PubMed Health⌕ Search

Biomedical subjects

T Wendt

Publications and source records attributed to T Wendt.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Ambulatory/partial inpatient phase II rehabilitation of heart patients in a Rhine-Main district rehabilitation clinic].

According to the guidelines and standards for a comprehensive phase II rehabilitation a new outpatient/part-time outpatient program was developed and started at an existing rehabilitation center in January 1997. All patients of the new program were included in a follow-up study and compared with patients of the same center, who met the inclusion and exclusion criteria for the outpatient mode, but wanted to perform their rehabilitation in the full-time residential mode. Both groups were examined before, at the end and 6 months after the program. Until December 1998 118 patients after an acute cardiac event such as myocardial infarction, PTCA or heart surgery were rehabilitated in the outpatient/part-time outpatient mode. The short- and medium-term results concerning somatic outcomes, e.g. the risk factor profile or the improvement of the maximum work capacity, were equal in both groups. Comparing the direct costs for a 4-week rehabilitation, the part-time outpatient program was 26%, the outpatient program even 52% cheaper than the standard full-time residential program. The new program is as effective as the residential rehabilitation, but it is cheaper. Because of the in- and exclusion criteria it is suitable for only a subgroup of cardiac patients, because of the demands and standards the new program it can be offered only in special rehabilitation centers.

Adult↗
PubMed1998

[Full working capacity instead of threatened retirement. Thrombendarterectomy in chronic thromboembolic pulmonary hypertension].

HISTORY AND CLINICAL FINDINGS: A 56-year-old man in marked right heart failure (stage III-IV of the New York Heart Association classification) and severe pulmonary hypertension was admitted to a rehabilitation clinic for therapeutic and social-medical assessment. On physical examination the important features were markedly distended neck veins, tachycardia at rest (90/min), a loud 2nd pulmonary sound and dyspnea. INVESTIGATIONS AND DIAGNOSIS: Non-invasive tests (ECG, echocardiography, abdominal ultrasound and lung functions) confirmed right heart failure; invasively obtained haemodynamic data indicated its severity. Selective pulmonary angiography defined the embolisation to be central and bilateral. TREATMENT AND COURSE: As intensive drug treatment and physiotherapy had failed to achieve significant improvement, operative removal of the bilateral central and some segmental pulmonary thrombi was performed and an inferior vena caval filter inserted. Immediately after operation the markedly elevated right-heart and pulmonary artery pressures fell markedly and there was dramatic improvement in the patient's general condition and in his physical capacity. Angiography demonstrated largely normal pulmonary perfusion. Instead of the anticipated retirement, the patient was discharged on anticoagulants, in the expectation of a return to full-time work. CONCLUSION: With pulmonary thrombendarterectomy severe chronic thromboembolic pulmonary hypertension may well be treated.

Echocardiography↗
PubMed1998

[Current research in cardiologic rehabilitation in Germany].

Within a few years a lack of research in cardiologic rehabilitation in Germany has changed to a boom in scientific work in that field. The short-term results of inpatient programs, collected in a number of multicenter studies, are available today. Long-term outcomes of these programs will be published soon. The main problem in Germany today is not the lack of research anymore but the poor reputation of rehabilitation in public and the missing acceptance of the published outcomes. In future the problem of preserving short-term rehabilitation benefits in the long run and economic questions will become more important.

Ambulatory Care↗
PubMed1998

Early diagnosis of cardiac involvement in systemic sclerosis by 123I-MIBG neurotransmitter scintigraphy.

Cardiac involvement of systemic sclerosis (SSc) is associated with a poor prognosis. Arrhythmias and conduction disturbances are a known feature of SSc. From histopathological examinations, it is known that the conducting system is secondarily involved as a result of focal fibrosis of the myocardium. Fibrotic changes are believed to be related to vasospasms, such as Raynaud's phenomenon. The sympathetic nervous system is very sensitive to ischaemia, impairing the energy-dependent uptake of intraneuronal norepinephrine. 123I-metaiodobenzylguanidine (123I-MIBG) is a metabolic analogue of norepinephrine and can therefore be used as a marker of norepinephrine depletion. The aim of the study was to evaluate the incidence and extent of SSc-associated ischaemic damage due to primary cardiac involvement by assessing intraneuronal 123I-MIBG uptake and distribution. Supplementary myocardial stress and rest perfusion scintigraphy, together with cardiological examinations (including an exercise stress test, Holter ECG and echocardiography), were performed in 18 patients. None of the patients showed evidence of ischaemia upon myocardial perfusion stress SPET or exercise stress. ECG at rest detected pathological conductance disturbances in one patient (6%). Holter ECG evoked pathological arrhythmias in three patients (17%). The echocardiograms of four patients (22%) showed a slight impairment of left ventricular diastolic function. 123I-MIBG scintigraphy revealed an inhomogeneous reduction of norepinephrine content in 15 patients (83%). It would appear that 123I-MIBG scintigraphy is able to detect cardiac SSc involvement prior to cardiological investigations.

