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Biomedical subjects

H Pichlmaier

Publications and source records attributed to H Pichlmaier.

At least 181 records · Page 10Linked to original sources
PubMed1979

[Results of selective proximal vagotomy for gastroduodenal ulcer (author's transl)].

Between 1971 and 1976 selective proximal vagotomy (SPV) was performed in 526 patients with uncomplicated duodenal ulcer and in 37 with gastric ulcer. The operative mortality was 0.18%. The post-operative course was without complication in 90%. One to five years post-operatively 75% of patients with duodenal ulcer were largely without symptoms (Visick I and II), a dumping syndrome was present in 6.5%, diarrhoea in 4.2%, gastric outlet stenosis in 1% and recurrent ulcer in 10.9% of patients who could be re-examined. Recurrent ulcer occurred in eight of 36 patients re-examined after SPV for gastric ulcer. Results of SPV so far have shown it to be a useful alternative to gastric resection in the treatment of duodenal ulcer. But its place in the treatment of gastric ulcer remains undecided.

Diarrhea↗
PubMed1979

[Canine kidney preservation by intermittent perfusion with hypothermic Collins- or Sacks-solution (author's transl)].

37 canine kidneys were intermittently perfused with Collins- or Sacks-solution every 2--6 h. 32 of these kidneys were transplanted after 12--24 h storage time. Additionally, 24 kidneys were stored under hypothermia for 12--24 h and then transplanted (control group). During perfusion the oxygen consumption of the kidneys and the enzyme and lactate release were measured. It was impossible to improve the results of hypothermic storage preservation by intermittent perfusion of the kidneys, on the contrary kidney function deteriorated by the number of perfusion processes. The failure of intermittent perfusion is caused by the increase of renal vascular resistance during perfusion. From the oxygen consumption and lactate release measurement it was concluded, that the washout solutions for kidney preservation should contain more substrate which can be utilized under anaerobic conditions to improve the results of hypothermic storage preservation.

Animals↗
PubMed1979

Surgical treatment of tracheal stenosis.

During the last 3 1/2 years 8 patients underwent segmental resection of the trachea and one patient underwent resection of the carina at the Department of Surgery, University Hospital, Köln. Follow-up investigation in 6 month intervals showed good results in 6 patients. The complicated course of 1 of our patients with tumor infiltration of the trachea is discussed. In this case a large esophagotracheal fistula was covered with a vascularized esophageal segment. Suggestions for surgical indications in segmental resection of benign esophageal stenosis are outlined.

Adolescent↗
PubMed1979

[Indications for the correction of tracheal stenosis caused by prolonged artificial ventilation of polytraumatized persons (author's transl)].

Pronounced, short-length narrowing of the trachea combined with dyspnoea at rest is an absolute indication for partial resection. For stenoses of moderate degree the indications for surgical intervention are as yet not clearly defined. They depend not only on the clinical, roentgenological and tracheobronchoscopic findings, but also on the results of lung function tests. Changes in respiratory function become noticeable at reduction of under 30% of the tracheal diameter. Experiments with artificially induced stenosis have shown an exponential rise in flow resistance when the diameter of the trachea was narrowed to below 8 millimetre. observations made in patients have proved that the experimental results also apply clinically. The indications for surgery of a tracheal stenosis should be made dependent on the results of the determinations of flow resistance, whole body plethysmography and expiratory and inspiratory volume/1 sec. Flow resistance exceeding 5 cm H2O/1 sec, equivalent to narrowing to under 8 mm in diameter, is considered to be an indication for partial resection.

Humans↗
PubMed1978

[Bile duct reconstruction with pendunculate jejunal grafts (author's transl)].

A pedunculate patch, obtained from a disconnected segment of jejunum, was implanted into the longitudinal incision of the ductus choledochus. Intra-operatively, the findings were based upon direct cholecystocholangiography; postoperatively, upon laboratory tests. After an observation period of 12 months a new cholangiography of the transplant was made along with a selective picture of the mesenteric arteries. The choledochus duct with the transplant was examined histologically. Three dogs died immediately postoperatively of peritonitis due to suture insufficiency. Five dogs died of invaginate ileus. These animals, as well as the remaining 8 dogs showed macroscopically and microscopically a smooth and uneventful healing of the transplant at the end of the observation period. Radiographies showed free flow of the biliary duct system. The selective mesenteric arteriographies evidenced beginning anastomosis between the transplant and the capillaries of the bile duct. Based on the results presented, the pedunculate jejunal graft can be considered well suited as an expansion graft for the bile duct.

