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Biomedical subjects

H Pichlmaier

Publications and source records attributed to H Pichlmaier.

At least 163 records · Page 9Linked to original sources
PubMed1981

[Results of renal transplantation 1968-1979 (author's transl)].

173 renal transplantations were done over a period of 12 years. Among these were 162 first, 10 second and one third transplantation. The one year survival rate of transplanted kidneys (all cases) was around 50%, patient survival was 81.6%. Survival rates did not depend statistically on tissue compatibility, immediate function of kidney, duration of kidney conservation, donor age, commencement of graft versus host reaction, and duration of preoperative dialysis. Although the number of HLA identity has increased during the observation period, there was no increase of transplant survival rate. This may possibly be explained by the negative influence of the steady increase of conservation time during the same period.

Adolescent↗
PubMed1981

Effect of hypotension on the results of kidney storage and the use of dopamine under these conditions.

The influence of the length and severity of hypotension on the results of kidney preservation was examined in dogs. Successful 24-hr hypothermic kidney storage was possible, if the donor animal was subjected to hypovolemic hypotension (mean blood pressure 60 mm Hg) for a duration 1 to 4 hr. If the blood pressure was lowered to 50 mm Hg, successful kidney preservation could not be obtained. It was concluded that the level of hypotension was of more importance than its duration. After 24 hr of cold ischemia, the function of kidneys from hypotensive donors could be improved significantly if dopamine was given to the recipient. The preservation injury itself could not be counteracted by dopamine because dopamine did not improve the function of kidneys which were removed from normotensive donors but were stored for 24 hr under hypothermia.

Animals↗
PubMed1981

[Indications for the various surgical procedures in hepatic echinococcosis].

This report deals with 38 patients suffering from hydatid disease of the liver. The most frequently performed operative procedures were hepatic resection (n = 16), filling the cavity with normal saline solution (n = 16), filling the cavity with normal saline solution (n = 8), and total cystectomy (n = 6). Hepatic resection is mainly indicated in patients with alveolar echinococcosis of the liver lobe have to be removed. In patients with only one hydatid cyst of the liver the simple method of saline filling should be preferred. The prerequisite of saline filling is that no biliary fistula exists. If the remaining cavity of the hydatid cyst fills with bile, it can be easily drained under local anaesthesia with computertomographic control. Mebendazole was given in two cases with alveolar echinococcosis of the liver that could not be treated surgically. In both cases this treatment proved to be effective.

Adult↗
PubMed1981

[Electrostimulation test for intraoperative vagotomy control. Results of a prospective randomized study].

In a prospective random trial the intraoperative electro-stimulation test of Burge and Vane was conducted with 100 patients, in whom selective proximal vagotomy was performed for a duodenal ulcer. In 6 out of 50 patients histologically proved nerve fibres were found by the applying of the test. The postoperative acid values did not differ significantly between those patients who underwent the electrostimulation test and those who did not. The rate of recurrence was 8% in both groups 2-4 years after the operation. Obviously, the application of the test did not have any effect on the results.

Adolescent↗
PubMed1980

[Reconstruction of benign biliary tract stenoses. Experimental experience with autologous and heterologous transplants (author's transl)].

A pedicled autologous jejunum transplant and a free bovine collagen prosthesis were tried for the treatment of short, benign stenoses of the bile duct in animal experiments. In both cases at follow-up periods of 6--18 months an unrestricted flow of bile was recorded in the plastically dilated bile duct macroscopically, radiologically and by the chemical laboratory. On the basis of these results in animal experiments, 3 patients were treated with a pedicled jejunum transplant for the correction of short benign stenosis of the bile duct following previous cholecystectomy. All the patients are free from complaints after observation periods of 6 months, 1 year and 2 1/2 years.

Animals↗
PubMed1980

[Liver resection in focal nodular hyperplasia and liver cell adenoma (author's transl)].

Focal nodular hyperplasia of the liver was found in 3 women, and liver cell adenoma in a 4th woman. There is a possible association with the use of oral contraceptives. The indication for operation in these cases depends on the size of the tumour (danger of rupture of tumour and haemorrhage). It is also present when a malignant tumour cannot be excluded. Resection of the liver was performed predominantly with good results so far. Three of the patients described underwent the same surgical procedure. For the future one should aim at tumour enucleation alone.

Adenoma↗
PubMed1980

[Problem in indication and artificial ventilation during segmental resection of the trachea (author's transl)].

Based on clinical experience and lung function data (bronchial resistance and inspiratory and expiratory FEV1) obtained in experiments with stenosis in the front of the mouth, bronchial resistance and inspiratory and expiratory FEV1 should first be determined. Resection of tracheal stenosis is indicated at a bronchial resistance of more than 5 cm H2O/1/s. This corresponds to a stenosis diameter of less than 8 mm. In the case of carinal resection, one lung can be ventilated by artifical respiration for a short time only. The data obtained during resection confirm the well-known requirement of clamping the opposite pulmonary artery.

Airway Resistance↗
PubMed1980

[Problems in the management of liver trauma (author's transl)].

