Publications (61)85.96 Total impact
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Article: Empfehlungen des International Cardiology Forum (ICF) 1998 zur Revision der bestehenden Richtlinien zur Diagnostik und Therapie der instabilen Angina pectoris und des nicht-transmuralen Myokardinfarktes
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ABSTRACT: Rasche Fortschritte im Verständnis und in der Behandlung der instabilen Angina pectoris sowie des akuten Koronarsyndromes machen von Zeit zu Zeit Überarbeitungen der Therapie-Leitlinien für diese Erkrankung erforderlich. Die hier gemachten Empfehlungen basieren auf einem Consensus, welcher aufgrund der Diskussionen des ‘International Cardiology Forum im September 1998’ erreicht werden konnte. Obwohl die Empfehlungen in Teilbereichen weiterhin umstritten bleiben, gibt es wesentliche Bereiche, bei welchen zwischenzeitlich eine ausreichende Datenbasis aus Studien vorliegt, welche Änderungen in den therapeutischen Gepflogenheiten nahe legen. Rapid progress in the understanding and treatment of unstable angina and acute coronary syndrome are prompting occasional revisons to current treatment guidelines. The recommendations contained in this paper are based on the consensus reached during discussions at the ‘International Cardiology Forum’ in September 1998. Consensus was reached on significant major points, although some aspects remain controversial. A substantial body of data accumulated in a host of studies justify changes to current treatment habits. Schlüsselwörter Instabile Angina pectoris – Unstabile¶Koronarsyndrom – Therapie –¶DiagnoseKey words Unstable angina –¶acute coronary syndrome –¶therapy – diagnosisZeitschrift für Kardiologie 04/2012; 89(8):706-721. · 0.97 Impact Factor -
Article: [Persistent sinusoids of the left chamber wall].
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ABSTRACT: Angiographic pictures of persistent sinusoids of the left chamber wall are presented. The clinical significance of this very rare phenomen is not clear yet.Zeitschrift für Kardiologie 04/2002; 91(3):267-8. · 0.97 Impact Factor -
Article: Aberrant right subclavian artery (arteria lusoria) as a rare cause of dysphagia and dyspnea in a 79-year old women with right mediastinal and retrotracheal mass, and co-existing coronary artery disease.
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ABSTRACT: A rare case of a 79-year old women with dysphagia and dyspnea secondary to compression of the esophagus by an aberrant right subclavian artery (ARSA, A. lusoria) is presented. This abnormality is generally silent and often an incidental x-ray finding. Computed tomography and intraarterial angiography, including direct catheterization of the ARSA, established the diagnosis. The interdependence with a co-existing coronary artery disease is discussed. Thus, ARSA has to be taken into account in patients with abnormal x-ray findings presenting with dysphagia and dyspnea.VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases 08/2001; 30(3):225-8. · 1.31 Impact Factor -
Article: [Recommendations of the International Cardiology Forum (ICF) 1998 on revision of the current guidelines for the diagnosis and treatment of unstable angina pectoris and nontransmural myocardial infarct].
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ABSTRACT: Rapid progress in the understanding and treatment of unstable angina and acute coronary syndrome are prompting occasional revisions to current treatment guidelines. The recommendations contained in this paper are based on the consensus reached during discussions at the 'International Cardiology Forum' in September 1998. Consensus was reached on significant major points, although some aspects remain controversial. A substantial body of data accumulated in a host of studies justify changes to current treatment habits.Zeitschrift für Kardiologie 09/2000; 89(8):706-21. · 0.97 Impact Factor -
Article: Exhaustive cycle exercise induces P-selectin expression, coagulation, and fibrinolysis activation in ultraendurance athletes.
Thrombosis Research 06/1999; 94(4):263-9. · 2.44 Impact Factor -
Article: [Detection of bone metastases in patients with neuroendocrine gastrointestinal tumors].
