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Biomedical subjects

M Zander

Publications and source records attributed to M Zander.

30 records · Page 2Linked to original sources
PubMed1987

[Motion analysis of the Carpentier ring in the tricuspid position: an echocardiographic and hemodynamic study].

The echocardiographic and hemodynamic results before and after (30 +/- 4 months) mitral valve replacement and tricuspid valvuloplasty using a Carpentier ring were compared in 37 patients. The motion of the Carpentier ring in the echocardiogram was related to the pulmonary artery pressure curve and the intracardiac phonocardiogram for exact temporal relation. Pressure measurements were done using a tip micromanometer. Postoperatively 29 patients were clinically improved showing a decrease of the mean pulmonary artery pressure from 63 +/- 14 mm Hg to 41 +/- 18 mm Hg (p less than 0.001) as well as of the right atrial pressure from 13 +/- 4 mm Hg to 8 +/- 3 mm Hg (p less than 0.01). The postoperative decrease of the opening amplitude of the septal tricuspid leaflet from 22 +/- 3 mm to 10 +/- 4 mm (p less than 0.001) and of the EF-slope from 125 +/- 45 mm/s to 34 +/- 41 mm/s (p less than 0.001) in 9 patients was a sign of an inflow obstruction in the right ventricle. During the synchronous pressure measurement in the right ventricle and in the right atrium, a mean diastolic pressure gradient of 3.9 +/- 1.4 mm Hg was registered postoperatively in these patients. Five patients showed persisting right heart failure, in one a severe tricuspid regurgitation was still present, in 4 patients the pressure gradient exceeded 5 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗
PubMed1985

Echocardiographic and hemodynamic evaluation of carpentier tricuspid valvuloplasty.

To study the long-term results of tricuspid valvuloplasty, pre- and postoperatively (39 +/- 11 months), echocardiographic and catheterization data were collected in 37 patients (mean age, 58 +/- 8 years). Because of severe mitral stenosis, all patients received a porcine heterograft in the mitral position and underwent reconstructive tricuspid surgery with Carpentier rings (#32, n = 12; #34, n = 15; #36, n = 10). Sizing was performed by measuring the anterior leaflet area using an obturator. In nine patients, tricuspid leaflets were slightly shrunken at the insertion site of the chordae tendineae. Postoperative echocardiography and right heart catheterization were performed with simultaneous pressure recordings in the right ventricle and right atrium. A significant clinical improvement was noted in 24 patients, and this correlated with significant hemodynamic improvement. In eight patients, no clinical improvement was observed. Patients were divided into subgroups according to echocardiographic and hemodynamic criteria. Group A (n = 17) was composed of patients with significant improvement of hemodynamics, without detectable tricuspid valve dysfunction. Group B (n = 11) was composed of patients with slight-to-moderate tricuspid incompetence, detected by contrast echocardiography. In nine of these patients, the size of the RA and the diameter of the IVC were significantly smaller than preoperatively. In patients of Group C, echocardiography and catheterization data showed a slight-to-moderate tricuspid stenosis with a mean diastolic pressure gradient of 3.9 +/- 1.4 mm Hg (max 6.2 mm Hg, min 2.4 mm Hg). Although the area of the anterior tricuspid leaflet was slightly underestimated, we determined that long-term results of tricuspid valve annuloplasty with a Carpentier ring were encouraging.

Journal Article↗
PubMed1983

[Tumors of the colon following ureterosigmoidostomy].

This report presents three cases of colon tumors which developed after an ureterosigmoidostomy. In a checkup, four years after the operation, an inflamed polyp was found in one patient. The second patient developed an adenoma in the section of the colon where the ureter had been implanted. The last patient died of adenocarcinoma of the colon 26 years after her operation. Possible reasons for the development of the tumors, specifically the cancerous ones, are discussed. The risk of developing colon carcinoma is 500 times higher in those who have had an ureterosigmoidostomy than in healthy people. In the case that the ureters are rediverted the section of the colon where they were previously attached must be excised; since there is a strong possibility of cancerous development. To detect the early development of tumors in the colon, we suggest that patients have their stool tested for blood at regular intervals starting 3 years post operatively. If no problems arise barium enema and coloscopy are recommended every five years.

Adenocarcinoma↗
PubMedDate not supplied

Stability of vitamins in soybean oil fat emulsion under conditions simulating intravenous feeding of neonates and children.

The stability of the fat-soluble vitamins and thiamine, riboflavin, pyridoxine, ascorbate, and folic acid when administered as part of Intralipid 10% was evaluated. Intravenous pediatric vitamin formulations (Vitalipid N Infant and Soluvit Infant) containing the daily dose for term neonates were diluted with Intralipid to final volumes of 12.5 mL or 260 mL. The volumes were then delivered for 24 hours via dihexylethyl-phthalate-free in vitro infusion systems that simulated clinical conditions. The first vitamin-Intralipid admixture (12.5-mL volumes) was pumped (by syringe) during 24 hours through neonatal infusion sets placed in an incubator (37 +/- 1 degree C, bilirubin light). Aliquots were collected at the beginning of the experiment and after 24 hours of infusion. The second admixture (260-mL volumes) was pumped (by a peristaltic pump) through infusion sets during 24 hours and was exposed to periodic indirect sunlight and to continuous fluorescent light to stimulate the feeding of a child. Aliquots were collected at 0, 8, and 24 hours during administration of the admixtures. The vitamin concentrations were measured by high-performance liquid chromatography. The effect of the vitamins on the stability of the emulsion was also assessed by visual inspection, lipid globule size distribution, and pH change. Losses of vitamins vary from different experimental conditions and were for the fat-soluble vitamins essentially nil, except for phylloquinone, which was 5% to 17% below the initial level. Thiamine, pyridoxine, and folic acid were stable. Losses of riboflavin and ascorbate amounted to 10% to 20% and 9% to 52%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Stability↗
PubMedDate not supplied

Analysis of the measurement of four wound variables in elderly patients with pressure ulcers.

The suitability of four different methods for measuring pressure ulcer size was investigated during 10 consecutive weeks in a group of 11 elderly patients. The methods used were: 1. Volume measurement by filling the wound cavity with a gel 2. area measurement, by tracing the wound boundary outlined on transparent film with a digital planimeter 3. perimeter measurement, by tracing the wound boundary outlined on transparent film with a digital measuring pen 4. depth measurement using a millimeter probe. The mean values of the rate parameters for volume, area, perimeter, and depth were approximately in the proportions 3:2:1:1, which mirrors the inherent geometric dimensions of the corresponding variables. The methods used for measuring perimeter and depth were less reliable than the methods used for measuring volume and area. Thus, the use of both volume and area measurements in recommended. The former is best suited for deep ulcers and the latter for broad, irregularly shaped ulcers.

Aged↗