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Biomedical subjects

K W Schneider

Publications and source records attributed to K W Schneider.

18 recordsLinked to original sources
PubMed1978

[Transfemoral embolus aspiration from both renal arteries].

In a 50-year-old female patient who had suffered from coronary heart disease for about 3 years, a cerebral embolus resulted in left-sided hemiparesis. Four days later she became anuric. Acute thromboembolis occlusion of the renal arteries was assumed and renal angiography was performed. The angiography showed complete obstruction of the left renal artery and partial obstruction of the right renal artery. Due to the poor general condition of the patient it was not possible to carry out renovascular surgery or streptokinasetherapy. An attempt was therefore made to remove the emboli from the renal arteries by a new technique (transfemoral embolus aspiration). The subsequent angiography showed normal circulation in the right kidney and improved circulation in the left kidney. Ten days of dialysis treatment were required until urine production started again. Death then occurred from other causes. The autopsy confirmed free permeable renal vessels and absence of permanent sequelae in the parenchyma.

Aortography↗
PubMed1978

[Heart tumour in the right atrium: clinical recognition and therapeutical management (author's transl)].

A 62 year old lady came to the hospital in cause of right heart failure. Right and left heart catheterization and cineangiocardiography revealed a tumour in the right atrium. Further angiographic investigations demonstrated a hypernephroma in the left kidney. The operation of both tumours was successful. Pathohistological examination confirmed the diagnosis of hypernephroma in the left kidney with metastasis into the right atrium.

Adenocarcinoma↗
PubMed1978

Effect of beta-sympatholytic agents on vascular responses to noradrenaline and potassium chloride.

Vasoconstrictory responses to noradrenaline (NA) or high potassium chloride (130 mM) usually show a biphasic behaviour: an initial peak is followed by a lower steady state level. The influence of three beta-sympatholytic agents (propranolol, pindolol, practolol) and a "Ca-antagonist" (verapamil) on this particular behaviour of KCl-induced vasoconstrictions was compared with responses to NA. Studies were performed on the intact vascular bed of an isolated intestinal preparation of the rat. 1. Increases in the concentration of propranolol and pindolol from 10(-10) to 10(-6) M attenuated the vascular responses to high KCl. Practolol, however, distinctly enhanced the KCl-responses. NA (1.3 microgram/ml)-elicited vasoconstriction was found to be influenced in a similar manner by the beta-receptor antagonists used, though lower concentrations of pindolol had an enhancing, higher concentrations a reducing effect on the constrictory responses to NA. 2. The extent to which the biphasic response adjusted to the steady state level was concentration-dependently increased KCl-responses and significantly decreased to a monophasic response to NA, in the presence of the beta-sympatholytic agents. 3. By using a quotient of deltaPs (steady-state phase) to deltaPi (initial vasoconstriction) and by comparing the effect of the three beta-sympatholytic agents with that of verapamil on this quotient showed a concentration-dependent decrease in presence of the beta-sympatholytic as well as of the Ca-antagonistic agents. These myotropic actions, i.e. negative influences on the mechanism of vascular smooth muscle activation ranged in the following sequence: Verapamil greater than propranolol greater than pindolol greater than practolol. 4. The mechanism underlying the biphasic responses to high potassium chloride are concluded to be basically different from the NA-responses because they are inversely affected by beta-sympatholytic agents. The steady-state response to KCl was found to be very sensitive to non-specific pharmacological actions of beta-sympatholytic substances. The myotropic action of the beta-receptor antagonists is compared with that of the Ca-antagonist verapamil and the role of calcium in the mechanism of activation of vascular smooth muscle is discussed.

Adrenergic beta-Antagonists↗
PubMed1977

[Mitral valve replacement in large hearts (author's transl)].

Of 61 patients with mitral valve defects operated on, 9 had a heart with an external volume of more than 1700 ml. Five of these patients died, four are still alive today. Three patients from the group with an external heart volume between 1247 ml and 1700 ml died, and in the group of patients with an external heart volume of less than 1247 ml no patient has died as yet. Under certain circumstances, the preoperative size of the heart can be a measure with which the limits of surgical mitral valve replacement can be defined.

