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Biomedical subjects

W Otto

Publications and source records attributed to W Otto.

At least 19 recordsLinked to original sources
PubMed2002

[Differential therapy in radial head fractures].

The therapeutic regimen of radial head fractures, especially of displaced and comminuted types is controversial. The radial head resection has been critically reviewed over the past years. From 1984-1993 and 1996-1999, 105 radial head fractures were treated in our hospital. 74 were subject to clinical and radiological follow-up. Fracture-types were classified according to Mason. Undisplaced fractures were treated conservatively, displaced 2-fragment-fractures by an open reduction and screw fixation, and multifragment-fractures by a radial head resection. The results were studied on a functional and radiological basis using the "Functional Rating Index" of Broberg and Morrey and the radiological Score of Albrecht and Ganz. After conservative therapy over 80 % achieved excellent and good as well as 12.5 % satisfactory and 6.3 % unsatisfactory results. After reduction and internal fixation again 80 % had excellent and good results. After radial head resection excellent and good results were achieved in 54.6 % of the cases, satisfactory results in 24.2 % and in 21.2 % unsatisfactory results, however prognosis-influencing concomitant injuries were often present in the latter group. Using the right indication and technique, the radial head resection still is a recommendable therapeutic procedure with an altogether good prognosis. This especially applies to isolated radial head fractures where excellent and good results can be achieved in approximately 70 %.

Adolescent↗
PubMed2001

Carcinoma adenoides cysticum as a primary neoplasm most probably derived from biliary ducts--case report.

UNLABELLED: Adenoid cystic carcinoma is a typical tumor of large and small salivary glands and sometimes of the breast. The aim of this report is presentation of a case of primary liver cancer with adenoid cystic cancer histology in 21-year old female patient. The tumor was discovered accidentally during pregnancy. The patient did not complain of any ailments. In biochemical tests only slightly elevated bilirubin, alkaline phosphatase and GGT concentrations were observed. No focal lesions in other organs were found in imaging examinations. Huge tumor of 30-cm diameter was found during surgery, encompassing almost whole left and right lobe of the liver. The biopsy taken from the tumor revealed histological picture typical for adenoid cystic carcinoma. Additional stainings and immunohistochemical examinations pointed to biliary ducts as possible place of origin of the neoplasm. SUMMARY: Among primary liver tumours of atypical clinical course the possibility of adenoid cystic carcinoma, deriving most probably from the biliary ducts, should be considered.

Adult↗
PubMed2000

[Acetabulum fractures. Diagnosis, classification, evaluation].

Diagnostics of acetabular lesions rest on careful explored medical history, clinical findings and X-ray-examination. Apart from standard radiography (pelvis a. p., injured hip a. p., iliac-oblique and obturator-oblique), which enables classification and supports strategic therapy decisions, computed tomography is considered indispensable by the majority. Fragment interposition, marginal impaction and concomitant occult pelvic ring fractures are detected and are the basis for special tactical decisions in operative treatment. The classification of Letournel with 5 elementary and 5 associated fracture types is still widely used. The AO-classification gives a solid basis for scientific evaluation and is a fundamental for a therapeutic concept with its basic structure with types and groups, ascending according to damage severity. Evaluation of acetabular fractures has to include additional and concomitant lesions and expected late damages. Only an anatomic reconstruction of the weight bearing part of the socket gives a chance for functional restitution. Osteoarthritis and disabling ectopic ossifications are not always avoidable and are subsequently the cause of impairment and respectively loss of working ability.

Acetabulum↗
PubMed1999

Safety and immunogenicity of an acellular pertussis vaccine in premature infants.

OBJECTIVES: To evaluate the safety and immunogenicity of a two-component acellular pertussis vaccine in preterm infants. STUDY DESIGN: Fifty preterm infants (25-35 weeks of gestation; mean, 30.8 weeks) and 50 term infants as a control group received a two-component acellular pertussis vaccine irrespective of their biological age and actual weight. Adverse reactions were registered by parents on a diary card and reviewed on each visit. Antibodies against pertussis toxoid (PT) and filamentous hemagglutinin (FHA) were determined with an enzyme-linked immunosorbent assay before the first and after the third vaccination. RESULTS: The infants of both groups showed an increase in geometric mean titers (GMT) against PT and FHA after vaccination (3 doses). There was a significant difference of antibody concentration between the preterm and the control group. The GMT for PT antibody of the preterm infants was 64. 16 U/L, and for the term infants it was 98.96 U/L. The GMT for FHA was 50.92 U/L in preterm versus 86.02 U/L in the control group. Efficacy of the immunization (more than a fourfold increase of antibody concentration in each infant) was 93.5% in the preterm group with respect to PT and 82.6% with respect to FHA. The incidence of adverse reactions was low and comparable in both study groups. CONCLUSION: Immunization with an acellular pertussis vaccine is safe for preterm infants. The immune response is significantly lower compared with a control group of term infants, but efficacy is high.

