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Biomedical subjects

H Schilling

Publications and source records attributed to H Schilling.

At least 55 records · Page 3Linked to original sources
PubMed1990

[The sonographic image of gallbladder adenomyomatosis].

Compared with oral or intravenous cholecystography, a diagnosis of adenomyomatosis of the gall bladder is only rarely made by ultrasound. In nine patients this diagnosis was made by sonography and confirmed at operation or by cholecystography. In four patients it was an incidental finding during ERCP. The main feature is localised or generalised thickening of the wall of the gall bladder with a smooth outer contour. In seven cases there were small cysts in the wall and in two echogenic areas in the wall. An important criterion for distinguishing between inflammatory and neoplastic mural thickening is the contractility of the gall bladder.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1990

[Cytostatic and immunosuppressive treatment of ocular Behçet syndrome].

Ocular symptoms of Behçet's syndrome in 16 patients and the results of cytostatic and immunosuppressive therapy with cyclosporin A (6 patients), chlorambucil (6 patients), and a combination of cyclophosphamide and procarbacin (4 patients) are described. The clinical course and therapeutic outcome were compared to the patients' visual acuity and the duration of the disease prior to institution of cytostatic therapy. Average follow-up was 4.6 years, maximum 9 years. The principal ocular symptom in all patients was hemorrhagic, occlusive periphlebitis. Other symptoms, in descending order of frequency, were chorioretinitis, iridocyclitis, complicated cataract, secondary glaucoma and exudative retinal detachment. The patients in whom cytostatic therapy was instituted no later than 6 months after onset of the disease showed an improvement in or stabilization of visual acuity, as well as a clear reduction in signs of intraocular inflammation and frequency of recurrence. No improvement in visual acuity or ocular symptoms was achieved in cases where the disease was very advanced, despite cytostatic-immunosuppressive therapy. The results support early institution of immunosuppressive therapy in cases with Behçet's syndrome where severe, irreversible damage has not yet occurred and in which vision is threatened in both eyes. However, due consideration must be given to the potential risks of immunosuppressive therapy, in particular the risk of a malignant tumor.

Acyclovir↗
PubMed1989

[The prognostic significance of the differential blood count in patients with chronic myeloid leukemia].

In 66 patients (37 male/29 female, median age 51 years) with CML in stable phase the initial smears of the peripheral blood were evaluated in regard to survival. Differential count was performed on 500 nucleated cells by two investigators working independently and blind. Scrutinized statistical analysis revealed not only the well-known predictive value of the number of myeloblasts, but also a significant prognostic impact for the percentages of polymorpho-nuclear granulocytes, eosinophils and basophils.

Blood Cell Count↗
PubMed1989

[Prenatal diagnosis and obstetric management in association of hydramnios and homozygosity].

The patient was referred to hospital in the 29th week of gestation owing to polyhydramnions. Ultrasonography revealed isolated left-sided hypertrophy (from foetal chest to the lower extremity) with subcutaneous lymph cysts. Amniocentesis for genetic examination revealed a chromosomal disorder showing homozygous t(13q, 14q) translocation. This extremely rare anomaly could be explained only and was finally proven by a father-daughter incest. The authors underline the necessity of karyotyping as well as the ultrasonic exclusion of foetal malformations in patients with polyhydramnions.

Abnormalities, Multiple↗
PubMed1989

[Treatment of the dry eye with vitamin A acid--an impression cytology controlled study].

To test the efficacy of topically applied tretinoin eyedrops (0.01%, twice daily, in a solution of peanut oil) in the treatment of squamous metaplasia of the conjunctival epithelium associated with dry-eye, the authors evaluated the impression cytology (IPC) of a total of 31 patients. The cytological findings were classified into four different stages with an overall range from 0 to 9 points. The average period of treatment was 12 weeks. The patients were classified into three groups: (1) Those with mucin deficiency (Mucin less than - greater than; n = 19), (2) those with Keratoconjunctivitis sicca (KSC; n = 6), and (3) a control group in whom pure peanut oil was used (n = 6). The IPC showed a considerable improvement of squamous metaplasia in the mucin less than - greater than group, by an average of 4.3 points (from 6.2 points before treatment to 1.9 points). No changes were seen in the IPC of the KCS patients or the control group. The results of this study show a good effect of tretinoin eyedrops in patients with a significant decrease in or loss of goblet cells seen in the IPC, a decreased break-up time and with no severe aqueous deficiency of tear film. These patients seem to have a "primary" mucin deficiency induced by the decrease in or loss of goblet cells. There is no indication for tretinoin treatment in patients with aqueous deficiency involving major or accessory lacrimal glands. The results of other previous and recent studies on tretinoin treatment are discussed.