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ABSTRACT: In patients with neuroendocrine gastrointestinal tumors and liver metastases, but without known extrahepatic manifestations, liver transplantation may be indicated as curativ or "long-term-palliativ" therapy. For these patients the absence of bone lesions is mandatory. 4 patients with a histologically proven neuroendocrine tumor were examined in order to exclude further metastases. We compared the diagnostic value of somatostatin-receptor-scintigraphy (SRS), X-ray, 99mTc-DPD-scintigraphy, CT and MRI. In all 4 patients bone metastases could be detected using SRS, CT und MRT. In one case MRI proved multiple infiltrations, while SRS showed only a solitary, focal lesion. 99mTc-DPD-scintigraphy was positive in 3 cases, X-ray in 1 case. As a diagnostic strategy we initially recommend somatostatin-receptor-scintigraphy. When locating suspect areas in SRS, MRI should be the method of choice for the exact evaluation of malignant bone infiltrations. A CT-guided biopsy is necessary to gain histological information.Der Radiologe 04/1999; 39(3):235-40. · 0.61 Impact Factor -
Article: [Heart diseases in thoracic radiographic images. 2].
Der Radiologe 03/1999; 39(2):164-72. · 0.61 Impact Factor -
Article: Zur Detektion von Knochenmetastasen bei Patienten mit neuroendokrinen gastrointestinalen Tumoren
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ABSTRACT: Einleitung: Bei Patienten mit neuroendokrinen gastrointestinalen Tumoren und multipler Lebermetastasierung ohne weiteren Nachweis extrahepatischer Manifestationen kann die Lebertransplantation als ein kurativer Therapieansatz oder als „Langzeitpalliativtherapie” durchgeführt werden. Für diese Patientin ist der Nachweis oder Ausschluß ossärer Filiae von existentieller Bedeutung. Material und Methodik: 4 Patienten mit einem histologisch gesicherten neuroendokrinen Tumor wurden mit der Fragestellung zusätzlicher Metastasenmanifestationen untersucht. Dabei wurde die Wertigkeit der Somatostatin-Rezeptor-Szintigraphie (SRS) im Vergleich zur konventionellen Röntgenaufnahme, der 99mTc-DPD-Szintigraphie, der CT und der MRT verglichen. Ergebnisse: Der Nachweis ossärer Filiae gelang bei allen 4 Patienten mittels SRS, CT und MRT. In einem Fall zeigte die MRT jedoch einen multiplen, kleinfleckigen Befall der ossären Strukturen, während in der Somatostatin-Rezeptor-Szintigraphie nur ein fokaler Herd nachgewiesen wurde. Die 99mTc-DPD-Szintigraphie war in 3 Fällen und die konventionellen Röntgenaufnahmen in einem Fall richtig positiv. Diskussion: Als diagnostisches Konzept schlagen wir initial die Durchführung einer Somatostatin-Rezeptor-Szintigraphie vor. Nach Lokalisation suspekter Areale durch die SRS sollte die MRT als Methode der Wahl zur exakten Abklärung einer malignen Infiltration zum Einsatz kommen. Zur Sicherung der Diagnose ist eine CT-gesteuerte Knochenbiopsie erforderlich. Introduction: In patients with neuroendocrine gastrointestinal tumors and liver metastases, but without known extrahepatic manifestations, liver transplantation may be indicated as curativ or „long-term-palliativ” therapy. For these patients the absence of bone lesions is mandatory. Methods: 4 patients with a histologically proven neuroendocrine tumor were examined in order to exclude further metastases. We compared the diagnostic value of somatostatin-receptor-scintigraphy (SRS), X-ray, 99mTc-DPD-scintigraphy, CT and MRI. Results: In all 4 patients bone metastases could be detected using SRS, CT und MRT. In one case MRI proved multiple infiltrations, while SRS showed only a solitary, focal lesion. 99mTc-DPD-scintigraphy was positive in 3 cases, X-ray in 1 case. Conclusion: As a diagnostic strategy we initially recommend somatostatin-receptor-scintigraphy. When locating suspect areas in SRS, MRI should be the method of choice for the exact evaluation of malignant bone infiltrations. A CT-guided biopsy is necessary to gain histological information.Der Radiologe 02/1999; 39(3):235-240. · 0.61 Impact Factor -
Article: [Heart diseases in thoracic radiographic images. I].
