Biomedical subjects
Publications and source records attributed to H Roth.
A detailed report is given on a modified surgical technique of the resection of the spleen. A successive division is performed within the area of the demarcation line after careful study of the vessels. The wound surface is sealed by fibrin and collagen fleece soaked with fibrin and therefore flexible.
The authors report on a disturbance of micturition following spinal anaesthesia which due to improper treatment took two months to resolve. The neurological status showed failures which were due both to the anaesthesia (irritation of root in the S 4 and S 5 regions by the spinal needle and action of the local anaesthetic agent) and to the surgery of a relapsing inguinal hernia (irritation existed, we could not exclude the possibility that the primary disturbance of bladder emptying was due to the anaesthesia and not to the surgical procedure of a possible mental component. In any case, the long-term atony resulting from the basically harmless handicap - even requiring placement of a suprapubic bladder fistula - could have been avoided if the postsurgical treatment had been conducted properly and in accordance with good medical practice.
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This double-blind cooperative study comparing pirprofen and acetylsalicylic acid (ASA) in the treatment of rheumatoid arthritis was conducted in 12 centres and involved 342 patients distributed throughout the United States. The patients were randomized to either pirprofen 200 mg four times a day or ASA 900 mg four times a day. The drugs were administered for 52 weeks. Nine standard clinical criteria were used for assessment of the therapeutic results by the investigators and by the patients themselves. Fifty-five % of the total patient population reported that they were highly satisfied with pirprofen, as against 47% with ASA. The investigators preferred pirprofen in 51% of the cases and ASA in 38% (p less than 0.05). Side effects (tinnitus, gastrointestinal disorders) were more frequent in the ASA group than in the pirprofen group. During the 52-week treatment-period, biological alterations were only observed in two patients (1 on pirprofen, 1 on ASA).
477 patients with soft tissue sarcomas, including 87 children (18.2%) were treated at the Surgical Center of the University of Heidelberg between 1950 and 1980. 22.8% of the patients with solid tumors (excluding brain tumors) in childhood were soft tissue sarcomas. In the pediatric age group there were 30% rhabdomyosarcoma and 20% angioblastic sarcoma. Since introduction of combined tumor therapy (surgery, radiation, and chemotherapy) the survival rate increased impressively from (29% to 58%).
5 cases of intramural haematomas are discussed. The haematomas were of different origin, were localized at different sites and treated differently. In one case an obstructive duodenal haematoma developed after a liver and spleen rupture. This hematoma was treated by gastro-enterostomy. In the second case the cause could not be determined. The third haematoma was induced by an intestinal clamp. In the last two cases there was a tendency to haemorrhages (Morbus Schönlein-Henoch and haemophilia A).
In recent years a multidisciplinary therapy contribution has brought about a remarkable change from a purely morphological to a markedly functional type of surgery in corrective operations of intersexual genitals. Methods of surgery generally in use today are described groupwise according to functional aspects. Their development is subject to cultural influences just as it depends on general medical progress and recent psychological knowledge.
The authors report on a consecutive series of 123 children (46 males, 54 females) with congenital duodenal obstruction who were operated on between 1962 and 1980 at the Department of Paediatric Surgery, University of Heidelberg, Surgical Centre. 78 patients (64%) had an extrinsic obstruction; in 36% of the children a membraneous stenosis or complete atresia was observed. 74 children (60%) were mature at birth and had no additional malformations. Out of the remaining 49 children, 25 were mature but had additional malformations. 13 prematurely born children without and 11 prematurely born children with additional malformations were seen. 17 (14%) out of 123 children died. In 74 cases with uncomplicated duodenal obstruction only 5 children (5%) died, as compared to 13 children (27%) out of 49 cases with complicated obstruction. A division of our patients into two time spans (1962 to 1971, 1972 to 1980) shows a total lethality of 25% for the first series, which included 39% cases with complications. In a consecutive series of 54 children operated between 1972 and 1980 no child died.
