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Biomedical subjects

T Hess

Publications and source records attributed to T Hess.

At least 145 records · Page 8Linked to original sources
PubMed1979

Treatment of a case of lanatoside C intoxication with digoxin-specific F(ab')2 antibody fragments.

In animal experiments arrhythmias induced by cardiac glycosides which prove fatal if untreated can be terminated by administration of glycoside-specific antibodies. Immunotherapy with digoxin-specific antibody fragments had hitherto only been employed on one occasion, namely in a person who had taken a massive overdose of digoxin with suicidal intent and who had failed to respond to symptomatic treatment. The present paper describes the use of F(ab')2 fragments of digoxin-specific antibodies in a female patient with lanatoside C intoxication to treat the associated life-threatening cardiac arrhythmia. The arrhythmia was rapidly terminated and normal sinus rhythm was restored. Treatment with the heterologous antibodies did not cause any side-effects.

Antibodies↗
PubMed1979

Transient global amnesia after clioquinol: five personal observations from outside Japan.

Five personal observations of an acute amnestic episode in younger individuals after intake of clioquinol are described together with three observations from the medical literature. In five of these cases the episode began after an unusually large dose, in three after a therapeutic one with a latency of about 24 hours. The clinical aspect closely resembled classical transient global amnesia but the episode after clioquinol lasted longer (24 hours to three days) and a more or less extensive retrograde amnesia persisted permanently. In one patient after three tablets of Mexase a clioquinol concentration of 12 microgram/ml in plasma was found 24 hours after the specified dose, which is an unexpectedly high concentration compared to those reported as late as 24 hours after a single equal dose of Mexase or any other clioquinol-containing preparation. Another patient had a brief relapse two years after the first episode, after a single therapeutic dose of another clioquinol preparation.

Adult↗
PubMed1978

The prevention and reversal of digoxin intoxication with specific antibodies.

The formation of digoxin-specific antibodies was induced in sheep by immunization with a digoxin-albumin conjugate. The efficacy of the antibodies was investigated in anesthetized cats. When the digoxin-specific antibodies were administered prophylactically as a gammaglobulin, IgG or F (ab')2 preparation, the dose of digoxin needed to induce ventricular dysrhythmia was significantly greater (p less than 0.001) for the pretreated animals than for the controls. To investigate therapeutic efficacy, the animals were digitalized with digoxin over a period of three days and were given digoxin injections on the fourth day to provoke ventricular tachycardia. Of the control animals, three died before two hours had elapsed and the arrhythmia persisted in the two remaining animals. By contrast, a stable sinus rhythm was restored in all animals which were treated with F (ab')2 fragment of the digoxin-specific antibodies after onset of ventricular tachycardia. The doses of digoxin required to trigger renewed ventricular dysrhythmia in these animals were greater than those required at the start of the experiment. The potential clinical use of digoxin-specific antibodies is discussed in the light of these results and reports in the literature.

Animals↗
PubMed1977

[Sclerosing peritonitis and practolol (author's transl)].

Skin manifestations, eye complications, a nephrotic syndrome, appearance of lupus erythematosus cells and antinuclear antibodies, sometimes combined with a systemic side effects of the beta adrenergic blocker Practolol. Another side effect is though to be sclerosing peritonitis. The latter is identical with the idiopathic fibroplastic peritonitis, described at the turn of this fibroplastic peritonitis, described at the turn of this century by German authors. Our own observation of a case of sclerosing peritonitis is compared with the literature. There is strong evidence for a causal relationship between longstanding Practolol-therapy and sclerosing peritonitis. Practolol was withdrawn from the market in 1975.

Aged↗
PubMed1975

[Mesenteric infarct during digitalis poisoning].

So-called nonocclusive or spastic mesenteric infarction is a well-known complication of severe circulatory failure with low cardiac output and hypotension. In recent years, acute mesenteric insufficiency has been described in connection with certain drugs. Clinical and experimental evidence suggests a relationship between digitalis therapy, especially overdigitalization, and nonocclusive mesenteric infarction. Two cases are presented in support of this hypothesis. Both patients had digitalis intoxication and died from nonocclusive mesenteric infarction proven by surgery, autopsy and, in one case, arteriography. No cause other than digitalis intoxication (shock, severe cardiac failure or other drugs) could be found. Despite the frequent occurrence of digitalis intoxication, nonocclusive mesenteric infarction is a rare event. Interruption of digitalis therapy does not alter the usually fatal outcome. Experimental data with glucagon and phenoxybenzamine suggest that a therapeutic trial with these drugs might be worth while. Digitalis should be used with caution in shocked patients, since in these the splanchnic circulation is usually critical.

Aged↗
PubMedDate not supplied

[Primary stability of autologous and heterologous implants for intervertebral body spondylodesis].

In this study, we tested the stability of the xenograft SURGIBONE and of human iliac crest graft depending on the donor's bone density. The mean load bearing capacity of SURGIBONE was 4816 N, the compressive strength 32.8 N/mm2. This even exceeds the values given by the producer. Yet in clinical use the material caused problems by collapses or lysis of the graft. According to our results, those failures can not be explained by missing primary stability. Perhaps there is a immunogenic reaction of the host against the remaining protein as it once was proved for the "kielspan"-graft. The iliac crest grafts of donors with normal bone density had a load bearing capacity of 3397 N. Grafts of donors with reduced bone density of less than 60 mg/ml Ca-Equivalent showed reduced load bearing capacities of 2265 N. DEXA (Dual-Energy X-Ray Absorptiometry) seems to be suitable to scan preoperatively the iliac crest graft stability in order to recognize the danger of reduced stability by osteoporosis.

