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Biomedical subjects

H Grimm

Publications and source records attributed to H Grimm.

At least 73 records · Page 4Linked to original sources
PubMed1991

In vitro activity and cross resistance studies with cefpodoxime.

On the basis of MIC determinations and appropriate MIC breakpoints, 370 pathogens showed complete cross resistance between cefpodoxime and cefuroxime axetil, cefotiam hexetil, cefixime and cefotaxime in 69.7%, 80.3%, 92.2% and 87% of the strains, respectively. Cefpodoxime was superior to cefuroxime axetil in 28.7%, to cefotiam hexetil in 17.6%, to cefixime in 7% of strains and to cefotaxime not at all. On the other hand, we found cefpodoxime to be inferior to the cephalosporins mentioned in 1.6%, 2.1%, 0.8% and 13%, respectively.

Anti-Infective Agents, Urinary↗
PubMed1991

[Kinetics of bacterial wash-out in the Haemonetics Cell Saver III].

Autologous, outdated blood units were inoculated with four types of bacteria--Pseudomonas aeruginosa, Escherichia coli, Streptococcus faecalis, Staphylococcus aureus--in two concentrations (10e4, 10e6) to test the effect of the washing procedure (Cell Saver III Haemonetics) on the elimination of bacteria. The elimination rate ranged from 17% (Streptococcus faec. 10e4) to 96% (Pseudomonas aer. 10e6). These results confirm the routine use of wash centrifuge systems (type Cell Saver) to process shed wound blood as well as drainage blood for autologous transfusions.

Blood↗
PubMed1991

[The effect of sulbactam on the in vitro activity of mezlocillin, piperacillin and cefotaxime].

The in vitro activity of mezlocillin (MZL, CAS 51481-65-3), piperacillin (PIP, CAS 61477-96-1) and cefotaxim (CTX, CAS 63527-52-6) alone and in combination with sulbactam (SBT; CAS 68373-14-8) against mezlocillin-resistant pathogens was determined in a multicenter study. A total of 870 strains were investigated (481 Enterobacteriaceae, 57 Pseudomonas aeruginos, 41 Acinetobaster spp., 194 Bacteroides fragilis, and 97 Staphylococcus spp.). Determinations of MIC were performed according to DIN-guidelines (agar-dilution method for aerobes and microbroth-dilution method for anaerobes). Sulbactam was added in fixed concentrations of 5 mg/l and 10 mg/l. In all sulbactam-combinations examined mean MIC as well as MIC50 and MIC90 were reduced compared to the respective values for the antibiotics alone. Consequently, percentages of susceptible strains increased significantly: i.e. for Enterobacteriaceae: MZL 1% vs. MZL + 10 mg/l SBT 53%; PIP 4% vs. PIP + 10 mg/l SBT 54%; CTX 52% vs. CTX + 10 mg/l SBT 68%. The effect of sulbactam was most pronounced in Bacteroides spp. with an increase in susceptible strains from 2% to 97% for MZL, from 6% to 95% for PIP and from 7% to 98% for CTX. The results indicate that by adding sulbactam the in vitro activity of mezlocillin, piperacillin and cefotaxim against resistant pathogens is augmented significantly. In addition, the spectrum of antibacterial activity is extended to anaerobic pathogens such as Bacteroides spp. The availability of sulbactam as a monosubstance for combination with various beta-lactam-antibiotics thus represents a useful improvement of therapeutic options in bacterial infections.

Acinetobacter↗
PubMed1991

[Pancreatic pseudocysts and their interdisciplinary therapy].

A retrospective analysis was performed of 87 patients with pancreatic pseudocysts admitted at the Dept. of Surgery University of Hamburg from 1985 to 1989. Pseudocysts as a result of chronic pancreatitis were found in 54%. 42 patients underwent 49 operations, 35 have been drained endoscopically. In 10 cases there was spontaneous remission. 25 patients were treated by Roux-en-Y cystojejunostomy. In 14 patients a resection of the pancreas was performed. The mean follow-up interval was 26 (operative treated) and 22 months (endoscopic treatment). 50% of all patients in both groups reported pain relief. The mortality in operated patients was 7% and 0% for endoscopic treatment. In ten cases a recurrent disease was observed.

Adult↗
PubMed1991

Endoscopic sclerotherapy--personal experience.

Over the last 12 years, treatment of bleeding esophageal and gastric varices has improved considerably. By the use of new techniques and with increased experience the results of endoscopic sclerotherapy have been optimized. Acute variceal bleeding, esophageal or gastric, can now be reliably and definitively stopped using the tissue adhesive Histoacryl Blau. This is also applicable to all patients irrespective of their liver status at presentation. As expected, the mortality of acute variceal bleeders has decreased considerably, no death from bleeding occurring in the last 5 years. This has obviated the need for emergency surgery, balloon tamponade or vasopressin infusion. Using an aggressive sclerotherapy technique in the bleeding-free interval, varices of all grades can now be effectively eliminated within an average of 3 sessions covering 3-4 weeks. With the intra- cum peri-variceal injection technique not only are the visible veins eradicated, but also fibrosis of the inner esophageal wall is achieved at the same time. If careful attention is paid to certain details of the technique and instruments, and with close follow-up, patients of portal hypertension can now live well in terms of liver function, without the danger of further variceal bleeding.

