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Biomedical subjects

H D Schmidt

Publications and source records attributed to H D Schmidt.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Postvagotomy complications: stomach bezoars - case report and review of the literature].

A 59 year old female with multiple gastric surgical procedures (Billroth I and Billroth II) for recurring ulcer disease developed a gastric phytobezoar following an additional truncular vagotomy within 2 months. Already 1 month after complete endoscopic removal the phytobezoar recurred in spite of dietary restrictions. The phytobezoar was successfully dissolved by oral Cellulase-therapy. The truncular vagotomy and its influence on gastric motility has to be considered as the cause of the repeated bezoar formation.

Bezoars↗
PubMed1982

[Validity of the transcutaneous PO2-measurement during pharmacologically induced changes of skin perfusion (author's transl)].

The validity of transcutaneous oxygen partial pressure (tcPO2) was tested during pharmacological vasodilatation and vasoconstriction of the skin. Measurements of transcutaneous oxygen partial pressure (tcPO2) were done on the hairless skin of the abdomen in 18 anaesthetized rabbits, when beta-pyridyl-carbonyl (Ronicol) was used as a vasodilator and vasopressin (Pitressin) as a vasoconstrictor. Vasodilation yielded no significant influence on the tcPO2-measurement. Vasoconstriction, however, resulted in a marked decrease of the tcPO2-signal (p less than 0.001). During this phase tcPO2 did no longer reflect arterial PO2 which remained nearly constant. In this experimental model vasoconstrictive drugs may cause a marked underestimation of the arterial oxygen tension. The dependence of the tcPO2-measurement on maximal local skin perfusion should be considered in intensive care patients.

Animals↗
PubMed1982

[(Progressive papillomatosis of the common bile duct with tendency to malignant change) ].

Report of a case of progressive papillomatosis of the common bile duct from our hospital--the sixteenth described in the literature. For the first time it had been possible to diagnose the progressive papillomatosis of the common bile duct is a precancer state, this disease should be listed among the differential diagnosis of obstructive jaundice, when all other causes have been excluded. Confirmation of the diagnosis necessitates radical surgery, in order to guarantee optimal management.

Common Bile Duct Neoplasms↗
PubMed1981

[Percutaneous transhepatic gallstone extraction (author's transl)].

Gall stones 1-3 cm in size were removed in three out of four patients from the common bile duct using a Dormia basket via the percutaneous transhepatic route. This method is indicated in selected cases: inoperable patients or those with a high surgical risk, and calculous obstruction after hepatico-jejunostomy. The method is limited in stones over 1 cm by their hardness.

Aged↗
PubMed1980

[Endoscopic sclerotization of the oesophagus wall or transhepatic thrombosis of the coronary vein: Alternative or complementary therapy of bleeding oesophageal varices in portal hypertension (author's transl)].

Endoscopic sclerotization of esophageal wall has been performed in 48 patients with bleeding of esophageal varices. The mortality rate in the acute bleeding was 29,2%. There was no mortality, if sclerotherapy was done in the non hemorrhagic interval. Of the 48 patients 25 are still alive, 8 more than 2 years without bleeding. In 12 cases we performed transhepatic obliteration of the V. coronaria ventriculi. Only in 3 of them no further hemorrhage occurred within 6 months. Fibrosclerotization seems to be superior to the transhepatic obliteration, because the primary mortality and complications are lower and long term results better.

Coronary Vessels↗
PubMed1980

[O2-uptake of the cirrhotic liver. An experimental study (author's transl)].

