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Biomedical subjects

R Aurisch

Publications and source records attributed to R Aurisch.

At least 19 recordsLinked to original sources
PubMed2005

Scintigraphic results in patients with lung transplants: a prospective comparative study.

AIM: We addressed the feasibility of scintigraphy in the postoperative monitoring of lung transplants. METHOD: 37 patients (22 women, 15 men, 37 +/- 15 years) in good clinical condition were examined after lung transplantation. Scintigraphic procedures for assessing ventilation (133Xe), perfusion (99mTc microspheres) and aerosol-inhalation (99mTc aerosol) were performed for all patients. The findings were compared with those of established diagnostic modalities. RESULTS: All lung transplants showed homogeneous ventilation but with a non-physiologic difference of over 20% between both pulmonary lobes in one-third of the cases. There was a difference between the impairement of perfusion and ventilation in the presence of an impaired Euler-Liljestrand reflex in 14/37 (38%) patients. Furthermore, bronchoscopy and aerosol-inhalation scans often did not correlate, e. g. a bronchoscopically evident stenosis was not necessarily associated with an increased activity, and vice versa. Although peripheral mucociliary clearance was preserved after transplantation, stasis in central airways resulted in significantly impaired global clearance. CONCLUSION: Ventilation and perfusion scintigraphy reveal in a significant number of lung recipients pathologic findings and therefore can be recommended for postoperative monitoring. From a clinical point of view aerosol-inhalation scintigraphy (clearance) is not of any additional value.

Cystic Fibrosis↗
PubMed1999

Evaluation of shunt function in hydrocephalic patients with the radionuclide 99mTc-pertechnetate.

In most cases of shunted hydrocephalus, shunt malfunction is evaluated by clinical examination and neuro-imaging. However if there is a discrepancy between neurological examination and imaging, additional shuntography can be helpful in the evaluation of the shunt function. In our clinic, radionuclide-imaging shuntography using (99m)technetium-pertechnetate was performed in 85 children between 1992 and 1995. The results of shuntography were evaluated visually and from time-activity curves. Shuntography had a sensitivity of 96%, a specificity of 89%, and an accuracy of 93%, proved either by surgery or by clinical follow-up for 2-5 years. Corresponding to these results, we recommend the use of shuntography in cases with an uncertain shunt function before surgical revision.

Adolescent↗
PubMed1999

[Myocardial ischemia caused by ICD electrodes?].

We report on a 65 year old man, in whom an ICD was implanted. Seven months later we found a remarkable close relation between the tip of the ICD electrode and the distal part of the left anterior descending artery (LAD). LAD seems to be compressed from electrode during systole. This is possibly the cause of an ischemia in myocardial scintigraphy.

Aged↗
PubMed1998

[Septal myocardial perfusion in complete left bundle branch block: case report and review of the literature].

Myocardial scintigraphy was performed three times in a 55-year-old woman with left bundle branch block (LBBB). A significant LAD stenosis had been excluded by coronary angiography. The first scintigraphy was performed with Tc-99m sestamibi after submaximal bicycle exercise and revealed a septal perfusion deficit. This deficit could not be reproduced in the following examinations after pharmacological stress testing with dipyridamole using both Tl-201 and Tc-99m sestamibi. Perfusion at rest assessed with Tl-201 was normal in all studies. It is concluded that pharmacological stress testing with dipyridamole is to be preferred in patients with LBBB. With respect to the accuracy of myocardial perfusion imaging the choice of the radiopharmaceutical plays a less important role.

Bundle-Branch Block↗
PubMed1998

Scintigraphic localization of lymphatic leakage site after oral administration of iodine-123-IPPA.

UNLABELLED: Chylothorax can occur secondary to traumatic lesions of the thoracic duct caused by chest injuries, surgical procedures involving the pleural space, neoplasms or malformations of the lymphatics. METHODS: Lymphatic leakage sites were localized by scintigraphy after oral administration of the 123I-labeled long-chain fatty acid derivative iodophenyl pentadecanoic acid (IPPA). We report on three patients with different lymphatic leakage sites and on one normal control subject. RESULTS: IPPA scintigraphy localized the lymphatic leakage site correctly in all three patients. In two of them, the method even guided the successful surgical treatment of the leakage. CONCLUSION: This approach is suitable for detecting lymphatic leakages of intestinal origin.

Administration, Oral↗
PubMed1996

[Diagnosis and therapy of postoperative chyloperitoneum].

