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Biomedical subjects

K Stapenhorst

Publications and source records attributed to K Stapenhorst.

At least 19 recordsLinked to original sources
PubMed1987

Intracellular pH measurement during cardiac arrest in ventricular myocardium by Bretschneider's cardioplegic solution HTK and St. Thomas Hospital solution with and without procaine.

Intracellular pH (pHi) has been measured in human or cat ventricular muscle during 60, 120 and 180 minutes of cardiac arrest by Bretschneider's cardioplegic solution HTK or St. Thomas solution with and without procaine. In 319 control measurements in modified Tyrode's solution pHi (mean, S.D.) was 7.38 +/- 0.02 (n = 128) during the first hour, 7.36 +/- 0.03 (n = 112) during the second hour and 7.35 +/- 0.03 (n = 79) in the third hour. The pHi in right ventricular muscle of the cat and left ventricular human muscle did not differ significantly during the time of measurements (Bretschneider HTK). The values (human/cat) in the first hour were 6.85 +/- 0.03 for both groups, 6.72 +/- 0.04/6.68 +/- 0.04 during the second hour and 6.70 +/- 0.03/6.67 +/- 0.05 in the third hour of measurement. The values for the St. Thomas solution with/without procaine were 6.83 +/- 0.02/6.74 +/- 0.03 in the first hour, 6.79 +/- 0.02/6.82 +/- 0.04 during the second hour and 6.68 +/- 0.03/6.82 +/- 0.02 in the third hour. An important difference to all other solutions was the observation made under the St. Thomas solution with procaine, that after recovery to normal values pHi decreased between the 2.-5. minute to values of 6.39-6.48 when the preparations were superfused with Tyrode's solution again. No recovery within 1 hour was observed. This fall in pHi was accompanied by a contracture.

Action Potentials↗
PubMed1984

[Stress tolerance following traumas of the thorax and great vessels].

After clinical investigation the most important diagnostic procedure is the simple chest X-ray in upright position. In case of hemothorax or pneumothorax the insertion of a large chest tube in the third of fourth intercostal space is necessary. Patients with traumatic flail chest and paradoxical respiration need first of all immediate intubation and artificial respiration, afterwards operative stabilization is beneficial in selected patients. In case of severe intrathoracic hemorrhage and in case of injuries of the lungs, heart and great vessels an active surgical approach is a life-saving treatment. Apart from patients with very bad general condition the usual diagnostic measures and an adequate conservative or surgical treatment can always be tolerated by the patient considering his life threatening condition.

Aorta, Thoracic↗
PubMed1983

[Surgical treatment of aortic isthmus stenosis in adults].

The report refers to a group of 34 adult patients. End-to-end anastomosis was performed in 15 cases, interposition or bypass of prostheses in 13 cases and plastic operations in 6 cases. The surgical mortality rate came up to 2.9%. Paradoxical hypertension encountered in 19 cases was the main problem in the postoperative period.

Adolescent↗
PubMed1981

Prolonged safe ischemic cardiac arrest using hypothermic Bretschneider cardioplegia combined with topical cardiac cooling. Clinical experience with cardiac arrest of up to 180 minutes in a few borderline cases.

Out of 494 patients operated upon using Bretschneider cardioplegia, 8 complicated surgical procedures (3 cases of single or double valve replacement combined with coronary bypass grafting, 2 cases of double valve replacement, 2 cases of multiple coronary bypass procedures and one case of aortic valve replacement with replacement of the ascending aorta) required a mean aortic cross-clamp time of 164 minutes. Four patients had a single infusion, and 4 other patients 2 or more infusions, of cold cardioplegic solution. With the aid of topical cooling, the myocardial temperature was reduced to a mean value of 12.8 degrees C. Postoperatively the heart in all patients resumed a good contractile activity. None sustained myocardial infarction during the perioperative or postoperative period. One patient died on the 19 postoperative day because of subdural hemorrhage not related to the cardioplegic procedure. All other patients have survived from 10 to 63 months (mean 23 months).

Coronary Artery Bypass↗
PubMed1978

[Surgical treatment of the flail chest (author's transl)].

Six patients with traumatic flail chest underwent surgical stabilization using a procedure introduced by Brunner, Hoffmeister and Koncz (2). Compared with internal stabilization by intermittend positive pressure respiration (IPPR), there are some advantages: Time of artificial respiration is shortened, early mobilization is possible, nursing is easier. The procedure is simple to do and is indicated in those patients, in whom longterm artificial respiration is not necessary for other reasons.

Adult↗
PubMed1977

[Cardioplegia according to Bretschneider for valve replacement: clinical experiences and electronmicroscopical results (author's transl)].

We report about clinical experiences with the cardioplegia according to Bretschneider combined with deep selective hypothermia of the heart in 44 patients. Before, during and after cardioplegia we made biopsies from the left ventricle of 6 patients for electronmicroscopical examinations. Besides the mitochondrial changes already known we saw a break-down of the nexuses. We discuss the importance if these changes for the action of the cardioplegia. Both changes seemed to be reversible. The clinical results and the immediate and later postoperative follow-up demonstrate, that with the described technique a good myocardial protection can be done. This procedure allows operating with a low risk at a completely arrested and relaxed heart until 130 minutes.

Adult↗