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Raab S, Hagleitner G, Motz R, Fellner FA, Shamiyeh A. Perirectal intraperitoneal splenosis: A case report of MRI with laparoscopic correlation. Radiol Case Rep 2021; 16:1543-1547. [PMID: 33948131 PMCID: PMC8081866 DOI: 10.1016/j.radcr.2021.03.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/19/2022] Open
Abstract
Splenosis is a benign acquired condition, which appears after rupture of the spleen and heterotopic auto-transplantation. Mostly found as an incidental finding on cross-sectional imaging, definitive diagnosis is frequently made histologically after resection or tissue sampling. We report a case of a 36-year-old male patient who presented with increased susceptibility to infections, chronic fatigue, and a history of traumatic splenic rupture. Cross-sectional imaging showed perirectal formations within the mesorectal fascia, and extraperitoneal splenosis was suspected. Due to the radiologically unclear entity of the masses, diagnostic laparoscopy with tissue sampling was performed. Intraoperatively the masses turned out to be intraperitoneal. Histological workup showed splenic tissue, consistent with intraperitoneal splenosis after splenic rupture. In this article we want to discuss important imaging findings and their differentials, as well as clinical implications for this rare entity.
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Affiliation(s)
- Sandra Raab
- Department of General and Visceral Surgery, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Linz, Austria
| | - Georg Hagleitner
- Central Radiology Institute, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Linz, Austria
| | - Reinhard Motz
- Institute of Pathology and Molecular Pathology, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Linz, Austria
| | - Franz A Fellner
- Central Radiology Institute, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Linz, Austria.,Medical Faculty of the Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Andreas Shamiyeh
- Department of General and Visceral Surgery, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Linz, Austria
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Grosse C, Grosse A, Salzer HJF, Dünser MW, Motz R, Langer R. Analysis of cardiopulmonary findings in COVID-19 fatalities: High incidence of pulmonary artery thrombi and acute suppurative bronchopneumonia. Cardiovasc Pathol 2020; 49:107263. [PMID: 32784110 PMCID: PMC7365076 DOI: 10.1016/j.carpath.2020.107263] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 02/06/2023] Open
Abstract
Since its recognition in December 2019, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has rapidly spread globally causing a pandemic that represents the greatest medical challenge in decades. The aim of the study was to evaluate the spectrum of cardiopulmonary pathology of COVID-19 based on (non-minimal invasive) autopsies performed on 14 COVID-19 decedents. Bilateral diffuse alveolar damage (DAD) was found in all patients. Superimposed acute bronchopneumonia was present in 11 of 14 (78.6%) patients and was considered the major cause of death in 2 patients. A key finding was the presence of thrombotic/thromboembolic vascular occlusions. We classified 5 types of pulmonary thrombi: 1. capillary microthrombi (11/14, 78.6%); 2. partially organized thrombi in mid-sized pulmonary arteries with complete vessel occlusion; 3. non-organized thrombi in mid-sized pulmonary arteries that did not completely fill out the vessel lumen and probably represented thromboemboli rather than thrombosis; 4. bone marrow emboli (1/14, 7.1%); and 5. septic pulmonary thromboemboli (1/14, 7.1%). Pulmonary thrombi in mid-sized arteries were noted in 5 of 14 (35.7%) patients, causing pulmonary infarction and/or pulmonary hemorrhage. All patients had evidence of chronic cardiac disease, including myocardial hypertrophy (13/14, 92.9%), mild to marked coronary artery atherosclerosis (14/14, 100%) and focal myocardial fibrosis (3/14, 21.4%). Acute myocardial infarction was found as concurrent cause of death in 3 (21.4%) patients, and significant cardiac hypertrophy (heart weight 750 g) was present in 1 (7.1%) patient with ATTR-positive cardiac amyloidosis. The autopsy findings confirm that COVID-19 is a systemic disease, with major involvement of the lungs, that increases the risk of cardiac and vascular complications including acute myocardial injury and thrombotic/thromboembolic events. Secondary acute bronchopneumonia is a common complication in patients with COVID-19 and may be the major cause of death.
