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Biomedical subjects

J Lichtenberg

Publications and source records attributed to J Lichtenberg.

At least 19 recordsLinked to original sources
PubMed1997

The rat subcutaneous air sac model: a new and simple method for in vivo screening of antiangiogenesis.

An experimental rat model, the Subcutaneous Air Sac (SAS) model, was developed to provide an animal model in which neo-vascularization can be easily assessed in situ and quantified using a radiolabelled plasma marker. The SAS model was designed to replace a previous model where neovascularization was induced by chemical injury of rat or rabbit cornea or by implantation of tumour cells intracorneally, a methodology which is believed to cause severe pain to the animals. In the SAS model the air sac replaces the cornea as a transparent avascular substratum in which vascularization can be observed. The air sac is induced by injection of air subcutaneously on the back of the animal. After 8 to 10 days a sufficient air sac has been established. The animal is anaesthesized and by a minor operation the cellulose sponge is implanted upon the air sac under the skin. The vasoproliferative effect of the cellulose sponge causes formation of new vessels which are macroscopically visible 10 days after implantation. The ability of the in vivo SAS model to show an antiangiogenic effect of a systemically applied test compound was investigated using the fumagillin analogue TNP-470 (ochloro-acetylcarbamoyl)-fumagillol) as a positive control at dose levels of 0, 1, 2.5, 5 and 10 mg/kg/day given subcutaneously for 10 days. The neo-angiogenesis was scored both in situ using a subjective point system and by measuring the 125I-activity of the implant and the membrane after an intravenous injection of 125I-labelled antibodies. The neo-angiogenesis was reduced by approximately 45-50% in animals treated with 5 or 10 mg/kg/day of TNP-470 compared to animals treated with the vehicle. The animals treated with 10 mg/kg/day TNP-470 showed signs of toxicity. The SAS model is considered highly relevant for in vivo testing of potential antiangiogenic drugs on humane grounds. The high reproducibility, the low cost and the technical simplicity of the method makes it attractive.

Air↗
PubMed1995

[Aneurysms of the left atrium and left atrial appendage].

BACKGROUND: The authors deal with the problem of rare congenital and acquired aneurysm of the left atrium and auricular appendage. The authors attempted to compare findings on operation with results of preoperative examinations and evaluate the yield of echocardiographic and angiocardiographic examinations. METHODS AND RESULTS: The authors had the opportunity to encounter this unusual finding of cardiac aneurysms in five patients operated in 1987-1990 on account of an advanced mitral defect associated in two patients with ischaemic heart disease. In all patients acquired aneurysms were involved. In two a large thrombus was found. CONCLUSIONS: In the diagnosis of aneurysms of the left atrium and auricular appendage transoesophageal echocardiography proved to be the most reliable method.

Aged↗
PubMed1995

[Survival in patients after surgical closure of post-infarction rupture of the ventricular septum].

The authors discuss in the introduction hitherto reported data on the incidence and course of post-infarction ruptures of the interventricular septum and the results of conservative treatment. The high mortality rate after the conservative procedure led to attempts to resolve post-infarction ruptures of the interventricular septum surgically. The authors discuss in detail the indications for early and delayed operations has a decisive influence on the patients' survival. The authors had the opportunity to operate since 1978 till February 1986 five patients with post-infarction perforation of the interventricular septum. Four of the patients were women, one was a man. The mean age of the operated patients was 61 years, the oldest patient was a 75-year-old man and the youngest a 46-year-old woman. During the last check-up in 1994 it was revealed that of five operated patients three had died. One of them three years after operation and two after seven years. One female patient survives for 13 years and one for 11 years. Both are in a satisfactory conditions.

Aged↗
PubMed1994

[Advantages of lung surgery via medial sternotomy and use of extracorporeal circulation in very advanced lung tumors].

The authors present their initial experience with surgery of pulmonary affections in 32 patients where they used medial sternotomy as the route of approach. They provide evidence of the advantages of this approach, in particular in high-risk patients, and of the favourable effect of this approach on the postoperative course. Successful radical surgery under conditions of extracorporeal circulation, although a very advanced tumour was involved where posterolateral thoracotomy was unequivocally contraindicated, indicates that there is a possibility to extend indications of surgical therapy of otherwise inoperable pulmonary tumours.

Extracorporeal Circulation↗
PubMed1993

[A new method of retrograde hypothermic cardioplegia].

Application of the cardioplegic solution dramatically improved the results of the operations in ECC. Authors discussed the methods of application of the cardioplegic solution, mainly in the connection with its applications to the sinus coronarius. This is then discussed from another point of view of its use. In the field of the cardioplegy there is referred about new authors' method, and so on the possibility of its use, and the most propriete indications. Described method is available and its parameters, verified clinically and experimentally, are advantageous in the stated situations.

