Search PubMed⌕ Search

Biomedical subjects

B Hammer

Publications and source records attributed to B Hammer.

At least 73 records · Page 4Linked to original sources
PubMed1996

[MALT-type low-grade B-cell lymphomas of the stomach and Helicobacter pylori].

From January 1 1994 to March 1 1995 we observed 6 patients with gastric low-grade B-cell lymphoma of MALT type in association with Helicobacter pylori infection. Endoscopically only 3 of the 6 patients presented with pathological findings. All but one patient with metastatic carcinoma received antibiotic therapy for Helicobacter pylori. Follow-up was not possible in one patient who died unexpectedly. In all 4 patients followed-up, eradication of Helicobacter pylori resulted in regression of the malignant lymphoma. During the median follow-up time of 7 months (2-13 months) no relapse of lymphoma was observed. Our results confirm that gastric low-grade B-cell lymphoma of MALT type can regress after eradication of Helicobacter pylori.

Adult↗
PubMed1996

[Left-sided hydronephrosis as the first sign of Crohn disease].

HISTORY AND CLINICAL FINDINGS: A previously well 29-year-old man was referred to the emergency department because of acute left lower abdominal pain without intestinal symptoms. Physical examination was unremarkable except for moderate suprapubic pain on pressure. INVESTIGATIONS: There was evidence of a urinary infection. Erythrocyte sedimentation rate was increased (48 mm/h) and C-reactive protein elevated to 42 mg/l. There was mild leucocytosis (10000/microliter). Abdominal sonography revealed an enlarged left renal pelvis with hydroureter and possible prevesical stone, findings confirmed at excretion urography. TREATMENT AND COURSE: He was discharged with the suspected diagnosis of ureteric stone and given co-trimoxazole, diclofenac and hyoscine butylbromide. After discontinuing medication the same symptoms developed two weeks later. Cystoscopy and retrograde pyelography were unremarkable and it was assumed the stone had been passed. The patient was again discharged on the above medication. When it was discontinued the same symptoms recurred and he was again admitted. Computed tomography, selective small-intestine radiology, coloscopy and biopsy indicated Crohn's disease with hydronephrosis as complication. Treatment trial with prednisone and mesalazine brought about only transient improvement so that an ileocaecal resection and ureterolysis were performed. The patient has since been free of symptoms. CONCLUSION: If there are urological complications, chronic inflammatory intestinal disease should be included in the differential diagnosis even in the absence of any intestinal symptoms.

Adult↗
PubMed1996

[Indications for, results and consequences of 24-hour esophageal pH monitoring].

Gastroesophageal reflux disease accounts for approximately 75% of esophageal pathology. Accurate diagnosis can be complicated by the absence of endoscopic esophagitis in about 40% of patients with typical symptoms or atypical symptoms such as chest pain, chronic cough or wheezing. A number of tests have been developed to aid diagnosis, but 24-hour pH monitoring has emerged as the standard in reflux diagnostics. Although this method has been known for a long time, it has only become popular since small, portable digital recorders have been available. The aim of this retrospective study was to analyze our first experience with this method. Included in the study were the first 50 consecutive patients in our hospital who had undergone endoscopy of the upper GI tract followed by 24-hour pH monitoring. As a recorder we used the "GastrograpH-Fresenius Mark II". In agreement with the literature we considered the following findings as abnormal: esophageal acidity below pH 4 > 5% of total time or > 8% of upright time or > 3% of supine time, more than 4 reflux episodes of > 5 minutes, duration of the longest reflux episode more than 20 minutes. With this definition there were 24 patients (48%) with reflux disease. The reflux episodes chiefly occurred in daytime (68%), as known from the literature. The indications for this examination were chiefly given by pneumologists (50%), followed by gastroenterologists (22%) and cardiologists (14%). Acid block therapy was performed in 83%, with success in 42% and failure in 8%. In 50% of the patients the necessary data were lacking. Based on these results we conclude that 24-hour pH monitoring has shown itself reliable for the diagnosis of reflux disease and should always be performed in patients with negative endoscopic examination but typical or atypical symptoms of gastroesophageal reflux.

Adult↗
PubMed1996

[Value of abdominal ultrasonography in deep venous thrombosis. Retrospective study of 104 patients].

