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Biomedical subjects

T Schubert

Publications and source records attributed to T Schubert.

At least 55 records · Page 3Linked to original sources
PubMed1989

Intraabdominal abscesses--percutaneous catheter drainage versus operative treatment.

From 65 patients with 73 abscesses 38 were treated by operation and 27 by PCD. The mean duration of drainage was 6.8 days (OP) and 7.4 days (PCD) respectively. In the surgical group 2 patients needed reintervention and 1 died due to sepsis. In the PCD group 1 patient had to be operated on because of insufficient drainage and 1 died after perforation of the colon. With modern techniques of imaging (Ultrasound, CT) PCD is a useful tool in the therapeutic regimen of intraabdominal abscesses. PCD has to be considered as definitive treatment or preparation for surgical eradication. Above all indication to PCD depends on localization and cause of the abscess.

Abdomen↗
PubMed1989

A multicenter, randomized, double-blind trial of somatostatin in the management of acute hemorrhage from esophageal varices.

A prospective, randomized, placebo-controlled, double-blind, multicenter clinical trial of intravenous somatostatin (Stilamin; Serono Laboratories, Inc., Randolph, MA) was performed in 102 patients with actively bleeding esophageal varices from August, 1985, to November, 1986. Patients had major hemorrhage indicated by hematemesis or melena and evidence of significant blood loss. For entry, patients had to have endoscopic demonstration of active bleeding from esophageal varices or stigmata of recent hemorrhage and bright red blood in the gastric aspirate with no other source of bleeding found. Randomized patients received identical-appearing somatostatin or placebo for a 30-hr study period. Those given somatostatin received a 250-micrograms bolus and a 250-micrograms per hr infusion with repeat bolus and doubling of the infusion if the bleeding was not controlled. In retrospect, 18 patients could not be evaluated. Of the 84 evaluable patients, 48 received somatostatin and 36 placebo. They were comparable in age, gender, severity of liver disease and history of variceal bleeding. Transfusion requirements were similar in both groups. Bleeding stopped for 12 consecutive hr during 30 hr of the study period in 31 (65%) of the somatostatin group vs. 30 (83%) of the placebo group (p = 0.06). The median time to cessation of bleeding was 2 hr in the placebo group and 3 hr in the somatostatin group. Deaths following the study period were nine (25%) in the placebo group and 15 (31%) in the somatostatin group. Within the limitations of the present study, we conclude that somatostatin was ineffective in the management of active bleeding of esophageal varices.

Adult↗
PubMed1989

Adenosine cardioplegia. Adenosine versus potassium cardioplegia: effects on cardiac arrest and postischemic recovery in the isolated rat heart.

Adenosine is a potential cardioplegic agent by virtue of its specific inhibitory properties on nodal tissue. We tested the hypothesis that adenosine could be more effective than potassium in inducing rapid cardiac arrest and enhancing postischemic hemodynamic recovery. Isolated rat hearts were perfused with Krebs-Henseleit buffer or cardioplegic solutions to determine the time to cardiac arrest and the high-energy phosphate levels at the end of cardioplegia. Cardioplegic solutions contained adenosine 10 mmol/L, potassium 20 mmol/L, or adenosine 10 mmol/L + potassium 20 mmol/L and were infused at a rate of 2 ml/min for 3 minutes at 10 degrees C. Both time taken and total number of beats to cardiac arrest during 3 minutes of cardioplegia were reduced by adenosine 10 mmol/L and adenosine 10 mmol/L + potassium 20 mmol/L when compared with potassium 20 mmol/L alone (p less than 0.001). Tissue phosphocreatine was conserved by adenosine 10 mmol/L when compared with potassium 20 mmol/L, being 7.1 +/- 0.2 (mumol/gm wet weight (n = 7) and 6.0 +/- 0.3 mumol/gm wet weight (n = 5), respectively (p less than 0.05). Postischemic hemodynamic recovery was tested in isolated working rat hearts. After initial cardiac arrest, the cardioplegic solution was removed with Krebs-Henseleit buffer at a rate of 2 ml/min for 3 minutes at 10 degrees C, and thereafter total ischemia was maintained for 30 or 90 minutes at 10 degrees C before reperfusion. Adenosine 10 mmol/L enhanced recovery of aortic output when compared with potassium 20 mmol/L or adenosine 10 mmol/L + potassium 20 mmol/L, the percentage recovery after 30 minutes of ischemia being 103.0% +/- 4.4% (n = 6), 89.0% +/- 5.8% (n = 6), and 86.6% +/- 4.3% (n = 6), respectively (p less than 0.05 for comparison between adenosine 10 mmol/L and potassium 20 mmol/L). Thus adenosine cardioplegia caused rapid cardiac arrest and improved postischemic recovery when compared with potassium cardioplegia and with a combination of these two agents.