Endoscopy, Gastrointestinal↗
PubMed1991

Acute gastrointestinal bleeding as a complication of pancreatic pseudocysts.

We report on 6 patients with chronic pancreatitis and pancreatic pseudocysts, operated on for acute bleeding into the cyst. The splenic artery and vein, the renal artery, the aorta and the splenic parenchyma were identified as bleeding sites. In 4 patients the acute hemorrhage occurred during hospitalization. In all patients the operative procedure included hemostasis and/or drainage/resection of the cyst. In 3 cases an additional splenectomy was performed. None of the patients died postoperatively. In 5 patients the pancreatitis was induced by alcohol abuse. In all patients the pseudocysts were diagnosed prior to the acute hemorrhage. CT-scan and angiography were able to localize the origin of the bleeding in 2 cases.

Acute Disease↗
PubMed1990

Endoscopic treatment of a pancreatic abscess originating from biliary pancreatitis.

We present a case report of a patient with two large pancreatic abscesses and an associated colonic fistula originating from acute gallstone pancreatitis, which we treated endoscopically. The common bile duct stones were extracted after a papillotomy. The abscess in the pancreatic head was drained into the duodenum and the one in the pancreatic tail irrigated through a nasopancreatic catheter using normal saline mixed with gentamycin. The colonic fistula was finally obliterated using a two-component fibrin glue.

Abscess↗
PubMed1990

Immunochemical characterization and quantitative distribution of pancreatic stone protein in sera and pancreatic secretions in pancreatic disorders.

A fluorometric immunoassay has been established to quantitate pancreatic stone protein providing a sensitivity for concentrations from 0.015 to 0.5 micrograms/mL. When concentrations of pancreatic stone protein were determined from pancreatic secretions obtained either from patients suffering from chronic pancreatitis (n = 31) [including the calcifying forms (n = 10)], pancreatic cancer (n = 22), or nonpancreatic diseases (n = 17), no significant differences were found. In contrast, increased concentrations were found in serum samples from patients with chronic (39/66) and acute pancreatitis (16/20) compared with control patients. The differences between these diagnostic groups and controls were highly significant (P less than 0.0001) and independent of pancreatic enzyme activity. Immunochemical analyses of serum pancreatic stone protein showed an isoelectric point (pH 9) similar to that reported for the pancreatic thread protein. With respect to recent communications, these data do not support the etiopathogenic role postulated for pancreatic stone protein in chronic pancreatitis and chronic calcifying pancreatitis by other investigators.

Adult↗
PubMed1990

Endoluminal ultrasound for the diagnosis and staging of pancreatic cancer.

For pancreatic cancer, endosonography is at present the most accurate method of imaging, especially for detecting small lesions and assessing the extent of locoregional tumour spread. Although the overall accuracy of tumour detection is nearly 100%, differentiation between cancer and pseudotumours of inflammatory origin may sometimes present a problem. Clinical history, symptoms and other imaging techniques, particularly ERCP, should therefore always be considered. On the other hand, endosonography is indicated when the other imaging techniques are negative or doubtful in the presence of a high index of clinical suspicion. In cases with proven malignant tumours, it should be performed for proper staging. The overall accuracy of staging the primary tumour is 80-90%, whereas for detecting lymph nodes it is around 75%. In contrast to angiography, endosonography gives more detailed information of major vessel involvement, an important factor in deciding whether the tumour is resectable. Endosonography is, however, not suitable for the detection of distant metastasis due to the limited penetration of ultrasound. The newly developed echoduodenoscopes, equipped with a working channel and an elevator, provide the possibility for improved accuracy of biopsy under endosonographic guidance, and under clinical evaluation. This should further improve the differentiation between pancreatic cancer and inflammatory pseudotumours, which continues to be a significant clinical problem. So far no procedure-related complications of endosonography have been reported. An adequate experience in conventional ultrasound and endoscopy is essential, however, in order to achieve reliable results.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1990

Is the syntax development of dysphasic children deviant and why? New findings to an old question.

The present study addresses three main issues: First, it considers whether the syntax development of dysphasic preschoolers is adequately described as being a purely quantitative retardation or whether there are qualitative differences as well. Second, the suggestion put forward by Grimm (1987) that the syntactic deficits of dysphasic children result from deficient language processing strategies is further explored. Third, it asks whether the language deficits are related to specific structural and interactional aspects of the language input. We examined two groups of children with comparable levels of language development: 8 dysphasic children, ages 3:9 to 4:8 years, and 8 control children, ages 2:1 to 2:11 years, who showed normal language development. The empirical evidence suggested that the dysphasic children's syntax development was not only delayed but also deviant, and that the children's deviant syntax structures were the result of insufficient language processing and could not be traced back to structural characteristics of the sentences used by their mothers.

