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Biomedical subjects

F Gerlach

Publications and source records attributed to F Gerlach.

At least 19 recordsLinked to original sources
PubMed2004

[Glossary on patient safety -- a contribution to on-target-definition and to appreciate the subjects of "patient safety"].

Since the release of the report "To Err is Human" by the American Institute of Medicine (IOM) the subject "Medical Risks, Errors and Patient Safety" has gained increasing interest in literature. In Germany, neither extensive statistics nor generally significant epidemiological studies regarding common errors associated with damages caused to patients' health exist. In recent years the subject has become increasingly interesting both in specialist discussion and it the lay press; it has become evident that the different use of terms, especially those originating from the Anglo-Saxon language, can lead to misunderstandings. Hence, as one of the first steps of its action programme, the expert panel "Patient Safety" of the German Agency for Quality in Medicine has compiled a glossary of technical terms to provide adequate support to the discussion this important subject of nomenclature.

Germany↗
PubMed2002

[Anal sphincter-CT and dorsal sphincteropexy - a new approach in therapy of obstructive defecation disorder].

The dysplasia of anal sphincter represents an obstructive defecation disorder. The disease is known as "anterior displaced anus" in pediatric surgery. An anorectal malformation with missing dorsal osseous fixation of the sphincter complex is the underlying cause. Beyond clinical symptoms and examination result (anterior displaced anus with palpable dorsal gap) the defect can be visualized by computered tomography. A surgical correction is possible by the simple intervention of dorsal sphincteropexy. In our trial with 48 patients (male n = 12, female n = 36, mean age 51 +/- 17 years, follow-up in 39 patients) a significant improvement of defecation could be achieved in 46 % of the patients. In correlation to a good clinical outcome a significant reduction in the defecation score was observed. 10 % of the patients had only small changes in symptoms. However, the proportion of dissatisfied patients was relatively high with 44 %. In this group patients with long-standing chronic constipation and laxative abusus were found more often and the rate of previous anal or abdominal surgery was quite higher. Dissatisfied patients showed a higher variation in symptoms of pelvic floor disorders (e. g. anal pain syndrome) besides the rectal evacuation disorder. In addition to the heterogenity of symptoms chronic alterations of pelvic floor structures might create worse results in patients with chronic constipation. In spite of a lot of publications dealing with the functional anatomy of the pelvic floor only a few investigations on the dorsal sphincter dysplasia in patients with rectal evacuation disorder are found in the literature. Further investigations on this disorder are necessary.

Adolescent↗
PubMed1983

[Long-term follow-up of mechanical anastomoses in surgery of the large intestine. Prospective study of 683 patients].

The long-term results of colorectal and coloanal anastomoses using the EEA, SPTU and ILS circular staplers are reviewed. Anastomoses with these stapling devices were performed in 683 patients between September 1978 and April 1982. 91% of patients with rectal carcinoma underwent rectal resection and restoration of bowel continuity. All patients were operated on for the same way. We used a cancericidal rectal irrigation with 5.0% Sublimate (HgCl2) regularly in all patients with carcinoma. The inferior mesenteric artery is ligated and divided, preserving the arcade between the ascending and descending branch of the left colonic artery. The incidence of postoperative complications amounted to 17%. Intraoperative complications occurred in 12,7% (anastomotic leak 8%, difficult extraction 1,5%, bleeding 0,4%, instrument failure 2,8%). The incidence of dehiscence of anastomosis after low anterior resection (n = 422) was 15% and 3% after high anterior resection (n = 261). The clinical leakage in both groups was 4.2 and 2.3% respectively. Two of 23 patients died because of anastomotic leakage only .4 patients (1.3%) have been observed to develop a recurrent anastomotic tumour and 18 (5.8%) developed a recurrent pelvic tumour. To test the sphincter function after a very low colo-rectal anastomosis (3.5 to 5 cm from cutaneous-anal verge) 32 patients were examined by using manometric studies. There were no statistically differences between normal subjects and those patients in resting pressure, maximum squeeze pressure, and length of anal canal. A significantly lower rectal compliance and rectal capacity could be found.

