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Biomedical subjects

R Hoffmann

Publications and source records attributed to R Hoffmann.

At least 379 records · Page 21Linked to original sources
PubMed1990

Obstructive ileus and acute pancreatitis.

A 48-year-old patient presented with a 24 hour history of diffuse abdominal pain and diarrhea. Based on elevated serum amylase and lipase levels, a CT-scan, and a history of chronic alcohol intake, acute alcoholic pancreatitis was diagnosed. The patient clinically improved under conservative therapy, but after restarting enteral nutrition on the fourth day, he developed full blown mechanical ileus. Intraoperatively, an adhesive band and acute edematous pancreatitis and fat necrosis was found. Retrospectively, the initial clinical symptoms and plain abdominal x-ray findings suggest coincidence of obstructive ileus and acute pancreatitis. We hypothesize that obstructive ileus had triggered pancreatitis.

Acute Disease↗
PubMed1989

[Cheilitis granulomatosa as the first manifestation of Crohn's disease].

A 39-year-old man developed a painless swelling of the lower lip, which histologically was a granulomatous inflammation of the corium as in granulomatous cheilitis. Four weeks after onset of the disease recurrent diarrhoea set in, the result of Crohn's disease of the jejunum, terminal ileum and caecum. Granulomatous cheilitis, occurring as sole sign of the Melkersson-Rosenthal syndrome, is a manifestation of Crohn's disease. Even if there are no intestinal symptoms. Crohn's disease must be excluded in the differential diagnosis.

Adult↗
PubMed1989

A study of tobacco carcinogenesis XLIV. Bioassay in A/J mice of some N-nitrosamines.

The evaluation of the tumorigenic activity in A/J mouse lung of certain tobacco N-nitrosamines, namely 3-(methylnitrosamino)propionic acid (NMPA), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and 4-(methylnitrosamino)-4-(3-pyridyl)-butyric acid (iso-NNAC), had the following results (total dose in micromol per mouse/lung tumors per mouse): NMPA (200/7.1 +/- 2.9); NNK (2/15.7 +/- 4.1); iso-NNAC (200/0.24 +/- 0.43); saline control (0.2 +/- 0.4). The tumorigenic activity of NMPA was not surprising since its lower homologue, N-nitrososarcosine, as well as its higher homologue, 4-(methylnitrosamino)-butyric acid, are known carcinogens. The high tumorigenic activity of NNK in strain A/J mice confirms earlier findings as to its carcinogenic potency in rats and hamsters. The lack of tumorigenic activity of iso-NNAC supports the observation that the pyridyl rest adjacent to the nitrosamino group inhibits the activity of some tobacco-specific N-nitrosamines (TSNA). Iso-NNAC is most likely formed endogenously from the nicotine metabolites cotinine and 4-(methylamino)-4-(3-pyridyl)butyric acid.

Animals↗
PubMed1989

Experimental transmission of two Myxobolus spp. developing bisporogeny via tubificid worms.

Spores of Myxobolus cotti El-Matbouli and Hoffmann 1987 and M. cerebralis Hofer 1903 (fresh or after 5 months in mud) are taken in by tubifex worms and develop in their gut epithelium cells into actinosporea of the genus Triactinomyxon. Triactinomyxon deriving from M. cotti differ distinctly from those derived from M. cerebralis in morphology and the number of sporozoites in the epispore. It could be shown that Triactinomyxon spores infect fish either via the water (bullhead, rainbow trout) or by feeding of infected tubifex (rainbow trout), developing into Myxobolus spores in central nervous tissue (bullhead) or cartilage (rainbow trout). Fresh or ripened spores of M. cotti and M. cerebralis were not infectious for bullheads or rainbow trout, respectively. The results of our experiments confirm the hypothesis that the life cycle of M. cotti and M. cerebralis includes an intermediate host and a metamorphosis into actinosporea of the genus Triactinomyxon.

Animals↗
PubMed1989

Shock-wave therapy of gastric outlet syndrome caused by a gallstone.

A patient with gastric outlet syndrome (Bouveret's syndrome) caused by a large gallstone impacted in the duodenal bulb was successfully treated by extracorporeal shock-wave lithotripsy. Thus, open abdominal surgery could be avoided. For disintegration of the stone, three consecutive lithotripsy procedures were necessary. Thereafter, stone fragments could be extracted endoscopically. Extracorporeal shock-wave lithotripsy could become a non-surgical alternative in patients with obstruction of the duodenum caused by a gallstone.

Aged↗
PubMed1989

[Surgical treatment of chronic upper ankle joint instability in childhood].