Chyloperitoneum is a rare complication of surgical procedures. We report a case of severe chyloperitoneum after abdominothoracic esophageal resection with two-field lymphadenectomy. After diagnosis was established, the lymph leak was located with oral iodine-marked fatty acids (123I-pentadecanoic acid) showing increased activation in the right middle abdomen. Because conservative treatment with total parenteral nutrition showed no decrease in chyle volume, relaparatomy was performed and the lymphatic fistula was successfully treated with suture ligatures. Pathophysiology and different options for localization and treatment of postoperative chyloperitoneum are discussed.

Carcinoma, Squamous Cell↗
PubMed1996

[Value of lymphatic outflow directed continuity dissection in melanoma surgery].

Radicality of the surgical procedure in patients with intermediate and high risk melanomas is enhanced by the additional removal of the transit tract between tumor and regional lymph node (continuity dissection). After introduction of the lymphatic out flow scintigraphy in 1984, the accurate removal of the transit tract is easily possible in tumors located on the trunk, the upper arm and the thigh as well as of the head/neck region. The main reasons for the improved survival rates are the exact removal of the transit tract together with potentially existing occult tumor cells or in transit metastases, respectively, as well as ectope lymph node metastases and the consequent elective lymph node dissection.

Adult↗
PubMed1993

[Circulatory changes in acute sauna hyperthermia after heart transplantation].

The authors report on the influence of a single sauna-stay of patients following heart transplantation (HTX) during the rehabilitation phase III. Investigations of blood pressure, heart rate, changer in hemodynamics in the small and large vessels in 8 male patients following HTX (medium age: 42 years) showed that sauna-hyperthermia is well tolerated. We watched significant decreases of blood pressure (systolic and diastolic values), an improvement of the microcirculation in the small vessels, an increase of the left ventricular ejection fraction (LVEF) and a decrease of the total peripheric vascular resistance (TPVR). Possibilities and limitations of sauna-therapy for the therapy of risk factors following HTX especially under immunosuppression are discussed. First results are demonstrated.

Acclimatization↗
PubMed1993

[Value of nuclear medicine procedures in evaluating the hemodynamics in physical medicine and cardiac rehabilitation].

This is a report on the application and importance of nuclear-medical procedures in physical therapy and rehabilitation. In particular, attention is focused on the parameters of peripheric haemodynamics (T1/2 and -A) and of the left ventricular ejection fraction. The authors aim at demonstrating their own results gained during the last 10 years in different groups of patients suffering from cardiovascular diseases at rest and under load. The results are critically estimated, including the relevant literature, and conclusions are drawn for clinical practice.

Adult↗
PubMed1993

[Autogenic training in hypertensive dysregulation after aortocoronary venous bypass operation of coronary heart disease].

The authors report on the influence of autogenous training on blood pressure at rest and under stress conditions in patients with coronary heart disease following coronary bypass operation. We investigated the influence of autogenous training on the microcirculation and the left ventricular ejection fraction (LVEF) as well. The results showed a significant decrease in blood pressure at rest and also an increase of muscle circulation F and of LVEF.

Adult↗
PubMed1993

[Sauna therapy in coronary heart disease with hypertension after bypass operation, in heart aneurysm operation and in essential hypertension].

It is reported about the influence of the sauna therapy on blood pressure, heart frequency, peripheric hemodynamics (Xenon-133-muscle-clearance) and the reaction of the cardiac output or left ventricular ejection fraction with hypertonia patients, patients with coronary heart disease (CHD) and hypertension and after aneurysm resection after heart infarction. It was shown that sauna therapy has a positive effect on hypertonic regulations troubles. One of the reasons of lowering blood pressure is the significant improvement of the peripheral hemodynamics. Sauna therapy does not result in any improvement of the left ventricles pumping function after operation. All described groups of patients showed a good tolerance and compliance with sauna therapy.

Adult↗
PubMed1992

[Ventilation and hemodynamics as control parameters of spa treatment].

Physical endurance training as practised at spas in the active treatment of hypertension will usually result in an increase in oxygen supply reserves and will also improve haemodynamics, so that it could help in objectively identifying the success of cardiovascular treatment. For this reason we conducted a bicycle ergometer load test in recumbent position in a group of 23 male hypertensives in stages I and II (age between 25 and 58 years) before and after a treatment course at a spa of 4 to 5 weeks' duration. The measurement parameters were ECG, blood pressure, cardiac output and the ventilatory parameters tidal volume, oxygen uptake, respiratory equivalent and respiratory quotient. Significant blood pressure reductions were seen if the load did not exceed 75 watts. The treatment course had a definite influence on cardiac output at rest and under stress. The treatment course achieves reduction and largely also normalisation of the tidal volume which is otherwise higher than in healthy persons. No influence is exercised on the respiratory equivalent. Reduction of the tidal volume and of the oxygen uptake, as well as reduction of the respiratory quotient after the treatment course can be interpreted as an improvement in the economy of the cardiovascular system. The ventilatory parameters are only conditionally suitable for arriving at an objective assessment of the curative effect of the treatment course.

