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Biomedical subjects

M Ries

Publications and source records attributed to M Ries.

At least 73 records · Page 4Linked to original sources
PubMed1993

Total cavopulmonary anastomosis: selection criteria related to postoperative results.

In this study we review our experience with total cavopulmonary anastomosis (modified Fontan procedure) which was performed in 31 patients. One patient died from postoperative cardiac low-output syndrome, the other died from a neurological complication (early mortality 6.5%). During a mean follow-up period of 15 months there was no late mortality. Preoperative assessment showed that one, two, or three of the Choussat criteria (defining the ideal Fontan candidate) were not fulfilled by 39%, 16% and 6% of our patients. In the 2 patients who died 2 and 3 of those criteria were not fulfilled. Poor outcome could not be predicted based on assessment of the pulmonary artery size (expressed as the McGoon-ratio or the Nakata-index) alone. In order to assess the relationship of pulmonary artery size and pulmonary arteriolar resistance (PVR) as a predictor of outcome, we introduced two new indices (McGoon-ratio/PVR and Nakata-index/PVR). The patient who died from poor postoperative hemodynamics had the lowest values of all patients. Among the 29 survivors we did not observe significant acquired postoperative arrhythmias. In our experience the total cavopulmonary anastomosis can be performed with a low mortality and good postoperative results. Patients who do not fulfill at least 8 of the Choussat criteria and children with a low ratio of pulmonary artery size to PVR are high-risk patients. In these children we recommend either a bidirectional Glenn anastomosis as a first-step procedure or a total cavopulmonary anastomosis with a fenestration of the intraatrial tunnel.

Adolescent↗
PubMed1993

[Acute mesenteric vein thrombosis. A rare complication after splenectomy due to autoimmune hemolytic anemia in childhood].

Mesenteric vein thrombosis is a rare but severe complication in children requiring splenectomy. We report on a 5-year-old boy with an autoimmune hemolytic anemia who underwent splenectomy because of severe side effects from cortisone therapy. 10 months after splenectomy he presented with signs of a paralytic ileus. Laparotomy showed mesenteric vein thrombosis with hemorrhagic bowel infarction requiring resection of two thirds of the small intestine. An early recognition and thrombolytic or surgical treatment of mesenteric vein thrombosis may reduce the incidence of hemorrhagic infarction, peritonitis, and secondary complications in these patients.

Anemia, Hemolytic, Autoimmune↗
PubMed1993

[Congenital cystic bile duct dilatation. Presentation of clinical symptoms, diagnostic possibilities and therapy based on 6 cases].

BACKGROUND AND METHODS: Congenital cystic dilatation of the bile ducts represents an uncommon anomaly of the biliary system. We report on 6 patients suffering from cystic biliary duct dilatations which were treated in our hospital between 1980 and 1992. Clinical signs included upper abdominal pain, white or clay-colored stool, icterus and/or palpable tumor. According to the classification of Todani, 4 children had type Ia cysts, 1 child a type Va cyst and 1 child a type Ia cyst with extrahepatic biliary atresia. RESULTS: Among the diagnostic methods sonography is preeminent and permitted demonstration of intra- and extrahepatic biliary duct dilatations in all of our patients. In 2 patients small cystic dilatations could be distinguished from hepatic vessels by colour-coded Doppler sonography. CONCLUSION: The treatment of choice is the resection of the dilated extrahepatic biliary ducts followed by hepaticojejunostomy using the Roux-en-Y-technique.

Abnormalities, Multiple↗
PubMed1993

[Extensive subdural hematoma with brain edema and brain death. Sequela of late manifestation of vitamin K deficiency].

After an uneventful pregnancy and birth without vitamin-K-prophylaxis a seven-week-old breast-fed infant showed a subdural hemorrhage caused by vitamin-K-deficiency. Laboratory investigations indicated a subclinical cholestasis. The infant died 3 days later. This case once again provides a strong argument for routine vitamin-K-prophylaxis after birth for all infants.

Blood Coagulation Tests↗
PubMed1992

Colour Doppler imaging of intracranial vasculopathy in severe infantile sialidosis.

Neonatal ascites is usually attributed to prenatal infections, lysosomal storage disease and anomalies of the genitourinary tract, gastrointestinal tract or cardiovascular system. We report one case of neonatal ascites associated with infantile sialidosis. Cerebral sonography showed stripe-like intracerebral echogenicities in the region of the basal ganglia. Colour Doppler imaging demonstrated blood flow within the echogenicities confirming the suspected diagnosis of intracranial vasculopathy.

Adult↗
PubMed1992

Amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a clinical entity differentiated during the last few years into definite, probable, possible and suspected ALS. There are many hypotheses trying to explain its genesis: slow virus hypothesis, trace elements, immunologic and trophic factors, excitotoxins, metabolic influences, DNA anomalies, and so on. It is necessary to differentiate ALS like syndromes and ALS variants. Some of the ALS like syndromes can be treated. Only the disease elaborated like that may be submitted to clinical therapeutical trials or molecular-genetic research. Palliative therapy is still necessary. It does not prolong life, it makes its quality better.

Amyotrophic Lateral Sclerosis↗
PubMed1992

New chromogen for assay of glucose in serum.

