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Biomedical subjects

J Erhard

Publications and source records attributed to J Erhard.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Normal findings with duplex sonography of liver blood vessels--experience in the examination of 100 patients with healthy livers].

100 patients of our kidney transplantation program and uneventful as regards their liver history were indexed by the pulsatile flow (PFI) of the hepatic artery and the damp curve (DI) of the hepatic veins. The average age of the patients was 36 years (20-50y). The pulsatile flow index (PFI) was calculated as 0.4 to 0.7. The damp index (DI) as 0.3 to 0.54. In 10 of these volunteers the measurement was performed 3 times per day for 5 days: there was no difference to be found in comparison to the values of the total group. The presented values of the PFI and DI give the normal range and will be the basis for further investigations in patients after liver transplantation or suffering from liver diseases.

Adult↗
PubMed1993

[Increased plasma endothelin concentrations in patients after liver transplantation and in liver cirrhosis].

Endothelin, one of the most potent vasoconstrictors known today, is released by the vascular endothelium. Patients after liver transplantation and patients with liver cirrhosis show significantly higher plasma endothelin concentrations and significantly reduced results in the quantitative liver function tests (ICG-HL, GEC, Lidocaine-HL, MEGX) compared with healthy control persons. The plasma endothelin concentrations were better correlated with the more liver bloodflow dependent function tests (ICG-HL, Lidocaine-HL) than with the more metabolic-capacity dependent function tests (GEC, MEGX). As cyclosporine A in vitro can increase the liberation of endothelin, we conclude that in patients after liver transplantation an endothelin mediated cyclosporine induced hepatotoxicity might be the reason for the demonstrated association.

Endothelins↗
PubMed1993

[Measuring impedance for evaluating ischemia damage to the human liver in preparation for transplantation].

In 22 human donor livers the measurement of the non-invasive bioelectrical impedance was performed prospectively to evaluate the degree of tissue damage sustained during cold ischemia. The results of the measurement were correlated with liver function, the method of organ preservation and the period of ischemia. The impedance was measured in vivo as 620 ohm (at 192 Hz), the phase angle as -7.4 degrees (at 5 kHz). The results were compared with the data obtained from 72 patients who underwent elective laparotomies. The 22 donor livers were studied further during ischemia. The method was found to be a reliable way of detecting severe damage to the hepatocytes during the cold ischemia.

Adolescent↗
PubMed1993

Acute liver necrosis in the HELLP syndrome: successful outcome after orthotopic liver transplantation. A case report.

We discuss the case of a 30-year-old primipara woman who developed a liver rupture as a complication of the HELLP syndrome. A liver necrosis and bleeding made a hepatectomy necessary. A portocaval shunt was able to maintain the patient until she underwent urgent liver transplantation. In an excellent state of recovery, the woman and her baby were discharged from the hospital 66 days after having been admitted.

Adult↗
PubMed1993

Complications related to thoracic epidural analgesia: a prospective study in 1071 surgical patients.

In a prospective study, the complications of 1071 patients scheduled for thoracic epidural catheterization for postoperative analgesia (TEA) were studied. All catheters were inserted preoperatively between segment Th 2/3 and Th 11/12 under local anesthesia. Balanced anesthesia with endotracheal intubation and TEA were combined. Postoperatively 389 patients (36.9%) were monitored on a normal surgical ward. Buprenorphine, 0.15 to 0.3 mg, and if needed bupivacaine 0.375% 3-5 ml h-1 were given epidurally. Primary perforation of the dura occurred in 13 patients (1.23%). Radicular pain syndromes were observed in six patients (0.56%). In one patient (0.09%) respiratory depression was seen in close connection with the epidural administration of 0.3 mg buprenorphine. Although 116 patients (10.83%) showed one abnormal clotting parameter but no clinical signs of hemorrhage, there was no complication related to this group. No persisting neurological sequelae caused by the thoracic epidural catheters were found. In conclusion, continuous TEA with buprenorphine for postoperative pain relief after major abdominal surgery is a safe method without too high a risk of catheter-related or drug-induced complications, even on a normal surgical ward and when one clotting parameter is abnormal.

