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Biomedical subjects

J Hasse

Publications and source records attributed to J Hasse.

At least 55 records · Page 3Linked to original sources
PubMed1996

Bilateral myoclonus of the trapezius muscles after distal lesion of an accessory nerve.

Observations of rhythmic or semirhythmic myoclonus due to a peripheral nerve lesion are exceptional. We report on a patient with thorax trauma with multiple bilateral hematomas of the paravertebral musculature. Eight years later he developed rhythmic myoclonus of both trapezius muscles and thoracic pain. Infiltration of a paramedially located scar at the level of D5-6 with a local anesthetic agent led to an intermittent relief of the myoclonus as did anesthetic blockade of the left accessory nerve. Surgical excision of the scar, which contained multiple dystrophic axons on histological examination, cured the patient's symptoms as illustrated in a videotape. This indicates that peripheral afferents contributed to the myoclonus. Ephaptic transmission, ectopic excitation, or misdirected neuronal sprouting secondary to the trauma are possible peripheral mechanisms responsible for the movement disorder. Successful blockade of the left accessory nerve with bilateral relief of the symptoms suggests a secondary, more centrally located mechanism, e.g., in the brain stem, probably driven by an altered afferent input. It is concluded that rhythmic or semirhythmic and focal myoclonus need a careful workup to look for a peripheral cause because such a condition would be accessible for surgical treatment.

Accessory Nerve↗
PubMed1996

[Surgical treatment of bronchial carcinoma in advanced age].

As live expectancy increases, the number of elderly patients 70 and more years of age are also increasingly represented in a thoracic surgical series. The preponderance of malignant disease in this group, particularly lung cancer, is common. Progress in anesthesia, intensive care and operative techniques in recent years has reduced the risk of morbidity and operative mortality in this age group. Operative and 30-day hospital mortality was 4.8% in our series.

Aged↗
PubMed1995

Lectin binding sites and immunocytochemical characterization of normal pleural mesothelium.

20 specimens of normal pleural mesothelium were investigated with six lectins using isolated cells and tissue specimens as well as two different fixation techniques (glutaraldehyde and formaldehyde) and 10 monoclonal antibodies (MAb) on cytologic preparations only. Lectin binding sites for ConA, WGA, and PNA were present in all cases, whereas binding sites for the lectins HPA, SBA, and UEA-I could never be found. There was no staining difference with the two preparation and fixation techniques proving that they may be used to compare directly histologic and cytologic studies. Ten of fourteen histologic specimens were positive for the blood group antigen Lewis(y), three of them were positive for the antigen Lewis(b), all fourteen specimens were negative for Lewis(a) and Lewis(x). In all cases, mesothelial cells expressed ICAM1 and pancytokeratin. The antibodies against EMA, CEA, CD24, CD15, CD20, CD5, and HEA125 showed no reaction in mesothelial cells. Because HPA, UEA-I, SBA as well as CEA and HEA125 react in a high percentage with adenocarcinomas, non reactive cells of pleural effusions negative with these markers may be confidentially considered to be mesothelial in origin.

ABO Blood-Group System↗
PubMed1994

Evidence for preservation of epithelial function in cryopreserved porcine and human bronchi.

Porcine and human bronchi have been investigated in vitro without or after storage at -196 degrees C in Krebs-Henseleit solution containing 2.0 M dimethyl sulphoxide and 0.1 M sucrose as cryoprotectants. In bronchi from both species maximal post-thaw contractile responses to acetylcholine (ACh) were reduced by about 25-30% compared to unfrozen bronchi. To assess the viability of bronchi and endothelium-denuded rat aortic strips, was employed. The release of an epithelium-derived inhibitory factor (EpDIF) was induced by ACh and assessed in terms of concentration-dependent relaxation of the endothelium-denuded rat aortae. Following removal of bronchial epithelium, ACh failed to elicit any relaxation of rat aorta. With cryopreserved bronchi from both pig and human about 5 and 30 times higher concentrations of ACh, respectively, were required to elicit the same relaxant response as with unfrozen bronchi. The results suggest that after the freezing-thawing process both smooth muscle and epithelial function is largely preserved and provide support for the use of cryopreservation for storage of airway preparations for pharmacological studies.

Acetylcholine↗
PubMed1994

Pulmonary arteriovenous malformations. Case reports and literature review.

