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Biomedical subjects

F Harder

Publications and source records attributed to F Harder.

At least 217 records · Page 12Linked to original sources
PubMed1987

Indications for needle catheter jejunostomy in elective abdominal surgery.

Needle catheter jejunostomy for postoperative nutritional support is now employed worldwide. However, there is a large discrepancy regarding indications for this technique which this study attempts to rectify. The need for nutritional support after elective abdominal procedures in 464 patients was analyzed and compared with the experience with needle catheter jejunostomy in 42 patients. The results show that needle catheter jejunostomy is indicated after extensive operations of the upper gastrointestinal tract, for example, esophagectomy, total gastrectomy, and the Whipple procedure. With minor upper gastrointestinal operations, or procedures of the lower gastrointestinal tract, needle catheter jejunostomy should be performed only in patients with poor nutritional status or in the presence of postoperative chemotherapy or radiotherapy. In an unclear situation, liberal insertion of the needle catheter jejunostomy and a postponed decision on enteral feeding is recommended, as there is no significant catheter-related morbidity.

Abdomen↗
PubMed1987

Endoscopic sphincterotomy and surgical approaches in the treatment of the 'sump syndrome'.

The 'sump syndrome' is a rare, late complication of choledochoenterostomies. We observed 13 patients with this syndrome. The clinical features included recurrent cholangitis, liver abscesses, and recurrent pancreatitis. Five patients were treated by surgery, eight patients endoscopically. Reviewing an average follow up period of 22 months (range 6-60) after therapeutic endoscopy and 57 months (range 1-126) after different surgical procedures, we conclude that endoscopic sphincterotomy with removal of the debris is as efficient a therapy of the 'sump syndrome' as surgical sphincteroplasty and entails a smaller risk for the patient. We therefore advocate that endoscopic papillotomy should first be tried in all cases of 'sump syndrome' in the absence of suprapapillary stricture of the bile ducts.

Adult↗
PubMed1987

Cyclosporin A and osteonecrosis of the femoral head.

A vascular osteonecrosis has occurred in 5 to 40 per cent of patients who have undergone transplantation of a kidney and generally has been considered to be a complication of the use of corticosteroids. Currently cyclosporin A is in general use for its immunosuppressive property, so that a lower dose of corticosteroids is needed. We analyzed the cases of a series of our patients who underwent transplantation of a kidney in order to find out if our present regimen, using cyclosporin A, influenced the prevalence of osteonecrosis of the femoral head. Of a total of 270 patients, osteonecrosis of the femoral head developed in fifteen of 174 who received conventional immunosuppressive therapy and in only one of ninety-six who received cyclosporin A (p less than 0.05). During the first two months after transplantation, the mean dose of prednisone was approximately 2.5 milligrams per kilogram of body weight per day in the group that received conventional immunosuppressive therapy and approximately 1.1 milligrams per kilogram of body weight per day in the group that received cyclosporin A (p less than 0.001). We concluded that the pathogenesis of the osteonecrosis in patients who underwent transplantation of a kidney was probably related to the higher doses of corticosteroids that were administered.

Azathioprine↗
PubMed1986

[Splenectomy: surgical indications in malignant hematologic diseases].

Indications for splenectomy in malignant hematological diseases are discussed for relief of symptoms (splenomegaly, cytopenias), for staging (M. Hodgkin) or improvement of survival (hairy cell leukemia). The role of splenectomies is also evaluated for Non-Hodgkin lymphomas, chronic lymphatic leukemia, myelofibrosis and for chronic myeloic leukemia.

Hematologic Diseases↗
PubMed1986

[Do pathologico-anatomic parameters modify the incidence of recurrence following conservative breast surgery and radiotherapy?].

201 breast cancer patients (pT1-2, pN0-1) were treated with conservative breast surgery and radiation therapy. 28 (13.9%) treatment failures, -13 (6.5%) local recurrences, 4 (2.0%) axillary - and 11 (5.5%) distant metastases -, were found overall after a mean follow-up of 47 months. The differences between pT2 and pT1-tumors (20.6% vs 10.5%) and nodal positive versus nodal negative patients (28.1% vs 6.8%) are statistically significant. No differences were seen regarding histological features.

Breast↗
PubMed1986

"Brunneroma": hamartoma or tumor?

Clinically relevant "tumors" of duodenal glands (Brunner's glands) are uncommon. We present a patient suffering from an exceptionally large tumor of the pars descendens of the duodenum. The tumor remained undetected at endoscopy and is of interest because of its localization, size and its presumable production of urogastrone (human epidermal growth factor). "Brunneromas" are probably hamartomas rather than true neoplasias.

Adult↗
PubMed1986

[Rectal prolapse].

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Fecal Incontinence↗