PubMed Health⌕ Search

Biomedical subjects

H J Meyer

Publications and source records attributed to H J Meyer.

At least 19 recordsLinked to original sources
PubMed2005

Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP).

A case of fatal pulmonary embolism with acrylic cement occuring during a percutaneous vertebroplasty on account of a fracture of L1 is described. Autopsy confirmed the presence of large amounts of surgical cement in the paravertebral venous system and in the pulmonary arteries. This rare complication occurred because perivertebral venous cement migration was not recognized during vertebroplasty. To our knowledge, this is the first case of fatal pulmonary embolism caused by surgical cement following a percutaneous vertebroplasty.

Aged↗
PubMed2003

[From endoscopic mucosa ressection to gastrectomy. How radical must surgery be for stomach cancer?].

The aim of surgical treatment is complete resection (Ro-resection) of the tumor in all dimensions of its growth, i.e. resection of the tumor infiltrated stomach including the locoregional lymph nodes. This can be achieved by stage- or histology adapted surgery resulting in subtotal distal and total gastrectomy as complementary procedures. Local excision of gastric carcinoma in curative intent is indicated only in mucosal carcinoma of the intestinal type. The extent of lymph node dissection is still under discussion; the results depend on the experiences of the surgeon. Several studies have shown a prognostic improvement after systematic (D2) lymphadenectomy in stage II/IIIA-disease or in patients with a low incidence of lymph node metastases. Pancreas preserving splenectomy is suggested in tumors of the proximal stomach or after direct infiltration of these organs. The Roux-en-Y procedure represents the most commonly used method of reconstruction after subtotal distal or total gastrectomy. The importance of the duodenal passage as well as of the pouch construction must be investigated in prospective studies in the future. This is true for the value of perioperative multimodal treatment options.

Gastrectomy↗
PubMed2002

[Results two years after stapler hemorrhoidectomy versus Milligan-Morgan procedure].

The aim of this investigation was to demonstrate possible advantages of stapler hemorrhoidectomy in comparison to the Milligan-Morgan procedure. 96 patients with an average age of 54 years were treated in a two year period (7/1998-8/2000) by stapler hemorrhoidectomy. The complication rate was 12.5 % and included one mechanical stapler defect, two cases of bleeding, five cases of urinary retention and four of perianal edema. The use of analgesics was small with 70 % requiring no medication at all. Hospitalisation post-operatively was 3.3 days with patients under 65 years old and 4.7 days in those over 65 years. These data were compared retrospectively to that of Milligan-Morgan hemorrhoidectomy (214 patients) performed between January 1990-December 1997. The stapler patients had less pain, fewer complications and shorter hospitalisation. Using a questionnaire, all stapler patients and 50 Milligan-Morgan controls were evaluated. 78 % responded at 13.8 months after stapler hemorrhoidectomy, 63 % 54.1 months after Milligan-Morgan. The degree of satisfaction was high in both groups (93 vs 94 %). One patient in the Milligan-Morgan group suffered a recurrence. No further symptoms had been experienced by 57 % after stapler, 68 % after Milligan-Morgan procedure. Faecal continence represents a problem in the stapler group. Stapler hemorrhoidectomy is an effective treatment for IIIrd degree hemorrhoids. In comparison to the Milligan-Morgan procedure, it has advantages in the early post-operative period. Defecation problems can occur with an unknown prognosis. Without long-term results and because of the comparatively high cost of the procedure the indication for stapler hemorrhoidectomy should be carefully made.

Adult↗
PubMed2002

Efficacy of a 1% lambdacyhalothrin cattle Pour-on (Saber) against sucking and biting lice infesting beef cattle.

Four studies were conducted to determine the efficacy of a 1% lambdacyhalothrin pour-on (Saber Pour-on, Schering-Plough Animal Health) for control of sucking lice (Linognathus vituli, Haematopinus eurysternus, Solenopotes capillatus) and biting lice (Damalinia bovis) on beef cattle. Seventy-four mixed-breed cattle naturally infested with one or more species of lice at locations in Wisconsin, Nebraska, Oklahoma, and North Dakota were included in the study. Pretreatment lice samples were taken and identified by genus with the exception that sucking lice were not identified by genus at the North Dakota site. In January or February, half of the cattle at each location received a single application of 1% lambdacyhalothrin pour-on at 10 ml per head for cattle weighing less than 273 kg (600 lb) or 15 ml per head for cattle weighing 273 kg or more. The other cattle at each site served as untreated controls. Lice on designated body areas were counted 2, 4, 6, and 8 weeks after treatment, and the sum of all lice observed on each counting area was reported for each animal. The collective efficacy 6 weeks after treatment against three species of sucking lice (L. vituli, H. eurysternus, S. capillatus) was 88.4% at the Wisconsin site, 92.0% at the North Dakota site, and 100% at the Nebraska and Oklahoma sites. The 1% lambdacyhalothrin pour-on eliminated all biting lice within 2 weeks after treatment, and no biting lice were detected 8 weeks after treatment. A single treatment of 1% lambdacyhalothrin pour-on administered when lice populations were highest (January or February) provided effective season-long control of both biting and sucking lice on cattle.