Absorptiometry, Photon↗
PubMedDate not supplied

[Experimental studies on the role of intramedullary alignment rods in the etiology of fat embolisms in knee endoprostheses].

Fat embolism syndrome (FES) during implantation of an uncemented resurfacing type of total knee replacement is the leading cause of postoperative mortality. A possible explanation might be the insertion of a solid intramedullary alignment rod, resulting in an intrafemoral pressure increase. On 45 cadaveric human femora we measured the resulting intramedullary pressure during insertion of three different alignment rods: a solid rod and a hollow shaped guiding rod, both 10 mm in diameter, and a fluted alignment rod of 8.5 mm in diameter. The highest intramedullary pressures occurred after placement of a solid 10 mm alignment rod (3.77 +/- 0.44 bar), followed by a fluted 8.5 mm rod (2.53 +/- 0.28 bar). In both cases, the increased pressure led to an extrusion of bone marrow contents through the venous system of the proximal femur. The least increase occurred after insertion of a hollow shaped alignment rod (0.26 +/- 0.03 bar) without any fat extrusion. Our study confirms the hypothesis that insertion of solid intramedullary alignment rods during preparation of the femoral shaft results in a dangerous pressure increase, so that embolization can occur. To minimize the risk of a FES, instruments should be modified in a manner, that only hollow shaped alignment rods are used.

Bone Marrow↗
PubMedDate not supplied

[Proprioceptive deficit following cruciate lesions--afferent disorder or compensatory mechanism?].

It was suggested that the ACL has not only mechanical functions but also acts as proprioceptive organ. In cruciate deficient knees pathological patterns of muscle control were found. These findings could be caused by a disturbed afferent signal from the disrupted ACL or by secondary changes in muscle innervation, which shall protect the instable knee against subluxation. 33 patients with unilateral operative ACL repair (21 cases with primary suture, 12 cases with autogenous ligamentum-patellae-reconstruction; average post op 36.5 yr) were examined clinically and with the KT 1000 arthrometer (MEDMETRIC Inc.). Patients history was evaluated by using the LYSHOLM score. During a cycling task the electromyographic activity was monitored from the thigh muscles (M. vastus lat. and med., lat. and med. hamstrings). In comparison to the ACL deficient patients, we tested 25 healthy subjects of same age and activity level. In the ACL group the following differences to the normals were found: the M. vastus lat. showed a significantly delayed onset, earlier end and shorter duration. M. vastus med. had the same pattern; the delayed begin of activity and the shorter duration were statistically significant. M. biceps femoris showed a significant later onset and shorter duration. So did the medial hamstrings; the differences, however, were not statistically significant. There was no significant difference between operated and healthy leg in the ACL group. By comparing the primary sutures and the ligamentum-patellae-reconstructions no significant differences were found. The instable patients (KT 1000 > 3 mm) of the ACL group showed more distinct differences in the EMG pattern than the patients with stable knee joints.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Comparative biomechanical studies of conventional and self-tapping cortical bone screws].

In normal cortical screws the thread must be cut by a separate thread-cutter. So a high stability of the connection is achieved. On the other hand thread cutting needs time, which may be assumed to several minutes during a plate osteosynthesis. To avoid thread-cutting, self-tapping screws were used 20 years ago. These old self-tapping screws had a reduced stability and a lower torque at the final screw driving so that they tended to destroy the thread. By a modification of the cutting edges at the tip of the screw the tapping quality is increased decisively. The microscopic examination showed a better cutting of the new screws with little difference to a thread-cutter. In biomechanical tests the final torque and the maximum tension force of the self-tapping screws were at the same level as in usual pre-cut screws. In the practical use the new self-tapping screws have a good handling and save time during operation. In osteoporosis, they should be used carefully in order to meet the opposite corticalis' hole and not to destroy the ipsilateral corticalis' thread.

Biomechanical Phenomena↗
PubMedDate not supplied

Primary stability of press-fit-implanted osteochondral grafts. Influence of graft size, repeated insertion, and harvesting technique.

The aim of this study was to evaluate the fixation strength of press-fit-implanted osteochondral grafts with respect to graft size (length and diameter), the effect of repeated insertion after pullout, and harvesting technique. Experiments were performed using the Osteochondral Autograft Transfer System on porcine femoral condyles. Failure loads of 10-mm-long grafts (mean, 47 N) were significantly lower than failure loads of 15-mm-long grafts (mean, 93 N) and 20-mm-long grafts (mean, 110 N) (all grafts, 11 mm in diameter). Reinsertion of the 15-mm-long grafts after initial pullout resulted in a significant reduction of failure loads (mean, 93 N versus 44 N). Failure loads of 8-mm-diameter grafts (mean, 41 N) were significantly lower than those of 11-mm-diameter grafts (mean, 92 N) (all 15 mm long). Levering of the tubular chisel during graft harvest significantly decreased press-fit stability as compared with simple turning of the chisel (mean, 32 N versus 52 N) (8-mm diameter and 15-mm length). These results suggest that primary fixation strength of press-fit-inserted osteochondral grafts depends on the size of the grafts and that repeated pullout and reinsertion of grafts as well as a nonoptimal harvesting technique (levering) will reduce primary stability.

Animals↗