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Biomedical subjects

O Wagner

Publications and source records attributed to O Wagner.

At least 109 records · Page 6Linked to original sources
PubMed1985

[Possibilities and problems of the detection of dementia syndromes in middle and advanced age using psychological tests].

In Gerontopsychiatry, standardised psychological methods are applied to investigate early stages of dementia, to quantify cerebral dysfunctions and to evaluate the degree and severity of dementia. Only some psychological tests and rating scales are apt to differential diagnosis: A clinical comparison of demented and depressive patients proved significantly different in three out of twelve psychological tests applied. The performance of memory, perception and reproduction of geometric forms (Benton Visual Retention Test) and the choice-reaction time was reduced in demented patients. Patients with different dementia types could not be differentiated by means of psychological tests. To verify the diagnosis of vascular dementia, a clinical-psychiatric Scale ("Ischemic Scale") proved to be of good clinical value.

Aged↗
PubMed1985

Tissue plasminogen activator inhibitor in human plasma: development of a functional assay system and demonstration of a correlating Mr = 50,000 antiactivator.

An assay system for determination of the "fast"-acting inhibitor (antiactivator, AA) of tissue-type plasminogen activator (tPA) in human plasma was developed. The system is based on incubation of plasma samples with various amounts of vessel wall-derived tPA for 8 minutes at 25 degrees C, followed by acidification and determination of the residual tPA activity by an indirect spectrophotometric assay. One unit of AA was defined as the amount inhibiting 1 U of tPA. AA levels in normal controls (n = 26) were 1.4 to 17.4 U/ml (median 3.0 U/ml) and 0.9 to 17.5 U/ml (median 3.0 U/ml) in patients with a history of deep venous thrombosis (n = 26). When plasma was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by reverse fibrin autography, AA activity appeared as an inhibitory band corresponding to a relative molecular mass of 50,000. In six samples the inhibitory activity of this band was directly correlated to the functional AA activity of the plasma samples.

Electrophoresis, Polyacrylamide Gel↗
PubMed1984

[The PTFE plastic prosthesis as an arterial replacement: experiences over a 5-year period].

Unilateral iliac femoral reconstructions with PTFE are yielding good results-similar to those with Dacron, with patency rates of 75, 67, and 65% at 1, 2 and 3 years, respectively (Kaplan-Meier). PTFE has additional advantages compared with other materials: a) no need of preclotting; b) smooth inner surface-easy thrombectomy in case of thrombosis and c) good handling characteristics. In view of the above-mentioned facts PTFE can be recommended without restriction for unilateral pelvic reconstructions. The functional early results of bilateral aorto-femoral Goretex-Y bifurcation grafts in 50 cases after 2 years are encouraging. Long-term results are still pending. Reports of other groups using this material as aorto-bifemoral substitute are not yet available. The functional results with PTFE for femoro-popliteal grafts are not satisfactory: 35% after 2.5 years. Extra-anatomical bypasses yielded 70% one-year functioning rate. Especially the ring-or spiral-armoured PTFE grafts seem to be suitable for these reconstruction procedures.

Aged↗
PubMed1984

[Anastomotic aneurysms as a late complication of reconstructive vascular surgery of the lower extremity].

29 operations were performed because of an anastomotic aneurysm in 25 patients. The incidence of false aneurysm was 0.7% (4079 reconstructive operations from 1964 to 1979). Arterial reconstructions previous to the formation of aneurysm were: aorto-femoral bifurcation graft 9, ileo-femoral bypass 9, femoro-popliteal reconstructions 11 (4 of them were Sparks' prostheses). 31% of the cases had complications (rupture, thrombosis) when operated, 73% were located in the groin. At the primary operation mostly Dacron had been used. In all instances non-absorbable synthetic suture material has been applied. If the interval between the first operation and the formation of the aneurysms is short infection is to be suspected. The diagnosis of aneurysms distal to the inguinal ligament is easy, aneurysms of the iliac region were found after complications (rupture, thrombosis) had occurred. The most frequent reconstructive procedure was graft interposition, but aneurysmorrhaphy was successful in certain cases. Two patients died postoperatively. Follow-up showed one recurrence (in the groin). We suggest that 1) insufficiency of the suture line because of tension 2) dilation of prosthetic dacron material have great importance for formation of anastomotic aneurysm, whereas local endarterectomy or end-side anastomosis do not seem to be significant.