Animals↗
PubMed1978

[Kidney preservation by hypothermic storage in Collins and Sacks solutions: the influence of 0-30 min of warm ischemia on the available preservation period (author's transl)].

123 kidneys of mongrel dogs were stored under hypothermic conditions in Collins or Sacks solutions for 12 up to 72 h and then transplanted. Before preservation the kidneys were subdued to 0-30 min warm ischemia. Kidney function after transplantation was measured by PAH-and inulin-clearances. Successful 24 h preservation was likewise possible with Collins and Sacks solutions if there was not any warm ischemia. Kidney function was reduced by the length of preservation, according to the formula; y = 166.02 . e-0,125x (y = PAH-clearance and x = preservation time). With both solutions the most attainable preservation time after 15 min warm ischemia was only 12 h, longer preservation time or ischemic periods were not tolerable. However, the function of the ischemically damaged organ was significantly better preserved by Sacks solution in comparison with Collins solution-although the preservation period could not be extended by this solution. Therefore, as far as human kidney preservation is concerned, Collins solution should be replaced by Sacks solution.

Animals↗
PubMed1978

[Replacement of the iliac veins and the infrarenal vena cava regment with heterologous grafts in animal tests (author's transl)].

A bovine collagen graft was implanted in 30 dogs for the replacement of the femoral vein, the iliac vein and the inferior vena cava. During the observation period up to 210 days six thromboses of the graft were observed. Histological results after 30 days: development of a "neo-intima" with collagen type III, originating from the anastomosis. After 90 to 210 days: Continuous endothelial layer of the graft with appearance of smooth muscle fibers in the neo-intima. From the graft bed there was found resorption of the bovine collagen and replacement by new collagen type III fibers.

Animals↗
PubMed1978

[Comparison of the value of various methods for diagnosis of gastroesophageal reflux].

At the University Surgical Clinic Köln-Lindenthal 5 different methods were employed for assessment of gastro-esophageal reflux between 1975 - 1976 in 283 patients with and without reflux disturbances. Clinically, a gastro-esophageal reflux was found in 72% of the cases. The measurement of intra-esophageal pH with reflux-provocation was the most sensitive, and at the same time the most specific (83, 3%). Significant differentiation betwen patients with and without reflux who had an axial hiatus-hernia could not be made, using x-ray examination and counting of the number of times swallowed in the acid-clearing test. The most suitable procedure in proving the presence of gastro-esophageal reflux was esophagoscopy, intra-esophageal pH-measurement and acid-clearing-and-pH determination, in all of which the results correlated with each other to a high degree.

Diagnosis, Differential↗
PubMed1978

[Preservation of kidneys with ischemic injury using hypothermic storage and mechanical prolonged perfusion].

Dog kidneys were flushed and stored in Collins (n = 30) and Sacks (n = 32) solution under hypothermia. These results were compared with those gained by mechanical perfusion (n = 21). Before preservation, the kidneys were subjected to 15 - 60 min of warm ischemia then stored for 12 - 24 h. It was concluded that 12-h preservation time after 15-min ischemic injury was the limit of hypothermic storage preservation. Sacks' solution gave better results than Collins' solution as regards the immediate function after transplantation. In contrast, mechanical perfusion was well tolerated for 24-h preservation time after a warm ischemia of 30 min. In case of warm ischemic damage, mechanical perfusion should be preferred to hypothermic storage.

Animals↗
PubMed1978

Replacement of the inferior vena cava and iliac veins with heterologous grafts in animal tests.

The use of a modified bovine collagen graft as a low-pressure conduit was investigated by implantation into the iliocaval system of dogs. In the 210 day observation period, a patency rate of 87.5% was achieved. Nearly all graft failures occured within the first 14 days following implantation; failure after that time did not seem to be dependent upon length of time of implantation. Progressive organization of the neointima was seen histologically. New smooth muscle fibers were observed in the neointima with electron microscopic evidence of reconstitution of the subendothelial membrane. Continuing resorption of graft collagen coincided with its replacement by newly developed collagen type III fibers in a surface-parallel orientation.

Animals↗