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Biomedical subjects

R Ernst

Publications and source records attributed to R Ernst.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Angioarchitecture of the ileum and colon in Crohn disease].

Vascular changes in resected bowels of Crohn's disease were examined angiographically, microangiographically, micro-preparatorily and histologically. The proper angioarchitecture of the small and the large bowel is being destroyed in the course of the ongoing inflammatory process. Dilated capillaries, destruction of the primary angioarchitecture and its replacement by an irregular, partially bizarre pattern of scar vessels with bundling of the unchanged Vasa recta as varying vessel diameters caused by obliterating secondary fibroses can be seen in advanced Crohn's disease. The angioarchitecture of the pseudo-polyps in Crohn's disease is characterized by an increased number of vessels, bizarrely bended vessels and a radial pattern of veins. All these vascular changes in Crohn's disease are to be seen as secondary changes due to the inflammatory reaction.

Adult↗
PubMed1992

[Arterial hypertension. Prevention in infants with congenital urinary tract malformations].

Eighty-nine newborns and infants with congenital urinary tract malformations were treated in the childrens' hospital of the Westfälische Wilhelms-University from 1986 to 1989. Twenty patients of this group (22.5%) developed severe hypertension requiring treatment within the first year of life. Mean age of diagnosis of hypertension was 5 months (range 0.5-12 months). Median values for blood pressure at time of diagnosis were 138 mmHg (range 120-170) for systolic and 92 mmHg (range 80-110) for diastolic values. Six patients showed characteristic symptoms for hypertension such as restlessness, sweating and sleep disorders. Plasma levels of renin were obtained in 12 of 20 patients. Five patients had raised plasma renin levels. All patients with a severe hypertension were treated with one to several antihypertensive drugs. Risk factors for the development of severe renal hypertension in early infancy are cystic renal malformation, vesico-ureteral reflux, obstructive uropathy and to our experience also short term percutaneous nephrostomy in obstructive uropathy in particular in connection with pyelonephritis. Hypertension can still appear after the successful surgical correction of urinary obstruction. We describe the group of patients with severe hypertension in our study group; diagnostic principles and our therapeutic approach are explained. We conclude that early diagnosis of severe hypertension and consecutive treatment are important in infants with congenital urinary malformations.

Antihypertensive Agents↗
PubMed1991

[Extremity-threatening ischemia in ergotism. Successful treatment with the intra-arterial administration of nifedipine].

A 39-year-old woman suffering from migraine took two suppositories of an ergotamine-containing proprietary drug (Cafergot, containing 2 mg ergotamine tartrate) for the first time again after an abstinence of two years. Twenty-four hours later she developed symptoms of decreased peripheral blood flow in all four limbs. Walking distance without pain was reduced to 100 m, but the severest changes affected the right arm, with livid discolorations and complete immobility 16 hours after the onset of symptoms. Despite administration of morphine derivatives the pain progressively increased. Angiography demonstrated spastic narrowing of all arm arteries below the axillary artery. No vessels were visualized below the lower-arm bifurcation. Thereupon 4 mg nifedipine were injected through the angio-catheter within 30 min (five individual doses of 0.8 mg each). This was followed by intravenous infusion of 0.5 mg/h. The pain immediately decreased and the livid discoloration as well as impaired arm movement improved. A residual deficit, incomplete lesion of the median nerve, persisted but gradually regressed during the following two months.

Acute Disease↗
PubMed1991

[Revascularization of colonic anastomoses].

The revascularization of colonic anastomosis after colon segmental resection in rabbits in 9 different end-on-end and inverting suture techniques was examined macroscopically, microangiographically, micropreparatorily and histologically. Independently of the suture technique revascularization started 4 days after surgery. 8 days postoperatively the suture line is mainly bridged, 14 days postoperatively the vasal connection to the opposite side is completed. The new vessels mainly originate from the subserosal and submucosal tissue. The adhesions participate in the revascularization, too. It (the revascularization) directly correlates with the development of granulation tissue. This is evident from the excess reactive revascularization of abscesses and ulcers in the anastomoses. There always results a vascular scar in the angioarchitecture of the colonic wall. Start and extent of the revascularization cannot--in contrast to former literature--be looked at as a guarantee of quality for the healing of anastomoses.

Anastomosis, Surgical↗
PubMed1991

[Sonographic versus radiological assessment of chronic outer ligament instability of the upper ankle joint].

Chronic instability of the lateral upper ankle joint ligament is usually diagnosed by clinical and radiological examination. For the evaluation of an ultrasound method of testing lateral instability of the ankle joint we carried out a prospective study. We examined 23 adults who were actively engaged in some form of sport (21 male, 2 female, mean age 32 years) and had a preexisting lateral instability of the ankle. The instability was measured in the standard planes using Scheuba's stress apparatus with simultaneous ultrasound monitoring. The ultrasound examination was performed by positioning the 5-MHz applicator on the lateral side of the Achilles tendon, thus defining a plane from which the instability could be measured in both examination planes by observing the deviation between dorsal inferior edge of the tibia and the dorsal border of the talar roll. For the two examination planes, Spearman's rank-correlation coefficient between the radiological and ultrasound methods was 0.83 and 0.92. The sensitivity of the ultrasound method was 0.90, and the specificity was 0.85. Our study showed a good correlation between the two methods. A pathological talar tilt according to radiological criteria was also revealed by ultrasonography. Thus, all the advantages of ultrasound are now available for the evaluation of chronic lateral instability of the ankle joint.

