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Biomedical subjects

A Senning

Publications and source records attributed to A Senning.

At least 127 records · Page 7Linked to original sources
PubMed1977

[Mediastinoscopy or thoracotomy? A prospective randomized study].

A prospective, controlled, randomized trial on the value of mediastinoscopy was performed during a 12-month period (1969-1970) on 130 patients with a bronchogenic carcinoma. Patients to be admitted to the study had to meet the criteria of being clinically operable. 126 patients could be followed up for the following 5 years. Of these patients 62 had a mediastinoscopy previous to the thoracotomy (Group A) and 64 had directly a thoracotomy (Group B). A curable resection was possible in Group A in 56.4% and in 73.5% in Group B. The perioperative mortality (30 days) is 8% for Group A and 16% for Group B. The mean survival rate is for patients with a positive mediastinoscopy which did not underwent thoracotomy with 6.8 months better than for patients which underwent directly an exploratory thoracotomy (2.7 months). The 5-year survival rate is despite the high perioperative mortality for Group B (16%)higher than for Group A(10%). Mediastinoscopy is with its low mortality and its better short surviving rate of great value for high risk patients and inoperable patients with bronchogenic carcinomas, but reduces the overall resectability and the 5-year survival rate.

Carcinoma, Bronchogenic↗
PubMed1977

[Various blood-foreign body reactions in the heart-lung machine in heart valve replacement and aortocoronary bypass operations].

Blood-foreign material interaction in the pump oxygenator was studied by means of scanning electron microscopy in 3 patients undergoing heart valve replacement (HVR) and 3 patients undergoing coronary bypass operation (CBO). While polyvinyl tubes show an average deposit of 60 thrombi/mm2 with 20--40 microns in size in CBO, bloodgas interface during HVR causes increasing thrombotic deposits (375 Mcthr/nm2, 25--50 microns in size). Distal to the pump the volume of particles may rise up 250 micrometer in HVR and up to 80 micrometer in CBO. In a 35 micrometer pore arterial-line-filter (Pall-Corporation) platelet clumps up to 1 mm in size are removed from circulating blood in HVR, and up to 300 micrometer thrombi in CBO. According to different platelet deposit proximal to the filter, more and larger thrombi can pass through the filter in HVR. Distal to the pump thromboemboli of 30--60 (maximum 90) micrometer in size can be observed in HVR. Particles of 20--35 (maximum 60) micrometer in size may pass through the filter and enter into the patient's circulation in CBO. As the results suggest, extracorporal circulation is more harmful for patients undergoing HVR than for those undergoing CBO.

Blood Cells↗
PubMed1977

[Bronchoplastic methods in the resection treatment of malignant bronchial tumors].

1548 patients who were hospitalized 1964--1975 for diagnosis and treatment of bronchogenic carcinoma, 779 underwent resection. 17 patients could be operated by lobectomy or bilobectomy and bronchial resection (sleeve resection). Postoperative complications were frequent (n = 8): 4 times bronchopleural fistula, 2 times empyema, once fatal pneumonia and once bronchial stenosis. The overalll mortality and the survival rates are comparable to those of patients with radical resections. Sleeve resection is therefore a suitable alternative to pneumonectomy in elderly patients with reduced pulmonary function, rarely indicated also by a favourable tumor size. Sleeve resection increases the resectability of malignant bronchogenic tumors by 2%. Methods to prevent or cure the postoperative complications consisted in the use of absorbable suture material and long lasting intrathoracic suction.

Adult↗
PubMed1977

[Operative mortality, mortality and late results in bronchial carcinoma].

457 patients with a bronchial carcinoma of the years 1947--1962 are compared with 126 patients of the years 1969--1970 and set up in comparison to the whole clinical material of the years 1960--1975. In the period between 1969 and 1970 radical resections were performed in 20% more patients than in the first period (1947--1962). Older patients were in the last period (1970--1974) more frequent. 8% of all patients in which lobectomy was performed and 5.5% of the patients in which pneumonectomy was performed were older than 70 years of age. Overall mortality has remained unchanged for exploratory thoracotomy (19%), palliative resection (17.5%) and "radical" resection (14%). For simple pneumonectomy the overall mortality went down from 19.2% (1960--1964) to 9.6% (1970-1974) and for simple lobectomy from 14.4% to 3.8%. The five-year survival rate after radical resections was 8% (first period 0%) and after simple resections 26% (26.2%). Patients with stage I epidermoid carcinoma had a five-year survival rate of 46%. Those with stage II (spread to ipsilateral hilar nodes) a five-year survival rate of 14.3% Patients with palliative resections and exploratory thoracotomy died within 16 months.