3-Iodobenzylguanidine↗
PubMed1997

Does additional brachytherapy improve the effect of external irradiation? A prospective, randomized study in central lung tumors.

PURPOSE: Endobronchial brachytherapy has become more widely used to increase the total local dose of irradiation ("boost") applied for the treatment of lung cancer. Apart from treatment for local stenosis, endobronchial brachytherapy in combination with external irradiation (EI) has the potential to improve local tumor control and perhaps prolong survival, but the real benefit has not been proven yet. To evaluate the possible effects of external irradiation with an additional boost of high dose rate (HDR) brachytherapy, we conducted a prospective randomized study. METHODS AND MATERIALS: Design-two groups were compared: Group 1 was treated with external radiotherapy alone (planned dose 60 Gy); Group 2 received an additional boost of HDR brachytherapy of scheduled 4.8 Gy each (at 10 mm from the source axis) before and after external irradiation. Patients-98 patients with advanced inoperable lung cancer were included in the study, 42 in Group 1 and 56 in Group 2. Both groups were comparable with respect to age, sex, tumor stage, Karnofsky performance status (KPS), and histology. RESULTS: A mean total external irradiation dose of 50.5 +/- 14.1 Gy in Group 1 and 50 +/- 12.5 Gy in Group 2 was applied. Group 2 received an additional dose of 7.44 +/- 2.6 Gy (at 10 mm depth) through brachytherapy. The median survival time in both groups was comparable (28 weeks and 27 weeks, respectively). In patients with squamous cell carcinoma (68 patients) Group 2 showed an advantage in median survival with borderline significance (40 vs. 33 weeks, p = 0.09). Group 2 showed also a better local tumor control in all patients; patients with squamous cell carcinoma had a significantly longer period of local tumor control. Fatal hemoptysis was the cause of death in 6 (14.2%) patients in Group 1 and 11 (18.9%) in Group 2 (p = 0.53). CONCLUSIONS: High dose rate brachytherapy in patients with inoperable lung cancer increased local control in our randomized study when used in combination with external irradiation. Survival time was also longer, but with no clear statistical significance. This applied especially to patients with squamous cell carcinomas. There was no statistically significant difference in the incidence of fatal hemoptysis between the two groups.

Brachytherapy↗
PubMed1997

Structure of the Lethocerus troponin-tropomyosin complex as determined by electron microscopy.

Native troponin-tropomyosin complex was isolated from Lethocerus indicus indirect flight muscle and tested for function. It was shown by rotary shadowing and by forming paracrystals on monolayers that the regulatory complex consists of a troponin head region approximately 130 A in diameter and a 400-A-long troponin T-tropomyosin tail. The complex forms paracrystals at the air-water interface on a positively charged monolayer. The globular head packs in rows 380 A apart which are bridged by the tail domain. Filamentous paracrystals were obtained by adding Mg2+ ions to the troponin-tropomyosin sample. These showed globular domains arranged in a regular pattern along "ribbon"-like filaments. The spacing of the repeat was determined to be 380 A.

Animals↗
PubMed1997

[The vaginal stump recurrence rate in endometrial carcinoma in relation to the target volume of postoperative HDR-afterloading brachytherapy].

