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Biomedical subjects

H Koch

Publications and source records attributed to H Koch.

At least 253 records · Page 14Linked to original sources
PubMed1987

[Clinical aspects and therapy of benign pleural mesothelioma. A case report].

It is reported on a large benign monophasic fibrous mesothelioma. Despite its enormous size it was clinically silent and caused considerable problems in diagnosis and localisation. Computed tomography and arteriography suggested that the tumour, which was attached to the diaphragm and vascularized by strong vessels of the left gastric artery arose from the retroperitoneum. Therefore, falsely, the patient underwent initial laparotomy. At thoracotomy, the pedunculated tumour war easily removed. Histiogenesis and prognosis are evaluated in detail.

Diagnosis, Differential↗
PubMed1987

[New aspects of causal therapy of hearing and speech development disorders caused by cleft palate].

Seromucous effusions were found in the tympanum in 91% of 208 cases of cleft palate. The incidence of recurrent mucosal effusions after paracentesis alone, in addition to drainage of the middle ear and poor speech results after veloplasty alone (according to Schweckendieck), led to the realization that hearing and speech disturbances in patients with cleft palates must be treated with a combination of morphologically correct veloplasty and tympanic drainage. Taking into consideration the fact that the auditory canal reaches maturation at the end of the first year of life, this procedure should be performed before the patient is 12 months old.

Child↗
PubMed1986

Indications for surgical removal of supernumerary teeth in the premaxilla.

Usually supernumerary teeth in the maxilla are removed surgically, often due to retention of the permanent teeth in the region, but in certain cases the supernumerary teeth do not cause alterations in the eruption, position or integrity of the permanent dentition. This study was performed in order to review the indications for such surgical removal. The patient records of 208 patients with supernumerary teeth during the period of 1970-81 were reviewed retrospectively. Of these patients, 52 non-operated were furthermore examined clinically and radiographically in 1982; mean observation time 7.3 years (1-22 years). Results showed that none of the 52 non-operated patients had any symptoms or pathologic conditions related to the supernumerary teeth. In 37%, progressive resorption of the supernumerary teeth was seen, and in 24% the pericoronary space was markedly reduced compared to the first examination. The position and morphology was found to have influence on the prevalence of retention of the permanent incisors (p less than 0.0001). Widening of the pericoronary space during the observation period of the non-operated patients was not seen in any of the cases. Of the total of 262 teeth, 2 well-defined pericoronary cyst (pericoronary space greater than or equal to 5 mm) were found. From the present study, it is concluded that supernumerary teeth in the premaxilla may cause pathological conditions. However, each case must be considered individually concerning surgical treatment, and if no retention of permanent teeth or pathological conditions are present, observation with regularly radiographic controls is advisable. Enlarged pericoronary space (1-3 mm) does not alone seem to indicate surgical treatment.

Adolescent↗
PubMed1986

Prophylactic sclerosing of esophageal varices--results of a prospective controlled study.

Of 60 patients suffering from various stages of esophageal varices with no previously recorded bleeding, 30 underwent combined peri- and intravascular fiberscopic sclerotherapy in a prospective controlled study. Each of the two groups consisted of 22 men and 8 women with an average age of 49 years. The cause of portal hypertension in 58 patients was a morphologically proven cirrhosis of the liver, due mainly to alcoholism. Portal vein thrombosis was present in two patients. The severity of the liver disease was first evaluated in accordance with the PUGH modification of the CHILD classification. 53% of the patients in the control, and 56% in the treatment, group belonged to the prognostically favourable CHILD A category. The period of observation was at least 26 months, with a mean of 36 months. Sclerotherapy lowered the risk of bleeding to 13.3%; in the control group it was 30%. The mortality rate during the overall observation period was lowered significantly (p less than 0.05) by sclerotherapy to 5.9% in the CHILD A group as compared with 25% in the control group. The mortality rate of CHILD B and C patients was over 40% in the control group and an unequally large 70% in the treatment group. The most frequent cause of death was bleeding from esophageal varices in the control group and liver failure in the treatment group. Complications were seen in 20% and paralleled the severity of the esophageal varices. All complications responded to conservative treatment and no fatality was seen.

