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Biomedical subjects

H Roth

Publications and source records attributed to H Roth.

At least 91 records · Page 5Linked to original sources
PubMed1985

Problems in spleen autotransplantation: comparative study of types of implantation in animal experiments.

Iatrogenic localized splenosis presents a seemingly simple surgical possibility for preserving partial function of the spleen. Until now, pathophysiological aspects, such as the drainage direction of venous blood from the spleen, possible splenic diseases in ectopic tissue, and the formation of pseudoabscesses as well as conditions for implantation have been given insufficient attention. In 45 Wistar rats, divided into three groups according to the surgical procedure (implantation in the greater omentum, liver, retroperitoneum), the taking of the grafts were examined macroscopically and histologically. Because of the results, and bearing in mind the mentioned criteria, a new method for spleen autotransplantation is suggested: the implantation into a pediculated flap of omentum and retroperitoneal displacement behind the splenic bed.

Animals↗
PubMed1985

[Cystic duplications of the cervical esophagus].

Cystic duplications in the cervical region are very rare. In most cases compression of the trachea leads to severe symptoms of respiration. Two cases of cystic duplication are described - a nine months old child and a newborn baby. In the first case the cyst was localized on the right side of the thyroid. Extirpation could be done without any complications. The operation on the second case was difficult. The tumor was localized between oesophagus and trachea rotating the larynx.

Diagnosis, Differential↗
PubMed1985

[Fractures in the elbow joint area in childhood and adolescence].

73 cases of elbow joint fractures were treated in our Dep. of Paediatric surgery over a period of 10 years. Most of the fractures in the region of the distal humerus are localized at the ulnar epicondyle and the radial condyle. At the proximal forearm the radial head and the radial collum fractures are dominant in respect to olecranon fractures. Only two cases involved a comminuted fracture of the distal humerus. Due to the fact that only a small number of cases involving a fracture of the radial epicondyle after a luxation of the elbow were registered, it is possible that we paid no attention to this kind of fractures. An early functional therapy in the case of segmental fracture of the radial head must be emphasized among the 11 cases with a conservative treatment. Another 3 cases with a radial head fracture, type Judet III, should be mentioned, because they were treated without reposition but were spontaneously redressed. The operation procedure and the late results by 62 patients are discussed with the results of other examiners. As expected the comminuted fractures of the distal humerus and the radial head had a bad prognosis. Functional relevant dislocations were rare. Only in one case after a conservative treatment of a lateral condyle fracture a development of a valgus position with a pseudarthrosis after a secondary dislocation was observed. In more than 90% of our cases we could achieve a complete anatomical reposition with good to very good functional results.

Adolescent↗
PubMed1985

[Ventral abdominal wall defects--antenatal diagnosis, course of pregnancy and post partum therapy].

The article reports on antepartal sonographic diagnosis and the course and completion of 27 cases with ventral abdominal wall defects. There were 17 cases of omphalocele, 4 cases of gastroschisis and 6 cases of complex ventral abdominal wall defects with associated malformations. In 23 of the 26 women examined prenatally via sonography (89%), the diagnosis was ventral abdominal wall defect. In the 3 cases not diagnosed via sonography, there was one case of intrauterine foetal death. In another case, Potter's syndrome with anhydramnion was found besides a foetal abdominal wall defect, whereas the last unrecognised case had been subjected to sonographic examination outside the hospital only. In 13 out of 17 cases (77%) with omphalocele there were additional malformations. On the other hand, no further associated malformations were seen in the 4 patients with gastroschisis. Complex abdominal wall defects (in the sense of total abdominal wall aplasias or thoracoabdominal gastroschisis, etc.) with multiple associated malformations occurred in the remaining 6 cases. The most frequently seen associated malformations in children with omphalocele were neural tube defects and skeletal malformations (35% each), followed by cardiac and vascular malformations and malformations of the digestive tract. In those women examined in our clinic via sonography who had foetal abdominal wall defects, amniotic anomalies were seen (hydramnion 44%, oligohydramnion 13%). Chromosomal anomalies occurred in omphalocele with 35% incidence. The results obtained point to the necessity of conducting detailed and accurate sonographic examination if a foetal abdominal wall defect is discovered, in order to exclude or confirm further associated malformations.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Muscles↗
PubMed1985

[Spleen autotransplantation--comparative animal experiment study of implantation sites].

Iatrogenically induced local splenosis seems to be a method for the partial preservation of splenic functions with appealing surgical simplicity. Pathophysiological aspects, such as flow direction of splenic venous blood, the ectopic occurrence of potential splenic affections, and the formation of pseudoabscesses as well as the preconditions for nidation of the autografts have not been sufficiently investigated so far. Sixty Wistar-rats, divided into four groups according to the surgical procedure performed (sites of implantation: omentum majus, liver, retroperitoneal space, pedicular omental flap), were subjected to macroscopical and histological studies with regard to the nidation of splenic autografts. Based on the results obtained and considering the above mentioned criteria, a pedicular omental wrap technique with or without retroperitoneal shifting and autograft fixation with fibrin glueing are suggested as the most preferable procedure.

Animals↗
PubMed1985

[Delayed diagnosis in right sided congenital diaphragmatic hernia].

Report on two cases with delayed diagnosis of congenital diaphragmatic hernia. The cause of partial and total opacity of the right chest was recognised only after thoracotomy which followed misdirected diagnostic procedures such as tomography, bronchoscopy and repeated punctures of the pleural cavity. In both cases a transdiaphragmatic liver prolapse with signs of transthoracic liver punctures was found. The diagnostic importance of sonography and if necessary, computed tomography and liver scintigraphy in infancy and childhood, is emphasised.

Diagnostic Errors↗
PubMed1985

[Problem of fracture of the radius head in the child].