Adult↗
PubMed1977

Arteriosclerotic coronary arterial aneurysms in a 49-year-old man with crescendo angina: family history, natural course and prevalence.

In a 49-year-old man with crescendo angina, elevated serum cholesterol level and an old posterior myocardial infarction, selective coronary arteriography showed multiple arteriosclerotic aneurysms of the right coronary artery associated with extensive and severe arteriosclerotic disease of the left coronary artery. The patient's mother and brother have both died of a myocardial infarction. Another brother suffers from angina and has documented arteriosclerotic coronary artery disease. Two sisters suffer from angina as well. The possibility of embolization of distal vessels from a friable clot of the aneurysms as a cause of the patient's infarction is discussed. To the best of our knowledge, this is the tenth patient with nonfistulous arteriosclerotic coronary artery aneurysm diagnosed and documented angiographically ante mortem. Including the present case and reviewing the literature, the prevalence of this condition among nonfistulous coronary aneurysms diagnosed ante mortem is 35 per cent and henceforth cannot be regarded as an incidental autopsy finding in cardiac asymptomatic patients.

Aneurysm↗
PubMed1976

[Coronary arteriography in threatened myocardial infarction. Performance and results (author's transl)].

Within 12 months, 315 coronary arteriographies were performed by the Sones-technique. There were no deaths. 6 of these patients with impending infarction were investigated as out-patients. Six patients with impending reinfarction were hospitalized before coronary arteriography. Nine patients were transferred to the Department of Cardiovascular Surgery of the University Hospital of Erlangen within 4-24 hours after the beginning of coronary arteriography. For one patient there was a transfer delay of 48 hours and in a second case 2 months. No problems arose from the geographical separation of both departments and the ambulant catheterization in certain cases.

Ambulatory Care↗
PubMed1976

[Significance of risk factors of functional disorders of pacemakers (author's transl)].

In spite of increasing reliability of pacemakers and expensive electronic monitoring systems unforeseen disorders of the regular stimulation of the heart cannot be prevented with certainty. Criteria are given by which the individual risk of the carrier of a pacemaker can be determined, so that the degree of danger can be foreseen. Individual methods of monitoring and in particular checking intervals adapted to the risk are suggested.

Aged↗
PubMed1975

[Coronary angiography in the pre-infarct syndrome (author's transl)].

During the first ten month of the past year (1974) we did 310 selective coronary arteriographies by the Sones technique at the Department of Cardiology of the Medical Clinic Würzburg. The incidence of complications in this comparatively small group was 0%. In seven cases we did an emergency coronary arteriography. Six of these patients were transferred immediately after examination to the Department of cardiac Surgery of the University of Erlangen for emergency aortocoronary vein bypass. One of these patients died within the next 6 hours postoperatively. Five patients in this group are in good condition. Three patients had a double aorto-coronary vein bypass.

Aneurysm↗
PubMed1975

Concealed retrograde conduction of an atrial echo in second degree A-V block of the Wenckebach type with modified ventricular acceleration.

Whereas second degree A-V block showing the classical pattern of the Wenckebach phenomenon is easily diagnosed, variant forms of the Wenckebach phenomenon in second degree A-V block may pose difficulties to the interpretor. A case is presented, where modified acceleration of the ventricles--a crucial "pointer" to the Wenckebach A-V block -- is disturbed by concealed conduction of an atrial echo. Differences in the electrocardiographic manifestation between this and the classical type of second degree A-V block of the Wenckebach type are discussed.

Atrial Fibrillation↗
PubMed1975

A modified technique for transseptal angiocardiography: review of 186 cases.