Adult↗
PubMed1978

[The value of radiographic examinations of the thorax in acute myocardial infarction (author's transl)].

The degree of pulmonary congestion seen on chest radiographs taken in the intensive care unit was compared with the end-diastolic pulmonary artery pressure in 65 patients with recent transmural myocardial infarcts without cardiogenic shock. There was good correlation between the radiographic appearances and the end-diatrolic pulmonary artery pressure, so that the severity of left heart insufficiency could be diagnosed radiologically at an early stage. Errors were due to the time interval which must pass before the radiographic appearances approximate the haemodynamic changes. This resulted in a diagnostic "phase lag" (following a rise in end-diastolic pulmonary artery pressure) or in a post-therapeutic "phase lag" (after a fall in end-diastolic pulmonary artery pressure). Repeated examinations allow one to recognize changes in the haemodynamics. One should pay particular attention to the features of pulmonary venous and pulmonary arterial hy

Acute Disease↗
PubMed1978

[Experiences with transcatheter emoblization in urology (author's transl)].

Transcatheter embolization of the kidneys and bladder is increasingly important. The main indication for embolization is persistent hematuria involving surgically nonaccessible renal and bladder cancer. Additional surgical management of the disease can be avoided. Another indication is the preoperative embbolization of the kidney which facilitates surgical procedure and possibly prevents tumor cell embolization in the venous circulation. The indication for embolization of bleeding bladder carcinoma is different and permanent arterial occlusion is only justified if other measurements fail.

Adult↗
PubMed1978

[Roentgen diagnosis of injuries of the ankle joint (author's transl)].

Lesions of the ankle joint affect the bone and/or ligaments. It will often be necessary to conduct additional radiological examinations besides the standard x-ray films. These additional examinations should include: 1. roentgenograms taken at an oblique angle; 2. x-ray films taken in forced extreme joint position in two planes; 3. roentgenograms comparing right and left; 4. arthrography. The article discusses the value and significance of the additional roentgenograms, with particular reference to the importance of the films of the forced extreme joint position.

Ankle Injuries↗
PubMed1976

[Catheter embolisation of metastasising renal carcinomas using butyle-2-cyano-acrylate (author's trabsl)].

Embolisation with butyle-2-cyano-acrylate was carried out in four inoperable renal carcinomas. By mixing this tissue adhesive with 50% glucose it remains suitable for embolisation for eight to ten minutes. Contact with blood produces the desired effect of immediate and permanent vascular occlusion. Since the material adheres to the vessel wall, it is not carried to any other vascular areas. No complications due to this material have been observed.

Adenocarcinoma↗
PubMed1976

[The manifestations of regional enteritis (Crohn's disease) in the stomach and duodenum (author's transl)].

Involvement of the stomach and duodenum is relatively rare, but produces distrinct radiological changes. In the stomach the antrum and pyloric portion are affected most frequently. Simultaneous involvement of the duodenum is common. Typical radiological changes consist of funnelshaped narrowing of the antrum, decreased motility of the wall of the stomach, cobblestone mucosa with flat ulcers, deformity of the pylorus and first part of the duodenum and stenosing lesions of the duodenum. If the gastro-duodenal changes occur together with the typical appearances in the jejunum, ileum and colon, then the diagnosis can be made by radiology alone.

Adolescent↗
PubMed1975

[The bilateral breast neoplasm].

Of 282 patients, who had been treated for breast cancer between 1968 and 1973, bilateral carcinoma was diagnosed in 23 women. In these, a simultaneous second carcinoma was found seven times; in 16 cases, the second carcinoma developed during the further course of the disease, wherein the free intervals amounted to maximally 20 years. Attention is drawn to the relatively high risk of up to eight or ten per cent for the development of a carcinoma in the contralateral breast following the previous unilateral carcinoma. This reason calls for a half-yearly, clinical and radiological check-up examination of women having been treated for carcinoma of the breast. Finally, the problem of differentiation of a primary, autonomous second carcinoma from metastases of the first carcinoma on the contralateral side is considered and discussed with regard to the corresponding references in literature.

Adult↗