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Biomedical subjects

G Steinau

Publications and source records attributed to G Steinau.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Incidence of contralateral inguinal hernias in infancy and childhood].

Inguinal hernia is a frequent surgical disease during infancy, occurring in 1 to 2% of all mature newborns and rise up to 30% of all premature babies. In 9.5% a contralateral hernia is found after unilateral operation. In our own patients this rate was 5.6%. The development of a contralateral hernia was significantly more often found in boys than in girls. If the hernia occurred during the first two months of life, a contralateral hernia developed later highly significant (p > 0.0001). Within the first two postoperative years the second hernia arose in 84.9%. We recommended to routinely operation for a contralateral hernia in all children younger than two months.

Adolescent↗
PubMed1996

Ruptured hepatic angiolipoma in tuberous sclerosis complex.

Tuberous sclerosis complex (TSC) may be associated with hepatic angiomyolipoma. In contradistinction to renal angiomyolipoma this lesion is rare, and nontraumatic hemorrhage has not so far been described. This is the first report of a spontaneously ruptured, surgically treated and histologically verified, hepatic angiomyolipoma in TSC. Anomalies of the vessel walls and consequently the hazard of bleeding are known to increase with the diameter of the tumor in other localizations. It is concluded that in cases with rapid tumor growth and marked vessel anomalies elective surgery should be considered.

Adult↗
PubMed1996

[Risk factors, preoperative delay and mortality in surgical gerontologic interventions].

A total of 1026 patients over 65 years of age underwent abdominal surgery during the period from 22 September 1987 to 12 February 1992 at the Surgical Department of Aachen Technical University. The data of these patients were analysed with respect to pre-operative risk factors, pre-operative rest period, their history and mortality. The following most important pre-operative risk factors were considered: cardiovascular diseases (45.9%), hypertension (28.7%), pulmonary diseases (19.4%) and diabetes mellitus (16.6%). Patients without pre-operative risk factors showed the lowest mortality rates if the pre-operative rest period was 1-2 days only, whereas patients with four or more risk factors showed the lowest mortality rates if the period of rest was 10-14 days. Mortality after emergency intervention (16.54%) was about three times as high as after elective surgery (5.54%). The anamnesis was 2-10 months for 30% of the patients whereas 8.2% of the patients reported a history of complaints of less than 24 h.

Abdomen↗
PubMed1996

[Abdominal interventions in advanced age: risk factors and fatal outcome].

1026 patients of more than 65 of age who underwent abdominal surgical treatment were retrospectively investigated with respect to pre-operative riskfactors, post-operative complications and mortality. Mortality after emergency intervention was with 16.54% about 3 times as high as after elective surgery (5.54%). 25.4% of all patients had no coexisting diseases. Preexisting diseases were cardiovascular (45.9%), hypertension (28.7%), pulmonary diseases (19.4%) and diabetes mellitus (16.6%). 37.32% of all patients showed one accompanying disease, 23.98% two, 10.4% three and 4 or more were described with 3.31%. The average number of riskfactors was 1.1 for patients aged 65-69 years, 1.34 for patients aged 70-74 years, 1.52 for those aged 75-79 years and 1.41 for patients over 80 years. There was a significant increase of mortality with rising numbers of riskfactors (p < 0.01). In 50.58% of all patients no post-operative complications developed. Cardiovascular, pulmonary and myocardial complications were the leading complications, occuring in 18.52%, 16.8% and 13.74% of patients, being followed by cerebral-vascular (5.63%) and renal (4.09%) complications. The incidence of medical complications was significantly higher after emergency than after elective surgery (p < 0.01). At least 4 and more complications occurred after 2.56% of elective interventions but after 20.24% of emergency surgery. A significant increase of postoperative complications has been observed with increasing extent of anaesthesia (p < 0.01). Moreover, the incidence of complications increased significantly with the amount of preoperative coexisting diseases (p < 0.01).

Abdomen↗
PubMed1995

[Reconstruction of the diaphragm with various materials. An animal experiment study].

The relative merits of three methods of diaphragmatic hernia repair were evaluated in animals. Eighty Sprague-Dawley rats underwent laparotomy. The control group had an incision in the diaphragm with primary repair. The other three groups underwent partial resection of the left hemidiaphragm. The defects were repaired in 20 rats with lyophilized Dura, in 20 with polytetrafluoroethylene (PTFE) and in another 20 with absorbable serosa from a cow. Seventy-two animals survived the operation; they were followed up by electromyography (EMG) and post-mortem physical and histological examinations after 3 and 6 months. The EMG showed normal function for the absorbable material. Only scanty physiological waves were registered in the PTFE group. The examination for stretching and stress showed good results for all materials tested. The histological examinations amount to strong foreign body reactions with Dura and PTFE groups. The absorbable bovine serosa had vanished after 3 months postoperatively. It is concluded that bovine serosa can be recommended for diaphragmatic hernia.