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Affiliation(s)
- Claudia Grosse
- Institute of Pathology and Microbiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria.
| | - Alexandra Grosse
- Institute of Pathology and Microbiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
| | - Helmut J F Salzer
- Department of Pulmonology, Kepler University Hospital, Krankenhausstrasse 9, 4041 Linz, Austria
| | - Martin W Dünser
- Department of Anaesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
| | - Reinhard Motz
- Institute of Pathology and Microbiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
| | - Rupert Langer
- Institute of Pathology and Microbiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria
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Weiss C, Angleitner-Boubenizek L, Motz R, Oppelt P. A desmoid tumour (aggressive fibromatosis) in an 80-year-old woman - case report of a rare differential diagnosis in gynaecology. J OBSTET GYNAECOL 2019; 40:139-140. [PMID: 31210068 DOI: 10.1080/01443615.2019.1588865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Christoph Weiss
- Department of Gynaecology Obstetrics, and Gynaecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Lukas Angleitner-Boubenizek
- Department of Gynaecology Obstetrics, and Gynaecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Reinhard Motz
- Department of Pathology and Microbiology, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Peter Oppelt
- Department of Gynaecology Obstetrics, and Gynaecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Linz, Austria
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Nagasawa H, Motz R, Hamada C, Kohno Y, Yamada Y. An interpretation of the neonatal period definition obtained with echocardiographic examination by using change point regression analysis. J Neonatal Perinatal Med 2019; 11:387-392. [PMID: 30149477 DOI: 10.3233/npm-1797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We had reported on the left ventricular end-diastolic dimension (LVDd) in normal children from the premature/neonatal period to the adolescence period by using two-dimensional echocardiography, and formulated equations to evaluate normal LVDd values by using body height as an index. There was an inflection point at around birth that seemed relevant to the fetal and neonatal periods for the relation of LVDd and body height. METHODS We aimed to reveal the true inflection point and its meaning by using change point regression analysis. The study group consisted of 421 neonates and infants. The ages at examination ranged from 24 weeks' gestation to 1 year after birth. The subjects' body heights at examination were between 31 and 75 cm. RESULTS The analysis showed no definite inflection point in height, and a flat bottom was observed between body heights of 48 and 55 cm. The inflection range seemed to mean the duration of the neonatal period, which connects the fetal and infantile periods. CONCLUSION The results revealed that neonates reach the infantile period slower than usually imagined, and the end of the neonatal period may be at the age when the body height is around 55 cm- in other words, at 2 months after birth. This manuscript might be the first one to consider the definition of the neonatal period using cardiovascular methods.
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Affiliation(s)
- H Nagasawa
- Department of Neonatology, Gifu Prefectural General Medical Center, Japan
| | - R Motz
- Department of Paediatric Cardiology, Elisabeth Children's Hospital, Klinikum Oldenburg, Rahel-Straus-Strasse, Oldenburg, Germany
| | - C Hamada
- Department of Industrial Management and Engineering, Tokyo University of Science, Tokyo, Japan
| | - Y Kohno
- Department of Neonatology, Gifu Prefectural General Medical Center, Japan
| | - Y Yamada
- Department of Obstetrics and Gynecology, Gifu Prefectural General Medical Center, Japan
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Weiss C, Angleitner-Boubenizek L, Motz R, Oppelt P. Desmoidfibromatose (Aggressive Fibromatose) – eine seltene Differenzialdiagnose in der Gynäkologie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- C Weiss
- Kepler Universitätsklinikum, Johannes Kepler Universität Linz, Universitätsklinik für Gynäkologie, Geburtshilfe und Gynäkologische Endokrinologie, Linz, Österreich
