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Biomedical subjects

H B Reith

Publications and source records attributed to H B Reith.

49 records · Page 3Linked to original sources
PubMed1989

[The value of sonography in assessing bone transplants--an experimental study].

The ultrasound control after spongiosa substance plasty is, as described, a supportive method to x-ray measurement. The clinical experience and results are most encouraging. Therefore an experimental proof of this method is necessary. The model is the complete lower leg after amputation. The tibia is prepared with autologous and homologous spongiosa substance with and without gradual decalcification. For fresh spongiosa there is an ultrasound examination from three to five mm and to a higher rate for decalcified spongiosa substance. The experimental results are the verification of clinical assessment.

Bone Transplantation↗
PubMed1989

[Ultrasound control of spongiosa transplant--support of radiologic diagnosis].

The x-ray control is standard for spongiosa substance plasty and shows three periods of healing. In the first two periods (vascularisation and osteogenic reaction) the examination is restricted. Ultrasound control is a simple handling method although a hyporesonance or non-resonance of calcareous bone exists. The follow-ups concerning spongiosa substance plasty are made by ultrasound and x-ray control, and more exact assessments are possible. Advantages and disadvantages of ultrasound in extremities are discussed.

Bone Transplantation↗
PubMed1989

[Early functional treatment of rupture of the fibular ligament with a personally developed ankle splint].

The inversion trauma of the ankle joint is one of the most important and frequent injuries. The treatment of recent rupture of the fibular ligament is now a point for discussion. Operative or conservative treatment is possible. The clinical evaluation of instability requires radiological control and stress test. With a new ankle splint we reduce pathological inversion of the ankle joint, so that we introduce a functional treatment. Our experience with this method will be demonstrated. 45 patients more than a half year after trauma reported good-to-excellent results. The objective evaluation shows in 95% good-to-excellent results. A secondary ligament reconstruction was not necessary.

Adult↗
PubMed1988

[The external ring fixation--experimental studies of bending stability in distraction osteosyntheses].

There is a high axial load for lower leg distractive osteosyntheses with external fixation systems. In searching for a high rigidity comparative investigations on the stability with different external fixators were carried out by an own-developed material testing machine. Our anular fixator showed more rigidity than a three-dimensional ASIF-external fixateur. The use for infected fractures by changing the treatment, pseudarthrosis and also distractive osteosyntheses with weight bearing (for example Ilisarov-method) is possible.

Biomechanical Phenomena↗
PubMed1987

[Treatment of tibial fractures with external ring fixation--I].

Notwithstanding the generally known principles of therapy, indications can be enlarged by use of an annular fixator to cover the following applications: 1. stage fractures of the tibia, 2. stabilisation of fractures of polytraumatised patients with no need for anatomic reposition in the first place, 3. closed lower limb fractures with soft tissue lesions. Possible unlimited correction of primary and secondary dislocations without the need for transposition of Steinmann pins already implanted, compatibility with AO external fixation systems for supplementary use of annular fixator elements for possible management of secondary dislocations and variable placeability of pins or screws for subsequent wound debridement and muscle flap transposition are major advantages of the annular fixator. Results so far obtained from use of the annular fixator are described by clinical examples.

Adolescent↗
PubMed1987

[Transfixation method--treatment of tibial fracture with external ring fixation--II].

The transfixation method first introduced by Böhler has been modified by means of a self-devised annular fixator and has thus been re-introduced by the authors of this paper, with the view to reducing the drawbacks of conservative and surgical treatment of closed lower leg fractures. Reposition of the fracture is achieved by means of this paper, with the view to reducing the drawbacks of conservative and surgical low. Retention is followed by application of a plaster cast up to the knee, with the Steinmann pins covered. Technique, indication, and results are described. Successful fracture consolidation was achieved in good position and with good functional results in all cases.

Bone Nails↗
PubMedDate not supplied

Improved sensitivity of fuzzy logic based tumor marker profiles for diagnosis of pancreatic carcinoma versus benign pancreatic disease.

BACKGROUND: The definite diagnosis of pancreatic tumors of unknown origin remains a clinical challenge. Imaging techniques may fail to differentiate malignant tumors from inflammation, especially in chronic pancreatitis. In a considerable number of cases, the definitive diagnosis needs laparotomy. Single tumor markers as CA 19-9 or CEA are of limited value in these cases because of their limited sensitivity and specificity. This study was performed to find out, whether a classification method based on fuzzy logic analysis of tumor marker profiles is feasible in patients with pancreatic carcinoma and benign pancreatic disease. PATIENTS AND METHODS: Tumor markers and other clinical and laboratory parameters of 74 consecutive patients, either with histologically proved pancreatic carcinoma (n = 43) or presumed benign pancreatic disease (n = 31) assessed by ultrasound, endoscopic retrograde pancreatography, or computed tomography were analysed in order to detect their diagnostic value in the multi-dimensional approach of fuzzy logic analysis. RESULTS: Given a specificity of 95%, sensitivity was considerably increased by the fuzzy logic method (83%) compared with the best single tumor marker CA 19-9 (65%). CA 19-9, CYFRA 21-1 and CA 15-3 gave the most considerable contributions to the classification system, whereas CEA, CA 125, CA 72-4, AFP, liver enzymes, lipase, amylase, bilirubin, and ferritin were of no or little value. CONCLUSIONS: Tumor marker profiles analysed with the fuzzy logic method may have an improved sensitivity compared with single standard tumor markers. The diagnostic efficacy should be proved in patients with pancreatic tumors of unknown origin.

