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Biomedical subjects

L Schmid

Publications and source records attributed to L Schmid.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Kasabach-Merritt syndrome. Intraoperative heparin therapy with follow-up combination therapy of heparin and ticlopidine for the control of intravascular coagulation].

A 39-year-old woman with Kasabach-Merritt syndrome (cavernous vascular malformations with disseminated intravascular coagulation) sustained a displaced fracture of the femoral shaft. Despite pronounced hypofibrinogenemia (< 0.1 g/l) there was no significant bleeding. The concentration of D dimer was raised to > 32 < 64 mg/l and that of prothrombin fragments F1 and F2 to > 10 nmol/l. The platelet count was 102,000/microliters and other coagulation parameters were normal or only slightly abnormal. The consumption coagulopathy was successfully controlled by continuous intravenous infusion of heparin (17,000 I.U./d) without need for clotting factor replacement, and was subsequently stabilized by combined treatment with low molecular weight heparin (5,000 I.U./d s.c.) and ticlopidine (250 mg twice daily by mouth). Oral therapy with acetylsalicylic acid alone or in combination with ticlopidine proved insufficient, being rapidly followed by a renewed fall in fibrinogen level and platelet count. The findings suggest that fibrin formation in the abnormal vascular territories was the principal pathogenetic factor in this case.

Abdominal Neoplasms↗
PubMed1993

[Management of acromioclavicular joint dislocation with the Wolter hook-plate. One year follow-up of 35 cases].

Wolter's hook-plate provides active abduction and forward-flexion of up to 90 degrees two days postoperatively. Prebending of the plate and a precise drill hole for the hook in the acromion prevents later impingement of the hook on the humeral head or subluxation in the acromioclavicular joint, respectively. According to the shoulder evaluation form of C.R. Constant, 33 of 35 patients operated on between 1987 and 1991 at the trauma departments in Schwaz/Tirol and Bad Ischl showed excellent results one year postoperatively.

Acromioclavicular Joint↗
PubMed1993

[Anatomic studies of percutaneous bore wire osteosynthesis of the distal radius].

Modified percutaneous K-wire pinning has been used for unstable distal radius fractures groups A 2.2-3, A 3.1-3, B 1.1-2, B 2.1-2, B 3.3, C 1.1-3, C 2.1-3, and C 3.1-2 according to the ASIF-classification in 90 patients with good results. No tendinous rupture or any weakness respectively, infection or secondary dislocation either had occurred six months postoperatively. In five cadavers experimental anatomical studies had revealed possible lesions of the tendons of the brachioradialis muscle, the short and long wrist extensors, the long thumb abductor and his short extensor respectively as well as the superficial radial nerve and the cephalic vein. Abnormous sensations in the scar or in the region of distribution of the superficial radial nerve had occurred in every second patient but had subsided six months postoperatively. No permanent nerve lesion was found. There has been bleeding from the cephalic vein after the stab incision for exposure of the tip of the styloid process in every third patient but had healed uneventfully in every case.

Bone Wires↗
PubMed1993

A crook plate for treatment of acromioclavicular joint separation: indication, technique, and results after one year.

From 1987 through 1991 thirty-five patients underwent surgical repairs with Wolter's crook plates for acromioclavicular joint rupture. Sixteen of the patients had Post type IV lesions: another 19 patients had the same procedure for Tossy type III lesions. Active shoulder motion up to 90 degrees of abduction and forward flexion was allowed 48 hours postoperatively. All but one patient regained full range of motion at 8 weeks. Precise bending of the plate before insertion and an accurate drill hole for the crook in the acromion were essential to prevent impingement and also precluded ventral or cranial subluxation in the joint. Using the shoulder evaluation method proposed by Constant and Murley, after 1 year 94.28% (33 of 35) of the patients had excellent results.

Acromioclavicular Joint↗
PubMed1993

A new approach to the subacromial space. Technique and 2-year results in 28 rotator-cuff repair cases.

We present a new approach to the subacromial space, consisting essentially of an osseous detachment of the deltoid muscle from the anterior and lateral rim of the acromion including the osseous origin of the coraco-acromial ligament. After acromioplasty and an eventual reconstruction of a torn rotator cuff, Kessler-sutures provide stable transosseous repair of the deltoid muscle. This method generally allows immediate active shoulder motion. 25 of 28 patients with rotator cuff ruptures alone or in combination with an impingement syndrome had good results according to the UCLA-score 2 years postoperatively. No serious complications regarding the function of the deltoid muscle or any failure of the accompanying acromioplasty occurred.