Antibodies, Viral↗
PubMed1997

Pancreatic spasmolytic polypeptide protects the gastric mucosa but does not inhibit acid secretion or motility.

The objectives of these studies were to examine whether the trefoil peptide porcine pancreatic spasmolytic polypeptide (PSP) had gastric mucosal protectant properties similar to its human equivalent human spasmolytic polypeptide (hSP) and to confirm the antisecretory and antimotility action of the peptide. PSP and recombinant hSP reduced gastric mucosal damage caused by a combination of subcutaneous indomethacin and restraint stress in the conscious rat. At a dose of 500 micrograms/kg bolus plus 500 micrograms.kg-1.h-1 sc, PSP significantly reduced the total area of damage by 58%. PSP at a dose of 150 micrograms/kg iv had no inhibitory effect on pentagastrin-stimulated gastric acid secretion in the perfused stomachs of anesthetized rats. This lack of antisecretory activity was confirmed in vitro using an isolated stomach preparation from the immature rat. PSP and hSP at concentrations up to 800 nM did not inhibit electrically or chemically evoked contractions of the guinea pig ileum and duodenum in vitro. Thus antisecretory and antimotility actions do not underlie the mucosal protectant properties of PSP. PSP did, however, stimulate cell migration, and this may, at least in part, account for its protectant properties.

Animals↗
PubMed1997

[Treatment of liver injuries in personal clinical material from 1990-1996].

From 1990 to 1996 two hundred and sixteen patients with abdominal trauma were treated in our Department. In 170 cases there were blunt, and in 46-penetrating injuries (stab and gunshot wounds). Injuries of the other regions of the body coexisted in 117 patients (multiple trauma). In 42 cases (19.4%) abdominal trauma caused injury to the liver. In this group blunt mechanism of trauma also dominated (71%). The victims were usually young men (90% of the group, mean age - 35.3 years). The most common cause of injury were traffic accidents (47.6%), penetrating injury being the second commonest cause (12 patients i.e. 29%). Four patients were treated conservatively, the remaining 38 required surgical intervention. Most frequently liver suture and peritoneal drainage were performed (20), followed by liver tissue resections (16) and liver packing (12). Other surgical procedures to treat coexisting injuries were performed in 24 patients. In 22 patients postoperative complications occurred: liver abscess in 6 cases, hemorrhage in 4, wound infection in 4, biliary fistula in 2, intrahepatic aneurysm in 2 and other complications in 8 patients. The mean time of hospitalisation were of 20 days (range: 0-64 days). Mean volume of blood transfused equaled 6.9 U. There were 16 deaths (38%), in all cases in multiple trauma victims. All patients with penetrating liver trauma survived.

Adult↗
PubMed1997

[Esophageal resection for cancer--analysis of postoperative complications from personal materials].

The aim of the present study was to analyse the rate of postoperative complications in patients after esophageal resection for cancer, as well as the dependence of its frequency from surgical tactics employed during the operation. Postoperative complications occurring in 38 patients who underwent esophagectomy and intrathoracic esophagogastric anastomosis (treated from 1978 to 1987) were compared with the same data of 74 patients (1988-1996) in whom the operation consisted of the total intrathoracic esophagectomy, cardia, lesser curvature of the stomach and large regional lymph nodes dissection. In these latter cases the esophagogastric anastomosis was performed in the neck. The most frequent postoperative complications in both groups were of cardiopulmonary origin. The anastomotic leak occurred less frequently in patients with cervical esophagogastric anastomosis. However, when occurred, healing was more likely by local drainage and conservative treatment. Anastomotic leaks after intrathoracic esophagogatric anastomoses were usually fatal. In these cases the only chance of patient's survival was an aggressive surgical treatment consisting of disconnection of alimentary tract: esophageal fistula in the neck and feeding jejunostomy.

Anastomosis, Surgical↗
PubMed1997

[Evaluation of the usefulness of the liver for transplantation based on 26 multiorgan harvests].

