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Biomedical subjects

A Scheidt

Publications and source records attributed to A Scheidt.

15 recordsLinked to original sources
PubMed2001

[Indications and technique for sclerotherapy of varicose veins].

Sclerotherapy is in general a very safe method for the treatment of teleangiectasias and reticular varicose veins done by an experienced therapist. The complication-rate is very low, with the use of Polidocanol the rate of skin-necrosis ranges between 0.001 and 0.2%, the incidence of superficial thrombophlebitis is 0.08%, the incidence of an allergic reaction is reported with 0.2%. The sclerotherapy of large perforating veins and the long or short saphenous veins is controversially discussed. The results of prospective randomized studies show better results with operative treatment in comparison to sclerotherapy. The recurrence-rate of sclerotherapy of the long saphenous vein varies between 22 and 37% after 3 years, between 40 and 70% after 5 years and 94% after 10 years. Before starting the sclerotherapy the extension of the varicose vein disease should be diagnosed correctly. The diagnosis can be obtained with duplex-ultrasound, that gives either functional and morphologic information about the deep and superficial venous system.

Follow-Up Studies↗
PubMed1996

The stentless Toronto SPV bioprosthesis for aortic valve replacement.

The Toronto SPV bioprosthesis for aortic valve replacement has been prospectively evaluated in 100 patients, since March 1993. Intraoperative transoesophageal and postoperative transthoracic echocardiography were used to assess valve function. Follow-up was complete in 74 patients at 6 months and in 38 patients at 1 year. The average valve size implanted was 26.5 mm. Some 37 patients had additional coronary artery bypass grafting surgery. The hospital mortality rate was 4%. Non-structural valve dysfunction occurred in one patient and late endocarditis in another patient required operation. There were no other valve complications. None of the patients developed clinically relevant aortic valve incompetence during follow-up and there was a significant decrease in pressure gradients, increase in valve orifice areas and decrease in left ventricular hypertrophy.

Aged↗
PubMed1995

[New treatment methods in heart valve surgery--the Toronto SPV stentless bioprosthesis].

Stentless valves may be an alternative to conventional stented bioprostheses and homografts. From all tissue valves homografts proved to have the best long term results. But homografts are not always available. Stentless bioprostheses are similar to homografts concerning in implantation technique, valve anatomy and physiologic function. The stentless design leads to remodeling of the left ventricle and the aortic root, resulting in a superior hemodynamic profile. Nevertheless long term results are required.

Adult↗
PubMed1995

Bone marrow fibroblasts from children with aplastic anemia exhibit reduced interleukin-6 production in response to cytokines and viral challenge.

Defects of the bone marrow microenvironment have been implicated in the pathogenesis of aplastic anemia (AA). We examined granulocyte/macrophage colony-stimulating factor (GM-CSF) and IL-6 production in bone marrow fibroblasts from five children with AA in response to cytokines and viral challenge with cytomegalovirus (CMV). Cytokine-stimulated IL-6 production in patients' fibroblasts was significantly reduced, whereas GM-CSF production was found to be comparable to normal controls. Also, CMV-mediated stimulation of IL-6 production was significantly lower in bone marrow fibroblasts from patients with AA. During the late phase of CMV-infection, IL-6 production was suppressed in CMV-infected fibroblasts from patients with AA with 90% inhibition of IL-6 protein production and marked reduction in IL-6 mRNA accumulation. Defective IL-6 production in bone marrow fibroblasts might contribute to hematopoietic suppression in some patients with AA.

Adolescent↗
PubMed1995

The Toronto SPV bioprosthesis: one-year results in 100 patients.

BACKGROUND: We studied the long-term results of heart valve replacement with the Toronto SPV bioprosthesis. METHODS: From March 1993 until July 1994 the Toronto stentless bioprosthesis was implanted in 100 selected patients with a mean age of 70.7 years. The predominant aortic valve lesion was stenosis in 94 and insufficiency in 6 cases. Eighty-eight patients received a valve 25 mm in diameter or larger. Additional coronary artery bypass grafting was performed in 37 cases. Hospital mortality was 4%. Seventy-four patients were seen at 6 months and 38 patients at 1 year follow-up. RESULTS: Structural deterioration, thromboembolism or hemorrhage were not encountered. Nonstructural dysfunction lead to reoperation in 1 patient. Another patient presented with endocarditis at 1 year postoperatively. There were no other valve-related complications. Echocardiographic mean pressure gradients ranged from 7.7 to 11.1 mm Hg postoperatively. There was a significant decrease in pressure gradients at 6 months of follow-up. Minimal aortic valve incompetence was seen in 3 patients. CONCLUSIONS: The Toronto stentless bioprosthesis has superior hemodynamics and is an excellent alternative to conventional stented bioprostheses. Long-term evaluation has to prove whether this promising new valve can live up to its expectations.

Adult↗
PubMed1995

[Thrombosed popliteal aneurysm--a cause of acute lower leg ischemia].

