Biomedical subjects

A Dörfler

Publications and source records attributed to A Dörfler.

42 records · Page 3Linked to original sources

PubMed1987

Pharmacokinetics of ofloxacin in patients on haemodialysis treatment.

Serum concentrations and pharmacokinetic parameters of ofloxacin were measured in 10 patients on haemodialysis treatment. Serum half-life during the interdialytic interval was 48 hours, and during haemodialysis treatment 10 hours. The decrease in serum concentrations during a 4-hour haemodialysis was 25%. After several doses of ofloxacin, saturation of the tissues and a rediffusion of ofloxacin from the tissues during haemodialysis has to be assumed. This equalizes the rate of elimination, and the serum ofloxacin concentration did not change during the last 2 hours of haemodialysis. The negative influence of phosphate binders on the resorption of ofloxacin can be confirmed. The following ofloxacin dosage regimen is recommended in haemodialysis patients: 200 mg initially, 100 mg loading dose after the first haemodialysis, then 100 mg daily.

Adult↗

PubMed1986

[Ofloxacin treatment in nephrologic problem patients with various degrees of chronic renal failure (including dialysis treatment). Preliminary results].

Treatment with ofloxacin in 15 patients with chronic renal failure at different stages is reported with respect to patients undergoing hemodialysis treatment. We noticed the elimination of gram-negative and gram-positive strains, even in patients who had extensive but unsuccessful antimicrobial pretreatment. In the reported collective an interaction between ofloxacin and phosphate-binders on aluminum hydroxide basis has to be considered in the individual cases. The dosage of ofloxacin has to be adapted to the stage of chronic renal failure.

Adult↗

PubMedDate not supplied

Utilization of magnetic resonance imaging in autopsy planning with specimen preservation for thoraco-omphalopagus symmetricus conjoined twins.

Conjoined twinning is a rare obstetric event that has fascinated physicians and laypersons alike for centuries. When this event occurs, early diagnosis, close prenatal management, and the proper route of delivery will assure the best possible outcome for mother and affected infants. Magnetic resonance imaging (MRI) is used both as an ancillary technique to the sonography for the antepartum diagnosis and in the preoperative planning for the surgical separation of conjoined twins. This report describes the MRI findings in conjoined twins of the thoraco-omphalopagus symmetricus type, a condition incompatible with extrauterine life. The twins were delivered at 21 weeks gestation. The MRI was used to evaluate the anatomic nature of the internal anomalies. These findings were then used to develop an autopsy approach plan that preserved the external phenotype. After dissection, the specimen was preserved by using polyethylene glycol and ultimately prepared for use as a teaching specimen.

Autopsy↗

PubMedDate not supplied

Emergency carotid endarterectomy.

OBJECTIVE: Evaluation of the therapeutical efficacy of emergency carotid endarterectomy (CEA) in neurologically unstable patients. PATIENTS AND METHODS: Three groups of a consecutive series of 71 emergency CEAs performed from 1980 to July 1998 were classified: (1) acute onset of severe stroke (n = 16), (2) progressive stroke/stroke in evolution (n = 34), and (3) crescendo transient ischemic attacks (n = 21). Cerebral coma, cerebral haemorrhage, and major ischemic stroke established in cranial computed tomography scans were contraindications for surgery. The neurological outcome was assessed by the modified Rankin scale. Long-term survival and long-term stroke recurrences were analyzed. RESULTS: The recovery/minor stroke rates (Rankin 0-3) in acute stroke, progressive stroke, and crescendo transient ischemic attacks were 56.3, 76.4 and 80.9%, respectively; the combined major stroke/mortality rates (Rankin 4-6) were 43.7, 23.6 and 19.1%, respectively. Intraoperative angiography in 39 patients detected early carotid reocclusions in 2 and intracranial embolism in 7 patients. Local application of thrombolytic agents (n = 5) may contribute to a better neurological outcome in emergency CEA. Life table probabilities of major strokefree survival were 74.5, 71.6, and 53.7% after 1, 2, and 5 years, respectively (including perioperative strokes). Life table probabilities to suffer no stroke recurrence during follow-up were 96.7, 96.7 and 85.3%, respectively (perioperative strokes excluded). CONCLUSIONS: Emergency CEA may be worthwhile in selected patients. Completion angiography is mandatory. Emergency CEA should be included in therapeutic strategies for ischemic stroke.

Adult↗

PubMedDate not supplied

Is stereotactic biopsy a reliable method to differentiate tumor from radiation necrosis?

We report a case of a 37-year-old female who suffered from seizures and underwent external beam radiotherapy due to a suspected low-grade astrocytoma in the left hemisphere. After 7 years free of seizures under antiepileptic treatment and no signs of change in the yearly performed control MRI, she developed a progressive right-sided hemiparesis. MRI now showed an enhancing lesion with space occupying perifocal edema in the entire left hemisphere. Stereotactic biopsy revealed only inflammation. Due to further progress of the neurological deficit an open biopsy was performed. Histological examination revealed a middle-graded astrocytoma and a radiation necrosis. This case demonstrates that radiation necrosis and tumor recurrence may develop concurrently and that it may be difficult to distinguish them by clinical or radiological methods.

Adult↗

PubMedDate not supplied

Potential of CT angiography in acute ischemic stroke.

PURPOSE: To study the ability of CT angiography to show intracranial arterial occlusion and collateral blood flow in patients with acute stroke. METHODS: Twenty-one patients with acute nonhemorrhagic stroke were studied prospectively with conventional CT, CT angiography, and digital subtraction angiography. On the basis of CT angiographic findings, two neuroradiologists independently assessed the site of arterial occlusion, the contrast enhancement in arterial branches beyond the occlusion as a measure of collateral blood supply, and the extent of diminished parenchymal enhancement; they then predicted the extent of ischemic infarction. RESULTS: Both raters correctly assessed all trunk occlusions of the basilar artery (n = 4), the internal carotid artery (n = 4), and the middle cerebral artery (n = 9). The chance adjusted interrater agreement was kappa = .78. The assessment of branch occlusions of the middle cerebral artery was less reliable. The agreement rate in judging the collateral state in 17 occlusions in the anterior cerebral circulation was 88%. The size of 21 (62%) of 34 hemispheric infarctions was predicted correctly. CONCLUSION: CT angiography quickly and reliably adds important information to conventional CT studies in cases of acute ischemic stroke. It shows the site of occlusion, the length of the occluded arterial segment, and the contrast-enhanced arteries beyond the occlusion as an estimate of collateral blood flow.

Adult↗