Acromion↗
PubMed1992

[Initial experiences with the humerus interlocking nail].

A preliminary report is given on the good results of eleven patients, who had been treated with a locking nail for a fracture of the humerus at three different trauma departments. No non-union, infection or radial palsy has been seen nor was there any neurovascular complication intraoperatively. Four patients had misalignments of up to 15 degrees, whereof three of them had combined varus-recurvation-angulations without functional or cosmetic sequelae. All but one had excellent functional results six months postoperatively. Bone healing could be confirmed three months postoperatively. Only transverse and spiral fractures of the second to fifth sixth had been treated until now, though open fractures up to the second degree can be managed too. Finally, some technical issues are considered, which include a better guiding device, the use of cancellous screws for proximal looking, a more oblique position of one of the proximal screwholes to obtain some kind of interfragmentary compression for appropriate fractures, and the use of a Williams-screwdriver.

Bone Nails↗
PubMed1992

Results from a statewide approach to adolescent tobacco use prevention.

BACKGROUND: The 1985 Minnesota Legislature established guidelines for school-based tobacco-use prevention programming and provided financial incentives to school districts to encourage them to adopt a broad range of preventive measures. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project was funded by the National Cancer Institute in 1986 to evaluate the Minnesota initiative through two parallel studies. METHODS: The Four Group Comparison Study was a prospective study of 48 school "units" which were randomly assigned to one of four conditions in 1987. Baseline observations were taken in the sixth grade in 1987, interventions were delivered in the seventh grade, and follow-up observations were taken in the seventh, eighth, and ninth grades. The Four Group Comparison Study was designed to evaluate the three middle-school interventions that were most widely adopted by Minnesota school districts as a result of the 1985 legislation. The Two State Comparison Study was a serial cross-sectional study of representative districts in Minnesota and Wisconsin. Annual surveys of ninth graders were conducted from 1986-1990. The Two State Comparison Study was designed to determine whether tobacco-use patterns changed in Minnesota relative to Wisconsin following the Minnesota legislation. RESULTS: The prospective study indicated that none of the interventions was more effective in reducing adolescent tobacco use compared with a randomized control group. The serial cross-sectional study revealed that there was a modest net decline in Minnesota relative to Wisconsin from 1986 to 1990, but that it was within the range of chance variation. CONCLUSIONS: Taken together, these results indicate that this legislative initiative was insufficient to reduce adolescent tobacco use statewide during the 5-year study period. Together with results from other recent studies, they suggest that even more intensive efforts may be required to effect widespread reductions in adolescent tobacco use.

Adolescent↗
PubMed1992

Complications of interlocking nailing for lower leg fractures: a 3-year follow up of 102 cases.

Of the 109 patients treated by interlocking nailing for lower leg fractures between 1985 and 1990 at the A.ö.KH Schwaz and the LKH Bad Ischl, Austria, 92 underwent follow-up examination. Data were analyzed using a personal computer. Special attention was paid to fracture pattern, level, complications, and length of sick leave. Compared with a previous study, an increasing number of compound fracture patterns were evaluated. Except for 14 misalignments and two late infections after new injuries, no other serious complications were detected. Interlocking nailing can be highly recommended even for open fractures up to the second degree at any level from the second fifth to the fourth fifth of the tibia.

Adult↗
PubMed1992

The fates of Czechoslovak contestants in Olympic games.

Since the Second Olympic Games of the new era up to the Games in 1988 on the whole 2031 Czechoslovak competitors participated in both Summer and Winter Games. The author succeeded in compiling items on the length of life and causes of decease of 265 Olympic participants who died up to the end of 1989. The study of those items revealed that the length of living of those athletes who died in the period 1950 till 1989 was 67.4 years. That indice may be compared with men in population with a mean length of life 67.7 years in 1988. It is however necessary to take into consideration that the studied sample of Olympic competitors represents a certain selection of men. The causes of natural death of Olympic competitors do not differ in principle from natural deceases of other former Czechoslovak athletes and also no expressive differences were found in comparison with natural causes of death of men in population.

Aged↗
PubMed1992

[Technique and results of modified percutaneous bore wire osteosynthesis of the distal radius].

A modified technique for percutaneous K-wire pinning of distal radius fractures is presented. With this method, three to four K-wires are introduced from the radial styloid process towards and through the dorsal, volar and ulnar proximal cortical wall, respectively. After the fracture fragments have been demonstrated to be stable, the wires are cut, bent over and fixed. Then a dorsal plaster splint is applied, which should be worn for 4-6 weeks, depending on whether or not there is a dorsal comminution zone. Fifty-five patients have been operated on by this method. At follow-up 6 months after the operation, no secondary dislocation, wire migration, infection, Sudeck syndrome or functional disturbance was seen. The advantage of this method is emphasized as compared with the usual, previously published method.