Adult↗
PubMed1989

[The exact prenatal diagnosis of abnormalities of the kidneys and efferent urinary system--a possibility for further decreasing perinatal morbidity and mortality].

Early detection of fetal malformations has become possible owing to the availability of highly advanced ultrasound systems. Majority of malformations, 30 per cent, has been recordable from urinary system. This system is early of access for the examiner, so that even sophisticated diagnosis of malformation is possible. High accuracy diagnosis has been increasingly helpful in forecasting pregnancy prognosis. Hence, with adequate perinatological management, it will be possible to influence on perinatal morbidity and mortality positively. 70 fetuses with malformations of kidneys and to urinary system have been observed in the context of this study. An assessment was made of diagnostic efficiency, postpartum development and long-range prognosis. Recommendations are derived from the above mentioned findings for perinatological approach in cases of diagnosed malformations of kidneys and the other urinary system.

Abnormalities, Multiple↗
PubMed1989

[Ultrasound diagnosis of severe fetal abnormalities].

Reported in this paper is a case of premature termination of pregnancy in the 29th week because of sonographically diagnosed multiple malformations of the fetus. Holoprosencephaly, omphalocele, polyspleny syndrome, double-outlet right ventricle, and several skeletal malformations were established by pathologico-anatomic investigations. Possible correlation between these malformations are discussed in some details.

Abnormalities, Multiple↗
PubMed1988

[Selective pregnancy termination by minor section in the 24th week in a discordant twin pregnancy and the spontaneous birth of a healthy child at term].

In a twin pregnancy of a 25-year-old woman one fetus was a normal male, while the other had hydrocephalus (6 mm thick pallium in the 23rd week) and a neural-tube defect in the thoracic-lumbar region. The abnormal fetus was removed by minor section in the 24th week, after which the normal one developed without complication. A healthy boy, weighing 3050 g and 52 cm long, was delivered spontaneously in the 39th week. Palpation of the uterus revealed a dehiscence, covered by muscle, in the region of the uterotomy scar, but it required no revision.

Adult↗
PubMed1988

[Angiotensin-converting enzyme inhibition: side effects and risks].

Adverse effects of converting enzyme inhibitors are either substance-specific (neutropenia, proteinuria, skin rashes, taste disturbances) or due to the converting enzyme inhibition (hypotension, functional renal insufficiency, hyperkalemia, cough, angioedema). They are rare nowadays because of better knowledge of the pharmacokinetics and -dynamics of the converting enzyme inhibitors, resulting in lower dosage, and because of identifying patients at high risk. The dosage must be adjusted according to renal function, in order to prevent accumulation and toxicity. In addition to patients with renal insufficiency, patients at high risk are those with a stimulated renin-angiotensin-aldosterone system, i.e. patients with renovascular hypertension or heart failure. Patients with collagen vascular disease, for example, systemic lupus erythematosus or scleroderma, should not be considered for long-term therapy with converting enzyme inhibitors because of the increased risk of neutropenia. Life-threatening angioedema may develop, mainly during the first few hours after drug administration.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1988

[Results of invasive and pharmacosonographic studies in pregnancy (I)].

In prenatal diagnosis besides radiographic methods there is a growing trend towards the use of invasive diagnostic techniques. These techniques have proved to be suitable for early detection of genetically determined conditions, diseases, and malformations of different origin. Invasive examination techniques were applied to 1.104 cases of prenatal diagnosis at Humboldt-University, Berlin, School of Medicine (Charité), Department of Gynaecology and Obstetrics, from January 1st, 1985, up to September 30th, 1987. In this paper importance and possible applications of these methods have been reported.