Der Radiologe 02/1999; 39(1):84-92. · 0.61 Impact Factor -
Article: Troponin T in patients with low grade or atypical angina. Identification of a high risk group for short- and long-term cardiovascular events.
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ABSTRACT: Cardiac troponin T is an established marker of cardiovascular risk in patients with severe angina pectoris. Data are scarce on patients admitted to a coronary care unit with low grade or atypical angina pectoris to rule out myocardial infarction. We investigated 106 patients (57.4 SD 11.6 years) with low grade (Braunwald class I) or atypical symptoms out of 702 patients admitted to the coronary care unit with suspected acute myocardial infarction. Serum concentrations of troponin T were measured at admission and 4 h later. In hospital cardiovascular events including acute myocardial infarction, life threatening cardiac arrhythmias, congestive heart failure, and death were recorded. Patients were additionally observed after 3 and 6 months post-discharge regarding acute myocardial infarction, unstable angina, rehospitalization for cardiac causes and death. The patients were divided into a troponin T positive (> or =0.2 microg x 1(-1) at admission or 4 h later; n=11) and a troponin T negative group. The mean value of troponin T 4 h after admission in the positive group was 0.58 microg x 1(-1). Of the troponin T positive patients, 0.82 (0.95 CI: 0.48-0.98) had a cardiovascular event during their stay in hospital vs 0.41 (0.95 CI: 0.31-0.52) of troponin T negative patients (P<0.05). In the troponin T positive group 0.64 (0.95 CI: 0.31-0.89) developed myocardial infarction in hospital vs 0.07 (0.95 CI: 0.03-0.15) in the troponin T negative group (P<0.001). Troponin T predicts outcome after 3 and 6 months significantly (P<0.05). Troponin T identifies patients with low grade or atypical angina at risk of severe short- and long-term cardiovascular events. Therefore, troponin T adds substantial information in patients with ruled out acute myocardial infarction. Troponin T positive patients have to be observed carefully regardless of their symptom intensity and may have to receive early cardiac catheterization; troponin T negative patients could be released safely from the coronary care unit early.European Heart Journal 12/1998; 19(12):1802-7. · 10.48 Impact Factor -
Article: Quantitative estimation of I-123-Iomazenil receptor binding in temporal lobe epilepsies using two SPECT acquisitions--comparison with the regional cerebral blood flow and a compartment model.
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ABSTRACT: To compare published fractional rate constants of I-123-Iomazenil (IMZ) and C-11-Flumazenil (three-compartment/four-parameter model) with a I-123-Iomazenil receptor index calculated from two SPECT acquisitions and to compare the receptor index of the epileptogenic area with the contralateral side in patients with unilateral temporal lobe epilepsies. 28 patients were studied. 13/28 patients had a drug-resistant unilateral temporal lobe epilepsy with a successful focus localisation performed by an extensive video/EEG monitoring. 15 other patients with clinically suspected focal epilepsy and a normal MRI and IMZ SPECT scanning were used as controls. SPECT scanning was performed in all patients 15 and 100 min after intravenous injection of 111 MBq IMZ and 10 min after application of 740 MBq Tc-99m-HMPAO. Quantification of the regional uptake was performed using ROI-technique and the specific and non-specific binding of IMZ was calculated. The receptor index was calculated by the difference of the specific binding from 15 to 100 min p.i. divided by the time interval. The receptor index showed a linear correlation with recently published fractional rate constants k3 (r = 0.69 and 0.67; p = 0.15) and a moderate correlation with the k4 constant (-0.53 and -0.43; p = 0.28) by the means of C-11-Flumazenil PET and I-123-Iomazenil SPECT studies, respectively. However, statistical significance was not reached due to the few data points available from the published reports. Furthermore, the IMZ receptor index was lower in the epileptogenic area of patients with unilateral temporal lobe epilepsies compared with their contralateral side (p = 0.02; Wilcoxon-test). The IMZ receptor index showed a weak correlation with the regional cerebral blood flow independent of the evaluated region (r < 0.4; p < 0.05). The IMZ receptor index indicated to be a simple routine approach to estimate the fractional rate constant k3 (r = 0.67). The lower value of the receptor index within the epileptogenic area might be due to a lower receptor density. However in further studies, IMZ might be a helpful tool to find out subtle changes of the receptor affinity due to its approximately 30-fold higher ligand-receptor affinity compared to C-11-Flumazenil.Nuklearmedizin 03/1998; 37(2):49-56. · 1.28 Impact Factor -
Article: [Use of Ga-67 SPECT in patients with malignant lymphoma after primary chemotherapy for further treatment planning: comparison with spiral CT].