Adult↗
PubMed1991

[Differentiation antigens on normal bone marrow cells and following culture with growth factors in patients with acute myeloid leukemia (AML)].

In an attempt to detect residual leukemic cells during complete remission (CR), we used 4 monoclonal antibodies detecting markers at different stages of myeloid maturation. Bone marrow cells of AML patients at diagnosis/relapse or in CR were compared with normal controls at day 0 and 7, after incubation with colony stimulating factors, by the alkaline phosphatase/antialkaline phosphatase method. In AML patients at diagnosis/relapse, the expression of the early differentiation markers (CD34, HLA DR) was significantly increased and that of the late marker CD15 significantly decreased at day 0. After day 7 liquid cultures, the markers HLA DR and CD13 were significantly increased and CD15 significantly decreased. During CR a significant increase in day 7 liquid cultures of the markers HLA DR and CD13 was found compared to normal controls. These results may reflect the proliferation in culture of residual leukemic cells in CR patients.

Adolescent↗
PubMed1991

[Peripheral spontaneous remission of hairy cell leukemia following transfusion-associated hepatitis C].

In a 59-year-old patient presenting in October 1981 with pancytopenia, hairy cell leukemia was diagnosed. Splenectomy, followed by treatments with oncovin, lithium, and prednisone were essentially without effect. Up to July 1984 the patient had been regularly transfused with a total of 62 unit. In June 1984 he acquired a transfusion associated hepatitis C which followed a chronic course and resulted in biopsy proven cirrhosis in 1989. The patient became independent of transfusions in July 1984. Repeated blood counts have shown a complete hematologic remission which has now lasted nearly 6 years, whereas focal leukemic infiltrates have persisted in the bone marrow. The patient has tolerated 20 courses of erythropheresis performed because of biopsy proven severe hepatic siderosis without a fall in hemoglobin. It is suggested that the spontaneous long-lasting hematologic remission of hairy cell leukemia is due to endogenous interferon produced in the course of chronic hepatitis C. Low serum levels of interferon-alpha and -gamma were detected.

Combined Modality Therapy↗
PubMed1991

A new technique for anterior acromioplasty.

A new approach to anterior acromioplasty is presented. Using the oscillating saw of the ASIF-miniset, the deltoid muscle is detached off the acromion together with an osseous slice. This technique provides a stable reduction of the muscle at the end of the operation and avoids painful periostitis postoperatively. In so far, early functional recovery can be undertaken as soon as three weeks postoperatively.

Acromioclavicular Joint↗
PubMed1991

Ceftriaxone and amikacin versus ceftazidime and amikacin in febrile granulocytopenia.

The efficacy and safety of the two antibiotic combinations, ceftazidime plus amikacin and ceftriaxone plus amikacin were compared in an open randomized trial. 100 episodes of neutropenia caused by malignant diseases and/or cytostatic drugs were evaluated in 66 males and 34 females with a mean age of 49.4 years. The types of infections treated were: septicemia 38, fever of undetermined origin 26, pneumonia 13, ear, nose and throat infections 11 and others 12. 17 episodes were not evaluable (6 protocol violations, 6 doubtful infections and 5 non-bacterial infections). The overall results were comparable, with a 74% success rate for ceftazidime and a 70% rate for ceftriaxone (criteria of the European Organization for Research and Treatment of Cancer). In the patients with septicemia, the success rate was 64% in the ceftriaxone and 57% in the ceftazidime group. Eight patients died during the treatment, in 5 cases due to infectious complications. There were no differences between the two groups in respect of efficacy or toxicity.

Adolescent↗
PubMed1990

[BEP-chemotherapy in patients with testicular tumors--is it worthwhile?].

Since 1985 44 consecutive patients with testicular cancer have been treated with a modified BEP regimen. 70% had metastatic disease and 30% received adjuvant therapy. After mean follow-up of 26 (8-56) months, 91% of patients are alive and all are in remission. Chemotherapy-related side effects were alopecia (100%), myelosuppression (100%), nausea/vomiting (89%) and fever (66%). Patients reported nausea has been rare. It is concluded that BEP chemotherapy is a highly effective treatment which secures complete remission or cure even in patients with advanced metastatic disease. In retrospect the patients considered the treatment worthwhile despite the stress involved.

Adult↗