Amniocentesis↗
PubMed1988

[Results of invasive and pharmacosonographic studies in pregnancy (II: Amniofetography)].

Prenatal diagnosis of fetal diseases and malformations, using invasive techniques is outlined in this paper. The value of amniofetography under present conditions is discussed together with the use of drugs both isolated and in conjunction with fill-up of the amniotic cavity. Indications for puncture of fluid-filled body cavities, with reference being made to patients looked after at the Humboldt-University Berlin, School of Medicine (Charité), Department of Gynaecology and Obstetrics, from 1985 up to 1987, are reported, too.

Congenital Abnormalities↗
PubMed1988

[Treatment of cruciate ligament lesion following knee trauma].

In the treatment of the capsular ligament lesions of the knee joint, the most important therapeutic measure is the reconstruction of the central pillar of the cruciate ligaments. 112 patients with ruptures of the cruciate ligaments and associated injuries have been operated from 1975 through 1985. 78 out of them can be checked-up. Most of the accidents are due to sports or professional activities. 76% of the patients are treated early, i.e. within the first six days from the accident. The rates of simple instabilities as well as of anteromedial rotation instabilities are 40% each, the remaining injuries are severe combined traumas to the knee. In many cases the articular structures are involved, too. The surgical procedure is described. In 89% of the cases, the articular stability is restored with very good or good success by reconstruction. A permanent instability is only observed in two patients. Taking into consideration the mobility and the subjective opinions of patients, 71% have very good or good results.

Adolescent↗
PubMed1988

[Intrauterine exchange transfusion in Rh immunization].

Intra-uterine exchange transfusion was performed on a patient in the 30th week of gestational age for Morbus haemolyticus fetalis. The indication for intra-uterine intervention resulted from spectrophotometric investigation of amniotic fluid which had revealed Zone III according to Liley as well as incipient hydropic development and development of ascites. The pregnancy had to be terminated for pathological CTG, four days after therapy. Postnatal neonatological intensive therapy included two exchange transfusions, before the child was dismissed in clinically intact condition.

Adult↗
PubMed1987

[Perinatal medicine study group. Diagnosis and therapy of ventral schistasis].

Reported in this paper are twelve cases of ventral schistasis transferred for cooperative prenatal assessment, diagnosis, and therapy to the Berlin Charité Hospital of Gynaecology and Obstetrics in 1985 and 1986. Concomitant malformations were recorded from eight in ten omphaloceles. Three of these children were delivered on full term by spontaneous parturition or caesarean section. They were surgically treated immediately after birth. Gastroschisis was recorded from two pregnancies with ventral schistasis. No generally valid recommendation can be given for approach to ventral schistasis. The approach should rather be interdisciplinary and should be preceded by careful diagnosis. Parents should be involved in decision-making.

Abdominal Muscles↗
PubMed1987

[Modification of the spectrum of neonatal surgery by prenatal diagnosis].

Expansion of prenatal diagnosis will alter the spectrum of neonatal surgery. The ethos of the medical profession calls for decision in favour of the mother, whenever evidence can be produced to the effect that a severely damaged or nonviable foetus may endanger the health of the pregnant woman. Humanistically and legally warranted termination of pregnancy in such cases will reduce the number of severely malformed newborns on whom nothing can be done but palliative treatment. Early detection of foetal diseases will enable, on the other hand, well-timed preparation of acutely necessary life-saving interventions and will bring down the rate of emergency operations on newborns.

Amniocentesis↗
PubMed1986

[Difficulties in the recognition and evaluation of injuries of the anterior cervical spine].

The difficulties encountered in diagnosis, course and medical opinion are shown by two cases concerning the upper cervical spine. One of them was a condyle of the third occipital bone due to predisposition, the other a splintered fracture of the lateral mass of the atlas. A definitive medical opinion can only be established on the basis of an analysis of symptoms and findings, an objective assessment of the course and a precise diagnosis. This prevents disappointment and helps to avoid a lot of paperwork and protracted procedures.

Adult↗