| | - L Angleitner-Boubenizek
- Kepler Universitätsklinikum, Johannes Kepler Universität Linz, Universitätsklinik für Gynäkologie, Geburtshilfe und Gynäkologische Endokrinologie, Linz, Österreich
| | - R Motz
- Kepler Universitätsklinikum, Johannes Kepler Universität Linz, Institut für Pathologie und Mikrobiologie, Linz, Österreich
| | - P Oppelt
- Kepler Universitätsklinikum, Johannes Kepler Universität Linz, Universitätsklinik für Gynäkologie, Geburtshilfe und Gynäkologische Endokrinologie, Linz, Österreich
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Hanfstingl K, Pekar-Lukacs A, Motz R, Guenova E, Hoetzenecker W. Successful Treatment of Pityriasis Rubra Pilaris with Ixekizumab. Case Rep Dermatol 2018; 10:97-100. [PMID: 29867429 PMCID: PMC5981592 DOI: 10.1159/000488902] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 03/28/2018] [Indexed: 12/28/2022] Open
Abstract
Pityriasis rubra pilaris is an inflammatory dermatologic disorder of unknown cause and often confounded with psoriasis. It is characterised by hyperkeratotic follicular papules, scaly erythematous plaques, palmoplantar keratoderma, and a progression to generalised erythroderma. Here, we report the case of a 68-year-old man with pityriasis rubra pilaris, who was successfully treated with ixekizumab, an interleukin-17A inhibitor.
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Affiliation(s)
- Kathrin Hanfstingl
- Department of Dermatology, Kepler University Hospital Linz, Linz, Austria
| | | | - Reinhard Motz
- Department of Pathology, Kepler University Hospital Linz, Linz, Austria
| | - Emmanuella Guenova
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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Webinger J, Abdul-Khaliq H, Apitz C, Berger F, Dalla-Pozza R, Eichhorn J, Gravenhorst V, v d Hagen M, Kehl H, Lange M, Motz R, Neudorf U, Stiller B, Dittrich S. Evaluation einer Multizentrischen Studie nach dem Arzneimittelgesetz im Kindesalter (Eudra-CT Nummer: 2009-009871-36). Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0033-1354479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kronberg K, Motz R, Härle T, Elsässer A. [Pulsatile tumor on the left side of the thorax after heart surgery]. Dtsch Med Wochenschr 2012; 137:1910-3. [PMID: 22996576 DOI: 10.1055/s-0032-1305326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
HISTORY AND ADMISSION FINDINGS In a 67-year-old woman a large haematoma developed on the left side of the chest after two sternotomies because of an aortic valve and aorta ascendens replacement for aortic type A dissection. After a few weeks, a pulsating mass remained over the 6th left parasternal intercostal space. A consultant general surgeon punctured the lesion and aspirated bright red blood. The patient was transferred for further diagnostic procedures to the cardiology department. INVESTIGATIONS Ultrasound examination of the pulsating mass showed a 35 mm echo-free cavity with turbulent flow in the color Doppler. To clarify the inflow into this perfused cavity magnetic resonance imaging (MRI) with angiography of the thorax vessels was performed. The cavity was found to be a perfused pseudoaneurysm originating from the native left mammary artery. The aneurysm had a 6 mm long neck and a diameter of 35 mm. An interventional closure was planned. TREATMENT AND COURSE With access via the right groin a 6 French LIMA guiding catheter was inserted into the origin of the left internal mammary artery. With a 0.014 inch Balance Middleweight coronary guide wire it was possible to engage the pseudoaneurysm. Over the wire, a tracker 18 infusion catheter was pushed down and placed in the pseudoaneurysm. The closure was performed by insertion of a 0.018 inch 3 cm/4 mm Hilal Microcoil into the aneurysm neck. The mammary artery was anatomically and functionally unaffected. After the deposit of a coil, the inflow was stopped. An ultrasound showed a blood coagulation in the pseudoaneurysm, which decreased in size over time. CONCLUSION After sternotomy a pseudoaneurysm of the left internal mammary artery had developed. As a noninvasive imaging modalitiy the magnetic resonance angiography showed well the exact flow into the aneurysm and allowed the planning of the intervention. The closure was achieved with a microcoil with preservation of the native internal mammary artery.