Aged↗
PubMed1976

[Life expectancy and frequency of infarct after aorto-coronary bypass].

Survival rate and incidence of myocardial infarction after aortocoronary bypass operation in 274 patients are presented. Mortality was 5.1% within the first postoperative month and the 5-year-survival rate was 86%. There were 24 perioperative myocardial infarctions and another 21 infarctions over the next 5 years. Comparison of these data with the natural history of coronary heart disease suggests a possible prolongation of survival after bypass surgery. The incidence of myocardial infarction appears to be unchanged.

Angina Pectoris↗
PubMed1976

["Impending infarct". Clinical, ergometric and angiographic pre- and postoperative results in 12 emergency operated patients. Preliminary report].

Pre- and postoperative results are presented in 12 patients who underwent emergency aortocoronary bypass. Operative mortality was zero. 1 patient died 8 months after surgery. Postoperative follow-up averaged 12.5 months (2-37 months). Postoperatively, 7 patients were totally angina-free, 1 was considerably improved and 3 were unchanged.

Coronary Artery Bypass↗
PubMed1976

[Left ventricular function at rest and during dynamic load before and after aortocoronary bypass. Preliminary report].

17 patients with coronary artery disease were studied before and 10 +/- 3 months (mean +/- 1 SD) after aortocoronary bypass surgery. Left ventricular performance was analyzed at rest and in 12 cases during dynamic exercise (work load 59 +/- 22 watts) with tip manometer pressure measurements. The degree of coronary artery obstruction was estimated pre- and postoperatively by vascularization index (VaI). Patients were separated into 2 groups (group A: 8 patients with postoperatively improved VaI, and group B: 9 patients with unchanged or worsened VaI). Apart from a significant fall in LVEDP (p less than 0.025) in group A, there was no significant change in left ventricular dynamics in either group at rest, while a significant improvement in mean LVEDP (p less than 0.05), max dP/dt (p less than 0.05), Vpm (p less than 0.005) and Vmax (p less than 0.005) during dynamic exercise was observed in group A, but no significant change in these terms in group B, after surgery.

Coronary Artery Bypass↗
PubMed1976

[Bronchial carcinoids (author's transl)].

Of 35 patients with bronchial carcinoids seen at the Kantonsspital Zürich during 16 years, 33 underwent an operative resection. The endoscopic resection is not recommended because of the risk of hemorrhage recurrence, and that this operation results in only partial removal of carcinoids which develop extrabronchially. It is concluded that bronchial carcinoids are potentially malignant tumours and that resection should be most radical if they show recurrence, invasive growth or metastases. Controls are necessary for a long period of time because even in presence of metastases the growth is very slow.

Adolescent↗
PubMed1976

Evaluation of a fluid-controlled artificial heart.

The Zurich A. H. is a pneumatic drive biventricular cardiac prosthesis with tubular silicone rubber membrane, tilting discvalves, and fluid control system. Membrane position is monitored throughout the cardiac cycle to prevent systolic membrane collapse or insufficient diastolic filling. This A. H. was implanted in 25 dogs weighing 23-50 kg. In five animals, the A. H. performed satisfactorily for more than 24 hr. At an average flow rate of 60-90 ml/min per kg, the aortic pressure ranged from 80 to 100 mm Hg, and both left and right atrial pressures were within normal range. The animals were awake, and they breathed spontaneously after 24 hr; average plasma hemoglobin levels averaged 91 mg/100 ml, and platelet counts decreased to 65,000 cu mm. In three animals subjected to the A. H. pump for 24 hr, the A. H. was removed and replaced with a transplant. Adequate transplant function was obtained, but there were no long-term survivors. Adequate hemostasis, sepsis, and complex organ dysfunctions associated with prolonged pumping are currently the main biologic problems.

Animals↗
PubMed1976

[Complications in bronchoplastic surgery of benign and malignant lung neoplasms].

Out of 1629 patients who were hospitalised 1963 to 1973 for diagnosis and treatment of bronchogenic tumors, 731 underwent resection. 20 patients could be operated upon by lobectomy or bilobectomy and bronchial resection (Sleeve-resection). In two other patients the tumor could be resected through a bronchotomy. Postoperative complications were frequent (n = 6) on patients with malignant tumors (n= 15). We saw 3 times a bronchopleural fistula (2 patients had to be reoperated, 1 death), once a fatal empyema, once a fatal pneumonia of the contralateral side and once a bronchial stenosis of 50% of the lumen. On the patients with a benign tumor (n = 7) we saw in one patient a bronchopleural fistula and in another endobronchialgranulomas due to non resorbable suture material. Methods to prevent or cure these complications are presented consisting in the use of absorbable suture material and long lasting intrathoracic suction.

Adult↗