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Biomedical subjects

R Ott

Publications and source records attributed to R Ott.

At least 91 records · Page 5Linked to original sources

Popliteal arteriovenous fistula after corrective upper tibial osteotomy.

Injuries to the popliteal artery or vein are rare complications of knee arthroscopy or osteosynthesis at the distal femur or the proximal tibia. We report a case of iatrogenic arteriovenous fistula after proximal tibial osteotomy for varus deformity. A 71-year-old woman complained of pain and swelling of the foot 9 weeks after a corrective barrel-vault osteotomy of the left tibia. Angiography demonstrated an arteriovenous fistula between the popliteal vessels due to osteotomy of the tibial head. The fistula was separated and popliteal vessels closed by continuous suture and a small saphenous vein patch.

Aged↗

[Health surveys in the plastering trade of the Basel region].

This health study was formulated for the plastering trade in the Basel region, which would be offered to all employees and included in their contracts. It covers the following points: Impaired mobility, especially back problems. Heart and circulation problems. General body fitness. It involves random testing of anonymous individuals and through a detailed study medical risk factors and early warning symptoms are established. Included in this preventive study is also information about the possible avoidance of damage to health and prevention of long term effects.

Calcium Sulfate↗

Pain in extracorporeal shock-wave lithotripsy: a comparison of different lithotripters in volunteers.

The aim of the present study was to investigate pain sensations experienced during extracorporeal shock-wave application, comparing an electrohydraulic (MPL 9000; Dornier Medizintechnik, Germering, Germany), an electromagnetic (Lithostar Plus; Siemens, Erlangen, Germany), and a piezoelectric (Piezolith 2300; Wolf, Knittlingen, Germany) shock-wave system. In nine healty volunteers, three therapeutically used intensities were applied in a randomized order with each lithotripter (MPL 9000: 16, 20, and 24 kV; Lithostar Plus: settings 5, 7, and 9; and Piezolith 2300: settings 2, 3, and 4). The subjects received nine series of 20 shock waves amounting to a total of 180 shock waves per session. The treatment was performed under clinical conditions, and no premedication was given. A visual analog scale and the McGill Pain Questionnaire were used for assessment of pain. In addition, somatosensory evoked potentials caused by shock-wave stimulation were recorded. Some of the volunteers were unable to bear the pain caused by the highest shock-wave intensity of the electrohydraulic (n = 3) and the electromagnetic system (n = 4). Estimates using the visual analogue scale showed increased pain sensations with increasing energy settings for each lithotripter. The amplitudes of the somatosensory evoked potentials became larger, and latencies shortened with increasing stimulus intensities (P less than 0.05). Subjective estimates by means of the visual analogue scale (P less than 0.01) as well as the McGill Pain Questionnaire (NS) and the somatosensory evoked potentials (P less than 0.05) showed that stimulation by the piezoelectric lithotripter was less painful than stimulation by the two other generators.

Adult↗

Extracorporeal shock wave lithotripsy in symptomatic cholesterol gallbladder stone patients with a second generation electrohydraulic lithotripter (MPL-9000): experiences with 106 patients over 15 months.

One hundred and six patients were treated with a second generation underwater spark discharge lithotripter (Dornier MPL-9000). During the 15-month study period, Kaplan-Meier analysis predicted a stone clearance rate of 16.5% after 4 months, 37% (7 months), 71% (10 months), and 81% (15 months), respectively. Patients with multiple stones had a 5% probability to be free of stones after 13 months of treatment, when compared to 100% in patients with solitary stones smaller than 2 cm (p less than 0.001). Stones with densities below 100 Hounsfield units (HU) on computed tomography disappeared in 75% of the cases within 13 months. Rim calcified stones were cleared in 100% after 10 months of treatment. Fragmentation efficacy proved to be an essential predictive parameter for stone clearance: a fragment size below 5 mm after extracorporeal shock wave lithotripsy resulted in a 100% stone clearance within 13 months regardless of the initial stone number, size, and density. None of the stones fragmented to pieces of more than 10 mm in diameter could be dissolved within the observation period. Obviously, modern generation electrohydraulic lithotripters are effective in stone fragmentation, thus providing the basis for successful bile acid therapy provided the patients are properly selected.

Adolescent↗

Total biliary protein, mucus glycoproteins, cyclic-AMP, and apolipoproteins in the gallbladder bile of patients with cholesterol stones and stone-free controls.

