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Biomedical subjects

H Pichlmaier

Publications and source records attributed to H Pichlmaier.

At least 145 records · Page 8Linked to original sources
PubMed1983

Surgery of the venous system - present state of the art.

The current status of surgery of the inferior vena cava, and the iliac and femoral veins in cases of phlebothrombosis, of postthrombotic syndrome, and in traumatic lesions is discussed. Each intervention in the venous system requires an exact preoperative diagnosis including phlebography and phlebodynamometry. After a mean observation period of 26 months, 41.4% excellent results were obtained following venous thrombectomy in cases of phlebothrombosis. Vena cava blockade as a prophylactic measure against pulmonary embolism is an accepted procedure now. It remains, however, limited to a few exceptional situations. Venous injuries proximal to the elbow and the knee can be successfully treated by direct suture or graft implantation with good functional results, whereas ligature of large veins causes postthrombotic syndrome of the limbs in over 50% of the cases. Chronic occlusion of iliac veins and postthrombotic syndrome may be treated by reconstructive methods, with the aid of a temporary arterio-venous fistula. The prerequisites of patent run-in and run-off reduce the number of operations to but a few cases.

Adult↗
PubMed1983

["Peel away introducer"--a new technic for implantation of central venous catheters for long-term parenteral feeding].

For longterm intravenous parenteral nutrition silicone catheters are used, which usually are operatively implanted by dissecting out the subclavian or internal jugular vein. By means of the "peel-away-introducer" percutaneous placement of this catheter is now possible using a modified Seldinger technique. The new method of catheter placement is described in detail.

Catheterization↗
PubMed1983

[Transanal endoscopic surgery of the rectum - testing a new method in animal experiments].

Surgery of the lower third of the rectum can be done without difficulty through the anus using an endoscopical approach. Polyps or tumors located in the upper two thirds of the rectum can be removed using the Mason or Kraske procedure, or by the transabdominal approach. A new endoscopic technique has been developed with the aim, to allow surgery in the whole rectum through the anus. The rectum is being dilated by mechanical means and air insufflation. An oblique angle stereoscopic endoscope as well as modified surgical instruments are used. In animals 47 excisions of mucosa were done, and the incisions were closed by continuous suture. Application of this technique in a clinical setting is planned.

Anal Canal↗
PubMed1983

[Circular stapling anastomosis (EEA) following gastrectomy].

After total gastrectomy because of gastric malignancies 31 oesophagojejunostomies performed in end-to-side fashion using a standard manual technique were compared with oesophagojejunostomies performed in end-to-end fashion by mechanical stapling (EEA). After manual suturing there was a leak in 29% and 25.8% out of all patients died. After automatic mechanical suturing anastomotic failure was seen in 12.9% with a postmortality rate of 3.2%. These results show, that by mechanical stapling a secure oesophagojejunostomy is possible and the risk of gastrectomy can be reduced.

Adult↗
PubMed1983

[A recent procedure for intraoperative autotransfusion].

At the surgical unit of the University of Cologne a new system for autotransfusion (Solcotrans) was used in 18 patients. This system consists of a plastic case connected with a vacuum pump by an airtube. After filling the plastic case with 50 ml sodium citrate, 450 ml of blood can be aspirated by the surgeon and be reinfused by the anaesthesiologist. The system was used in shunt-surgery at portal hypertension, at venous thrombectomy and at aneurysms of the aorta abdominalis. Through this, stored blood was not necessary in 13 operations.

Aorta, Abdominal↗
PubMed1983

[A new method for intraoperative autotransfusion].

In the surgical department of the University of Cologne a new system for autotransfusion (Solcotrans) was used 74 times in 18 patients. This system consists of a plastic case connected with a vacuum pump by an air tube. After filling the plastic case with 50 ml of sodium citrate, 500 ml blood can be aspirated by the surgeon and reinfused by the anaesthetist. The system was used in venous thrombectomy, in aneurysms of the abdominal aorta and in shunt surgery due to portal hypertension. Thus stored blood was not necessary in 13 operations.

Aortic Aneurysm↗
PubMed1983

[Colloid osmotic pressure--a parameter of postoperative protein therapy. A pilot study].

120 intensive-care patients were examined postoperatively in a pilot study. The patients were divided into two groups. In group 1 human albumin was given when the serum protein concentration decreased below 5 g%, in group 2 when the colloid osmotic pressure (COP) decreased below 27 cmH2O. Patients of group 2 received less human albumin, but despite the lower human albumin supply these patients did not worse postoperatively as compared to group 1. On the contrary, the trend could be observed that the periods of ventilation were shorter (possibly due to the lower volume load of the patients) and the serum creatinine concentrations were lower (possibly due to the increased supply of crystalloid solutions) if smaller amounts of albumin were given. It may be concluded that the postoperative human albumin supply is unnecessary if the COP ranges 27 cmH2O or more.

