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Biomedical subjects

H Hamelmann

Publications and source records attributed to H Hamelmann.

At least 73 records · Page 4Linked to original sources
PubMed1982

[Analysis of therapeutic failures of three surgical concepts for treatment of duodenal ulcer-results of a prospective consecutive study (author's transl)].

In a prospective study 3 surgical concepts were used to treat patients with chronic duodenal ulcer. In concept I 64 patients were treated with "individual ulcer surgery", i.e. depending on the general condition of the patient, the local intraoperative situation and preoperative acid output, either selective vagotomy with pyloroplasty, with antrectomy (B-I) or B-II gastrectomy were used. In concept II 62 patients were treated with selective vagotomy and pyloroplasty. In concept II 110 patients with highly selective vagotomy and treated without drainage. The conditions were diagnosed and the patients were treated in a standardized manner. Follow-up rates were 90% and above and the results were analyzed according to Troidl's definition of operative failures after 1-year follow-up. Lethality was 0% in all concepts (I-III). Recurrent ulcer: I=0%, II=3%, III=4.5%. Complaints with Visick-classifications III and IV: I=14%, II=12.8%, III=45%. Changing symptoms: I=0%, II=0%, III=1%. No acid reduction: I=0%, II=4.9%, III=l6,4%. The lowest recurrence rate and best acid reduction was concept I, the best overall clinical outcome concept III. Highly selective vagotomy without drainage is preferred as the least major and most careful procedure at the moment.

Duodenal Ulcer↗
PubMed1981

[Systemic antibiotic prophylaxis in elective colon surgery. Results of a controlled study].

A prospective controlled, randomized trial was carried out among 70 patients undergoing elective colonic surgery; 31 patients received a systemic prophylaxis with cefotaxime (3 h) before surgery for 4 days and 29 patients were controls. The large bowel preparation consisted of whole gut irrigation with 0.9% NaCl and Paromomycin 1 g/l. Both groups were well matched after randomization. The rate wound infections in the control group was 28% and, in the test group, 6.4% (p less than 0.05, chi2-test). A trend toward a lower rate of urinary tract infections, an astomosic dehiscences and septicemic complications was recognizable in the test group, but not significant.

Aged↗
PubMed1981

[Value of circular mechanical colon and rectum anastomosis. Prospective study of 91 patients].

A prospective study was carried out on 91 patients to evaluate colonic and rectal anastomoses constructed with an EEA stapling gun. The concept comprises the following: orthograde lavage, cecal fistula or colostomy, intraoperative sufficiency control of the anastomosis, intraoperative direct measurement of the height of the anastomosis, postoperative X-ray control of the anastomosis using standardized techniques, classification of the cases into three groups according to the height of the anastomosis: 3-5 cm, and over 9 cm. Characterization of the patients was accomplished biostatistically using the Median-Quartil system. Primary hospital letality of 2% was due to heart failure. Imparied wound healing occurred in 11%. Secondary suture dehiscence was roentgenologically identified in a total of 18% of which only 7% showed clinical symptoms. Stenosis was determined by X-ray in 11% with only 1% demonstrating a temporary clinical correlation. For especially low rectal anastomoses at 3-5 cm the EEA stapling gun appears to have a great technical advantage over hand-placed sutures, allowing extension of indications for low anastomoses.

Adolescent↗
PubMed1980

[Validity of retro- and prospective data analysis (authors' translation)].

Retrospective chart analysis of 88 operated patients with bronchial carcinoma showed grave deficiencies. In 15% the reason for admission to hospital was not available and the exact smoking habits of 74% were not known. Retrospective TNM-classification was possible in only 59%. It was known in 67% whether a radiotherapy and in 17% whether a cytostatic therapy was additionally performed. Only 13 of the 20 surviving patients participated in the follow-up. In contrast with these figures, a prospective collection of data (44 patients) has an effectiveness of 95% or more for all parameters.

Bronchial Neoplasms↗
PubMed1980

[Auto-suture stapler EEA in surgery of the colon and rectum [author's transl)].

The increasing use of auto-suture staplers for gastrointestinal anastomoses makes it necessary to test the value of this new method of suturing. In a "pilot study" the practicability, the tightness and permeability of the anastomosis and complications were tested and analysed in a total of 30 colon and rectal anastomoses using the EEA-suture gun. The results of 14 colon resections and 16 low anterior resections justify the further use of the EEA auto-suture apparatus and raise the question of a prospective controlled random study in which manual and mechanical machine sutured anastomoses are compared.

Colon↗
PubMed1979

[Histamine level and histamine metabolism of the human liver in biliary tract diseases].

In a control group (n = 12) the histamine content of the liver was 1.42 microgram/g tissue and the activity of the histamine-degradating enzyme, HMT, 421.5 pmol/(min . mg protein). In patients with affections of the biliary tract (n = 12) the histamine content was significantly raised to 3.09 microgram/g tissue and the HMT activity slightly diminished [349 pmol/(min . mg protein)]. The lowest values of HMT activity were found in the livers of those patients with histologically proven damage of liver cells.

