PubMed Health⌕ Search

Biomedical subjects

R Pfitzner

Publications and source records attributed to R Pfitzner.

At least 19 recordsLinked to original sources
PubMed2003

[Abscess of the mitral annulus mimicking left atrial tumour - case report].

A case of a 70-year-old female with hypertension, atrial fibrillation and angina pectoris, admitted to the hospital due to echocardiographically detected left atrial tumour, is presented. Differential diagnosis included thrombus, myxoma, infectious or neoplastic tumour. The patients underwent surgery. Histopathological examination revealed the presence of an abscess in the left atrium. This report underlines the difficulties in the diagnosis of cardiac tumours.

Abscess↗
PubMed2001

[Self-estimation of the quality of life in adult patients after surgical correction of atrial septal defect type II (ASD II)].

Health estimation was performed in 134 patients (where 67% were women), aged 17-70, mean 42 years, 2-3 years after surgical correction of atrial septal defect type II (ASD II). The study consists of clinical examination and self-estimation of the quality of life with help of a mall questionnaire, with return ratio of 90%. The improvement of health status was declared by 80% of patients, where 23% stated considerable improvement. While 15% did not confirm any significant changes and 5% noticed worsening quality of life status (mainly connected with postoperative pain). The physical condition improved similarly, with range of tolerable physical effort doubled. The frequency of dyspnea, chest pain and palpitation decreased from 72%, 67% and 87% to 47%, 43% and 47%, respectively, as well as their intensity. More over, the frequency of anxiety decreased from 70% to 62% with reduction of its intensity. Both, before and after surgery, the environmental estimation and self-estimation was very good (77% versus 78%, 78% versus 89%) respectively, and predominant were optimistic attitudes. Post-operative improvement of the quality of life correlating to the clinical state, confirms the suitableness of surgical correction of ASD II, independent of age.

Adolescent↗
PubMed1999

The quality of life after aortic valve replacement with homografts or prosthetic valves.

BACKGROUND AND AIM OF THE STUDY: The study aim was to evaluate the quality of life in patients after homograft or prosthetic aortic valve implantation. Evaluation was based on clinical and echocardiographic examinations, and on analysis of data from patient questionnaires. METHODS: Patients undergoing either homograft (HV, n = 220) or prosthetic (PV, n = 220) aortic valve replacement were investigated. The patients groups were similar in age, sex, follow up period, risk factors and type of heart defect, and did not demonstrate any dysfunction of the replacement valve. RESULTS: During both pre- and postoperative periods, no significant inter-group differences were identified with regard to the occurrence of retrosternal pain, dyspnea, palpitation, fear reaction and circulatory efficiency based on NYHA classification, and self-evaluation of physical activity assessed by patient questionnaires. The majority of patients in both groups noticed on increase in their quality of life and physical activity. The reduced sexual activity (50%) and fear reaction (30%) in both groups did not correlate with their improved sense of well-being. Up to 14.6% of PV patients did not accept the implanted valve, and 65 (29.5%) would have preferred an HV, despite the need for reoperation. Following surgery, 21% of HV patients resumed work, compared with only 7.7% of PV patients. The frequency of claims for disability pension after surgery did not correlate with the considerate clinical and subjective improvement. CONCLUSIONS: In patients receiving either homograft or prosthetic valves, the subjective evaluation of life quality is comparable with the clinical evaluation, though the homograft valve was better accepted than its prosthetic counterpart.

Adult↗
PubMed1999

Effects of cyclosporin A on contractile activity and cytoskeleton in chick embryo cardiomyocytes.

The effects of cyclosporin A (CsA), a clinically used immunosupressive drug, on contractile activity of chick cardiomyocytes grown as small aggregates or explants suspended on a network of elastic glass fibres or cultured in a monolayer were analysed in vitro with computer-aided image cytometry methods. At therapeutic concentrations (200-1500 ng/mL), CsA induced changes in the frequency and amplitude of the beating activity of cardiomyocytes 15 min after application. Longer treatment of cardiomyocytes, for 20-24 h, additionally induced changes in their shape and cytoskeleton organization (F-actin and alpha-actinin distribution). These results indicate that CsA is able to affect directly the contractile activity, morphology, and cytoskeleton architecture of heart cells.

