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J Scharf

Publications and source records attributed to J Scharf.

137 records · Page 8Linked to original sources
PubMedDate not supplied

[Plasma separation as an effective treatment of glomerulonephritis in lupus erythematosus].

Positive anti-DNA-antibodies and lowered C3 and C4 levels were found in serum of a 13 year old girl presenting with edema, microscopic hematuria and proteinuria. Renal biopsy revealed diffuse endo- and extracapillary glomerulonephritis with mesangial deposits of IgA, IgG, IgM, C1q, C3 and fibrinogen. In spite of treatment with prednisone (60 mg/m2/d) severe nephrotic syndrome (proteinuria greater than 20/d) developed with excessive hypertension and deterioration of renal function (GFR: 20 ml/min./1,73m2 BSA). Plasma exchange therapy (3 sessions) led to recovery of renal function, blood pressure and complement activity and to a reduction of anti-DNA-antibodies and protein excretion.

Adolescent↗
PubMedDate not supplied

[Determination of heart time volume using the Fick principle in the early postoperative phase after correction of congenital heart defects. Comparison of the calculation of arterio-mixed venous oxygen differences and pulmonary oxygen uptake with the calculation of arterial-central venous oxygen differences and pulmonary oxygen uptake].

UNLABELLED: Comparison of the calculation by means of the arterio-mixed venous oxygen difference and the oxygen uptake with the calculation by means of the arterio-central venous oxygen difference and the oxygen uptake. OBJECTIVE: How reliable is the measurement of cardiac output on Fick's principle without a pulmonary artery catheter? SETTING: PICU in an University hospital. DESIGN: In the postoperative period following complete repair of congenital heart disease we carried out 91 simultaneous measurements of blood gases in 45 infants and children (mean age 18.6 months, mean body weight 8.9 kg) from a systemic artery, the A. pulmonalis, and the V. cava superior. We also determined the pulmonary oxygen uptake in 24 patients (48 measurements). Cardiac output was calculated on Fick's principle using the arterio-mixed venous oxygen difference and the pulmonary oxygen uptake (HZV a-pa) and compared to the cardiac output derived from the central venous values (HZV a-zv). We differentiated between patients with a left to right shunt of 10% or more postoperatively (group A, n = 18) and all others (group B, n = 27). RESULTS: In both groups the correlation coefficient between HZV a-zv and HZV a-pa was high (group A: r = 0.97, group B: r = 0.94). In group A HZV a-pa (mean: 1958 ml/min) was higher than HZV a-zv (mean: 1340 ml/min), group B showed the opposite situation (mean HZV a-pa: 1136 ml/min, mean HZV a-zv: 1373 ml/min). With the Wilcoxon signet-rank test we found significant differences between the partial pressure of oxygen and the saturation of central venous and mixed venous blood samples in both groups, but HZV a-zv and HZV a-pa were different significantly on a level of p < or = 0.01 only in group A. CONCLUSIONS: In both groups HZV a-pa and HZV a-zv correlated well. Therefore, if a pulmonary artery catheter is not inserted; the course of the cardiac output can be calculated with acceptable reliability from the central venous blood gases. By means of Fick's principle the pulmonary blood flow is determined, which is higher than the systemic blood flow in cases of left to right shunting, because of the recirculation in the pulmonary blood circuit. Interpreting the results this has to be taken into account.

Arteries↗
PubMedDate not supplied

[Multiple cerebral infarcts with resulting multicystic encephalomalacia in a premature infant with Enterobacter sakazakii meningitis].

Enterobacter sakazakii is an uncommon cause of neonatal meningitis. The prognosis of newborns with meningitis due to Enterobacter sakazakii is poor, the fatality rate is reported as high as 50%. Survivors usually have severe neurologic complications. Most computed tomography (CT) findings were low density lesions of white matter and cortex suggesting infarctions which underwent cystic degeneration. We present one premature baby with meningitis due to Enterobacter sakazakii and large bilateral regions of hypo- and hyperdensity suggesting massive hemorrhagic and nonhemorrhagic intracerebral infarctions leading to multiple cystic encephalomalacia.