BACKGROUND: Basis for adjuvant strategies for patients with endometrial carcinoma is a postoperative staging including criteria such as myometrial tumor infiltration and histological grading. Such adjuvant strategies include afterloading therapy of the vagina as a long-established therapeutic concept. Our aim was to investigate the influence of the target volume on treatment results (i.e. local tumor control, side effects) in these patients. PATIENTS AND METHOD: At Jena University, Department of Radiotherapy, from 1981 to 1990 108 patients with endometrial carcinoma were postoperatively treated with high dose radiation brachytherapy of the vagina without additional percutaneous radiotherapy. Histology showed more or less differentiated adenocarcinoma in 90% of all patients, all patients were postoperatively stage I or II without proven lymphatic metastases. Dependent on individual figures patients were distributed to 3 different groups: group A: 4 x 10 Gy, tissue-thickness of 1 cm (vaginal apex) respectively 0.5 cm (lower vaginal walls); group B: 4 x 10 Gy, tissue thickness of 1 cm (upper vaginal wall); group C: 4 x 10 Gy, tissue-thickness of 0.5 cm (both excluding the lower vaginal walls). RESULTS: Both 3-year survival rates (group A: 96.6%, group B: 96.9%, group C: 97.7%) and tumor relapse rates of the vaginal apex (group A: 0, group B: 3.1%, group C: 2.2%) don't show significant differences. No case of local tumor recurrence was seen in the upper 2/3 of the vagina and the pelvic walls. Late side effects concerning bladder and rectum (grade III to IV, EORTC/RTOG) could be minimized by reducing the treatment volume (group A: 6.8%/12.6%, group B: 6.2%/3.1%, group C: 2.2%/0). CONCLUSIONS: Our results show the value of postoperative afterloading brachytherapy in patients with endometrial carcinoma, the brachytherapy of the upper vaginal wall is a sufficient therapeutic concept. Radiotherapy of the lower vaginal walls does not contribute to better tumor control, while it does significantly increase the number of unwanted side-effects in our investigation.

Adenocarcinoma↗
PubMed1996

Intravenous somatic gene transfer with antisense tissue factor restores blood flow by reducing tumor necrosis factor-induced tissue factor expression and fibrin deposition in mouse meth-A sarcoma.

Fibrin is deposited on the endothelial cell surface in the vasculature of murine methylcholanthrene A-induced sarcomas after injection of tumor necrosis factor (TNF). Capillary endothelial cells of the tumor vascular bed become positive for tissue factor after TNF injection, based on immunocytochemistry and in situ hybridization. Intravascular clot formation was not dependent on tissue factor derived from tumor cells, since in vessels of tumors not expressing tissue factor, TNF also induced fibrin/fibrinogen deposition. However, the time course of fibrin/fibrinogen deposition after TNF differed in tumors expressing no, little, or greater amounts of tissue factor. Fibrin/fibrinogen deposition was more rapid in tumors in which the neoplastic cells expressed tissue factor than in tumors not expressing tissue factor. In the tumors not expressing tissue factor, activation of coagulation was dependent on TNF-induced synthesis of tissue factor by host cells, i.e., endothelium or monocytes/macrophages. Intravenous somatic gene transfer with tissue factor cDNA in the antisense orientation (but not sense or vector alone) reduced intravascular fibrin/fibrinogen deposition and restored blood flow to the tumor, showing that de novo tissue factor expression is central in TNF-induced activation of the coagulation mechanism.

Animals↗
PubMed1996

[Total skin electron beam irradiation in cutaneous T-cell lymphoma].

PURPOSE: Patients with cutaneous T-cell lymphoma are treated in Germany mostly by dermatological local therapy like corticosteroids or PUVA-irradiation. Total skin electron beam irradiation is used rarely, even though it has a potentially curative character. We present an analysis of patients, who received a total skin electron beam irradiation after having progressive disease following other treatment modalities. PATIENTS AND METHODS: Twenty-one patients (mean age 58.9 years) in different stages were treated (stage IB and IIA n = 4, stage IIB n = 8, stage III n = 3, stage IV n = 6). All patients had progressive disease under other forms of local therapy. The irradiation was performed from 6 directions per hemibody using 2 axial fields which have each an 18 degree angle to the horizontal level. Six and 7 MeV fast electrons were used. Total dose was between 8 and 36 Gy in single dosis of 1 x 4 up to 5 x 2 Gy per week. In underdosed areas and areas of tumors of the skin boost irradiation with small fields was given. RESULTS: All patients had a good tumor regression (complete remission: n = 10, partial remission: n = 11). With the follow-up between 4 and 93 months total- and recurrence-free survival was 18 and 7 months (median). Patients in early stages with slow but complete remission of the symptoms had the best prognosis. Because of the small case number there was no significant difference between the groups. There were no severe side effects of the radiotherapy noted. CONCLUSION: Our analysis shows on a small patient number, that total skin electron beam irradiation has a good palliative effect on patients who have progressive disease following other types of treatment like PUVA or corticosteroids. The recurrence-free survival of 2 out of 4 patients with early stage disease (I-IIA) up to 93 month shows the potentially curative character of the treatment.