Administration, Cutaneous↗
PubMed2001

[Developments in inguinal hernia based on newly introduced intervention techniques in the North Rhine district].

In Germany inguinal hernia surgery has changed over the last decade from conventional repairs without alloplastic material to video-assisted minimal invasive techniques or Lichtenstein repair. Since 1991 every patient undergoing inguinal hernia repair has been documented in the North-Rhine area in a routine quality-surveillance study. A total of 173,923 patients with 192,718 groin hernias (85.26% male and 14.74% female) were operated on. In 1993 the Shouldice repair was performed in 54.2%, the Bassini operation in 26%, the transabdominal laparoscopic TAPP repair in only 3.2% of cases. In 1999 the TAPP repair was performed in 13%, the extraperitoneal video-assisted TEP repair in 14%, Lichtenstein repair in 18.5%, Shouldice repair in 35% and the Bassini operation in only 4.8%. The percentage of operations was 13.4% over the last 10 years. However, there was an increase from 12.8% in 1993 to 14.1% in 1997, and a rate of 13.5% in 1999. The following complications were observed: hematoma/seroma formation in 3.78%, wound infection in 1.15%, testicular edema in 0.37% and scrotal edema in 0.64%. The data document the introduction of three new methods for inguinal hernia repair (TAPP, TEP and Lichtenstein repair). A decrease in operations on recurrences is not observed.

Female↗
PubMed2001

[Multimodality therapy concepts in stomach carcinoma].

The prognosis of gastric cancer is still poor even after curative R0 resection. Therefore, among various multimodality treatments a lot of phase II/III studies have been carried out evaluating preoperative chemotherapy. Although some positive results have been obtained after this procedure, neoadjuvant chemotherapy is still an experimental approach. In the future the prediction and evaluation of response must be defined more exactly. Using intraoperative radio- or intraperitoneal (hyperthermal) chemotherapy reduction of regional relapse or peritoneal carcinomatosis could be obtained without increased survival in general. According to experience in Japan adjuvant (immuno-)chemotherapy can increase the overall survival rates and even in the Western hemisphere some actual studies with adjuvant chemo- +/- radiotherapy could demonstrate a benefit of survival in patients with lymph node metastases. Nevertheless, multimodality treatment strategies must be investigated in further uniform prospective study protocols.

Clinical Trials as Topic↗
PubMed2000

Water-binding solid scintillators: synthesis, emission properties, and tests in 3H and 14C counting.

Spectral and time-resolved fluorescence properties as well as relative fluorescence quantum yields of carbodiimide derivatives of 2.5-diphenyloxazole (PPO) (prepared by H2S elimination from the corresponding thioureas), of some intermediates in the preparation, and of several other PPO derivatives were investigated in solution and in the solid state to test their suitability as solid scintillators. The carbodiimides reacted slowly with water under acidic conditions to yield ureas. These systems were compared with solid mixtures of other PPO derivatives with sodium sulfate as a drying agent, as chemically water-binding solid scintillators in 3H and 14C counting. Both the chemically and the absorptive water-binding scintillators proved capable of counting 3H and 14C decay, and open a way to the counting of aqueous samples by solid scintillators without a drying step.

Carbon Radioisotopes↗
PubMed2000

Functional results of reconstruction after subtotal or total gastrectomy.

The aim of surgical treatment of gastric cancer must be complete removal of the tumor including systematic lymphadenectomy. The performance of R0-resection has to take into consideration tumor site as well as the histomorphological type described by Lauren. Therefore, subtotal distal- or total gastrectomy are complementary operative procedures nowadays. From the oncological point of view proximal gastrectomy might be indicated in some situation but increased postoperative morbidity including severe reflux-esophagitis can be obtained. According to the functional outcome subtotal distal gastrectomy should be preferred whenever justified oncologically in comparison to total gastrectomy. Among the different reconstructive methods after total gastrectomy the Roux-en-Y technique is one of the most common procedure performed. Furthermore, some patients can benefit from a reconstruction of a gastric substitute and maintenance of duodenal passage but the superiority of this technique must be evaluated in further prospective studies. The question of the optimal mode of reconstruction of the upper gastrointestinal tract is still open.

Anastomosis, Roux-en-Y↗
PubMed1999

Lymph node dissection for gastric cancer.