Heart Arrest, Induced↗
PubMed1993

[Retrograde myocardial revascularization using a bypass into the cardiac vein].

The authors submit a review of the surgical treatment of ischaemic heart disease, and based on data from the literature and their own experience, they evaluate the asset of so-called indirect revascularization operations under conditions when an aortocoronary bypass is impossible or has only a short-term effect due to the diffuse sclerotic affection of the coronary circulation. Special attention is paid to attempts of retrograde revascularization of the heart muscle by bypasses into the coronary veins. Because at present the possibility of indirect revascularization of the myocardium by a retrograde approach via the cardiac veins still remains a by far not yet resolved problem, the authors recommend for situations where the aortocoronary bypass is out of question a procedure making use of the advantages of a direct aortocoronary bypass and Vineberg's operation performed so as to relieve the blood flow through the sclerotic coronary artery beneath the anastomosis. In special situations also a sequential bypass could be considered with a side-to-side anastomosis into the artery and end-to-side into the appropriate vein.

Coronary Artery Disease↗
PubMed1992

[One-stage surgery in concomitant heart and lung disease].

The authors evaluate the advantages and disadvantages of one-stage operations in concomitant cardiac and pulmonary diseases and define the optimal indications for this procedure. The justification of one-stage operations in selected patients is confirmed by the authors' own experience assembled in two patients. One suffered from lung cancer and ischaemic heart disease and the other one from a tuberculoma and ischaemic heart disease. The one-stage operation in both patients was without complications.

Coronary Artery Bypass↗
PubMed1992

[An unusual finding of annular sclerosis of the mitral valve during heart surgery].

The authors present an uncommon finding of annular sclerosis of the mitral valve in four patients. On operation in three instances severe and in one instance a mild degree of annular sclerosis of the mitral valve was revealed. Two men were 55 and 67 years old and two women were 40 and 67 years old. In two instances the operation was indicated by a myxoma in the left atrium and in two instances by advanced insufficiency of the mitral valve.

Adult↗
PubMed1992

Model scenes: implications for psychoanalytic treatment.

Model scenes are constructed by analyst and patient to organize puzzling information, integrate previous understanding, and initiate further exploration of experience. They are derived from a variety of sources: literature (oedipal myth); transference; ordinary or traumatic childhood events that occupy a pivotal position. Model scenes may conceptualize experiences of any age and motivational system, and are contrasted with screen memories and "telescoping" of events. Two clinical examples are used to illustrate the relation between the model scene and the transference. Model scenes provide a valuable clinical tool for moving from general to specific experience. They afford empathic entry into the transference experience and the opportunity through which the experience of motivations representative of past and present can be conceptualized and integrated into a cohesive self organization.

Adult↗
PubMed1991

[A mobile thrombus simulating a myxoma of the right atrium].

Two-dimensional echocardiography is due to the detailed visualization of the right atrium and adjacent structures an indispensible non-invasive method for the detection pathological masses. In the differential diagnosis of these masses most frequently a mobile thrombus and myxoma are involved. The authors are presenting the case-history of a 71-year-old female patient where during hospitalization on account of a suspect non-Q-wave myocardial infarction in an anteroseptal position echocardiography revealed a pathological mass in the right atrium. From the case-history and results of examinations it was not possible to evaluate unequivocally the nature of the revealed mass. In view of the considerable risk of embolization into the pulmonary artery and coinciding ischaemic heart disease the patient was indicated for surgery and a mobile thrombus was removed. The described case draws attention to the differential diagnosis of right atrial masses and the optimal therapeutic approach.

Aged↗
PubMed1991

Uncommon findings on surgery of benign heart tumours.

The authors describe four cases of uncommon surgical findings in patients with the diagnosis of cardiac myxoma. In the first patient an encapsulated tumourous growth in the left atrium was present which was in the mural annulus of the mitral valve and in the adjacent parts of the atrial and ventricular wall and was evaluated from the histological aspect as annular sclerosis. In the second patient a tumour-like thrombus was detected in the right atrium which had the shape of a basket handle and was attached by two stalks to the atrial septum. The third patient had a myxoma of the left atrium covering a concurrent defect of the interatrial septum and the fourth patient had a large myxoma in the left atrium with three calcified small tumours in the area of the mural annulus of the mitral valve.

Adult↗
PubMed1991

[Coronary arteritis and its clinical significance].

