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Biomedical subjects

P Rehak

Publications and source records attributed to P Rehak.

At least 73 records · Page 4Linked to original sources
PubMed1993

"Mammacompliance": an objective technique for measuring capsular fibrosis.

The results achieved with silicone implants are usually assessed on the basis of the clinical and therefore subjective technique of Baker's classification. Yet, for scientific studies, more objective measurements are clearly necessary. For this reason, the calliper originally developed by Burkhardt and used for measuring compressibility of the breast was adapted, adding a force transducer and a distance-measuring device, which allowed us to plot a force-distance graph for each breast. In soft breasts, the curves obtained rise very slightly, while firm breasts produce sharply rising curves. The data computed from the graphs give the degree of "mammacompliance" and are expressed in centimeters at a defined force value. Sixty-eight augmented and reconstructed breasts were examined with this device. Measurements also were taken on a series of 59 normal, untreated breasts for comparison. A strong correlation was found between the mammacompliance values and Baker's classification. At the same time, the results revealed a number of clinical misjudgments. Our technique permits the objective assessment of capsular contracture. Being highly sensitive, it is an excellent method to control and monitor postoperative development and therapeutic concept.

Breast↗
PubMed1991

Postoperative myocardial ischaemia in patients with recent myocardial infarction.

Fifteen patients (10 men and five women; mean age 67.3 yr) with a history of a recent (less than 1 yr) myocardial infarction underwent ambulatory ECG monitoring for 5 days after non-cardiac surgery. The duration, number and severity of ischaemic episodes were maximal within the first 12 h after surgery and again on the 3rd day after operation. The difference in the duration of ischaemic episodes between the 2nd and 3rd days after operation was statistically significant (P less than 0.05). There were no perioperative myocardial infarctions and all patients were discharged from hospital.

Aged↗
PubMed1990

[Preoperative risk assessment: long-term electrocardiography for directed diagnosis of arrhythmias].

The role of ambulatory electrocardiography for detection, confirmation, or exclusion of severe forms of arrhythmias was investigated in our preoperative anesthesia clinic. In a prospective study over a period of 21 months, 30 of 8935 preoperatively evaluated patients (0.3%) scheduled for noncardiac surgery were monitored by 24-h ambulatory ECG. Indications included common clinical reasons for ordering an ambulatory ECG and additional specific "anesthesiologic" indications: Syncopes, dizziness, or other manifestations possibly related to cardiac arrhythmias; Rhythm disturbances under antiarrhythmic drug therapy; Suspected paroxysms of supraventricular tachycardia; Q-T syndrome, R- on-T phenomenon; Insignificant rhythm disturbances in patients with significant cardiac disease such as cardiomyopathy, aortic stenosis, mitral valve prolapse; Rhythm disturbances in patients with poor general medical status; Recent myocarditis with arrhythmias; Previous known or suspected intraoperative cardiac complications; Suspected sick sinus syndrome. The mean age of the patients was 63.9 years; most (24/30) were classified as ASA III. In 4 patients with suspected bradycardic rhythm disturbances the ambulatory ECG proved a useful method for further decision-making compared to the routine resting ECG. According to the long-term ECG recordings 22 patients were classified as Lown IV. After effective antiarrhythmic therapy--usually with propafenon--none of these patients (n = 13) or those classified as Lown 0 to III (n = 8) showed intraoperative arrhythmias or other hemodynamic problems. In contrast, of the patients with complex rhythm disturbances refractory to antiarrhythmic drug therapy (n = 4) or those in whom emergency operations were performed without antiarrhythmic drug therapy (n = 2), 4 developed severe arrhythmias or other intraoperative hemodynamic problems. Two died on the 1st postoperative day.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[The preoperative outpatient clinic--possible use of a personal computer].

