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Biomedical subjects

H Roth

Publications and source records attributed to H Roth.

At least 55 records · Page 3Linked to original sources
PubMed1987

Optic disc cupping as clinically estimated from photographs.

Cup-to-disc ratios of 204 right eyes were evaluated by two clinicians and by a trained grader using a standardized grading scheme. Mean measurements by the grader were greater than estimates made by either clinician. The measurement scheme used by the trained grader has a high degree of reliability and validity. The standard protocol provides an objective assessment of optic disc cupping and could be easily adapted for office use.

Diabetic Retinopathy↗
PubMed1987

[Ovarian pseudocysts in female newborn infants: prenatal ultrasonic diagnosis and surgical consequences].

During the last year we diagnosed within the scope of preventive medical care of pregnant women in about the 30th pregnancy week, seven foetuses with abdominal cystic tumours by ultrasound examination. Postpartal ultrasound controls of the mature newborn confirmed the findings. After laparotomy we found ovarian pseudocysts with a volume up to 90 ccm. Histologically we could not identify ovarian tissue. In 66% of the cases we found small cysts on the contralateral ovary. Differential diagnosis and the possible complications must be considered. A laparotomy should be performed and only by high steroid serum level a conservative therapy with MPA should be considered. This is the case in premature newborn with an immature endocrine regulation mechanism.

Diagnosis, Differential↗
PubMed1987

[Cantrell's syndrome].

Congenital diaphragmatic hernia is associated with a high mortality, especially when combined with other defects. The unusual repeated combination of the same congenital abnormalities by a number of patients and the fact that during embryonic life these organs develop from the mesoderm implies the existence of a specific syndrome. This article summarises the available clinical data and reports on three cases with Cantrell's syndrome, showing different pattern of congenital defects such as: 1) supraumbilical abdominal wall defects; 2) a defect of the lower sternum; 3) a deficiency of the anterior diaphragm; 4) a defect in the diaphragmatic pericardium; 5) congenital intracardiac defects.

Abdominal Muscles↗
PubMed1987

[Arterial blood supply of the upper pole of the spleen in main artery occlusion].

Vascular dissections of the splenic-, gastric- and pancreatic region, corrosion specimens of the upper splenic pole and arteriographies of the superior polar artery after trunc lienal artery occlusion in human served as an answer to the question of the arterial supply of the upper lienal pole. The present results point out the importance of the upper polar artery and the existence of intersegmental anastomosis. The latter gain importance in case of trunc splenic artery occlusion. The short gastric vessels are of subordinate value.

Collateral Circulation↗
PubMed1987

[Gastrointestinal perforations in neonatal surgery].

From 1970 until 1987 we treated 69 newborns with gastro-intestinal perforations. Immediate measures in form of laparotomy were undoubtedly necessary. Regarding our casuistic the authors present the clinical findings, necessary preoperative diagnostic measures and intra-operative and postoperative treatment. The localisation and the origin of the perforation are pointed out. The most frequent localisation was the small bowel (58%), followed by the colon (35%). Etiologically we found extensive NEC, atresias, meconium ileus and Hirschsprung's disease. In 4 cases iatrogenic rectum perforations, in 3 cases spontaneous gastric and duodenal perforations and twice an appendicular perforation were seen. Our operative procedure depends on the localisation, the degree of peritonitis, on intestinal necrosis and trophic alterations of the gut following ileus. In spite of intensive care, the mortality rate is still very high indicated with 33%. Furthermore more than half premature newborns died (18 out of 33). Based on these facts we propose quick diagnostic measures, interdisciplinary cooperation, an emergency operation followed by intensive care to ameliorate the results. Nevertheless we must keep in mind that newborns, who some years ago were condemned to die, nowadays can be operated, thus changing the mortality of gastro-intestinal perforations.

Colonic Diseases↗
PubMed1987

[Intestinal invagination. Analysis of case reports in the last 45 years].

The retrospective study analyses 219 children with intussusception, who were treated in the Dpt. of Pediatric Surgery, university of Heidelberg between 1942 and 1986. The patients were divided into three groups. The mortality of the first group (1942-1966) was 20%. Since 1966, however, no patient with intussusception was lost. Recent diagnosis advances with ultrasonography allowed early diagnosis and at the same time the complication rate dropped from 34 (group 2, 1967-1981) to 11% (group 3, 1981-1986). Simultaneously the intestinal resection rate was reduced. The developments in diagnosis and therapy during the last 45 years, based on the analyses of the three groups, are discussed in detail with the literature.

Child, Preschool↗
PubMed1986

[Peculiarities of juvenile vertebral fractures and dislocations of the cervical vertebrae].

