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Biomedical subjects

J H Müller

Publications and source records attributed to J H Müller.

At least 73 records · Page 4Linked to original sources

[Late results following palliative vascular embolization in inoperable kidney tumors. (Preliminary report)].

During 18 months in 15 patients with inoperable renal tumours palliative therapeutic vascular embolisations were carried out with the help of an own catheter technique. In contrast to preoperative embolisation (16 patients) in the inoperable cases a non-absorpable polyvinyl alcohol foam substance ("Ivalon") was used, which leads to a secure permanent vascular occlusion. The haematuria occurring in all patients which many times threateningly increased was removed in all cases. There did not appear any essential complications. However, on account of the formation of a symptomatology of renal infarction a clinical after-treatment is necessary. In 12 patients regulary clinical and paraclinical control examinations during an observation period of on an average 11 months were carried out (minimum 6 months, maximum 18 months). 11 of these patients were still alive at the end of the report and had a tolerable or even improved general condition. In angiographical after-controls of 4 patients, and in one case by autopsy, permanent vascular occlusions with formation of necroses of a large area and partly considerable restriction of the tumour kidneys were found. In these cases the therapeutic embolisation led to a provable damage of the tumorous process. An influence of metastases distant from the primary tumour was not observed.

Embolization, Therapeutic↗

[Function of the left ventricle in the acute phase of myocardial infarct].

In the acute phase of myocardial infarction in 22 patients intraventricular pressure measurements (left and right heart catheters) were performed. In addition to this in 17 cases a qualitative and quantitative angiocardiographical judgment of the function of the left ventricle was done. A group of 9 patients with healthy heart served as control group. The group with infarction showed typical findings deviating from the normal. Stroke volume, cardiac output and stroke work of the left ventricle were significantly decreased. The systolic ejection fraction which was highly significantly reduced in contrast to the normal value proved as a particularly sensitive index. The contractility parameters dp/dt max. and VCE(dp/dt max.) were also highly significantly reduced; aortic mean pressure and heart rate did not show any significant changes. A compensation of the decrease of the heart function depending on contractility is achieved in the acute phase of the myocardial infarction by a significant increase of the wall stiffness, in which case apparently the ventricle practically exclusively by this means strives for an optimum filling pressure in order to maintain a sufficiently large stroke volume. The practically unchanged enddiastolic ventricle volume excluded at least for the uncomplicated infarction in the acute stage an essential participation of Frank-Starling's compensation mechanism.

Acute Disease↗

[Phlebography before and after surgery of the deep femoral and pelvic veins (author's transl)].

This paper deals with indications and results of phlebographic diagnostics in acute and chronic occlusive processes of the deep veins of the leg and the pelvis. While in former times phlebography was mostly with regard to surgical treatment of varicose veins, today the reconstruction of obliterated deep veins of the lower extremity by by-pass procedures or thrombectomy come to the fore. In the postoperative period is only phlebography that will prove the therapeutical effect exactly.

Femoral Vein↗

[Complex angiographic diagnosis of space-demanding processes in the kidney including renocystography].

Issuing from the experiences of the complex angiorgraphic diagnostics of space-demanding processes of the kidneys in 400 patients value and sequence of different angiographic methods including renocystography are discussed. The diagnostic certainty in hypo- and avascular tumours by the renal phlebography and in cystic processes is essentially increased by percutaneous puncture. In malignant tumours before operation the judgement of the endovenous extension is always to be demanded, which is most certainly achieved by direct venography. A diagnostic step programme is proposed, to make possible the rational use of the methods.

Angiography↗

[The place of adrenal angiography (phlebography and arteriography) in the diagnostic stepwise program in arterial hypertension].

Arteriographical and phlebographical methods are distinctly suited for the diagnostics of the adrenal glands in the stop program of the combat against hypertension. Hypervascular tumours of the adrenal medulla, especially phaeochromocytomata may be established arteriographically relatively certainly. Avascular processes of the adrenal cortex, however, are better to be diagnosed by the selective phlebography of the adrenal glands. The phlebography is also suited for the planimetric determination of the size. The following uncorrected normal values were established: on the left m1 = 10.58 +/- 1.17 cm2, on the right m2 = 6.95 +/- 1.39 cm2. The mean value of normal couples of adrenal glands is M = 18.17 +/- 1.96 cm2. The left adrenal gland is statistically significantly larger than the right one (p greater than 0.001). In 214 patients altogether 44 selective arteriographies and 276 selective phlebographies of the adrenal glands were performed. As angiographical basis examination of all patients was at first performed an abdominal aortography or an angiography of the kidneys. The phlebographical diagnostics was successful on the left in 98.7% and on the right in 90.4% of the cases. 72 patients had pathological processes of the adrenal glands, out of them 20 times a solitary adenoma of the adrenal glands was present. 38 patients had a one- or double-sided hyperplasia, and 4 patients had a phaeochromocytoma. In 10 other cases more infrequent changes were found.

Adenoma↗

[Myocardial blood flow and ventricular function in dependence on the size of myocardial infarct].

In eight dogs three branches of the left anterior descending coronary artery were occluded by successive ligations. Each time coronary flow reserve was measured by injecting dipyridamole (0.4 mg.kg-1). After an infarction of 13% of the left ventricle there was a significant decrease of Vmax and dp/dtmax (p less than 0.05). Measurements of regional myocardial blood flow detected an infarction of 5% of the left ventricle, whereas the total myocardial blood flow was reduced significantly when 17% of the left ventricle was infarcted.

Animals↗