An association between venous thrombosis and cancer was first suggested by Armand Trousseau in 1865 and subsequently confirmed by a number of studies. It was therefore concluded that laboratory tests, chest radiograph and abdominal ultrasonography should be routinely performed on all patients with deep venous thrombosis. The aim of our retrospective study was to detect the clinical relevance of abdominal ultrasonography findings, especially tumors, in patients with deep venous thrombosis of the lower extremities. All patients with deep venous thrombosis hospitalized between 1990 and 1994 in the department of internal medicine of our hospital were registered. Only patients were included in the study who (1) underwent abdominal ultrasonography in our department; (2) had confirmed acute deep venous thrombosis; (3) had no known malignancy. Malignancies which appeared after hospital stay were detected by telephone inquiry among patients and general practitioners in February 1995. Of the 371 patients with deep venous thrombosis 104 were included in the study. We found abnormal ultrasound findings in 68 patients (65%), but only in 23 patients were the findings of clinical relevance, in 12 of whom (12%) there was a connection with deep venous thrombosis. Ultrasound detected 3 malignancies (3%). The overall rate of newly detected malignancies was 10 (10%), of which 6 were detected during hospitalization and 4 afterwards. Based on these results we can recommend routine performance of abdominal ultrasonography on patients with deep venous thrombosis. A literature overview is given.

Abdomen↗
PubMed1996

[Physician-patient relations and stress caused by coloscopy in patients with chronic inflammatory bowel disease].

The relationship between doctors and patients with inflammatory bowel disease is usually considered complex and difficult. We analyzed the quality of this relationship and the stress inflicted on the patients by endoscopy. 76 patients with Crohn's disease or ulcerative colitis answered a questionnaire. More than three quarters considered their relationship to their doctors good or very good. The patients expressed a wish for more information on the pathophysiology and treatment options of their disease. The stress placed on the patients by endoscopy was considered severe or very severe by 57%. We conclude that the relationship between doctor and patients with inflammatory bowel disease is generally considered good or very good. Endoscopies are highly stressful for most patients and we recommend appropriate sedation.

Colonoscopy↗
PubMed1996

[Social consequences and quality of life in patients with chronic inflammatory bowel disease].

We conducted a survey on the quality of life and social consequences for patients with inflammatory bowel disease. Questionnaires of 41 patients with Crohn's disease, 28 patients with ulcerative colitis and 7 patients with overlap colitis were evaluated. All the patients had been hospitalized in the past. 15 patients (20%) were unable to work due to inflammatory bowel disease. 9 (12%) of these 15 patients received a disability pension. 11 patients (15%) had to change a place of work and 16 (21%) had had financial problems due to inflammatory bowel disease. 4 patients (5%) had had to give up a partnership due to the disease. For 16% of the patients their perceived quality of life during the past 4 weeks was poor or very poor, while 35% of the patients perceived their overall quality of life as poor or very poor since the beginning of the disease. We conclude that inflammatory bowel disease affects job and financial matters rather than partnerships. The quality of life is judged by many patients as considerably diminished.

Adult↗
PubMed1996

[Lag screw osteosynthesis in median mandibular fractures--technique and outcome].

The lag screw technique for treatment of simple median and paramedian fractures of the mandible is reemphasized. Major advantages over bone-plate fixation are the rapid application since adapting and bending of a bone plate is obviated as well as the lower costs of the osteosynthesis material. A review of 12 patients with fractures of the anterior mandible who had lag screws placed for fracture treatment showed that it is a successful method of providing rigid internal fixation associated with a low postsurgical complication rate.

Bone Screws↗
PubMed1996

[Gunshot injuries of the mandible].

43 patients with gunshot wounds of the mandible were treated in Tübingen and Basel between 1968 and 1995. Among them were 31 patients ( = 72.09%) with bone loss and defect fractures. Over that time period the treatment principles of gunshot wounds have not changed. They are based on an early soft tissue closure and an approach from the inside to the outside. Besides that modern techniques in maxillofacial reconstructive surgery, which include the application of biocompatible plates and screws and the introduction of microvascular reconstructive techniques, have enlarged the therapeutical options. Every patient needs an individual approach to his special medical condition, which is illustrated in three exemplary cases. The combination of the above mentioned modern reconstructive techniques prevents long and multiple hospital stays and invalidity. Furthermore it is the basis for social reintegration as well as functional and esthetic rehabilitation.

Adolescent↗
PubMed1996

[Therapy of infected mandibular fractures].