In addition to diagnostic and therapeutic problems of the bony spine injuries in childhood, questions of the participation of the growth plate arise and indicate the following treatment. In the last decade we treated 23 spine injuries, resulting after fall from height. Most of the cases showed single to multiple compression fractures of the anterior spine followed in a descending frequence by the lateral compression fractures, the disconnection ot the epiphyseal plate of the axis and the actual luxation fractures with injury of the stratum germinativum. In contrast to the prognostic favourable impression fractures with a spontaneous correction, luxation fractures with or without paraplegia must be repositionned and stabilized.

Cervical Vertebrae↗
PubMed1986

Programmed electrical stimulation to determine the need for antiarrhythmic therapy in patients with complex ventricular ectopic activity.

Patients with complex ventricular ectopy (greater than or equal to Lown grade III) and organic heart disease (OHD) are at increased risk for sudden cardiac death. Despite this fact, many such patients will remain free of symptomatic ventricular arrhythmia and thus are unnecessarily exposed to antiarrhythmic drug toxicity and arrhythmic potentiation. Programmed stimulation (PS) was used to direct therapy in 88 patients with asymptomatic ventricular ectopy complicating OHD. Thirty-three had inducible ventricular tachycardia (VT) and underwent treatment. The 55 patients without inducible VT (less than or equal to 6 repetitive ventricular responses) are the focus of this study. Three patients required treatment for persistent cardiac awareness. The remaining 52 have been followed for 22 months off antiarrhythmic drugs and all have remained free of subsequent major arrhythmic events. Therefore, in patients with complex ventricular ectopy, OHD, and absence of prior symptomatic ventricular arrhythmia, PS identifies patients at low risk for future disabling or life-threatening arrhythmic episodes and patients with absence of inducible VT can usually be managed without antiarrhythmic drugs.

Adult↗
PubMed1986

[Delivery planning and interdisciplinary management of large coccygeal teratomas].

Prenatal sonographic screening and a growing experience of examiners with regard to possible congenital malformations such as large coccygeal teratomas have induced the request for an early interdisciplinary consultation between obstetrician, human geneticist, paediatric surgeon, neonatologist and psychologist. It should aim at a careful information and counselling of the parents with regard to the mode of delivery and possibilities of operative management. The prerequisites for far sighted planning and performance of delivery are demonstrated by the example of large coccygeal teratomas. The availability of equipment, facilities and manpower at the time of delivery guarantees a course of delivery at reduced risk and is, together with the psychological guidance of the parents, a basic element of optimal care for the newborn.

Coccyx↗
PubMed1986

[Fractures and cartilage injuries of the knee joint in children].

In the last decade we treated and followed up 48 children in the Department of Paediatric Surgery in Heidelberg with fractures and cartilaginous injuries of the knee joint. In 13 cases we could see severe osseous injuries localised at the epiphyseal plate. With decreasing frequency, the following conditions occurred: avulsion fractures of the intercondylar eminence, fracture of the tibia head in children, fractures of the patella and avulsions of the tuberositas tibiae. Furthermore, we report about the special problems of foreign bodies incorporated in the knee joints of children, particularly if sewing needles are involved.

Cartilage, Articular↗
PubMed1986

[Implantation technic of a peritoneal dialysis catheter in infancy and childhood].

Since 1979 the continuous ambulatory peritoneal dialysis (CAPD) is used even in childhood. Practical management and tolerance of this method over a longer period are dependent on the compatibility of the chosen catheter material, the implantation technique and the exact introduction in catheter care with sac changing. The used variant of the classical Tenckhoff-catheter with spiral end and individually fitted cuffs has proved to be reliable. The left-sided paramedian incision is the preferred operative access. The transrectal position of the catheter guarantees its cranio-caudal course and placement of the spiral in the minor pelvis. The standardisation of surgical procedure in all details is an essential assumption for the improvement of long-term catheter function.

Catheters, Indwelling↗
PubMed1985

Problems in spleen autotransplantation: comparative study of types of implantation in animal experiments.

Iatrogenic localized splenosis presents a seemingly simple surgical possibility for preserving partial function of the spleen. Until now, pathophysiological aspects, such as the drainage direction of venous blood from the spleen, possible splenic diseases in ectopic tissue, and the formation of pseudoabscesses as well as conditions for implantation have been given insufficient attention. In 45 Wistar rats, divided into three groups according to the surgical procedure (implantation in the greater omentum, liver, retroperitoneum), the taking of the grafts were examined macroscopically and histologically. Because of the results, and bearing in mind the mentioned criteria, a new method for spleen autotransplantation is suggested: the implantation into a pediculated flap of omentum and retroperitoneal displacement behind the splenic bed.

Animals↗
PubMed1985

[Cystic duplications of the cervical esophagus].

Cystic duplications in the cervical region are very rare. In most cases compression of the trachea leads to severe symptoms of respiration. Two cases of cystic duplication are described - a nine months old child and a newborn baby. In the first case the cyst was localized on the right side of the thyroid. Extirpation could be done without any complications. The operation on the second case was difficult. The tumor was localized between oesophagus and trachea rotating the larynx.

Diagnosis, Differential↗