Animals↗
PubMed1999

[Not Available].

The author shows some crucial points of the Budapest School of psychoanalysis, founded by Ferenczi, like the role of external reality, and of social factors in the development and psychopathology of the human being. He introduces Ferenczi's theory of trauma and tries to show that Ferenczi's ideas from 1932 contain all important elements of modern concepts on trauma. Ferenczi's pupils, as Imre Hermann, Alice and Michael Balint, Istvan Hollos a.o. contribute to the further development of the thoughts of their teacher and don't turn their back on the trauma as psychoanalysis in general did. The author closes with some contributons to the theory of trauma by present Hungarian psychoanalysts, especially about the phenomenon of social traumatisation.

Dreams↗
PubMed1998

[Calcification of allogenic aortic heart valves].

The material used for the studies consisted of allogenic aortic valves (AAV) collected from 14 individuals. The necessity of AAV replacement arose from growing circulation insufficiency and AAV dysfunction. The aim the study was the determination of the elemental composition and crystallographic structure of the inorganic deposits in AAV. Moreover, the results of the physicochemical investigations were correlated with clinical data (age of the patient, time between valve replacement surgeries, endomyocarditis, number of infections during last 12 months, arterial hypertension and disturbance of the lipid balance) and with echocardiographic examinations (cusp mineralization and perforation, vegetation, systolic and diastolic dimensions of the left ventricle, maximal and average gradient through allograft valve as well as range of the recoil wave to left ventricle). It was found that mineralization of the AAV cusps was a time-dependent process and took place predominantly at the surface of the cusp. The elemental composition and crystallographic data revealed that the inorganic deposits in AAV were composed of hydroxyapatite crystals. However, the presence of other calcium salts was also found. The development of the mineralization process in AAV does not correlate with endomyocarditis, arterial hypertension and the disturbance of the lipid balance. Probably, endomyocarditis and arterial hypertension induce the pathologic alternations of AAV independently from the mineralization process. The echocardiographic estimations of the pathomorphologic changes of the aortic valve cups are not always consistent with the results of the physicochemical studies.

Adult↗
PubMed1998

[Coronary bypass grafting after failed percutaneous angioplasty (PTCA)].

Between January 1991 and September 1997, in the Cardiovascular Surgery Department of the Institute of Cardiology of Jagiellonian University Medical School, 23 patients underwent emergency CABG due to acute myocardial ischaemia in result of failed PTCA. Over the same period of time invasive cardiologists performed 1883 PTCAs out of which 23 (1.2%) were emergency cardiosurgical procedures, and in 38 patients, stents were implanted in the damaged coronary arteries. The patients' age ranged from 37 to 67 years (median 52.2). In all patients good left ventricular function was preserved, median ejection fraction being 64%. Two patients required IABP to support left ventricular function. 1-4 bypass grafts were implanted (median 1.9 per patient). In one patient, internal mammary artery was collected and then implanted into anterior interventricular branch. The most common complication was myocardial infarction which occurred in 12 patients (52%). In ten patients low output was observed postoperatively. One operated patient (a female died (4.3%). The mean time of hospitalization was 11 days. Emergency myocardial revascularisation procedures performed after failed PTCA, bring higher risk of mortality and dangerous postoperative complications.

Adult↗
PubMed1997

Clinical and echocardiographical study of the aortic homograft implantations in patients with Marfan syndrome.

