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Biomedical subjects

J Heine

Publications and source records attributed to J Heine.

At least 19 recordsLinked to original sources
PubMed1990

Operative therapy in metastases and primary tumors of the spine.

Benign and primary malignant tumors of the spine require a ventral procedure to remove the tumor and to stabilize the spine. Experience in the last years has shown that sole laminectomy in children can no longer be recommended. An instrumentation of the spine to prevent kyphosis must be performed. The rate of pseudarthrosis was of course, high when the kyphosis was treated by an exclusive dorsal instrumentation. In patients with severe kyphosis a combined procedure with ventral and dorsal operation is necessary. Solitary metastases of cancer of the prostate, breast, and the thyroid gland show a better prognosis than metastases of cancer of the lung or the stomach. Thus metastases of the first group which also show a dependency on hormones, should be operated on by a ventral procedure, independent of the location of the tumor. In cases of multiple metastases and bad condition of the patient a ventral operation is not indicated. In these cases, a dorsal procedure with decompression and stabilization allows mobility of the patients until only few days before death. An implantation of instrumentations that include a transpedicular screwing can result in spreading of the tumor to the neighboring vertebrae. Therefore, this kind of operation should be the "ultima ratio".

Adolescent↗
PubMed1990

[Optic nerve evulsion].

A nine-year-old boy suffered an evulsion of the optic nerve as a result of being hit on the left eye with a stick. The anterior segment showed only superficial injury. Possible causes of optic nerve evulsion are discussed.

Child↗
PubMed1989

[Chorioretinitis in miliary tuberculosis].

The author presents a case of tuberculous chorioretinitis in a patient with miliary tuberculosis. Miliary tuberculosis with ocular involvement has become rare, because with modern chemotherapy miliary spread can usually be prevented. The chorioretinal changes, which in this case were completely reversible, are described and illustrated with fundus photos and angiograms.

Chorioretinitis↗
PubMed1989

[The progression of untreated idiopathic scoliosis in the x-ray image].

The natural history of scoliosis, or lateral curvature of the spine, was followed up in 135 patients (111 girls, 24 boys) for a total average period of 52.4 months. We observed patients with a curvature of between 5 degrees and 30 degrees none of whom had been treated specifically as orthotics or with electrical stimulation or by surgery. Two groups of patients with progressive curvature were differentiated: 1) in 62.2% of the patients the curvature progressed by more than 5 degrees during the entire observation period; 2) in 36% of the patients we found an increase in curvature by more than 5 degrees within one year. Another result of our study was that idiopathic scoliosis is particularly dangerous in young patients with a "0" Risser sign. Thoracic curvatures and double major curvatures were more liable to progress than lumbar and thoracolumbar curvatures. Even a small angle of curvature in young patients must be taken seriously.

Adolescent↗
PubMed1989

[Acquired ocular melanosis].

A case of ocular melanosis with a 24-year follow-up is presented. On the basis of the course and the results of histologic findings (conjunctival biopsy) it was classified as benign acquired melanosis with pronounced junctional activity. The constantly changing clinical appearance, ranging from a deep black conjunctiva to ultimately white tissue, is described and discussed.

Biopsy↗
PubMed1986

Combination therapy for resectable and unresectable adenocarcinoma of the pancreas.

The current report summarizes our experience with 77 patients with cancer of the pancreas treated over 3.5 years. Patients were not assigned to a definite group of therapy, but through the availability of different drugs and different types of treatment several comparable groups have evolved. All patients have received radiofrequency hyperthermia and chemotherapy, but in addition, some have received selective immune stimulation with one of two low-molecular-weight compounds. The data show that radiofrequency hyperthermia permits the use of a lower dose of chemotherapy, with an apparent response to treatment. This response is enhanced significantly by the addition of selective immune stimulation. A further, more rigorously defined study will be undertaken to confirm this data.

Adenocarcinoma↗
PubMed1986

[Comparison of volume substitutes 5 percent human albumin and 6 percent hydroxyethyl starch (40,000/0.5) in pediatric anesthesia].