Adult↗
PubMed1982

Dopamine treatment of human cadaver kidney graft recipients: a prospectively randomized trial.

In a prospectively randomized trial, 50 human cadaver kidney graft recipients were tested for the effect of dopamine infusion on kidney function after transplantation. The kidneys were taken from beating-heart donors under optimal conditions. The dopamine infusion did not affect the dialysis frequency in the 1st week after transplantation, in the dopamine group only slightly better creatinine clearances could be detected. However, the diuresis increased significantly when dopamine was given and this resulted in the fact that in the dopamine group 47.4% of the patients were dialyzed although the diuresis amounted to more than 11/day as compared to 15.7% of such patients in the nondopamine group. These findings correspond to experimental data, which showed that the dopamine infusion of the recipient mainly ameliorated renal function in those cases where kidneys were taken after hypotensive injury of the donor.

Cadaver↗
PubMed1982

Preoperative parenteral feeding in patients with gastrointestinal carcinoma.

In a comparative clinical trial to examine the influence of 10 days of preoperative parenteral nutrition (PPN) on the postoperative complication rate for gastrointestinal carcinoma 59 patients (controls) received the regular hospital diet and 66 received PPN. The two groups were similar in nutritional status and in distribution of site and stage of tumour and type of operation. The rates of postoperative wound infection, pneumonia, major complications, and mortality were generally lower in the PPN group, but the differences were significant only for major complications and mortality. The clinical results can be explained by the improvement in various indices of humoral and cellular immunocompetence and the protein status in the PPN group and their deterioration in the control group during the preoperative course.

Body Weight↗
PubMed1982

Successful treatment of streptozotocin diabetes of the rat by transplantation of the islets from a single donor pancreas.

A new digestion chamber was developed which made it possible to isolate 500 islets from the pancreas of one adult rat. The mesh chamber enabled us to remove islets out of the collagenase solution as soon as they are separated from pancreatic tissue. The islet injury due to collagenase was diminished, and the time of warm ischemia during digestion was considerably reduced. With this method it was possible to treat the diabetes successfully in eight of 14 rats. The condition of the remaining six rats was considerably improved, and no animal died due to diabetes during 90 days of surveillance as compared to a 50% death rate in the diabetic control group. A cataract did not occur in any transplanted rat, whereas it was observed in all surviving animals of the diabetic control group. If the complete separation of endocrine and exocrine tissue in a density gradient was abandoned the transplantation results improved significantly.

Animals↗
PubMed1982

[Surgery of diseases of the veins (author's transl)].

The article describes the present state of surgery of the v. cava inferior, of the veins of the pelvis and legs in acute phlebothrombosis, post-thrombosis syndrome, traumatic lesions, congenital malformations and in tumour surgery. Every surgical performance concerned with the venous system must be diagnostically clarified by phlebography. The veins of the thigh and pelvis are well visualized by means of ascending phlebography. Closely meshed functional testing by means of phlebography control, as well as venous pressure measurements and peripheral phlebodynamometry are required for timely recognition of an early relapse and for assessing the results of surgery.

Adolescent↗
PubMed1982

[Complaints after cholecystectomy (author's transl)].

Complaints after cholecystectomy are caused by bile duct disturbances (concrements in the choledochus, stenosis of the papilla, anatomic anomalies of the ducts), by diseases of neighbouring organs (pancreas, liver, stomach) or by functional disturbances. Diagnosis of organic disease can be established by appropriate means, that of functional disturbances by exclusion of organic causes. Therapy depends upon the underlying disease. Improvement of endoscopic procedures has let to the point, that in many cases secondary operations have become unnecessary. Close cooperation is necessary between internist, surgeon, and endoscopist, if an appropriate therapeutic procedure is to be found.

Aged↗
PubMed1981

[Choice of donor and the results of renal grafting (author's transl)].

For the calculation of the donor influence on the results of renal grafting, all non-renal causes of transplant failure must be excluded. The following criteria for the selection of a suitable kidney donor were found: the urine production of the donor in the last hour before nephrectomy should amount to at least 200 ml and the age difference between donor and recipient should be not more than 20 years. Proteinuria, a high serum creatinine level, vascular anomalies and a long operation time for vascular anastomosis were unfavourable. The preservation time, the warm ischemia time and the sex of the donor have little effect. If no rejection crises occurred within the first 3 weeks after transplantation, the transplant survival rate increased from 45% to 71%.

Adult↗