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Biomedical subjects

M Smola

Publications and source records attributed to M Smola.

10 recordsLinked to original sources
PubMed1992

[Modern cardiac pacing. I. Dual-chamber pacemakers: 10 years' experience].

Dual chamber cardiac pacemakers restoring an impaired atrioventricular synchrony meet a demand of contemporary so-called physiologic cardiac pacing. 39 dual chamber (DDD) pacers were implanted in 1982-1991 in our center. They improved both well-being and hemodynamic values (doppler echocardiography) more distinctly than common ventricular demand devices did. P-wave driven ventricular pacing in normal sinus node function (in 40 per cent of our DDD patients) made a frequency response in physical exercise possible. A short atrioventricular delay in DDD pacing proved to be helpful in the treatment for reentry tachycardias refractory to antiarrhythmic drug administration. Demanding implant, high price, lengthy programming as well as a higher incidence of complications (30.7 per cent) as compared to ventricular pacemakers (7.6 per cent) were the main problems of DDD ones.

Adult↗
PubMed1992

[Modern cardiac pacing. II. Rate responsive pacemakers: clinical experience].

Rate responsive cardiac pacemakers adapting their pacing frequency according to physical effort are able to solve not only a bradycardia, but a chronotropic incompetence too. 23 rate responsive pulse generators, implanted in 1987-1991 in our center, simulated the physiological conditions and in this way they significantly improved both working capacity in bicycle stress test (p < 0.0001) and well-being in comparison with ordinary demand pacers. The incidence of complications did not exceed that in simple common pacemakers, but the rate adaptive ones were expensive and their programming was time consuming. In all three rate adaptive principles used their non-specific response revealed some imperfection of sensor driven devices. In addition, both in QT and in respiratory dependent systems their pretty proportional frequency response was delayed, while the irregular pacing rate in body activity sensor was not very proportionate to the physical exercise. The non-specific sensor response may be reduced by a combination of biologic sensors.

Adult↗
PubMed1991

Prednimustine combined with mitoxantrone and 5-fluorouracil for first and second-line chemotherapy in advanced breast cancer.

A total of 60 patients with advanced breast cancer were treated with a combination of prednimustine (P: 110 mg/m2, days 1-5), mitoxantrone (M: 12 mg/m2, day 1) and 5-fluorouracil (F: 500 mg/m2, day 1) (PMF). Treatment was repeated every 3 weeks. In all 53 patients were evaluable for response. A total of 12 subjects had failed prior chemotherapy for metastatic disease. In response to PMF treatment we observed 21 partial remissions and 3 complete remissions, amounting to a total response rate of 45%. The median duration of response was 39 weeks, and median survival was 56 weeks. Dose-limiting side effects were leukopenia (40 cases) and thrombocytopenia (11 patients). Nausea and vomiting was experienced by 93% of subjects; in 56% of cases it reached WHO stage II-III. Alopecia occurred in 18% of our patients. Our results suggest that PMF represents an active regimen in the treatment of advanced breast cancer and yields a response rate of 45%. Considering that the majority of our patients had not received prior chemotherapy, the question remains open as to whether a 45% response rate outweighs the observed toxicity.

Adult↗
PubMed1990

[Perioperative subjective emotional state].

The aim of adequate preoperative medication is to minimize the patient's anxiety level. Preoperative anxiety can be consciously and specifically orientated or it can be masked. This double-blind study was performed to evaluate the effects of an anxiolytic drug in comparison with a placebo perioperatively and to assess the post-operative course of the important factors anxiety, depression and asthenia. The Mannheim inventory for subjective state and STAI (State-Trait-Anxiety-Inventory) were offered. The study was undertaken in 60 female patients, who were operated for suspected carcinoma of the breast. We conclude that in such a specific group of patients extensive preoperative psychological preparation must be backed up by the administration of an anxiolytic drug.

Adaptation, Psychological↗
PubMed1990

4'-O-tetrahydropyranyl-doxorubicin in advanced breast cancer: a phase II study.

In a phase II study, 35 patients with advanced breast cancer were treated with 4'-O-tetrahydropyranyl-doxorubicin (THP-DXR) (70 mg/m2 i.v. on day 1); treatment was repeated every 3 weeks. Eight patients had failed prior chemotherapy for advanced disease. A total of 34 patients were evaluable for response. After a median of 10 treatment courses (range, 3-15), objective tumor response was seen in 59% (20 of 34 patients) (95% confidence limits, 42%-75%). In all, 17 partial remissions and 3 complete remissions were observed; stable disease occurred in 13 patients. The median duration of response was 42+ weeks (range, 21 - 77+ weeks). The dose-limiting side effects were leukopenia (26 patients, WHO grade III-IV) and thrombocytopenia (9 patients, WHO grade II-IV). Nausea/vomiting was experienced by 34 patients; in 18, it reached WHO grade II-III. Other treatment-related side effects included alopecia (WHO grade II-III) in 26 patients and stomatitis and diarrhea (WHO grade I-III) in 9 patients. At cumulative doses of THP-DXR of at least 700 mg/m2 (range, 700-1,050 mg/m2), no signs of congestive heart failure were observed. We conclude that THP-DXR is effective for first- and second-line chemotherapy in advanced breast cancer and that side effects are manageable.

Adult↗
PubMed1989

Multiprogrammable pacemakers: are their advantages fully employed?

Out of 1265 pacemakers implanted between 1981 and 1987 in our center, 50 (4.0 percent) were of SSI M mode. Utilization of the programming capability of these multiprogrammable single-chamber pulse generators was investigated. All devices were programmed to the "energy saving mode" ensuring the longest lifetime possible. Half of them did not have to be reprogrammed for any other reason, the other half had to be programmed for cardiological and/or technical dysfunctions. Full utilization has been made of the programmability of these sophisticated and expensive units and their wide application is justified.

Arrhythmias, Cardiac↗
PubMed1987

[Complications and failures in free-flap transplantations].

Complications and failures in nine cases of free flap transfer are reported. With increasing experience the number of failures declines. In six of seven cases with total flap necrosis technique and tactics in microsurgical procedure were responsible for the disaster. The failure in the other case was due to thrombosis of an axillary vein and thoracodorsal vein leading to necrosis of a latissimus dorsi flap. A dorsalis pedis flap was saved by arterial inflow through a flap vein. The fact that not one flap could be saved by revision is accounted for by the circumstance that the monitoring looks at capillary filling alone. It is possible that the Laser-Doppler-flowmetry is a useful and practical method for objective monitoring.

Adult↗
PubMed1987

[Stonefish stab injury of the hand].

The authors report a sting injury by a stonefish in the hand. First aid and surgical treatment are discussed. The biology of the stonefish is reviewed.

Adult↗
PubMed1985

[Established and new surgical procedures in the therapy of breast cancer].

The established surgical procedure in the treatment of mammary cancer today is, without any doubt the modified radical mastectomy (Patey, Dyson). The adjuvant radiation therapy, following modified radical mastectomy, could not improve the all over survival of mammary cancer patients. Within the last years the breast conserving surgical procedures went more and more into the field of interest, especially of the patients. That is the reason, why these treatment-schedules should be considered very carefully according to thorough oncological principles. The radiation therapy within the conserving treatment is necessary as primary treatment in addition to surgery.

Breast↗