[Relation of peak flow and spirometry values in patients following bone marrow transplantation]. / Relation zwischen dem Peak Flow und spirometrischen Werten bei Patienten nach Knochenmarkstransplantation.

In about 30% of patients who were subjected to bone marrow transplantation, progressing interstitial and rarely obstructive pulmonary diseases can result in death. Early identification of curable diseases such as pulmonary changes during a "graft versus host reaction" would be desirable. Retrospective evaluation of 159 lung functions in 60 patients after bone marrow transplantation, however, revealed only moderate sensitivity of the peak flow value to vital capacity and FEV1, so that only pathological levels of this parameter will signify noticeable reductions in spirometric values.

[Noninvasive assessment of the severity of obstruction in hypertrophic obstructive cardiomyopathy (HOCM) in bidirectional Doppler sonography of the common carotid artery. Simultaneous comparison with invasive measurements]. / Nichtinvasive Beurteilung des Schweregrades der Obstruktion bei hypertrophisch-obstruktiver Kardiomyopathie (HOCM) mit der bidirektionalen Dopplersonographie der Arteria carotis communis. Simultaner Vergleich mit invasiven Messungen.

A series of 6 patients with HOCM underwent pre- and poststenotic left ventricular pressure measurements with simultaneous monitoring of the Doppler velocity in the right common carotid artery. Baseline measurements were followed by interventions. Mean pressure gradient was 37 +/- 17 mm Hg at baseline, during Valsalva test 61 +/- 19 mm Hg, postextrasystolic 86 +/- 36 mm Hg, after 0.8 mg NTG 104 +/- 57 mm Hg. Midsystolic velocity decreased when the pressure gradient increased. These data suggest that changes in the carotid artery Doppler velocity correspond to alterations in the pressure gradient. Midsystolic retrograde flow was found in 5 out of 6 patients with pressure gradients exceeding 80 mm Hg. Abnormalities in midsystolic flow were never observed in control subjects. We conclude that carotid Doppler sonography is a useful adjunct to the non-invasive evaluation of patients with HOCM.

Coronary rheothermia: a quasi non-invasive method for controlling bypass patency.

A method based on the principle of thermodilution was developed for a quasi non-invasive permeability control of aortocoronary bypass. An epivascularly-attached thermistor records the cooling of the bypass wall when, following the intravenous injection of 5 to 10 ml of a NaCl solution at 4 degrees C, a bolus of cooled blood passes through the bypass. During cardiosurgical intervention, the thermistor is attached to the venous bridge by one or 2 sutures. The efferent cable goes through the thorax wall and is coupled to a subcutaneously implanted telemetric amplifier unit. The influence of the vessel wall on the perivascular temperature signal, as compared to the intravascular one, was studied in acute and chronic animal experiments. In acute experiments the perivascular peak of temperature was found to be lower than the intravascular one. Continuous measurements over 9 days showed variations in the perivascular signals which must have been due to changes in the thermal capacity of the tissue coupled to the thermistor as well as to changes in resistance caused by a variable extent of scarred area and by the varying water content of the wound bed. These variables will continue to keep rheothermia within the limitations of a method with primarily binary results (= bypass: open or closed). Given stable coupling conditions after full development of the scar around the thermistor, the signal falsification by the then constantly coupled tissue capacity becomes calculable such as to obtain semiquantitative results which, theoretically should vary predominantly with cardiac output.