Pulmonary arteriovenous malformations (PAVM) represent an uncommon disease with only 500 reported cases. To emphasize the resectional surgical standard, 2 patients with PAVM and pulmonary right-to-left shunt are presented and the optional treatments discussed. One patient had suffered from a cerebrovascular accident. The other patient's diagnosis resulted from a coincidental finding in connection with an unrelated illness. Because of the risk of acutely developing complications, especially disabling or fatal cerebral ischemia, therapy is generally recommended even in asymptomatic patients. The 2 patients presented here were treated by resection. Surgical treatment with a very low risk and parenchyma-sparing technique remains the golden standard for large isolated malformations. In addition to the established and reliable operative therapy, since 1978 catheter embolization is becoming the method of choice with an increasing range of indications in those centers experienced with this technique.

Adult↗
PubMed1993

[Thoracic surgery in advanced age. Indications and results with special reference to bronchial cancer].

BACKGROUND: As the life expectancy in the general population increases, a constant rise in the number of patients of advanced age undergoing thoracic surgery is also observed. MAJOR TOPICS DISCUSSED: Among the indications for operations on the chest, malignant diseases head the list. Thanks to advances in anesthesia, intensive care and surgical techniques, the peri-operative mortality rate in this age group has been appreciably reduced in recent years. In our own patient material, the relevant figure was 4.37%, and is thus in the lower range of internationally comparable mortality associated with major oncological operations on the chest. CONCLUSION: Patients in their seventies or eighties should not be denied thoracic surgery for age reasons; the decisive factors are the general level of activity of the patient and his/her motivation.

Aged↗
PubMed1993

Carcinosarcomas of the lung. Three case reports and literature review.

Therapy and course of pulmonary manifestations of carcinosarcomas in three patients are described. For this rare mixed tumor there is a prevalence among men between the ages of forty and seventy. Operative therapy should be employed whenever possible, because of the poor results achieved thus far using radiotherapy or chemotherapy. Carcinosarcomas were thought to have a worse prognosis than other non-small-cell bronchial carcinomas but an increasing number of reports indicate a similar clinical course and prognosis. Pneumonectomy was required for two of our patients and lobectomy was performed in the third. The period of observation extended over two years. One patient, tumor stage T4N0M0 died of his disease after seven months. The two other patients, tumor stages T3N0M0 and T2N1M0, were operated on thirty-three and thirty-five months ago respectively and are clinically disease-free and in good health.

Aged↗
PubMed1993

Cryopreservation of human bronchi.

Human bronchi have been investigated in vitro without or after storage at -196 degrees C in different media containing 1.8 M dimethyl sulfoxide and 0.1 M sucrose as cryoprotectants, dissolved in either fetal calf serum (FCS), Krebs-Henseleit solution (KH), or 50% FCS in KH as vehicles. As assessed by the post-thaw responses to both carbachol and histamine, optimal preservation of contractile responsiveness was obtained with bronchi that had been frozen in a medium containing KH solution as the vehicle. With each group of cryopreserved bronchi, maximal responses to relaxant agonists such as isoprenaline, papaverine, and the potassium channel activator bimakalim were attenuated by up to 50%, and the passive resting tension after maximal pharmacological relaxation was considerably higher than in the unfrozen tissues. The evidence suggests that, despite some reduction in elasticity, cryopreservation of human bronchi at -196 degrees C preserves both contractile and relaxant mechanisms and offers clear potential for storing human airway smooth muscle for subsequent pharmacological experiments.

Animals↗
PubMed1993

[Recurrent intervention in surgery of pulmonary metastases].

Pulmonary resection for recurrent metastatic disease in 39 patients undergoing 52 thoracotomies resulted in a cumulative survival rate of 75% at 3 years an 52% at 5 years, with no operative mortality. A significant factor influencing survival was duration of disease-free interval after treatment of primary tumor and the time interval between the first pulmonary metastasectomy and the appearance of recurrent pulmonary metastases. The route of metastatic spreading and the number of metastases were of no prediction for postthoracotomy survival.

Adolescent↗
PubMed1993

[Tracheal and bronchial rupture after blunt thoracic trauma].

