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Biomedical subjects

H Wolff

Publications and source records attributed to H Wolff.

At least 163 records · Page 9Linked to original sources
PubMed1988

[Initial clinical experiences with heart transplantation in East Germany].

An account is given in this paper of first experience from orthotopic heart transplantation. Six of eight patients with transplants have so far survived, with two of these having been in very good general condition for more than a year. All surgical indications were derived from myocardial dilatation. A triple combination of cyclosporine A, prednisone, and azathioprine was used for immunosuppression.

Follow-Up Studies↗
PubMed1988

[Selective proximal vagotomy with and without pyloroplasty--results of a randomized clinical study of duodenal ulcer 5 and 8 years after surgery].

Selective proximal vagotomy (SPV) with pyloroplasty (n = 39) and without (n = 39) were compared five and eight years after surgery in a randomized clinical study. Pyloroplasty according to Finney had no effect on ulcer recurrence rates after both periods of time (7.9:7.9 or 10.8:8.3 per cent). Additional pyloroplasty, too, had no statistically significant effect on incidence and severity of post-vagotomy syndrome, dumping and diarrhoea, though some trend towards an increase was discernible in wake of pyloroplasty. Occurrence of the lactase deficit syndrome after SPV with pyloroplasty was increased with statistical significance. Lasting loss of senses of appetite and saturation was observed for the first time after SPV, on top of the lactase deficit syndrome. Clinical results recorded after five and eight years did not reveal any significant difference between both groups. These findings are likely to suggest that SPV without pyloroplasty is sufficient for surgical treatment of duodenal ulcer. However, pyloroplasty in combination with SPV has continued to be fully indicated for no-resection therapy of ulcerogenic pyloric stenosis.

Adult↗
PubMed1988

[Indications for the Scribner shunt in hemodialysis].

The indication to a Scribner shunt as vascular access for hemodialysis has been reduced significantly by the use of central-venous catheters and creation of subcutaneous access methods. In 13 patients suffering from septic complications of the central-venous vascular access catheters a Scribner shunt was created for continuation of hemodialysis. After removal of infected catheters and specific antibiotic therapy the sepsis could be controlled in 12 patients within 4-18 days.

Adult↗
PubMed1988

[The syndrome of retrograde venous arterialization following arteriovenous vascular anastomoses for hemodialysis].

In 9 patients with arterio-venous side-to-end anastomosis on the forearm as vascular access for chronic hemodialysis an uniform symptom complex was observed: retrograde flow of the ectatic vein into the periphery, swelling and pain in this area, partly with trophic skin disorders on the hand. After occlusion of the arterio-venous anastomosis these symptoms could reversed completely with exception of venous dilation.

Adolescent↗
PubMed1988

[Factors influencing the duration of function of arteriovenous vascular anastomoses in hemodialysis].

The function of an arterio-venous vascular access is influenced by vascular material, hemodynamics, blood coagulation and technique and number of punctures. By careful intraoperative handling, optimal postoperative care and treatment of the vascular access during and after hemodialysis the functional duration may be influenced effectively. The technique of puncture, the puncture cannula and the skill of the "puncture" are of great importance.

Arteriovenous Shunt, Surgical↗
PubMed1988

[Blunt abdominal trauma].

Serious intraabdominal injury due to intraabdominal hemorrhage, gastro-intestinal laceration with peritonitis or incarceration of abdominal organs. The most important question in the management is to ascertain a laparotomy or the diagnostic of a specific organ injury is needed. The peritoneal lavage is a great help in making this decision. The x-ray examinations of thorax, abdomen and bones are required. Adjunctive diagnostic modalities for subtile examination of organs are ultrasound, computed tomography and angiography. These examinations have a limited application. Exploratory laparotomy should be done if there are signs of peritoneal irritation with an increased tendency. 168 patients with blunt abdominal trauma where treated in Charity-hospital of Berlin. The laparotomy was necessary in 78 patients. In 70 cases we found organ injuries. It was pointed to splenic repair, the management of liver injury especially the packing of the laceration and the treatment of the injuries of gastro-intestinal tract, pancreas- and diaphragmatic rupture.

Abdominal Injuries↗
PubMed1988

Immunohistologic characterization and quantitation of leukocyte subpopulations in human semen.

Various major leukocyte subpopulations (granulocytes, monocytes/macrophages, B lymphocytes, helper and suppressor/cytotoxic T lymphocytes) were detectable in human semen by applying monoclonal antibodies (MAbs) specific for pan-leukocyte and leukocyte subpopulation markers. MAb-labeled cells in smears of washed human semen were visualized by a standard streptavidin-biotin immunoperoxidase method. This approach was validated by testing the MAb panel against sections of human testis and epididymis to rule out cross-reactivity with immature germ cells or other reproductive tract cells, and against peripheral blood leukocytes that had been incubated in human semen to ascertain leukocyte marker stability in seminal plasma. When the immunoperoxidase technique was applied to semen smears from 17 proven fertile men and 51 randomly selected infertility patients, the authors found highly varying total leukocyte numbers, ranging from 8970 to 20,520,000 per ejaculate among fertile men (median, 170,000), and from 43,120 to 104,580,000 among infertility patients (median, 1,035,000). Higher means and medians of granulocytes, monocytes/macrophages, and lymphocyte subsets were seen in the infertility group. These results warrant further investigation on the diagnostic utility of semen leukocyte profiles and the possible role of seminal leukocytes in male infertility.

