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Biomedical subjects

J Heinz

Publications and source records attributed to J Heinz.

At least 19 recordsLinked to original sources

[Results of surgical therapy of acute pancreatitis].

Operative treatment of acute pancreatitis was carried out in 143 patients. The disease was caused by bilestones in 68%, by alcohol in 23%, idiopathic in 8%, and by different reasons (postoperative, helminthic disease) in 1% of the patients. The severity of the disease was classified into the grades I to III according to Kümmerle. The lowest rate of complications and lowest mortality rates were observed in operations performed within the first hours or after two weeks after the beginning of the disease. The alcoholic pancreatitis showed the lowest mortality rate (16%), despite of 81% of these patients suffering from the severe grades II and III. This may result from the decision in favour of early second look operations in these patients.

Acute Disease↗

Psychiatric epidemiology of an Indian village. A 19-year replication study.

This 1988 study reports the point and lifetime prevalence of psychiatric disorders, using DSM-III-R criteria, of a sample (approximately 25%) of adult members of an Indian village previously studied in 1969. The basic instrument was the Schedule for Affective Disorders and Schizophrenia, augmented by available medical information and administered by experienced psychiatrists. Subjects were interviewed and results were weighed for the age- and sex-distributed population. The results indicated a high point prevalence of alcohol dependence (32.8%), with a lifetime prevalence of 72.8%, among males. The lifetime prevalence of affective disorders among women was also high (36.8%), but less so among men (19.3%). When compared with the DSM-III-R diagnoses of the 1969 study, the point prevalence rates of alcohol dependence and abuse disorders fell from 39% to 21%. Also, fewer subjects were judged to be psychiatrically impaired. Even though the prevalence of psychiatric disorders was lower in the current study, the rates for alcohol disorders and affective disorders were still far higher than those reported in Epidemiologic Catchment Area studies. Alcohol dependence (especially among young men) and affective disorder (among women) were major problems.

Adult↗

[Transgenicular amputation with myocutaneous gastrocnemius flap in arterial occlusive disease].

41 knee disarticulations in patients with gangrene due to periphere vascular disease were performed using a myocutaneous flap of the gastrocnemius muscle as described by Klaes and Eigler in 1985. In many cases disarticulation was preceeded by reconstructive vascular procedures or amputation at a lower level. Primary healing of the stump was achieved in 80% of the cases. 29% of the patients were able to walk with the aid of a prosthesis.

Aged↗

[Results of surgery of the hemorrhaging stomach and duodenal ulcer--a 10-year retrospective study].

Operations were performed on 131 patients for haemorrhagic peptic ulcer at Wenckebach Hospital, between 1977 and 1986. Roughly two thirds of all patients had never had ulcer before. Persistent haemorrhage was recorded from about 20 per cent of these cases by emergency gastroscopy. Immediate surgical action had to be taken on 23.7 per cent. Interval interventions were possible for 28.2 per cent, while almost 50 per cent had to be laparotomised for early recurrent bleeding. Mortality in the wake of immediate emergency operations and surgery for recurrent bleeding was nearly twice as high as that in the context of interval interventions. Resection was performed on 70 per cent, haemostasis only on 26 per cent, and additional vagotomy on 14 per cent. Overall mortality amounted to 27.5 per cent including 36.6 per cent for women and 22.8 per cent for men. Ulcer localisation had no impact on mortality. The highest mortality rate, 38.2 per cent, was recorded from patients on whom only haemostasis had been performed, while 16.7 per cent were recorded from those to whom additional vagotomy had been applied. Lethality in the context of resection amounted to 25.6 per cent. Twenty-three patients had to be relaparotomised (17.6 per cent), which pushed up the mortality rate to 43.5 per cent.

Adult↗

[Bilateral spontaneous rupture of the patellar tendon in systemic lupus erythematosus. A case report and review of the literature].

A rupture of the patella ligament occurs after acute trauma or if there are factors that could have predisposed to the rupture like former injuries or operations of the knee or systemic diseases. If symptoms like loss of active extension, no patella tendon reflex, and a proximally displaced patella in radiograph appear in cases of those diseases, it should be thought of the rare rupture of the patella ligament. It will be treated operatively by suture of the tendon supporting by a wire, applying a cast for six to eight weeks and following physical therapy.

Female↗

[The use of fibrin tissue adhesive in parenchymal organs of the abdomen. An experimental study in rabbits and dogs (author's transl)].

In rabbits and dogs standardized lesions of the liver, kidney, and spleen were treated by application of human fibrinogen tissue adhesive. In all cases this procedure resulted in a complete control of bleeding as well as a stable and lasting closure of the wounds. During the postoperative observation time of one month, the fibrinogen tissue adhesive was initially infiltrated by leucocytes and macrophages and subsequently resorbed by a granulating tissue, characterized by the early appearance of numerous fibroblasts. Our clinical experience, until now, confirms these promising experimental results.

Animals↗

Mitral regurgitation and characteristic changes in impedance cardiogram.

We have noted that the impedance cardiographic waveform of patients with mitral regurgitation may show typical abnormalities not found in other forms of cardiac disease, either valvular or congenital. In order to investigate this we reviewed the impedance cardiograms of all our patients who had also undergone cardiac catheterisation, and selected two groups both of which were inclusive and complete: (1) 22 patients with the diagnosis of normal heart, and (2) 36 patients with the diagnosis of isolated mitral regurgitation. An index was calculated algebraically from the change of impedance (delta L) tracing by adding together the height of the C wave and the height of the nadir of the X descent and subtracting the height of the V wave, that is delta Z index (in units of ohms) = C + X - V. The mean delta Z index for the normal group was 1.64 and for the mitral regurgitation group 0.96 ohms. Similarly, an index was calculated from the first time derivative of the change of impedance (dZ/dt) tracing, that is dZ/dt index (in units of ohms/s) = C' + X' - V'. The mean dZ/dt index for the normal group was 1.32 and for the mitral regurgitation group 0.48 ohms/s. Though there was some overlap of individual points between the two groups, the mean values for both the delta Z index and the dZ/dt index separated the group with mitral regurgitation from the normal group with a high level of statistical significance. We concluded that mitral regurgitation might be associated with a characteristic abnormality of the impedance cardiographic waveform. In addition, an index can easily be calculated from the tracings which may be useful in identifying patients with mitral regurgitation.

Adolescent↗