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Biomedical subjects

J Hoch

Publications and source records attributed to J Hoch.

At least 55 records · Page 3Linked to original sources
PubMed2000

[Radical procedures on the thyroid gland at the turn of the millennium].

The increasing demands for radical thyroid operations by endocrinologists led during the last decade to elaboration of tactics and surgical techniques of thyroid operations. Nowadays as radical operation removal of all thyroid tissue is considered, and when malignancy is suspected, also removal of the affected lymph nodes. While in 1992 the ratio of radical thyroid operations did not exceed 30%, at present these operations account for more than 90%. Our experience is based on results assembled in a group of 4960 patients operated on account of thyroid disease with the conclusion, if judged with regard to postoperative complications, radical removal of the thyroid gland is nowadays almost equally safe as subtotal surgery. Sufficiently radical surgery prevents moreover a relapse of the disease. An essential part of treatment of thyroid disease should be interdisciplinary collaboration in particular among endocrinologists, sonographists and surgeons, not only during preoperative preparation but also during the regular postoperative follow up of patients.

Czech Republic↗
PubMed2000

[Diagnosis and treatment of pelvic and perineal defects and fistulae and reconstructive surgery using a gluteus maximus flap].

In the form of a comment some aspects of diagnosis and treatment of unhealed pelvic and perineal defects and fistulas were analysed. Based on author's own experience with the treatment of 2 females with postradiation rectovaginal fistulas and 2 males with perineal sinus after proctectomy the authors discuss some advantages and technical aspects of pedunculated myoplasty by the gluteus maximus muscle.

Female↗
PubMed1999

[Does osseous extensor tendon avulsion or rupture really exist? Histologic plastination studies of insertion of the extensor aponeurosis and significance for operative therapy].

With the help of thick, transparent finger cross sections, it was shown that fibers of the extensor aponeurosis insert distal to the avulsed fragment of the distal phalanx. The consequence for hand surgery is not to expose the fragment through a dorsal incision, but through a mid-lateral one. In this way, the distant parts of the aponeurosis distal to the fracture remain intact, and there is no break in the continuation of the dorsal extension plate.

Finger Injuries↗
PubMed1999

Perinatal management of fetal hemolytic disease due to Rh incompatibility combined with fetal alloimmune thrombocytopenia due to HPA-5b incompatibility.

We report out experience in the perinatal management of a complex case of fetal hemolytic disease primarily due to Rhesus incompatibility combined with fetal alloimmune thrombocytopenia. The lowest fetal hemoglobin and platelet levels were 2.6 g/dl and 13,000/microliter, respectively. Intrauterine treatment consisted of six transfusions of packed red cells into the umbilical vein and one transfusion of platelets. The neonate required four transfusions of packed red cells to correct her hyporegenerative erythropoiesis. Postnatal management also included one platelet transfusion, intravenous immunoglobulins and erythropoietin. Although some degree of fetal thrombocytopenia may invariably be found in fetal red cell incompatibility, other rare causes need to be excluded.

Adult↗
PubMed1999

[Chylothorax--a rare type of pleural effusion. Case report].

Chylothorax is a rare type of pleural exudate. The diagnosis, assessment of etiology, reflections on the type of treatment, as well as treatment are associated with various pitfalls. The authors present the case-history of a patient with spontaneous chylothorax on the right who was successfully treated by surgery after possible ways of conservative treatment were exhausted. Surgical treatment involved severing and ligature of the thoracic duct.

Chylothorax↗
PubMed1998

[Malnutrition in a patient with short-bowel syndrome].

The short bowel syndrome is a relatively frequent complication of extensive resection and by reducing the absorption capacity the function of the gut is markedly impaired. An important part of postoperative care is therefore to ensure nutrition of these patients. The authors demonstrate on the case-history of a 40-year-old patient after repeated revision of the abdominal cavity on account of adhesions the development of severe malnutrition after jejunotransversoanastomosis. As the small intestine was not resected (concurrent blind loop syndrome), the patient was indicated for surgery. After surgery all complaints disappeared and the nutritional status improved.

Adult↗
PubMed1998

[Tissue amino acids in patients with colorectal carcinoma].

Different catabolic conditions have their special characteristics of intracellular biochemical changes. The objective of the presented work is to assess the concentration of free amino acids in muscles of patients with colorectal carcinoma. In a group of 17 patients the free amino acid level was assessed in tissues and plasma. Material was collected on operation by biopsy of the rectus abdominis muscle, the concentration of different amino acids was assessed by the HPLCV method with fluorescent detection. For statistical evaluation the T-test was used. From the results ensues that in patients with colorectal cancer in plasma statistically significantly lower taurine, glutamine, valine, tyrosine levels were found, intracellularly significantly reduced levels of taurine, glutamic acid, methionine and ornithine were recorded. Significantly elevated intracellular levels of valine, isoleucine, leucine, tyrosine and phenylalanine were found. Assessment of the tissue aminoacidogram is the first step when attempting to influence the intracellular amino acid concentration by defined dietetic preparations.