Since 1977, the Department of Anesthesiology of the University of Graz has had a preoperative clinic. Since August 1988 we have processed current data using a personal computer (PC). We have adapted an IBM-compatible PC and a commercial data-processing program (dBase III plus) for the special requirements of the preoperative clinic. The procedure is directed by menus and is also easy to learn for non-professionals. Important functions have been executed automatically by the current program, such as loading the software or securing the data on a floppy disk. No additional work is necessary for data input. Every test result can be supplied immediately by a printer, whereby important parameters are denoted as such. After 13 months of testing, we could see that the use of a PC offers an inexpensive possibility for processing medical data with the help of electronics. The installation was not destined to remain a short trial, but will become a permanent system at our clinic.

Anesthesiology↗
PubMed1988

[Value of 24-hour long-term pH monitoring with computer-assisted evaluation in gastroesophageal reflux disease].

There are a variety of diagnostic procedures in use to confirm the diagnosis gastroesophageal reflux (reflux-esophagitis, GER). The accuracy of the described methods are different. Computerized 24 hours long term pH monitoring has established to be a very reliable procedure in the diagnosis of GER. From 1984 to 1986 134 patients underwent 24 hours pH monitoring besides X-ray, scintiscan, and esophageal-manometry. The combination of manometry and 24 hours pH monitoring has given the biggest insight into the pathogenesis of GER and seems to be undispensable for specific therapeutic procedures.

Electrodes↗
PubMed1988

Intraoperative heart rate reduction--alinidine versus metoprolol.

In a double-blind randomized protocol the effectiveness of the specific bradycardic agent alinidine (0.6 mg.kg-1 i.v.) was compared to that of the betablocker metoprolol (0.035 mg.kg-1 i.v.). Twenty-four coronary artery disease patients undergoing a bypass procedure with an intraoperative heart rate increase of more than 20% were included. Patients with a concomitant intraoperative mean arterial pressure increase of more than 30% or with an intraoperative wedge pressure higher than 15 mmHg (2.0 kPa) were excluded. After application of alinidine and metoprolol, heart rate decreased significantly (P less than 0.01) in the alinidine group from 88 +/- 19 beats per min to 72 +/- 13 and in the metoprolol group from 82 +/- 16 to 72 +/- 12. Baseline values were not obtained. Compared to the hemodynamic changes in the metoprolol group, the alterations of pulmonary capillary wedge pressure (PCWP) (P less than 0.05), stroke volume index (SVI) (P less than 0.05), left ventricular stroke work index (LVSWI) (P less than 0.01) and right ventricular stroke work index (RVSWI) (P less than 0.05) in the alinidine group were statistically significantly different. PCWP remained unchanged after alinidine and increased in the metoprolol group (1.4 +/- 0.4 to 1.6 +/- 0.4 kPa). In the alinidine group LVSWI (43.1 +/- 15 to 49.2 +/- 18 g-m.m-2), RVSWI (5.1 +/- 4 to 6.6 +/- 3 g-m.m-2) and SVI (37.2 +/- 12.2 to 42.5 +/- 12.8 ml.m-2) increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Pulmonary exchange of solutes during experimental lung lavage in pigs.

Unilateral continuous lung lavage in a nonregenerating system (3,000 ml isotonic cristalloid) was done in 12 pigs for 270 min. The concentration of substances in serum and fluid was measured. Half-time (t1/2) of exchange and permeability constants (P) were determined. In the fluid Na+ decreased significantly (t1/2 = 107 min, P = 7.8 x 10(-7]. Urea increased significantly, reaching serum level after 270 min (t1/2 = 109.1 min, P = 6.18 x 10(-6]. Ca2+ (t1/2 = 36.7 min, P = 4.1 x 10(-7] PO4 = (t1/2 = 173.3 min, P = 1.1 x 10(-7], and creatinine (t1/2 = 55.2 min, P = 6.2 x 10(-7] also increased markedly but did not reach serum level. The adjustment to serum concentration may be prevented by interaction between diffusion, active transport or Donnan's equilibria. K+ increased almost linearly, documented by the long half-time (t1/2 = 7,835.2 min, P = 7.7 x 10(-7] and did not reach serum level. The calculated limit value was higher than the serum level. Active transport systems or influx of K+ from cellular compartments rather than from the serum might be involved in its linear kinetics. Total protein (t1/2 = 61.5 min, P = 2.06 x 10(-9] and albumin (t1/2 = 58.8 min, P = 1.7 x 10(-9] increased initially but levelled far below the serum value. The low P indicates a lack of significant permeation. Initial increase may be due to washout of the epithelial lining fluid compartment. There was minimal transfer of lavage fluid into the organism (10-20 ml/30 min). Serum concentrations were not affected by the lavage.