In 15 Beagles with cirrhosis of the liver (TAA induced) and in 22 healthy controls the flow in the hepatic artery (Q a.h.) and in the portal vein (Q v.p.) was measured by kineangiodensitometry. The oxygen content in the hepatic artery, portal and hepatic vein was determined after withdrawal by inserted catheters. Thereafter the O2-uptake (V O2) via portal vein (V pO2) and hepatic artery (V aO2) was calculated. The control animals showed Q a.h. of 175 +/- 25 ml/min and Q v.p. of 511 +/- ml/min. In the cirrhotic animals Q a.h. rose up to 205 +/- 31 ml/min, there was a decrease of Q v.p. to 260 +/- 49 ml/min. V O2 of the liver of the controls was 5,6 +/- 1 ml/100 g/min. V aO2 ws 2,0 +/- 0,4 ml/100 g/min (35%), V pO2 was 3,6 +/- 0,7 ml/100 g/min (65%). In the cirrhotic animals V O2 decreased to 4,7 +/- 0,9 ml/100 g/min, V aO2 rose up to 3,0 +/- 0,6 ml/100 g/min (64%), V pO2 was reduced to 1,7 +/- 0,6 ml/100 g/min (36%). There was a statistically significant difference of all values measured (p less than or equal to 0,01). In cirrhosis of the liver the hepatic artery carries the main oxygen supply.

Animals↗
PubMed1980

[Long stump of the cystic duct causing trouble after cholecystectomy (author's transl)].

Of 4,058 patients who had had surgery in the years 1964-1977 because of disease of the extrahepatic biliary system 232 had to be operated upon again; in 9% of these the remaining stump of the cystic duct was found to be too long. In one third of these cases a causal relationship between long stump and clinical trouble could be suspected. From analysing these cases it became clear, that complications arising in the long stump e.g. inflammation or formation of new stones, involving in some cases extended parts of the hepatic biliary system,--caused the troubles. Reoperation should be performed early; a long stump should be shortened and the biliary duct system should be investigated intraoperatively in order to exclude other pathological conditions. Three fourths of our patients became symptom-free after the second operation; in the other patients secondary changes of the hepatic biliary system had already become autonomous and were responsible for the further course of the disease.

Cholangitis↗
PubMed1979

The effect of changes in cardiac frequency on left and right ventricular dP/dt max at different contractile states of the myocardium.

In 17 canine heart-lung preparations the dependence of frequency potentiation of the right and left ventricular myocardium on the basic inotropic state of the heart was investigated. The effect of unipolar stimulation of the right atrium on dP/dt max in both ventricles was measured. The aortic pressure was maintained constant. Shortly after isolation of the heart, a stepwise increase of rate from 140 to 200 beats/min only had a very weak influence on left ventricular dP/dt max. With deterioration of the myocardium the frequency potentiation of dP/dt max increased considerably. End-diastolic pressure regularly decreased with rising cardiac frequency. Since the real positive inotropic effect is masked by the concomitant fall in diastolic loading, the end-diastolic pressure was maintained constant in a second group of 8 hearts during rate variation. The most pronounced inotropic effect was now found shortly after isolation of the heart. A rate increase of 30 beats/min resulted in a 20% rise of dP/dt max. The frequency potentiation decreased with deterioration of the heart resulting in a 12% dP/dt max increase at an estimated inotropic state of 50% of control. When the contractile state of the heart was improved above the control state by calcium application the frequency potentiation of the myocardium decreased. In the right ventricle similar results were obtained except for the fact that no significant correlation between the steepness of the frequency characteristics and the contractile state of the heart could be found when the end-diastolic pressure was kept constant.

Animals↗
PubMed1979

[Evaluation of liver haemodynamics by spleno-portography in portal hypertension (author's transl)].

In 68 patients arterial and portal blood flow were measured by angiodensitometry in the course of routine, indirect splenoportography. Results were compared with those already published, with investigations of a model and with animal experiments. It was shown that, given certain underlying conditions, reliable results can be obtained even in the presence of a pulsatile flow and incomplete contrast mixing. Compared with other procedures, the method has the advantage of providing a complete picture of liver haemodynamics in the course of routine splenoportography in a simple way and without affecting the patient further. As a result the indications for performing a shunt and the choice of the shunt technique can be more accurately determined.

Blood Flow Velocity↗
PubMed1979

Direct effects of dopamine, orciprenaline and norepinephrine on the right and left ventricle of isolated canine hearts.

