[Acute hemodynamic effects of alifedrine in patients with heart failure]. / Hämodynamische Akutwirkung von Alifedrin bei Patienten mit Herzinsuffizienz.

The newly synthesized cardiotonic agent alifedrine (1-cyclohexyl-3-[(1S, 2R)-2-hydroxy-methyl-2-phenylethylamino]-propan-1-one) was shown to have vasodilating and positive inotropic effects in experimental animals. The effectiveness was tested in 8 patients with congestive heart failure already receiving digitalis and diuretics. After the intravenous administration of 40 mg alifedrine, cardiac output and stroke volume index increased and systemic vascular resistance and left ventricular filling pressure decreased. Left ventricular ejection fraction improved and there were no significant changes in heart rate and mean aortic pressure. Alifedrine, therefore, improves left ventricular performance in patients with congestive heart failure treated with digitalis and diuretic agents.

Changes in contractility and oxygen metabolism of isolated canine heart following application of urapidil.

Changes of contractility and oxygen metabolism following the administration of urapidil (Ebrantil) are described. Investigations were carried out on isolated, metabolically supported canine hearts. Results show that this drug has a myocardial effect in addition to its known antihypertensive effect. Moreover, a dose-dependent negative inotropism is coupled with a reduction in myocardial oxygen consumption. Urapidil reduces the cardiac metabolic rate, decreases cardiac load due to a reduction in peripheral resistance, and has a negative inotropic action. These properties are usually found only in beta-blockers.

[Segmental colonic atresia - a contribution to the differential diagnosis of ileus in the newborn (author's transl)]. / Die segmentale Kolonatresie - ein Beitrag zur Differential-diagnose des Neugeborenen-Ileus.

Segmental atresia of the colon is regarded as an urgent emergency in the neonatal period and quick diagnosis and surgical interference are necessary. In spite of the rarity of this condition it could be thought about in the differential diagnosis in infants with relevant symptoms and can be diagnosed by simple means. The author's own technique is described in relation to the case of atresia of the transverse colon. The aetiology, classification, clinical picture, diagnosis and treatment are discussed. The prognosis depends very much on early diagnosis.

[The effect of AR-L 115 BS on contractility dynamics of the isolated, metabolically supported dog heart (author's transl)]. / Die Wirkung von AR-L 115 BS auf die Kontraktionsdynamik des isolierten, metabolisch unterstützten Hunde-Herzens.

In this study the contractility dynamics of the left ventricle are analysed independent of respiration, pre- and afterload, heart rate and perfusion pressure. These parameters alter varyingly following the administration of 2-[(2-methoxy-4-methylsufinyl)phenyl]-1H-imidazo[4,5-b]pyridine (AR-L 115 BS) so that the study plan selected must take these factors into account. The model employed consisted of a metabolically supported isolated pulsating dog's heart. The dose of AR-L 115 Bs used was 0.125 mg/kg body weight and it was infused over a period of 30 min. Altogether the study demonstrates that AR-L 115 BS has a marked positive inotropic effect on the isolated heart even under the conditions of infusion. The coronary resistance diminishes and the cardiac output increases.

Preoperative condition of neonates who have ultimately died.

In a retrospective study the case sheets of 42 neonates are examined. They were infants with oesophageal atresias, small and large intestinal atresias, exomphalos and gastroschisis, diaphragmatic hernia, intestinal obstruction as well as two children with a ruptured spleen secondary to birth trauma. Various laboratory investigations such as the pH, pCO2, standard bicarbonate and serum electrolytes as well as the child's weight on admission and, if possible, the birth weight were evaluated. There was no definite relationship between the preoperative laboratory values and the chances of survival of surgical neonates except if the values were extreme. Infections and septicaemia were the most important causes of postoperative complications.

Transcutaneous PO2 measurement on skin transplants.

Trnascutaneous PO2 measurements are suitable for an objective control of free skin transplants and pedicle flaps if used with standardized and controlled hyperemia. They are also suitable for monitoring the rejection of skin allografts and to investigate the influence of drugs on skin transplants in general.

[The effect of citrate or heparin coagulation on the dog's heart work in autotransfusion]. / Der Einfluss von Citrat- oder Heparinanticoagulation bei der Autotransfusion auf die Herzarbeit des Hundes.

During massive autotransfusion in the dog, the different anticoagulation processes have an important influence on heart work and performance. This is especially marked with citrate, depending on the amount and the transfusion rate. In spite of normovolemia both parameters show a transient decrease up to 40% - 50% with ACD and up to 60% - 70% with CPD. These different reactions may be due to the corresponding composition of each stabilizer. The effect is abolished by simultaneous use of citrate and calcium, which may prove that the observed changes are caused mainly by a depletion of ionized calcium caused by the rapid transfusion. This is comparable to the well-known citrate intoxication. In contrast both cardiac parameters decrease only about 10% with heparin anticoagulation. Heparinization seems to be preferable to citrate as regards heart work and performance during massive autotransfusion. Also the two citrate stabilizers significantly differ in their effect on both cardiac parameters, the use of ACD being favoured.

Modulation of the prostaglandin-induced intestinal motility in humans through the transmitters of the vegetative nervous system.

Research was done on the reciprocity between adrenergic and cholinergic stimulating or inhibiting pharmaceuticals and the prostaglandin-induced intestinal motility. By cholinergic activation, the amplitudes of the prostaglandin-dependent rhythmical contractions of human taenia coli were intensified. There was very little influence on the frequency of contractions, however. Simultaneous stimulation of adrenergic beta-receptors by increasing doses of adrenaline or noradrenaline caused the contraction amplitude and frequency to decrease continually until the contractions were completely eliminated. The cholinergic effect could be suppressed with atropine, the adrenergic-stimulated reaction was reversed by the blockage of beta-receptors. It was completely abolished by simultaneous addition of alpha- and beta-receptor-blocking drugs.

[Computer assisted heart and circulation analysis in experimental septic shock (author's transl)]. / Rechnerunterstützte Herz- und Kreislaufanalysen beim experimentellen septischen Schock.

Developping a model of shock applying to the clinical manifestation is necessary to investigate the pathogenesis of septic shock and to identify the letality causing organ. Perhaps the hyperkinetic syndrome may play an important role. The extensive experimental data is processed by a digital computer. Explanations are given for the experimental apparatus and the structure of the Fortran-program.

Transcutaneous pO2 of volunteers during hyperbaric oxygenation.

Continuous transcutaneous pO2 measurements (tcPO2 measurements) were performed in healthy volunteers who were breathing air and oxygen under hyperbaric conditions (max. 4 ata). The results show a close correlation of PO2 values measured by the noninvasive method, in blood from discret arterial punctures, chamber PO2, respectively, the PO2 of the inspiratory gas mixture which was checked up to maximal values of 2,200 mm Hg. The PO2 in the arterial blood samples was measured immediately after the puncture insight the hyperbaric chamber using a specially designed through electrode.

[Contractility of the left ventricle in experimental septicemia]. / Die Kontraktilität des linken Ventrikels bei experimenteller Septicämie.

In experimental septicemia a decrease of myocardial contractility could be demonstrated. Periodically a correlation between disturbance of contractility and endotoxinemia exists. Starting point of infection and type of bacteria were of no detectable influence. As far as the disturbance of contractility is concerned one must take into consideration the cardiotoxic effect of endotoxin, the influence of shock mediators, lacticemia as well as the decrease of coronary perfusion pressure.