In the last ten years 43 patients with blunt liver trauma and 11 with penetrating liver wounds have been treated. The mortality rate after blunt liver trauma was close to 63%; all penetrating wounds were survived. The prognosis after trauma depended significantly on the number of additional wounds, the extent of blood loss, and the age of the patients. Management of liver trauma was performed in most of the cases (n = 41) by suture and drainage. Packing of the wounds and resection were performed in four cases each. In nine cases, the bleeding did not stop sufficiently after suture, debridement, or packing of the wounds. It is concluded that in those cases hepatic resection or hepatic artery ligation - depending on the extent of trauma - should be done in future.

Adolescent↗
PubMed1980

[Therapy of benign bile duct stenosis (author's transl)].

Simple end-to-end reconstruction of benign bile duct stenosis is possible only in a few cases. To preserve the function of papilla of Vater as the best anticholangitis therapy, we developed a method of bile duct expansion by a pedunculated jejunal patch-graft in animal experiments. After these successful experiments three patients with iatrogenic short bile duct stenosis were treated with this operation. These patients remain free of pathologic clinical and radiological findings 8-30 months after surgery.

Adult↗
PubMed1980

[Indication and operative technique in chronic occlusions of the innominate artery and proximal subclavian artery (author's transl)].

Surgery is indicated in clinical stage II and cases of subclavian steal syndrome. Endarterectomy by mid-sternotomy is the operation of choice for obliteration of the innominate artery. The lethality rate is 6%. Occlusion of the left proximal subclavian artery can be treated by transthoracic endarterectomy or extrathoracic bypass procedure. The bypass procedure is preferred because of low operative lethality rate (0.8% versus 7% in transthoracic procedure). Occlusions of the right proximal subclavian artery are treated by supraclavicular endarterectomy.

Adult↗
PubMed1980

Kidney storage at subzero temperatures using a hyperosmolar perfusate.

32 dog kidneys were stored in a hyperosmolar perfusate (770 mosm/kg) at minus2 and plus4 degrees C, respectively, for 12-48 h and thereafter autotransplanted. 18 kidneys of the control group were stored in Collins solution at plus4 degrees C. The immediate function of the kidneys after transplantation was measured by p-aminohippuric acid and inulin clearances. Successful 24-hour preservation was possible by use of the hyperosmolar perfusate. Kidneys stored in the hyperosmolar perfusate at minus2 degrees C were better preserved than kidneys stored in Collins solution at plus4 degrees C. The addition of human albumin to the hyperosmolar perfusate did not improve the preservation results.

Albumins↗
PubMed1980

[Parenteral feeding in outpatients. Indications, technic, experiences].

Home parenteral nutrition is indicated in the short bowel syndrome, chronic inflammatory bowel disease and as an adjunct to cancer therapy. For venous access the cannulation of a collateral of the subclavian vein and the central venous silastic catheter have proved helpful. Our own experience with 19 patients shows, that with careful supervision home parenteral nutrition can be performed with low risk.

Adult↗
PubMed1980

[Late results after surgery in chronic pancreatitis (author's transl)].

122 patients were operated upon because of chronic pancreatitis within 15 1/2 years. Mortality during and immediately after surgery was 9.8%, later mortality was 4.9%. 104 patients were still alive at follow up. In 40 patients most of the pancreatic parenchyma was left during surgery. Late results were good or satisfactory in 67.5%; carbohydrate tolerance was impaired in 35%, and exocrine insufficiency of the pancreas was present in 32.5% of these cases. In another group most of the pancreas was removed; 86% of these patients improved permanentely, 46% had impaired carbohydrate metabolism, 83% exocrine insufficiency of the pancreas. Good results can be achieved, if impaired carbohydrate metabolism, 83% exocrine insufficiency of the pancreas. Good results can be achieved, if indications are carefully choosen. Personality traits of the patients have to be taken into account when choosing the surgical approach. Advantages of a two session surgical approach combined with conservative treatment are discussed.

Alcoholism↗
PubMed1979

[Computer tomography on the pancreas. A diagnostic extension from the surgical aspect (author's transl)].

125 patients were subjected to computer tomography on account of suspected pancreatic disease. 48 patients were operated on--the computer tomography (CT) diagnosis was confirmed in 85.5% of the cases. Acute pancreatitis can be detected by CT if it is accompanied by an appropriate enlargement of the organ. Chronic pancreatitis can be recognized by deformations of the organ, calcifications or formation of pseudocysts. Pancreatic carcinoma is recognizable when it is larger than 3 cm accompanied by a change in the shape of the organ or if infiltration of neighboring structures has occurred. Computer tomography offers patients a safe, non-invasive method of performing follow-up examinations at short intervals.

Acute Disease↗
PubMed1979

[Segmental venous replacemnet with heterologous graft (author's transl)].

Results of animal experiments are presented on the applicability in the low pressure system of a collagen prosthesis, which has been used successfully, for considerable time, in the arterial replacement in patients and dogs. Grafts of up to 7 cm in length were implanted into the suprarenal segment of the inferior vena cava (v. cava caudalis) in dogs and observed clinically over a period of more than 500 days. Histological investigations were made. With some limitations the results obtained are considered as good and point towards the applicability of the examined graft material in the low pressure system.

Animals↗