UNLABELLED: This study is aimed at the clinical and morphological criteria of estimation of the liver harvested for transplantation. In the period from January 1996 to May 1997 our team obtained 26 livers at the multi-organ harvesting. Most of the donors were young people after the trauma of central nervous system. The liver was harvested according to the principles of Starzl's fast method with the successive preparation on the "cold table". The donor's clinical status was estimated, as well as appearance, density and colour of the organ, quality of perfusion with UW solution In 23 cases the histological examination of the harvested organ allowed to estimate the degree of steatosis, hepatocyte necrosis, vacuolar degeneration and other abnormalities. In 3 cases the graft was estimated only by means of macroscopic examination. RESULTS: As a result of clinical and histological findings 8 organs were considered as unsuitable for transplantation. In one case the histological findings were the contraindication despite the satisfactory macroscopic appearance of the organ 15 organs were successfully transplanted, proving the conformity of clinical and histological criteria. In 4 livers (15%) the abnormalities of arterial supply were found. CONCLUSIONS: Clinical and pathomorphological estimation of the harvested liver is adequate to it's suitability for transplantation, advisable for the centres initiating the liver transplantation program. Detailed analysis of the donor's clinical status and laboratory data and competent macroscopic estimation of the harvested liver allow the experienced surgeon to resign from the routine histological verification, which might be necessary in doubtful cases only.

Humans↗
PubMed1996

[Value of ultrasound examination in injuries of the symphysis].

Lesions of the symphisis are usually diagnosed by a pelvis X-ray. The use of ultrasound examination is not very common. The application of the ultrasonic head in a suprasymphyseal manner will result in good images of the anterior pelvis. The outcome of diastasis as well as of the edge of the symphysis measurements taken by ultrasound were comparable to the X-ray picture. Therefore ultrasound investigation is usefull for primary diagnosis and follow-up examination in injuries of the symphysis. Accompanying fractures of the pelvic ring stay in this case undetected.

Adult↗
PubMed1996

[An interesting case: late sequelae of a primary asymptomatic glass fragment injury of the wrist].

Report of a female patient, aged 29 at the time of a glass-fragment laceration, who complained six years after the injury of paraesthesia at the index finger. At the surgical exploration, a glass fragment was found in the tendon of the palmaris longus, which had irritated the median nerve. In the discussion of problems of injuries with broken glass, exact primary, diagnostics and open exploration is required.

Adult↗
PubMed1995

Endoscopic laser treatment of benign tracheal stenoses.

We present the technique and results of endoscopic neodymium-yttrium aluminum garnet laser treatment of benign tracheal stenoses. This therapy was used in 15 patients with tracheal stenoses. Benign tracheal granulomas were caused by prolonged tracheal intubation in eight patients, permanent maintenance of tracheostomy tube in five patients, and nonspecific inflammatory process of the trachea in two patients. The clinical picture was dominated by dyspnea and stridor. The achievement of normal tracheal patency required several laser therapy sessions, repeated at 5- to 7-day intervals. In 30% of patients additional laser vaporization was required as well. The immediate and short-term results were encouraging; in all cases the normal tracheal lumen was restored, resulting in alleviation of patients' symptoms.

Adult↗
PubMed1994

[Endoscopic treatment of iatrogenic tracheal stenosis by laser Nd:YAG].

The authors present the technique and results of endoscopic Nd:YAG laser treatment of inflammatory tracheal stenoses. This kind of therapy was employed in 10 patients with tracheal stenosis, resulting from long-term nastotracheal intubation (6 cases), tracheostomy tube after radical laryngectomy (3 cases) and tracheal trauma. The laser fiber was introduced into trachea by the operative channel of a flexible bronchoscope and vaporization of obstructing tissues carried out using contact method in continuous mode of light emission (power 7-20 Watts). The achievement of normal tracheal patency usually required several laser therapy sessions (3-5), repeated in 3-5 days intervals. The short-term results are encouraging: in all cases the normal tracheal was lumen was restored, resulting in alleviation of patients' symptoms. In 3 cases a recurrent tracheal stenosis, requiring additional laser treatment was observed.

Endoscopy↗
PubMed1993

Fibroblast growth factor in gastroprotection and ulcer healing: interaction with sucralfate.

The study was designed to determine the gastroprotective and ulcer healing efficacy of basic transforming growth factor (bFGF) and to assess whether this peptide contributes to the action of sucralfate on the rat stomach. Application of human recombinant bFGF (1-100 micrograms/kg/hour subcutaneously) failed to affect the formation of acute gastric lesions induced by 100% ethanol and acidified aspirin but reduced the stress induced by gastric lesions. Sucralfate (100-200 mg/kg given orally) protected gastric mucosa against the ethanol, aspirin, and stress induced acute gastric lesions but the addition of bFGF (100 micrograms/kg subcutaneously or intragastrically) failed to affect sucralfate induced protection against ethanol or aspirin but increased that against stress. Administration of bFGF (3-300 micrograms/kg/day) by an intragastric or an intraperitoneal route or sucralfate (400 mg/kg/day) orally to rats with acetic acid induced gastric ulcers, enhanced the healing rate of these ulcers during seven day treatment in a dose dependent manner. This was accompanied by a pronounced increase in the number of capillaries and myofibroblasts and in DNA synthesis and DNA and RNA concentrations in the granulation tissue in the ulcer area. [125I]bFGF (1 microCi) applied subcutaneously or intragastrically accumulated in two to threefold higher amounts in the ulcer area than in the intact mucosa, particularly in rats treated with sucralfate. Concurrent treatment with indomethacin (2 mg/kg intraperitoneally) delayed ulcer healing and reduced the binding of labelled bFGF to the ulcer area, angiogenesis, and DNA synthesis by sucralfate. Addition of [125I]bFGF to sucralfate at various pHs resulted in the coprecipitation of bFGF by sucralfate in a pH dependent manner from about 10% at pH 7.0 to 90% at pH 1.5. Thus bFGF shows little protective activity and is not essential for gastroprotection afforded by sucralfate but plays an important part in healing of gastric ulcers possibly due to its growth promoting and angiogenic actions.

