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Biomedical subjects

W Grimm

Publications and source records attributed to W Grimm.

At least 19 recordsLinked to original sources
PubMed1992

Electrocardiographically documented unnecessary, spontaneous shocks in 241 patients with implantable cardioverter defibrillators.

The incidence and cause of electrocardiographically documented spontaneous implantable cardioverter defibrillator (ICD) discharges for a rhythm other than ventricular tachycardia (VT) or fibrillation (VF) (unnecessary shocks) were determined in 241 patients who underwent ICD implantation between March 1983 and November 1991. During follow-up of 24 +/- 20 months, 54 of 241 patients (22%) received a total of 132 unnecessary ICD shocks confirmed by Holter or telemetry monitoring or stored electrograms (Egs) from the ICD. The rhythm preceding these unnecessary ICD shocks was atrial fibrillation in 30 patients, sinus or supraventricular tachycardia (SVT) in 11 patients, antitachycardia pacing triggered by atrial fibrillation or SVT resulting in VT in 5 patients, nonsustained VT in 3 patients, and normal sinus or pacemaker rhythm in 10 patients. Unnecessary ICD discharges occurred most frequently during the first week after implantation or generator replacement (18 of 54 patients [33%]). Unnecessary ICD discharges could be documented more often by stored Egs in patients with devices with Eg storage capability (Ventritex Cadence, 19 of 54 patients [35%]) than by Holter or telemetry monitoring in patients with devices without Egs storage capabilities (34 of 193 patients [18%], P < 0.01), despite a shorter mean follow-up duration of 14 +/- 9 months versus 26 +/- 21 months, respectively. Only six of 54 patients (11%) in whom unnecessary ICD discharges occurred had recurrent unnecessary shocks during 22 +/- 20 months of follow-up after treatment directed at the cause of the first episode or device reprogramming to preclude non-VT rhythm detection.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial Fibrillation↗
PubMed1992

[Scintigraphic use of 87Y during 90Y therapy of bone metastases].

Carrier-free 87Y is produced by cyclotron irradiation of Rb. It decays with a half-life of 80.3 h, transforming via 87mSr to stable 87Sr with the emission of gamma lines of 0.48 and 0.39 MeV. Experience in 6 patients shows good scan quality and correspondence between 99mTc-DPD and 87Y images useful in 90Y-citrate therapy for bone metastases. 87Y offers new possibilities of studying biological kinetics in 90Y therapy. To avoid contamination this should only be used in departments with possibilities of radioactive waste storage and controlled disposal.

Aged↗
PubMed1990

[Fatal pulmonary embolism in venous thrombosis of the leg and pelvis during lysis therapy].

A 19-year-old girl had for four weeks the clinical signs of recurrent pulmonary emboli and deep-vein thrombosis (tachycardia, dyspnoea, right inguinal pain), which had been misdiagnosed. The correct diagnosis was made only after drastic deterioration in her condition following appendicectomy for falsely diagnosed appendicitis. Urokinase infusion (80,000-160,000 IU/h for 11 days) having failed to bring about improvement, much greater than ultra-high much less than thrombolysis with streptokinase was begun (250,000 IU streptokinase over 30 min, followed by 9 million IU over 6 hours). Fatal pulmonary embolism occurred seven hours after the end of the infusion. Autopsy revealed extensive separation of thrombotic material in the pelvic veins. This observation and other reports should serve as a warning against using streptokinase in ultra-high doses if large veins, as those in the pelvis, are involved.

Adult↗
PubMed1990

The six-minute walk--an adequate exercise test for pacemaker patients?

In many pacemaker patients bicycle and treadmill ergometry are not practicable. As an alternative, we performed a 6-minute walk on a 20-m corridor in 97 pacemaker patients, who were asked to walk as far as possible determining their speed by themselves. Results were compared with those of bicycle ergometry in 42 of these patients and with treadmill exercise of a group of 92 other pacemaker patients. In the 6-minute walk, performance and maximal heart rate were slightly lower (49 +/- 18 W; 96 +/- 23 beats/min) than in bicycle (57 +/- 16 W; 110 +/- 26 beats/min) and treadmill ergometry (50 +/- 37 W; 102 +/- 35 beats/min). A good correlation was found between walking and bicycling (r = 0.74) and in subgroups of patients with different pacemaker indications. All patients preferred the walk to bicycle ergometry considering it to be more related to daily physical activity. In conclusion, a 6-minute walk is a simple and physiological exercise test for nearly all pacemaker patients with good correlation to other types of exercise. It seems to be preferable to other tests because of its better acceptance and practicability.

Aged↗
PubMed1990

Symptoms, cardiovascular risk profile and spontaneous ECG in paced patients: a five-year follow-up study.