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ABSTRACT: To compare the diagnostic value of gallium scintigraphy using a SPECT technique with spiral CT for evaluating activity following chemotherapy in patients with malignant lymphoma and to determine treatment options. The results of gallium scintigraphy in 28 patients with malignant lymphoma (19 Hodgkin's disease, 9 high grade non-Hodgkin's lymphoma) following curative treatment were compared with the CT morphology in relation to inactive regions and residual masses. Ga-67-SPECT proved superior to CT for evaluating the activity in 85 initially involved nodes (sensitivity 94.4% against 83.3%; specificity 100% against 92.5%). It was, however, inferior for demonstrating organ involvement in 28 instances. In seven patients with residual masses, Ga-67-SPECT directly affected staging and further therapy. The increasing use of secondary treatment schemes for curative purposes makes Ga-67-SPECT a suitable method for the early recognition of residual activity in Hodgkin's disease and high grade non-Hodgkin's lymphoma.RöFo - Fortschritte auf dem Gebiet der R 12/1997; 167(5):458-66. · 2.76 Impact Factor -
Article: Hemodynamic action of captopril in coronary patients with heart failure tolerant to nitroglycerin.
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ABSTRACT: At present there is little dispute that clinical tolerance of organic nitrates occurs during long-term treatment of patients with stable angina pectoris and congestive heart failure. Captopril exerts a favorable hemodynamic effect in coronary patients with heart failure who are clinically tolerant to nitroglycerin. Development of nitrate tolerance was observed during intravenous nitroglycerin treatment (10 mg/h) in 16 of 19 patients (7 women, 12 men; mean age 56 +/- 8 years) with coronary heart disease [stenosis > or = 75%, New York Heart Association (NYHA) classes II-III). The criterion applied was a loss of efficacy of at least 50% with regard to mean pulmonary capillary wedge pressure compared with the maximum effect of nitrate. The effect of captopril (50 mg p.o.) was determined in a blank test. Captopril (50 mg p.o.) was administered again at the stage of clinically manifest nitrate tolerance. Compared with the effect of captopril alone, significantly more pronounced reductions in mean pulmonary capillary wedge pressure (33% compared with 27%) and in mean pulmonary arterial pressure (36% compared with 17%) and significantly greater increases in cardiac index (14% compared with 7%) and stroke work index (34% compared with 18%) (p < 0.05 in each case; Wilcoxon test for linked random samples) were measured. Maintaining nitroglycerin infusion, the effect of captopril (at least 90% of the maximum effect) lasted for 123 +/- 24 min. The baseline values (at least 75% decline in the effect of captopril) were only reached after 369 +/- 34 min. The results document a favorable hemodynamic effect of captopril in nitrate tolerance which is significantly better than that of captopril alone.Clinical Cardiology 12/1997; 20(12):999-1004. · 2.15 Impact Factor -
Article: [Early clinical experiences with MR-guided laser-induced thermotherapy (LITT) of liver metastases in preoperative care].