Esophageal and Gastric Varices↗
PubMed1986

Ultrasound in cholangiofibromas of the liver detected by laparoscopy.

We investigated the question as to whether benign cholangiofibromas of the liver (biliary microharmatomas) show specific structures in ultrasound. Patients with single, sporadic, multiple or diffuse cholangiofibromas (n = 53), detected by laparoscopy and verified by histology, were examined by ultrasound. The single and sporadic type (n = 30) could not be detected by US. In patients with the multiple and diffuse type (N = 23) the descriptive US finding was: "increased content of fibrous tissue, cirrhotic transformation possible". Thus we conclude that patients with non-specific alterations of the liver in the ultrasound image must undergo further investigation by laparoscopy. Blind biopsy is not capable of verifying the presence of cholangiofibromas.

Adenoma, Bile Duct↗
PubMed1986

Changes of plasma fibronectin concentration and phagocytic activity in immunosuppressed patients during selective decontamination.

Plasma fibronectin and phagocytic activity play important roles in combating infections. The question is discussed, whether both defense systems are also of importance in immunosuppressed patients. Further, the behaviour of plasma fibronectin determined by laser nephelometry, and phagocytic activity determined by chemiluminescence is demonstrated in patients with leukaemia under the conditions of selective decontamination of the intestinal tract. The following results are shown: Plasma fibronectin concentration decreases 10 to 14 days before onset of the first clinical signs of an infection. Plasma fibronectin level changes appear earlier than that of C-reactive protein (Crp). Therefore, it is suitable as a parameter for assessment of the course of an infection. Decreased plasma fibronectin levels occurring over longer periods have to be regarded as unfavourable prognostic criterion. The phagocytic activity of immunosuppressed patients selectively decontaminated is significantly below that of healthy adults. A clear assignment of phagocytic activity to the clinical picture, the number of granulocytes and plasma fibronectin level is not possible at present. Additional studies are necessary. Both plasma fibronectin level and phagocytic activity do not appear to be influenced by selective decontamination of the intestinal tract.

Anti-Bacterial Agents↗
PubMed1986

[Iatrogenic aluminum osteopathy in a uremic infant].

An infant with uremia due to congenital renal hypoplasia was treated with oral aluminum hydroxide for 9 months in an attempt to reduce hyperphosphatemia. An increasingly painful osteopathy with pathological fractures ensued with loss of thoracic wall stability and respiratory failure. Increased serum aluminium levels and histochemically proved deposits of aluminium at the mineralisation front between calcified and noncalcified osteoid were demonstrated. In the context of recent findings concerning aluminium bone toxicity it is beyond doubt that this phosphate binding agent was detrimental for this child. Though a low phosphate diet normalized hyperphosphatemia after aluminium hydroxide treatment had been stopped, no effect on the progressive osteopathy was observed. Since aluminium hydroxide as a phosphate binder can be replaced by calcium carbonate or a low phosphate diet at least in young children, it should not be further recommended in this age group. This seems especially important in nondialyzed patients.

Aluminum↗
PubMed1986

[Results of radiation therapy in cervix carcinoma with reference to side effects].

The analysis of 770 patients after irradiation of cervix-carcinoma from 1968 to 1976 with Cobalt 60, radium or operation or only irradiation therapy shows five-year survival rates of 78% for stage I, 61% for stage II, and 23% for stage III. Bowel reaction was seen in 27%, 4% developed stenoses, 1.3% a recto-vaginal fistula. A complication of the bladder was seen in 18%, 2.7% had an ureteral stricture and 0.8% a bladder-fistula.

Cobalt Radioisotopes↗
PubMed1985

[Damage caused by biological warfare agents].

After a short introduction concerning the development of the biological warfare agents is referred to the present possibilities of the action of pathogenic microorganisms as biological warfare agents. Furthermore, the peculiarities of the course after aerogenic infection as well as the principles of the diagnostics and the treatment in the base after an action of biological warfare agents are described. It is referred to the significance of the urgent prevention.

Biological Warfare↗