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Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete最新文献

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[Synopsis of the interactions of heart and lung function]. [心肺功能相互作用的概述]。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-11-01
J Winkler, A Plath
{"title":"[Synopsis of the interactions of heart and lung function].","authors":"J Winkler,&nbsp;A Plath","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Due to the close connection between the functions of heart and lung there are no pathological changes in the one system without altering the physiology of the other. The interactions between heart and lung and their possible reactions are shown in some selected examples. On the one hand, in advanced lung diseases and in cor pulmonale one has to be on the look-out for concomitant disturbances of the left ventricular function for diagnosis, prognosis and therapy and on the other hand, there are deteriorations of chronic heart diseases due to secondary bronchopulmonary diseases. The treatment of combined cardiopulmonary disorders requires particular care.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 11","pages":"550-4"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19278192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Current aspects in diagnosis of chronic cor pulmonale]. [慢性肺心病的诊断现状]。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-11-01
L Steiniger
{"title":"[Current aspects in diagnosis of chronic cor pulmonale].","authors":"L Steiniger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pulmonary hypertension occurs frequently in patients with chronic obstructive lung diseases and contributes to a poor prognosis. Most common symptoms in addition to dyspnea, cough and expectoration are fatigue, syncopes, chest pain and peripheral oedema. No single non-invasive method such as lung function testing, blood gas analysis, ECG, chest x-ray, myocardial scintigraphy and isotopic radionuclide ventriculography is sufficiently reliable for predicting pulmonary hypertension. Only the combination leads to the diagnosis of pulmonary hypertension and cor pulmonale within acceptable limits. Echocardiography was found to be a reliable method of assessing right ventricular function. Doppler echocardiography is most useful with a specificity and sensitivity of about 80%. As \"golden standard\" cardiac catheterisation is still required for the measurement of pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), cardiac output (CO) and pulmonary capillary wedge pressure (PCWP) at rest and exercise.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 11","pages":"532-7"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19279660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Noninvasive diagnosis of pulmonary hypertension in patients with COPD using regression and discriminant analysis]. [基于回归和判别分析的COPD患者肺动脉高压无创诊断]。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-11-01
H Franz, J Schauer
{"title":"[Noninvasive diagnosis of pulmonary hypertension in patients with COPD using regression and discriminant analysis].","authors":"H Franz,&nbsp;J Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The evidence of elevated non-invasive parameters in prediction of pulmonary hypertension was examined in 168 patients with chronic obstructive pulmonary disease (COPD). Forced vital capacity (FVC), Tiffeneau-test (FEV1), oxygen partial pressure, x-ray ascertained diameter of right descending branch of pulmonary artery (RDB), myocardial scintigraphy, and right ventricular ejection fraction showed significant differences between patients with and without pulmonary hypertension. Neither of them alone allows prediction of pulmonary pressure exactly, only in combination non-invasive parameters are usable. In non-invasive diagnosis of catheterisation we suggest to use a regression function including FEV1, FVC and RDB by an ascertained specificity of 80% and sensitivity of 75%. To classify the patients according to normal and increased pulmonary artery pressure, FEV1, RDB and myocardial scintigraphy by a discriminant function with specificity/sensitivity of 80%, are relevant parameters. Accurate diagnosis of latent pulmonary hypertension requires right heart catheterisation. The domain of non-invasive diagnosis is screening and therapy monitoring of pulmonary hypertension, or if right heart catheterisation is contraindicated.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 11","pages":"538-43"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19279661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Therapy of chronic cor pulmonale]. 慢性肺心病的治疗。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-11-01
J Schauer