Guidelines for the choice of conservative or operative treatment of fractures of the proximal radius are derived from a study comprising 21 children. Postoperative complications and long-term failures are specifically stressed. True intraarticular fractures of the radial head are rarely observed in children. Major problems arise in the treatment of comminuted fractures of the radial head associated with dislocation of the elbow, since these show the worst prognosis. Displaced marginal fractures below 3 mm are suited for early functional treatment using conservative procedures. 18 patients suffered a fracture of the radial neck type III and IV (Judet). Despite low failure rates of the operative therapy, we have recently been refraining from the operation.

Adolescent↗
PubMed1985

Cytotoxicity of lectins on rat intestinal mucosa enhanced by neuraminidase.

The lectins wheat germ agglutinin (WGA) and Concanavalin A (ConA) were perfused into an isolated small intestinal segment alone or after prior perfusion with neuraminidase for a 10 day period in the rat. Intestinal morphometry, intraepithelial Lymphocyte (IEL) and round cell content as well as digestive capacity was measured in the loop and in the adjacent segments. Both lectins induce a mucosal transformation in all segments but ConA is more effective than WGA. Pre-incubation with neuraminidase enhances the action of ConA throughout, whereas only a partial enhancement of the effect of WGA is observed. The mucosal transformation after long term perfusion with the lectins resembles the hyperregenerative adaptation of the mucosa due to gluten in coeliac disease and may thus serve as an animal model for this disease.

Animals↗
PubMed1985

[Influence of the volume of peridural morphine bolus injections on morphine concentration in the cisterna magna of the dog].

14 dogs received randomly a bolus injection of either 2 mg morphine in 10 ml isotonic saline solution or 2 mg morphine in 1 ml isotonic saline solution epidurally at T6. An epidural infusion of 0.16 mg morphine/0.06 ml/h was applied immediately following the 1 ml bolus injection of morphine. Cisternal cerebellomedullary CSF samples were taken at varying intervals to determine free morphine immunoreactivity by radioimmunoassay. Within 20 min after the 10 ml bolus injection the peak CSF morphine concentration of 3594 +/- 910 ng/ml was reached. Following this, CSF morphine levels decreased exponentially and after 48 h 8 +/- 3 ng/ml were measured. The peak CSF morphine concentration of 139 +/- 51 ng/ml was, however, reached only after 2 h following the 1 ml bolus injection plus the infusion treatment. Despite the additional infused amount of 7.68 mg over 48 h the CSF morphine concentrations decreased also exponentially and after 48 h 16 +/- 4 ng/ml were measured. One may conclude, therefore, that the risk of respiratory depression is negligible under epidural infusion treatment following an initial "Low-Volume"-bolus injection of 2 mg morphine, a recommendable method for treating post-operative pain. High-volume bolus injections of morphine should generally be abandoned in epidural treatment of pain.

Animals↗
PubMed1984

[Tumors of the adrenal gland in childhood. Report of 38 patients].

During the past 17 years at the Department für Pediatric Surgery, University of Heidelberg, 38 children aged 1.6 to 14 years were adrenalectomized (unilateral 3.3, bilateral 5). Individual diagnoses were: neuroblastoma 23; pheochromocytoma 5; adrenocortical carcinoma 8; adrenocortical adenoma 4; bilateral nodular hyperplasia 2 cases. Patients with histologically benign lesions are alive and without recurrence more than 5 years after surgery, except one patient who developed Nelson's tumor after bilateral adrenalectomy for Cushing's disease. Of the patients with malignant adrenal tumors 21 died within 18 months after therapy was started, a 7 years old girl with an adrenal carcinoma died after a period of 3.6 years of combined treatment. In most cases of adrenocortical tumors virilization was the prominent feature.

Adenoma↗
PubMed1983

Compliance with disulfiram treatment of alcoholism.

One hundred twenty-four men were randomly assigned to receive disulfiram with a riboflavin marker or riboflavin alone. During a one year follow-up urine specimens were collected at each visit and analyzed for riboflavin. There was a strong relationship between excellent attendance and infrequent drinking. For subjects taking disulfiram there was a high correlation between a subject submitting 15 or more positive urines during follow-up and infrequent drinking. For the disulfiram patients there was also a strong relationship between continuous usage of disulfiram and infrequent drinking. However, the correlation between percentage of urine specimens positive for the riboflavin marker and infrequent drinking was slight. This occurred because a person who was drinking tended to return for follow-up only when he was not drinking and thus submitted only a few specimens of which the majority were positive. We conclude that (1) excellent attendance, (2) submission of a large number of positive urines and (3) a period of continuous compliance to the disulfiram regimen were highly associated with infrequent drinking.

Adult↗
PubMed1983

[Technical aspects of splenectomy].

A detailed report is given on a modified surgical technique of the resection of the spleen. A successive division is performed within the area of the demarcation line after careful study of the vessels. The wound surface is sealed by fibrin and collagen fleece soaked with fibrin and therefore flexible.

Fibrin↗
PubMed1983

[Disturbance of micturition, a harmless side effect of subdural regional anesthesia?].

The authors report on a disturbance of micturition following spinal anaesthesia which due to improper treatment took two months to resolve. The neurological status showed failures which were due both to the anaesthesia (irritation of root in the S 4 and S 5 regions by the spinal needle and action of the local anaesthetic agent) and to the surgery of a relapsing inguinal hernia (irritation existed, we could not exclude the possibility that the primary disturbance of bladder emptying was due to the anaesthesia and not to the surgical procedure of a possible mental component. In any case, the long-term atony resulting from the basically harmless handicap - even requiring placement of a suprapubic bladder fistula - could have been avoided if the postsurgical treatment had been conducted properly and in accordance with good medical practice.

Anesthesia, Conduction↗