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Biomedical subjects

A Huber

Publications and source records attributed to A Huber.

At least 163 records · Page 9Linked to original sources
PubMed1993

Peri-operative elastase-alpha-1 proteinase inhibitor in patients with postoperative intervertebral discitis.

In a prospective study of 251 patients operated upon for lumbar disc herniation it has been investigated whether the preoperative and early postoperative values of Elastase-alpha-1 Proteinase Inhibitor (EPI)-an indicator of inflammatory processes-and C-reactive Protein (CRP)-a well known predictor of some postoperative complications-were correlated to the later development of discitis. Postoperatively discitis developed in 14 patients. A randomly chosen group of 15 complication-free patients out of the total of 251 cases was used as control group. Elevated EPI plasma values, especially in the pre-operative and first postoperative days, turned out to be significantly related to the likelihood of later discitis development, but no such relation for the CRP plasma values could be established. Thus and early prediction of patients at risk for this complication seems to be possible by pre- and postoperative measurement of EPI. It could be justified-but its usefulness has yet to be proven-to give antibiotics prophylactically and other anti-inflammatory medication in patients with elevated pre- and postoperative EPI values.

Acute-Phase Reaction↗
PubMed1993

[Disorders of pupillary motoricity].

1. Disorders of the parasympathetic outflow (iris sphincter muscle disorders): lesions of the oculomotor nerve, tonic pupil, Adie's pupil syndrome. 2. Disorders of the sympathetic outflow (iris dilator muscle) Horner's syndrome (neuron I, II, III). 3. The afferent pupillary defect (lesions of the optic nerve, the chiasm and the optic tract): amaurotic pupil rigidity, amblyopic pupil disturbance, bitemporal pupil rigidity, homonymous hemianopic pupil rigidity, Argyll-Robertson pupil.

Afferent Pathways↗
PubMed1993

[Whiplash trauma of the cervical spine from the neurosurgical, traumatologic and psychologic viewpoint].

Since the early 50's, whiplash injury has been a subject of intensive study in order to find out the genesis of this disease. Unfortunately, most of the studies were planned retrospectively and were based on inhomogeneous groups of patients. In our prospective study, we tried to keep the patient group homogeneous. 62 patients were examined neurologically and radiologically immediately after the accident. Furthermore, they underwent a psychological test, the so-called Freiburg personality profile. 6 months later the patients were checked again. On the basis on our findings, the suspected psychological influence has to be confirmed. Preexisting degenerative lesions of the cervical spine, also, are undoubtedly prognostic for longer-lasting symptoms.

Adult↗
PubMed1993

[An unusual case of a blow-out fracture. Entrance of a bone fragment into the frontal lobe after a ski accident].

Due to a ski accident a 16-year old girl suffered from headache, periorbital hematoma and ptosis of the right eyelid. No penetrating injury could be seen, but in the CT scan a blow-out fracture of the orbital roof and floor was verified. Since there was no evident lesion of the eye muscles, an operative indication could only be a neurosurgical one. Because of the traumatic connection between frontal cerebrum and sinus maxillaris we expected a CSF rhinorrhoea, which could not be confirmed.

Adolescent↗
PubMed1993

[Supratentorial glioma: analysis of clinical and temporal parameters in 163 cases].

163 cases of supratentorial astrocytomas and glioblastomas were evaluated retrospectively after close-meshed observation and treatment. We attached the greatest importance to the reevaluation of already known prognostic parameters and to the temporal analysis of the course of gliomas. We could confirm the influence of the histologic grade on the survival time. Histologic grading by means of immunohistochemistry proved to be more precise than grading only by means of HE staining. Furthermore, the patient's age was one of the most important prognostic variables for survival time after operation. Other factors were the first preoperative Karnofsky rating, the preoperative diameter of the tumour, the duration of preoperative symptoms and the interval between operation and diagnosis of tumour recurrence as well as between tumour recurrence and reoperation. Epileptic seizures as preoperative symptoms were found to be far less prognostic for survival time. Localisation of the tumour, other preoperative symptoms, Karnofsky rating before reoperation and the extent of tumour resection proved to be of no importance for survival time.

Adolescent↗
PubMed1993

[The role of the neurosurgeon in histopathologic diagnosis].

Neurosurgical practice has proved that the establishment of a correct neurohistopathologic diagnosis is sometimes difficult. Inconsistency of diagnoses resulting from unbiased examinations of several neuropathologists is not uncommon. The authors-neurosurgeons-have performed 300 fast neurohistopathologic examinations by means of smear technique. Correct diagnosis was stated in more than 90% of cases. Bioptic examination may represent a contribution in cases where postoperative irradiation is indicated, namely under diagnostically controversial circumstances. The authors re-evaluate the possibilities of utilization of smear technique for the purpose of histopathologic diagnostics performed directly by neurosurgeons. (Tab. 7, Ref. 5.).

Biopsy↗
PubMed1993

[Perforated small intestine diverticulum as a cause of acute abdomen in Ehlers-Danlos syndrome].

Based on a rare case of perforated small-bowel diverticulum combined with Ehlers-Danlos syndrome (EDS) we investigated in a retrospective study several swiss hospitals for symptomatic small-bowel diverticulosis aiming at any clue on EDS. We came up with 15 more cases, 5 of them with perforation, yet none showed any sign of EDS. A review of the literature on either small-bowel diverticulosis or the intestinal complications of EDS amounted to 131 cases of perforation and 11 cases of symptomatic small-bowel diverticulosis in combination with EDS, 2 of them suffering from perforation. Regarding the rarity of these diseases the number of patients presenting both is surprising. Although the EDS-specific histopathological changes of the skin could not be shown in the specimen of the intestinum, it seems quite reasonable to suggest an increased incidence of diverticulosis in patients with EDS, since the weakness of the connective tissue allows an easy protrusion of the mucosa through the intestinal wall.