Adult↗
PubMedDate not supplied

Spontaneous intracerebral hemorrhage following carotid endarterectomy. Experience of 328 operations from 1983-1988.

In a consecutive series of 328 carotid endarterectomies there were two cases of postoperative intracerebral hemorrhage. The patients with transient ischemic attacks and subsequent major cerebral infarction had repair of their very tight carotid stenosis. Each developed intracerebral hemorrhage after a symptom free interval and hypertension was uncontrolled during the postoperative period. Hypertension is a significant complication of carotid endarterectomy and may be a prominent factor in the development of intracerebral hemorrhage after carotid endarterectomy. Also defective cerebrovascular autoregulation in chronic ischemic brain regions may predispose patients to intracerebral hemorrhage.

Cerebral Hemorrhage↗
PubMedDate not supplied

"Ring fixator" for treatment of lower leg fractures. A review of 30 cases treated by a new external fixation system.

Besides generally known therapeutic practice, indications can be discovered and more easily evaluated by using a "Ring Fixator". Applications include the following: (1) stage fractures of the tibia, (2) stabilisation of fractures of polytraumatized patients with no need for prior anatomical reduction and (3) closed lower limb fractures with severe soft tissue lesions. The major advantages of the "Ring Fixator" include the following: possible unlimited correction of primary and secondary dislocations without needing to transpose implanted Steinmann-pins or Schanz' screw; compatibility with ASIF external fixation systems for supplementary use of "Ring Fixator" elements; possible management of secondary dislocations and variable placement of pins or screws for subsequent wound debridement and muscle flap transposition. Results so far obtained using the "Ring Fixation" are illustrated by clinical examples.

Adult↗
PubMedDate not supplied

[Role of surgery in the treatment of severe acute necrotic pancreatitis].

Between May 1975 and December 1991, a total of 208 patients were operated upon for severe acute necrotic pancreatitis. The decision whether to operate on patients with clinical and biologic aggravation despite particularly sustained intensive care was taken after evaluation of ultrasound and CT scan images. Combining pancreatic body resections and necrotic tissue excision with laparostomy and staged lavage drainage reduced global mortality rate from 49.2 to 16.4 p. cent. The criteria used for determining the indication for surgical intervention, and the technical and tactical operative procedures applied allowing this improvement, are described and discussed.

Acute Disease↗
PubMedDate not supplied

Cytokine activation in patients undergoing open or laparoscopic cholecystectomy.

BACKGROUND: Laparoscopic surgery is estimated to produce a minor surgical injury in comparison with open and laparoscopic cholecystectomies. Studies in the past compare almost data of the first hours until day two. However, the surgical injury and the wound healing metabolism has to be detected. METHODS: A prospective study was designed to investigate cytokine responses after surgical injury. Twenty-three patients with symptomatic cholelithiasis were admitted to the study. Eleven patients underwent conventional (open) and twelve patients laparoscopic cholecystectomy. Circulating concentrations of cytokines-including Interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-alpha) and neopterin, were compared between both groups. In addition, association of the cytokines with clinical parameters including leucocytes, urea, fever and C-reactive protein (CRP) were assessed. We are using ELISA-test of Medgenix GmbH, Ratingen, Germany and BRAHMS Diagnostica, Berlin, Germany. RESULTS: Enhanced cytokine responses were observed in the conventional group compared to the laparoscopic group. On day 3 after operation, the second increase in cytokine levels (but smaller than the first increase) were observed in both groups. In the conventional group, a slightly high correlation ratio between the urea and cytokine levels was found. However, only neopterin and urea association on postoperative day 3 (r = 0.65) was significant (p < 0.05). There was no significant association between CRP and cytokine levels in both groups. CONCLUSIONS: Cytokine response after cholecystectomy demonstrates the lesser degree of surgical injury in the laparoscopic group, however, TNF-alpha demonstrates on day 4 a similar increase in both groups. This is a new result of studies working in this field. In conclusion, the benefit of laparoscopic surgery results only in the minimal access to the abdominal cavity, the wound healing metabolism is at last the same in both groups.

Aged↗
PubMedDate not supplied

Left cerebral hemi-neglect following carotid TEA: diagnostic, pathogenetic and therapeutic considerations.

OBJECTIVE: This paper describes the first case report in the literature of a hemi-neglect following carotid desobliteration. The disorder is explained in detail and diagnostic as well as pathogenetic aspects are discussed in depth. SUBJECT: Hemi-neglect syndrome is thought to be a rare complication after carotid-desobliteration. It describes a neuropsychological disorder which can affect motor, sensory and visual modalities, either singly or in combination. The diagnostic approach is rather simple but requires thorough clinical assessment. It can be caused by embolic or hemodynamic reasons; the clinical findings in either case are highlighted and discussed in detail. CONCLUSIONS: Pre-operative diagnostic evaluation and perioperative management of patients with ICA-stenosis should be undertaken in close co-operation between surgeons and neurologists. This way, the risk of developing neurological complications (i.e. neglect) after surgery can be estimated in the individual case. In high risk cases, indication for surgery should be seen critically.

Aged↗