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Biomedical subjects

R Heyd

Publications and source records attributed to R Heyd.

24 records · Page 2Linked to original sources
PubMed1996

[Pneumoperitoneum and pneumoretroperitoneum without perforation].

Asymptomatic radiologically recognised pneumoperitoneum still remains a diagnostic and therapeutic dilemma, because free intraperitoneal air is not necessarily caused by alimentary tract perforation. We present two cases of nonsurgical pneumoperitoneum (caused by pneumomediastinum and pneumatosis intestinalis cystoides) and their typical radiologic findings. Other causes of pneumoperitoneum that do not necessitate laparotomy so as cited in the radiologic and surgical literature are discussed.

Adult↗
PubMed1996

[Universal organ involvement in Rendu-Osler-Weber disease: interdisciplinary diagnosis and interventional therapy].

A case of hereditary hemorrhagic teleangiectasia (HHT, Morbus Rendu-Osler-Weber) in a 63-years-old patient presenting with recurrent gastrointestinal and nasopharyngeal bleeding who required transfusion of 100-200 units of red blood cell concentrate a year is reported. Endoscopically, one source of bleeding could be located in the upper part of the jejunum. Multiple Osler spots were found in the antrum, the bulbal and descending part of the duodenum without signs of bleeding. Colonoscopy revealed no further lesions. Selective mesentericography visualized dilatation of the arterial arcardes in the duodenal region with early venous filling. During coeliacography, parenchymal deposits of contrast medium appeared in the liver. Numerous angiodysplastic arterial alterations from the lower ethmoidal arteria were shown to be another source of bleeding. They were embolized using microspheres and thereby terminating epistaxis. Termination of epistaxis was the crucial prerogative for the consecutive aortal valve replacement. At abdominal ultrasound, the liver harbored multiple anechoic lesions and a bigger cystic formation with portal inflow and early venous distribution. This teleangiectatic portovenous-malformation was confirmed on abdominal computertomography and on T1-enhanced images of MRT, too. This case examplifies the universal character of organ distribution in HHT and underlines the value of complementary diagnostic and therapeutic modalities.

Combined Modality Therapy↗
PubMed1995

[Postoperative, conventional fractionated radiotherapy for prevention of heterotopic ossification after total endoprosthesis of the hip joint].

Radiotherapy is the only local means of treatment in the prevention of heterotopic bone formation. It is possible to reduce the incidence of HO following total hip arthroplasty from an average of 50% without further treatment to an average of 8% using different doses and fractionation schemes. In this retrospective clinical study 22 hips of 20 patients were treated with a conventional fractionated radiotherapy. Total doses of 12.0-20.0 Gy in daily fractionation of 200 cGy single doses were applied 18 hips were postoperatively irradiated as secondary prophylaxis against recurrence of HO. 4 hips were high-risk cases with contralateral HO after previous hip surgery. After 6-30 months observation periods the roentgenogramms were analyzed with a modified Brooker-Score. Patients with a score > II were classified as nonresponders. 95.5% of the treated hips showed satisfactory results, only one hip (4.5%) achieved a score IIIA. In this case radiotherapy was interrupted after 3 x 200 cGy. The high therapeutic efficiency of local irradiation in the prevention of heterotopic bone formation following total hip replacement could be proved. No considerable side effects were observed. Further prospective clinical investigations are necessary to optimize the doses and fractionation schemes.

Aged↗
PubMed1995

[Immunoglobulin for prevention of radiogenic mucositis].

Among various therapies administered during radiation-induced mucositis, treatment with immunoglobulin has proven clinically successful. In this study the efficacy of prophylactic applications of immunoglobulin was investigated from January 1992 through August 1993. Forty-two patients with histologically-proven head and neck cancer were given postoperative radiation treatment. In cases with macroscopic tumor residues or inoperability, combined radio-chemotherapy was given. This included 51.3 Gy at 1.9 Gy 5x/week, boosted to 10-26 Gy at 2 Gy 5x/week and carboplatin 60 mg/m2 at days 1-5 and 29-33. Panthenol (4x10 ml/day) and nystatin (4 x 1 ml/day) were given to 20 patients as prophylactic treatment for mucositis. Twenty-two subsequent patients also received intramuscular 800 mg (5 ml) human immunoglobulin (1x/week). According to the Seegenschmiedt/Sauer classification the extent of mucositis was determined 3x/week. Comparison of the distribution of maximal mucositis revealed a slightly more severe mucosal reaction in the control group (n.s.). Analysis of the mean degree of mucositis in both groups demonstrated statistically significant differences (p = 0.031) related to the whole collective and patients receiving concomitant chemotherapy while no effect of immunoglobulin was found in patients treated by radiation alone. In the immunoglobulin-treated-group, the time from the beginning of therapy to the first interruption was prolonged 5 days (37.5 +/- 13.1 vs. 42.7 +/- 13.3 days), but this difference was not significant. Although prophylactic application of immunoglobulin seemed to lower the degree of radiation-induced mucositis, this effect was less significant when compared to the immunoglobulin given in a therapeutic manner.

Adult↗