In a follow-up study the results after rigid internal fixation (RIF) in 23 patients with mandible fractures showing signs of bone infection at the fracture sites are presented. Depending on the bony defect RIF was performed with or without additional autogenous bone grafts. RIF led to a calculable and uneventful bone healing despite the infections. The plates must be fixed with at least 3 screws on each fracture site and outside the infected areas. An adequate soft tissue coverage is a prerequisite for primary or secondary bone transplantation. In our series infected fractures were usually observed in problem patients as alcoholics, drug addicts or uncooperative patients as mentally disabled or aged persons. These patients also frequently escape from the follow-up program. To prevent complications an osteosynthesis in problem patients should be performed with enough stability so no compliance is required.

Adolescent↗
PubMed1996

[Development of a resorbable implant: experimental reconstruction of the orbits with polylactate membranes. Animal model and preliminary results].

In a complex animal model in five sheep, PDS or polylactic biodegradable membranes were used for reconstruction of large orbital defects in combination with autogenous bone grafts and stable internal fixation with titanium miniplates and screws. Because of anatomical similarities, animal model and human clinical findings are comparable. After eight weeks, in four sheep all reconstructions were separated from the maxillary and frontal sinus by a continuous mucosal layer. The bone grafts were integrated into the bony frame of the orbit. Foreign body reactions were milder with polylactic membranes compared to PDS, probably due to the slow degradation of polylactide. These preliminary results will lead to a further study with a larger series to compare the two biodegradable materials and to prepare the way for clinical use of polylactic membranes in orbital reconstruction.

Animals↗
PubMed1995

Comparison of mortality from acute myocardial infarction in patients receiving anistreplase with those not receiving thrombolysis.

Within 1 year, 434 patients were admitted to 14 hospitals with suspected acute myocardial infarction (AMI) < or = 4 hours after the onset of symptoms. Group A consisted of 171 patients (39%) treated with thrombolysis, and group B consisted of 263 patients (61%) with contraindications. Patients in group A more likely had a "definite AMI" (92%; group A1) than patients in group B (67%; group B1). Group B1 had 277 contraindications (1.6/per patient) with increased risk for life-threatening bleeding being the most frequently recorded at admission. The in-hospital mortality in group A1 was 7% (11 of 158) and in group B1, 27% (47 of 177) (p < 0.0001). Age and type of therapy (thrombolysis or no thrombolysis) were identified as independent predictors of increased mortality (p < 0.0001 and < 0.05, respectively). Thus, although most patients with an AMI are excluded from thrombolytic therapy because of contraindications, our data suggest that their in-hospital mortality is unexpectedly high. Further evaluation of this group of patients is warranted to define the impact of contraindications as an independent factor of mortality.

Aged↗
PubMed1995

[Endoscopic palliation of malignant esophagus processes using a self-expanding metallic stent].

We investigated the palliative effect of self-expanding metallic stents on malignant obstruction of the esophagus in 10 patients. All patients had high grade dysphagia and one had an esophago-bronchial fistula. Endoscopic insertions of the prosthesis was done under sedation. Dilatation of the stricture prior to insertion was rarely necessary. Coated stents were used as secondary treatment for patients with fistulae. The procedure related morbidity was low and no mortality was observed. The stents remained patent during the residual lifetime of the patients. Dislocation or perforation did not occur. The median survival of 8 deceased patients was 3.5 months (range 1.25-14.5 months). At present 2 patients are still alive 2.7 and 1.5 months after the procedure. Self-expanding stents in the esophagus provide good palliative therapy of dysphagia or fistulae caused by malignant tumors. Insertion is relatively simple and safer than in nonexpandable types. These improvements may justify the considerably higher price of these devices.

Aged↗
PubMed1995

Stabilization of the short sagittal split osteotomy: in vitro testing of different plate and screw configurations.

Using a 3-dimensional in vitro model, the stability of different types of osteosynthesis for the short sagittal osteotomy was tested. The following four groups of plate and screw configurations were evaluated: Group I: Fixation with miniplates using monocortical screws only, Group II: Fixation with miniplates, but with two of the screws engaging both fragments, Group III: Same as group II with an additional position screw, Group IV: Fixation with 3 position screws. The stability obtained with miniplate fixation using monocortical screws only (group I) was by a factor of 2.9 less than position screw fixation (group IV), which is considered to be an approved standard. In order to increase the stability of miniplate fixation, the screws in the area of overlapping bone should engage both fragments.

Bone Plates↗