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ABSTRACT: To evaluate the LITT-induced changes with the aid of MRT and correlate these with histopathological findings. Five patients with solitary colorectal liver metastases were treated by means of MR-guided LITT before liver resection. Application time and energy of the Nd:YAG laser (1064 nm) was 10-20 minutes and 4.5-8.8 W. MRT monitoring during the LITT was carried out with temperature-sensitive T1 weighted sequences (FLASH-2-D, turbo FLASH). The extent of the induced necrosis as seen on MR was compared with the unfixed specimen and with the histopathological findings. The extent of necrosis visible by MRT correlated with the histopathological findings with an accuracy of 95.3% +/- 4.2%. Following single treatments (three cases) the metastases suffered a reduction of 24%-55% of their original volume. In two patients a second application produced laser-induced necrosis of 78% and 98% of volume. In these two patients a temperature sound was used for measuring regional heating and showed an exact correlation with MR thermometry. The results of pre-operative MR-guided LITT indicates the potential of this form of treatment for obtaining reproducible tumor necrosis of liver metastases.RöFo - Fortschritte auf dem Gebiet der R 06/1996; 164(5):413-21. · 2.76 Impact Factor -
Article: Iodine-123-iodo-lisuride SPECT in Parkinson's disease.
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ABSTRACT: Recently, [123I]iodo-lisuride was synthesized for possible applications in SPECT studies. The purpose of this investigation was to compare the striatal binding and kinetics of this radioligand in patients with Parkinson's disease and normal controls. Six patients with Parkinson's disease and three normal controls were examined. After intravenous injection of 111 MBq [123I]iodo-lisuride, sequential SPECT examinations at 20, 40, 80 and 120 min were performed. For each SPECT series the basal ganglia-to-cerebellum ratio of tracer accumulation was calculated. In one patient a repeat SPECT examination was undertaken under identical conditions to test the reproducibility of the procedure. In two other patients a second SPECT examination was performed after injection of cold lisuride as a receptor saturation study. In addition, the time course of the radioactivity was measured in the plasma and red blood cells in each individual. In both patients and controls, the highest tracer accumulation was found within the striatum. The basal ganglia-to-cerebellum ratio was 1.182 and 1.303 at 20 min, 1.353 and 1.450 at 40 min, 1.490 and 1.533 at 80 min, 1.550 and 1.583 at 120 min for patients and controls, respectively, which was not statistically different. In the saturation study, 50 micrograms and 100 micrograms cold lisuride led to a 28% and 33% reduction, respectively, of the basal ganglia-to-cerebellum ratio at 120 min. The ligand showed a rapid decline in plasma and red blood cells. The percent injected dose per liter was calculated to be 1.6 and 0.9, respectively, for plasma and red blood cells at 20 min. Iodine-123-iodo-lisuride SPECT seems useful for imaging intact striatal dopamine D2 receptors in patients with Parkinson's disease and may provide clinically relevant information for quantitative assessment of the availability and integrity of dopamine D2 receptors.Journal of Nuclear Medicine 02/1996; 37(1):22-5. · 6.38 Impact Factor -
Article: Left ventricular hypertrophy and diastolic dysfunction: their relation to coronary heart disease.
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ABSTRACT: Diastolic dysfunction is an early sign in the temporal sequence of ischemic events in coronary heart disease. The ischemic cascade, beginning with an oxygen demand supply imbalance and metabolic alterations, identifies diastolic disorders of the left ventricle (LV) as an early phenomenon, sometimes before systolic dysfunction, electrocardiographic changes, or chest pain occur. Although the physiology of diastolic function is complex, the factors contributing to diastolic disturbances can be differentiated into intrinsic and extrinsic LV abnormalities. Intrinsic mechanisms include (a) impaired LV relaxation, (b) the complex of LV hypertrophy, and (c) increased LV asynchrony. Myocardial hypertrophy leads to an increase of the myocardial mass/volume ratio, and the degree of hypertrophy is the main determinant of chamber stiffness. The main, if not unique, determinant of myocardial diastolic tissue distensibility is the structure and concentration of the collagen. Consequently, tissue stiffness is increased in coronary disease by reparative interstitial fibrosis or scar following myocardial infarction. In myocardial hypertrophy the LV collagen concentration is elevated due to reactive fibrosis. An increase in regional asynchrony of LV contraction and relaxation is a result of regional ischemia as well as of LV hypertrophy and tissue fibrosis. Factors extrinsic to the LV causing diastolic disorders include (a) increased central blood volume, which will increase left ventricular pressure without altering the LV pressure-volume relation, and (b) ventricular interaction mediated by pericardial restraint, which may cause a parallel upward shift of the diastolic LV pressure-volume relation. Improved insight into the mechanisms of LV relaxation and filling characteristics help in the treatment of LV diastolic dysfunction.Cardiovascular Drugs and Therapy 09/1995; 9 Suppl 3:533-7. · 3.13 Impact Factor -
Article: [Brain SPECT with 123I-lisuride in patients with Parkinson's disease and controls].
