[Method and clinical use of functional electrostimulation].
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Adolescent↗
Biomedical subjects
E Moritz
Publications and source records attributed to E Moritz.
[Combination of ankylosing spondylitis with dermatomyositis and atypical gout (isolated gout kidney)].
In a 58-year-old man with the clinical and radiological signs of definite ankylosing spondylitis in its final stages, HLA B 27 positive, an onset of dermatomyositis was observed with characteristic clinical, histological, and pathological findings, and with high titers of ANA. It had been discovered years before that a gouty kidney with pyelonephritis accompanied the advanced ankylosing spondylitis. On the basis of these findings a triple association of etiologically different diseases could be diagnosed. After treatment with cortisone, allopurinol, and azathioprine appeared an acute and no longer controllable panmyelophthisis. That a malignant tumor could have caused the dermatomyositis was excluded by autopsy. Diagnostic questions concerning the gouty kidney as well as factors explaining the acute and deadly progress of a panmyelophthisis after the administration of a rather mild immunosuppressive agent are discussed.
Dermatomyositis↗
Circular stapling techniques for low anterior resection of rectal carcinoma.
BACKGROUND/AIMS: This report provides our experience in 103 patients with adenocarcinoma of the rectum along with a general overview of the use of circular stapler in rectal surgery. MATERIALS AND METHODS: Forty-two patients were randomized to a rectal anastomosis using either the single (SST) or double stapling technique (DST). RESULTS: From February 1991 to the present, 61 consecutive patients were treated to a rectal anastomosis using the DST. Perioperative mortality was 4.7 percent unrelated to the use of staplers. Statistically significant differences were noted: the mean distal resection margin measured 25.3 mm for SST and 35.0 mm for DST (p = 0.0274), without doughnut rings. Anastomotic stricture occurred in 3 patients (25%) using the 28-mm cartridge and in 1 (1.4%) using the 31-mm cartridge, respectively (p = 0.0082). To evaluate the different stapling techniques with bacterial contamination, the drain fluid was examined for lysozyme activity. When the SST was used, statistically significant enzyme activity increased as compared with the DST. Clinical leaks were noted in 9.5 percent (2/21) of the SST and in 2.4 percent (2/82) of the DST. The median follow-up of patients in the randomized study was 45 months (range, 32-62 months). Of the patients who underwent a potentially curative resection, seven (17.9 percent) developed a local recurrence, with no statistically significant differences in the stapling techniques of local recurrence and overall survival. CONCLUSIONS: Our experience, and that reported in literature, suggests that the double stapling technique is useful for restorative resection of rectal cancers.
Adenocarcinoma↗
Early detection of anastomotic leaks after colorectal surgery by measuring endotoxin in the drainage fluid.
BACKGROUND/AIMS: Early detection of anastomotic leaks after colorectal anastomosis is essential for adequate intervention to prevent peritonitis. We investigated whether the measurement of endotoxin (LPS) concentrations in the drainage has any value for the early detection of anastomotic leaks. MATERIALS AND METHODS: Twenty two patients with colorectal anastomosis were enrolled in this study, 3 developed clinically established signs of anastomotic leaks and 19 recovered without complications. LPS concentrations in the drainage, the total daily excreted LPS amounts, leukocyte and thrombocyte counts, plasma urea and creatinine, and body temperature were measured for up to 8 days after surgery and tested for their value to detect anastomotic leaks. RESULTS: LPS concentrations in the drainage fluid and daily excreted LPS amounts of patients with anastomotic leaks were significantly higher compared to the group without anastomotic leaks. On the third postoperative day, LPS concentrations ranged from 5270 to 6750 pg/ml in patients with anastomotic leaks and from 1 to 1848 pg/ml in patients without complications. Total daily excreted LPS amounts were 270-675 ng/day in patients with anastomotic leak and 0-92 ng/day in patients without anastomotic leaks. Both LPS-related parameters allowed reliable detection of anastomotic leaks on day 3 after surgery (Student's t-Test, p < 0.0005), while leukocyte and thrombocyte counts, plasma urea and creatinine, and body temperatures of both patient groups were not significantly different at any time (p > 0.05). CONCLUSION: We found that the measurement of LPS concentrations in the drainage and the daily excreted LPS amount could be valuable parameters for the early detection of anastomotic leaks as early as on the third post-operative day.
Adult↗