Abdominal Muscles↗
PubMed1997

Serum selenium, plasma glutathione (GSH) and erythrocyte glutathione peroxidase (GSH-Px)-levels in asymptomatic versus symptomatic human immunodeficiency virus-1 (HIV-1)-infection.

OBJECTIVES: Antioxidant defense status was investigated in HIV-infected patients by measuring serum selenium, erythrocyte glutathione peroxidase (GSH-Px) activity, plasma thiol (-SH) and glutathione (GSH) concentrations along with the assessment of the clinical stage and surrogate markers of HIV-disease. DESIGN, SETTING AND SUBJECTS: Serum selenium levels were determined cross-sectionally in 104 sequentially selected HIV-infected patients (83 outpatients and 21 patients with ongoing AIDS defining events). The patients were classified into three stages of the disease, I, II and III according to the 1993 Centers For Disease Control (CDC) classification system for HIV-infection. GSH-Px activities, plasma SH and plasma GSH concentrations were determined in a subset of 24 patients at stage I and 12 patients at stage III with an active AIDS-defining disease. RESULTS: Mean serum selenium levels were lower in CDC stage II (68.7 +/- 20.9 micrograms/l; P < 0.01; n = 34) and stage III (51.4 +/- 14.7 micrograms/l; P < 0.01; n = 37) HIV-infected patients than in healthy subjects (89.2 +/- 20.9 micrograms/l; n = 72) and stage I patients (82.3 +/- 20.5; microgram/l; n = 33). Serum selenium levels were positively correlated with CD4-count (r = 0.42; P < 0.001; n = 104) and inversely with levels of soluble tumor necrosis factor receptors type II (r = -0.58; P < 0.01; n = 35), neopterin (r = -0.5; P < 0.001; n = 80) and beta 2-microglobulin (r = -0.4; P < 0.001; n = 94). Hepatitis C virus (HCV) and HIV-coinfected patients at CDC stages I and II showed markedly lower selenium concentrations compared to HIV-infected patients without concomitant HCV-infection. Serum selenium and GSH-Px activity in hospitalized AIDS patients was significantly lower as compared to asymptomatic patients and healthy subjects, whereas plasma SH and GSH concentrations were lower in both, asymptomatic -and AIDS-patients, than in the controls. CONCLUSION: The results show that stages I-III of HIV-disease are characterized by significant impairments of antioxidative defenses provided by selenium, GSH-Px, SH-groups and GSH.

Adult↗
PubMed1997

[Portal vein thrombosis after splenectomy].

Elective splenectomies in haematologic malignancies are associated with two serious risks: infection and thrombotic complications. The case of a patient operated on for chronic lymphatic leukaemia with subsequent postoperative portal vein thrombosis is described. The complication was detected using abdominal ultrasonography and was treated successfully with anticoagulants (Fraxiparin).

Humans↗
PubMed1997

[Intrauterine transfusion in fetal alloimmunothrombocytopenia: comparison of maternal and fetal weight-adjusted IgG therapy with exclusive fetal thrombocyte transfusion].

Fetal alloimmune thrombocytopenia is caused by maternal immunization against a fetal platelet antigen and transplacental transfer of the antibody into the fetal circulation. Since 10-20% of the fetuses or newborns are threatened by intracranial hemorrhages, early management is required. Fetal blood sampling should be started between the 20th and 22nd week of gestation to assess fetal phenotype and platelet count. Different concepts to elevate the fetal platelet count have been discussed: maternal intravenous immunoglobulins, fetal intravenous immunoglobulins, or only repeated fetal platelet transfusions. Our investigations suggested that platelet transfusions in short intervals appear to be the only effective regimen to increase platelet counts in thrombocytopenic fetuses at risk.

Birth Weight↗
PubMed1996

Shape recovery and volume calculation from biplane angiography in the stereotactic radiosurgical treatment of arteriovenous malformations.

PURPOSE: A model for calculating the three-dimensional volume of arteriovenous malformations from biplane angiography. METHODS AND MATERIAL: Three-dimensional (3D) volume reconstruction is easily feasible with axial, coronal, or sagittal computer tomography (CT) and nuclear magnetic resonance (NMR) scans. On the other hand, radiosurgical treatment of arteriovenous malformations (AVM) is exclusively based on two orthogonal stereotactic projections, obtained with angiographic procedures. Most commonly, AVM volumes have been calculated by assimilating the nidus volume to a prolate ellipsoid. We present an algorithm dedicated to 3D structure reconstruction starting from two orthogonal stereotactic projections. This has been achieved using a heuristic approach, which has been widely adopted in the artificial intelligence domain. RESULTS: Tests on phantom of different complexity have shown excellent results. CONCLUSION: The importance of the algorithm is considerable. As a matter of fact: (a) it allows calculations of complex structures far away from regular ellipsoid; (b) it permits shape recovery; (c) it provides AVM visualization on axial planes.