Cerebral Infarction↗
PubMedDate not supplied

MRI of pouch-related fistulas in ulcerative colitis after restorative proctocolectomy.

PURPOSE: Our purpose was to determine the value of MRI in diagnosing pouch-related fistulas in patients with ulcerative colitis and to compare pulse sequences with and without contrast enhancement in their performance of visualization. METHOD: Forty-four patients with pelvic symptoms after restorative proctocolectomy underwent MRI. All 26 patients with pouch-related fistulas were treated surgically; 18 patients with pouchitis were treated conservatively. MRI was performed at 1.0 T with T1-weighted FLASH sequences before and after administration of Gd-DTPA, T2-weighted and proton density-weighted turbo SE sequences, and a T2-weighted fat saturation sequence. Images were analyzed for the presence of fistula; pulse sequences were additionally compared for best visualization on a four point scale of diagnostic confidence. RESULTS: MRI detected 23 of 26 cases of fistulas; there were no false-positive diagnoses. Surgery revealed fistulas in three cases in which no pathology was found on MRI. Two patients had a short sinus tract at the pouch-anal anastomosis, and a third patient had a pouch-vaginal fistula. The Gd-enhanced FLASH sequence obtained the highest score, and second best was the T2-weighted fat saturation technique. CONCLUSION: MRI is a valuable technique for diagnosing pouch-related fistulas, However, there are limitations in detection of short sinus tracts and pouch-vaginal fistulas. Highest diagnostic confidence is obtained with a Gd-enhanced FLASH sequence, which might be helpful after pelvic surgery or if the fact saturation technique is equivocal.

Adult↗
PubMedDate not supplied

Hyperbaric oxygenation combined with nifedipine treatment for recent-onset retinal artery occlusion.

We describe the results of early hyperbaric oxygenation combined with nifedipine treatment for central retinal artery occlusion, and explain the results pathophysiologically. We report four cases in which hyperbaric oxygenation therapy was applied in combination with nifedipine, eyeball massage, and glycerol for the treatment of central retinal artery occlusion. In two of the cases in which therapy was started less than 100 minutes after the acute onset of visual loss and one case in which therapy was started during the course of central arterial occlusion, considerable improvement in visual acuity was observed, while in the fourth case in which therapy was started six hours after the acute onset of visual loss, no improvement appeared. We conclude from these results that hyperbaric oxygenation therapy has a beneficial effect on the final visual outcome of central retinal artery occlusion, provided it is applied early enough. Further investigation is needed to fully define the nature and terms of this beneficial effect.

Adult↗
PubMedDate not supplied

A change in ocular involvement in a patient suffering from ankylosing spondylitis and Behçet's disease.

We report a case of a young man suffering from both ankylosing spondylitis and Behçet's disease in whom the character of the ocular involvement changed according to the predominant disease at a given time. When the clinical picture was one of ankylosing spondylitis, only anterior uveitis was observed, while the clinical picture of Behçet's disease occurred with panuveitis and retinal vasculitis. To the best of our knowledge, this is the first report in the English literature of two different patterns of ocular involvement in the same patient with two seronegative arthritides.

Adult↗
PubMedDate not supplied

Refraction in premature babies: a prospective study.

Refraction in 67 premature babies was examined and followed during seven years. There was continuous changing of refraction towards emmetropia in all refraction groups. Fifty-four percent of myopic eyes remained myopic at the age of seven years but in all the eyes myopia was of lower degree than at birth. In our series there was no relationship between myopia and RLF.

Age Factors↗
PubMedDate not supplied

Proptosis as presenting symptom of orbital foreign body.

An unusual case of orbital foreign body is presented. The foreign body had penetrated through a small wound of the upper lid and was asymtomatic for two years. Proptosis due to hyperostosis of the orbital roof was a presenting symptom of the foreign body.

Abscess↗
PubMedDate not supplied

Juvenile retinal detachment.

Among the total of 537 patients treated for retinal detachment 27 (5.02%) were under the age of 20. In 44.44 percent of the cases, there was a history of trauma. In 58.33% of the fellow eyes in this group of patients, retinal pathology was found. This pathology is considered to be a predisposing factor and trauma itself is only a trigger in causing retinal detachment.

Adolescent↗