Human albumin 5% (HA), frequently used in paediatric anaesthesia as a human plasma substitute, could be replaced by hydroxyethyl starch 6% (HES) 40,000/0.5 provided its use would not entail any disadvantages but rather advantages instead. This problem was studied by examining 30 children (mean body weight 32.5 kg) in general anaesthesia. During about 3 hours of surgery the patients lost up to 15 per cent (approx. 400 ml) of blood volume. In a randomised study the blood loss was compensated either via HA or HES with 14 ml/kg body weight each, respectively. Blood pressure and pulse rate remained within the normal range. Haemodilution was represented by a drop in the erythrocyte count to about 3 million/microliter, haematocrit (HCT) to about 30% and haemoglobin to approx. 10 g/100 ml. Slight metabolic acidosis (Bodansky unit = -4 mmol/l) was found to be statistically not significant (= n.s.) with both methods, as was the difference in serum albumin and during serum electrophoresis. Serum [Na+] was reduced in those children who had been treated with HES, to 137.33 +/- 33.30 mmol/l; however, in those children who received HA with low sodium content (statistically significant difference = s.s.) the corresponding level was 134.15 +/- 2.36 mmol/l. Serum creatinine rose in each case from 60 to 80 mmol/l (s.s.), renal function being slightly impaired probably due to the anaesthesia and surgery. The value according to Quick's test and the partial thromboplastin time (PTT) remained in the normal range both with HA and HES treatment (in each case over 70% and below 25s, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1986

The surgical reduction of spondylolisthesis.

The Schnöllner operation for reduction of spondylolisthesis was performed through a transversal incision. After removal of the disc, two pedunculus screws with two different threads are inserted. Over these screws the reduction is performed against a slotted sacral plate. The operations were performed at the following levels: 48 at L5-S1, seven at L4-L5, and two at both levels. 70.8% of the patients had preoperative lumboischialgia, 23.3% lumbalgia. Postoperatively, 92.1% were without pain. Twenty-seven patients had preoperative sensory disturbances, while only five had such disorders five years after operation. New sensory disturbances occurred after operation in 11 patients, seven of these persisted. Before operation, 27 patients had pareses of the foot and toe extensors; after operation, ten of them. Paresis occurred in 12 cases, of which three persisted. In 13 cases the reposition was complete, in 17 cases the displacement after operation ranged from 11% to 30%. The lumbosacral angle was markedly diminished.

Adolescent↗
PubMed1975

[Pulmonary vascular pressures and blood gases in young patients with thoracic scoliosis (author's transl)].

Pulmonary artery and pulmonary wedge pressures were measured at rest and during exercise in 25 young patients with moderate to severe scoliosis. Simultaneous determinations of arterial blood gases and pH were performed. The results of the vascular pressure measurements were compared with those obtained in 15 healthy young subjects. In all patients the pulmonary artery and pulmonary wedge pressure were normal at rest. During mild ergometer exercise, however, an abnormal rise in pulmonary artery pressure occurred in 9 patients. Moreover, an increased diastolic pressure gradient across the pulmonary vascular bed was found in some scoliotic patients indicating an elevated pulmonary vascular resistance. It is supposed that this haemodynamic abnormality is primarily due to a restriction of the pulmonary vascular bed. Relationships between pulmonary artery pressure and arterial oxygen tension and blood pH, respectively, could be found. The possible significance of these results is discussed.

Adolescent↗
PubMed1975

[Progression of untreated idiopathic scoliosis up to the end of growth].

110 patients with idiopathic scoliosis are reported on, who had no treatment for 2 years or more before growth stopped. Another 36 patients untreated for 1 year could be observed. The changes in the scoliotic angle were followed up radiologically and entered into a diagram. The average progression of these scolioses during one year were calculated. Progression was always most pronounced between the 10th and 15th year and coincided with the prepubertal increase in growth. This has to be expected 2 years later in boys than in girls. The degree of progression definitely depended on the site of the primary curve. Thoracic and S scoliosis showed most pronounced progression, followed by thoracolumbar and lumbar scoliosis. Progression was worse the earlier scoliosis was diagnosed.

Adolescent↗
PubMed1975

[Progress of untreated scoliosis following poliomyelitis up to the end of the growth-period (author's transl)].

Further to an earlier paper on progression of untreated idiopathic scoliosis 37 patients with scoliosis following poliomyelitis are reported on. 16 of them could be observed for 2 years or more having had no treatment. Their progression is clearly more extensive than that of idiopathic scoliosis. But like them it is at a peak during the prepubertal spurt of growth. It also is more obvious the earlier it is recognized. The prognosis of post-poliomyelitic scoliosis is particularly bad when it starts shortly after onset of the paralysis.

Adolescent↗