Adolescent↗
PubMed1996

Therapy with intravenous immunoglobulin G (ivIgG) during pregnancy for fetal alloimmune (HPA-1a(Zwa)) thrombocytopenic purpura.

We have evaluated the effect of maternal intravenous immunoglobulin G (ivIgG) treatment on platelet counts in fetal alloimmune thrombocytopenia. Seven patients were studied. All of them were multiparous women who had been immunized against the HPA-1a antigen during previous pregnancies and had given birth to at least one severely thrombocytopenic infant. In this study, umbilical blood collection was performed first at the 20th week of gestation and repeated 2-13 times (mean 6 times), depending on the degree of fetal thrombocytopenia. Fetal platelet counting was combined with intrauterine transfusion of 20-30 ml of HPA-1a-negative platelet concentrates to prevent bleeding following umbilical cord puncture. Initial fetal platelet counts ranged from 10,000 to 91,000 per microliters. Maternal treatment with ivIgG (1 g per kg body weight; mean dose 70 g) was given once a week over 7 weeks. In five of seven cases, the basal platelet count did not rise and in two of these cases, it decreased during maternal ivIgG treatment. In one fetus, the baseline platelet count increased from 10,000 to 35,000 per microliters during ivIgG, and in another fetus from 23,000 to 64,000 per microliters. Our observations suggest that ivIgG has no definite benefit for fetal alloimmune thrombocytopenia. Since platelet counts can be very low, careful fetal monitoring by umbilical blood sampling is required. Frequent platelet transfusions in short intervals may be necessary to increase platelet counts in extremely thrombocytopenic fetuses.

Antigens, Human Platelet↗
PubMed1996

Prevalence of and risk factors for Helicobacter pylori infection in the western part of Germany.

OBJECTIVE: To ascertain the prevalence of Helicobacter pylori infection in Germany and to identify risk factors associated with H. pylori seroconversion. METHODS: Two hundred and sixty blood donors (169 men, 91 women; median age 29 years, range 18-61 years, 92% with German parents, all white) were studied. None had previously been treated for H. pylori infection. Their serum samples were analysed for H. pylori immunoglobulin (lg) G antibodies with a validated enzyme-linked immunosorbent assay (ELISA). All subjects completed a complex questionnaire under supervision. Special attention was paid to their present and childhood (at the age of 8 years) living conditions. To identify independent risk factors for seropositivity, a multivariate, stepwise forward, unconditional, logistic regression analysis was performed. RESULTS: In total, 102 participants (39.2%) were seropositive for H. pylori. Seroprevalence increased significantly with age (21.1% aged 21 or younger compared with 60.0% over 51 years of age). According to the multivariate analysis of the unclassified data [odds ratio (95% confidence interval)], variables such as age [1.04 (1.01-1.07) per year], persons per room in household in childhood [2.14 (1.07-4.26)] and number of children (< 8 years) in household at present [1.79 (1.01-3.16) per child] were significantly and independently associated with H. pylori seroprevalence. CONCLUSION: Crowded living conditions in childhood affect current H. pylori status. In addition, the number of children in the present household increases the risk of infection for the adult family members. This suggests that children are an additional source of infection, probably due to close and frequent physical contact outside the immediate family.

Adult↗
PubMed1996

[Comparative study of 2-piece colostomy systems (ConvaTec Combihesive Flexible, Coloplast 2002 and Hollister Guardian in the Czech Republic)].

In three surgical centres in the Czech Republik three modern two-piece colostomic systems where compared which are at present available in the Czech republik, incl. an attempt to assess how they influence the quality of life of the patients. The investigation comprised 117 patients mean age 59 years-93 after colostomy, 13 with ileostomy. The investigated systems were ConvaTec Combihesive Flexible, Coloplast 2002, Hollister Guardian two-piece ostomy systems with a closed sac and inner filter. The main investigated parameters were: tolerance of the products, preference expressed by the patient, the state of the skin beneath the plaster and the index of general health (GWBI). From the investigation ensued that in the Czech Republic the system ConvaTec Combihesive proved very useful and there probably will not be a demand for a change to another system offered by distinguished producers, as such a change would not entail any advantages. It was revealed that when the ConvaTec Combihesive system is used, the skin is maintained in a good condition which has a favourable impact on the feeling of wellbeing and improves the quality of life.

Colostomy↗