Adenosine↗
PubMed1989

[The production of eluates for testing acute cytotoxicity by a new method].

In vitro tests of new biomaterials require internationally and nationally eluates increasingly. Only the extracted substances become effective in the cells in that way. The material surface has the greatest influence on the quantity of the released substances by elution. The surface of diverse undefined mixture quantities is definable exactly by means of a gas adsorption method (BET method). The influence of the secondary technologies was tested by the atom adsorption spectrometry. The Jena bioglass ceramics could be estimated successfully by this method.

Biocompatible Materials↗
PubMed1989

[Parasitic liver cyst. Indications and choice of procedure in cystic echinococcosis].

About 60-90% of clinically diagnosed cases of echinococcosis are found in the liver. Half of these patients show episodes of acute abdominal or back pain. The others complain about discrete and unspecific symptoms. Diagnosis is confirmed by combination of imaging techniques and serologic tests. Operation still is the only way for eradication of the parasite. This paper presents a summary of the literature and clinical data of 27 patients treated in our hospital from 1966 to March 1988. Cystectomy with omentoplasty is confirmed to be a simple and effective surgical method in operative treatment of echinococcosis.

Adolescent↗
PubMed1988

Radiology and pathology in canine acalculous cholecystitis.

Although the value of hepatobiliary scan and ultrasonography are well established in calculous cholecystitis, their role in acute acalculous cholecystitis (AAC) is less certain. This study assesses the diagnostic reliability of these tests in AAC chemically induced in 10 dogs with rutin, a compound known to induce AAC. Ultrasonography demonstrated pericholecystic fluid or wall thickening in 8 of 10 dogs. Hepatobiliary scans were abnormal in only 2 of 9 dogs. Pathologic evaluation showed significant abnormalities in all gallbladders. Our studies confirm the usefulness of ultrasonography in diagnosing AAC and suggest caution in using a normal hepatobiliary scan to exclude the diagnosis of AAC.

Animals↗
PubMed1988

Acute hemoperitoneum from rupture of a hepatocellular carcinoma.

A male patient with cirrhosis presented with acute right upper quadrant pain, systemic hypotension, and falling hematocrit. Abdominal paracentesis confirmed acute hemoperitoneum, and abdominal computed tomography (CT) scan demonstrated a large hepatic mass consistent with hepatocellular carcinoma (HCC). This rare presentation of a malignancy uncommon in North America leads to a discussion of the differential diagnosis of acute hemoperitoneum and a review of the literature on acute hemoperitoneum and HCC.

Acute Disease↗
PubMed1987

Improved survival in variceal hemorrhage with emergent sclerotherapy.

Over a 2-yr period (1984-1985) we performed emergent endoscopic injection sclerotherapy (EIS) within 12 h in 25 consecutive episodes of variceal hemorrhage (VH). The outcome was compared to the preemergent period (1982-1984) when 22 episodes of VH were treated first with vasopressin and balloon tamponade, and then by EIS, in cases which failed to resolve. In those with decompensated liver disease, average transfusions dropped from 12.3 to 7.1 units of blood. Continued bleeding decreased from 53% to 13% and mortality from 47% to 13%. Persons with compensated liver disease had fewer recurrent bleeding episodes, and tended toward decreased transfusion requirements and mortality with EIS. Our experience suggests that emergent EIS is the treatment of choice for acute VH.

Blood Transfusion↗
PubMed1986

Phenytoin hypersensitivity hepatitis and mononucleosis syndrome.

We present a patient who developed a mononucleosis syndrome 6 weeks after starting phenytoin therapy for a seizure disorder. Improvement followed initial discontinuation of the phenytoin, but near-fatal hepatic necrosis resulted from intravenous phenytoin rechallenge. A serious reaction with a 18% overall mortality, phenytoin hepatitis may closely resemble infectious mononucleosis with fever, pharyngitis, lymphadenopathy, and atypical lymphocytosis. Continued administration of phenytoin or later rechallenge may increase the severity of the reaction.

Adult↗
PubMed1983

Acute renal failure secondary to myoglobinuria associated with Legionnaires' disease.

A case of nonfatal Legionnaires' disease was complicated by rhabdomyolysis, myoglobinuria, and acute nonoliguric renal failure. It was not determined whether the rhabdomyolysis was secondary to direct toxic effect of the organism or due to a circulating factor causing muscle necrosis. This case provides additional evidence that rhabdomyolysis with subsequent renal failure may be a serious complication of Legionnaires' disease.

Acute Kidney Injury↗