Adult↗
PubMed1992

[The effect of health resort therapy on cardio-regulation following heart transplantation with special reference to CO2 balneotherapy].

It is being reported about the influence of a CO2-bathing series with 12 patients after heart-transplantation in connection with a light-motion therapy on blood pressure and haemodynamics. The comparative group was a group of 12 heart-transplantation patients of the same age without cure during the comparative time. It was shown that the balneotherapy after HTPL has positive effect on the development of the systolic blood pressure under rest and exercise. The peripheric microcirculation (musculus tibialis anterior) improved significantly. The left ventricular ejections fraction (LVEF) kept without change. Generally, the balneotherapy is well tolerated by heart-transplantation patients. There is no danger of a cardiac overcharge of the left ventricle.

Adult↗
PubMed1992

[Importance of left ventricular function for active early ambulation following acute myocardial infarct].

On the 4th postmyocardial infarction day a risk group determination among n = 80 patients was undergone on the base of LDH-isoenzyme-monitoring. The active early mobilization was carried out following corresponding risk groups: less risk (38%) until the 14th, middle risk (23%) until the 21st and high risk (38%) until the 28th postmyocardial infarction day or longer. The average period of hospitalization was 21.1 day. The exercise load test was done successful in 97% by patients with low risk and in 40% by patients with high risk. The ejection fraction was 51.3% for patients with low risk and 38.5% (p less than 0.01) for patients with high risk. The exercise test at discharge is usefull for check of the risk from the acute phase and for the determination of high-risk patients for physical conditioning.

Aged↗
PubMed1991

[Modification of inspiratory phase angle behavior in oscilloresistometry].

The diagnosis of pulmonary emphysema and fibrosis is possible by measuring the inspiratory behaviour of phase angle PSI of oscillation method. In addition to the different lung compliance as the main reason an influence of the shifting intrathoracical blood volume as the result of the pressure change is discussed especially for the appearing secondary PSI-periodic. Because a direct experimental evidence is not present in this study it was attempted to describe qualitatively the blood volume shift. Thoracic electrical impedance plethysmography and methods of nuclear medicine were used as methodological base. Although impedance plethysmography appears theoretical suitable and there are references, that alterations being independent from the heart rhythm may be detected, the originally aim of the study was not reached by the used method. The registration of radioactive labeled blood over the thoracical region by means of methods of nuclear medicine was applied as an alternative method. In contrast to the theoretical concept of a suction effect of the decreasing pressure during inspiration a decrease of the impulse rate and an increase of the latter during expiration was found. The reason could be the isolated registration of changes in the alveolar vessels. Possible secondary oscillations, which could be in relation with findings of lung mechanics, were not observed.

Adult↗
PubMed1991

[The surgical risk in patients with cardiac diseases].

The increase in the number of patients with heart and circulatory diseases during selective surgical operations in the past decades is due to both the epidemiologic situation and the increase in the number of old and very old people. To ensure optimum perioperative care of these patients, the anaesthetist must know the degree of illness of each individual and the functioning state of the haemodynamic system. In this paper we show factors which increase the perioperative risk of cardiac complications. These factors are traceable on a semiquantitative basis by the remaining function of the myocardium or the risk of ischaemia of the cardiac muscle. Many clinical symptoms or diagnoses do not affect the perioperative risk. To judge preoperative risks and specific perioperative changes in medication, cooperation between the anaesthetist and cardiologist is required.

Aged↗
PubMed1990

[Therapy of perioperative myocardial damage in aortocoronary venous bypass surgery].

The perioperative lesion of the myocardium in heart-lung machine operation can on principle not be prevented despite complex measures of the protection of the myocardium and the individual monitoring of the patients, this particularly by including patients with high risk of ischaemia of the myocardium (instable angina pectoris, stenosis of the trunc and greatly restricted left-ventricular function, respectively) in former years. In a proved perioperative lesion of the myocardium the limitation of the myocardial lesion stands in the centre of intensive-medical measures with vasodilators and positive inotropic substances.

Cardiac Output, Low↗