Adult↗
PubMed1988

Evaluation of granulocyte elastase as a seminal plasma marker for leukocytospermia.

To evaluate the relationship between concentrations of the granulocytic enzyme polymorphonuclear (PMN) elastase in seminal plasma and the presence of high numbers of white blood cells (WBC) in semen, specimens from 118 infertility patients were analyzed for each variable. PMN-elastase levels were determined by an enzyme-linked immunosorbent assay and WBC numbers by a recently described immunohistologic technique. PMN-elastase levels in seminal plasma correlated well with WBC numbers in semen (r = +0.755). A three-step grading system of PMN-elastase values as low/normal (less than 250 ng/ml), intermediate (250 to 1000 ng/ml) and high/pathologic (greater than 1000 ng/ml) showed a highly significant relationship to a similar WBC number grading system: low/normal, less than 10(5) WBC/ml, intermediate, 10(5) to 10(6) WBC/ml, and high/leukocytospermic, greater than 10(6) WBC/ml semen. Incubation of semen at 37 degrees C resulted in a slight continuous decrease of immunoreactive PMN-elastase at a rate of approximately 10% per 3 hours. As all 18 samples with more than 1000 ng PMN-elastase per ml seminal plasma showed more than 10(6) WBC/ml semen, PMN-elastase levels above 1000 ng/ml were diagnostic for leukocytospermia.

Humans↗
PubMed1987

[Results of computed tomographic diagnosis in the grading of acute pancreatitis].

By means of computed tomography, it is possible to classify cases of acute pancreatitis into four grades of severity with reasonable accuracy: oedematous, sero-exudative, haemorrhagic-necrotic and abscess formation. Necrotic pancreatic tissue can be differentiated from normal tissue by means of dynamic computed tomography with a high degree of accuracy and the organ can be demarcated more clearly. Of 230 patients with acute pancreatitis, 89 were treated surgically. Correlation between the CT classification and surgical findings was achieved in 83% of the cases in the three serious grades. In 86 patients (96.6%, necrosis was correctly diagnosed. The problems that arise when trying to differentiate between the haemorrhagic-necrotic form and abscess formation are discussed, particularly when there is an absence of gas in the latter type.

Acute Disease↗
PubMed1987

[Pancreatic cancer from the viewpoint of the surgeon].

The incidence of carcinoma of the exocrine pancreas has gone up by factors of something between 2 and 4 in countries of advanced civilization over the past 30 years. Modern diagnostic methods have enabled safe detection of the carcinoma in 85 per cent of all cases. Laparotomy is justified in situations in which the operability of a pancreas tumour cannot be reliably established by other approaches. Radical therapy should include cephalic or total duodenopancreatectomy and romal of regional lymph nodes. Diffuse metastasation or infiltration of the mesenteric superior arteries and veins, the hepatic artery, and the portal vein result in inoperability. Operations for exocrine pancreas carcinoma were performed on 226 patients at the Surgical Department of Charité, between 1979 and 1985. Tumours were radically removed in 104 cases. Surgical mortality accounted for 14 per cent. Chemotherapy or radiotherapy of pancreas carcinoma should be reverified for their life-extending effectiveness. Aggravating fatty degeneration of the liver was found to develop two years after pancreatectomy and calls for modified treatment.

Combined Modality Therapy↗
PubMed1987

[Results of treatment of pyogenic liver abscesses].

In the last 7 years 53 patients with liver abscesses were treated at surgical clinic of Charité. Since November 1982 we treated in 27 cases with solitary and multiloculary liver abscesses by percutaneous drainage of the abscess diameter more than 3 to 4 cm. 12 patients with multiloculary small biliary liver abscesses were treated by antibiotics. The bacteriological examination were performed after CT-supported puncture of the abscess. Seven patients with complicated abscesses could not be healed with CT-drainage. Surgical drainage via laparotomy was necessary. The diagnostic clarification of the dignity is important in every case. The lethality of all treated liver abscesses was 5.6% and the causes of death were the existing basic diseases.

Adolescent↗
PubMed1987

[Allogeneic transplantation of the small intestine--animal experiments and a clinical retrospect].

Allogenic transplantation of small intestine has proved to be an alternative therapy for complex failure of intestinal functions. Attempts in that direction had been made over many years, but impressive were obtained only under conditions of modern immunosuppressive therapy. Hence, wider clinical application is imminent at an international scale. Reference is made in this paper to the authors' own experience obtained from mongrel dogs for an account of indications, surgical technique for collection of intestine and transplantation, perfusion and preservation of the donor organ as well as of various pathophysiological, functional, and immunological aspects. Results obtained at different centres are discussed, with reference being made to individual cases and clinical findings recorded from them. The survival rate of animals which have undergone transplantation of the small intestine provides evidence for the possibility of such organ transplantation and means a challenge to all involved in conventional intestinal surgery and modern medical transplantation.

Adult↗
PubMed1987

[Problems of antineoplastic chemotherapy of pancreatic cancer].

Antineoplastic chemotherapy of pancreas carcinoma remains to be an area of intensive research. There are no convincing suggestions for far as to clinical superiority of polychemotherapy. However, combined methods seem to improve survival in cases of both advanced and surgically removed pancreas carcinoma. New, effective pharmaceuticals should be looked for in the foreseeable future. Interdisciplinary approaches will continue to be of great importance.

Antineoplastic Agents↗