Acetates↗
PubMed1992

[Neuropsychiatric manifestations of Saethre-Chotzen syndrome].

Four psychiatric patients with SCS are described. All exhibited essential tremor, minimal cerebral dysfunctions, speech disorders, bradyphrenia, disorders of personality with psychasthenie and suspicious traits, restrictions, increased irritability and depressivity, one case of mutism due to abnormal reaction and one of alcohol hallucinosis. The possibility of cosmetic handicap caused by craniofacial dysplasia should be taken into mind and perhaps surgically corrected. Because the craniofacial dysplasia is mostly moderate and the syndactylies are slight the SCS remains often unrecognized, but apart from psychic maldevelopment it is significant as the result of frequent association with other malformations.

Acrocephalosyndactylia↗
PubMed1991

[Vascular stenosis of the branches of the aortic arch. Surgical treatment and long-term follow-up].

Since 1971 69 patients have been operated on for lesions of branches of the aortic arch (71 surgical procedures). In 80% of the patients extrathoracic reconstructions were performed, mainly carotid-subclavian bypasses (64%) using knitted dacron grafts (6 mm and 8 mm diameter). A transthoracic approach was used in 20% of the patients. No patient died after operation and no ischemic neurological deficit occurred. The cumulative survival rate was 89% after five and 59% after ten years. The cumulative patency rate in the survivors was 100% after transthoracic approach after five and ten years. Identical patency rates were observed after extrathoracic carotid-subclavian bypass using 8 mm dacron grafts, whereas in 6 mm grafts the patency rate was only 67% after five and ten years. 85% of all patients were symptom-free and additional 10% improved. These results confirm that carotid-subclavian bypass using 8 mm dacron grafts has a long term patency rate identical to those after anatomical transthoracic procedures.

Female↗
PubMed1989

[The influence of thermal load on the immunochemical detection of dried blood plasma supplements in meat mixtures].

Addition of blood plasma to meat products is not permitted in the FRG unless these products are heat processed using an internal temperature of 80 degrees C (German regulation of meat and meat products: "Verordnung für Fleisch und Fleischerzeugnisse"). Such heat process may have an unfavourable effect on the detectability of blood plasma. Since blood plasma or dried plasma may originate from different animal species (porcine or bovine) two different anti dried blood plasma-sera (porcine and bovine) are required for immunochemical analysis. The varying quality of these sera has to be considered when interpreting the results. Seven M urea extract turned out to be suitable for detection of dried plasma additives and proved to be highly effective particularly when examining heated samples. Both the gel-diffusion and the electro immuno assay proved useful for the detection of dried blood plasma, provided the examined extracts had been adequately diluted. Immunochemical reactivity was hampered by the heat process which was given to the sample. Accordingly, the concentration of the plasma in a particular sample cannot be determined unless the time/temperature data of the process applied to the sample were given and model samples were tested for comparison.

Animals↗
PubMed1989

[Fracture of the tibial shaft--still a traumatology problem?].

Diaphyseal fractures of the lower leg have continued to hold a special position in terms of incidence, type, severity, and frequency of typical complications as well as healing disorders. Despite general consensus regarding fracture healing and major factors of influence, there still is discrepancy of opinions and recommendations, in the context of pathophysiology, mechanics, and therapy. All in all, 302 fresh fractures and 134 cases of delayed healing or pseudoarthrosis in the diaphyseal region were treated, between 1971 and 1985. It has been the authors' experience that conservative treatment, according to the classical school, should be applied whenever possible. The trend in surgery, primarily for open fractures, is towards adequately dimensioned fixateur externe. Accurately defined minimum instability and healing with callus formation are nowadays appreciated and preferred. The fibula-ligament-membrane-complex may assume great importance to instable or defective forms of tibial fractures. Experimental and clinical investigations are likely to suggest that, depending on the individual case, the fibula should be included in the overall therapeutic concept, when it comes to impaired or delayed healing and pseudoarthrosis.

Adolescent↗