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Biomedical subjects

W H Heiss

Publications and source records attributed to W H Heiss.

16 recordsLinked to original sources

Optomotor and neuropsychological performance in old age.

While a delayed initiation of visually guided saccades with increasing age has been documented in a number of studies, little research has been done on the control of antisaccades. The present study investigates aging effects on the control of visually guided saccades (prosaccades) and antisaccades as well as a selection of neuropsychological functions by the cross-sectional comparison of 14, 22, and 16 participants aged 20-35 years, 59-73 years, and 74-88 years, respectively. The geriatric and neurological status of the elder participants (including evidence from computed tomography, electroencephalography, and neurological soft signs) was assessed. In four task blocks of 200 trials each, pro- and antisaccades were elicited under the 200-ms-gap and overlap conditions. Left- and right-sided stimuli were presented in random order at 4 degrees, and the order of the task blocks was varied within each age group. In addition, the Wisconsin card-sorting test (WCST) and working memory, go-nogo discrimination, alertness, and stimulus-response incompatibility tests were administered. Participants aged 59-73 years exhibited widespread reductions of optomotor and neuropsychological performance, with greatest effect sizes of age differences in the optomotor parameters and the WCST measures. A further decay after the age of 73 years was discernible in those optomotor functions reflecting saccade disinhibition (in particular, directional errors during the antisaccade task and premature responses) and the performance in some neuropsychological tests. In line with previously published reports, variance in optomotor performance could be explained by two factors, accounting for a total of 76% of the age variance. Our results suggest that the investigation of saccade control may be a highly sensitive tool for neurodevelopmental aging research.

Adult↗

Influence of enoximone and UDCG-115 on coronary hemodynamics in idiopathic dilated cardiomyopathy.

Coronary hemodynamics were studied in 24 patients with idiopathic dilated cardiomyopathy and in 17 patients without any significant heart disease under resting conditions using the argon method. Neither myocardial blood flow normalized for 100 g muscle tissue nor myocardial oxygen consumption per minute (MVO2) or oxygen supply-demand ratio were different between these 2 groups of patients. When enoximone (1 to 2 mg/kg body weight) was given intravenously in patients with idiopathic dilated cardiomyopathy, myocardial oxygen consumption decreased by only 8% (difference not significant), whereas a significant (p less than 0.05) 26% decrease of myocardial oxygen consumption was observed after UDCG-115 (1.25 mg/hour intravenously). However, with both substances the oxygen supply-demand ratio significantly increased from 1.46 +/- 0.10 to 1.57 +/- 0.20 (p less than 0.025; enoximone) and from 1.40 +/- 0.08 to 1.56 +/- 0.19 (p less than 0.05; UDCG-115), respectively. It is concluded from these data that (1) resting coronary hemodynamics related to a unit of myocardium are not different between normal and idiopathic dilated cardiomyopathy, and (2) phosphodiesterase inhibitors exert beneficial effects on coronary hemodynamics by improving the oxygen supply-demand ratio.

Cardiomyopathy, Dilated↗

[Segmental aganglionosis of the small intestine--myth or reality? (A case report)].

Reports on zonal aganglionosis of the bowel are very rare and the few cases reported concern colon and rectum. We present a case of segmental aganglionosis of the jejunum in a 2-months-old boy. He had to be operated upon twice because of an ileus of the short bowel. At the second operation, a 10 cm long narrow segment of the jejunum was resected. The histological examination revealed a segmental aganglionosis of the plexus myentericus. Possible causes of this rare zonal aganglionosis could be: 1. Local damage of the plexus myentericus through anoxia. 2. Primary abnormity in the gastrointestinal anlage. 3. An intrauterine inflammation. 4. A double migration and development gradient of the precursors of the neuroblasts, from each end to the middle of the gut. A defect in the microenvironment of the enteric neurons would result in their failure in differentiation. This possible explanation would challenge the accepted theory of pathogenesis of colonic aganglionosis.

Follow-Up Studies↗

Influence of phosphodiesterase inhibition on myocardial energetics in dilative cardiomyopathy.

The effects of inhibition of phosphodiesterase by enoximone on left ventricular haemodynamics and myocardial energetics were investigated in 10 patients with idiopathic dilative cardiomyopathy. After intravenous administration of enoximone, there was a significant reduction of left ventricular systolic pressure from 126 +/- 21 to 93 +/- 16 mm Hg, of left ventricular end-diastolic pressure from 16 +/- 8 to 5 +/- 3 mm Hg and of left ventricular end-diastolic volume from 287 +/- 54 to 215 +/- 69 ml. Left ventricular pressure-volume work decreased significantly from 12.1 +/- 3.6 to 7.6 +/- 2.8 mm Hg.l. Heart rate was 87 +/- 17 before and 103 +/- 18 min-1 after administration of enoximone (p less than 0.01). Left ventricular systolic stress-time integral, a major determinant of myocardial oxygen consumption, decreased by 49% from 91 +/- 32 to 46 +/- 15 10(3) dyn.s/cm2 (p less than 0.01). In contrast myocardial oxygen consumption per beat was reduced by only 18%, from 138 +/- 28 to 113 +/- 17 microliters O2/100 g (p less than 0.01). The economy of myocardial contraction as calculated by the ratio of systolic stress-time integral to myocardial oxygen consumption per beat was 675 +/- 192 before and 370 +/- 128 dyn.s.100 g/cm2.microliter O2 after administration of enoximone. In conclusion, the phosphodiesterase inhibitor enoximone exhibits vascular and myocardial effects. The myocardial effects result in decreased economy of myocardial contraction. The possible molecular mechanisms of these energetic changes are discussed.

Cardiomyopathies↗

[Blunt abdominal trauma caused by child abuse].

We report about 3 boys under 4 years of age with abdominal blunt trauma following child abuse admitted to our clinic with different diagnoses. Common were fresh or older haematomas, burn wounds, for which the parents had no plausible explanation. The children had no skeletal or intracranial lesions, but they developed abdominal pain, which became worse in the absence of the parents. X-ray and the clinical course lead us to laparatomy. In all cases we found lesions of the intestines, especially near the duodenojejunal flexure, hepatoduodenal ligament, root of the mesentery, mesocolon and retroperitoneum, in one case a pancrease rupture. All these lesions were caused by child abuse. We want to point out the problem in the diagnosis of battered child syndrome, especially of the abdominal blunt trauma.

Abdominal Injuries↗

[Tuberculosis of the knee joint in a BCG-vaccinated child].

The case of a 17-month-old boy with tuberculosis of the knee is presented. Problems in diagnosis and treatment of this uncommon joint disease are pointed out. This complication is becoming nearly unknown, so that nowadays the diagnosis and therapy are almost regularly delayed. In every case of disease of the knee all diagnostic methods have to be used to recognize it. In this case, 5 months of therapy elsewhere passed before the diagnosis was made at a surgical exploration with biopsy of the joint. After drainage, inmobilisation and chemotherapy the healing was uneventful. The patient has no complaints and has full range movement of the knee 1/2 year after the end of therapy.

BCG Vaccine↗

[Bilateral diaphragmatic hernia].

A case of a newborn with bilateral Bochdalek's diaphragmatic hernia is reported. Because of respiratory distress the patient had to be operated on urgently; the left diaphragmatic hernia was repaired. On the 12th day of life, relaparatomy was performed and the right diaphragma was operated because of a suspected ileus. The clinical course was good and at the age of 11 weeks the patient was discharged. This malformation is extremely rare. Extensively studied cases of bilateral diaphragmatic hernia are not often found in literature.

Hernia, Diaphragmatic↗