UNLABELLED: Only few data are available about the course of symptoms, cardiac diseases, and spontaneous rhythm in pacemaker patients. Therefore, we followed the course of 308 paced patients (age 72 +/- 11 years) with a mean implantation time of 63 +/- 45 months. RESULTS: The symptom triad of syncope, dizziness, and dyspnea improved remarkably in 93% of patients. Thirty-nine percent suffered from coronary heart disease. The risk factors of hypertension (47%), nicotine (37%), and diabetes mellitus (25%) were found significantly more often than in a normal population with the same age and sex profile. In VVI paced patients with sick sinus syndrome (SSS, n = 67) atrial fibrillation (AF) occurred significantly more often (42%) than in patients with AV block (n = 80, 23%, P less than 0.05). Only one out of 41 DDD paced patients showed AF at follow-up. VVI stimulation seems to favor AF due to retrograde conduction in SSS. Only 3% of patients with SSS developed second- or third-degree AV block. Therefore, atrial pacing is preferable in most patients with SSS.

Aged↗
PubMed1989

Plasmid content, serotypes, and antimicrobial susceptibility of Neisseria gonorrhoeae strains isolated in Munich in 1987-88.

Eighty-four strains of Neisseria gonorrhoeae isolated in Munich between January 1987 and June 1988 were characterized in terms of their plasmid content, protein I serovar and susceptibility or resistance to four antimicrobial agents. Eighty two percent of the strains belonged to serogroup 1B, the three most prevalent serovars being 1B-1, 1B-2 and 1B-6. Among the serogroup 1A strains, 1A-2 was the commonest serovar. Fourteen strains (16.7%) lacked the 2.6 Md cryptic plasmid, although two of these strains contained the conjugative gonococcal plasmid. Although some degree of resistance to penicillin and tetracycline was noted, all the strains were sensitive to spectinomycin and cefotiam.

Anti-Bacterial Agents↗
PubMed1989

RCBF-quantification with 99mTc-HMPAO-SPECT: theory and first results.

The activity concentrations of 99mTc-HMPAO in brain after intravenous injection were evaluated in 25 patients using SPECT. With additional first pass studies of heart and brain with the short lived isotope 195mAu, the cardiac output and the mean cerebral transit times of the patients were measured a short time before the HMPAO injection. The time dependence of 99mTc-HMPAO activity in the brain was registered during the first 5 min after injection over both hemispheres. Using a simplified three compartment model it was possible to calculate the mean retention fraction of HMPAO in brain from the time activity curves. It could be shown that the regional cerebral blood flow in ml/min per 100 g can be calculated from the activity concentration of HMPAO in the brain, the cardiac output and the retention fraction. In 15 of the 25 cases the rCBF was measured using the planar 133Xe inhalation method as a reference. We found a significant correlation between the mean hemisphere CBF from our method and the mean hemisphere grey matter CBF from the Xenon method with a correlation coefficient of 0.73.

Adolescent↗
PubMed1989

[Disseminated herpes zoster in chronic lymphatic leukemia].

A 73-year-old woman suffering from chronic lymphatic leukemia presented a rare variant of zoster with disseminated eruptions. Ultrastructural negative staining revealed viruses of the herpes group. Herpes simplex was excluded by means of fluorescence-labelled monoclonal antibodies (HSV-1/HSV-2 direct specimen identification/typing test). It is proposed that the conventional classification of zoster into a segmental and a generalized variant should be supplemented.

Aged↗
PubMed1989

[The etiopathogenesis of ulcus molle: current status of knowledge--approaches to future research].

Chancroid is a sexually transmitted disease characterized by genital ulceration. Although the pathology of chancroid lesions has been well described, we still know relatively little about the mechanism by which the causative agent, the bacterium Haemophilus ducreyi, produces disease. It is hoped that a better understanding of both the pathogenicity of H. ducreyi and the pathogenesis of chancroid will provide a rational basis for the development of improved strategies for the control of this disease.

Animals↗
PubMed1988

Course of symptoms and spontaneous ECG in pacemaker patients: a 5-year follow-up study.

We investigated the course of symptoms and the spontaneous ECG retrospectively in 308 patients who had received a pacemaker because of atrioventricular (AV) block (n = 115), sick sinus syndrome (SSS, n = 107), bradyarrhythmic atrial fibrillation (bradyarrhythmia, n = 51), carotid sinus syndrome (CSS, n = 16), complete bifascicular block associated with 1st degree AV block (n = 13) and with other indications (n = 6). The mean implantation time was 63 months. The clinical state of 93% of all patients improved after pacemaker implantation; their symptoms decreased markedly. Persisting syncopy in some patients with SSS, however, supports a restricted implantation policy. We rarely saw improved AV conduction in patients with AV block (11%). Furthermore, in patients with SSS, atrial fibrillation occurred significantly more often (35%) than in those with AV block (17%; P less than 0.01). Only 3% of patients with SSS developed 2nd and 3rd degree AV block within the observation period. In all patients with initial bifascicular block and additional 1st degree AV block, pacing prevented further syncopal attacks; four of them showed 3rd degree AV block at control, indicating that pacemaker implantation is mandatory in symptomatic patients with bifascicular disease and 1st degree AV block.

Adult↗
PubMed1988

Atrial fibrillation and embolic complications in paced patients.

