[Not Available].
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Animal Population Groups↗
Biomedical subjects
S Kleine
Publications and source records attributed to S Kleine.
[Does velopharyngoplasty as a speech-improving measure in cleft palates lead to obstructive sleep apnea?].
Velopharyngoplasty performed to correct velopharyngeal insufficiency in cleft palate patients may cause obstructive sleep apnea in individual cases. The aim of this study was to answer the question, following velopharyngoplasty to what extent and with what frequency can signs of breathing disturbances during sleep be observed. Following the recommendations of the German Sleep Society, a step-by-step procedure was adopted. In 25 patients, in some cases before the operation and in all cases following surgery, nightly oxygen saturation, heart rate, and snoring were recorded. When observable pathological signs surfaced, a cardiorespiratory polygraph was taken. Up to this point only quickly passing signs of sleep related breathing disturbances have been observed. In not a single case could lasting sleep related breathing disturbances as a result of velopharyngoplasty be proven. Nevertheless, the call for pulse oximetric monitoring in the immediate postoperative phase together with corresponding pre-operative observation is legitimate. Even if at this point the danger of sleep related breathing disturbances following velopharyngoplasty appears to be minimal, these preliminary results should be polysomnographically studied within the framework of a much larger test study in order to reach still more reliable conclusions and in order to intercede if necessary with counter measures in the rare individual case of breathing disturbance during sleep following velopharyngoplasty.
Adolescent↗
[Valine and branched-chain amino acids in the treatment of hepatic encephalopathy].
We studied the effects of infusion of a liver adapted amino acid solution (Amino-Mel hepa: Group A) versus a liver adapted amino acid solution plus L-valine (Amino-Mel hepa + L-valine: Group B) in 30 patients with decompensated liver cirrhosis with coma. Each 15 patients were randomly allocated to the group A and B, respectively. Both regimens included the infusion of glucose and fat, further supplementation of vitamins and trace elements in addition to the amino acid solution. The results of this study show that in patients with advanced stage of hepatic coma a valine increased supply of branched chain amino acids neither influences the course of the disease nor the death rate. The prognosis of patients with this disease is mainly determined by liver function and accompanying complications.
Amino Acids, Branched-Chain↗
[Value of ultrasound tomography in the diagnosis and follow-up of fatty liver].
In a prospective study 187 patients with diffuse fatty infiltration of the liver, estimated by ultrasound tomography, were investigated. In any case the history as well as the results of clinical investigation and the lab findings were known to the observer. Liver blind punctions were performed after a short time, on an average of 11 days. In 91.4% the sonographic diagnosis "fatty infiltration of the liver" could be confirmed by histological findings, while in the other cases the diagnosis was incorrect or incomplete respectively. Following sonographic criterions any results were graduated into three groups and compared with the percentage of fat infiltrated liver cells found by histological investigation. There was a high accuracy in patient with fatty liver: 90.9% could be established by ultrasound tomography. Only in those cases, in which the sonographic diagnosis "fatty infiltration" is not confirmed by case history, clinical and lab findings, the liver biopsy is to be performed.
Biopsy, Needle↗
[T cell subpopulations in peripheral blood and liver tissue in acute HBsAg-negative hepatitis].
By means of monoclonal antibodies against surface antigens of mononuclear cells we examined alterations of T-cell-subpopulations of peripheral blood and liver tissue in the course of acute HBsAg-negative hepatitis. Used methods for determination were the immunofluorescence for blood lymphocytes, respectively the peroxidase-anti-peroxidase-(PAP)-technique for round-cell-infiltrates of the liver based on paraffin fixed sections. The focus of attention was the relation of T4-(helper/inducer) to T8-(suppressor/cytotoxic) cells, the so-called immuno-regulatory quotient. With advancing improvement in the course of the disease we observed in peripheral blood a decrease of T4+/T8+ ratio from very high (3.6) to normal (1.9) values. By examination of the tissue round-cell-infiltrates we found a contrary behaviour to the peripheral blood with a low T4+/T8+ ratio in the liver, characteristic to more acute phases and due to an T8+-cell interchange between periphery and liver. This may be common for all virus diseases and without specificity for defined types of acute hepatitis. Beside this exists the possibility T4+/T8+ ratio has any prognostic value.
Female↗
[Initial clinical experience using an interdisciplinary management concept for pregnant patients with liver damage].
