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Biomedical subjects

H Hertz

Publications and source records attributed to H Hertz.

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

[Therapeutic procedure in initial traumatic shoulder dislocation (arthroscopy--limbus refixation)].

This is a report of the therapeutic measures following primary traumatic dislocation of the shoulder in young patients (under 40 years of age). In order to rule out a disruption of the glenoid labrum, all patients were subjected to arthroscopy and disruption thus diagnosed in 38 of 48 cases. Surgical refixation of the glenoid labrum was performed on these patients. The ten patients with a stable labrum were given a Gilchrist dressing, immobilizing the shoulder for two to three weeks. Eight of the ten patients who had only had arthroscopy were followed up for an average of three years (two to six years). One developed recurrent dislocation of the shoulder. 31 of 38 patients who had had surgical refixation of the glenoid labrum were followed up for an average of 2.4 years (two to 5.8 years). None of these patients developed recurrent dislocation. Clinically, 25 patients have no pain whatsoever, while five report minor complaints, 30 patients are satisfied with the surgical outcome and only one is not.

Adolescent↗
PubMed1990

Changes in T1 relaxation processes in the bone marrow following treatment in children with acute lymphoblastic leukemia. A magnetic resonance imaging study.

Magnetic resonance imaging (MRI) and T1 relaxation time measurements of the vertebral bone marrow were performed in 11 children with acute lymphoblastic leukemia (ALL) at diagnosis. Nine of the children were re-examined after chemotherapeutic treatment. The results were compared with histological data from bone marrow biopsies obtained in close association to the MR examinations. Ten age matched children were examined as a control group. A 1.5 Tesla whole body scanner was used for the measurements. The pretreatment T1 relaxation times of the bone marrow were significantly prolonged, compared to the age matched controls. After chemotherapy the T1 relaxation times of the children with ALL decreased significantly towards or into the normal range. A significant correlation was found between the T1 relaxation time and the content of malignant blast cells in the bone marrow.

Adolescent↗
PubMed1990

[Simultaneous bilateral Achilles tendon rupture following minor trauma on steroid treatment--a case report].

The case of a bilateral simultaneous achilles tendon rupture under steroid therapy is reported in a 69 years old patient. The diagnosis includes clinical investigation, MRI, ultrasound and histological investigation. The steroid therapy was indicated because of a rheumatoid disease and pain in the shoulder. The cause of the influence of the steroid therapy as well as the literature supporting to this cases is discussed. Both achilles tendons were reconstructed in one operation.

Achilles Tendon↗
PubMed1990

[Prevention of thromboembolism in para-articular femoral fractures of the hip--results of a prospective randomized study of heparin-DHE and ASS-DHE].

The effectiveness of prophylaxis of thromboembolism either by acetyl-salicylic-acid (ASA) 0.5 g + dihydroergotamin (DHE) 2.5 mg three times a day or by Heparin 5000 IU + 0.5 mg DHE (HDHE) three times a day was compared in 404 patients, elder than 55 years, with fractures close by the hip joint. Effectiveness was proved daily clinical controls, perfusion scintigraphy on the day after admission, the fourth postoperative day and the day before discharge and by autopsy of the died patients. Clinical manifest thrombosis were seen on the operated legs in the HDHE-group in 7.6% of the patients, in ASA-DHE-group in 15.6%, on the not operated leg under prophylaxis by HDHE in 3.8%, by ASA-DHE in 4.1% of the patients. Increased postoperative bleeding could be found under HDHE in 16.1% of the patients, under ASA-DHE in 9.3% of the patients, wound haematoma in 9.5% under HDHE and in 5.7% of the patients of the ASA-DHE-group. Superficial wound infections occurred under HDHE in 8.1%, under ASA-DHE in 5.7% of the patients, deep infections under HDHE in 0.5% and under ASA-DHE in 1.6% of the patients. Gastrointestinal bleeding under HDHE in 0.5% of the cases and under ASA-DHE in 3.1% of the cases. Prophylaxis had to be discharged in 7.6% of the patients of the HDHE-group and of 19.7% of the ASA-DHE-group. Pathologic perfusion scars should be found in 54.0% of the patients of the HDHE-group and in 54.9% of the ASA-DHE-group. Pulmonal perfusion became worse despite of prophylaxis by HDHE in 15.6% of the cases and despite prophylaxis with ASA-DHE in 17.6%. Pulmonal perfusion became better under HDHE in 11.9% and under ASA-DHE in 12.4% of the cases. The mortality was 9.7%. Fatal thromboembolism occurred under HDHE in three patients (1.4%) and under ASA-DHE in three patients too (1.6%), after subcapital fractures in 0.5%, after pertrochanteric fractures in 2.1% and after subtrochanteric fractures in 6.25% of the patients without any significant difference between the two groups of prophylaxis. Fatal gastrointestinal bleeding had to be remarked in 1.0% of the patients of the HDHE-group and in 2.1% of the ASA-DHE-group, fatal infections in 0.5% of the patients of the HDHE-group and in 1.6% of the ASA-DHE-group. Fatal cardinal infarction could be seen under HDHE in 1.9% of the patients, under ASA-DHE no fatal cardial infarction occurred.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1990

[Knee puncture via a closed system].