Popliteal artery aneurysms (PAA) frequently remain asymptomatic up to the event of acute thromboembolic occlusion. Acute occlusions in the femoro-popliteal level without cardial source of embolism, a pulsating tumor in the knee pit or preexisting abdominal-or groin aneurysms are suspicious for the disease. Between 01/87 and 07/93 we saw 21 popliteal aneurysms in 14 patients. In 50% of the cases the aneurysms were found bilaterally. Arteriosclerosis was the most frequent cause, in 30% as a generalised dilative angiopathy. 18 aneurysms were operated upon, 11 in the stage of acute ischemia among a total of 190 acute vascular occlusions in the same period. Treatment consisted in total resection and anatomical reconstruction by means of saphenous vein interposition. The patency rate in our patients operated in the stage of acute ischemia was 73% during this observation period; one major amputation was carried out. The postoperative course of all 7 electively operated aneurysms was without complications. PAA is readily diagnosed by ultrasound. Because of the catastrophic consequences of an acute ischemia resulting from thrombosis we also tend to operate asymptomatic cases. For that reason the contra lateral knee of the healthy appearing leg should be included in the examination as well as higher located possible locations of dilatative angiopathy. A thrombotic treatment, PTA, stent implantation or embolectomy cannot be recommended because of remaining wall adhesive thrombi with danger of embolisation.

Adult↗
PubMed1995

[May recurrent goiter be resected bilaterally? Value and results of intraoperative laryngoscopy].

Operations for recurrent goiter are considered to range among the most difficult procedures in thyroid surgery and are marked by unusually high subsequent damages of the recurrent nerve. Results from 89 patients with recurrent goiter operated over the last six years and our own experiences with intraoperative laryngoscopy are presented. This procedure is applicable in 60% of all cases with true bilateral thyroid recurrency and accounts for a realistic help in deciding whether to continue the operation with simultaneous resection of the contralateral side.

Cicatrix↗
PubMed1994

Hemodynamic assessment of the stentless Toronto SPV bioprosthesis by echocardiography.

Since March 1993 the Toronto SPVTM bioprosthesis has been implanted in 100 patients. Our prospective study evaluated the echocardiographic valve characteristics and the influence of the echocardiographic assessment on surgical technique. Transesophageal echocardiography (TEE) was applied before and during surgery, and transthoracic echocardiography (TTE) postoperatively. The average valve size implanted was 26.5 mm. Follow up was complete in 74 patients at six months and in 38 patients at one year. Pre-cardiopulmonary bypass (CPB) TEE valve sizing was accurate by +/- 1 mm in 81 patients as compared to mechanical sizing. Post-CPB valve closure was concentric in 99 patients. Minimal aortic incompetence was present in seven patients at one week, in two patients at six months and in one patient at one year. Mean pressure gradients ranged from 7.7 to 11.1 mmHg postoperatively. Overall mortality was 4%. One patient with non-structural dysfunction and another with endocarditis at one year postoperatively were reoperated successfully. At follow up there was a significant decrease in transvalvular pressure gradients and an increase in valve orifice areas. In 32 patients a decrease in left ventricular posterior wall (LVPW) hypertrophy was found (p < 0.001). There was a decrease in tissue depth and recurrence of the dynamic movement of the aortic root. It is concluded that TEE valve sizing is reliable for early valve selection. Valve incompetence is not a clinically relevant issue using the oversizing technique. Improved hemodynamics at follow up can be explained by remodeling of the aortic root and by a decrease in left ventricular hypertrophy. The excellent hemodynamic profile, resembling native aortic valve function, is impressive and has to be confirmed by long term evaluation.

Adult↗
PubMed1989

[Cytomegalovirus infection and inner ear deafness].

Bilateral sensorineural hearing loss of patients is correlated with elevated antibody titres against cytomegaly virus in serum in children as well as in adults. Unilateral deafness correlates with mumps infection. This is shown in a German population as well as in a Mediterranean group of patients. There is no evidence between antibody titer of Coxsackie virus, adenovirus and herpes virus or toxoplasma gondii interaction and sensorineural hearing loss neither unilaterally nor bilaterally.

Antibodies, Viral↗
PubMed1983

Bacteriologic contamination in an air-fluidized bed.

An air-fluidized bed was found to be a potential bacteriologic hazard when used by heavily infected burned patients. Even after following the manufacturer's protocol for eliminating bacteria from the bed and for cleaning the filter sheet, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus fecalis, Escherichia coli, and Serratia marcescens were recovered. Use of the bed was suspended until an effective disinfecting procedure was developed for the filter sheet and weekly removal of solid materials from the bed was instituted.

Bacterial Infections↗
PubMed1980

A nosocomial epidemic of antibiotic-resistant Serratia marcescens urinary tract infections.

Serratia marcescens is an important pathogen in hospitalized urologic patients. We herein describe an epidemic of 134 urinary tract infections caused by a multipe antibiotic-resistant Serratia marcescens. A common source in the cystoscopy area was responsible for 105 infections Cross-contamination on patient floors amplified the magnitude of the epidemic. There was significant patient morbidity, although no deaths could be attributed directly to the outbreak. Particular attention is directed to patient risk factors and the clinical significance of nosocomial Serratia marcescens infections. The clinical approach to epidemic antibiotic-resistant Serratia urinary tract infection should not rely primarily on antibiotic therapy. Stress is placed on the importance of an interdisciplinary approach to hospital-acquired infections in general and Serratia marcescens urinary tract infections in particular.

Cross Infection↗