Complete tumor removal with margins of clearance at the resection lines must be the aim of today's surgical treatment of gastric cancer, and this must be applied even in lymph node dissection. But, over the last few decades, the extent and impact of lymphadenectomy remains controversial. Whereas Japanese centers advocate extensive lymph node dissection as the base of their excellent results, many Western surgeons, supported by actual randomized trials, believe that the potential benefit of such procedures cannot outweigh the risk of increased postoperative morbidity and mortality. However, if lymphadenectomy is restricted to the removal of nodes only, it does not influence the operative risk. Further, the lymph node ratio and number of lymph nodes involved are relevant prognostic parameters. Survival improvement can be achieved in a moderate degree of metastatic involvement of the nodes (pN0,1). Therefore, systematic lymph node dissection should be an integral part of the curative resection sought. Limited or no lymphadenectomy might be indicated in noncurative surgery or in special types of mucosal early gastric cancer, respectively.

Humans↗
PubMed1999

Experimental animal myopia models are applicable to human juvenile-onset myopia.

Landmark explorations by Hubel and Wiesel investigating the importance of visual impressions in postnatal development of the visual system demonstrated that neural connections and eye growth can be affected by the absence of a clear retinal image during a critical period of postnatal development. Fundamental theories on neural plasticity and deprivation have recently been established that presume that a reduced quality of the retinal image during infancy and early childhood triggers an elongation of the posterior chamber of the eye, a so-called form deprivation myopia (FDM). In a retrospective multicenter study of 187 patients who suffered from phlyctenular keratitis with corneal opacification since early childhood, we reviewed data on gender, year and age at onset of the disease, refraction, and ultrasound biometry. Compared with the average refraction of +0.5 diopter (D) found in the general population, the mean refraction of -4.43 D that we found in our study demonstrated a marked shift toward myopia of almost 5 D. Patients with an early onset of phlyctenular keratitis had considerably higher myopia (-6.68 D) than those with a late onset (-1.67 D). Additionally, an axial elongation was confirmed by ultrasound biometry. Our average, axial length was 26.53 mm, compared with the epidemiologic mean of 24.00 mm. This myopic shift of 2.53 mm was caused mainly by an enlarged vitreous cavity. These results support the finding that blur can affect eye growth and lead to FDM not only in animal experiments but also in human beings.

Age of Onset↗
PubMed1999

[Keratoplasty and donor age distribution].

BACKGROUND: In the past corneas from young donors were favored. There are only few reports of PK with old donor corneas. Concerning donor age we were not very stringent in our patients. Therefore many old corneas were transplanted. We present long-term results of these patients and enter again into the unanswered question: Is there a correlation between graft failure and donor age? PATIENTS AND METHODS: We retrospectively analyzed 615 PK out of 1986 to 1991. In addition to own records we requested reports from retreating ophthalmologists concerning graft clarity. Mean follow-up was 37.3 months. Two thirds of our recipients had favorable diagnoses for graft success (keratoconus 30.6%, Fuchs dystrophy 17.6%, bullous keratopathy in pseudophakia 14.1%, keratitis scrophulosa 5.5%). RESULTS: The donor age was between 31 and 98 years, average age 71.2 years (SD 11.8). Out of 615 transplants 61 became cloudy. The mean age of all clear transplants was 71.0 years compared to 72.7 years in opaque transplants. The difference was not significant. Excluding all high-risk patients (herpes, varia, glaucoma, aphakia, Re-OP) 401 patients were left. In this group there also was no significant difference between donor age of clear and cloudy transplants. We finally compared all patients with endothelial problems (Fuchs dystrophy and bullous keratophathy). Even in this group donor age had no significant influence on graft survival. CONCLUSION: In spite of spare resources and hundreds of waiting patients in the past many corneas were rejected on the basis of donor age. Our results should encourage eye banks and cornea surgeons to accept even very old corneas, when other screening criteria are good.

Adult↗
PubMed1999

[Stomach carcinoma. Optimizing therapy by stomach replacement or subtotal resection?].

The extent of surgical resection in the treatment of gastric carcinoma depends on the tumor site as well as on the histomorphological type according to Lauren taking into account the margins of clearance at the oral resection line. Following subtotal distal gastrectomy functional long-term results might be generally better in comparison to total gastrectomy. Among the large variety of operative methods of reconstruction after total gastrectomy the Roux-en-Y procedure is preferred by the majority of surgeons. Nevertheless, according to experimental and clinical trials jejunal interposition technique seems to allow a more physiological gastric replacement with improved postoperative function and quality of life. Furthermore, jejunal interposition can influence the motility of the entire intestinal tract resulting in a better functional outcome. The importance of pouches for gastric substitute with positive impact on the long-term nutritional status must be clarified in further clinical trials. In conclusion, the question of ideal mode of reconstruction of the upper gastrointestinal tract is still open and continues to be found out.

Anastomosis, Roux-en-Y↗
PubMed1998

[Acute appendicitis in advanced age].