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Affiliation(s)
- K Kronberg
- Integriertes Herzzentrum, Klinik für Kardiologie, Klinikum Oldenburg.
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9
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Wöhrer A, Waldhör T, Heinzl H, Hackl M, Feichtinger J, Gruber-Mösenbacher U, Kiefer A, Maier H, Motz R, Reiner-Concin A, Richling B, Idriceanu C, Scarpatetti M, Sedivy R, Bankl HC, Stiglbauer W, Preusser M, Rössler K, Hainfellner JA. The Austrian Brain Tumour Registry: a cooperative way to establish a population-based brain tumour registry. J Neurooncol 2009; 95:401-411. [PMID: 19562257 DOI: 10.1007/s11060-009-9938-9] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 06/02/2009] [Indexed: 11/26/2022]
Abstract
In Austria, registration of malignant brain tumours is legally mandatory, whereas benign and borderline tumours are not reported. The Austrian Brain Tumour Registry (ABTR) was initiated under the auspices of the Austrian Society of Neuropathology for the registration of malignant and non-malignant brain tumours. All Austrian neuropathology units involved in brain tumour diagnostics contribute data on primary brain tumours. Non-microscopically verified cases are added by the Austrian National Cancer Registry to ensure a population-based dataset. In 2005, we registered a total of 1,688 newly diagnosed primary brain tumours in a population of 8.2 million inhabitants with an overall age-adjusted incidence rate of 18.1/100,000 person-years. Non-malignant cases constituted 866 cases (51.3%). The incidence rate was higher in females (18.6/100,000) as compared to males (17.8/100,000), while 95/1,688 (5.6%) cases were diagnosed in children (<18 years). The most common histology was meningioma (n = 504, 29.9%) followed by glioblastoma (n = 340, 20.1%) and pituitary adenoma (n = 151, 8.9%). Comparison with the Central Brain Tumor Registry of the United States (CBTRUS) database showed high congruency of findings. The ABTR model led by neuropathologists in collaboration with epidemiologists and the Austrian National Cancer Registry presents a cooperative way to establish a population-based brain tumour registry with high quality data. This setting links cancer registration to the mission of medical practice and research as defined by the World Medical Association in the Declaration of Helsinki. The continued operation of ABTR will aid in monitoring changes in incidence and in identifying regional disease clusters or geographic variations in brain tumour morbidity/mortality.
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Affiliation(s)
- Adelheid Wöhrer
- Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
- Austrian Society of Neuropathology, Austria, Austria
| | - Thomas Waldhör
- Center of Public Health, Department of Epidemiology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Harald Heinzl
- Core Unit for Medical Statistics and Informatics, Section of Clinical Biometrics, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Monika Hackl
- Austrian National Cancer Registry, Statistics Austria, Guglgasse 13, 1110, Vienna, Austria
| | - Johann Feichtinger
- Department of Pathology, Krankenanstalt Rudolfstiftung, Juchgasse 25, 1030, Vienna, Austria
| | | | - Andreas Kiefer
- Institute of Pathology, State Hospital Klagenfurt, St. Veiter Strasse 47, 9020, Klagenfurt, Austria
| | - Hans Maier
- Department of Pathology, Medical University of Innsbruck, Christoph-Probst-Platz Innrain 52, 6020, Innsbruck, Austria
| | - Reinhard Motz
- Department of Pathology and Neuropathology, State Neuropsychiatric Hospital Wagner-Jauregg, Wagner-Jauregg-Weg 15, 4020, Linz, Austria
| | | | - Bernd Richling
- Department of Neurosurgery, Christian Doppler Clinic, Paracelsus Private Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Carmen Idriceanu
- Department of Neurology, Christian Doppler Clinic, Paracelsus Private Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Michael Scarpatetti
- Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036, Graz, Austria
| | - Roland Sedivy
- Department of Clinical Pathology, General Hospital St. Pölten, Probst-Führer-Strasse 4, 3100, St. Pölten, Austria
| | - Hans-Christian Bankl
- Department of Clinical Pathology, General Hospital St. Pölten, Probst-Führer-Strasse 4, 3100, St. Pölten, Austria
| | - Wolfgang Stiglbauer
- Institute of Pathology, General Hospital Wiener Neustadt, Corvinusring 3-5, 2700, Wiener Neustadt, Austria
| | - Matthias Preusser
- Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Karl Rössler
- Task Force for Neurosurgical Oncology, Austrian Society of Neurosurgery, Austria
| | - Johannes Andreas Hainfellner
- Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria.
