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Biomedical subjects

A Tuchmann

Publications and source records attributed to A Tuchmann.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Indications for primary anastomosis following resection of acute diverticulitis of the large intestine].

A retrospective review of 102 patients (1979-1987) was performed to evaluate the surgical management of complicated diverticulitis. The following operative strategy was found to be effective: 1. the Hartmann procedure in free perforation and diffuse peritonitis; 2. resection with primary anastomosis in free perforation and localized peritonitis, covered perforation, inflammatory tumor and fistulas, if healthy bowel ends could be used for anastomosis.

Acute Disease↗
PubMed1986

[Scalpel and CO2 laser in the animal experiment. A comparative study of inoculation tumors of the mouse].

The study hereby submitted has been designed to show whether there are any differences between using a conventional knife or a CO2-laser when excising and grafting tumors in animal experiments. The animals were C57Bl/6 mice, the tumor was the Lewis lung carcinoma. Eight days after tumor inoculation into the subcutaneous layer of the back, 213 mice were treated by tumor excision either with a conventional knife or a CO2-laser. 86 excised tumors were cut and the tumor surface was swabbed into the subcutaneous layer on the nape of 86 tumor-free mice. Survival times of the laser-operated animals were insignificantly longer. However, small tumors showed markedly longer survival times. The interval without recurrence was longer for all tumor sizes when the laser was used (p less than 0.005). The laser method yielded lower growth rates when the tumor surface was swabbed into tumor-free mice (p less than 0.0001). Histological and cytological tests of the laser-excised and -swabbed specimen demonstrated a high rate of cell destruction. Therefore, the CO2-laser seems to have some importance in cases where the incision is made close to the tumor or where the tumor surface may be lesioned.

Animals↗
PubMed1986

Comparative study of conventional scalpel and CO2-laser in experimental tumor surgery.

The study hereby submitted has been designed to show whether there are any differences between using a conventional knife or a CO2-laser when excising and grafting tumors in animal experiments. The animals were C57B1/6 mice, the tumor was the Lewis lung carcinoma. Eight days after tumor inoculation into the s.c. layer of the back, 213 mice were treated by tumor excision either with a conventional knife or a CO2-laser. Eighty-six excised tumors were cut, and the tumor surface was swabbed into the s.c. layer on the nape of 86 tumor-free mice. Survival times of the laser-operated animals were insignificantly longer. However, small tumors showed markedly longer survival times. The interval without recurrence was longer for all tumor sizes when the laser was used (P less than 0.005). The laser method yielded lower growth rates when the tumor surface was swabbed into tumor-free mice (P less than 0.0001). Histological and cytologic tests of the laser-excised and- swabbed specimen demonstrated a high rate of cell destruction. Therefore, the CO2-laser seems to have some significance in cases where the incision is made close to the tumor or where tumor surfaces may be lesioned.

Animals↗
PubMed1985

[Morphologic changes in artificial prostheses following para-articular knee bypass operations].

A report is presented on two helically reinforced polytetrafluoroethylene vascular prostheses in the femoro-popliteal (below-knee) position which thrombosed in the early postoperative period. Lateral angiography in the 45, 90 and 120 degree position of the knee joint showed short (2 mm) mild stenosis like kinking in case 1. At reoperation in case 2 the prosthesis was kinked in the longitudinal axis. Femoro-popliteal allografts across the knee joint should accomplish the following demands: 1. no kinking on postoperative lateral angiography with the knee joint bent and 2. intact prosthesis at reoperation.

Arterial Occlusive Diseases↗
PubMed1985

Computed tomography in aortobifemoral Y grafts.

The fact that we have experience in assessing aortic aneurysms and the need for a noninvasive morphologic and hemodynamic method of examination for the follow-up of aortoiliac surgery motivated us to initiate a dynamic CT study of bifurcation prosthesis. Twenty-seven Y grafts (25 Dacron, 2 polytetrafluoroethylene) were studied by CT scan 1 month to 7 years postoperatively. There were normal CT findings in 16 patients, neointima formation in 6, graft occlusion (1 limb of the Y graft) in 3, and dilatation of the prosthesis in 2. Patent grafts showed enhancement of contrast medium. CT scans corresponded to clinical findings in all instances. Because of its noninvasiveness, assessment of perivascular changes, and semiquantitative measurements, dynamic CT may be applied in the follow-up of aortofemoral bifurcation grafts.

Aged↗
PubMed1985

[Pre- and postoperative diagnosis of an aortic aneurysm by dynamic computed tomography with omission of angiography].

A study which was prospective with regard to the method, showed 41 cases of aortic aneurysms in a collective of 3597 body-CT-examinations (1.14%). By means of CT and its possibility of reconstruction all morphological details of an aneurysm become visible. The course of the vessels to the bowel and to the kidneys are shown with the same excellence as in angiography. However, additional information which angiography cannot supply, is also given, like non-perfused lumen, changed wall structure and perivascular changes. Measurement of flow can be performed in the vessel and in the organ, the arterial supply of which is involved in aneurysmatic disease. The method is non-invasive. This is important for control after operation. Morphological changes of the vessel prosthesis are detected, as well as bleeding and infection. Functional parameters are determined semiquantitatively.

Adult↗
PubMed1984

[Indications and results of gastric bypass in the treatment of extreme obesity].