Airway disruptions after blunt chest trauma are rather infrequent with an incidence of about 1%. Even in large centers with many such casualties they are episodical. The clinical picture is not an uniform one, and typical clinical signs occur often without an airway lesion. Therefore, the correct diagnosis may be delayed. Two case reports, one with a tracheal rupture, the other with complete disruption of the main right bronchus are presented. Both patients showed significant soft tissue emphysema, increasing dyspnea and hypoxia respectively within a few hours after their accident. The diagnosis was established bronchoscopically after time intervals of 8 and 32 hours respectively, followed by immediate surgical correction. Both patients experienced a smooth recovery with good longterm results. In blunt chest trauma presenting with subcutaneous emphysema, pneumomediastinum, pneumothorax, hemoptysis and respiratory distress, tracheobronchial disruption should be considered. In this case, expert bronchoscopy, preferably by a surgeon with large thoracic experience, is mandatory.

Adolescent↗
PubMed1992

[The solitary pulmonary histoplasmoma].

A 63-year-old man who grows orchids as a hobby, fell ill with weakness and pain in his hips and legs 2 months after his latest trip to South America (Ecuador). The WBC count was 9900/microliters with unremarkable differential count while blood sedimentation rate was raised to 60/100 mm. The chest X-ray demonstrated in the right upper lobe a well-circumscribed coin lesion (3 cm diameter) of soft-tissue density, uncalcified and without cavitation. Computed tomography in addition revealed an enlarged lymph-node at the lower hilar pole, but no mediastinal lymphoma. Bronchoscopy demonstrated narrowing of a subsegmental ostium of the 6th segment on the right. An attempt at transbronchial biopsy failed. As a peripheral bronchial carcinoma was suspected, a posterolateral thoracotomy was performed (4 months after the trip to Ecuador). Rapid histological examination was negative for tumour and the lesion was therefore enucleated. Histologically (Grocott silver staining) a histoplasmoma was diagnosed. Several serum samples were positive for precipitating (M-band) and complement-binding antibodies (titre 12 days preoperatively was 1:16). The postoperative course was without complication. No anti-histoplasma antibodies were demonstrable 1 year postoperatively.

Antibodies, Fungal↗
PubMed1992

Perioperative antibiotic prophylaxis in general thoracic surgery.

A prospective study of the efficacy of ampicillin in combination with sulbactam, a beta-lactamase inhibitor, (A/S) in perioperative prophylaxis was performed. The study consisted of two independent parts performed at the same time. Part I included 60 patients with lobectomies and segmentectomies. Group A (A/S 1 x 3 g "single shot") was compared with group B (A/S 3 x 3 g). Superficial wound infections occurred in 3 patients of group A and in 2 patients of group B. There was no empyema. Bronchitis and pneumonia were found in 10 patients of group A and in 7 patients of group B. Part II examined 25 pneumonectomies receiving A/S 3 x 3 g for 3 days. Concentrations of ampicillin and sulbactam in serum and lung tissue were determined and showed adequate levels to cope with usual bacteria in lung surgery. There was one superficial wound infection, 2 cases of bronchitis, and 2 cases of pneumonia.

Ampicillin↗
PubMed1992

[Thoracic endometriosis--2 case reports and review of the literature].

Thoracic endometriosis is characterised by recurring pulmonary symptoms in association with the menstrual period. Pleural endometriosis manifests itself as recurring pneumothorax or hematothorax while pulmonary endometriosis is characterized by hemoptysis. The pathogenetic mechanism is not completely understood but it appears that hematogenous and lymphangitic embolization of endometrial tissue may play a significant part in parenchymal and pleural endometriosis respectively. Clinical symptoms begin with ovulation. Hemoptysis is explained by sloughing off of decidual tissue and an increased capillary fragility during menstruation. Rupture of pleurally based alveoli in the vicinity of endometrial tissue or necrosis of the diaphragm at the side of diaphragmatic endometrial implants might be causative for the development of a pneumothorax. Therapy of both forms of thoracic endometriosis consists in hormonal suppression but in some cases surgical intervention might become necessary.

Endometriosis↗
PubMed1992

[New developments in surgery of pulmonary metastases].

Two groups of patients, 107 between 1977-1986 and 122 between 1987-1991, who underwent surgery for pulmonary metastases, were compared with each other. The most frequent primary sites were the kidney and the testes in the first and the kidney and the colon-rectum in the second group. We recorded a 1-year survival rate of 79% and a 5-year survival rate of 37% in the first group. In the second group there was a 3-year survival rate of 53%. Our analyses are showing that more metastatic lesions are usually found at operation than indicated by CT scan preoperatively. The discrepancy amounts to 19% in presumably solitary metastases and increases to 50% and more if two or more lesions were identified preoperatively. Therefore, bilateral exploration is advocated as a standard procedure in pulmonary metastatic surgery.

Adolescent↗