Humans↗
PubMed1989

[The significance of a staged diagnostic-therapeutic program for the disease course in patients following unstable angina pectoris during a follow-up period of 3 1/2 years].

Among a group of 160 patients (146 men and 14 women) who had been admitted to our hospital under the picture of an unstable angina pectoris and whom we treated according a standardized diagnostic-therapeutic step programme 8.7% of the patients died of a cardiovascular disease during a period of 3 1/2 years. In 8% of our patients an acute myocardial infarction occurred during the period of observation. A diagnostic-therapeutic step programme was the basis for a differential therapy adapted to the individual course of the disease. We think that this therapy concept first of all corresponds to the individual dynamics of the course of the disease of patients with coronary heart disease.

Angina Pectoris↗
PubMed1989

[Percutaneous catheter embolization of the of the internal iliac artery in life-threatening gynecological bleeding].

16 patients with life-endangering hemorrhages caused by gynecologic malignancies have been treated with the percutaneous transcatheter embolisation. In general for embolisation of the internal iliac artery gelfoam was used. Life-endangering bleeding could be stopped in all cases, only 3 mild persistent bleedings and another recurrence of hemorrhage could be controlled conservatively. Major-complications did not occur. The significant advantage of catheter embolisation in controversy to surgical treatment is discussed.

Adult↗
PubMed1989

[Diagnostic strategy in suspected renovascular hypertension].

iv-DSA is an excellent method for detecting suspected stenosis of the renal arteries. In essential hypertension among 19 patients a frequency of 15.8% was found, in patients with accelerated hypertonus (n = 23) the percentage of renal artery stenosis was twice this rate (30.4%). In case of a positive or unclear outcome of iv-DSA, intraarterial angiography with ever ready PTRA is advisable.

Adolescent↗
PubMed1988

[Local intra-arterial fibrinolytic therapy in acute vascular occlusions in the area of the internal carotid artery].

Report on the first experiences with the local intraarterial streptokinase therapy in 5 patients with acute obliteration processes of the vascular system of the internal carotid artery. Two peripheral obliterations (occlusions of the main branch of the media) could be completely recanalised, with complete regression of the neurological symptomatology. In one of the three complete occlusions of the internal carotid artery (region of the siphon) a considerable partial recanalisation could be achieved. A fourth patient could be dismissed with an essential clinical improvement 11 days later despite angiographic persistence of the occlusion. Two patients died. As directive value for the dosage from 50,000 to 100,000 units streptokinase are proposed as short-term infusion in 30 to 60 minutes.

Acute Disease↗
PubMed1988

[Associated thrombotic processes of the superficial, perforating and intramuscular venous system in patients with acute phlebothrombosis of the lower extremities].

In a retrospective study 100 phlebograms of the legs of patients with definitive acute phlebothrombosis were examined for additional thrombotic processes in the superficial venous system, in the perforating and muscular veins. They could be confirmed in 77% of the cases, whereby preferredly the superficial venous system (long saphenous vein and lateral branches) were affected. A temporary coordination of superficial thrombophlebitis and phlebothrombosis cannot be made. At first it is adhered to the approved strategy of diagnosis that an acute superficial thrombophlebitis is no indication for phlebography. It is demanded the immediate application of invasive and non-invasive examination methods, when there is the least clinical suspicion of a deep venous thrombosis.

Female↗
PubMed1988

[Acute phlebographic diagnosis of thrombotic complications in gynecology and obstetrics].

From 1971 to April 1986 phlebography was performed in a total of 459 patients suspected clinically having an acute phlebothrombosis. From 112 female patients (24.4%) coming from the departments of gynaecology and obstetrics in 94 cases an acute or subacute phlebothrombotic process was proved phlebographically. The main age of these female patients was 29 +/- 11 years (17 to 76 years). A combined ileo-femoral-crural vein thrombosis in 44.7% was the most frequent localization and expansion, however, an isolated thrombotic process of pelvic veins was found in 25.6% only. A coincidence of the calculated age of thrombosis and clinical symptoms could be proved in 62 female patients (66%), but often the phlebographically calculated thrombus age was much longer than suspected by clinical symptoms alone. Foudroyant pulmonary embolism was observed in each fifth or sixth patient. The special technique of phlebographic investigation is discussed in detail with the judgement of a differentiated therapy of phlebothrombosis and pulmonary embolism.

Adolescent↗
PubMed1987

[Initial experience using percutaneous transluminal coronary angioplasty in the immediate management of acute myocardial infarct].

Reported in this paper is experience obtained from coronary diagnosis and coronary fibrinolysis in acute myocardial infarction. Local fibrinolysis was applied to 69 patients, with 2 X 75,000 units of streptokinase in 30 minutes being the dose for orientation. Percutaneous transluminal coronary angioplasty was added in those cases in which therapeutic fibrinolysis proved to be insufficient. An additional bypass operation was required by nine patients.

Angioplasty, Balloon↗
PubMed1986

The cost and appropriateness of health care technology in South Africa. A plea for the development of a local medical equipment industry.

Some of the main reasons for the increase in the cost of health care technology are summarized. Local problems in the health care delivery system are not being solved effectively by imported medical equipment. The expertise required for the local solution of problems is available in the RSA and should be developed further. A private-sector consortium with matching funding from the State should serve as a clearing house for developing and evaluating assessment criteria, promoting the use of existing cost-efficient medical technologies, and identifying obsolete and inappropriate ones. The formation of a local health care technology corporation should be considered seriously.

Costs and Cost Analysis↗
PubMed1986

[Arterial hemodynamics of kidney transplants after end-to-side and end-to-end anastomosis (experimental study in the dog)].

Arterial hemodynamics of end-to-side versus end-to-end anastomized kidney grafts were studied comparatively in anaesthetized dogs with bilateral autotransplants. Evaluating the data of mean pressure in the renal artery (Pm), amplitude of the pulse-pressure (delta P), maximal steepness of the pulse-pressure (dp/dtmax), maximal speed of the flow-waves (Vimax), planimetric percentage of positive and negative shares of the flow-curves and the resulting "effective" level, mean renal blood flow (Vtotal) and the amount of vascular resistance calculated from the quotient Pm/Vtotal, it was found that delta P, dp/dtmax, Vimax and Vtotal were significant higher immediately after transplantation using end-to-end anastomoses as compared with end-to-side anastomoses. However, controls following 4 months after the transplantation revealed normal hemodynamic findings and no differences in the course of anastomotic pulse curves were observed. The initial disparity in the hemodynamics of both types of anastomoses was refered to different modules of elasticity (E) in consequence of unequal lengths of anastomoses reflecting the pulse waves by increased peripheral resistance.

Animals↗