We describe a colorimetric assay for glucose determination in human serum, with use of the chromogen 2-amino-4-hydroxybenzenesulfonic acid (AHBS), glucose oxidase, and peroxidase. With this assay, glucose concentrations less than or equal to 27.8 mmol/L can be measured in serum, with a sample/reagent volume ratio as low as 0.0025. The chromogen itself is easily soluble in water and does not require other components for the color change, making the reagent composition less complex. A single working reagent is used, and the reaction is completed within 10 min at 37 degrees C. The absorbance of the yellow reaction product is measured at 415 nm, and a blank sample measurement is not needed. The average analytical recovery of glucose in different human sera was 97.6%, with no significant interference of reducing compounds in serum. The results of the recommended procedure correlated well with those of the phenol/4-aminoantipyrine method of Trinder.

Blood Glucose↗
PubMed1991

Microheterogeneity of urinary albumin and tubular proteinuria in juvenile diabetes mellitus.

We studied differential urinary albumin excretion by a double one-dimensional gel electrophoresis with decyl sodium sulphate-polyacrylamide gel electrophoresis in the first, and isoelectric focusing in the second dimension in 37 diabetic children and 20 healthy subjects. In addition, total proteins, albumin, beta 2-microglobulin and molecular size distribution of urinary proteins were measured, the latter using sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Whilst albuminuria was not significantly different from controls we found an increased microheterogeneity of urinary albumin in 38% of patients. In addition, low molecular weight protein (P less than 0.05) and beta 2-microglobulin excretion (P less than 0.01) were elevated. It is suggested that the appearance of highly heterogenous albumin in the pI range of 5.3-5.9 is the result of a decreased tubular reabsorption.

Adolescent↗
PubMed1990

Simultaneous palsy of facial and vestibular nerve in a child with Lyme borreliosis.

We describe a boy with borreliosis characterized by lymphocytic meningitis and simultaneous palsy of facial and vestibular nerves on the left side. A mild sensoneural affection was also confirmed by brainstem evoked response audiometry. While symptoms of vestibular dysfunction quickly decreased during antibiotic treatment, facial palsy improved only slowly.

Child↗
PubMed1990

Demonstration of perivascular echogenicities in congenital cytomegalovirus infection by colour Doppler imaging.

Two children with congenital cytomegalovirus infection and intracerebral echogenicities were investigated by computer sonography and colour Doppler imaging (CDI). By simultaneous imaging of brain tissue and CDI, blood flow within the stripe-like echogenicities of the basal ganglia was demonstrated. Using CDI the echogenicities were identified as the walls of thalamostriate vessels.

Basal Ganglia↗
PubMed1990

[Evaluation of diagnostic efficacy in radiology. Literature review].

The recent development of new imaging procedures has lead the radiologists to assessing the diagnostic efficacy of the available examination techniques in order to reduce medical care costs. In cooperation with epidemiologists and statisticians, several methods of statistic analysis of the diagnostic efficacy of the procedures such as sensitivity and specificity evaluation, ROC analysis, disease prevalence, predictive value of tests, etc... have been developed. Benefit-cost and cost-efficiency analyses have also been performed, with a view to improving the quality of long-term medical care for the patient at a lower cost both for himself and the society.

Costs and Cost Analysis↗
PubMed1989

Cortical pelvic strains with varying size hemiarthroplasty in vitro.

Four human pelves were dissected of soft tissues and instrumented with rosette strain gages. The pelves were left intact (not separated at the pubic symphysis or sacroiliac joints) although each of the eight hemipelves was tested separately. The pelves were loaded to simulate single leg stance with use of a wire mesh cemented to the wing of the ilium, representing the abductor muscles. Loading was carried out with the intact hip joint and 1 mm undersized, correct sized, and 1 mm oversized hemiarthroplasty. The correct sized component produced a strain pattern closet to normal. The oversized component was associated with an increase in strain at the medial acetabular dome.

Acetabulum↗
PubMed1989

Normal pelvic strain pattern in vitro.

Four cadaver pelves were dissected of soft tissue and each of the eight hemipelves instrumented with ten rosette strain gauges. Static loading was conducted to simulate single leg stance, and applied through the intact hip joint. The medial portion of the pelvis was under tension directed vertically and the lateral ilium was in compression. This strain pattern is consistent with bending applied to the ilium from the action of the abductor and joint reaction forces.

Biomechanical Phenomena↗
PubMed1989

[An unusual late manifestation of hemorrhage caused by vitamin K deficiency].

After an uneventful pregnancy and birth at home without vitamin K-prophylaxis, a 13-day-old breast-fed newborn showed an unexplained swelling of his right elbow and avoided movement of his right arm. One week later a swelling of his left thigh and hip with extensive hematoma led to the diagnosis of vitamin K-deficiency. The initial symptoms can be interpreted as an unusual primary manifestation of late hemorrhagic disease caused by vitamin K-deficiency.

Blood Coagulation Tests↗
PubMed1988

Total dislocation of the talus. Case report with a 13-year follow up and review of the literature.

Simultaneous dislocation of the talus from the tibiotalar, talocalcaneal, and talonavicular joints is uncommon and usually occurs from considerable violence. Total dislocation of the talus is frequently an open injury, or the skin may be tented over the dislocated talus leading to skin slough. Infection and avascular necrosis may follow. Treatment options include closed or open reduction, talectomy, and arthrodesis. The following case and literature review illustrate some of the problems encountered and factors that influence the outcome of this injury.

Adult↗