The Department of Traumatology of the Hanover Medical School treated 347 patients having chronic instability or second stage rupture of the fibular ligament system, by surgery, during 1971 through 1986. Children were represented by one-seventh of the total number of patients only (13%; n = 44); however, in children the preoperative and intraoperative findings are different from normal findings and must be treated surgically in a special way. Whereas in adults old osseous/osteochondral ligament tears are apt to be rare (16% of the cases), they can be seen in children in almost every second case (18 of 44). Surgical approach requires a step-by-step procedure to achieve maximum stability and minimum functional loss. First Choice: Direct reconstruction of the ligament in case of ligaments which are present but have not healed correctly from a biomechanical point of view (e.g. pseudoarthroticosseous ligament tear) or in case of second-stage rupture (n = 20). Second Choice: Double periosteal flap plasty in case of necessary replacement of only one ligament (n = 13). Third Choice: Tenodesis of m. peroneus brevis using only half of the tendon chip while sparing the epiphysis if the condition persists for many years, or if ligaments cannot be reconstructed or replaced intraoperatively or if there is a combined instability of the ankle joint and the talo-calcaneonavicular joint (n = 11). In almost 90% of the cases very good to good results were obtained after five years, assessed according to a 100-point schema.

Adolescent↗
PubMed1989

Variations in period-analysed EEG asymmetry in REM and NREM sleep.

Monopolar EEG was recorded from lateral frontal and parietal sites with linked ear reference during sleep in 24 adults. Electrode placement followed the 10-20 International system. EEG was quantified using digital period analyses. The absolute difference in interhemispheric EEG parameters was compared for Stage 2, REM, and a slow wave sleep measure. The absolute difference measures reflect the degree of symmetry or asymmetry, regardless of the hemisphere of origin. Theta and delta activity in slow wave sleep was more asymmetrical than in either Stage 2 or REM. REM sleep was associated with the smallest asymmetries. These results do not support a right hemisphere REM, left hemisphere NREM relationship. Rather they suggest that REM sleep is associated with relative hemispheric symmetry whereas asymmetries are most prominent in slow wave sleep. Stage 2 sleep was significantly less asymmetrical than slow wave on a number of theta and delta measures. The significant differences between slow wave and Stage 2 sleep may denote functional differences within NREM sleep stages.

Adolescent↗
PubMed1989

Age related randomized comparison of sequentially applied high-dose versus intermediate dose cytosine arabinoside in combination with mitoxantrone (S-HAM) in the treatment of relapsed and refractory acute myeloid leukemia: study design and preliminary results.

In a prospective randomized trial, the pending question was addressed whether Cytosine arabinoside (Ara-C) should be applied at high or intermediate dose to patients with relapsed or refractory acute myeloid leukemia. Based upon the previously established regimen of the sequential application of Ara-C and Mitoxantrone (S-HAM) patients below 60 years of age were randomized to receive Ara-C at either 3.0 g/m2 vs 1.0 g/m2 per dose while older patients were randomly assigned to either 1.0 g/m2 or 0.5 g/m2 Ara-C. At the present early stage 51 patients have entered the study and 37 are currently evaluable for response and toxicity. Complete remissions were achieved in 14 of 28 patients below 60 years of age and in 3 of 8 older cases. Predominant side effects consisted of nausea and vomiting, diarrhea and stomatitis. Further recruitment of patients and longer follow-up is required for the assessment of the various treatment arms.

Age Factors↗
PubMed1989

[Distal radius fracture. Fracture stabilization with biodegradable osteosynthesis pins (Biofix). Experimental studies and initial clinical experiences].

K-wire stabilization and casting of unstable or intraarticular fractures of the distal radius has proven to be an effective method of treatment since many years. However the need of implant removal after fracture healing is a disadvantage of this method. For this reason we investigated on the use of biodegradable implants in a fracture model of the distal radius. The biomechanical testing with Polydioxanon-(PDS)-pins (Ethipin) showed too small primary stability for the use in vivo. Osteosyntheses with three Polyglycolacid-(PGA)-rods Biofix compared with three K-wires 1.6 mm on the other hand showed 82% initial stability. From May to September 1988 typical distal radius fractures in 11 patients have been stabilized with Biofix-rods. The result of primary reduction could be obtained in all cases. These first experiences suggested, that stabilization of distal radius fractures with Biofix-rods might alternatively be performed instead of K-wire pinning.

Adult↗
PubMed1989

[Liquid-crystal-contact-thermography (LCCT)--a new diagnostic method for determination of skin circulation. Results of 300 studies].

In cases where minor differences in skin temperature are of importance, LCCT can be used. Furthermore LCCT can be used to document the malperfusion of the leg and postoperative flow control of a bypass after revascularization, as well as determination of the site of amputation in cases where revascularization is not possible. General surgery, traumatology: LCCT is well suited as a screening method in the diagnosis of deep venous thrombosis. Our clinical trial with more than 300 patients documents the simple, non-invasive use of LCCT. More than 80 patients had parallel ascending venography performed in order to document sensitivity and specificity of LCCT. We found LCCT to have a sensitivity to 95% and a specificity of 86% when compared to venography. LCCT must be performed by a physician to rule out other pathogenic factors leading to either a rise or a fall in skin temperature. As LCCT is an absolutely non-invasive method and having a high sensitivity and specificity it is well suited as screening method in the diagnosis of deep venous thrombosis. LCCT can be recommended to all angiologic wards and certainly to very surgical clinic, as the early recognition or exclusion of postoperative deep venous thrombosis is its main goal.

