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Biomedical subjects

B Neidhardt

Publications and source records attributed to B Neidhardt.

50 records · Page 3Linked to original sources

[Acute abdomen in immune complex vasculitis].

The case of a 51 year old male with 6 months history of loss of weight and abdominal pain is discussed. Laparotomy revealed gangrene of the gall bladder and perforation of the small intestine with consecutive peritonitis. Postmortem examination showed hypertensive intracerebral bleeding and disseminated infarctions of the abdominal organs and the kidneys. Histological findings including immune-fluorescence methods revealed the final diagnosis of immune complex vasculitis.

Abdomen, Acute↗

[Effective treatment of duodenal ulcer with cimetidine (author's transl)].

Twelve male duodenal ulcer in-patients received in a double-blind trial either the histamine H2-receptor antagonist cimetidine (4 X 200 mg/d p.o.) or placebo capsules. Ulcer sizes were assessed endoscopically before therapy followed by repeat endoscopy at weekly intervals. Duodenal ulcer healing was significantly more rapid in cimetidine-treated patients than in those receiving the placebo (chi2 test; P less than 0.0005). Plotting of log ulcer sizes (mm2) against time (days) resulted in regression lines the slopes of which indicated the respective half-time of ulcer healing: about 6 days on cimetidine therapy and about 20 days on placebo treatment. Gastric secretion of acid, protein, pepsin, and N-acetylneuraminic acid-containing glycoproteins was not altered by a 4-week course of daily cimetidine or placebo, nor pancreatic secretion of bicarbonate and enzymes. No statistically significant changes in laboratory findings (haemoglobin, white blood-cells, neutrophils, platelets, alkaline phosphatase, blood-urea, serum-creatinine, GOT, GPT) were associated with treatment.

Adolescent↗

[Determination of splenic size by ultrasonic scanning (author's transl)].

Two dimensional B-Scans make it possible to examine and measure the spleen. In 62 patients the size of the spleen was evaluated by ultrasound; the results were compared with the size of the organ after extirpation: In 58 of 62 cases there were correct results. Therefore, the ultrasonic determination of the splenic size is a reliable method for clinical questions.

Evaluation Studies as Topic↗

[Consumption coagulopathy in a case of cystic spleen (author's transl)].

A case of a 65-year old female patient is reported, dealing with consumption coagulopathy and secondary hyperfibrinolysis due to cystic spleen. Following treatment with heparin, antifibrinolytic agents and replacement of clotting factors prior to surgery, the patient attained a satisfactory condition to be operated on. After removal of the cystic spleen, which was interspersed with massive hemorrhages, blood coagulation returned to normal quickly and continuously. The pathogenesis of consumption coagulopathy in relation to cystic spleen is discussed and it is referred to the pathomechanism of similar blood disorders in hemangiomatous and cavernous lesions of Kasabach-Merritt-syndrome, Klippel-Trenaunay-syndrome and pachymeningeosis haemorrhagica interna.

Aged↗

[Is factor XII deficiency a contraindication to surgery?].

The case of an 18-year-old girl with a moderately severe Hageman factor deficiency (Factor XII 2.5%) is described. In this girl, an osteotomy of the pelvis after Chiari was carried out. Both the operation itself and the postoperative healing process were without complications and no signs of any abnormal tendency to haemorrhage were observed. Blood transfusions were not necessary. On the basis of this observation and a review of the literature for the attempt is made to establish general guide lines the procedure to be adopted for surgery in cases of Hageman factor deficiency.

Blood Coagulation Disorders↗

[Exploratory laparotomy and splenectomy in lymphogranulomatosis (author's transl)].

Exact determination of the extent of the disease is necessary for optimal treatment of lymphogranulomatosis. To this purpose 53 patients with lymphogranulomatosis had an exploratory laparotomy and splenectomy (42 adults and 11 children). On the basis of the operation results the pre-operative staging had to be revised in 14 patients and the treatment plan had to be changed in most cases. Lymphogranulomatosis of the spleen was demonstrable in 27 cases. Histologically the mixed-cell type was most commonly seen in the spleen. The size of the spleen was an unreliable diagnostic parameter as regards involvement with lymphogranulomatosis. In approximately a third of the adults with involved spleens the weight of the spleen was under 200 g. Hodgkin involvement of the liver was demonstrable in three patients; in these three cases splenic involvement coexisted. In seven patients post-operative complications occurred.

Adolescent↗

[Influence of cytostatic combination therapy with vincristine sulphate and iphosphamide on blood coagulation].

Disorders of blood coagulation were investigated before and during a cytostatic combination therapy with vincristine sulphate and iphosphamide (Asta Z 4942) in 12 patients with malignant tumours or haemoblastoses. Thromboplastin time, partial thromboplastin time, thrombin time, heat-dependent fibrin, clot retraction, and clotting factors II, V, VIII, IX, X, and the platelet count were determined. A change in the plasmatic coagulation system attributable to the combination therapy could not be demonstrated in any patient. The influence of the cytostatic combination on the platelet-dependent haemostasis was small; a decrease in platelet count could be observed in only one patient, in whom an additional causative damage to thrombopoiesis due to the underlying disease could be assumed. Regardless of the cytostatic therapy there were indications of a hypercoagulability in 10 patients. This explains the increased susceptibility of such patients for thromboses or consumption coagulopathy.

Adult↗