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Biomedical subjects

H Strosche

Publications and source records attributed to H Strosche.

At least 19 recordsLinked to original sources
PubMed1998

Long term results after rotation angioplasty and catheter atherectomy. A retrospective analysis.

Rotationangioplasty and catheter atherectomy using the TEC device was performed in 33 patients with peripheral arterial occlusive disease. Thirty-five femoral or popliteal artery occlusions could be recanalized with an initial patency of 100%. After 5 years the patients were re-evaluated by clinical examination, colour duplex scanning and in 5 cases by intra-arterial angiography. According to life table analysis there was no patent femoral or popliteal vessel after 5 years in those patients treated initially for rest pain or ischemic tissue loss. 82% of those treated for claudication had a re-occluded artery. In 5 cases a major amputation was necessary. 42% of those patients who were initially treated far disabling claudication had a severe deterioration of their functional status with development of critical ischemia. In 9 of these cases reconstructive arterial surgery was required which failed in one patient with subsequent limb loss. In the retrospective study presented patients with occlusions up to 30 cm and more were treated. Combining two interventional techniques there is a high initial success rate with poor long term results. Therefore these devices should be reserved for high risk patients who would not tolerate reconstructive vascular surgery. They should not be used in patients with claudication although even extensive occlusions can be recanalized there is an imminent danger of causing significant deterioration of the patients functional status.

Aged↗
PubMed1995

[Heparin-associated thrombocytopenia caused by low-molecular-weight heparin].

Recent studies have shown that low-molecular-weight heparins (LMWH) are not suitable for treating patients with heparin-associated thrombopenia (HAT) type 2, as they can cause the same complications as unfractionated heparin UFH. The case described ist that of concerns as female patient who died after developing HAT type 2 following LMWH given perioperatively to prevent thromboembolism. This case indicates again that LMWH can trigger HAT type 2 even if administered only once a day. For HAT to be successfully treated it is essential that the condition is diagnosed early enough by means of routine regular laboratory checks of the number of thrombocytes during any heparin treatment in order to detect the disease before clinical symptoms become apparent.

Aged↗
PubMed1990

Acute non-calculous cholecystitis.

Shock gall-bladder is a complication that can arise following trauma or after an operation. The sex distribution, disease frequency and mortality rate associated with this condition are presented and possible pathophysiology is discussed. Post-traumatic cholecystitis seems to occur most often in the second to fourth decade of life. The aetiology remains unknown and may be multifactorial. An awareness of this complication and a resort to early surgery can largely protect the patient from severe consequences.

Acute Disease↗
PubMed1989

Influence of prostaglandin E1 on muscular tissue-PO2 in patients with diabetic gangrene.

Intraarterial infusions of short acting vasoactive drugs have been established in the treatment of peripheral occlusive disease. We studied the effect of prostaglandin E1 on the tissue pO2 of the tibialis ant. muscle. Using a fast responding polarographic pO2-probe of the hypodermic needle type, tip diameter 300 microns, we made tissue pO2 investigations in 9 patients with diabetic gangrene. pO2-measurements were done before, during and after administration of 0.2 microgram PGE1/min i.a.. PGE1 led to a slight decrease of the mean muscular pO2 during application followed by a reincrease after the end of infusion. It is known that intraarterial PGE1 infusion leads to an increase of transcutaneous pO2 of the forefoot. Our results show, that there is no increase of tissue pO2 of the tibialis ant. muscle. The reason might be a changed distribution of blood flow in favour of an increased oxygenation of the skin due to PGE1 administration.

Aged↗
PubMed1989

Development of muscular tissue PO2 after vascular reconstructive surgery.