Humans↗
PubMed1989

[Rupture of the fibular ligament of the upper ankle joint].

A prospective randomized trial was performed to compare conservative functional treatment and operative functional treatment for rupture of the lateral ankle ligament. On the basis of the results observed 1 and 2 years after injury, primary functional therapy with a orthetic support appeared to be the method of choice. In a 100-point clinical check-up scale we were not able to find any statistical differences between the treatments. This type of conservative treatment gives a high degree of mechanical stability, a shorter time off work and the ability to take a full, active part in sports within 3 months in all cases. Operative treatment is indicated only in cases of dislocation of the foot and ankle, ankle ligament rupture with additional osteochondral talus fracture, and second-stage injuries or reruptures.

Adult↗
PubMed1989

[Management of sonography in blunt abdominal trauma].

A standardized management of sonography in blunt abdominal trauma has replaced peritoneal lavage in our department. The sonographic evaluation is performed simultaneously with additional diagnostic and therapeutic procedures in the emergency room. The primary goal is the exclusion of intraabdominal bleeding. The management and the results of the diagnostic procedure are presented with reference to a consecutive series of 314 patients with blunt abdominal trauma or polytrauma. In 71 patients, laparotomy was performed because the sonographic findings were felt to indicate it. Only in two cases was the sonographic assessment incorrect (false-positive). Frequent sonographic and clinical controls are required especially when sonography cannot totally exclude intraabdominal bleeding during the initial assessment. If any discrepancies between negative or uncertain sonographic and suspect clinical findings remain, further high-tech diagnostic methods or exploratory laparotomy become necessary.

Abdominal Injuries↗
PubMed1989

[Liquid crystal contact thermography--a new screening procedure in the diagnosis of deep venous thrombosis].

In search of a sensitive, simple, non-invasive screening method in the diagnosis of Deep Vein Thrombosis (DVT) we become aware of the recent possibility of Liquid Crystal Contact Thermography (LCCT). From October 1987 all patients over 40 years of age undergoing visceral surgery were examined on the second postoperative day by means of the LCCT Method. Furthermore patients of the traumatological clinic with high risk for DVT (hip surgery) were controlled. In case of positive thermography or uncertain interpretation a phlebography was performed and thermography repeated. Until the end of February 1988 316 patients were submitted to LCCT. In the beginning of the study pathologic and iatrogenic factors which lead to a rise in temperature of the leg, caused differential diagnostic problems. In the course of the study the LCCT turned out to be a reliable screening method in the diagnostic of DVT. In our study the LCCT has a sensitivity of 94%. The specificity was, as expected, a bit lower and is 86%. The high sensitivity and somewhat lower specificity (which is without consequence for the patients) shows that LCCT is well suited as screening method, especially since it is non-invasive. Differential diagnostic aspects are discussed.

Abdomen↗
PubMed1989

[Imitation of acute, deep venous thrombosis of the lower leg by a ruptured Baker's cyst].

In case of a swollen leg, differential diagnosis includes deep venous thrombosis. After having ruled out a thrombosis by venography, other causes have to be sought. We report a case where massive swelling of the lower leg was due to the arthrographically proven rupture of a Bakers' Cyst. Had more emphasis been put on recording the patients history, time loss and diagnostic procedures could have been minimized.

Aged↗
PubMed1988

Is trisomy 11 another nonrandom chromosomal anomaly in acute nonlymphocytic leukemia and myelodysplastic syndromes?

Four cases with trisomy 11 as the sole chromosomal anomaly are reported, three with de novo acute nonlymphocytic leukemia (ANLL) and one with a myelodysplastic syndrome (MDS) after treatment for multiple myeloma. In reviewing the literature, we found 19 additional cases with trisomy 11 as the sole cytogenetic defect. All patients except one were reported to have ANLL or MDS. Thus, it seems that trisomy 11 is another rare but nonrandom chromosomal anomaly in ANLL and MDS. So far, no apparently characteristic clinical or cytologic signs have been found in these cases.

Chromosome Banding↗
PubMed1988

[Soft-tissue cervicofacial emphysema and pneumomediastinum caused by self injury].

A prison inmate was referred to us for diagnostic procedures and therapy due to a combination of pneumomediastinum with emphysema of neck and face. External injuries were absent and pathogenesis remained uncertain until thorough examination of the patient revealed two intraoral wounds, presumably from a needle, reaching into the maxillary sinus. This large subcutaneous emphysema of the face, neck and mediastinum was the result of an exaggerated Valsalva maneuver. With this self-inflicted injury, unknown to us, the prisoner achieved the desired immediate admission to hospital.

Adult↗