Adult↗
PubMed1995

[Primary radiotherapy of nasopharyngeal carcinoma].

One hundred twenty-one patients treated for nasopharyngeal carcinoma with radiation therapy were analyzed; 85 were male, 36 were female. Twenty-one percent had tumour stage T0/T1; 32.5%, T2; 27.5%, T3; and 19%, T4. In 75% of the cases, the lymph nodes were involved. Twelve patients underwent a neck dissection. Histology showed squamous cell carcinoma in 38%, lymphoepitheloid carcinoma in 41.4%, undifferentiated carcinoma in 19%, and adenocarcinoma in 2%. Beginning in 1980, a modified radiation technique with large portals and an increase of the dose from 57.1 Gy to 61.5 Gy targe volume dose was used. Five year overall survival was 32.1%, recurrence-free survival, 30.7%; and local recurrence free survival, 45.8%. Age, sex, and T stage had no significant influence on survival. Multivariate analysis (Cox model) showed that involvement of the lymph nodes, histology, and the new irradiation technique with the higher total dose significantly influenced survival.

Adenocarcinoma↗
PubMed1995

Palliative endobronchial brachytherapy for central lung tumors. A prospective, randomized comparison of two fractionation schedules.

AIM OF THE STUDY: Remote high dose rate brachytherapy is an effective local treatment modality for central lung tumors and has the potential to improve survival time. Optimal dose and fractionation schemes have not been identified yet. We conducted a prospective randomized study to compare two treatment schedules in terms of survival time, local tumor control, and possible complications. DESIGN: Group 1 received 4 brachytherapies with a dose of 3.8 Gy (at a 10-mm depth) on a weekly basis, and group 2 received 2 treatments with 7.2 Gy (at a 10-mm depth) at a 3-week interval. At a depth of 5 mm, the calculated doses would be 8 and 15 Gy. This study is still ongoing. Here we report interim results. PATIENTS: Ninety-three patients with advanced cancer were included in the study; 44 were in group 1 and 49, in group 2. Both groups were comparable regarding age, sex, tumor stage, Karnofsky performance status, and histologic findings. INTERVENTIONS: A mean total irradiation dose of 13.4 +/- 5.2 Gy for group 1 and 13.7 +/- 4.4 for group 2 were applied (calculated at 10 mm from the source axis, equivalent to 27.9 Gy in group 1 and 28.5 Gy in group 2 at a 5-mm depth). RESULTS: The 1-year survival rate was 11.4% in group 1 and 20.4% in group 2. No significant difference in survival time was found, but mean survival was longer in group 2 (49 weeks) than in group 1 (26 weeks). Local control after 3 months was comparable in both groups. Fatal hemoptysis occurred at a similar rate in group 1 (22.2%) and in group 2 (21.1%). CONCLUSION: High-dose rate brachytherapy with 2 x 7.2 Gy with a 3-week interval is equivalent to a 4 x 3.8-Gy regimen on a weekly basis. The shorter treatment schedule is more convenient for patients, does not cause more side effects, and provides an equal local tumor control.

Adult↗
PubMed1995

Tissue factor expression in an animal model of hydronephrosis.

BACKGROUND: Hydronephrosis is associated with interstitial fibrosis and occlusion of renal capillaries by fibrin. However, the mechanisms leading to fibrin formation is unknown. METHODS AND RESULTS: Twenty days after unilateral ligation of the ureter, interstitial fibrosis occurred in the ligated kidney. Fibrosis was preceded by infiltration of inflammatory cells (macrophages, B and T lymphocytes). Staining with an antibody against von Willebrand factor demonstrated newly formed capillaries in the fibrosing tissue as well as prominent fibrin deposition. Fibrin staining was found around vessels, in the interstitium, the glomeruli, and tubuli. Fibrin deposition was less prominent in the non-ligated kidney and almost absent in sham-operated animals. The expression of tissue factor, the central initiator of coagulation, was induced within 5 days after ligation in the operated kidney but not in the sham-operated animals. Tissue factor positivity was observed by immunohistochemistry in vascular endothelial cells, the vessel wall, tubular epithelial cells, glomerular capsular cells, Bowman's space and in the interstitium. Tissue factor induction was due to increased transcription, since in-situ hybridization showed increased levels of mRNA in the ligated kidney compared to sham-operated rats. The tissue factor gene is under control of the transcription factors activator protein-1 (AP-1) and nuclear factor-kappa B (NF-kappa B). When extracts of operated organs were compared with kidneys of sham-operated rats or contralateral kidneys in electrophoretic mobility shift assays, an increase in AP-1 and NF-kappa B binding activity to their respective binding sites in the tissue factor gene was observed in the operated, but not in the contralateral kidney or kidneys of sham-operated animals. CONCLUSION: Ureteral ligation leads to infiltration of inflammatory cells, increased AP-1 and NF-kappa B expression in the kidney, resulting in increased tissue factor transcription and translation, and ultimately in increased fibrin deposition.

