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Biomedical subjects

B Lerf

Publications and source records attributed to B Lerf.

9 recordsLinked to original sources
PubMed2006

[Unstable thorax after a coughing fit in a 70-year-old adipose patient].

Lung herniation is uncommon and has been defined as the protrusion of pulmonary tissue and pleural membranes through defects of the thoracic wall. In combination with rib fractures caused by single massive coughing fit, spontaneous lung herniation has previously been reported only three times. To our knowledge, in combination with multiple rib fractures and flail chest, as in the case presented, it has never been reported. Large lung hernias should be treated with prosthetic patches because of unlikely spontaneous recovery and the risk of incarceration. In our case, an anterolateral thoracotomy was performed. After resection of the herniated pleural membrane, a 30 x 30-cm polypropylene mesh was fixed to the diaphragm and with nonresorbable pericostal sutures to the thoracic wall. With this procedure, the loss in stability caused by the ruptured anterior intercostal muscular system could be restored. The postoperative course was uneventful, and the patient was dismissed on day 12.

Aged↗
PubMed1983

[Prolapse of the small bowel through the vaginal vault, following hysterectomy].

Within 7 years 4 cases of prolapse of the small bowel through the vaginal vault stump were observed. These occurred between 5 and 10 years following two cases of radical abdominal hysterectomy for cancer and two cases of vaginal hysterectomy and colporrhaphy. The small bowel was replaced three to six hours following the prolapse by median laparotomy. One patient died following late sepsis after the laparotomy.

Aged↗
PubMed1983

Renal oncocytoma: a rare renal tumor with typical angiographic features.

We report on a case of renal oncocytoma (proximal tubular adenoma) with typical vascular architecture. The vascular supply of the oncocytoma showed a 'spoke-wheel'-like pattern. The typical angiographic features may help to differentiate oncocytomas from hypernephromas and thus diagnose it as such in the preoperative period. By the use of the electron microscope some typical invasions into a small vein could be traced, therefore it seems likely that renal oncocytoma is semi-malignant. Confusion of the renal oncocytoma with a large renal cyst is a classical diagnostic error which can be fatal.

Adenoma↗
PubMed1977

[Septicemia in the intensive care of severely injured patients].

In surgical intensive care septicaemia, confirmed by bacteriological culture, was found in 46 out of 1143 severely injured patients. Source of this complication was infection of the respiratory tract in 43%, intraabdominal infection in 17%, and a septic wound in 15%. Mortality was 50%. Early diagnosis (fever, increase of leucocytes and toxic signs in differential blood count, thrombocythemia, decrease of anorganic phosphate), prophylaxis, and treatment are discussed.

Adolescent↗
PubMed1976

[Arterial stenoses after kidney transplantation].

After 268 kidney allotransplants, 7 cases of renal artery stenosis were observed. An additional 3 patients were referred to use from another center. The outstanding symptom of all 10 patients was hypertension refractory to medical treatment, beginning not later then 10 months after transplantation. In 9 cases there was a murmur over the transplant. In 6 patients hypertension was accompanied by a deterioration of renal function which was resistant to antirejection therapy. The tentative diagnosis was confirmed by selective renal arteriography of the transplant. Two main types of stenoses could be diagnosed: Segmental stenoses, 0.5-2 cm distal to the anastomosis, which were due to intimal lesions caused during removal of the kidney or by the perfusion canula; and kinking stenoses due to a technically inadequate implantation. Hypertension was controlled in all but 1 patient with reconstruction of the artery. Therefore, hypertension after kidney transplantation refractory to medical treatment should be further investigated with selective renal arteriography of the transplant. Stenoses with clinical symptoms which are confirmed by arteriography should be surgically corrected.

Adult↗