Animals↗
PubMed1995

[Ambulatory pediatric surgery--limits and risks from the clinical viewpoint].

Day-care surgery in childhood has to meet the same safety criteria as inpatient care; thus, a knowledge of the risks and limits is mandatory. The kind of operation, its duration, concomitant diseases, the patient's age, previous vaccinations, and social conditions limit the feasibility of day-care surgery. Premature infants under the age of 1 year should not be treated on an outpatient basis because of the higher incidence of early postoperative complications. Above all, anesthesiological problems play an important role in day-care patients; fortunately, most of them are minor complications. During a 14-year period 2179 children were treated in our department on an outpatient basis, resulting in a total complication rate of 1.7% and unexpected inpatient care of 1.1% of the patients in our series. Daycare surgery can be regarded as standard treatment for most of the surgical routine procedures in children.

Adolescent↗
PubMed1994

[Laparoscopic resection of bleeding Meckel's diverticulum].

The most malformations of the gastrointestinal tract are the Meckel's diverticula. In 25% of all complications of this disease you will find a bleeding of the diverticulum. We report a case of a 12 year old boy treated laparoscopically for a bleeding diverticulum and we describe the technical procedure. The first choice in diagnosis in the scintigraphy with 99mTc-pertechnate, at which the proof of ectop stomach mucous membrane is necessary. Laparoscopic resection of a bleeding Meckel's diverticulum performed by an experienced surgeon is a safe and considerate procedure in laparoscopic technique.

Child↗
PubMed1993

Hirschsprung disease: paternal transmission to a son.

Hirschsprung disease (HD) is genetically heterogeneous with approximately 4% familial occurrence. The recurrence risk is higher in patients with severe involvement. We describe the transmission of histotopochemically proven HD from a father with long aganglionic segment disease to a son with ultrashort segment disease. This observation suggests that the length of involvement in HD is related to the variable expression of the gene defect. It also suggests autosomal dominant inheritance of HD.

Adult↗
PubMed1993

[Intra-abdominal migration of a Kirschner wire from the femoral neck].

A epiphysiolysis capitis femoris in a child was treated bei Kirschner-wire fixation. Postoperatively one of these wires broke and presumably migrated through the acetabulum intraperitoneally into the true pelvis. The Kirschner-wire fragment was removed by laparotomy. We discuss the technique of application of Kirschner-wires and complications of the procedure, in particular migration and dislocation.

Bone Wires↗
PubMed1993

[Ambulatory surgery interventions in childhood in a surgical clinic].

Between Jan. 1, 1980 and Dec. 31, 1990 1 688 children underwent One-Day-Surgery at the Surgical Department of the Rhenish-Westfalian Technical University. More than 85% of the operations were inguinal hernias (n = 765), phimoses (n = 324) and umbilical hernias (n = 185). The children's age ranged from 3 months up to 14 years. 27 patients (1.6%) could not be dismissed at the same day because of early complications. Two postoperative hemorrhages after circumcision led to readmissions and reoperation. More than 90% of the parents and 85% of the pediatrists were satisfied with the One-Day-Surgery. A responsible and successful One-Day-Surgery needs qualified surgeons, a well defined organizational structure and the observance of forensic problems.

Adolescent↗
PubMed1992

[Interrupted suture versus adhesive dressing in skin closure of pediatric inguinal hernia--a controlled randomized prospective study].

The skin closure with resorbable interrupted sutures (Dexon 6x0) was compared with adhesive plasters (Leukostrip) in a randomized prospective clinical trial with 100 children with an inguinal hernia. The same operative technique was used in both groups. There were no significant differences referring to the complication rates and the cosmetic results between both groups. Skin closure with adhesive plasters significantly saved operation-time and reduced costs. It can be recommended in cases of infantile inguinal hernias.

Bandages↗
PubMed1992

Immunohistochemical reactivity of neuropeptides in plastic-embedded semithin sections of the myenteric plexus in infantile hypertrophic pylorus stenosis.