{"title":"[Therapy of chronic cor pulmonale].","authors":"J Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treatment of chronic cor pulmonale consists in therapy of causing disease and early influence of pulmonary hypertension. Long-time oxygen therapy is proved to be an effective measure of live support. Drug effects on pulmonary hypertension up to now are unsatisfactory. In special cases vasodilators have to be checked on responder rate. Right heart decompensation requires an in-patient treatment; physical rest, oxygen insufflation and diuretics are reliable.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 11","pages":"544-9"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19278191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Pathophysiology of pulmonary hypertension and chronic cor pulmonale]. [肺动脉高压和慢性肺心病的病理生理学]。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-11-01
S Daum
{"title":"[Pathophysiology of pulmonary hypertension and chronic cor pulmonale].","authors":"S Daum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pulmonary circulation has become possible only by right heart catheterisation. The point of increased pressure in relation to pulmonary capillary wedge pressure is divided into postcapillary (passive), capillary and precapillary (active) pulmonary hypertension (PH). We assume that reduction of alveolar oxygen partial pressure leads to a growth of mast cells not only peribronchially, but also especially perivascularly, causing pulmonary arteriolo-vasoconstriction during release of eicosanoids (mediators). The individual components (vasoconstrictive, obliterative, obstructive, reactive, nutritive, primary, porto-pulmonary) are discussed. Long-term elevated pulmonary artery pressure (increased arterial vasoconstriction) results in right heart hypertrophy, which begins particularly in the right heart ejection tract. Depending on the underlying parenchymal or vascular diseases, we must differentiate between chronic cor pulmonale parenchymal or vascular. Right ventricular catheterisation may be differentiated into compensated or decompensated situation. Timely normalisation of pulmonary artery pressure may even lead to regression of the right ventricular hypertrophy. Right ventricular contractility on hypoxia is basically different in adapted and non-adapted patients (important for therapy and prognosis). Progression of right ventricular muscle mass and constant myocardial vasculature will cause stenocardias; in that case, permanent oxygen insufflation is indicated. Right ventricular hypertrophy affects the left heart, conducting alteration in pulmonary circulation (pulmo cardialis).</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 11","pages":"525-31"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19279659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Primary pulmonary hypertension]. [原发性肺动脉高压]。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-11-01
J Winkler
{"title":"[Primary pulmonary hypertension].","authors":"J Winkler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 1% of the patients with cor pulmonale the cause of the high pulmonary artery pressure remains unclear. The underlying severe and mostly progressive pulmonary vascular disease with unknown aetiology is defined as primary pulmonary hypertension (PPH) with three different pathomorphological subtypes, plexogenic pulmonary arteriopathy (PPA), thrombotic pulmonary arteriopathy (TPA) and pulmonary venoocclusive disease (PVOD). The endemic occurrence of PPH after the ingestion of anorexigenic drugs (aminorex fumarate) and toxic rapeseed oil lead to the hypothesis that PPH is a pulmonary vascular reaction to exogenous toxic agents on the base of a genetic disposition. The initial response could be an endothelial cell dysfunction leading to pathological proliferation of vascular smooth muscle cells, vasospasm and local disturbances of haemostasis. The derived therapeutic concepts with vasodilators (high dose calcium channel-blocking therapy, prostacyclin) and with anticoagulant drugs show some encouraging results. The lung and heart-lung transplantation have become real therapeutic options for the patients with PPH considering the mostly still very unfavourable prognosis of PPH.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 11","pages":"555-62"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19278193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Clinical aspects, diagnosis and therapy of pulmonary embolism]. 【肺栓塞的临床特点、诊断及治疗】。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-11-01
F Heinrich
