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Biomedical subjects

O Mann

Publications and source records attributed to O Mann.

At least 19 recordsLinked to original sources
PubMed2007

[A sizeable chance--surgical management of profound obesity concurrent with post-traumatic osteoarthrosis].

In times of plentiful nutrition an environmental advantage turns into a problem - obesity. Apart from an increase in morbidity and overall mortality the development of osteoarthrosis is well documented. Pre-arthrotic conditions may arise from trauma and can lead, depending on the pattern of injury, to full-blown arthrosis. The presence of obesity can play the role of a relevant progressive factor in this setting. Here we report about the case of an obese man (BMI 53.5 kg/m(2)), who suffered a fracture of the femoral head with acetabular participation (Pipkin IV) as well as a fracture of the tibial plateau. Operative management and rehabilitation were followed by gastric bypass surgery for weight reduction. The case is discussed with regard to the present literature.

Adult↗
PubMed2006

Microscopic and electronic structure of semimetallic Sb and Semiconducting AlSb fabricated by nanoscale electrodeposition: An in situ scanning probe investigation.

The nanoscale electrocrystallization of pure Sb and the compound semiconductor AlSb on Au(111) has been studied by in situ scanning probe techniques (STM and STS) employing an ionic liquid electrolyte, {AlCl3-[C4mim]+Cl-} (1:1) containing SbCl3. The characteristic changes of the electronic structures with varying potentials have been probed for the first time by normalized differential conductance spectra, (dI/dU)/(I/U). In the underpotential deposition range of Sb the formation of two layers is observed. For the first monolayer a (square root 3 x square root 3)R30 degrees structure is determined from atomically resolved STM images. During the deposition and dissolution of the Sb monolayers characteristic wormlike or spinodal structures appear indicating surface alloying of antimony with the gold substrate. Under overpotential conditions two different Sb structures have been observed. If the deposition potential is continuously stepped to -0.1 V, Sb nanostripes form. On the other hand, randomly dispersed small clusters occur if the potential is jumped from 0.0 to -0.3 V vs Al/Al(III). Both modifications exhibit typical semimetallic behavior as shown by the STS spectra. At -1.1 V the cyclic voltammogram shows a clear reduction wave that is assigned to AlSb compound formation. Deposits in this potential range are characterized by a homogeneous distribution of clusters with diameters of approximately 20 nm. Conductance spectra of these clusters exhibit the main features of the electronic structure of the bulk semiconductor AlSb, with a band gap of 2.0 +/- 0.2 eV. Electrodeposition experiments on both sides of the compound deposition potential show a strong doping effect that is manifest in the corresponding conductance spectra.

Journal Article↗
PubMed2005

Customized surgical strategy in chronic pancreatitis.

Despite major advances in the management of patients with chronic pancreatitis, yet the disease remains an enigmatic process of uncertain pathogenesis, unpredictable clinical course, and unclear treatment. In most of the cases intractable pain is the main indication for surgical intervention. Furthermore complications related to adjacent organs, endoscopically not permanently controlled pancreatic pseudocysts, ductal pathology, conservatively intractable internal pancreatic fistula or suspected malignancy also require surgery. The ideal surgical approach should address all these problems--tailoring the various therapeutic options to meet the individual patient's needs. In our opinion, the ideal procedure for chronic pancreatitis is the duodenum preserving pancreatic head resection in terms of an extended drainage procedure, were the extent of the pancreatic head resection may be tailored to the morphology of the pancreatic gland, thus allowing a tailored concept (to resect and/or drain as much as necessary but as little as possible). Looking at the present data, there is no need to transsect the pancreatic axis above the portal vein. If portal vein thrombosis is present, an extended drainage procedure is mandatory without transsection of the neck of the pancreas.

Chronic Disease↗
PubMed2004

Management of an unclear bile duct stenosis.

It is frequently difficult to determine whether a bile duct stricture is benign or harbors a malignant tumor based on medical history alone. Therefore, cholestasis of unknown etiology requires a thorough diagnostic evaluation to make a definitive diagnosis and choose the best course of treatment for the patient. We report the case of a 42-year-old man who developed cholestasis 6 years after undergoing orthotopic liver transplantation for end-stage liver disease. The bile duct was dilated by interventional endoscopy, and a brush cytology was obtained. Cytology revealed an inflammatory reaction. Three months later, the stricture persisted. We performed a forceps biopsy, and the diagnosis of a cholangiocarcinoma was confirmed histologically. We conclude that a combined application of brush biopsy/forceps biopsy and endoscopic measures is essential in cases of bile duct strictures of unknown etiology. Occasionally, surgical confirmation may be required. In any case, a single brush cytology is insufficient for diagnosis.

Adult↗
PubMed2002

Intractable hiccup: an odd complication after laparoscopic fundoplication for gastroesophageal reflux disease.