The authors submit a report on a 47-year-old man with the syndrome of angina pectoris and history of myocardial infarction who died after a revascularization operation of the heart from left ventricular insufficiency. On necropsy extensive arteritis of the coronary vessels with aortitis was revealed and with arteritis of the small intramyocardial and lienal arteries and arteries in the renal pelvis. They describe in detail the histological finding on the blood vessels, and consistent with some data in the literature, they assume that this disease forms a separate unit. It must be considered in particular in middle-aged men who have signs of coronary ischaemia and risk factors suggesting atherosclerosis, not occur in the case-history.

Angina Pectoris↗
PubMed1989

[Long-term prognosis of patients with chronic post-infarct aneurysms. II. Comparison of patients treated conservatively and surgically].

UNLABELLED: Survival rates were determined for a group of 136 patients in whom left ventricular aneurysm was determined by angiography. They were treated medically (99 patients) or surgically (37 patients). Congestive heart failure was predominant in all patients. The two groups did not differ in regard to clinical and haemodynamic data except for a more extensive coronary artery disease in the surgical group. Survival rates at the 5, 7 and 9 years were 62.5%, 52.5% and 37.5% in the medicaly treated group and 50%, 40% and 32.5% in the surgical group. Functional improvement at least one Functional Class NYHA was present in 75% patients postoperatively, and in 27% of patients treated medically. CONCLUSION: In patients with left ventricular aneurysm with predominant congestive heart failure surgical treatment improved quality of life but did not increase long-term survival.

Chronic Disease↗
PubMed1989

[Surgical treatment of postinfarction heart aneurysms and akinesias].

The paper deals with the problem of surgical treatment of cardiac aneurysms and akinesias from the aspect of indication of surgical tactics and technique, risk factors and achieved results. The group of 117 patients is divided into 74 patients operated in 1970-1982 and 43 patients operated in 1983-1987 when already medium hyperthermia was used permanently, similarly as cold cardioplegia, complete haemodilution, pulsed extracorporeal circulation and relieving drainage of the left ventricle via the pulmonary artery. The reduction of early mortality from 24.3% to 4.7% provides clear evidence of the advantages of this procedure. The authors draw attention to differences in indications of surgical treatment between classical aneurysms and akinesians and to the importance of revascularization operations performed nowadays, using aortocoronary bypasses.

Adult↗
PubMed1989

[Surgical treatment of tumors of the heart].

The authors present an account on four cases of cardiac myxoma and two cases of a secondary malignant tumour. Despite the low incidence of cardiac tumours this disease must be taken into consideration. The diagnosis was established by echocardiography and angiography. Two-dimensional echocardiography is, however, often sufficient. Early surgical treatment has very favourable results in bening tumours. The prognosis of patients with malignant tumours is very poor and experience with treatment is scanty.

Heart Neoplasms↗
PubMed1989

[Stress perfusion tomography of the myocardium using the 201 thallium isotope in cardiac surgery--evaluation of initial results].

Initial results of evaluation of scintigraphic examinations by means of the isotope 201thallium indicate the importance of this method in cardiosurgery, in particular in the postoperative evaluation of the effect of bypass operations. In patients with an objective improvement on the postoperative scintigrams also subjective improvement of the condition was recorded.

Adult↗
PubMed1989

[Results of surgical treatment of pulmonary carcinoma in patients over 60 years of age].

The authors submit an analysis of patients operated in 1972-1982 at the First Surgical Clinic, Faculty of General Medicine, Charles University Prague. The group of patients was divided into those under 65 years and those above this age. The effect of the patients' age on the postoperative course was investigated, the survival of the two groups was compared, the causes of early postoperative deaths, the extent of the disease and histological type of tumour were evaluated. In was revealed that the risk of early postoperative death within one month is greater in patients above 65 years where it is 19.6%, as compared with 11.3% in the younger group. The risk increases in particular in patients above 70 years where it is as high as 26%. There is no fundamental difference in the causes of death between the two groups. The highest percentage of operated patients dies from embolism (40% and 42% in the patients above 65 years), the second place is held by inflammatory pulmonary complications which are somewhat more frequent in patients of the younger age group (24% as compared with 15% in the older patients). The survival curves of patients who had a radical operation in stage I and II of the neoplastic disease are almost identical and there is no significant difference in the survival of the two groups. In the group under 65 years 30% survive five years, in the older group 25%. The ratio of differentiated types of lung cancer, i.e. adenocarcinoma and epidermoid carcinoma is equal in both groups, contrary to small-cell carcinoma which was recorded in 6% in the older patients, as compared with 15% in the younger ones.

Age Factors↗