{"title":"[Clinical aspects, diagnosis and therapy of pulmonary embolism].","authors":"F Heinrich","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pulmonary embolism is a frequent and malignant complication of other diseases. To consider this is the most important step. ECG, pO2/pCO2, chest X-ray are used for differential diagnosis; pulmonary embolism is directly confirmed by scintigraphy, echocardiography, pulmonary angiography and pulmonary artery catheterisation, supplemented by examination of lower venous system (sonography, phlebography). Small emboli should also be noted as a signal of dangerous recurrence. The choice of the therapeutic method (embolectomy, fibrinolysis, anticoagulation) depends on the severity of pulmonary embolism, available methods and present contraindications. Depending upon the severity and general condition of the patient, it may be necessary to disregard possible contraindications against therapeutic methods that may cause desobliteration. Anticoagulation is used as prophylactic method, in exceptional cases a blockade is applied to the vena cava inferior.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 11","pages":"518-24"},"PeriodicalIF":0.0,"publicationDate":"1993-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19279658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Basic therapy of rheumatoid arthritis. Comparison of methotrexate and sulfasalazine]. 类风湿关节炎的基础治疗。甲氨蝶呤与柳氮磺胺嘧啶的比较。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-10-01
W Keitel, R Keitel, T Pap
{"title":"[Basic therapy of rheumatoid arthritis. Comparison of methotrexate and sulfasalazine].","authors":"W Keitel,&nbsp;R Keitel,&nbsp;T Pap","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In a retrospective analysis a total of 167 patients with rheumatoid arthritis (RA) who had been treated with the basic therapy formulas of methotrexate (MTX) or sulfasalazine (SUL) were evaluated with respect to therapeutical result and side effects after a period of 12 months. There was no randomization as to either MTX (n = 87) or SUL therapy (n = 80), but deliberate use of therapy according to prior treatment and activity of the illness. Apart from a significantly higher number of inflammatory joint conditions in the MTX group there was no difference in the two patient groups at the beginning of the study. MTX treatment led clearly to a more conspicuous activity decrease of the illness (ESR, joint index) and a more favourable effect on the locomotor function. Furthermore, the sphygmomanometer readings (for grip strength determination), the dose reduction of the concomitant prednisolone medication as well as the doctor's opinion were in favour of MTX. The portion of patients who had to discontinue the therapy because of side effects (= 11%) and lack of effect (= 9%) was exactly identical in both groups of patients. Both substances have shown to be effective basic therapy formulas for rheumatoid arthritis, while methotrexate has a few advantages.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 10","pages":"480-3"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18899970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Chronic pollution with environmental toxins: formaldehyde]. 【环境毒素:甲醛慢性污染】。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-10-01
O Paulus, R Werk, J Heinrich, H Schweisfurth
{"title":"[Chronic pollution with environmental toxins: formaldehyde].","authors":"O Paulus,&nbsp;R Werk,&nbsp;J Heinrich,&nbsp;H Schweisfurth","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Formaline is a colourless, strongly odoriferous gas. It is a very important basic component in chemical industry. It has become well known as a poison in residential areas due to its appearance in chipboard panels. Formaline causes a variety of acute and chronic toxic stress symptoms. In many cases the relation of formaline exposition and symptoms is difficult to demonstrate. The main keys to diagnosis are a very careful anamnesis and the cumulated appearance of symptoms. We intend to show several possible sources of stress symptoms caused by formaline, as well as diagnostic possibilities. This includes several methods of diagnostic assessing formaline concentration in the air, and several suggestions for the reduction of formaline emission.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 10","pages":"511-5"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19244749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Functional studies of the autonomic nervous system]. 自主神经系统的功能研究。
Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-10-01
W H Jost, U Kirchhöfer, A K Bellon, K Schimrigk
{"title":"[Functional studies of the autonomic nervous system].","authors":"W H Jost,&nbsp;U Kirchhöfer,&nbsp;A K Bellon,&nbsp;K Schimrigk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are many methods to choose from in the investigation of the autonomic nervous system. The value of the individual tests to the clinician varies according to the method of investigation used. No one test can elucidate all the information needed for all functional disturbances. As a routine, measurement of blood pressure and heart rate reaction to active orthostasis and heart rate variation with deep breathing and the Valsalva manoeuvre can be useful. Spectral analysis of the heart rate is an easily performed test, only minimally disturbing for the patient, and is a valid means of investigation which may find a way into routine clinical use in the future.</p>","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 10","pages":"469-75"},"PeriodicalIF":0.0,"publicationDate":"1993-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19244842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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