- Austrian Society of Neuropathology, Austria, Austria.
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Hirschburger M, Hecker A, Padberg W, Neubauer BA, Motz R, Haase C, Marquardt T, Hahn A. Treatment of gastroesophageal reflux with nissen fundoplication and gastrostomy tube insertion in infantile pompe's disease. Neuropediatrics 2009; 40:28-31. [PMID: 19639525 DOI: 10.1055/s-0029-1231066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In infantile Pompe's disease, enzyme replacement therapy (ERT) has been shown to reverse cardiomyopathy, improve skeletal muscle strength, and prolong survival. We report on five patients in whom complications related to gastroesophageal reflux (GER) resulted in deterioration of their clinical status despite initial improvement under ERT. Surgical antireflux therapy, performed in four, yielded positive results in two. Three patients experienced severe aspirations related to GER and underwent fundoplication and gastrostomy subsequently. Two did not regain former motor functions and deceased shortly thereafter, while one slowly recuperated and is in a stable state at age 53 months. In a further patient, severe GER prompted fundoplication at age 17 months. No aspirations occurred until the girl deceased probably due to cardiac arrest 20 months later. These cases suggest that infants with Pompe's disease under ERT may benefit from timely performed fundoplication and gastric tube placement.
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Affiliation(s)
- M Hirschburger
- Department of General and Thoracic Surgery, University of Giessen, Giessen, Germany
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11
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Motz R, Waltner-Romen M, Geiger R, Wessel A. [Blood pressure difference between upper arm and thigh, and aortic stiffness in healthy subjects and in patients after coarcectomy]. Klin Padiatr 2001; 213:290-4. [PMID: 11582529 DOI: 10.1055/s-2001-17222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The blood pressure difference between the right arm and the legs is often used as an estimate of a possible gradient across a coarctation or recoarctation aortae. We wanted to test the reliability of this hypotheses while estimating the local stiffness of the aortae ascendens and abdominalis. PATIENTS We examined 50 healthy children and adolescents as well as 50 patients of a similar age after repair of an coarctation aortae. There was no relevant recoarctation on echocardiography or magnet resonance tomography. METHODS We measured in all patients the blood pressure by oscillometry three times on the right upper arm and thigh. At the same time we measured the systolic and diastolic diameter of the aorta before the branching of the truncus brachiocephalicus and the branching of the truncus coeliacus. The local stiffness was calculated, using the stiffness index b, from the aortic diameter and the corresponding blood pressure. RESULTS The systolic blood pressure difference showed in healthy subjects and patients after coarctation a wide range (about 60 mm Hg). The diastolic and mean blood pressure showed a slightly smaller range. There was no significant difference in this respect between the two groups. The stiffness index beta was elevated after coarcectomy in the aorta ascendens compared to healthy subjects. The local stiffness of the abdominal aortae were similar in both groups and showed a similar increase with advancing age. DISCUSSION The blood pressure difference between the upper arm and thigh showed a wide range. Therefore is the blood pressure difference an unreliable tool to estimate the severity of a re-coarctation. The local stiffness of the aorta ascendens was elevated after coarctation and implied at least a partial loss of the Windkessel. The local stiffness in the aorta abdominalis was normal after coarctation repair.