Punctures of the joints, particularly the knee joint are performed quite often in every day practice. There are relatively simple procedures and carry a very low rate of infection. Infections of the joint space secondary to joint punctures are rare but catastrophic when they do occur. This new method of joint puncture operates in a closed system and provides the possibility of intraarticular administration of drugs, an act which will help to reduce the chances of infection after joint punctures or operations.

Drainage↗
PubMed1990

Skeletal transfixation in treatment of comminuted fractures of the distal end of the radius in the elderly.

Ninety-five patients (71 females and 24 males), average age, 69 years (35-92 years), with comminuted distal radial fractures were treated with transfixation wires (Kirschner wires) through the bases of metacarpals II-V and an above-elbow plaster cast. Two cases of early infections and four of Sudeck's dystrophy (4.2%) were encountered. Followup studies which lasted an average of 24 months (9-50 months) could be conducted on 77 patients. Using Sarmiento's ratings 27 patients fell into the very good category, 44, good, eight, fair, and two, poor. Although most of the cases were of the comminuted intra-articular fracture types, good results were achieved with this simple and quite straightforward method.

Adult↗
PubMed1990

Recommendation for collection of venous blood from children, with special reference to production reference values.

Reference values should be produced under standardized conditions. To enable comparison it is desirable to use the same procedure also in other clinical situations. A procedure for the collection of venous blood from children with special reference to production of reference values is recommended. It deals with five items: preparation of the child before specimen collection, preparation of the blood collection site, equipment for specimen collection, the specimen collection itself, and handling and storage of the specimen. Alternative methods are described since no single method is suitable for all paediatric age groups. The problem of adhering to a proposed procedure during routine clinical work is also commented upon. The recommendation has been produced as a joint effort of the Scandinavian Committee on Reference Values and a working group set up by the National Paediatric Societies in the Nordic countries.

Adolescent↗
PubMed1990

[Results of conservatively treated radius fractures at typical sites].

The results of 78 displaced Colles' fractures treated with reduction and below-elbow plaster were investigated. The follow-up varied from 11 to 24 months (phi 14 months). According to the schema of Sarmiento 66.7% of the patients had a very good or good result; 33.3% had a moderate or poor result. Most of the poor results were intraarticular fractures type C (AO). Primarily anatomical reduction leads to the best results. Every further reduction leads to a poor result, as well as to a higher number of Sudeck's disease.

Adult↗
PubMed1990

[Percutaneous drill wire fixation in treating distal radius fractures at risk of dislocation].

We are presenting an investigation of 47 cases treated with Kirschner wire fixation using drill wires for distal radius fractures. The average study period was 18 months after the fixation (13-25 months). Using Sarmiento's ratings we obtained the following results: 21 patients were rated as excellent, 19 as good, 6 as fair and 1 as poor. In contrast to a good reduction with a stepless joint surface, the initial fracture form and displacement does not influence the functional end results.

Adult↗
PubMed1990

[Transfixation in treatment of comminuted fractures of the distal end of the radius].

In comminuted fractures of the distal radius we apply our own method of transfixation. A Kirschner-wire is put through the bases of the metacarpal II-V, in addition an above elbow-plaster is applied. 47 persons (38 female, 9 male, age: phi 69 a) treated by this method have been checked-up after 16 months (26-5 months). In spite of the predominantly negative prognosis of the C3 fracture, according to the scheme of AO, we found out in our check-up considering principles of Sarmiento a good or a very good result in 41 cases (87%).

Adult↗
PubMed1989

Incidence of childhood cancer in Denmark 1943-1984.

A population-based study was carried out on 5790 tumours in children (aged 0-14 years) diagnosed in the period 1943-1984 in Denmark. Cases were identified from the files of the high-quality National Cancer Registry in which codes for tumours were based solely on topography until the end of 1977. To achieve a uniform data set following the outlines of the International Classification of Diseases for Oncology (ICD-O) coding system used by the Cancer Registry today, all cases of childhood cancer diagnosed prior to 1978 were re-evaluated, and an ICD-O code was applied. Tumours were aggregated into diagnostic groups suitable for analysis and presentation using an internationally agreed scheme, which was designed by the Manchester Children's Tumour Registry and modified recently by the International Agency for Research on Cancer. The average incidence rates for all histological types of childhood cancer combined were 137 per million boys and 111 per million girls, which are close to those reported from the USA but higher than most of the overall figures reported from Europe. The proportions of specific tumours were similar to those observed in other industrialized countries. The well known excess of cancer cases among boys compared to girls was due mainly to the occurrence of 90% more lymphomas, 30% more leukaemias and 15% more tumours of the central nervous system (CNS) among boys. Although significant increases were seen in the subgroups of CNS neoplasms and neuroblastomas (both sexes) and of lymphomas (boys only), no overall increase in childhood cancer was observed during the 42-year period of registration. While the increase in the incidence of CNS tumours was explained at least partly by better cancer surveillance, no interpretation can be offered for the increases seen for neuroblastomas and lymphomas. Our descriptive data suggest that environmental exposures do not play any significant role in the aetiology of the majority of childhood cancers.

