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Biomedical subjects

A Kuhnert

Publications and source records attributed to A Kuhnert.

27 records · Page 2Linked to original sources

Clinically relevant differences between amelanotic malignant melanoma and granuloma pyogenicum.

Macroscopic discrimination between amelanotic malignant melanoma (aMM) and the so-called granuloma pyogenicum (GP) is often uncertain since reliable criteria for a clear differentiation of either growth are lacking. In a search of such criteria we analysed the data of 57 consecutive in-patients with cutaneous aMM and of 83 with GP presenting at our Department during the years 1970-1988. The following items were compared with each other: duration from growth onset to definite diagnosis, site of growth, age and sex of the patients. Significant differences (p less than 0.01) between either growth were found for all items evaluated. Our results substantiate the hitherto gained impression of a remarkably shorter median history of GP as compared to aMM (5 vs. 26 weeks). Furthermore, aMM prevailed in elder (age greater than 50 years) particularly female (70%) patients, whereas GP developed about equally in both sexes and at all ages. Site distribution was also found to differ for either growth (GP predominantly in the head and neck region, rarely on lower limbs; aMM in all areas, rarely on the trunk). These data yield additional measures for clinical distinction between aMM and GP.

Adolescent↗

[Relaparotomy in childhood].

From 1.1.1976 to 31.12.1983 1,793 laparotomies were performed on children up to the age of 15 years at the Hospital of Pediatric Surgery, Mainz University. The incidence of acute unplanned relaparotomies was 4.6%. The most frequent indication of acute relaparotomy was postoperative obstruction due to adhesions (in 53% of all cases); burst abdomen, peritonitis, intestinal perforation, anastomotic insufficiency and secondary hemorrhage were less frequent causes of repeated abdominal procedures. 15% of all relaparotomised children underwent more than one repeat laparotomy. More than 40% of acute relaparotomies were performed on children within their first year of life. 56% of all relaparotomies had to be performed within the first four postoperative weeks, 87% within the first year. The lethality rate of acute relaparotomy was 15%. Lethality was especially high in children suffering from anastomotic insufficiency or burst abdomen; it increased with the number of relaparotomies. The significance of preoperative sonography for the diagnosis leading to acute unplanned relaparotomies is discussed and commented with examples.

Abdomen, Acute↗

[Ultrasonics and lavage in polytraumatized patients with blunt abdominal trauma].

The reliability of sonography and peritoneal lavage in assessing the need for immediate surgical intervention in blunt abdominal trauma was examined in a controlled prospective and retrospective study. Whereas no false results occurred using peritoneal lavage, false negative findings in sonography were 9.8% and false positive findings 3.9%. A significant difference was also found on retrospective evaluation of all cases with diagnostic peritoneal lavage (2.2% false results) and ultrasound investigations (14.9% false results). This demonstrates that sonography cannot fully replace peritoneal lavage as a diagnostic method in blunt abdominal trauma.

Abdominal Injuries↗