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Biomedical subjects

R Lufschanowski

Publications and source records attributed to R Lufschanowski.

At least 19 recordsLinked to original sources
PubMed2001

Severe rhabdomyolysis associated with the cerivastin-gemfibrozil combination therapy: report of a case.

Cerivastatin is the new 3rd-generation of the synthetic 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, the 1st drugs of choice for treating hypercholesterolemia. A potent inhibitor of HMG-CoA reductase, it possesses a high affinity for liver tissue and decreases plasma low-density lipoprotein cholesterol at microgram doses. Cerivastatin produces reductions in low-density lipoprotein cholesterol of 31.3% and 36.1% at doses of 0.3 and 0.4 mg/day, respectively It is an uncomplicated agent with regard to its pharmacokinetic profile, low potential for interaction with other drugs, and suitability for use in those with impaired renal function. Most other statins have been implicated in causing rhabdomyolysis, either as monotherapy or in combination with other agents. We report what to our knowledge is the most profound case yet in the literature of rhabdomyolysis in association with cerivastatin-gemfibrozil combination therapy, in regard both to the extreme elevation in serum creatinine kinase and to the patient's near-paralytic weakness.

Aged↗
PubMed1994

Gianturco-Roubin stent placement for variant angina refractory to medical treatment.

A 43-yr-old man with mild, fixed obstruction of the left anterior descending (LAD) coronary artery and severe, uncontrolled variant angina underwent placement of an endovascular stent to preserve patency of the artery. The decision for stent placement was based on several factors, including refractoriness to medical treatment and standard balloon angioplasty, documented spasm localized to the proximal LAD lesion, and the morbidity, mortality, and costs associated with the surgical approach in this type of patient. At follow-up, there was moderate restenosis of the stented coronary segment; the vasospastic angina syndrome had totally resolved.

Adult↗
PubMed1994

Transesophageal electrocardiography and adenosine in the diagnosis of wide complex tachycardia.

The diagnosis of wide complex tachycardia based on surface electrocardiography can be difficult. Misdiagnosis occurs frequently and is commonly associated with increased morbidity and mortality. We describe a case of wide QRS complex tachycardia in which transesophageal electrocardiography and intravenous adenosine were used to obtain a reliable diagnosis. These are safe and readily available tools for elucidating the mechanism of wide complex tachyarrhythmias in hemodynamically stable patients.

Adenosine↗
PubMed1987

Severe diffuse obstructive coronary artery disease in an infant.

Severe diffuse obstruction of the coronary arteries was diagnosed in an 18-month-old girl who presented with signs and symptoms of severe congestive cardiomyopathy. Most reported cases of myocardial infarction in neonates or infants have been secondary to obstruction of a single major coronary artery owing to thrombosis or embolism; diffuse multiple obstruction involving the entire coronary artery system, as in our case, has not previously been described. Although the exact cause of the obstruction remained unknown, the most likely mechanism was in situ thrombosis.

Journal Article↗
PubMed1982

Intermittent disappearance of a patent ductus arteriosus murmur: report of a case and review of the literature.

A 10-year-old girl with a diagnosis of patent ductus arteriosus from the time of birth was noted to have disappearance of her typical continuous murmur on two separate, well-documented occasions. Cardiac catheterization showed a small patent ductus arteriosus with a pulmonic/systemic flow ratio of 1.3:1. Conservative treatment was advised. Twelve other cases of intermittent disappearance of the murmur of a patent ductus arteriosus were found in the literature.

Journal Article↗
PubMed1981

Early experience of transluminal coronary angioplasty (TCA) by the brachial artery (the Sones technique in transluminal angioplasty).

Sixteen transluminal coronary angioplasty procedures (TCA), eight right coronary artery (RCA) and eight left anterior descending coronary artery (LAD), by the brachial artery cut-down approach, were attempted with 9/16 (56%) immediate successes and 2/16(12%) early recurrences. The procedure success rate for RCA obstructive lesions, 6/8 (75%) was greater than for LCA obstructions, 3/8 (38%). In six unsuccessful procedures the balloon catheter could not be advanced into the lesion, and in one unsuccessful procedure dissection of the coronary artery proximal to the lesion occurred. The brachial (Sones) technique for transluminal coronary angioplasty permits the use of softer guiding catheters for selective probing and approach to the coronary lesion but may be more likely to induce coronary spasm. Complete and high-resolution pre TCA angiograms with multiple views to disclose the exact anatomy of the coronary artery and its lesion is essential to ensure successful dilatation.

Adult↗
PubMed1980

Heterotopic epithelial replacement (so-called "mesothelioma") of the atrioventricular node, congenital heart block, and sudden death.

Heterotopic epithelial replacement (so-called "mesothelioma") of the atrioventricular node is a rare cause of congenital heart block and sudden death; only about 50 cases have been reported in the literature in predominantly female patients ranging in age from infancy to 86 years. The lesion is virtually impossible to diagnose clinically and can be recognized at postmortem only by histologic examination of the atrioventricular conduction tissue. A unique case is reported since the patient, a young, asymptomatic woman, was chosen by chance as the subject of an electrophysiologic study of bradycardia 6 years before her sudden death. The morphologic (light- and electron-microscopic) findings of the atrioventricular node studied at autopsy were supportive of heterotopic epithelial origin of the lesion. The disputed histogenesis is briefly discussed.

Adolescent↗
PubMed1978

Anomalous left coronary artery from pulmonary artery. Unusual case complicated by coronary arterial disease and fistula from coronary artery to left ventricle.

A 42-year-old woman with an anomalous left coronary artery originating from the pulmonary artery and a fistula from the left coronary artery to the left ventricle was treated by aortocoronary bypass grafting of an autologous saphenous vein. The presence of an abundant collateral circulation and of fistulous communications between the left coronary artery and the left ventricle, in our opinion, was the reason that this patient remained asymptomatic until the age of 40 years. We believe that this is the first report of the findings in an adult patient who had these two rare congenital anomalies complicated occlusive coronary arterial disease.

Adult↗
PubMed1976

Supravalvular mitral stenosis associated with tetralogy of Fallot.

The association of tetralogy of Fallot with supravalvular mitral stenosis is a rare anomaly that has been reported only once previously. The difficulty of preoperative diagnosis is emphasized. Although left-sided obstructive lesions in association with tetralogy of Fallot are rare, their recognition is imperative since these are surgically correctable anomalies and potentially lethal, as proved in this case and the one previously reported.

Adult↗