Age Factors↗
PubMed1990

ESWL and gallstone dissolution with MTBE via a naso-vesicular catheter.

Endoscopic placement of a naso-vesicular catheter was successful in 90% (45/50) of patients with cholecystolithiasis. The first 7 patients were treated by MTBE dissolution alone. Dissolution was discontinued after a maximum of 14 days, as only two patients were rendered stone free. In one patient, 3 tiny pigment stones were sucked out through the catheter, and in another inoperable patient a pigtail endoprosthesis was finally inserted into the gallbladder. In the remaining 36 patients, combined ESWL and MTBE dissolution therapy was carried out. Treatment was broken off by one patient after one week, and interrupted in another due to catheter dislodgement. After an average of 10 days with 1-9 ESWL sessions (average: 3) complete stone clearance was achieved in 60% (20/34) of patients. Fourteen of the patients who completed treatment, and the one with catheter dislodgement still have sludge in the gallbladder, which is being treated with oral bile acids. The procedure-related complication rate was 10% (3 pancreatitis, 1 cystic duct perforation and 1 guidewire impaction). The mortality rate was zero. There was no evident complication due to either ESWL or MTBE dissolution.

Catheterization↗
PubMed1990

A new technique for replacing an obstructed biliary endoprosthesis.

We report on a new method of stent exchange using a threaded device that enables removal of the clogged stent while simultaneously maintaining the original pathway without withdrawing the endoscope. With this method stent replacement has become more reliable, safer, simpler and quicker. This technique is also suitable for removal of stents dislodged inside the duct.

Cholestasis↗
PubMed1990

[Technical variants and problems in endoscopic tube implantation].

Compared to other endoscopic procedures, implantation of an esophageal prosthesis is a relatively invasive treatment modality. It is mainly indicated as a symptomatic therapy in patients with unresectable tumours. The indication should therefore be clearly established. Since the results of surgery and radiotherapy have improved, an objective selection of the treatment modality is only possible in an interdisciplinary set-up. Any palliative therapy is expected not only to be less risky but should be immediately effective in relieving the patients symptoms and thus improve the quality of life. Endoscopic tube implantation fulfils this requirement regarding relief of dysphagia compared with other palliative methods eg: laser/BICAP. Re-establishing a lumen for oral feeding with photo or electrocoagulation in very advanced tumours is a long and labourious path. For such cases and for fistulae, implantation of a tube is the treatment of choice.

Esophageal Neoplasms↗
PubMed1990

[Value of sono- and computerized tomography as a localization procedure in primary hyperparathyroidism].

A total of 56 patients underwent preoperative high-resolution sonography (4 MHz); 33 had additional computed tomography (4 mm slices, contrast material as drip infusion) to localize abnormal parathyroid tissue in primary hyperparathyroidism. The sensitivity of sonography was 48% compared to 38% for computed tomography. The efficiency of both techniques was mostly dependent on size and location of the parathyroid. Computed tomography was superior in detecting ectopic parathyroids. Because of its low sensitivity sonography is only of facultative importance as a localization procedure for primary hyperparathyroidism. Computed tomography is indicated only for localizing ectopic parathyroid tissue after initial operation has failed.

Adenoma↗
PubMed1990

[Lung metastases--can resection also be justified in synchronous liver metastasis?].

There is general agreement on the preconditions necessary for the resection of lung metastases: the primary tumor has to be resected completely, a local tumor recurrence as well as metastases in other organs have to be excluded. 5-year survival rate of patients operated under these criteria is said to be about 20 to 40% (number of own patients: 72; 5-year survival rate: 30.2%. Only in a few cases, however, lack of metastases in other organs is given. Often there are synchronic liver metastases. Local intraarterial chemotherapy doesn't put much burden on the patient, induces a decrease of liver metastases in 30% and a complete remission in a few cases, respectively. Between 1981 and 1987 we performed local chemotherapy of the liver in 575 patients. 110 patients showed lung metastases in the course of the treatment or during the aftercare period. In 8 patients we resected lung metastases occurring after remission of liver metastases. 7 patients died 11 to 28 months after the operation, 1 patient is still alive 16 months postoperatively.

Adult↗
PubMed1990

[Secular trend of body height and "acceleration" or fluctuation in growth in height in child development--on questions of methodology in relation to pre-historical skeletal remains].

The possibility of obtaining information on growth and development from prehistoric and early historic skeletal remains of children and juveniles is discussed. Beside simple measurements of length there are some new methods of assessment, e.g. control of "Harris' lines", thickness of bone corticalis including cremated bones, diameters of neural canal and vertebral body height. Estimation of age based on dentition must be presumed in every case. Results show oscillations rather than a linear or curved trend in only on direction. The phenomenon of acceleration can also not be seen as a return to earlier phases of mankind.

Adolescent↗