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Biomedical subjects

W Deuel

Publications and source records attributed to W Deuel.

13 recordsLinked to original sources
PubMed1991

[Brain abscess as a complication of Osler's disease with lung involvement].

Eight months after sustaining a reversible left motor hemisyndrome, predominantly of the arm, a 47-year-old man known to have hereditary haemorrhagic telangiectasia (Osler's disease) again developed neurological symptoms (headache, vertigo, unsteady gait) with fever (up to 38.5 degrees C). Clinical features and findings on computed tomography indicated a cerebellar abscess. This was resected because it continued to enlarge despite antibiotic treatment with daily 2 g ceftriaxone and twice daily 0.5 g ornidazole. As another manifestation of Osler's disease further tests revealed an arteriovenous malformation (2.5 x 2.0 cm) in the right upper lobe of the lung, presumably the cause of the cerebral abscess. After wedge resection of the anterior upper lobe segment the further course was without complications.

Arteriovenous Malformations↗
PubMed1991

[Swelling of the knee, fatigue].

A 43 year old man was admitted because of fatigue and swelling of the knees. Swelling of both knees, acropachy and turtle-back nails were registered during clinical investigation and laboratory tests showed leucocytosis, increased blood-sedimentation rate and alkaline phosphatase. Leucine aminopeptidase was normal. X-ray showed symmetric metaphyseal periosteal reactions on femora and tibiae of both sides compatible with hypertrophic osteoarthropathy. A parahilar round tumor measuring 5 x 7 cm infiltrating the right upper lobe was detected on chest x-ray suggestive of lung cancer. Pierre-Marie-Bamberger syndrome was diagnosed (hypertrophic osteoarthropathy associated with cancer of the lung). Under radiotherapy to the tumor the osteoarthropathy subsided and alkaline phosphatase returned to normal.

Adult↗
PubMed1989

[Intestinal drug smuggling--a new diagnostic and therapeutic problem].

Since spring 1985 81 persons were examined because of suspected intestinal drug-smuggling (body-packing). 46 patients (57%) had drug-packages in the gastro-intestinal tract, in 35 persons (43%) the suspicion was not confirmed. 26 patients had swallowed the drugs (mostly cocaine) whereas in 20 cases drugs were found in the rectum (mostly heroine). Most important for diagnosis was abdominal x-ray whereas in our hands abdominal sonography was unreliable. When body-packing is diagnosed, observation and mild laxative in conjunction with sufficient beverages are recommended. Serious complications in our series comprised one patient with mechanical ileus and another with heroine-poisoning after rupture of a package.

Adult↗
PubMed1983

Left ventricular relaxation at rest and during handgrip in aortic valve disease before and after valve replacement.

In 14 patients (pts) with aortic valve disease (AVD) left ventricular (LV) relaxation was assessed by the time constant (T) of LV pressure (tipmanometer) fall before and 19 months after successful aortic valve replacement (AVR). 12 control pts (CO) were studied by the same technique. Preoperative LV ejection fraction in AVD (64%) and in CO (69%) did not differ. In AVD T was increased (60 ms) as compared to the CO (38 ms, P less than 0.05). During handgrip (HG) there was a similar increase of LV peak systolic pressure (LVSP), heart rate and peak measured contractile element velocity of shortening in AVD and in the CO. LV end-diastolic pressure varied minimally in both groups. T decreased during handgrip in CO (38 to 33 ms, P less than 0.01) and remained unchanged in AVD. Following AVR T at rest decreased insignificantly to 52 ms, but remained increased (P less than 0.025) as compared with CO. During postoperative HG however, a decrease to 47 ms (P less than 0.05) was noted. Postoperative angiographic LV muscle mass (105 g/m2) and LVSP at rest (137 mmHg) remained elevated (P less than 0.02) as compared to CO (72 g/m2; 119 mmHg). It is concluded that (1) in AVD with normal ejection performance LV relaxation at rest is prolonged and the reaction of relaxation to HG is abnormal despite preserved contractile response, (2) following AVR the response of LV relaxation to HG becomes normal and (3) elevated postoperative T at rest appears to be related to residual hypertrophy and probably also to the still increased LVSP rather than to intrinsic disturbances of myocardial relaxation.

Adult↗
PubMed1982

[Relaxation of the left ventricle in aortic stenosis before and after aortal valve replacement].

In 14 patients with aortic valve disease (AVD) left ventricular (LV) relaxation was assessed by the time constant (T) of LV pressure (tipmanometer) fall before and 19 months after successful aortic valve replacement. 12 control patients were studied by the same technique. Preoperative LV ejection fraction in AVD (64%) and in controls (69%) did not differ. In AVD T was increased (60 ms) as compared to the controls (38 ms. p less than 0.05). During handgrip there was a similar increase in LV peak systolic pressure (LVSP), heart rate and peak measured contractile element velocity of shortening in AVD and in the controls. LV enddiastolic pressure varied minimally in both groups. T decreased during handgrip in controls (38 to 33 ms, p less than 0.01) and remained unchanged in AVD. Following aortic valve replacement resting T decreased insignificantly to 52 ms but remained increased (p less than 0.025) as compared to the controls. During postoperative handgrip, however, a decrease to 47 ms (p less than 0.05) was noted. Postoperative LVSP at rest (137 mm Hg) and LV muscle mass (105 g/m2) remained elevated (p less than 0.02) as compared to the controls (119 mm Hg; 72 g/m2). It is concluded that (1) in AVD with normal ejection performance LV relaxation at rest is prolonged, (2) the reaction of relaxation to handgrip is abnormal despite preserved contractile response, (3) following aortic valve replacement the response of LV relaxation to handgrip becomes normal and (4) elevated postoperative T at rest appears to be related to still increased LVSP postoperatively and residual hypertrophy rather than to intrinsic disturbances of myocardial relaxation.

Aortic Valve↗
PubMed1981

[How dependable is the end systolic pressure/volume relationship for the determination of left ventricular contractility in aortic valve diseases?].

The validity of the end-systolic pressure/volume ratio (ESP/ESVI) was evaluated in 88 patients with aortic valve disease (31 with aortic stenosis, 28 with aortic insufficiency and 29 with combined valve disease) by comparing the ESP/ESVI ratio with left ventricular systolic function parameters. The results demonstrate that in practice a normal EST/ESVI ratio excludes depression of myocardial contractility. A reduced ESP/ESVI ratio found in 57 patients did, however, correspond to other systolic function parameters indicating depressed or possibly depressed contractility in only 38 patients (66%), whereas biplane left ventricular ejection fraction and the isovolumic velocity indices were normal in 19 patients (33%) - 10 of whom had aortic insufficiency, 8 combined valve disease and only 1 aortic stenosis. It is therefore concluded that the ESP/ESVI ratio is of possible value for the diagnosis of depressed contractility only in patients with aortic stenosis.

Adult↗