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PubMed1984

[Early postoperative morphology of the carotid artery following endarterectomy: systematic prospective studies with a high resolution ultrasound real-time imaging system].

The ultrasonic morphology of the carotid artery following 55 endarterectomies in 50 patients was systematically studied using a high resolution ultrasound duplex system. The typical findings were: At the site of endarterectomy the new vessel wall showed: lack of the "sonographic tunica intima"; the thickness of the vessel wall was reduced with less pronounced ultrasonic structure compared with healthy subjects; the surface toward the lumen was less smooth; "ultrasonically soft" thrombotic layers with irregular surface, individual distribution (sometimes only spots) and thickness (0.5 to 4.0 mm) were seen in the majority of patients. The edge of the tunica intima was always visible in the common carotid (edge of endarterectomy), whereas in the internal carotid artery there was often an interference of the jaw. The change of caliber at the site of the edge of the tunica intima was dependant on the thickness of the "sonographic intima" as well as on the layer of the vessel wall in which endarterectomy was done. At the site of arterial clamping intramural haematomas, lesions of the tunica intima with thrombotic layers causing some stenosis were observed after 9 of 55 procedures. Vascular sutures were always visible as bright spots. A "normalisation" of the pulsatory motion of the vessel wall as well as "normalisation" of local flow patterns could be seen in dependence on the morphological "normalisation". The soft thrombotic layers of the new vessel wall were especially pronounced at sites of incomplete endarterectomy, in one case with change of the vessel geometry and in another case were the opposite carotid was operated on 3 days later. Obviously, a short phase of high instability of the endarterectomy site (3 days, development of the platelet-fibrin layer) is followed by a period of relative instability of the new vessel wall, which lasted for 4 to 8 weeks. In 5 patients with central neurological deficits following surgery, especially pronounced soft thrombotic layers of the new vessel wall including 2 complete occlusions and 1 near-occlusion were observed.

Aged↗
PubMed1984

Efficacy of nitrendipine as baseline antihypertensive therapy.

To determine whether calcium antagonists might be used alternatively to beta-blockers in antihypertensive therapy, we investigated if monotherapy with oxprenolol (160-320 mg/day) and nitrendipine (20-40 mg/day) were equally effective on clinical casual blood pressure (BP), ambulatory BP monitoring (Remler), and BP during mental challenge (video game). In a prospective randomized long-term study, 60 white male civil servants (mean +/- SD = 43 +/- 6 years) with mild essential hypertension only were treated for at least 4 months. Average BP before therapy was 149 +/- 11/97 +/- 11 mm Hg. The antihypertensive effect was not different between the two groups (19/14 versus 21/12 mm Hg). Both groups did not differ in BP at rest, in BP during mental challenge (141 +/- 7/109 +/- 5 versus 146 +/- 9/112 +/- 8 mm Hg, NS), and average ambulatory BP monitoring at work (122 +/- 12/81 +/- 17 versus 132 +/- 14/79 +/- 17 mm Hg, NS), which was identical with the clinical casual BP. Thus, nitrendipine can effectively be used in long-term baseline antihypertensive monotherapy.

Adult↗
PubMed1984

Postoperative assessment of below-knee bypass grafts.

Our results seem to demonstrate that, even when healthy or arteriosclerotic arteries tolerate knee flexion without any impairment of blood flow, all bypass materials, to a certain extent, have a tendency toward morphologic changes, such as kinking, looping, stenosis and decrease of peripheral blood flow. Reocclusion in below-knee reconstruction, which cannot be explained by poor outflow situation or technical faults, might be related to the graft material used as well as hemodynamic changes caused by flexion of the knee joint. With the use of ASV grafts, these changes are minimal and of little or no clinical importance; when HUV is used, these changes are more distinctive and might, in some instances, be the cause of reocclusion. This could explain the difference in the late results with the use of ASV or HUV. The results of reinforced PTFE still await evaluation. However, it should be kept in mind that the results in addition to the already mentioned influences are also caused by neointima proliferation and progression of the disease.