Among 6,404 deliveries in 49 cases (0.8%) a liver disease was diagnosed in the course of pregnancy. The onset of the disease happened exclusively in the last trimester of pregnancy. In 36 pregnant women a hyperbilirubinaemia of diagnostic value was stated. As an informing diagnostic procedure the only determination of the alanine-aminotransferase activity has been proved to be sufficient. In every fifth pregnant woman the liver disease was observed in connection with a preeclampsia. The preterm delivery rate was 16.3%. An intrauterine growth retardation was found in 22.4% of women with hepatopathy during pregnancy. In 5 out of 34 patients asked for a post partum control a manifestation of the liver disease, respectively a cholecystopathia, was present and follow-ups were necessary. An interdisciplinary concept of treatment is emphasized to treat these pregnant women in cooperation with the specialist of internal medicine. Methodically an additional sheet of documentation is used, which contains important data of patients history and all obstetrical, clinical and laboratory results accompanying the pregnant woman during pregnancy and post partum controls.
Combined Modality Therapy↗
[Functional muscular abdominal distension--a case report].
The rare clinical picture of the functional muscular distension must be demarcated from organic changes which are connected with an increase of the abdominal volume such as intraabdominal tumours, accumulations of fluid or gatherings of gas or pregnancy. In this symptom a functional disturbance is concerned which appears in patients with vegetative lability or psychic peculiarities and by changes of tension of the musculature surrounding the abdominal space leads to the intermittent or chronic protrusion of the abdomen. By means of an anaesthesia the presence of a functional cause can be made evident: after injection of anaesthetics the protruding abdominal wall is subsiding. The knowledge of the picture of the disease saves long diagnostic ways which contribute to the fact to fix labile patients extremely to the observation of their abdomen and to favour the manifestation of a neurosis. The often unsatisfying therapeutic long-term effect is in contrast to the harmlessness of this symptom.
Abdominal Muscles↗
[Pathogenesis, clinical aspects and development of fatty liver].
Anamnestic, clinical, biochemical and bioptic examinations were performed in 127 patients with fatty infiltration of the liver of different degrees of severity. Anamnesis, clinical practice and laboratory findings can only throw the suspicion on the fatty infiltration of the liver. For the verification of the diagnosis and for the gradation first of all the liver biopsy is necessary. Alcohol clearly plays the most important part as a cause of the development of the fatty infiltration of the liver, followed by adiposity, diabetes and hyperlipoidaemia. Because of the great medical and social-economic importance fatty infiltration of the liver cannot longer be taken for a harmless disurbance.
Adult↗
[Hepatological aspects of surgical interventions in the stomach].
By means of quantitative-biochemical and histomorphological methods after vagotomies changes of the liver could be proved to a smaller extent than after resections of the stomach (Billroth II). Among the bionomic operation methods the supra-selective proximal vagotomy without pylorplastics is superior to other methods under the aspect of the change of the liver.
Gastrectomy↗
[Pneumoperitoneum without obvious perforation--a case history].
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Abdomen, Acute↗
[Gastrectomy patients--a retrospective study].
Of 39 patients with resected stomach the endoscopic and radiological findings as well as the anamnestic and paraclinical data were analysed retrospectively and compared. In contrast to the patients with recidivation ulcer and stump gastritis the patients with a gastric stump carcinoma had an essentially higher average age and, in general, a considerably longer postoperative interval. The endoscopy, including biopsy, achieved a considerably greater diagnostic security in the various groups of disease than the X-ray examination. Symptoms, such as decrease of weight, gastric pains and vomiting, were most frequently found in patients with carcinoma.
Aged↗
[The effectivity of long-term treatment of porphyria cutanea tarda from a hepatological viewpoint].
34 Patients with an ascertained porphyria cutanea tarda who underwent a long-term therapy a comprehensive internal and hepatological diagnosis was made. In these cases for the first time the estimation of the intrahepatic distribution of enzymes and its comparison with the serum enzymes were also performed. The liver histology allowed a division of our patients into three groups, in which cases the reactive hepatitides prevailed and a conspicuously large proportion of normal histological findings were present. The comparison of all data got with the literature made the conclusion possible that the phlebotomy therapy as well as the care in a special dispensary for years lead to very favourable results on liver and skin.
Bloodletting↗