A report is presented on gastric bypass (n = 27) and gastroplasty (n = 2) in patients with morbid obesity. One patient died postoperatively (mortality 3.4%). Mean weight prior to operation was 129 kg (96 to 205 kg), i.e. 117% (63 to 253%) in excess of the ideal weight. During a follow-up period of 6 to 46 months, the mean loss of weight amounted to 38 kg (3 to 77 kg). 86% of the patients judged their condition as being very good to good. Diseases related to obesity were reduced to a remarkable degree: hypertension from 43 to 5%, hypertriglyceridaemia from 50 to 5% and diabetes mellitus from 52 to 13%. Two patients had to be reoperated on due to a peptic jejunal ulcer, five because of an incisional hernia. No patient suffered from diarrhoea, calculi of the biliary or urinary tract or electrolyte disorders. On the basis of these results gastric bypass would appear to be indicated for the treatment of obesity not amenable to conventional therapy.

Adult↗
PubMed1984

[Anastomotic aneurysms as a late complication of reconstructive vascular surgery of the lower extremity].

29 operations were performed because of an anastomotic aneurysm in 25 patients. The incidence of false aneurysm was 0.7% (4079 reconstructive operations from 1964 to 1979). Arterial reconstructions previous to the formation of aneurysm were: aorto-femoral bifurcation graft 9, ileo-femoral bypass 9, femoro-popliteal reconstructions 11 (4 of them were Sparks' prostheses). 31% of the cases had complications (rupture, thrombosis) when operated, 73% were located in the groin. At the primary operation mostly Dacron had been used. In all instances non-absorbable synthetic suture material has been applied. If the interval between the first operation and the formation of the aneurysms is short infection is to be suspected. The diagnosis of aneurysms distal to the inguinal ligament is easy, aneurysms of the iliac region were found after complications (rupture, thrombosis) had occurred. The most frequent reconstructive procedure was graft interposition, but aneurysmorrhaphy was successful in certain cases. Two patients died postoperatively. Follow-up showed one recurrence (in the groin). We suggest that 1) insufficiency of the suture line because of tension 2) dilation of prosthetic dacron material have great importance for formation of anastomotic aneurysm, whereas local endarterectomy or end-side anastomosis do not seem to be significant.

Aged↗
PubMed1984

[Dynamic computer tomography following vascular operations in aortic aneurysms or aortoiliac occlusive disease].

Thirty-five aorto-iliac reconstructions (27 aorto-bifemoral Y-grafts, two aortic tube grafts, one aortic endarterectomy, 5 ileo-femoral bypass operations) were studied by CT-scans one week to seven years postoperatively. A General Electric CT/T 8800 with Dynapak software was used. Coronary, sagittal and oblique reconstructions as well as time-density diagrams were performed. There were normal CT-findings in 22 patients (63%), excessive Neointima formation in seven, graft occlusion (one limb of Y-graft) in three, prosthetic dilatation in two and suspicious graft infection in one patient. Patent bypasses showed enhancement of contrast medium. CT-scans corresponded with clinical findings in all instances. Because of its non-invasiveness, assessment of perivascular alterations and semiquantitative measurements dynamic CT is applicable in the follow-up of aorto-iliac arterial reconstructions.

Aged↗
PubMed1984

[Late results following carotid endarterectomy].

186 carotid endarterectomies (142 patients) were performed under regional anaesthesia between 1976 and 1983: 32% in asymptomatic stage, 36% in TIA, 4% in frank stroke, 28% in completed stroke. Postoperative mortality was 3.8%, neurologic deficit following endarterectomy 4% (2% transient, 2% permanent). Patients were followed-up six months to seven years after the operation: The incidence of late stroke amounted to 7% (11% in TIA-patients, 5% in patients with completed stroke before endarterectomy). 24% of the operated patients died during the follow-up period, 46% because of myocardial infarction or heart failure, 14% because of stroke. Recurrent stenosis occurred in 6% (indirect Doppler-sonogramm), two patients (3%) with symptomatic recurrent stenosis underwent reoperation.

Arteriosclerosis↗
PubMed1983

[Surgical treatment of peripheral arterial occlusive diseases].

Within a period of 18 months 75 operations (25 aorto-femoral, 50 femoro-popliteo-crural reconstructions) were performed: early failure in lower limb reconstructions 8% (rate of amputation 4%), operative mortality 2,7%. Only 15% of the patients had claudication, 85% rest pain or gangrene. Because of the low number of reinterventions (8% postoperative rethrombosis or hemorrhage), the 2,7% mortality and the reasonable 20-2 months' follow-up results (83% good function) we believe that arterial reconstructive surgery has a place in the field of operative activities of a municipal hospital.

Adult↗
PubMed1982

[Repair of internal carotid artery stenosis. Results of reconstruction in 129 patients].

128 Patients were operated upon consecutively since 1965 for lesions of the carotid bulb (stadium I.: n = 21;stadium II: n = 45;stadium III: n = 33; stadium IV:n - 29), a postoperative neurological deficit was noted in 4,7%, the cerebral lethality was 1,9%. The procedure was done in general anesthesia with moderate elevation of the systemic blood pressure. In case the pressure readings obtained in the stump of the internal carotid artery were below the level of 50 mm of mercury an intraluminal shunt was used. Considered an average lethality of 7% per year 48 patients died during follow-up, 5 for cerebral. 10 for internal medical reasons, in 33 cases the results of post mortem examination was not available. After a mean follow-up time of 7 years 41 patients were re-evaluated 4,8 recurrent stenoses, 2,4% intracranial and 9,4% changes in the contralateral carotid artery were detected. Only 4,8% showed abnormalities on neurological examination, which underscores the importance of non invasive diagnostic tools.

Adult↗
PubMed1981

[Diagnosis and results of treatment in appendicitis].

In a period of 5 years 3455 appendectomies were performed because of appendicitis. Acute appendicitis (i.e. gangrenous appendicitis, appendiceal abscess, perforated appendicitis) was found in 30% of all appendectomies. Histological finding, sex, age, symptoms, duration of illness until operation, technique of operation and postoperative complications were documented in a form suitable for computer input and analyzed. The lethality of appendectomy was 0.38%.

Adolescent↗