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Biomedical subjects

J Holzki

Publications and source records attributed to J Holzki.

36 records · Page 2Linked to original sources
PubMed1993

Prehospital care of burns: an analysis of 3 years use of the emergency physician system (EPS) Cologne.

Little information is available about the vital parameters of burns victims shortly after the accident. Therefore cases of burns, electrical and caustic injuries presenting to the Cologne Emergency Physician System over 3 years (n = 262) were prospectively studied and analysed. The average incidence in Cologne, Germany (population 1 million), of burns victims attended by the Emergency Medical System and emergency physicians at the scene was 74 adults and 14 children per year. Children are mainly injured by scalds (41.4 per cent); adults by fire accidents (43 per cent). A classification of the victims at the site of the accident according to their vital signs (Trauma Score (TS) after Champion H. R., Sacco W. J. and Carnazzo A. J. et al. (1981) Trauma Score. Crit. Care Med. 9, 672) showed, that in spite of a major burn injury, the vital signs were usually not or only slightly impaired. Subsequent measurements instituted by the emergency physician at the scene increased with decreasing initial TS. With TS = 14, 50 per cent of the patients were intubated; below 14 points nearly 100 per cent. The fluid administered also increased with a decreasing TS.

Adolescent↗
PubMed1990

[Tracheal instability in tracheo-esophageal abnormalities].

The clinical pattern of signs and symptoms of respiratory complications due to flaccid trachea has been analysed in 83 children treated in our hospital between 1983 and 1988 for tracheo-oesophageal malformations. These signs and symptoms are classified according to endoscopic findings, and are thus arranged according to various degrees of severity. Of the surviving children who were followed up and who were suffering from oesophageal atresia Vogt III B, only 5 of 57 were without a pointer towards flaccid trachea, whereas in oesophageal atresia Vogt II there were two of three. The two children with an isolated tracheo-oesophageal fistula showed abnormal findings both clinically and via endoscopy. 16 of the 20 children with very severely pronounced flaccid trachea--defined by the occurrence of life-threating apnoeas and an endoscopically identifiable tracheal collapse of more than two-thirds of the lumen--were subjected to surgery via aortosternopexy. A marked and identifiable improvement was obtained in 15 cases. Complications caused by surgery consisted of temporary phrenicus lesions in two cases.

Aorta, Thoracic↗
PubMed1989

[Emergency separation of a neonatal xypho-omphalopagus twin].

We report on the emergency separation of xyphophagus-omphalophagus conjoined twins. The twins were delivered by Caesarean section in the 35th week of pregnancy. They were conjoined between the omphalus and xyphoid process and had a fusioned common liver. All other organs including the peritoneal cavities were separate. One of the twins showed normal development, whereas the other was multifocally deformed with microcephalus, complex vitium cordis, microintestine and malformation of the extremities. Due to the extremely poor general condition of the deformed twin immediate emergency separation was mandatory even before completing the diagnosis of circulatory condition and liver formation. The deformed twin died during the operation and the fully developed twin on the 7th day after the operation after cerebral haemorrhage with haemorrhagic diathesis. The report gives a detailed description of the specific foetal circulatory condition and the problem of a postoperatively occurring partial necrosis of the liver.

Cardiovascular Abnormalities↗
PubMed1989

[About the problem of congenital laryngo-tracheo-esophageal cleft].

The congenital laryngo-tracheo-oesophageal cleft is an extremely rare anomaly representing an incomplete or absent separation of larynx and trachea from the oesophagus. Depending on the extent of the anomaly, the phenomenon is classified into laryngeal cleft (type I), cleft affecting the superior part of the trachea (type II) and defect extending to the bifurcation (type III). We report on 3 cases. A boy with a type II cleft died at the age of two days due to respiratory insufficiency conditioned by aspiration, before surgery would have been possible. In another boy with a type II cleft closure was successfully performed in several sessions. A girl with a type III cleft died at the age of five months after the defect had been almost completely closed in two sessions. The right main bronchus and the right lung were hypoplastic and also the left main bronchus was partly represented by skin formation only. This resulted in progressive respiratory insufficiency. Both boys had an associated malformation of the G syndrome type. Despite the unhappy outcome of the last of three cases mentioned above, it seems that stepwise closure is less associated with surgical risk than surgery in a single session. A review of the 24 cases of cleft described in the literature shows that these children present very serious treatment problems and that there is a high incidence--amounting to 60%--of associated malformations, especially of the lungs and bronchi.

Abnormalities, Multiple↗
PubMed1978

[Quality and quantity of the amino acid pattern in protracted total parenteral hyperalimentation of newborns after surgery].

The determination of plasma amino acids is of utmost importance in the newborn, since there is little information about cumulation or chronic deficiency in long-term parenteral nutrition, in particular in the operated neonate. Two patients were investigated, the first of which was subject to total parenteral nutrition for 115, the second for 56 consecutive days. The plasma levels of amino acids are discussed in relation to clinical findings and nitrogen-balances. The importance of an adequate administration of trace minerals is stressed.

Amino Acids↗