Biliary Tract Diseases↗
PubMed1978

[Lung-cancer (author's transl)].

The prognosis after resection of bronchial carcinoma is not only influenced by operative techniques but by the histologic cell type, the general conditions of the patient, and specially by the stage of the disease. Therefore I recommend the routine use of mediastinoscopy, since resection of the tumor proves to be not curative in presence of perinodal growth or contralateral lymph node metastases. Followup of all patients is necessary for critical evaluation of surgical success and quality of live.

Bronchial Neoplasms↗
PubMed1978

[Manometric studies of the anal canal in chronic primary fissure before and after management using dilatation or sphincterotomy].

Manometric investigations in patients with primary chronic fissure in ano were performed before and after stretching or sphincterotomy in a randomized clinical trial. Length of the functional anal canal was not influenced by the procedures. At a six-month follow-up, the maximum resting anal pressure was significantly lower in both groups. After stretching and sphincterotomy, the site of maximum pressure in the anal canal had moved orally. This demonstrates that an elevated resting anal pressure is one of the pathogenetic mechanisms for the development of a primary chronic fissure. It is successfully cut off by either stretching or sphincterotomy.

Adult↗
PubMed1978

[Dilatation or sphincterotomy as the treatment of primary-chronic fissure in ano. Results of a random, clinical study after 2-3 years].

In a randomized clinical trial, 66 patients were treated for primary chronic fissure-in-ano by anal dilatation or sphincterotomy. Of the 64 patients still living, 57 (89.0%) could be submitted to a follow-up examination 26.7 +/- 4.6 months after the operation; 63 of them were surveyed on the basis of a questionnaire. Six patients who had reported functional lesions after operation at a six-month follow-up were reexamined: in two cases improvements were recorded, in the case of three patients the symptoms remained unchanged, and in one case a complete reduction was achieved. Though no significant difference (p less than 0.1) was noted with a recurrence rate of 20.5% (n = 7) after the dilatation versus 3.1% (n = 1) after the sphincterotomy, a definite trend was obvious. These findings support the sphincterotomy as being a definitive therapy for primary chronic fissure-in-ano.

Adult↗
PubMed1978

[Acid reduction and ulcer healing through vagotomy: is an inhibition of histamine release an essential reason for this?].

In a prospective, consecutive study the histamine content of corpus mucosa and the basal and maximally stimulated acid output were measured in male patients who had selective vagotomy to correct a chronic duodenal ulcer. The increase in histamine content after vagotomy was directly proportional to a decrease in maximum acid output. The relationships between histamine content, recurrent ulcer, and reduction in acid output point to a causal relationship between inhibition of histamine release and successful vagotomy.

Adult↗
PubMed1977

Influence of H1- and H2-receptor antagonists on the circulatory system and on the endogenous plasma histamine concentrations in dogs.

The effects of the H1-receptor antagonist dimethpyrindene and the H2-receptor antagonist burimamide on circulatory and respiratory parameters and on plasma histamine levels were tested in 21 mongrel dogs. Both drugs released histamine. The incidence for this effect was 10/11 in the case of dimethpyrindene and 5/10 in the case of burimamide. Following dimethpyrindene all animals showed arterial hypotension, pulmonal hypertension, decrease in peripheral resistance and hyperventilation. The portal venous pressure was increased in dogs reacting by a histamine release. Following burimamide both an initial arterial hypertension and a subsequent hypotension were observed the latter being more pronounced in the group with histamine release. In this group the portal venous pressure raised considerably. In the non-reacting animals cardiac output was elevated, probably due to a release of catecholamines. It seemed remarkable that the effect of exogenous histamine on portal venous pressure was completely blocked by dimethpyrindene, but not the action of histamine released by the drug itself. It is concluded that the effects of anti-histaminic drugs on possibly histamine-induced physiological and pathophysiological processes should be interpreted very carefully as far as their specificity is concerned.

Animals↗
PubMed1976

[Treatment of primary chronic fissure-in-ano by anal dilatation versus sphincterotomy (author's transl)].

A double-blind, randomized, controlled trial in the treatment of primary chronic fissure-in-ano by digital stretching of the anal canal or by a modified lateral subcutaneous sphincterotomy is reported. Whereas there was no difference in the postoperative course of both groups, by checking 65 of 66 patients 6 months postoperatively, we found significantly more lacks of continence after stretching. There was no difference regarding recurrence rate. Pressure monitoring of the anal canal showed significantly higher values at rest in both groups before operation. No correlation between results of monitoring anal pressure and defects of anal continence has been seen. These results point out that in treatment of primary chronic fissure-in-ano the lateral subcutaneous sphincterotomy is superior to anal dilatation regarding postoperative defects of anal continence. The recurrence rate in the present study does not force to prefer one of these two methods. Manometric investigations show that the resting pressure in anal canal seems to be elevated in primary chronic fissure-in-ano.

Adult↗