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Biomedical subjects

H Roth

Publications and source records attributed to H Roth.

At least 109 records · Page 6Linked to original sources

[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↗

[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↗

[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↗

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↗

[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↗

[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↗

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↗

[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↗

[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↗

[Comparative therapeutic activity of pirprofen and acetylsalicylic acid in rheumatoid arthritis. A 12-month controlled multicenter study].

This double-blind cooperative study comparing pirprofen and acetylsalicylic acid (ASA) in the treatment of rheumatoid arthritis was conducted in 12 centres and involved 342 patients distributed throughout the United States. The patients were randomized to either pirprofen 200 mg four times a day or ASA 900 mg four times a day. The drugs were administered for 52 weeks. Nine standard clinical criteria were used for assessment of the therapeutic results by the investigators and by the patients themselves. Fifty-five % of the total patient population reported that they were highly satisfied with pirprofen, as against 47% with ASA. The investigators preferred pirprofen in 51% of the cases and ASA in 38% (p less than 0.05). Side effects (tinnitus, gastrointestinal disorders) were more frequent in the ASA group than in the pirprofen group. During the 52-week treatment-period, biological alterations were only observed in two patients (1 on pirprofen, 1 on ASA).

Anti-Inflammatory Agents↗

[Soft tissue sarcomas in childhood (author's transl)].

477 patients with soft tissue sarcomas, including 87 children (18.2%) were treated at the Surgical Center of the University of Heidelberg between 1950 and 1980. 22.8% of the patients with solid tumors (excluding brain tumors) in childhood were soft tissue sarcomas. In the pediatric age group there were 30% rhabdomyosarcoma and 20% angioblastic sarcoma. Since introduction of combined tumor therapy (surgery, radiation, and chemotherapy) the survival rate increased impressively from (29% to 58%).

Adolescent↗

[Problems of intramural haematomas in childhood. A report of 5 cases].

5 cases of intramural haematomas are discussed. The haematomas were of different origin, were localized at different sites and treated differently. In one case an obstructive duodenal haematoma developed after a liver and spleen rupture. This hematoma was treated by gastro-enterostomy. In the second case the cause could not be determined. The third haematoma was induced by an intestinal clamp. In the last two cases there was a tendency to haemorrhages (Morbus Schönlein-Henoch and haemophilia A).

Child↗

[Surgical management of intersexuality in infancy and childhood--medication, procedure and operation schedule (author's transl)].

In recent years a multidisciplinary therapy contribution has brought about a remarkable change from a purely morphological to a markedly functional type of surgery in corrective operations of intersexual genitals. Methods of surgery generally in use today are described groupwise according to functional aspects. Their development is subject to cultural influences just as it depends on general medical progress and recent psychological knowledge.

Age Factors↗