The aim of the study was to assess the long-term results of surgical treatment with homogenic aortic grafts (HAGs) implantation in patients with Marfan syndrome. There were 31 patients with Marfan syndrome and aortic aneurysm who were operated on between 1980 and 1996. Aortic dissection was diagnosed in 14 patients, DeBakey Type I in six patients and Type II in eight patients. Four patients had to be operated urgently in cardiogenic shock with cardiac tamponade. Sealing up and reinforcement with strip of felt or Gore-Tex has been applied in 22 patients. The surgical modifications mentioned above have been applied since 1987 in all patients with the diameter of the aortic ring exceeding 30 mm or with active infective endocarditis or during reoperation. In 16 patients the space between the aortic homograft and patients own aortic wall was joined to the right atrial auricle. Patients were followed up for 12-179 months (average: 94.6 +/- 499). Three patients died in the early postoperative period and four patients died in the late postoperative period. Rethoracotomy because of bleeding complications was necessary in five patients. HAG damage was responsible for six other reoperations-new HAGs have been implanted in three patients and artificial prostheses were implanted in the other three patients. In the late follow-up period significant improvement in cardiac performance was observed in 24 patients (NYHA I or II). Survival probability of 15 years for the whole group was 80%. The lowest survival probability has been shown in the group of patients with DeBakey Type I aortic dissection (35% survived 15 years after operation). Echocardiographic follow-up has shown that the pressure gradient in HAG was low (7.4 +/- 6.2 mmHg). Only in two patients did the HAG gradient exceeded 20 mmHg. There were no significant differences concerning aortic ring diameters, dimensions of HAG and echocardiographic parameters between the group with surgical modifications, i.e. sealing up and reinforcement with strip of felt or Gore-Tex applied and the group in which these modifications were not applied. Homogenic aortic graft implantation as a method of surgical treatment of aortic aneurysm in patients with Marfan syndrome avoids postoperative anticoagulation, results in substantial improvement of cardiac performance and prolongs life. Surgical treatment should be considered in asymptomatic patients with large aneurysms (exceeding 55-65 mm) in patients with Marfan syndrome because there is a high risk of death in this group of patients in the case of dissection.

Adolescent↗
PubMed1996

Mineral-cholesterol concentrations of the aortic aneurysmatic wall.

Mineralogical investigations were performed on specimens from the aneurysmatic wall of ascending and descending thoracic and abdominal aortas collected intraoperatively from 10 patients (8 male, 2 female) aged 40-80 years. Scanning electron microscopy with energy dispersive x-ray analyses (microprobe-SEM/EDXA), and atomic absorption spectroscopy (AAS) showed incipient mineral and cholesterol depositions in the tissues of the patients when compared with the normal aorta of the young individual. Grains and crystals of cholesterol, and spherulitic mineralization, probably apatitic, were detected. It is suggested that localized cations imbalance precedes mineralization and is the potential co-factor of aortic wall pathology and aneurysm formation.

Adult↗
PubMed1996

Successful full-term pregnancy in a patient three and a half years after a heart transplant.

The patient is a 28 year old woman who received a heart transplant in 1992 secondary to hypertrophic cardiomyopathy with unremarkable post-operative course. In the period immediately post transplantation the patient was on a four-drug immunosuppressive regimen which was subsequently changed to standard three-agent therapy. This therapy was continued until the patient became pregnant. In the first trimester only Cyclosporine (CsA) was used, and thereafter, the patient was continued on the previous three agent regimen. Toward the end of pregnancy a rise in systolic pressure was observed, but the child was delivered by spontaneous vaginal delivery without complications in the 38th week of pregnancy. The newborn weighed 3320 g and was in good health. A sharp fall in the newborn CsA blood levels was observed post delivery reaching zero level on the third day of life. At the present time, both mother and baby are in good health, 6 weeks after delivery.

Adult↗
PubMed1995

[Use of mineralogic methods for examination of human tissues. I. Methods of mineralogic examination].

Pathologic mineralization in the human body may produce severe morbidity. Application of mineralogic methods of investigation makes possible closer cognizance of this process, and facilitates prophylaxis and treatment. The principles and employment of following methods are discussed: polarized light microscopy, transmission and scanning electron microscopy, infrared spectroscopy, X-ray diffraction, atomic absorption spectroscopy, electron microprobe, and neutron activation analysis.

Bone and Bones↗
PubMed1995

[Use of mineralogic methods for examination of human tissues. II. Mineralization of heart structures].

Using mineralogic methods of investigation there were analyzed 8 mitral and 6 aortic valves, removed during surgical replacement, and 18 concretions which occluded coronary arteries, removed during surgical revascularization procedures. In all samples two kinds of mineralization were stated: 1. secret-observed as higher than normal content of elements in the tissue, and detected using chemical methods only, and 2. apparent-observed as grains and crystals, composed mainly of hydrated phosphates and hydroxyapatite, often with deposits of lipids and cholesterol.