Basing on exemplary case histories - trauma, benign tumour and staging of lymphogranulomatosis - the possibility of maintaining the function of splenic tissue by means of partial splenic resection is discussed. Indication, surgical approach including fibrin glueing and postoperative follow-up are described, taking recent literature into account, and are discussed as an alternative to splenectomy and autotransplantation.
The brachial plexus can be located and blocked by a needle inserted perpendicularly to the frontal plane 3 cm medial to the coracoid process and 3 cm caudad to the clavicula. The method is easy to master, complications are of little consequence and the success rate with some experience high.
The method of partial splenectomy by applying fibrin glueing has become a safe surgical procedure thus opening new aspects of pediatric surgery of the spleen. Indications for partial splenectomy are discussed with special regard to Hodgkin's disease. The autotransplantation of splenic tissue--a localized form of iatrogenically induced splenosis--is considered as secondary to partial splenectomy since the arterial perfusion and the filter function of the spleen are not maintained. In cases, where partial splenectomy cannot be performed, splenic tissue should be placed in a retroperitoneal pouch of the splenic bed. The vulnerable infant omentum is rejected as a possible site of implantation since there is danger of spreading splenic tissue into the whole abdominal cavity inducing further complications by infections or neoplasma with splenic participation.
Polyamine (PA) and ATP concentrations have been measured in the S180 sarcoma damaged by endotoxin (1) 4 hours after administration, coinciding with the onset of hemorrhage, (2) at 8 hours, and (3) at 24 hours, preceeding overt necrosis. The putrescine (PU) content increased promptly, the spermidine (SPD) level dropped by 30% between 8 and 24 hours, while the spermine (SPM) concentration remained unchanged. The ATP level fell, reaching 1% of the control value at 24 hours. The parallel between increases in tumor PU content and urinary PU excretion appears to be largely fortuitous; no similar correlations existed in the cases of SPD and SPM. The development of tumor stasis and the alterations seen in PA metabolism of tumor-free controls suggest that the changes in liver PA concentrations and in urinary excretion primarily reflect responses of nonmalignant cells. Both these findings in animals without tumors and existing data from other experimental systems are consistent with the thesis that PA response patterns to a particular procedure are qualitatively similar regardless of the presence or absence of a malignant growth, and are characteristic of the procedure employed.
Over the past 10 years 18 patients have been operated upon (sometimes repeatedly) because of pulmonary metastases. The primary tumour with pulmonary secondaries was usually an osteosarcoma or a Wilm's tumour. The indication for surgery and the result of treatment are discussed. The pre-operative diagnosis is helped considerably by ventilatory and perfusion isotope studies.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Electron microscopic findings are reported on the localization and fine structure of glycolipid inclusions in different organs (heart, kidney, lymph nodes, arterial blood vessels, pancreas) in Fabry's disease in a female. The intracellular and extracellular inclusions were made up of multilamellar membraneous systems in concentric, excentric, and parallel arrangement. This fine structure is characteristic of liquid-crystalline phases of phospholipid-water systems. The same type of inclusions are found in the internal organs of heterozygotic women as in homozygotic men. The relationship between the glycolipid inclusions and the lysosomes is discussed.
Abnormalities in the choroidal circulation developed in two patients with arteriovenous fistulae in the area of the cavernous sinus. Fluorescein angiography in both patients revealed delayed filling of their choroidal circulation. In the first patient, this was associated with a central serous detachment of the retina secondary to a retinal pigment epithelial defect. In the second patient, a large choroidal detachment and serous retinal detachment, which resolved spontaneously developed. High venous pressure, low mean arterial pressure, and subsequent tissue hypoxia are postulated to be the cause of the altered choroidal circulation. The possibility of occult dural arteriovenous fistulae should be considered in the differential diagnosis in patients with a choroidal detachment, proptosis, and a red eye.