Intractable hiccup can be an unbearable circumstance and its treatment is often frustrating. More than 100 causes for hiccup have been described in the literature; the most common cause is gastroesophageal reflux disease (GERD). We report a case of a 31-year-old patient who suffered from intractable hiccup starting 3 weeks after laparoscopic Nissen fundoplication for GERD, a potential surgical complication that has not been described. After frustrating medical treatment, the patient underwent computed tomography and nerve stimulator-guided blockade of vagal and phrenic nerves on each side separately. Hiccup ceased only after blockade of the right phrenic nerve with 4 ml/h l% ropivacaine and relapsed soon after discontinuation. He underwent thoracoscopic right phrenicectomy, which rendered him symptom free for well over 2 months, at the time of this writing.

Adult↗
PubMed2002

Effect of prenatal glucocorticoids and postnatal nitric oxide inhalation on survival of newborn rats with nitrofen-induced congenital diaphragmatic hernia.

BACKGROUND/PURPOSE: Pulmonary hypertension and pulmonary hypoplasia account for the high mortality rate associated with congenital diaphragmatic hernia (CDH). In animal models of CDH, postnatal nitric oxide (NO) inhalation resulted in significantly better survival rates and antenatal glucocorticoid administration in improved lung compliance. The objective of this study was to evaluate the combined effect of prenatal glucocorticoid administration and postnatal NO inhalation on the survival rate of newborn rats with nitrofen-induced CDH. METHODS: Right-sided CDH was induced by maternal administration of a single oral dose (100 mg, intraperitoneally) of nitrofen on day 11.5 of pregnancy. Dexamethasone (DEX, 0.25 mg/kg) was given in groups III and IV by maternal intraperitoneal injection on day 18.5 and 19.5 of pregnancy. Control animals (groups I and II) received vehicle alone. After spontaneous delivery, the newborn animals were exposed to either NO (80 ppm; groups II and IV) or room air (groups I and III). Vitality (Rat-Score), sO(2) and survival were monitored continuously for 12 hours until animals were killed. Hernia size was estimated as percentage of total thoracic content. RESULTS: Right-sided CDH was observed in 392 of 491 newborn rats (81%). Animals with large hernias (>50%) died within 4 hours after birth, irrespective of treatment. Hernias with less than 50% of the thoracic volume were considered clinically relevant hernias. In this category, 12.5% of animals without treatment (group I) survived compared with 63.6% after NO treatment alone (group II; P <.01). Survival rate after DEX treatment alone (group III) was 69.4% (group III v I; P <.01). In group IV (DEX and NO) 95.2% of the animals survived (group IV v I; P <.001). In contrast to DEX alone, NO administration resulted in significantly better sO(2)(group II and IV) compared with group I (P <.05). CONCLUSION: Combination of prenatal maternal glucocorticoids and postnatal NO inhalation significantly improved survival rate of newborn rats with nitrofen-induced CDH.

Administration, Inhalation↗
PubMed2001

[Gastric substitute following gastrectomy].

Gastric substitute following gastrectomy. Following gastrectomy a variety of different reconstructive alternatives with different advantages and disadvantages have been proposed. Direct termino-lateral esophagojejunostomy with preservation of the duodenal passage or roux-en-Y jejuno-jejunostomy may be considered as current standard route of reconstruction. With current knowledge formation of a jejunal reservoir with a pouch length of 15 cm seems to be advantageous over simple roux-en-Y reconstruction. Preservation of the duodenal passage offers objective biochemical advantages, while its clinical implications have yet to be confirmed. True long term results of randomised studies are still pending. Thus, the technically easier pouch formation using the roux-en-Y reconstruction may currently be favored. Jejunoplicatio as an antirefluxive component of reconstruction is optional. Its value may well lie in the securement of a critical esophagojejunal anastomosis.

Anastomosis, Roux-en-Y↗
PubMed1999

[Involvement of the peripheral nervous system in Crohn disease].

In medical literature peripheral neurological disorders are associated with Crohn's disease only in particular cases. We report on two patients who suffering from Crohn's disease developed an acute Guillain-Barré syndrome or a polyneuropathy associated with myositis. Two weeks after a 65-year old female patient developed a serious Guillain-Barré syndrome, a haemorrhagical Crohn's colitis was diagnosed. Within a few weeks the specific therapy led to a satisfying recovery. A 45-year old female had suffered from Crohn's disease since 12 years. Within 8 weeks she developed a serious sensorimotor mixed axonal and demyelinating neuropathy and a granulomatous myositis. After treatment with steroids her signs constantly decreased. These observations as well as a literature review show that polyneuropathy and Guillain-Barré syndrome can be associated with chronic inflammatory bowel diseases. Our results suggest that peripheral neurological signs could be regarded as a possible extraintestinal manifestation of inflammatory bowel disease.

Aged↗
PubMed1998

[Non-cardiac chest pain].

Non-cardiac chest pain is caused in 50% by esophageal disorders. About 30% of such esophageal chest pain is induced by gastroesophageal reflux. 2/3 of esophageal chest pain is related to various esophageal motility disorders, which can be differentiated by manometry. Diagnostic procedures for esophageal dysfunction (endoscopy, radiology, long-term pH-metry) have been evaluated. Therapy of gastroesophageal reflux disease has been proven effective; maintenance therapy should be evaluated in further controlled randomized trials. Treatment of esophageal motility disorders, unsatisfactory so far, needs to be improved and standardized.