Adult↗
PubMed1994

[Surgical treatment of coronary artery disease in the opinion of "first-contact" physicians and their patients].

A group of physicians working at regional dispensaries in Cracow and its surroundings, and their patients were inquired about surgical treatment of coronary artery disease using specially prepared questionnaires. In comparison with a similar study, performed in 1987, a significant improvement of acquirement was stated in both groups. It may be connected with development of coronary surgery during the last years. However, the respondents emphasized a deficiency of easy accessible medical information on this topic.

Adult↗
PubMed1993

[Diagnostic difficulties in a 32-year old patient with cardiac tamponade].

At present the most frequent cause of cardiac tamponade is neoplasma. A case of a 32-year-old male with recurrent cardiac tamponade caused by pericardium mesothelioma is described. Despite advanced neoplastic process in the pericardium, pleura and mediastinum, neither radiologic examinations of the chest, echocardiography, nor repeated cytologic examination of the pericardial exudate, could establish the etiology of the tamponade. Only after a pericardial window had been performed was it possible to: 1) establish the diagnosis and introduce causal treatment; 2) prevent recurrence of the tamponade; 3) perform cytoreduction of the tumor. It seems that in cases of chronic exudative pericarditis of unknown cause it is proper to perform an early pericardial window as a diagnostic and therapeutic procedure.

Adult↗
PubMed1992

[Mineralization of heart valves].

Mineralization (calcification) of heart valves (mitral, aortic and aortic bioprosthesis) have been analyzed using; histology, x-ray diffraction, infrared spectroscopy, scanning microscopy, atomic absorption and electron microprobe. Obtained results showed the presence of two type of mineralization. First type is represented by grains composed of hydroxyapatite containing admixture of carbonates. This mineralization is seen macroscopically. Second type of mineralization is possible to determine only using chemical methods. It is represented by biological structures containing amount of Ca, P and other elements higher then normal heart valves. This second type of the mineralization conducts to the changes of physical features of the tissue. Both types of calcification develops because of the defects of atomic structure of biological components of heart valves (mainly collagen). These defects show the presence of free atomic bindings i.e. electric potential. Because of this, they are able to react with surrounding free joints, starting calcification. Defects of biological structures of heart valves are the results of infections, mechanical destruction of the valves etc. Calcification may be stopped on different stages of its development: or as secret calcification or may pass to the stage seen as apatite grains.

Adult↗
PubMed1990

["Adolescent crisis" diagnosis reflected in the Rorschach diagnosis].

In clinical practice the problem of diagnosis and illness concept in adolescent psychiatry is related to the highly important consequences concerning various therapeutic approaches. Though the socalled diagnostic category "adolescent crisis" is not a real psychiatric one it serves for this purpose. The first part of this report is a review on the development and common use of this concept. The second part is an attempt to investigate the phenomena of adolescent disorder which constitute the diagnosis. For this research we use the Rorschachtest based on the study of 10 catamnestically controlled single cases. Evidence for the prognostic value of the Rorschach-results is-with respect to the question "adolescent crisis or schizophrenia?--the patients' clinical state and Rorschach-findings 5 years after their first hospitalization. In addition an attempt is made for find a Rorschach-syndrome which is related to the diagnosis "adolescent crisis".

Adolescent↗
PubMed1987

Studies on the organization of the human apolipoprotein B 100 gene.

The organization of five exons of the 3' terminal end of the human apolipoprotein B 100 (apo B 100) gene 1906, 184, 115, 7572 and 374 bp long have been determined from two overlapping EMBL3 human genomic clones extending over 18 kb. They encode more than 70% of the apo B 100 amino-acid sequence. The introns between these five exons were sequenced revealing the common intron/exon splice junction sequences. The 7572 bp exon is the longest exon so far reported for mammalian genes with the proposed sequence coding for the LDL receptor binding site. Its possible relationship to apolipoprotein B 48 is discussed.

Apolipoprotein B-100↗