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Biomedical subjects

J Hasse

Publications and source records attributed to J Hasse.

At least 127 records · Page 7Linked to original sources

[Cardiac myxoma (author's transl)].

Between 1965 and 1974 ten patients were operared on for cardiac myxoma. There was a striking variety of signs and symptoms caused by tumour embolization, haemodynamic obstruction, and auto-immunological reactions. The diagnosis should be made early before the occurrence of irreversible complications, especially cerebral embolism. Echocardiography is a simple technique for the detection of atrial myxoma but a negative result does not exclude it, and diagnosis has to be confirmed by angiocardiography. The tumour should be removed as soon as possible after diagnosis. There is danger of tumour embolization in the course of operation. Operative mortality is low in patients with only haemodynamic complications, but in patients with previous cerebral embolism the risk is higher because of possible bleeding in the infarcted areas of the brain resulting from anticoagulation during cardio-pulmonary bypass. Nonetheless, the operation is indicated in all cases. If removal of the myxoma is complete, recurrence is rate and long-term results are good.

Adolescent↗

[Recurrent haemoptysis for a period of five years following aspiration of a gall stone].

The article deals with a case report of a 71-years-old female who suffered from hemoptysis over a period of five years. The first hemoptysis occurred postoperatively after a cholecystectomy in December 1966 and was thought to be caused by pulmonary embolism. Persisting episodes of more or less slight hemoptysis in the following years lead to repeated different diagnostic procedures. Radiologically there was an infiltration of the right lower lobe rather constant in size. Endoscopically no bronchial obstruction was visible. In July 1972 the patient suffered from a more severe hemoptoe. X-ray findings were nearly unchanged. With bronchoscopy the hemorrhage could be localized to the segmental bronchi 8 and 9. Right lower lobectomy was done in September 1972 without an exact preoperative diagnosis. The patient had an uneventful postoperative course despite of her age. Pathological examination of the specimen showed a foreign body looking like a gallstone. This diagnosis was confirmed by chemical analysis. To get an explanation we inquired into the circumstances of the cholecystectomy performed 5 years ago. These lead to the conclusion that the concrement must have been vomited and aspirated by the evidently not intubated patient. These suggestions were supported by the fact, that the former operation has been done because of a gangrenous gallbladder with a highly delated common duct and the duodenum, stomach and transverse colon being involved in an inflammatory infiltration. Dangers of asymptomic foreign body aspiration and diagnostic problems in non-opaque peripheral foreign bodies are discussed.

Aged↗

[Differentiated surgical therapy in congenital lobar emphysema (author's transl)].

Congenital lobar emphysema (CLE) is a clinical and radiological entity with a multiplicity of etiological factors. Six patients are presented with CLE of the left upper lobe. In three of them CLE was associated with cardiovascular malformation i.e. persisting ductus arteriosus and in one case additionally with double aortic arch. These infants were treated by division of the compressing vascular structure without lobectomy. Only one required secondary resection. Left sided CLE presumably caused by vascular compression should be considered a special group in which surgical correction without lung resection is justified.

Aorta↗

Concentrations of sulbactam/ampicillin in serum and lung tissue.

The penetration of sulbactam plus ampicillin into lung tissue was studied in 15 patients undergoing thoracic surgery for pneumonectomy after the administration of 1 g of sulbactam plus 2 g of ampicillin as a 15 min intravenous short infusion. Ampicillin serum concentrations declined from 40.8 mg/l at 1 h to 18.8 mg/l 2-4 h after administration. Concomitant serum concentrations of sulbactam were 25.5 mg/l and 11.8 mg/l, respectively. In lung tissue, peak ampicillin concentrations of 35.6 mg/kg were reached 1.5 h after administration declining slowly to 26.8 mg/kg after 2-4 h. The respective sulbactam concentrations were 8.6 and 5.5 mg/kg. In our study sufficient sulbactam and ampicillin levels active against important pathogenic organisms causing community- and hospital-acquired respiratory tract infections have been achieved in lung tissue, suggesting that the combination sulbactam/ampicillin is suited for the treatment of most community- and hospital-acquired respiratory tract infections as well as for chemoprophylaxis and treatment of postoperative lung infections after thoracic surgery.

Adult↗

Fluconazole concentrations in pulmonary tissue and pericardial fluid.