In the elderly, both the diagnosis and treatment of acute appendicitis require particular attention. The diagnosis is often made very late with 40% to 80% of the cases already having perforated. Reasons for the delayed hospitalisation include atypical course, reduction in sensitivity to pain in old age, and an inadequate ability to communicate. The prognosis of uncomplicated appendicitis is just as good in the old as in the young patient, but perforation and concomitant diseases worsen the situation appreciably. Early operation is therefore desirable. The preference of the author is for open, rather than laparoscopic, appendectomy.

Acute Disease↗
PubMed1998

[Determination of contour clarity in contrast-enhanced MR angiography: definition and clinical evaluation exemplified by ECG-triggered imaging of the thoracic aorta].

PURPOSE: The sharpness of the vessel contour in 3D contrast-enhanced MR angiography is defined by particular measurements of the signal intensity. To evaluate the facilities of an ECG-triggered data acquisition to optimize the MRA image quality of the thoracic aorta. METHOD: In phantom studies the sharpness of the vessel contour was defined as the distance of the extraluminal signal-minimum to the extraluminal maximum. Afterwards 30 examinations of the thoracic aorta with and without the use of an ECG-triggering were evaluated with regard to the sharpness of the vessel outline. RESULTS: The presented definition of the signal intensity is suitable for objective measurements of the vessel outline. At the level of the ascending aorta, ECG-triggered data acquisition increased the image quality significantly. CONCLUSIONS: An easy, practicable definition enables measurements of the sharpness of the vessel outline. ECG-triggered data acquisition is recommended for optimal visualization, especially of the ascending aorta.

Aorta, Thoracic↗
PubMed1998

[Prognosis of keratoplasty in keratitis scrophulosa peracta].

BACKGROUND: In spite of clear transplants the results of keratoplasty are often disappointing. We looked for possible reasons for these failures. PATIENTS AND METHODS: We analyzed in 204 eyes of 115 patients the factors influencing the prognosis. Our results are based on medical records and on demanded reports of the treating ophthalmologists. Patients were divided after different aspects (method of operation, beginning of the disease, operation of the first or second eye). RESULTS: A frequently associated cataract and the method of surgery (aphakia, one- or two-step, triple procedure) has no influence on the prognosis. However, age of onset and density of corneal scars are crucial. This is especially evident in eyes first operated on. In case of early onset (before the age of five) visual acuity only reached 0.21 average postoperatively, whereas patients with late onset gained visual acuity of 0.59. The fellow eye (n = 89) had postoperative visual acuity of 0.48. In patients with poor postoperative visual improvement (< or = two lines) high myopia was apparent in 50%. CONCLUSION: For estimating the prognosis besides early childhood amblyopia we must take into account high myopia induced by formdeprivation (FDM). Exact evaluation of patients' history and preoperative ultrasound biometry are recommended.

Adult↗
PubMed1998

[Hypothetical and reliable aspects of pre-, intra- and postoperative adjuvant therapy of stomach carcinoma].

The results of surgical therapy of gastric cancer could not be improved in recent years. Therefore, different perioperative modalities were investigated for this tumor. A series of studies could not show any survival benefit using postoperative adjuvant radio- or chemotherapy after complete resection of the tumor. Data available about preoperative chemotherapy in locally advanced tumor stages may demonstrate an increased R0-resection rate after objective remission resulting in a prolonged survival compared to surgery alone. Furthermore, in others trials intraoperative radiation or intraperitoneal chemotherapy could decrease the incidence of locoregional recurrence or peritoneal carcinomatosis and improve the overall survival rate. These treatment modalities, above all preoperative chemotherapy, must be proven in precisely defined patient populations within prospective trials to achieve clearcut data in the future.

Combined Modality Therapy↗
PubMed1997

[Perforation of the cervical esophagus after ventral fusion of the cervical spine. Defect coverage by muscle-plasty with the sternocleidomastoid muscle: case report and review of the literature].

The therapy for spontaneous or artificial perforation of the esophagus remains a controversial matter. The following case report deals with the medical history of an artificial esophageal perforation after operative treatment of cervical disc disease. A 68-year-old male patient underwent a C4/C5 and C5/C6 discectomy with interbody fusion of C7-T1 vertebral body, according to Smith-Robinson. During this operation, a 3-cm-long lesion was made in the posterior wall of the esophagus, which was treated 24 h later with a primary suture. The clinical follow-up was complicated by mediastinitis with subsequent multiorgan failure. After recovery from this critical condition the patient dysphagia, which was related to a persistent lesion in the posterior esophageal wall with endoscopically demonstrated dislocation of a screw. After removal of the screw, the lesion was covered by means of sternocleidomastoid myoplasty. Moderate postoperative dysphagia was successfully treated by bougienage.

Aged↗