Perforations of the left atrial or ventricular wall and extravasations of contrast medium during transseptal left heart catheterisation or angiocardiography can be eliminated by replacing the normally used transseptal catheters by Pigtail-catheters. With only 2.8% minor complications without sequelae in 181 successful studies, transseptal angiocardiography of the left heart through Pigtail-catheters is not only less hazardous than injections through the transseptal catheters used up to now, but possibly bears even less risk than direct retrograde injection into the left ventricle. The best method of showing the left atrial cavity and the mitral valve is transseptal left atrial injection. According to our findings in the evaluation of the ventricular function by means of quantitative angiocardiography, transseptal angiocardiography with injection into the left atrium is preferable to retrograde direct ventriculography, as ventricular ectopic beats were absent and supraventricular ectopic beats were as rare as 5% of cases. With this method, local disturbances of wall motion during injection could also be avoided and one or two more cycles could be evaluated before the depressant effect of contrast medium started.

Angiocardiography↗
PubMed1975

[A new method of transseptal levocardiography].

Perforations of the left atrial or ventricular wall and extravasations of contrast medium during transseptal left heart catheterization or angiocardiography can be eliminated by replacing the routinely used transseptal catheters with Pigtail-catheters. With 2.8% minor complications without sequelas in 181 successful studies, transseptal angiocardiography of the left heart through Pigtail-catheters is not only less hazardous than injections through the transseptal catheters employed up to now, but bears even less risk than direct retrograde injection into the left ventricle. To show the left atrial cavity and the mitral valve, transseptal left atrial injection is the method of choice. For quantitative angiocardiography to evaluate left ventricular function, transseptal angiocardiography with injection into the left atrium is superior to retrograde direct ventriculography in our experience, as ventricular ectopic beats were absent and supraventricular ectopic beats as rare as 5% of the cases, local disturbances of wall motion during injection could be avoided and 1 or 2 more cycles could be evaluated before the depressant effect of contrast medium started.

Angiocardiography↗
PubMedDate not supplied

[Myocardial metabolism under intravenous infusion of glucagon (author's transl)].

In 7 healthy-hearted probands the arterial-coronary-venous oxygen difference for glucose, K+, lactate, pO2, pCO2 and pH during a glucagon infusion was determined and compared with the values before and 10 minutes after infusion. Contradictory to the unchanged myocardial lactate extraction and the positively or negatively influenced K+-uptake recorded in the literature, in this contingent there was a statistically significant myocardial lactate production and an unchanged potassium uptake. The respiratory quotient of the heart increased. These changes are regarded as the result of a direct hormonal influence on the myocardial metabolism and have nothing to do with the change of an aerobic into an anaerobic metabolic state.

Arteries↗
PubMedDate not supplied

[The effect of intravenous infusion of glucagon on the contractility of the left ventricular myocardum in man (author's transl)].

In the cases of 10 cardially healthy humans and 5 patients with heart disease, the left ventricular pressure as well as different parameters of contractility - deduced from the pressure curve and its first derivative - were determined by a catheter-tip manometer (Statham SF - 1). In particular the following values were concerned: dP/dtmax,-dP/dtmaxDP, the maximal calculated shortening velocity of the contractile elements according to the 2-component heart muscle model (VCEmaxTP) as well as with the Maxwell model (VCEmaxDP) and finally the (extrapolated) maximum shortening velocity (Vmax) under a fictive zero load. The examinations were carried out before and during a 10-minute infusion of 60 mg/kg glucagon and 10 minutes after completing the infusion. Besides glucagon also digoxin, etilefrin-HCl-1) and orciprenaline-2) were delivered and the same measurements were performed as with glucagon. A definite statement about the priority of any one of the named indices of contractility is rendered more difficult, because the enddiastolic pressure does not change substantially with glucagon. An unequivocal demarcation of frequency and pressure effects and of inotropic mechanisms as just as impossible, because, with the exception of VmaxDP, all parameters react quantitatively and qualitatively in an equal manner. On the basis of VmaxTP the result of glucagon is only a slight increase in the myocardial contractile capability, which would hardley suffice for the treatment of patients, who do not respond to digitalis. The decline of VmaxDP under glucagon cannot be explained. Under digitalis, etilefrin and orciprenaline, a similar dissociation of values for the maximum shortening velocity according to the 2- or 3-component-model of the heart muscle cannot be demonstrated.

Adolescent↗