Adult↗
PubMed1990

[Disorders of microcirculation in colon anastomoses and their significance for the pathogenesis of suture dehiscence].

In this morphologic experimental study in the rabbit disturbances in the microcirculation at the site of colonic anastomoses were found in all suture techniques employed. They are caused by resection, intraoperative traumatization, the suture technique, and, secondarily, by abscess formation on the anastomosis. The suture-induced disturbances of the microcirculation lead to necroses of the mucosa, partial and complete necroses of the inverted cuff, and transmural necroses with destruction of the sero-serous contact zone. For the pathogenesis of anastomotic dehiscence only transmural and extensive complete necroses of the anastomotic bulge, including the serosal contact, are important. They result in transmural abscess formations which correspond to microscopic small secondary anastomotic leakages.

Abscess↗
PubMed1990

[Significance of sonography of the breast for surgical treatment of breast cancer].

In a prospective study of 119 patients with breast carcinoma the value of ultrasonography for surgical therapy was compared with the value of clinical results and mammography. The tumor localization (in 96.8%) and the exact preoperative staging following the pTNM-system (tumor size in 85.8%, lymph node involvement in 77.2%) were better predicted by ultrasonography than by mammography and clinical examination. Especially the multicentric-multifocal carcinomas (20 of 29 cases) were better detected. Preoperative ultrasonography especially improves planning a conservative management of breast cancer.

Breast Neoplasms↗
PubMed1990

[Perioperative ultrasound examination of the breast in breast cancer].

127 cases of breast carcinoma were examined in a prospective study. By means of preoperative ultrasonography the staging following the pTNM-system validates the tumor size in 85.5% and the lymph node involvement in 77.2%. Multicentric-multifocal carcinomas were diagnosed by ultrasonography in 20 of 29 cases, merely 9 of 29 by mammography. Ultrasonography of specimen is recommended in cases of negative clinical findings and positive ultrasound examination to verify tumour excision. In addition to clinical exploration and mammography the ultrasonography of the breast obtains a diagnostic significance for planning a conservative management of breast cancer.

Breast Neoplasms↗
PubMed1988

[Multiple lipomas of the colon. Case report with clinical, roentgenologic, angiographic and histologic findings].

Case report on a 26 year old woman with multiple lipomas of the colon and rectum and a neurofibromatosis simultaneously. Description and discussion of clinical data and differential diagnosis. The vascularisation of the lipomas and of the overlying mucosa was proved to be good angiographically. This is the reason for the frequent bleeding of the lipomas of the colon. The coincidence of multiple lipomas and neurofibromatosis is rare. Therefore conclusions for a possible common etiology of the two diseases should be drawn only after further reports.

Adult↗
PubMed1987

Homogeneous enzyme immunoassay (EMIT) protocol for monitoring tricyclic antidepressants on the COBAS-BIO centrifugal analyzer.

EMIT tests are available for quantitative determination of the tricyclic antidepressants amitriptyline (AMI), nortriptyline (NORT), imipramine (IMI), and desipramine (DMI). An extraction step before analysis eliminates cross-reacting polar metabolites. Excellent correlation between EMIT and high-performance liquid chromatography (HPLC) has been previously established. Most published protocols for using EMIT reagents on COBAS-BIO centrifugal analyzers were designed for analytes present at 1-50 mg/L in serum. AMI, NORT, IMI, and DMI are usually present at far less than 1 mg/L. We describe a COBAS-BIO EMIT protocol for assaying these analytes. Patient sample correlation between COBAS-BIO EMIT and EMIT-AutoLab were greater than 0.99. Between-run precision for single-point determinations was comparable to SYVA AutoLab performance [less than or equal to 11% at 40 micrograms/L AMI, NORT, IMI (80 micrograms/L DMI), and less than or equal to 4% at 200 micrograms/L AMI, NORT, IMI (400 micrograms/L DMI)]. With stored-curve updating, working reagents were usable for at least 14 days (AMI) or 23 days (DMI).

Antidepressive Agents, Tricyclic↗
PubMed1986

["My scale armor protects me"! The personality image and physical disability of psoriasis patients].

With the help of the Giessen-test and the Giessen-complaint form, 28 patients suffering from psoriasis were analysed regarding their personality image and physical disabilities. In comparison with controls (n = 1587), psoriasis patients believed themselves to have "negative social appeal" (p less than or equal to 0.05) and being "reserved" (p less than or equal to 0.01); however, they complained of less physical troubles than healthy controls or psychosomatic patients (p less than or equal to 0.01). Evaluation of these items pointed to depth psychological conflicts of the "not accepted body image" kind, which may precede the disease; the scales might serve as a barrier to psychological troubles.

Adult↗
PubMed1986

[Decision aids in determining therapy of breast cancer by preoperative staging using sonography and computerized tomography].

In a prospective study the preoperative ultrasonography of 54 cases of carcinoma of the breast was able to predict the pTNM staging precisely in 83.3% for tumor size and in 72.3% for lymphnode metastases. Multicentric-multifocal carcinomas were diagnosed by ultrasonography in 10 of 13 patients, better than by mammography (6 of 13). The CAT scan is indicated only in advanced tumor stages. The preoperative staging by ultrasonography enables with more precision planning and differentiated therapy of the carcinoma of the breast, especially in view of breast-preserving therapy.

Breast↗