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Biomedical subjects

J Köhler

Publications and source records attributed to J Köhler.

99 records · Page 6Linked to original sources

Biomechanics of valvular plane displacement of the heart.

There has been no consensus concerning the particular movement of the valvular plane of the heart (VPM). As shown in this study involving a mathematical model based upon the momentum equation and experiments on a specially designed artificial heart pump, the VPM not only results from the shortening of the heart, but also from blood flow within the heart and large blood vessels, from the forces caused by the muscle movements, and from the elastic properties of the heart's suspension. The results of the calculations and the experiments confirm the effect of the so-called valve mechanism and its influence on the economic beating action of the heart.

Aortic Valve↗

Overestimation of flow velocity through leaks in mechanical valve prostheses and through small orifices by continuous-wave Doppler.

The reliability of continuous-wave Doppler flow velocity measurements through small regurgitant lesions, such as in prosthetic leakage, has not been systematically analyzed. To evaluate the accuracy of continuous-wave Doppler in prosthetic valve leakage and small orifices in an in vitro, steady-flow model-flow velocities through the leaks of twelve intact mechanical prostheses and through six circular nozzles (area 0.5 to 20 mm2) were measured at pressure drops between 30 and 105 mm Hg. These results were compared with those predicted by the modified Bernoulli equation. Laser Doppler anemometry of flow velocities through the nozzles was also performed. Despite high correlation, there was substantial overestimation of Bernoulli predicted velocities by echo Doppler in the prosthetic leaks (mean +12.3% +/- 9.4%; range 90.3% to 143.4%). In the nozzles < or = 10 mm2, but not in the largest (20 mm2) nozzle, there was also overestimation of the Bernoulli predicted velocities (mean +6.2% +/- 2%). Laser Doppler anemometry of flow velocities through the nozzles showed slightly lower values than predicted by the Bernoulli equation. Thus, continuous-wave echo Doppler overestimates flow velocities through small orifices. This apparently is, at least in part, due to transit time effects and should be taken into account when using echo Doppler in small (< 10 mm2) orifices, such as in mild to moderate regurgitant lesions and prosthetic valve leakage.

Blood Flow Velocity↗

Duplication dup(1)(q32q44) detected by comparative genomic hybridization (CGH): further delineation of trisomies 1q.

Partial trisomy 1q is rare and mostly the result of an abnormal segregation of parental translocation chromosomes and their homologues. Only 31 cases have been described with pure partial trisomy 1q. In the fetus presented, chromosome analysis after amniocentesis had shown an unbalanced male karyotype with an aberrant chromosome 1. A de novo terminal duplication of the long arm was suspected but could not be verified by FISH in 1994. Five years after fetal death, retrospective identification of the additional material in 1q could finally be achieved by comparative genomic hybridization (CGH) using DNA extracted from formalin-fixed and paraffin-embedded fetal tissues. A direct duplication dir dup (1)(pter-->q44::q32.1-->qter) was found. Only 6 other individuals with duplication of this segment have been described so far. Comparative delineation of a dup1q phenotype with regard to size and origin of the dup (1q) segment evidenced that large duplications as well as proximal and interstitial duplications coincide with more severe visceral malformations, severe mental retar- dation and a short life span. Terminal duplications (1q32-->qter) concur with less severe malformations and longer periods of survival, but marked mental retardation. With small terminal duplications (1q42-->qter) dysmorphisms are usually mild and intellectual performance is mostly in the normal range.

Adult↗

[Potential drug interactions in the treatment of elderly patients with multiple morbidity].

In 196 hospitalized geriatric patients, drug prescriptions were assessed for potential drug interactions. Potential drug interactions were identified in 5.4% of 2,177 prescriptions. The risk increased with the number of prescribed drugs. Antipsychotics, tranquilizers, hypnotics, diuretics, cardiac glycosides and centrally acting analgetics were involved in more than 70% of potential interactions. Risks of potential drug interactions can be reduced by a reduction in drugs prescribed.

Aged↗