Animals↗
PubMed1986

[Antithrombin III behavior in open heart operations in infancy and early childhood].

Antithrombin III activity was evaluated preoperatively, intraoperatively and postoperatively in the plasma of 54 children with congenital heart disease undergoing open heart surgery. The patients were divided into an acyanotic and a cyanotic group. A comparison of these two groups indicated a significantly decreased AT III activity in cyanotic children as compared to acyanotic children throughout the perioperative phase. AT III levels decreased in the cyanotic group from 71.9 +/- 3.77% preoperatively to 61.5 +/- 2.15% (p less than 0.01) postoperatively and rose to 69.6 +/- 2.36% (p less than 0.01) on the first and to 78.9 +/- 2.24% (p less than 0.01) on the second postoperative day. In the acyanotic group AT III levels decreased from 84.3 +/- 1.98% to 73 +/- 2.97% (p less than 0.01) postoperatively and increased to 78.5 +/- 2.96% (p less than 0.01) on the first and to 90.2 +/- 3.06% on the second postoperative day. A few acyanotic patients, too, showed decreased values of AT III. However, they were never found to be as low as in the cyanotic group. Preoperative AT III values as well as the severity of underlying disease, the success of corrective surgical treatment and postoperative complications proved to be the predominant influencing factors of AT III activity.

Antithrombin III↗
PubMed1985

[The lower esophageal sphincter after sclerosing of varices].

Fiberendoscopic paravasal sclerotherapy of esophageal varices with Polidocanol at concentration of 1%, is a palliative therapy of a serious sickness. Due to the location of esophageal varices, paravasal sclerotherapy with all its alteration of the esophageal wall takes place in the lower third with its lower sphincter. Twenty middle-aged patients, both sex, with esophageal varices (stadium II-IV due to Paquet) underwent clinical, endoscopic and esophagomanometric control after completion of sclerotherapy. By reaching the therapeutic goal--the subepithelial layers--no pathologic change of the motility of the esophagus has been seen.

Adult↗
PubMed1984

[Myocardial changes in acute pulmonary artery embolism--an experimental study].

Massive pulmonary embolism usually causes acute right ventricular hypertension. Structural and hemodynamic effects of right ventricular overloading were studied in piglets (weight 17-22,5 kg). Pulmonary arterial obstruction (PAO) was achieved by temporary banding of the main pulmonary artery, the external diameter of the vessel being reduced to one-third (Group I) or by half (Group II) of the original size. In Group I PAO caused a twofold increase of systolic right ventricular pressure (RVP), whereas the systolic left ventricular pressure decreased to 30% of its original value; PAO was terminated after 25 seconds. After PAO, no changes of right or left ventricular function were observed in Group I. Electron microscopy revealed mitochondrial alterations and fragmentations of the sarcomeres. In Group II, PAO was maintained for 60 minutes. Due to PAO, the systolic RVP increased to twice the original value and the systolic aortic pressure decreased by 10%. During the PAO period, a continuous increase of enddiastolic RVP was observed in Group II. After termination of PAO, contractility parameters for the right ventricle were reduced, and right ventricular diameters (RVD) and enddiastolic RVP were increased in comparison to the pre-PAO values. As hemodynamic alterations increased corresponding to the duration of PAO, it is concluded that in case of acute pulmonary embolism early relief of right ventricular overloading may be important.

Acute Disease↗