[Botulism in birds living in an aquatic environment in Nové Mlýny in the Breclav District]. / Botulismus ptactva na vodním díle Nové Mlýny (okres Breclav).

Epizootic of wild water birds caused by the toxin Clostridium botulinum of C type occurred in extensive shallow artificial lakes of the Nové Mlýny dam system from May to October 1988 and later on from February to early April 1989. In total more than 3,000 dead or dying birds of 44 species were found, the following orders were prevailing: Anseriformes (56%), Lariformes (33%), Charadriiformes (6%) and Ralliformes (4%). Botulotoxin was detected at high concentrations in sarcophagic fly larvae of Calliphora vomitoria and Lucilia sericata which were collected in bird cadavers, but it was not found in different components of the aquatic environment (water, submersed vegetation, phytoplankton, zooplankton, Gastropoda, Crustacea, Oligochaeta, larvae of Odonata, Chironomidae and Ceratopogonidae). Future development of the epizootic situation in the Nové Mlýny artificial lakes will depend on the water level and meterological conditions in the critical period (May to September).

[Alternatives to glycoside therapy?]. / Alternativen zur Glykosidtherapie?

The narrow therapeutic range of digitalis glycosides and the danger of intoxication has prompted a search for alternative medication in recent years. Substances reducing the pre- and afterload of the heart are suitable therapeutic agents and vasodilators are, therefore, used as adjuvant or alternative therapy. Of all positive inotropic substances only the catecholamines play an established part in the treatment of acute myocardial failure. Pilot studies testing orally administrable positive inotropic substances are being conducted, but for the moment no such drugs are available for routine use. Digitalis still remains the drug of choice for all forms of primary impairment of contractility and/or supraventricular tachyarrhythmias. The appropriate dosage has to be adapted to the estimated lean body mass and, if necessary, reduced in a thin person, Digitoxin is preferentially used in cases with suspected renal insufficiency (especially in elderly patients).

[Radionuclide cardangiography as non-invasive assessment in coronary heart disease (author's transl)]. / Die Radionuklidkardangiographie zur nichtinvasiven Beurteilung der koronaren Herzkrankheit.

The method of radionuclide cardangiography (RNCA) has become a well-established method amongst non-invasive assessments in coronary heart disease (CHD). By means of RNCA the most important parameters of left ventricular function, viz. ejection fraction (EF) and wall motion (WM), can be determined very exactly. The first bolus pass method (FBP), which allows satisfactory separation between right and left heart, enables the additional determination of EF distribution, stroke volume (SV) and SV distribution. This method requires the technical necessity of a multicrystal gamma camera. Special nuclear medicine characteristics have been worked out for different groups of CHD. EF and WM show typical signs of angina pectoris, caused by exercise correlating with reduced perfusion in the referring section of WM. While these changes may be reversible after nitrate administration, pathological myocardial function caused by acute myocardial infarction (AMI) or manifest heart failure is not reversed by nitroglycerine. Typical findings were seen in the course of AMI: initial decrease in global EF and diffuse (multilocated) asynergies in the left ventricular wall; in the second week possible start of recovery, including regression of dyskinesia to akinesia at the end of hospitalization. Especially in the early phase of AMI it was demonstrated that FBP--as a non-invasive technique--gives high information quality which is unequalled by other comparable methods. Therefore, the described method of FBP should be classified as very useful and effective in clinical cardiology.

Comparison of supine and sitting body position during a triangular exercise test. I. Experiences in healthy subjects.

A comparison of haemodynamic parameters is performed during a triangular exercise test on bicycle ergometer in respect of studying the influence of supine and sitting body position. At the maximal symptom-limited work load reached the heart rate is on the average 9.2% higher, the arterial systolic pressure 16.1% and the cardiac output 17.2% less in the sitting body position (P less than 0.001). On the opposite the pulmonary artery pressure during work is of slightly but not significantly higher level in the sitting position than in the supine. This phenomenon is explained by a prevailing of the beta-adrenergic tonus in our untrained subjects, while total sympathetic stimulation seems to be comparable in both body positions.