The concentrations of total protein, mucus glycoprotein, cyclic-AMP, and apolipoproteins A-I, A-II, and B were determined in the gallbladder bile of patients with cholesterol gallbladder stones and in stone-free controls. The total protein content was significantly increased in gallstone patients (2.03 +/- 0.6 versus 1.31 +/- 0.67 mg/ml; p less than 0.05), as was the mucus glycoprotein concentration (380 +/- 88.5 versus 128 +/- 57.2 micrograms/ml; p less than 0.05). The cyclic-AMP concentration in the gallbladder fluid was increased up to 91 +/- 20 pmol/100 microliters in the gallstone subjects, as compared with 46 +/- 26 pmol/100 microliters (p less than 0.01) in stone-free controls. Cyclic-AMP concentrations correlated positively with the glycoprotein content of the bile in cholesterol gallstone patients (r = 0.66; p less than 0.05). The apolipoprotein concentrations were determined by the radial immundiffusion technique. The corresponding values for patients with stones and controls were 7.5 +/- 0.8 versus 3.0 +/- 0.8 for Apo A-I (p less than 0.025), 10.4 +/- 0.6 versus 6.3 +/- 1.3 for Apo A-II (p less than 0.02), and 1.9 +/- 0.5 versus 1.6 +/- 0.2 mg/dl for Apo B (NS), respectively. Biliary proteins probably play an important role in the nucleation process during the pathogenesis of cholesterol gallbladder stones.

Adult↗

In vitro fragmentation of gallstones: comparison of electrohydraulic, electromagnetic and piezoelectric shockwave lithotripters.

To compare the fragmentation efficiency of three different shockwave systems, 63 human gallstone triplets were disintegrated in vitro using an electrohydraulic (MPL 9000, Dornier), an electromagnetic (Lithostar Plus, Siemens) and a piezoelectric (Piezolith 2300, R. Wolf) lithotripter. Since each stone triplet was obtained from the same gallbladder, the concrements of one such set were identical in physicochemical parameters. According to the maximal diameter, the calculi were divided into group A (6 to 15 mm) and group B (16 to 30 mm). Shockwave application was terminated when residual fragments measured 4 mm or less. Forty-five triplets were fragmented at energy settings mainly used in clinical treatment of patients with gallbladder stones (MPL 9000: 20 kV; Lithostar Plus: setting 9 (maximal); Piezolith 2300: setting 3). The fragmentation endpoint was achieved in group A (n = 3 x 36) with the Piezolith 2300 after median 150 (range = 50 to 500) pulses and with the Lithostar Plus after 150 (50 to 750) pulses compared with 500 (50 to 1,500) pulses using the MPL 9000 (p less than 0.01). In group B (n = 3 x 9) the Lithostar Plus (median = 750, range = 250 to 1,250 pluses) required fewer discharges than the Piezolith 2300 (1,250, 250 to 2,500 pulses; p less than 0.05) and the MPL (1,500, 500 to 1,600 [upper limit] pulses; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Cholelithiasis↗

[Focal size and shock wave pressure: a comparison of three different physical shock wave generators].

Shock-wave delivery and focal size of three different generators-electrohydraulic, electromagnetic and piezoelectric--were compared. Pressure measurements were uniformly made by needle hydrophone (piezoelectric transducer). The smallest focus, 17 x 3 x 3 mm, was achieved with the piezoelectric system (50% isobars), while the focus with the electromagnetic generator was much larger (50 x 7 x 4 mm). With the electrohydraulic generator the focal size of the 60% isobars was 20 mm in the longitudinal axis. The highest pressure, 1512 bar, was achieved with the piezoelectric lithotriptor (mean shock-wave pressure in focus: electrohydraulic 1000 + 100, electromagnetic 1000 + 25, piezoelectric 1400 + 27 bar). The rapid positive pressure rise was followed by a slower pressure fall and a small negative wave. In the focal region the negative pressure wave was between 112 and 200 bar with the electrohydraulic system, 100-146 bar with the electromagnetic one, and 134 bar with the piezoelectric one. The significance of the negative wave is not clear; perhaps it contributes to the development of the cavitation effect and facilitates stone fragmentation.

Electromagnetic Phenomena↗

[Alternative treatment methods in complex fractures and fracture-dislocations of the anterior tarsus].

Obtaining and maintaining an anatomic reduction are the keystones in the treatment of severe midtarsal injuries to avoid long-term disability. The use of the small external fixator or the minidistractor allows an indirect reduction with careful management of the soft tissues. By leaving the external fixation for at least 8 weeks the important length of the medial and lateral longitudinal arch can be maintained. Further advantages are the postoperative observation of the soft tissues and circulation without cast immobilisation.