Aged↗
PubMed1984

[The PTFE-Y bifurcation prosthesis: early results].

During the past 2 years (April 1981-March 1983) 50 PTFE Y-grafts were implanted. The early results are good. Except one graft limb occlusion (8 months postoperatively), which was successfully managed by thrombectomy, all grafts are functioning well or did so until death. 5 patients (age 70-84 years, aortic aneurysm, additional vascular surgery) died 1 day to 8 weeks postoperatively. The death was not specifically related to the material of the new prosthesis. Advantages of PTFE are: a) no need of preclotting; b) absolute tight body of the prosthesis even in the heparinized patient; c) thrombectomy is easy to perform. Important technical details, mandatory for a safe operative procedure and for good functional as well as morphological results, are reported.

Adult↗
PubMed1983

[Subclavian-carotid artery transposition in the therapy of lesions of the proximal subclavian artery].

Employing an extrathoracic approach 10 patients were operated upon for 12 obstructive lesions of the subclavian arteries using carotid-subclavian anastomosis. The operation was indicated 3 times for the pathological entity of arterial stenosis embolizing into the vascular periphery, 3 times for claudication of the upper extremity and 4 times for cerebro-vascular insufficiency. Followed up to 31 months all anastomoses remained patent. All the complications were managed conservatively and were considered of minor importance.

Adult↗
PubMed1983

Lymphocyte transformation and isovolemic hemodilution with hydroxyethylstarch 450,000.

The effect of hemodilution upon lymphocyte transformation was studied in vivo. 20 p.c. of circulating blood volume was replaced by Hydroxyethylstarch 450,000 6%, (HES 450) and 24 hours later but prior to surgery lymphocyte transformation using PHA was not substantially changed. These findings were in accord with previous in vitro studies. There appeared to be no significant change of the total lymphocyte count, alteration of serum proteins seemed to be proportional presenting a mere dilutional phenomenon. It can thus be concluded that hemodilution does not impair cellular immune defense nor increase the risk for patients prone to sepsis or spread of malignancy.

Blood Cell Count↗
PubMed1983

[Functionally satisfying reconstruction of a combined abdominal, chest wall and diaphragmatic defect with corium following sternum tumor resection].

In a patient, suffering from a chondrosarcoma in the lower sternum, and having undergone radical tumor resection, we had to reconstruct the thoracic wall, the abdominal wall, and the diaphragm. This was done with autologous corium. We report on the advantages of this material and at the same time refer to that of a complete physiologic reconstruction of the diaphragmatic dome seems impossible if accompanied by defects of the thorax and the abdominal wall. Fitting a corset appears necessary as an external support.

Abdominal Muscles↗
PubMed1982

[Surgical therapy of malignant bone tumors and results of the treatment].

The surgical management of bone metastases should relieve pain and improve function. Of the operative cases (170 in the last 10 years), 30% underwent resectional therapy with successful implantation of an endoprosthesis. Surgical management of primary malignant bone tumors should result in cure. Since 1976, in 44 of 54 cases of osteosarcoma a tumor resection was performed and in 40 cases the operation was adequate. A rotation plasty operation was performed in 15 of the 44, a tumor endoprosthesis was implanted in 22, and other methods were used in seven.

Bone Neoplasms↗
PubMed1982

[Results of renal transplantation in childhood].

37 renal allografts were performed on 27 children of 2-16 years of age. In 67% function was maintained for more than a year. At the beginning of 1981, 13 children had functioning grafts with a median serum-creatinine level of 1.8 +/- 1.2 mg%. 4 children had a functioning graft for more than 7 years. All children with functioning grafts were fully rehabilitated. Hence, renal transplantation is the optimal therapy in chronic renal insufficiency in childhood.

Adolescent↗