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ABSTRACT: The goal was to visualize cerebral dopamine-D2 receptors in 6 patients with Parkinson's disease and in 3 healthy controls using iodine-123-Lisuride-SPECT. In addition, we performed receptor-replacement studies using 123I-Lisuride and cold Lisuride as competitive ligands. The highest uptake of 123I-Lisuride was observed in the striatum, a region with known high dopamine receptor density. In two patients premedication with cold Lisuride displaced 123I-Lisuride from the dopamine receptor. 123I-Lisuride is valuable as a radiotracer in cerebral dopamine-D2 receptor scintigraphy. Whether or not it is possible to determine dynamic changes of dopamine receptor density or function by receptor replacement studies needs further evaluation in larger patient populations.Nuklearmedizin 09/1995; 34(4):141-5. · 1.28 Impact Factor -
Article: [Stress reduction through listening to music: effects on stress hormones, hemodynamics and mental state in patients with arterial hypertension and in healthy persons].
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ABSTRACT: Stress hormones, tissue-plasminogen activator (t-PA) antigen, left-ventricular diastolic function and mood immediately before and after listening to three different kinds of music (a waltz by J. Strauss, a piece of modern classic by H. W. Henze, and meditative music by R. Shankar) were measured in 20 healthy persons (10 women, 10 men; mean age 25 [20-33] years) and 20 hypertensives (8 women, 12 men; mean age 57.5 [25-72] years). To recognise haemodynamic effects, mitral flow by Doppler ultrasound was used as a measure of left-ventricular diastolic function. Atrial filling pressure (AFF) was calculated from the flow integral (VTI) of the early E and the late A waves. The Zerssen scale was used to estimate the immediate mood of the subjects. In hypertensives the levels of cortisol (74 vs 78 ng/ml; P < 0.05) and t-PA antigen (4.3 vs 4.5 ng/ml; P < 0.05) were lower after than before the Strauss waltz. The muscle by Henze lowered the concentrations of cortisol (70 vs 84 ng/ml; P < 0.05), noradrenaline (203 vs 224 ng/l; P < 0.05) and t-PA antigen (4.1 vs 4.6 ng/ml; P < 0.05). After listening to the piece by Shankar the concentrations of cortisol (71 vs 78 ng/ml; P < 0.05), adrenaline 14.5 vs 24.5 ng/ml; P < 0.05) and t-PA antigen (4.2 vs 4.3 ng/ml; P < 0.05) were lower. In healthy subjects AFF (29 vs 26%; P < 0.05) rose after the Strauss music, VTI-E fell (69 vs 73 mm; P < 0.05, while natriuretic peptide rose (63 vs 60 pg/ml; P < 0.05.(ABSTRACT TRUNCATED AT 250 WORDS)DMW - Deutsche Medizinische Wochenschrift 06/1995; 120(21):745-52. · 0.53 Impact Factor -
Article: [Intravenous molsidomine administration in heart failure. Part I: Dose-response relationship with reference to hemodynamic parameters].
Medizinische Klinik 08/1994; 89 Suppl 2:47-9. · 0.34 Impact Factor -
Article: [Intravenous molsidomine administration in heart failure. Part II: Comparison with nitroglycerin and effectiveness in nitrate tolerance].
Medizinische Klinik 08/1994; 89 Suppl 2:50-3. · 0.34 Impact Factor
Top co-authors
Top Journals
Institutions
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1995–1999
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Humboldt-Universität zu Berlin
- Medical Department, Division of Nephrology and Internal Intensive Care Medicine
Berlin, Land Berlin, Germany
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1998
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Philipps-Universität Marburg
Marburg an der Lahn, Hesse, Germany
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1988–1996
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Freie Universität Berlin
Berlin, Land Berlin, Germany
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