Using a fast responding polarographic pO2-probe of the hypodermic needle type with a tip diameter of 300 microns we investigated the influence of vascular reconstructive surgery on the tissue pO2 of the tibialis ant. muscle. In 10 patients suffering from a peripheral occlusive disease state II-III according to FONTAINE measurements of tissue pO2, pain free walking distance and doppler-index were done preoperatively, 2 weeks and 6 weeks after surgery. The results show that reconstructive vascular surgery leads to an immediate improvement of the doppler-index. In contrast to that there is a time dependent increase of the mean tissue pO2 in the tibialis ant. muscle. This development of muscular oxygenation coincides with an increasing walking distance.

Female↗
PubMed1989

Changes of the ductus hepatocholedochus after gastric stimulant. Results of early functional sonography.

In a group of 44 healthy probands, the change in bile-duct size after ingestion of a gastric stimulant in the early stage of the regulation was examined. From an empty diameter of 5.62 mm, a statistically significant reduction to 4.00 mm was found after 5 min, followed by a further slight reduction to 3.86 mm after 10 min and to 3.57 mm after 20 min. The physiological basis is the influence of cholecystokinin on the ductus hepatocholedochus and the sphincter of Oddi. This eliminates the long examination and observation intervals typical of radiological diagnostics and justifies early functional sonographic investigation of the bile duct during abdominal sonography, which does not involve an additional time investment.

Adult↗
PubMed1989

[Surgical treatment of fresh subcutaneous rupture of the Achilles tendon and results of its treatment].

In the years between 1981 and 1986 32 patients with a subcutaneous rupture of the Achilles tendon were operated on. Two different surgical techniques were preferred: using the tendon of the m. plantaris as suture according to Streli, and Bunnell's suture. In a clinical exploration 17 patients could be recorded. According to the classification of Trillat, 70.6% of the patients show a very good result. That means that the patients have the same sports and professional efficiency as before the injury and operation, a painless Achilles tendon, a stable heel and unrestricted mobility.

Achilles Tendon↗
PubMed1989

Pharmacokinetics of mezlocillin in pleural fluid.

Mezlocillin concentrations in the pleural fluid and serum of six patients with malignant pleural effusion were determined following administration of 10 g mezlocillin over 30 minutes as a rapid infusion. Thirty minutes and eight hours after the infusion had been completed, concentrations of the active ingredient in the pleural fluid were 36.44 micrograms/ml and 112 micrograms/ml respectively; in the serum the respective values were 777.89 micrograms/ml and 44.22 micrograms/ml. The concentrations of active ingredient in the pleural fluid exceed the MIC for clinically significant pathogenic germs. The elimination half-life of mezlocillin in malignant pleural effusion is prolonged.

Adult↗
PubMed1989

[Intra-arterial infusion therapy of progressive diabetic foot gangrene with prostaglandin E1 amd cefotaxime].

15 patients with severe diabetic gangrene were treated with a combined intra-arterial PGE1/Cefotaxime infusion therapy. There was no indication for vascular reconstructive surgery. The average treatment took 24.7 days. 11 of the 15 patients were responsive to the therapy. Nevertheless 5 of these 11 patients had to be amputated below-knee in the further course of treatment. In 6 cases we succeeded in preserving the affected extremity in a state of acceptable use. One patient died during the study. No complications due to the therapy were seen. Considering that all patients were near to amputation when entering the study the result to have saved the extremities in 40% of the cases must be regarded as a success.

Alprostadil↗
PubMed1989

[Fully implantable catheter systems for arterial extremity infusion].

Twenty totally implanted arterial access systems for drug administration were used in 19 patients with peripheral arterial disease. A total of 458 short-term infusions were administered through the systems. The observation period was maximally 13 months. Infection occurred in one patient (5%), as well as one catheter occlusion and one arterial thrombosis, which was successfully treated by local thrombolysis. Long period usability with low complication rate distinguishes the system from conventional arterial access. Patient's acceptance was excellent.

Aged↗
PubMed1988

[Primary malignant tumors of the small intestine--symptoms, diagnosis and therapy].