Adult↗

Electromagnetic shock-wave lithotripsy of gallbladder calculi. Multicentered preliminary report on experience with 276 patients.

The Lithostar Working Group reports on the first 276 patients who underwent lithotripsy of biliary calculi by means of an electromagnetic Lithotriptor (Lithostar Plus from Siemens). Some 66% (183/276) and 27% (75/276) of the patients had solitary and two or three stones, respectively while 7% (18/276) had more than three gallbladder calculi. Calcified calculi were found in 11% of the patients. On an average the patients were treated in 1.6 (range 1.4-2.15) sessions; with the exception of one user the maximal energy (setting 9) was applied. The upper limit of shock waves per session was 1500-6000 (x = 2189 +/- 1058). 17% and 48% of the patients were free from calculi after 3 and 6 months, respectively. During the follow-up period 14% of the patients complained of severe biliary pain and 1.5% suffered from pancreatitis, which was controlled by conservative treatment. In three out of five patients with a transitory cholestatic jaundice endoscopic papillotomy was necessary. Four patients underwent an elective cholecystectomy. Considering the selection of the patients, the results obtained are comparable with those found in other studies.

Cholelithiasis↗

[Differential surgical treatment of ileus of the large intestine].

This is a report about 191 patients with colonic obstruction who were operatively treated between 1984 and 1988. A resection of the tumour was carried out in 106 cases while the other patients underwent palliative surgical treatment for various reasons. - A traditional surgical concept proved to be most satisfactory despite the modern forms of treatment such as primary subtotal colectomy, intraoperative lavage of the colon with resection and primary anastomosis, the internal bypass or preoperative laser dilatation. According to this concept tumours of the right half of the colon are primarily resected in the form of a right hemicolectomy; tumours of the left flexure undergo a two stage and those distal to the left flexure a three stage procedure. These principles were consistently applied in our patients and this resulted in an operative mortality of 0% after excluding patients who had a primary septic condition. In contrast, the operative mortality in the patients who were septic because of a colonic perforation (n = 23) was 47.8%. The worst prognosis could be found in cases with a perforation away from the tumour in the oral overdistended bowel such as coecum and ascending (n = 12). Here, the mortality was even 75% while true tumour perforations - which were usually sealed off - had a mortality of only 10% (n = 10). The main problem in the treatment of colonic obstruction, therefore, seems to be the patients who have a concomitant septic condition.

Aged↗

[Comparative evaluation of the potencies of external corticoids with various test methods].

In order to classify the new topical preparations amcinonide cream and prednicarbate cream according to the order of potency laid down by the EEC commission, we performed a number of test series in healthy young persons. Betamethasone valerate cream, clobestasol propionate cream, flumethasone pivalate cream, hydrocortisone butyrate cream, and hydrocortisone cream were comparatively tested. In addition, we included a cream base without any active substances in every test series. By means of the vasoconstriction test we were able to establish the order of rank according to potency starting from clobetasol propionate to hydrocortisone. Thus amcinonide was classified as a very strong corticoid preparation, whereas prednicarbate turned out to be moderately strong. The differences in potency between clobetasol propionate and amcinonide on the one hand and prednicarbate, flumethasone pivalate and hydrocortisone on the other hand were definitely proved (p less than 0.01). Further comparative studies were conducted on the basis of the kerosene test, the sorbic acid test, the prick test with codeine, and the anthralin inflammatory test. Moreover, the preparations underwent the formic acid test. The rank orders displayed in the individual tests largely agreed with that obtained by the vasoconstriction test. The exact differences in potency, however, were not as easy to define with the inflammatory tests. Thus the vasoconstriction test must still be considered an excellent screening technique with regard to the selection of corticoid preparations. Subsequently, these preparations should be investigated by means of clinical tests according to their ascertained potencies.

Adrenal Cortex Hormones↗

The biodistribution and pharmacokinetics of meta-iodobenzylguanidine in childhood neuroblastoma.

MIBG is generating considerable interest for the treatment of neuroblastoma. This study has investigated the biological variation in handling of the compound in children with neuroblastoma. The biodistribution of the compound has been characterised in children undergoing tracer administrations of 123I and 131I-mIBG. Estimates of hepatic and whole body radiation dose delivery have been made. The results indicate substantial interpatient variation in hepatic dose delivery. This organ may be critical in some patients undergoing targeted radiotherapy with mIBG.

3-Iodobenzylguanidine↗

[Not Available].

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Germany↗