Abdomen, Acute↗
PubMed1993

[Richter's hernia. An unusual disease course and incidence in a personal patient sample].

Richter's hernia is a special type of incarcerated hernia with strangulation of only a part of the circumference of the bowel wall. Diagnosis may be delayed for the frequent absence of intestinal obstruction or the mild local signs especially in the femoral site. Untreated, there may be formation of an abscess without communication to the peritoneal cavity with secondary formation of an enterocutaneous fistula. We describe the history of a 87 years old patient with a femoral hernia and formation of an enterocutaneous fistula 9 months after incarceration. Discussion with review of the literature.

Aged↗
PubMed1993

[The significance of computerized tomography for conservative treatment of liver trauma].

Increasing experience with early radiological evaluation by ultrasound (US) and computed tomography (CT) of patients with abdominal trauma is leading to more frequent use of conservative treatment in patients with severe liver injuries. In a retrospective study with predominant use of peritoneal lavage only 3 out of 100 patients with liver injuries were treated non-surgically. In a consecutive prospectively evaluated series of 75 patients with early use of US and CT, 30 patients in stable circulatory conditions were treated non-surgically. With increasing experience a higher percentage of patients, even with severe liver injuries, could be treated non-operatively. 17 patients with minor injuries (grade I and II, modified according to Moore) and 13 patients with severe injuries (grade III and IV) could be treated non-surgically. 2 patients with grade IV injury developed an arterial/portal-venous fistula and an arterial aneurysm which necessitated radiological embolizations. All conservatively treated patients have been followed up for a mean period of 18 months without complications. Although a precise anatomical classification of the liver injury degree seems difficult, the predictive value of computed tomography for non-surgical treatment was good. Use of iv-contrast is mandatory. We conclude that in experienced hands computed tomography allows precise evaluation of liver injuries for adequate treatment, provided careful follow-up (intensive care unit, CT, angiography) ensues to avoid complications.

Abdominal Injuries↗
PubMed1993

[The "hemorrhagic bowel syndrome" of swine: clinical, pathologo-anatomic and etiopathogenic aspects].

In an analysis of autopsy findings from 16,384 pigs (1980-90) 436 cases of haemorrhagic bowel syndrome (HBS) were found (2.66% of autopsies). In most cases fattening pigs (in the weight of 25-100 kg) were affected. HBS was significantly more frequent in females. Intestinal volvulus was confirmed in 56.2% of all cases of HBS, however by more careful examination between 1988 and 1990 even in 80% of cases. In most cases the degree of torsion was 180 degrees and the direction as seen with the pig lying on its back was anticlockwise. Clinical history as reported by owners revealed limited information: sudden death of one or several pigs within three months, association with whey feeding not uncommon. Significantly more cases of HBS were seen during spring and on mondays. Numerous yeasts could be detected in mucosal impression smears of ileum, colon and caecum. Additional analyses in six farms suffering from big losses due to HBS suggested that several environmental and management factors may be involved pathogenetically: feeding only once a day of excessive amounts of a liquid diet, especially whey (a highly fermentable substrate), poor hygiene of liquid diets (high bacterial counts and yeast concentrations). In mixed breeding and fattening units, the aforementioned factors could be responsible also for sudden deaths in dry sows caused by colonic bloat often associated with intestinal rupture and torsions of the stomach and/or the spleen.

Animal Feed↗
PubMed1992

[Percutaneous lumbar thermal sympathectomy: method, indications and results].

Thermal lumbar sympathectomy has been the method of choice since the 'eighties in the treatment of reflex dystrophy. We are using this method since January 1990. First results are presented and critically analysed. 15 patients who underwent thermal lumbar sympathectomy were examined and interviewed 1 year after treatment. 7 patients reported persisting pain relief, while the remaining 8 did not.

Adult↗
PubMed1992

Epidemiological experience in the mission of the United Nations Transition Assistance Group (UNTAG) in Namibia.

Epidemiological data have rarely been generated during United Nations (UN) missions to Third World countries, even in situations where there is hardly any combat involvement. Continuous surveillance was therefore carried out during the 12-month stay of UN personnel in Namibia in 1989-90. In this population of 7114 persons, mostly young men, the mortality rate was 255 per 100,000; death was mainly due to traffic accidents. Hospitalization was chiefly because of fever of unknown origin or trauma. Repatriation to the country of origin was necessary in 46 patients, frequently for psychiatric reasons including alcoholism. Over this one-year period there were, on average, 2.7 new consultations per person for treatment (mostly for dental problems), and 0.8 per person for prophylactic measures. The extremely high mortality due to traffic accidents indicates a need for prevention. In the selection process for future missions, more emphasis should be given to the psychological and dental health of volunteers. All military contingents and civilian groups should learn about effective preventive measures prior to their arrival, and adhere to them.

Accidents, Traffic↗
PubMed1991

[Continence-preserving proctocolectomy using an ileum-pouch-anal anastomosis].

Between 1985 and 1990 restorative proctocolectomy with ileo-anal anastomosis was performed in 19 patients (in 15 cases for ulcerative colitis, in 2 cases for familial adenomatous polyposis and in 2 cases for multiple synchronous colorectal carcinomas). Restoration of intestinal continuity was performed by ileo-anal J-pouch (j-shaped ileal reservoir) by the method of UTSUNOMIYA. Eleven patients were operated upon in a two-stage procedure and 8 patients in a three-stage procedure. There was no mortality and no pouch had to be removed. Mean bowel frequency is 5-6 times during daytime and 0-once during nighttime, a fact which speaks for the excellent quality of life in these patients.

Adolescent↗