26 patients with a primary malignant tumor of the small intestine could be found in the cases in the surgical department of the Marienhospital Herne, University of Bochum, from 1978 to 1987. By the anamnesis and findings on admission various symptoms and clinical results only a few cases advising symptoms for a malignant tumor of the small intestine were found. Often the diagnosis only could be found by an emergency operation. An amelioration of the bad prognosis will be possible with shortening the long latency between the first uncharacteristic symptoms and the right diagnosis. After going through the endoscopy and radiology with strong anamnesis and findings, the explorative laparotomy must be done as an compulsory step.

Adenocarcinoma↗
PubMed1987

[Densitometric follow-up of algodystrophy using computerized tomography].

Clinical and radiological findings obtained from diagnosis and follow-up examination of post-traumatic algodystrophy (Morbus Sudeck) are very much open to subjective interpretation. Decisive importance is attributed not only to alteration of soft tissue but also to typical distribution patterns and severity of bone demineralisation. No objectifiable and quantifiable have so far become available for proper assessment but are urgently desirable in view of the great number of therapeutic approaches. Densitometry integrated with computed tomography was applied to nine patients with algodystrophy of hand or foot in the region of spongy bones to determine absorption values which were then compared with those on the clinically intact side. Significant differences between sides proved to be objectifiable and were quantifiable measures by which demineralisation of the effected extremity could be assessed. Repeated examinations were undertaken for follow-up through a period up to nine months.

Adult↗
PubMed1986

[Clinical significance of the adenoma-carcinoma sequence. Results of a retrospective study].

Follow-up checks were applied to 81 of 140 patients with 249 adenomas of the large intestine. The results obtained from that study are reported in this paper. The generally known dependence of adenoma carcinoma sequence on histology, size, and basis of adenomas was confirmed. Since patients with adenoma are exposed to higher risk of carcinoma, colonic polyps, basically, should be removed as a form of cancer prophylaxis, and patients concerned should be regularly monitored. A follow-up programme is proposed in this paper, with reference being made to the authors' own rates of recurrence and to those reported in the literature.

Adenocarcinoma↗
PubMed1986

[Is the gallbladder a shock organ?].

Detrimental effect of shock on gallbladder is a rare complication which may occur in the wake of trauma or surgery. Sex ratio, incidence, lethality, and possible pathophysiological processes are stated and discussed. The incidence of posttraumatic cholecystitis appeared to be higher among patients in the second to fourth decades of age, while postoperative cholecystitis was more often recorded from patients in the fifth to seventh decades of age. The aetiology is still unknown and may be of multifactorial nature. This cannot be conclusively elucidated from one individual case. Early detection of the complication and early operation may widely protect the patient from more severity.

Aged↗
PubMed1985

Stricter selection criteria improve the results of shunt surgery.

Between October, 1976 and December, 1982, 176 patients with full-blown liver cirrhosis were referred to us either with Acute oesophageal variceal bleeding, or after having had such a haemorrhage. Eight of these patients died of a haemorrhage that did not respond to conservative treatment, or of hepatic failure after emergency surgery. After receiving initial conservative treatment, 168 patients were classified in accordance with clinical, biochemical and haemodynamic selection criteria, particular importance being attached to the haemodynamic criteria. One-hundred-and-one of these patients in whom a shunt operation was not justifiable, were treated conservatively by means of repeated sclerotherapy. In the cases of acute bleeding, a balloon tamponade was performed in 3, an emergency shunt procedure in 1 and palliative dissection surgery in 4. Twenty-three patients in a non-bleeding state were treated conservatively without sclerotherapy. Shunt surgery was performed in 44 patients; out of the 42 patients shown by our selection criteria to be suitable for shunt surgery, only 1 patient died, 5 days after the operation, of cardiac failure with underlying toxic cardiomyopathy. In view of the low early mortality rate in selectively operated patients, a major argument against the use of the shunt for the treatment of portal hypertension is no longer valid, and it should again be considered whether the surgical procedure might not provide better long-term results than does conservative sclerotherapy alone.

Gastrointestinal Hemorrhage↗