Adolescent↗
PubMed1989

A population-based study of children with standard risk acute lymphoblastic leukemia in the five Nordic countries. A follow-up of 230 patients.

Two hundred and thirty children with standard risk acute lymphoblastic leukemia (ALL) were diagnosed during a period of 3 years from July 1, 1981 to June 30, 1984 in the five Nordic countries. Criteria for standard risk ALL were age above 2.0 and below 10 years, WBC less than or equal to 20 x 10(9)/l, no evidence of CNS-involvement, mediastinal mass or T- or B-cell leukemia. The children were treated without prophylactic CNS irradiation, the majority (200 patients) according to two treatment programs. Follow-up of the entire group after a minimum of 30 months showed 64% of the children living in complete continuous remission with a probability of event-free survival of 0.60. The treatment results are not entirely satisfactory and intensification of therapy is required. A subgroup of patients with WBC between 10 and 20 x 10(9)/l and with adverse prognosis was identified, justifying a change of the present criteria for risk grouping.

Adolescent↗
PubMed1989

[Surgical complications following implantation of femur head prostheses in a traumatology patient sample. Prevention and therapy].

At the 1st University-Clinic of Traumatology, Vienna, 420 patients with a medial fracture of the femoral neck received a femoral neck prosthesis (59 male, 361 female, phi age 81.3 years; range: 60-97 years). Severe early complications were fractures of the femoral shaft in 1.19%, that healed without problems after cerclage and plate osteosynthesis, and early infections in 3.1%. The rate of infections can be reduced to 1% prophylactic administration of antibiotics, surgery in an laminar airflow operating theater, and by the use of cement containing antibiotics. Dislocation of the prosthesis was observed in 2 patients (0.47%). the low rate of dislocation appears to be due to the antero-lateral operative approach according to Watson-Jones without osteotomy of the trochanter as well as to the precise technique of implantation of the prosthesis. More frequent late complications were periarticular calcification in 20 cases (4.7%) and protrusion in 18 cases (4.28%). However, only one out of the patients with calcification is restricted in his movements, and only 3 out of the patients with protrusion do complain of symptoms. The low rate of symptomatic protrusions is explained by a correct level of resection, by the implantation of a head prosthesis with appropriate dimensions and by the exclusion of patients with arthrosis of the hip or severe osteoporosis from the implantation of a femoral head prosthesis.

Aged↗
PubMed1989

[Traumatic spinal cord lesion. An interdisciplinary challenge--a synopsis of the early trauma phase].

Increased morbidity and mortality in patients with spinal cord injuries present the anesthesiologist with many problems. The extent of neuronal damage is determined not only by the initial trauma, but also by subsequent activation of lipid peroxidation and lipase reactions due to local ischemia of the spinal cord. Complete transection of the spinal cord is characterized by impairment of diaphragmatic function and cardiovascular depression due to functional sympathectomy. Since hypoxemia is a common finding in high tetraplegics, immediate, careful intubation is mandatory at the trauma site. Because of rotational instability of the cervical spine, any brisk movement of the neck must be avoided. Therefore, orotracheal intubation may be performed only after sufficient stabilization of the spine in a neutral position has been guaranteed. Functional sympathectomy of the cardiovascular system is responsible for the hypotension frequently seen in high tetraplegics. Adequate volume replacement is provided based on central venous and pulmonary capillary wedge pressures. Reduced sympathetic tone causes increased sensitivity to volatile and intravenous anesthetics, so that myocardial depressants (e.g. halothane) should preferably be avoided. Opioid-induced anesthesia and nondepolarizing muscle relaxants should, therefore, be the anesthetic technique of choice.

Combined Modality Therapy↗
PubMed1988

VM-26 (teniposide)-induced hypersensitivity and degranulation of basophils in children.

During a 7 year period, 16 episodes of VM-26 (teniposide) hypersensitivity occurred in our Department of Pediatrics. Eight of these (50%) were observed in neuroblastoma patients, of whom a total of 22 children had been treated with VM-26. The predominant signs were facial edema, flushing, urticaria, bronchospasm, tachycardia, and hypotension. All children with hypersensitivity recovered, but four of them were critically ill. No risk factors were found. In order to elucidate the mechanism of the hypersensitivity episode further, and to identify a possible allergen, histamine release from basophil leukocytes was performed by use of a glass microfiber method. Blood samples from nine cases reacting to VM-26, eight controls (children exposed to VM-26 without any hypersensitivity reactions), and 12 healthy children without previous exposure were challenged with VM-26 alone and with its vehicle, cremaphor. In all samples, it was found that VM-26 degranulated basophils, whereas no histamine release was seen after challenge with cremaphor. The reaction was dose-dependent, and not IgE-mediated, since IgE depletion of the cells did not abolish histamine release after VM-26 challenge.

Adolescent↗