Animals↗
PubMed1994

[The prognostic factors following the simultaneous radiochemotherapy of anal canal carcinoma in a multicenter series of 139 patients].

PURPOSE: Evaluation of prognostic variables, results and toxicity after chemo-radiation (CRT) of anal canal carcinoma (ACC). MATERIAL AND METHODS: Between 1982 and 1992, 139 patients with epidermoid carcinoma of the anal canal were treated by radiation and chemotherapy with 5-fluorouracil (5-Fu) and mitomycin C (MMC). 99 patients belonged to a prospectively designed trial (50 Gy, 2 courses of chemotherapy) and 40 to a historical control group (40 Gy, 1 course of chemotherapy). The female/male ratio was 116/23. Median age was 62 years. Staging (UICC 1987): T1: 16.5%; T2: 49%; T3: 23%; T4: 9.4%; unknown: 2.1%. Abnormal regional nodes were present in 15% of the patients. HISTOLOGY: Squamous cell carcinoma: 68%; cloacogenic carcinoma: 31%; unknown: 1%. External beam radiation (ERT) was given to the primary tumour including perirectal, inguinal and iliac nodes by a 3 to 4 field box technique (50 patients) or parallel opposed fields (89 patients). Median single fraction and total dose were 1.8 Gy and 50 Gy. An additional boost to the involved sites was delivered by ERT (32 cases; median dose 16 Gy) or interstitial brachytherapy (BT) in 28 cases with a median dose 14 Gy. 84 patients (60%) received 2 or more cycles, 50 patients (36%) 1 cycle, 5 patients (4%) no chemotherapy. RESULTS: The survival rate, NED-survival rate and local tumour control rate were 78%, 64% and 69% at 5 years. Anorectal function was retained in 94 of 139 patients (68%). Multivariate analysis indicated that T-stage (p = 0.037) and belonging to the historical control group (p = 0.003) were significant variables for local tumour control. T-stage was a marginally significant factor (p = 0.09) for NED-survival. Acute toxicity of grade 3 and 4 (WHO) was observed in 36%, severe late toxicity (grade 3 Eschwege) in 3% of the patients. CONCLUSIONS: CRT with 2 courses 5-FU, MMC and ERT to a total dose of 45 to 50 Gy is a safe and effective treatment for ACC. Intensification of treatment is recommended in advanced stages T3/4.

Adult↗
PubMed1993

Bone metabolism before and after irradiation with ultraviolet light.

The beneficial effects of ultraviolet light on cutaneous vitamin D synthesis, calcium metabolism, and bone formation are well known. Regarding the increasing fear of side effects from ultraviolet B (UV-B), lamps with less energy in the UV-B range have been developed. Two spectra with differences in the emission of UV-B have therefore been evaluated for their influence on calcium metabolism. A group of 24 healthy male volunteers was subdivided into two treatment groups. Group 1 was exposed to lamps with higher energy of total UV-B but less energy at the wavelengths below 300 nm than the lamps used in group 2. All subjects were irradiated ten times within 12 days. Exposure time was 3 min in the first session and time of exposure was increased by 10% in every following irradiation (suberythematous doses only). Before the first irradiation, 3 days after the last exposure, and after 4 more weeks, the serum parameters of bone metabolism were determined by standard laboratory methods. Significantly increased levels of 25-hydroxyvitamin D3 were found in both groups. There was only a slight increase of 1,25-dihydroxyvitamin D3. Parathyroid hormone decreased significantly in group 2 only. The data would suggest beneficial effects on bone metabolism for both regimens. The observed effects were more pronounced when shorter wavelengths (group 2) were applied, although the total energy of UV-B was lower in these lamps.

Adult↗
PubMed1993

Digital storage phosphor radiography for treatment verification in radiotherapy.