In order to investigate the clinical efficacy of the triazole antifungal agent fluconazole (FCA) in the treatment of pulmonary mycosis, in the present study the concentrations of fluconazole in human pulmonary tissue, pericardial fluid and serum were determined at 1, 2, 12 and 13 h after intravenous administration of fluconazole 200 mg. The mean FCA concentrations in the serum were 4.04 mg/l (1 h), 3.82 mg/l (2 h), 2.35 mg/l (12 h) and 2.13 mg/l (13 h). The respective FCA levels in the pulmonary tissue were 4.64 mg/kg, 4.54 mg/kg; 3.50 mg/kg and 3.40 mg/kg and the concentrations in the pericardial fluid were 3.86 mg/l, 3.57 mg/l, 2.35 mg/l and 2.13 mg/l. The FCA concentrations in the pulmonary tissue that were statistically significant higher than the serum concentrations were found at 2 h, 12 h and 13 h after intravenous administration (p < 0.05).

Animals↗

[Extrathoracal pulmonary sequestration in the differential diagnosis of paravertebral tumors in the neonate].

BACKGROUND: Paravertebral masses of the fetus are often detected during routine prenatal ultrasonography. The most common differential diagnoses of these tumors are neuroblastoma, adrenal hemorrhage, schwannoma and germ cell tumors. CASE REPORT: We report on a mature male newborn, who was diagnosed antenatally at 23 + 3 weeks of gestation with a tumor in the left paravertebral region. After birth the child was transferred to a neonatal unit. Tumor markers like urinary catecholamines were within normal limits, neuron-specific enolase was slightly elevated. MRI as well as ultrasonography confirmed a 3.2 x 2.2 x 1.6 cm large smoothed edged tumor in the left paravertebral region at the level of T10-T12. An open biopsy was performed, and the tumor which was located below the diaphragma was subtotally resected. Histopathology showed an extralobar pulmonary sequestration. Surgery as well as postoperative course was uneventful. CONCLUSIONS: Extralobar pulmonary sequestrations represent rare congenital anomalies, which are usually asymptomatic. Clear differentiation between tumor and pulmonary sequestration is seldom possible despite high resolution imaging studies. Hence, a biopsy procedure should be done for diagnosis of paravertebral masses.

Biopsy↗

[Lung resection in the principle disease of mucoviscidosis and status following poliomyelitis--2 case reports].

Two cases of destroyed lung after repeated pneumonia are reported; one in a patient suffering from cystic fibrosis in the age of 8 years, the other in a 15 year old girl with a phrenic nerve paralysis. In both children physiotherapy as well as retreatments with appropriate antibiotics did not achieve any long-term curative effect. Therefore a pneumonectomy was indicated. In the patient with cystic fibrosis a small air leak was observed on the first postoperative day at the bronchial suture line, which was treated with an immediate rethoracotomy and correction. In the other child a pericardial effusion 4 weeks after surgery occurred. Regression was seen within two weeks under antibiotic therapy. In diseases such as cystic fibrosis and paralysis of the diaphragm a resection of the lung is justified in cases even if they are complicated by recurrent infections due to atelectasis or bronchiectasia. The preoperative investigation includes the proof of a total lung failure by scintiscan and/or measurement of a mucociliary clearance. A non altered function of the remaining lung is a prerequisite.

Adolescent↗

Comparison of the sensitivity of sputum and brush cytology in the diagnosis of lung carcinomas.

OBJECTIVE: To describe the role of sputum and brush cytology in the diagnosis of lung carcinoma and to elucidate the influence of tumor location, histologic tumor type and stage on the sensitivity of both methods. STUDY DESIGN: Retrospective and performed on 415 lung cancer patients. Two hundred of them were investigated only by sputum collection, 119 only by brushing and 96 by both methods. RESULTS: The overall sensitivity of the sputum technique was 0.403 and that of the brush method 0.500, while a combination of both showed a sensitivity of 0.640. The diagnostic yield depended on tumor location, histologic tumor type and stage. Sputum specimens were most valuable in the detection of early and peripheral carcinomas, whereas brushing was superior in finding more advanced and centrally located malignancies. Regarding tumor type, squamous cell carcinomas were diagnosed to the greatest extent by both methods. CONCLUSION: A complementary role of both cytologic techniques can be postulated by our data as well as by a literature review.

Adenocarcinoma↗