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Affiliation(s)
- R Motz
- Abteilung Pädiatrische Kardiologie, Universitäts-Kliniken Innsbruck, Osterreich, Germany
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12
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Abstract
An atrial septal defect is commonly thought of as a benign cardiac lesion especially in infancy. The haemodynamic consequences for the lungs, nonetheless, can be comparable to that produced by patency of the arterial duct. In a preterm boy, this lesion led to the development of broncho-pulmonary dysplasia, and dependence on a respiratory ventilator. He could be extubated shortly after surgical closure of the septal defect.
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Affiliation(s)
- R Motz
- Paediatric Hospital of the University of Innsbruck, Austria
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13
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Abstract
OBJECTIVE Infants with severely reduced pulmonary perfusion due to complex congenital cardiac malformations are in need of an improved flow of blood to the lungs. One option for treatment is to construct a systemic-to-pulmonary arterial shunt. Although such shunts have been used since 1945, their spontaneous occlusion remains a major problem in the long-term. DESIGN We studied all infants in whom a systemic-to-pulmonary arterial shunt had been constructed using a Gore-Tex tube graft between December 1989 and March 1996. PATIENTS Of 46 infants undergoing construction of a shunt, 7 (15%) died within 30 days of surgery. The shunts had to be taken down in 2 infants. Thus, 37 infants were included in the study. All but three infants received Aspirin. Aspirin was discontinued on the personal decision of individual physicians. Of 22 infants, 3 never received Aspirin, and in 19 it was stopped well before undertaking subsequent surgery. Aspirin was administered continuously to 15 infants until further surgery. RESULTS Those in whom Aspirin was discontinued, or not given, and those receiving Aspirin until further surgery, were comparable concerning their age, time of follow-up, severity of the cardiac lesions, and size and type of shunt. Partial or complete occlusion of the shunt occurred in 2 of 15 (13%) infants taking Aspirin, but was seen in 12 of 22 (54%) infants in whom Aspirin was discontinued. Of these, 3 died due to acute occlusion of the shunt. CONCLUSIONS Aspirin reduced effectively the rate of occlusion of systemic-to-pulmonary arterial shunts, and should be continued as long as the shunt is in place.
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Affiliation(s)
- R Motz
- Clinic for Paediatric Cardiology, Georg-August-University, Göttingen, Germany.
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Abstract
BACKGROUND/AIMS Pulmonary side effects of interferon-alpha therapy of chronic hepatitis C seem to be rare. So far, only two cases of sarcoidosis in association with interferon-alpha treatment of chronic hepatitis C have been described. METHODS/CASES We report on three patients who were treated with recombinant interferon-alpha2a for chronic hepatitis C, two of them in combination with ribavirin. These patients developed pulmonary sarcoidosis 12, 20 and 21 weeks, respectively, after beginning interferon therapy, one patient with Löfgren's syndrome. In one patient sarcoidosis emerged only after discontinuation of interferon therapy because of treatment failure. Clinical symptoms of sarcoidosis in the three patients were suggestive of side effects of interferon-alpha. Interferon therapy was discontinued and spontaneous remission was observed in all three cases 5, 6, and 8 months, respectively, after the onset of symptoms. CONCLUSION The occurrence of sarcoidosis in association with interferon-alpha therapy for chronic hepatitis C may have been underestimated so far. This could be due to the fact that symptoms of sarcoidosis and common side effects of interferon are similar, and sarcoidosis may occur after the end of interferon therapy. We hypothesize that interferon-alpha as a potent stimulator for T-helper 1 (Th1) immune responses may trigger the compartmentalized Th1 reaction that has been shown to take place in sarcoidosis.
