Biomedical subjects

J Fahlke

Publications and source records attributed to J Fahlke.

25 records · Page 2Linked to original sources

PubMed1998

[Recommendations for adjuvant chemo- and hormone therapy of breast carcinoma].

Recommendations for adjuvant treatment of patients with breast cancer are given based on the International Consensus panel of adjuvant Therapy of Breast Cancer in St. Gallen in 1998. Possible therapeutical options (antihormonal therapy, chemotherapy with CMF or EC/AC) are discussed in dependence on the risc of recurrence. Problems of individual therapeutical strategies are discussed additionally.

Antineoplastic Agents, Hormonal↗

PubMed1998

[Locoregional and systemic therapy of advanced pancreatic carcinoma].

Pancreatic cancer has a very poor prognosis despite surgical resection or chemotherapy. For patients with a pancreatic cancer stage III or IV, locoregional or systemic chemotherapy is often the only chance for treatment. In our opinion, locoregional treatment is currently the best concept.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1997

[Laparoscopic transperitoneal adrenalectomy--technique and personal experiences].

Laparoscopic transperitoneal and endoscopic extraperitoneal adrenalectomy are two safe options in minimally invasive surgery associated with very low morbidity. The anterior transperitoneal approach we prefer yields a better exposure of the anatomic structures and allows the surgeon to orient himself more easily. In addition, various other laparoscopic maneuvers may be performed synchronously. We report on our own experience with eight laparoscopic transperitoneal adrenalectomies performed in four cases unilaterally and in two additional cases bilaterally during April, 1996, and January, 1997, in six patients aged 20 to 56 years. The indications were in four cases pheochromocytoma (operated on bilaterally in two cases), and in the remaining two cases adrenal Cushing's syndrome. The duration of surgery was approximately 240 min for bilateral adrenalectomy and 166 min for unilateral adrenalectomy, respectively, with an intraoperative blood loss of about 50 to 400 ml. Except for haematoma of the abdominal wall there were no other postoperative complications. The serum levels of interleukin 6 and 10 underline the minimal invasiveness of this technique, since there were only small increases of interleukin 6 and interleukin 10.

Adrenal Gland Neoplasms↗

PubMed1990

Influence of preservation solutions on lipid peroxidation and mitochondrial respiration in rat kidneys.

The role of hypothermic storage of rat kidneys on lipid peroxidation compared to its effect on mitochondrial respiratory parameters has been investigated. Rat kidneys were flushed with cold solutions of isotonic sodium chloride; Euro-Collins'; preservation solution containing histidine buffer, tryptophane, and alpha-ketoglutarate (HTK); or hypertonic citrate and then stored for 20 hr at 4 degrees C. After storage, the endogenous contents of malondialdehyde as well as the chemically (by Fe2+/ascorbic acid) and enzymatically (by Fe3+/ADP/NADPH) induced generation of malondialdehyde were measured in cortical homogenates and partly in mitochondria and microsomes by the thiobarbituric-acid reaction. Compared to the values measured in fresh, unstored kidneys, the levels of malondialdehyde were significantly higher in kidneys preserved in solutions of isotonic sodium chloride or HTK. This stimulating effect of the HTK solution on the generation of lipid peroxidation products could also be established when homogenate was incubated with this solution. Euro-Collins' and hypertonic citrate solution did not change the endogenous contents of malondialdehyde in kidneys during hypothermic storage. Both the chemically and enzymatically induced lipid peroxidation increased after hypothermic storage of kidneys in all solutions investigated. No direct relationship between the contents of malondialdehyde and respiratory mitochondrial parameters was detectable. The results demonstrate that the extent of lipid peroxidation does not correlate with preservation effectiveness.

Animals↗

PubMed1990

[Na K ATPase activity in rat kidneys following storage at 4 degrees C in various kidney preservative solutions].

The Na-K-ATPase is the enzymatic basis of a energy-dependent transport of sodium and potassium through the cell membrane and is therefore of importance to the survival of organs during periods of decreased energy supply. In the present paper the influence of various preservation solutions on the activity of this enzyme was examined. It was shown that Na-K-ATPase activity in rat kidneys did remain unchanged after 48 hour preservation in various preservation solutions (Bretschneider, Ross, Collins, Sacks, Belzer). Therefore, its estimation is no valuable for evaluation of preservation solutions.

Animals↗

PubMedDate not supplied

Diagnostic workup before laparoscopic cholecystectomy--which diagnostic tools should be used?

BACKGROUND/AIMS: A prerequisite for successful laparoscopic cholecystectomy is the exclusion of potential risks such as cholangiolithiasis, anatomical malformations or diseases of the stomach. As there is no general agreement regarding the appropriate preoperative diagnostic workup, we compared different diagnostic methods as to their value in detecting unknown accompanying diseases and complications. METHODOLOGY: Between 9/90 and 8/93, we performed 850 laparoscopic cholecystectomies. The first 700 were included in this study. A prospective comparison was carried out of the diagnostic accuracy of history, physical examination, laboratory tests, upper gastrointestinal endoscopy or barium meal, i.v. cholangiography and abdominal ultrasound. RESULTS: Measurement of the diameter of the common bile duct was found to be a good noninvasive method for diagnosing common bile duct stones (sensitivity 80%, specificity 99%). In combination with the history and the laboratory tests the sensitivity could be improved to 99%. The sensitivity of i.v. cholangiography in detecting common bile duct stones was 80%, the specificity 99.3%. 646/700 patients underwent preoperative endoscopy/barium meal. In 53 (8.2%) patients pathological findings were found, but only in 4 cases (0.6%) they influenced the indication for laparoscopic cholecystectomy. In 1 patient an advanced gastric cancer was diagnosed 6 months after laparoscopic cholecystectomy, the preoperative barium meal did not show any pathological findings. CONCLUSIONS: The results show that routine ultrasonography in combination with history and laboratory tests prior to laparoscopic cholecystectomy can be recommended for detecting common bile duct stones. In patients with 1 or more pathologic finding endoscopic retrograde cholangiopancreatography should be performed preoperatively. A gastroscopy should be done in patients with nonspecific upper abdominal pain, history of peptic ulcer disease and persisting pain after laparoscopic cholecystectomy.

Adult↗

PubMedDate not supplied

Percutaneous treatment of rare latrogenic arteriovenous fistulas of the lower limbs.

Postoperative iliac and popliteal arteriovenous fistulas are extremely rare. This article describes the percutaneous endovascular treatment of iatrogenically induced arteriovenous fistula in two patients with simultaneous use of intravascular ultrasound. In a 61-year-old woman, a fistula between popliteal artery and vein, inadvertently created during implantation of a prosthetic knee joint, was treated with a novel polytetrafluorethylene (PTFE) stent graft. A 48-year-old man underwent endovascular treatment of a large fistula between the right common iliac artery and the left common iliac vein, inadvertently induced during surgery on an intervertebral disc. Congestive heart failure induced by the arteriovenous communication was reduced rapidly. Our results indicate that percutaneous treatment in conjunction with intravascular ultrasound is a useful therapeutic option for vascular lesions. It is less invasive than open vascular reconstruction and has a comparably high success rate.

Arteriovenous Fistula↗