The potential of digital storage phosphor radiography (SR) to improve image quality of portal radiographs is evaluated. Conventional film radiographs (FR) and corresponding SR verification images of an anthropomorphic phantom and various irradiation ports of patients were obtained with high-energy photon beams. For both techniques conventional films and storage phosphor screens were placed into a cassette with steel screens. Images were evaluated according to contrast and spatial resolution, delineation of anatomical structures, position of shielding blocks and accuracy of field alignments. Evaluation of 33 pairs of SR and FR portal images yielded a superior contrast resolution of SR in 47% (contrast air-soft tissue) and 37% (bone-soft tissue). Thus SR allows quick and easy detectability of anatomical structures as well as a better definition of block positions and field alignments. Shorter exposure times for computed images may result in a reduction of motion artefacts. SR images are indispensable in modern radiation therapy units, as they are instantly available in a computerized network for further image processing and analysis.

Humans↗
PubMed1993

[Does ST-elevation in stress ECG depend on the extent of collateral circulation?].

As a possible cause of exercise-induced ST-elevation in patients without myocardial infarction, a poor or absent coronary circulation to the poststenotic coronary segment was postulated. To check this thesis, we examined 10 patients (pts.) with ST-elevation, respectively, ST-depression and comparable coronary status (coronary score 12 vs. 12; mean stenosis diameter 86 vs. 85%) and exercise parameters (work load 150 vs. 137.5 Watts; exercise duration 2.8 vs 3.5 min) with regard to their collateral circulation. In the group with ST-elevation there were nine pts. with severe proximal stenosis of the left anterior descending artery (LAD) and one pt. with a stenosis in the middle third of the right coronary artery. The 10 patients with ST-depression had a proximal stenosis in the LAD. The extent of the angiographically seen collaterals was equal in both groups. As a result, this study demonstrates that the size of the collateral circulation has no influence on the exercise-induced ST-elevation. The most plausible cause of exercise-induced ST-elevation is a functional decrease of the lumen of a severe stenosis.

Arrhythmias, Cardiac↗
PubMed1993

[Surgical revascularization in patients with acute myocardial infarction].

This retrospective study was done to assess the results of emergency revascularization in patients with acute myocardial infarction. In addition, the influence of the mode of reperfusion was investigated in terms of morbidity and mortality. Between January 1987 and May 1992, 75 consecutive patients with acute coronary occlusion (in 87% PTCA-failure) received one of two different reperfusion protocols during emergency aortocoronary bypass operation. In 36 patients, the reperfusate was normal blood given at systemic pressure (uncontrolled reperfusion); in 39 patients, the ischemic area was initially reperfused for 20 minutes with a blood cardioplegic solution (substrate-enriched, hyperosmolar, hypocalcemic, alkalotic, diltiazem-enriched) given at 37 degrees C and at a perfusion pressure of 50 mmHg. Thereafter, the heart was kept in the beating empty state for 30 minutes before extra-corporeal circulation was discontinued (controlled reperfusion). Regional contractility (echocardiography, radionuclide ventriculography), electrocardiogram (ECG), release of creatine kinase and MB-isoenzyme of creatine kinase as well as hospital mortality were assessed. Quantification of regional contractility was done with a scoring system from 0 (normokinesis) to 4 (dyskinesis). Data are expressed as mean +/- standard error of the mean (SEM). Both groups were well matched for age, sex, and the distribution of the occluded artery. In the controlled reperfusion group, there was a higher incidence of additional significant stenosis (2.2 +/- 0.1 vs 1.7 +/- 0.1) and cardiogenic shock (36% vs 17%). Furthermore, the interval between coronary occlusion and reperfusion was longer in the controlled reperfusion group (4.1 +/- 0.3 vs 3.3 +/- 0.3 hrs; p > 0.05). Regional contractility returned to normal after controlled reperfusion (score 0.8 +/- 0.2; normokinesis = 0, slight hypokinesis = 1). In contrast, regional contractility remained depressed severely after uncontrolled reperfusion with normal blood (score 1.5 +/- 0.3; p < 0.05). Enzyme release and ECG-changes were similar in both groups postoperatively. While only 2 of 39 patients died in the controlled reperfusion group (5.1%), mortality increased to 11.1% (4/36) if normal blood is used as the primary reperfusate. Our data show, that the surgical revascularization during acute myocardial infarction can be performed with acceptable mortality and morbidity rates. Further improvement of the results can be obtained if controlled regional reperfusion for the previously ischemic area is used.

Angioplasty, Balloon, Coronary↗