Angina Pectoris↗
PubMed1995

[Septic portal vein thrombosis. Its successful therapy by local fibrinolysis and a transjugular portasystemic stent-shunt (TIPS)].

HISTORY AND FINDINGS: A 68-year-old man, without any preceding hepatic or abdominal disease, suddenly developed a severe septic illness with consumptive coagulopathy and upper abdominal pain. B-mode and duplex ultrasonography revealed fresh portal vein thrombosis. Despite extensive conservative measures there was no significant improvement after one week and further thrombus extension with threatened acute mesenteric vein occlusion. TREATMENT AND COURSE: Local fibrinolysis with recombinant plasminogen activator and urokinase via percutaneous transjugular intrahepatic catheterization of the portal vein achieved almost complete dissolution of the thrombus within 3 days. Subsequently the portal vein catheter was changed into a transjugular portosystemic stent shunt (TIPS). CONCLUSIONS: While local or systemic fibrinolysis has been practised in previously reported cases of acute portal vein thrombosis, the described use of TIPS introduces a new element. The shunt between hepatic and portal veins assures therapeutic access to the portal venous bed. It lowers portal vein pressure and can diminish the danger of recurrent thrombosis by raising portal flow. This minimally invasive procedure may be a nearly ideal treatment even in the course of portal vein thrombosis which has a high complication rate.

Aged↗
PubMed1995

[Chronic granulomatosis: a rare differential diagnosis in liver granulomas in adulthood].

A now 43-year-old man was known since childhood to have mesenteric and subcutaneous lymphadenopathy. Histological examination of liver biopsies and excision of some lymph nodes when an adult showed epithelioid granulomas, in places with Langhans giant cells. Diagnostic splenectomy revealed no pathological findings. His present admission to hospital was for an infection with high fever. On auscultation moist rales were audible over the apex of the left lung. The chest radiography showed pneumonic infiltration. Blood culture grew Pseudomonas aeruginosa. Ultrasound demonstrated hypoechogenic homogeneous and smoothly circumscribed round foci in the liver hilus and around the coeliac trunk. The upper lobe pneumonia healed under antibiotic treatment. As chronic granulomatosis was suspected, the nitroblue tetrazolium and superoxide production tests were performed. They demonstrated that the capacity of the granulocytes to form oxygen radicals was markedly diminished. Chronic granulomatosis is an inherited disorder of granulocyte function linked to the X-chromosome. It must be included in the differential diagnosis of any unclear granulomatous disease even in adults.

Adult↗
PubMed1995

[Incidence of ultrasound detectable liver hematomas after ultrasound controlled fine needle puncture with the 0.95 mm cutting biopsy cannula in comparison with percutaneous liver biopsy with the 1.4 mm Menghini needle].

BACKGROUND: Recently, a high incidence of ultrasound-detected hepatic hematomas due to percutaneous liver biopsy has been reported. Until yet, little is known about the incidence of asymptomatic hepatic hematomas following sonographically guided fine-needle biopsy. PATIENTS AND METHODS: For that reason, we carried out a prospective study with sonographic examinations before and after liver biopsy in 160 patients. 51 patients, aged 50 to 83, median 67 years, with focal liver lesions had ultrasound-guided liver biopsy using the 0.95 mm-cut biopsy-needle, in 109 patients (17 to 80, median 49 years) with diffuse liver disease percutaneous liver biopsy with the 1.4 mm-needle of Menghini was performed. RESULT: After fine-needle biopsy none of the 51 patients with focal liver lesions displayed liver hematoma on ultrasonography. In the group of patients who underwent percutaneous Menghini biopsy a liver hematoma, sized up to 12 x 5 cm in diameter, occurred four times (3.7%). CONCLUSION: The results of this study indicate that fine-needle biopsy of the liver is a particularly safe diagnostic procedure, when compared with percutaneous Menghini biopsy.

Adolescent↗
PubMed1994

[Prospective study of the incidence of ultrasound detectable liver hematomas after laparoscopically controlled liver puncture with the Silverman needle].

BACKGROUND: A high incidence of hepatic haematomas detected at sonography following percutaneous liver biopsy and laparoscopy-guided liver biopsy has recently been reported. PATIENTS AND METHODS: Prompted by this report, we carried out a prospective study on 71 patients aged between 20 and 79 years (median age: 51 years). The patients were examined by ultrasound prior to and following laparoscopy-guided biopsy with the Silverman needle. RESULTS: Only two of the 71 patients (3%) had a hepatic haematoma after biopsy. The haemangiomas had a maximum diameter of 2.6 cm, caused no pain, and disappeared again within ten days at the latest. No therapeutic measures were required. CONCLUSION: The results of this study indicate that laparoscopy-guided liver biopsy with the Silverman needle is associated with relatively few complications.

Adult↗