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Biomedical subjects

F Kümmerle

Publications and source records attributed to F Kümmerle.

At least 19 recordsLinked to original sources
PubMed1991

[Surgical consultation].

A consultation is a diagnostic aid aimed at obtaining an interdisciplinary consensus. Personal introspection and the necessity of consultation with physicians from other fields mark the individual limitations, which a doctor should regard. It is important to choose the right expert. The surgeon is usually called on the decide between surgical and conservative therapy. The value of consultative advice is beyond question, but qualitative and quantitative evaluation is impossible for lack of clinical studies. The results of "Second Opinion"-programs quantify differences in opinion between consulting surgeons.

Clinical Competence↗
PubMed1991

[The surgeon and therapeutic drugs].

The surgeon uses the scalpel rather than the prescription pad, but this fact is deceptive. Analysis of the development of surgical history yields an impressive insight into the interaction between medication and operative treatment. The impact of drugs can mean that some operative interventions do not need to be performed so often or even become totally unnecessary (ulcer or reflux surgery), while others are only made feasible at all by the availability of medical drugs (transplant surgery). The pathophysiology of a surgical intervention and perioperative intensive care medicine require that surgeons have detailed clinical and pharmacological knowledge relating to the operative procedure and the handling of technical devices. With regard to drugs, intensive care medicine confronts the surgeon with an inconceivable complex of interactions, side effects and dose adaptations. In addition, human suggestibility influences the outcome of operative interventions no less than medical drugs.

Anesthetics↗
PubMed1990

[Effect and importance of experience in determining indications and surgical technique].

Medicine is an empirical science in which there are very heterogeneous view about the importance of experience. Numerical data attempt to quantify the required experience for student education and clinical practice. Support systems, i.e. scores, decision trees, etc., facilitate decision-making for surgical indications and choice of operative techniques. They are aided by clinimetrical systems, i.e. controlled clinical trials and even computer assistance. Beyond all strategies of decision-making lies the accumulated individual experience of making the right decision at the right time. Experience is also at the bottom of the often cited intuition, clinical judgement and common sense.

Clinical Competence↗
PubMed1986

[Technical aspects of the use of ultrasound diagnosis in surgical interventions].

The following are the specifications for intraoperative sonography equipment: Small, easy-to-manipulate 7-10 mHz probes which can be gas-sterilised. The sound head contact surface should be 2 X 3 X 1 to 2 cm. Three probes of different shape. Transmission cable 2-3 m in length. Gas-sterilisable ultrasound unit, cable and plug. Large screen monitor. Control panel which can be encased with a plastic foil according to sterility requirements. 8 step gray scale. Integrated image storage. Documentation possibility using videotape and/or photographic unit. For intraoperative sonography the body parts to be examined are sonographed at a distance of 1-2 cm using a precursor water gap. Interpretation of sonographic images can be performed only in connection with the palpation findings of the surgeon.

Bile Duct Diseases↗
PubMed1985

[Intraoperative sonography in surgical diseases of the liver].

Intraoperative ultrasonography was performed in 24 patients with single or multiple liver metastases of colorectal cancer, in 4 patients with a hepatocellular carcinoma, in 2 patients with an hepatic abscess and in one patient with a focal nodular hyperplasia and one with a liver hemangioma. In 9 of 32 patients with inflammatory or malignant liver disease the tumors were not palpable or visible. These hepatic lesions were localized by intraoperative ultrasound. In 5 cases preoperative unknown hepatic tumors were diagnosed by intraoperative sonography.

Carcinoma, Hepatocellular↗
PubMed1979

[Modern methods in localization of pheochromocytomas (author's transl)].

In six patients with adrenal pheochromocytoma the tumors were localized by ultrasonography, phlebography of the adrenal glands and by estimation of plasma catecholamines selectively obtained from the vena cava and the adrenal gland veins. All tumors were localized by selective catecholamine estimation, five by ultrasonography, and four by phlebography. The smallest pheochromocytoma of 1.5 g weight was only localized by selective catecholamine estimation but not by ultrasonography or phlebography. This tumor, however, had been visualized by computed tomography. To avoid diagnostic errors by selective catecholamine estimation, it is important to withdraw blood from the adrenal gland veins prior to the injection of any radiographic contrast media, since this may result in an extremely enhanced secretion of catecholamines from the adrenal medulla.

Adrenal Gland Neoplasms↗
PubMed1979

[The diagnosis of phaeochromocytoma: sensitivity of vanillylmandelic acid and urinary catecholamine determination and the Katecult test (author's transl)].

Tumour weight was compared with maximal vanillylmandelic acid and catecholamine excretion in 24-hour urine in 21 patients with phaeochromocytoma. The tumour weight correlated both with vanillylmandelic acid (r = 0.805, P less than 0.001) as well as urinary catecholamine levels (r = 0.725, P less than 0.001). Normal vanillylmandelic acid excretion was found in seven patients; urinary catecholamine levels were abnormal in all patients. The Katecult test was additionally performed in ten patients, with nine positive results.

Adrenal Gland Neoplasms↗
PubMed1979

[Primary hyperparathyroidism (author's transl)].

Experience gained from 100 patients with surgically and histologically proven primary hyperparathyroidism over a period of 14 years led to simplification of diagnostic procedures and development of a surgical scheme. Over the years patients with discrete disease symptoms or with asymptomatic disease were observed more frequently. This can be seen as the result of earlier diagnosis due to increasing spread of laboratory autoanalysers and the resulting routine calcium determination. Development of surgical intervention is characterised by omitting preoperative diagnostic procedures to determine localisation, a schematised operation, and more reliance on macroscopic criteria rather than on quick sections during surgery.

Adolescent↗