[Plastic reconstructive microsurgery in post-traumatic infection control and therapy].
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Adolescent↗
Biomedical subjects
G Germann
Publications and source records attributed to G Germann.
[Open intercarpal palmar dislocation fracture with capitate fracture--stabilization by external fixation].
A case of open carpal dislocation fracture not previously described is reported on. Reduction and stabilization of the dislocation were successfully performed using external fixation without additional Kirschner wires. Despite extensive trauma, hand function is now excellent, and there are no signs of residual carpal instability.
Adult↗
[The significance of acalculous cholecystitis in prolonged respiratory failure in severely burned patients].
Acalculous cholecystitis is a very rare complication in severely burned patients. The correlation between acalculous cholecystitis and the development of a protracted pulmonary failure is demonstrated in 5 patients. Marked improvement of pulmonary function was achieved by cholecystectomy in all patients.
Burns↗
[The effect of arteriovenous fistulas on the metabolism and morphology of striated muscles].
The revascularization of ischemic extremities by retrograde arterial perfusion has been reported in clinical and experimental studies. The effect of retrograde perfusion on hemodynamics and metabolism of skeletal muscle was investigated in 86 rabbits with various types of AV-fistulas. Since blood flow was markedly reduced, levels of energy phosphates (ATP, CP) stabilized on a lower level. In all groups, lactate raised significantly. Focal morphological lesions were seen in all groups in a various degree. A high incidence of thrombosis was found at dissection. Maintenance of blood flow and metabolism after retrograde perfusion seems to be possible on a low level.
Adenosine Triphosphate↗
[Experimental studies of the effect of an arteriovenous fistula on postischemic skeletal muscle].
Arteriovenous fistulas have clinically been used for revascularization of ischemically damaged extremities. Therefore in an experimental study on hind legs of rats, the histomorphological changes on the M. tibialis anterior and the M. soleus following arteriovenous shunts in the femoral level with and without an ischemic lesion were performed. The results show that it is unlikely, to expect postischemic muscle protection by iatrogenic arteriovenous shunting.
Animals↗
The role of adrenal medulla in endogenous dopaminergic inhibition of aldosterone secretion.
Evidence has accumulated that aldosterone secretion is under endogenous dopaminergic inhibition. To examine potential sources of the dopamine thus inhibitorily acting in the adrenal zona glomerulosa, the responsiveness of aldosterone, plasma renin activity, prolactin, and plasma catecholamines to haloperidol, a dopaminergic antagonist, was studied in rats 6 weeks after unilateral adrenalectomy (Group B), 6 weeks after unilateral adrenal demedullation followed by contralateral adrenalectomy 5 days later (Group C), and in controls without any pretreatment (Group A). In Group C, there were increases in basal levels of norepinephrine (P less than 0.01), prolactin (P less than 0.02), and aldosterone (P less than 0.01). Basal plasma renin activity was also increased (P less than 0.05), epinephrine concentrations were decreased. Two hours after haloperidol 1 mg/kg b.wt. i.p., aldosterone levels were increased in Groups A + B (P less than 0.01) but unresponsive in Group C. Haloperidol-induced stimulation of prolactin and norepinephrine was not impaired by the surgical procedures. Epinephrine levels were increased by haloperidol only in groups A + B (P less than 0.002). In none of the groups were plasma renin activity or dopamine levels influenced by haloperidol. It is concluded that dopaminergic inhibition of aldosterone production is brought about neither by circulating dopamine nor by potential dopaminergic nerves accompanying arterial blood supply of the adrenal cortex but by dopamine originating directly in adrenal medulla.
Adrenal Medulla↗
Microcirculation in muscle.
The microvascular architecture in muscle is reviewed herein. The intrinsic vasculature is similar in different muscles. There are numerous arterioarterial (100 microns diameter) and venovenous (150 microns) anastomoses creating a large microscopical network. End-arterioles (30 microns), end-venules (50 microns), and capillaries (6 microns) form a smaller microscopical network. There are no arteriovenous shunts. Precapillary arterial vessels larger than 10 microns have one or several layers of smooth muscle cells. There are no precapillary sphincters. Postcapillary vessels larger than 15 microns have one continuous layer of smooth muscle cells. Calculations show that the cross-sectional area is the smallest and hence resistance the greatest in arterioles of 22 microns and venules of 40 microns. There is better physiological support for giving plasma expanders, such as dextran, rather than vasodilators in low flow situations.
Animals↗
An application of curriculum-based assessment: the use of direct and repeated measurement.
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Achievement↗
[Perioperative antibiotic prophylaxis in elective splenectomy. A randomized prospective study].
After elective splenectomy septic complications in the early postoperative period occur up to 45%. In a prospective, randomised, controlled study of 61 patients the incidence of postoperative infections with and without prophylactic use of an antibiotic was compared. 61 patients undergoing elective splenectomy were divided into two groups. 28 patients were operated without any antibiotic, 33 patients were given 3 X 1500 mg Cefuroxim (Zinazef) for three days, starting 1 h prior to the operation. Infections of the urinary tract and the lung were excluded preoperatively. With a standardized program we searched for intraabdominal abscesses, infections of the lung, the urinary system and the abdominal incision postoperatively. No fatal complication occurred. A significant reduction in total septic complication rate (p less than 0.01) and in pneumonia was found as well in benign as in malignant disease. The study shows, that the apparently disturbed immunological defense following splenectomy can be improved by the prophylactic use of antibiotics.
Adult↗
[Prophylaxis of stress ulcer in piglets by oral administration of prostaglandin E2 (author's transl)].
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Administration, Oral↗
Rapidly fatal necrotizing fasciitis after aesthetic liposuction.
Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection involving primarily the superficial fascia and subcutaneous tissue. The disease is caused by Streptococcus pyogenes or synergistic infection of anaerobic and facultative anaerobic bacteria. Further characteristics are severe, intolerable pain and a mortality rate of 30 to 50%. The NF can be initiated after surgical procedures, minor trauma, trivial scratches, in the setting of a chronic wound, or even in apparently intact skin. The age of the patient is not relevant for the prognosis of NF. As it is shown in this reported case, a young and previously healthy patient died after aesthetic liposuction in the course of a NF. Necrotizing fasciitis is a rare disease, therefore, it is important to review its diagnostic and clinical features, because only early diagnosis and prompt, radical surgery improves the survival rate.
Adult↗