Pyloric biopsies obtained at pyloromyotomy from 46 infants were studied by light and electron microscopy and compared to 8 autopsy control cases without any evidence of infantile hypertrophic pyloric stenosis (IHPS). A positive family history of this disorder was recorded in 8 cases (2 girls and 6 boys). The most frequent changes in the myenteric plexus comprised axonal alterations. In glial cells, cytoplasmic vacuolisation or an increase of intermediate filaments occurred. In ganglion cells, vacuolisation of perikaryal cytoplasm or dense bodies were observed. No obvious differences were seen between sporadic and hereditary cases. In addition to these fine structural alterations, immunohistochemistry in 6 IHPS cases and 4 controls revealed differences in the distribution of substance P, bombesin, calcitonin gene related peptide and enkephalin-like immunoreactivity within the myenteric plexus between IHPS and control cases. The immunoreactivity, however, was unevenly distributed from case to case and even within individual cases. The reduction of immunoreactivity corresponded, at least in part, to an increase of neurofilaments or abnormal organelles within axons. Increased immunoreactivity was apparently related to focal accumulation of dense cored vesicles noted in the preceding study. It is suggested that these and other changes reported interfere with the normal gastrointestinal reflex mechanisms leading to intestinal obstruction.

Female↗
PubMed1991

[Non-Hodgkin's lymphomas of the stomach. Therapy from the surgical viewpoint].

About 2-5% of all gastric tumours are Non-Hodgkin Lymphomas (NHL). In the last years we treated 15 patients with NHL of the stomach. Six of these patients were classified to group IE according to Ann Arbor classification, four to group II (three II 1 E and one II 2 E). In group III E were two patients (one III S and one III E) and one patient was classified to group IV. Ten patients displayed low grade and five high grade malignancies with respect to the Kiel classification. We performed in group I three gastrectomies and three BI resections. In four patients of group II two gastrectomies and two BI resections were carried out and in group III two BI resection. Our treatment policy consisted of operation and radiation in IE, to operation and chemotherapy in high grade lymphomas of group II, and operation plus radiation in low grade malignancies of group II. In group III we treated radiation, chemotherapy and operation and in group IV radiation and chemotherapy. In group I five patients survived, in group II two out of four and in group III one of two. The patient of group IV died within two years after diagnosis.

Adult↗
PubMed1991

[Extra-gastric non-Hodgkin's lymphomas of the abdomen--the role of surgical treatment].

A multimodality approach offers the best chance for treatment of Non-Hodgkin lymphoma. Surgery, radiation therapy, and/or chemotherapy when used in combination offer better response and longterm survival rates. Surgical therapy offers good results in stage I and II according to the Ann Arbor classification. Aim is the excision of the tumor with the removal of lymph nodes. The best treatment in stage III and IV is chemotherapy and radiation followed by surgical tumor reduction. Complications like perforation or bleeding occurred while the patients received either chemotherapy or radiotherapy. Resection of the Non-Hodgkin lymphoma prevented the complications of hemorrhage and perforation associated with chemotherapy and radiation.

Adolescent↗
PubMed1990

Infantile hypertrophic pyloric stenosis: myopathic type.

Smooth muscle cell biopsies obtained at pyloromyotomy from 37 children with infantile hypertrophic pyloric stenosis (IHPS) were studied by light and electron microscopy and compared with 6 autopsy control cases without any clinical evidence of this disorder. In cases with IHPS an apparently irregular increase in the number of smooth muscle cells by mitosis was accompanied by an increase of the endoplasmic reticulum, proliferation of mitochondria and regressive changes, such as shrinkage, swelling, necrosis and apoptosis of smooth muscle cells. Other alterations, seen in some but not all cases consisted of large numbers of unusual dense granules some of which were clearly associated with actin filaments and, therefore, regarded as derivatives of the normally occurring dense bodies. Furthermore, intermyofibrillar and subsarcolemmal glycogen accumulations, various nuclear abnormalities and pleomorphic membranous cytoplasmic or nuclear bodies occurred. While smooth muscle cell abnormalities predominated in some cases of IHPS, in others there were more severe axonal changes in the myenteric plexus. It is suggested, therefore, that a primarily myogenic type of IHPS can be distinguished from a predominantly neurogenic type.

Biopsy↗
PubMed1990

[Common channel syndrome--2 case reports].

The common channel syndrome is a disease mostly of young girls. To demonstrate the problems of diagnosis and therapy we report on 2 cases operated on in 1987 and 1989. The long delay of several years between the onset of symptoms and the diagnosis might be shortened by improved diagnostic possibilities (Ultrasound, ERCP). In any case of hyperamylasemia or chronic pancreatitis in childhood an obstruction of the biliary tract should be excluded. The common channel syndrome can be treated by means of sphincteroplasty or a bilidigestive anastomosis.

Amylases↗