UNLABELLED: Atrial fibrillation (AF) and thromboembolism are discussed to be complications of the VVI mode. We reinvestigated the spontaneous ECG and the anamnesis of 246 pacemaker patients with the indications second and third degree atrioventricular block (AV block, n = lll), sick sinus syndrome (SSS, n = 101) and other indications (n = 34), all had shown sinus rhythm at implantation. The mean implantation time was 63 +/- 45 months (203 VVI and 43 dual chamber pacemakers). THE RESULTS: (1) Atrial fibrillation was found in 63 patients (26%). Only one of them had a DDD pacemaker inserted, the implantation time of dual chamber devices being shorter, however, (2) The incidence of AF in patients with SSS (37%) was significantly higher (P less than 0.01) than in patients with AV block (19%). (3) Three patients suffered from strokes or transitory ischemic attacks in the follow-up, only one of them had AF at control. CONCLUSIONS: Our results confirm that VVI stimulation favors AF long-term which is most likely due to irritation of the atrial rhythm by retrograde conduction. In our patients the incidence of thromboembolic complications was not higher in the group of patients with AF. However, from this study in surviving patients, we cannot exclude that we lost some patients due to severe stroke.

Aged↗
PubMed1987

[Diagnosis of growth hormone deficiency with the growth hormone releasing factor GRF 1-40. The potentials and limits].

Eleven patients with constitutionally delayed development, seven patients with idiopathic growth hormone deficiency and ten patients with craniopharyngeoma received growth hormone releasing factor GRF 1-40 in a dose of 1 micrograms/kg body weight as a bolus injection. In the patients with constitutionally delayed development, a mean maximum HGH value of 86.7 microU/ml was measured 30 minutes after GRF injection. Considerably higher HGH stimulation values were thus obtained after GRF than with conventional stimulation methods. In the patients with idiopathic growth hormone deficiency or craniopharyngeoma, there was mostly only a slight rise of the growth hormone level with a delayed onset. Merely two patients with craniopharyngeoma could be adequately stimulated in accordance with conventional criteria (HGH greater than 12 microU/ml), although their values also remained markedly below those of the patients with constitutionally delayed development. Both patients had somatomedin C values which were below that normal for their age; together with the delayed rise in HGH after GRF, this allowed diagnosis of growth hormone deficiency.

Adolescent↗
PubMed1987

Hemodynamic effects of experimental testicular torsion.

Experimental testicular torsion must be used for certain studies of clinical relevance, but most experimental models either do not provide hemodynamic alteration comparable to the clinical situation or cannot guarantee reproducibility. Using a rat model arterial perfusion and hemorrhagic infarction were correlated to the degree of both intra- and extravaginal testicular torsion. Arterial inflow was measured sequentially with radiolabelled microspheres, hemorrhagic infarction was judged by the increase of testicular weight. Maximal hemorrhagic infarction and reproducible values were found when the spermatic cord was twisted together with the tunica vaginalis for 360 degrees-540 degrees.

Animals↗
PubMed1986

Human corticotropin-releasing hormone in depression--correlation with thyrotropin secretion following thyrotropin-releasing hormone.

Twenty-two subjects (11 patients with major endogenous depression and 11 controls) received an intravenous test dose of 100 micrograms human corticotropin-releasing hormone (h-CRH). Corticotropin (ACTH), but not cortisol, responses were blunted in depressives. Basal cortisol secretion was higher in depressives than in controls and was negatively correlated to the corticotropin response following h-CRH. This finding indicates the integrity of the glucocorticoid-dependent negative feedback regulation in depression and supports the view that hypercortisolism in depression is primarily due to a suprapituitary disturbance. Comparison of ACTH responses after h-CRH with thyrotropin (TSH) output following thyrotropin-releasing hormone (TRH) revealed a positive correlation (r = 0.65, p less than 0.001). The concordance between ACTH and TSH responses after specific challenges suggests that regulation of both systems is at least in part under a common control.

Adrenocorticotropic Hormone↗
PubMed1986

[Changing of organ distribution of radioactive yttrium in rats by varying amounts of carrier].

There is little change in the organ distribution of yttrium citrate complex after addition of 0.01 mg/kg BW as carrier. Adding increasing amounts of inactive yttrium up to 1 mg/kg BW caused a considerable reduction in bone uptake and an increasing accumulation in the liver and spleen by transformation to colloid. Uptake in the lung indicates formation of macro-particles. The transformation into colloid can be varied by changing the citrate concentration. The 90Y-citrate complex for therapy should be used either without or with very little carrier of inactive yttrium.

Animals↗
PubMed1985

[Blood picture changes in rats after 90Y-citrate administration].

Therapeutic doses of 90Y-citrate show a high selective accumulation in bone. Bone marrow is the critical organ. Investigations in rats show a decrease of leucocytes, erythrocytes and thrombocytes depending on dose. A significant decrease of the leucocytes and thrombocytes was seen with 0.5 mCi (17.5 MBq) 90Y per kg bodyweight, with 2.0 mCi (74 MBq) also of the erythrocytes. This would be equivalent to a dose of 35 to 140 mCi (1.295 to 5.18 GBq) for a normal patient (70 kg). Therefore, a single dose of 10 mCi (370 MBq) of 90Y-citrate should be tolerated by a tumor patient without any blood cell depression, if there was no prior chemotherapy.

Animals↗