Adolescent↗
PubMed1993

Bent subcutaneous peritoneal catheter shape for regular dialysis treatment in children.

A permanent bowing of the subcutaneous part of the Tenckhoff-type catheter (bent neck--Quinton, and swan neck--Accurate Surgical Instruments) enables the catheter to turn from an upward direction of the subcutaneous tunnel to a downward direction by a smooth 160 degrees-180 degrees bend creating a downward skin exit. We have used this catheter shape in combination with a coiled intra-abdominal edge. Two sizes are available for children. We use 2 cuffs and glue them ourselves according to the body size. In this study we compare the durability of the traditional subcutaneously straight catheter in 8 children aged 0.1-12.6 years (Group A) with the bent shaped catheter in 8 children aged 3.7-15.8 years (Group B). Median duration of function was 10.5 (2-34) and 8 (3-36) months, respectively. Frequency of complications was equal in both groups: peritonitis episodes 0.69/year in Group A and 0.53/year in Group B; tunnel infection 0.16 vs 0.11/year; skin exit infection 0.54 vs 0.53/year; noninfectious complications 0.16 vs 0.32/year; mean number of catheters used was 1.0 vs 1.1/treatment year. Treatment had to be terminated in some patients: kidney transplantation 5, kidney recovery 1, severe peritonitis 1. The bent subcutaneous catheter shape did not show any medical or technical disadvantage compared with the straight type, but the downward directed catheter skin exit can be covered invisibly under bikini or bermuda shorts which means aesthetic and social advantage. Whether the downward drainage of secretes and cell detritus influences the rate of tunnel infection positively cannot be answered to date.

Adolescent↗
PubMed1992

[Hemangiosarcoma of the liver. The diagnostic difficulties and therapeutic possibilities].

A 65-year-old man complained of decreasing physical capacity and weakness over the preceding six months, associated with marked painless jaundice and subsequently ascites. Despite extensive tests, some invasive, in three different hospitals no cause was found of the patient's symptoms and the marked though nonspecific abnormalities of various biochemical values (raised bilirubin concentration; increased alkaline phosphatase activity). Liver transplantation was performed because of progressive liver failure, without a firm diagnosis being established. At operation the liver was found to contain a haemangiosarcoma. The patient died 14 months after the transplantation of a suppurative cholangitis. At autopsy neither metastases nor recurrences were found.

Aged↗
PubMed1992

Involvement of dendritic cells in early insulitis of BB rats.

In this study, subsets of mononuclear infiltrates in pancreatic islets of BB rats at different stages of insulitis were determined by various monoclonal antibodies against rat lymphoid cells, including a mouse monoclonal IgM antibody that distinguishes between macrophages and dendritic cells (mAb 1F119). 1F119+ dendritic cells were absent in and around islets of Wistar control rats. In BB rats, the first alteration of islets detectable by immunohistochemistry when compared with normal islets was the enhanced expression of 1F119 antigen around and in the islets (17% 1F119+ islets). At disease stage 1 (i.e. no leukocyte infiltration after HE staining), lymphocytes and macrophages were almost absent. At disease stage 2 (leukocyte infiltration < 20 cells), a more intense form of dendritic cell infiltration was seen (stage 1 versus stage 2, P < 0.0001). In addition, ED2+ and ED3+ cells were present around the islets (50% of islets were infiltrated with 1F119+ cells versus 16% with ED2+, 19% with ED3+, 11% with W3/25+ cells, and 11% with OX8+ cells, P < 0.0001). At disease stage 3 (> 20 cells), a clear increase of ED2+ and ED3+ macrophages and of W3/25+ and OX8+ T-lymphocytes in the infiltrates was observed. These observations suggest a role for antigen presenting dendritic cells in the initiation of immune reaction in type 1 diabetes of BB rats.

Animals↗