[Rehabilitation of myocardial infarction (author's transl)]. / Rehabilitation - am Beispiel des Myokardinfarktes

The rehabilitation of patients with myocardial infarction starts at an early stage of the disease, with an activation programme. In the post-acute phase this is substituted by the early rehabilitation programme carried out in cardiological centres. When the patient is discharged from hospital he undergoes an approximately one year out-patient long-term rehabilitation programme, which encompasses all sorts of secondary prevention with respect to risk factors (i.e. carbohydrate and lipid metabolism disturbances, nicotine abusus, and hyperalimentation) as well as phychosocial assistance and adequate physical therapy. These procedures have yielded positive results. In a series of 800 patients who underwent long-term rehabilitation 75.8% had resumed work. Also important is that with the help of the long-term treatment the patients became less anxious and could hence be re-integrated more easily.

[Long-term ambulatory rehabilitation of patients with infarct. Clinical studies on patients during 1974 and 1975]. / Ambulante Langzeitrehabilitation von Infarktkranken. Klinische Beobachtungen am Krankengut der Jahre 1974 und 1975

An out-patients long-term rehabilitation program is performed in myocardial infarction for 6 to 12 months. It comprises all kinds of rehabilitation and secondary prevention. The working capacity measured by exercise tests can be improved and stabilized (mean improvement: 20%). 75.8% of office employees and 58% of workers return to work. There was not positive influence on plasma cholesterol and triglyzeride level, to be noticed. Upon inquiry, one year after myocardial infarction, 85% of patients had stopped cigarette smoking.

[An improved exercise test in coronary-heart disease: effect of molsidomin on erogometrically controlled exercise (author's transl)]. / Zur Verbesserung der Arbeitsbelastung Koronarkranker. Wirkung von Molsidomin auf die ergometrisch gemessene Arbeitstoleranz

The protective effect of molsidomin (N-ethoxycarbonyl-3-morpholinosydnonimine) during ergometric exercise was tested on 40 patients with coronary insufficiency proven by preliminary exercise tests or coronary arteriography. Changes in arterial blood pressure, heart rate, pulmonary artery pressure, ischaemic S-T depression and maximal working capacity were used as criteria. The drug increased maximal working capacity and decreased S-T segment depression. In addition it caused a fall in systolic and diastolic blood pressure and pulmonary artery pressure, at rest and during exercise. Resting heart rate increased slightly but during exercise the heart rate was reduced at comparable load stages. The results suggest that molsidomon may be an effective drug in the treatment of angina pectoris.

[Effect of Ouabain on cerebral blood flow (author's transl)]. / Beeinflussbarkeit der Hirndurchblutung durch Ouabain

The effect of 0.25 mg ouabain on cerebral blood flow (CBF) was investigated in patients with and without cerebrovascular disease using the xenon clearance method. The 36 patients included in this study did not show any signs of heart failure. Ouabain increased the CBF and this effect was demonstrable 15, as well as 90 min. after administration. This effect was proven statistically using the t-test for a comparison of the values with spontaneous changes in a control group without medication. The perfusion of pathologically-supplied brain regions was altered in the same way as the hemispheric flow; changes in the distribution of blood in the way of a steal effect were not observed. The haemodynamic parameters do not indicate a primary cardiac effect. Hence, an influence of ouabain on cerebral vessels might be responsible. The present results support reported clinical experience with ouabain for the treatment of patients with cerebrosvascular disease.

[The normal range of the pulmonary artery pressure during ergometrical exercise (author's transl)]. / Pulmonalarteriendruck unter ansteigender Ergometerbelastung

In healthy subjects the pulmonary artery pressure was measured during exercise tests with the aid of the flow guided catheterisation. The work load was determined on bicycle ergometer in recumbent position in form of a multistage exercise test with relative steady state periods till exhaustion was reached. In this way, during the highest work load (200 Watt) the systolic pulmonary artery pressure was 33.9 +/- 5.5 mm Hg, the diastolic pressure 17.5 +/- 3.6 mm Hg and the pulmonary mean pressure 24.7 +/- 4.0 mm Hg. The factors influencing the pulmonary artery pressure during work are discussed.