Unvernetzte epoxide-amin-additionspolymere, 32. Hochmolekulare polykationen vom michler-hydrolblau-typ und ihre dielektrische charakterisierung

A high-molecular-weight poly(leuco base) (M _n = 11000–18000) was obtained by addition polymerization of N,N′-dibenzyl-4,4′-methylenedianiline ( 2 ) and 2,2-bis[4-(2,3-epoxypropoxy)-phenyl]propane (diglycidyl ether of Bisphenol A) ( 1 ). The oxidation of this addition polymer with chloroanil, iodine, bromine, chlorine or antimony pentachloride results in polymeric dyes (absorption at λ = 620 nm) containing units of the “Michler Hydrolblau” type. The dielectric behavior in the frequency range 10² Hz up to 10⁷ Hz shows a dependence of the conductivity on the temperature. Polymer 4c exhibits a conductivity of σ = 6 · 10^?6 S/cm at 134,3°C and 10⁶ Hz.     

Surgical treatment of dissecting aneurysms of the aortic arch

Since May 1987 to May 1988, 8 cases of dissecting aneurysms of the aortic arch were treated surgically at the Department of Cardiovascular Surgery. Justus-Liebig University. Four cases were Standford A type and 4 were Stanford B type. All the patients were operated on under deep hypothermia (20 degrees C) and circulatory arrest, and aneurysms were repaired using pre-clotting graft without clamping the aortic arch. Bleeding from anastomosis line was controlled by fibrin coagulum. In addition, the auto-blood transfusion was applied using the cell saver system. This procedure could be performed in a short circulatory arrest and cardiac ischemic time. Seven patients were alive and discharged without neurological complication. Only one patient died because of the carotid artery dissection to the aortic dissection on the 2nd. post-operative days the clinical results were almost satisfactory. It appeared that surgical repair for dissecting aneurysm of the aortic arch could be performed safely and easily by this surgical technique and the know-how.     

Myxoma of the aortic valve in a child

Myxomas are predominantly located in the right on left atrium. We report an unusual case of a myxoma adherent to the aortic valve. The child presented with symptoms of subaortic stenosis. By invasive methods a tumor was diagnosed located at the aortic valve. After surgical removal the child recovered soon and is doing well. According to our knowledge this is the first report of a myxoma of the aortic valve.     

Pimobendan increases calcium sensitivity of skinned human papillary muscle fibers

The calcium sensitizing effects of the cardiotonic agent pimobendan on force production were investigated on chemically skinned human papillary muscle fibres. The papillary muscles were obtained from patients undergoing mitral valve replacement operations. Tension was produced by different free calcium concentrations and 100 mumol/l of pimobendan shifted the pCa-tension relationship significantly to the left. The effects of pimobendan were concentration dependent (10-300 mumol/l) but additionally also correlated with the state of left ventricular performance of the patients. Skinned papillary muscle fibres obtained from patients with reduced ventricular performance were more sensitive to calcium as well as pimobendan compared with fibres from patients with normal left ventricular performance. No differences in response to pimobendan were observed between fibres from NYHA II and NYHA III heart failure patients.     

Neurologic complications of coronary bypass surgery--a prospective study

Neurologic, cardiologic, and dopplersonographic findings of 303 patients undergoing coronary bypass surgery were evaluated in a prospective study. About 5% of the patients suffered from a prior stroke. Nearly 9% had a significant stenosis of an internal carotid artery detected by dopplersonography. Central nervous system complications occurred in 18.2% of the patients, predominantly temporary mental disturbances. Old patients and those with complicating heart failure were at higher risk for mental disorders. Approximately 3% of the patients suffered from a stroke with a permanent deficit. Half of them had a potential source of cardiogenic embolism. The risk of a complicating stroke was raised by the presence of a stenosis of a carotid artery, a heart failure, or an arrhythmia. The frequency of peripheral nervous system complications was 13.5% with temporary symptoms in about half of the cases. Brachial plexus paresis predominated with a particular risk in mammaria bypass grafting.     

Glomustumore

Due to their rarity, paragangliomas are seldom considered in the differential diagnosis of lateral neck masses. Therefore, paragangliomas are often not correctly diagnosed preoperatively, which leads to incomplete removal, thus resulting in multiple surgical procedures. Intraoperative incidental diagnosis necessitates complete tumor resection, which can be technically very demanding and complex.     

Comparison of sparfloxacin and clarithromycin in the treatment of acute bacterial maxillary sinusitis. Sparfloxacin Multicenter AMS Study Group

Five hundred four patients were enrolled in a randomized, double-masked, multicenter study comparing the efficacy and tolerability of a 10-day regimen of sparfloxacin with a 14-day regimen of clarithromycin in the treatment of acute maxillary sinusitis. Two hundred fifty-two patients received sparfloxacin as a single 400-mg dose on day 1 and 200 mg once daily for 9 additional days, and 252 patients received clarithromycin 500 mg twice daily for 14 days. In the all-treated population, clinical success was observed at 6 to 10 days after therapy in approximately 82% of the patients in each treatment group. A total of 430 patients met the inclusion criteria for clinical assessment. The success rates in these patients were also comparable, at 83.1% and 83.4% for the sparfloxacin and clarithromycin groups, respectively. Sustained clinical success rates in the all-treated population 3 to 4 weeks after therapy were 71.6% for the sparfloxacin group and 68.6% for the clarithromycin group. All treated patients were included in the tolerability analysis. The frequency of adverse events in the clarithromycin and sparfloxacin groups was 57.9% and 48.4%, respectively. The most frequently noted adverse events were diarrhea, photosensitivity reaction, taste perversion, nausea, and abdominal pain; >96% of adverse events in the sparfloxacin group and 94% of adverse events in the clarithromycin group were of mild or moderate severity. Among adverse events at least possibly related to study drug, photosensitivity reaction was more common in the sparfloxacin group (9.5% vs. 0.4%), whereas taste perversion (8.7% vs. 0.8%) and abdominal pain (3.6% vs. 1.6%) were more common in the clarithromycin group. Thus the sparfloxacin's more convenient regimen was as effective as clarithromycin in the treatment of acute bacterial maxillary sinusitis, and the overall frequency of adverse events with sparfloxacin was comparable to that with clarithromycin.     

Evaluation of aztreonam in experimental bacterial meningitis and cerebritis.

Aztreonam (SQ 26,776), a new monocyclic beta-lactam agent, was compared with ampicillin, ampicillin plus chloramphenicol, and gentamicin in rabbits with experimental meningitis induced by, respectively, ampicillin-susceptible Haemophilus influenzae, ampicillin-resistant H. influenzae, and Escherichia coli. Aztreonam was also compared with gentamicin in experimentally induced E. coli cerebritis in rats. Doses of the various agents were delivered that produced near-peak concentrations in serum comparable to those attained in humans on standard parenteral regimens. The percent penetration [( concentration in cerebrospinal fluid/concentration in serum] X 100) of aztreonam into purulent rabbit cerebrospinal fluid was 23% (versus 12, 27, and 21%, respectively, for ampicillin, chloramphenicol, and gentamicin). In experimental meningitis in vivo, aztreonam was more rapidly bactericidal than was ampicillin in ampicillin-susceptible H. influenzae meningitis, ampicillin or chloramphenicol in ampicillin-resistant H. influenzae meningitis, or gentamicin in E. coli meningitis. In the therapy of experimental cerebritis, the early stage of brain abscess formation, aztreonam reduced the numbers of E. coli in rat brain as rapidly as did gentamicin. Aztreonam deserves further evaluation in acute gram-negative bacterial infections of the central nervous system in both experimental animals and in humans.