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Affiliation(s)
- R M Hoffmann
- Department of Medicine II, Klinikum Grosshadern, University of Munich, Germany
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Wessel A, Motz R, Pankau R, Bürsch JH. [Arterial hypertension and blood pressure profile in patients with Williams-Beuren syndrome]. Z Kardiol 1997; 86:251-7. [PMID: 9235796 DOI: 10.1007/s003920050056] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The prevalence of hypertension and the diurnal blood pressure pattern were investigated in patients with Williams-Beuren syndrome (WBS) by blood pressure measurements in 142 children, adolescents, and young adults (female n = 62, male n = 80; median age 6.5 years (0.1-34.3 years)) and evaluation of ambulatory blood pressure data from 45 patients (female n = 21, male n = 24; median age 7.8 years (1-23.8 years)). Measurements revealed systolic hypertension in 46.5% of 142 patients, diastolic hypertension occurred in 36.6% (i.e. actual pressure > 95 percentile). According to the ambulatory data 42.2% of 45 patients had hypertension (mean arterial pressure > normal + 2SD). The nocturnal decline of the blood pressure was normal in hypertensive patients but reduced in normotensives (p < 0.01 vs normals). Males were more often hypertensive than females (46% vs 38%). Hypertensives had a higher body mass index than normotensives (19.5 vs 16.6 kg/m2, p < 0.05). In normo- and hypertensive WBS patients mean heart rates were elevated during day- and nighttime (p < 0.02 vs normals) the latter due to a reduced nocturnal decline. The prevalence of hypertension in WBS patients amounts to about 40%, thus being four- to eight-fold in comparison to healthy young adults or children. The diurnal blood pressure pattern and the elevated heart rates indicate that an increased arterial stiffness due to the vascular disease in the WBS and augmented sympathetic activity might play a role in the genesis of hypertension. Thus, effective antihypertensive treatment is likely to become difficult. From our experience beta-blocking agents are often successful in hypertensive WBS patients.
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Affiliation(s)
- A Wessel
- Klinik für Pädiatrische Kardiologie, Georg-August-Universität, Göttingen
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Motz R. Late haemothorax after oral vitamin K. N Z Med J 1992; 105:459. [PMID: 1436866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Motz R. [Solutions to implement standards of hygiene regarding semi-liquid manure]. Monatsh Veterinarmed 1972; 27:252-5. [PMID: 5048451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Motz R. [Chemical treatment of semi-liquid manure in large livestock systems]. Monatsh Veterinarmed 1969; 24:935-7. [PMID: 5407863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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von der Aa R, Motz R. [Epidemiologic aspects of veterinary medicine with regard to sewage from hospitals, abattoirs and carcass disposal installations]. Monatsh Veterinarmed 1969; 24:761-9. [PMID: 5407828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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von der Aa R, Bähr H, Breiter HJ, Jensch D, Motz R, Schultz J, Weser H. [Education of veterinarians, particularly in the field of hygiene, according to the decision of the State Council for Furthering the 3d Continuing Education Reform]. Monatsh Veterinarmed 1969; 24:672-6. [PMID: 5386149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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22
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Schultz J, Motz R, Schäfer M, Baumgart W. [Experimental studies on Aspergillus clavatus poisoning in cattle]. Monatsh Veterinarmed 1969; 24:14-7. [PMID: 5396641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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23
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Motz R, Schultz J. [Statement on the publication "proposal for the use of thin-layer chromatography to determine mycotoxins (mainly aflatoxins) in germinated malt feed" by M. Kuhnert and H. J. Buchheim]. Monatsh Veterinarmed 1968; 23:890-2. [PMID: 5707124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Motz R, Schultz J. [On the properties of aflatoxins and possibolities of their demonstration]. Z Gesamte Hyg 1967; 13:524-9. [PMID: 5594131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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25
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Schultz J, Motz R. [Toxin forming aspergillus flavus strains in fodder]. Arch Exp Veterinarmed 1967; 21:129-40. [PMID: 5629541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Schultz J, Motz R, Schäfer M. [The toxicity of malt seeds containing Aspergillus flavus]. Monatsh Veterinarmed 1966; 21:458-61. [PMID: 5966800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Schultz J, Motz R, Schäfer M. [On mycotoxicoses and toxic factors in moldy feed material]. Monatsh Veterinarmed 1965; 20:736-45. [PMID: 5880995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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