In 31 canine heart-lung preparations the direct cardiac effects of dopamine were compared to those of norepinephrine and orciprenaline. All three agents increased heart rate by 50-60% to a maximum of 240-250 beats/min. The inotropic effects of the three drugs were not significantly different. Even with the highest doses cardiac arrhythmias were rarely observed. To achieve maximal chronotropic and inotropic effects, dopamine required four times higher doses than norepinephrine and orciprenaline. All three drugs increased right ventricular dP/dt max by about twice as much as left ventricular dP/dt max. Peak systolic pressure (P max) in the right ventricle was increased 4-5 times more than P max in the left ventricle while mean aortic pressure was elevated by 12-16 mm Hg and mean pulmonary pressure by 6-14 mm Hg. The positive inotropic effect of all three sympathomimetics and of CaCl2 was substantially more pronounced on the right than on the left ventricle.

Animals↗
PubMed1979

[Comments on a concept of clinical child psychology].

Arguments in favor of establishing clinical child psychology as an independent subject are first discussed, and then the discipline itself is defined as a comparatively autonomous domain of psychology. Using three examples (research on reading and spelling weaknesses, the development of the memory and social interaction in ecological fields) it is shown that clinical child psychology can and must develop also through the utilization of fundamental research. The examples are closely related to aspects of the "Defective child" research project.

Brain Damage, Chronic↗
PubMed1978

[Possibilities of splenorenal anastomosis in portal hypertension].

The classical splenorenal shunt of Linton modified by Clatworthy is definitely superior to portocaval anastomosis. Between 1968 and 1976 in 225 patients with bleeding oesophageal varices a splenorenal anastomosis was performed in 47 cases, a portocaval in 30 cases and a mesentericocaval in 2 cases. There were 55 palliative operations as compared with 91 conservative therapeutic approaches. Over the last five years central termino-lateral splenorenal anastomses have been performed almost exclusively.

Esophageal and Gastric Varices↗
PubMed1978

[Other methods: dilatation, T-tube (author's transl)].

In the Department of Surgery of the University of Mainz we prefer dilatation for treatment of stenosis of the papilla. In 1063 cases out of 4058 operations for cholelithiasis, we opened the choledochus. In 944 patients, a dilatation was performed; 40 were treated by papillotomy; in 79 cases, primarily in the past, we performed a biliodigestive anastomosis. In 106 patients we finished the procedure by inserting a T-tube; in 838 cases primary closure of the choledochus was performed. In 12 complications of the dilatation (perforation, pancreatitis, restenosis), there was no mortality; therefore we conclude that dilatation of the papilla is a safe, simple, and effective procedure.

Ampulla of Vater↗
PubMed1978

Influence of the contractile state of the heart of the preload dependence of the maximal rate of intraventricular pressure rise dP/dt max.

In canine heart-lung preparations the relation between dP/Dt max and end-diastolic pressure exhibits the steepest slope shortly after isolation of the heart. When the heart is deteriorating, the slopes of the preload dependence of right and left ventricular dP/dt max are progressively reduced, but increase again after application of calcium. The preload dependence of dP/dt max is influenced by the contractile state of the myocardium. In the right and left ventricle the change in preload dependence of dp/dt max show a linear correlation. In the individual heart the slopes of the preload dependence of dP/dt max and of aortic flow (representing ventricular function curves) change in a very similar manner with varying contractility. In 33 different isolated hearts the slopes of the preload dependence of the two parameters show a good correlation shortly after isolation of the hearts. The preload dependence of dP/dt max can not only be used for assessment of acute variations in in myocardial contractility, but appears also to be at least as reliable as the ventricular function curves for the evaluation of the basic contractile state of different hearts. This study further shows that if dP/dt max is used for evaluation of relative changes in contractility, the quantitative results are influenced by the end-diastolic pressure level chosen.

Animals↗
PubMed1977

[Esophageal varices hemorrhage in portal hypertension (author's transl)].

Diagnostic and therapeutic possibilities for esophageal varices hemorrhage in portal hypertension are indicated with reference to 149 patients. In the acute phase, operative measures are to be rejected because the lethality is too high. Conservative treatment with a Blakemore-Sengstaken probe should always be introduced at first. After confirmation of the conditions in the liver, a pressure-reducing anastomosis operation (delayed emergency shunt) must be performed. For this purpose we prefer the terminolateral splenorenal anastomosis.

Adult↗