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Biomedical subjects

J Horntrich

Publications and source records attributed to J Horntrich.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Validation of intraoperative diagnostic criteria in the differentiation of benign stenoses of Vater's papilla].

The following criteria were recorded from complex intraoperative bile duct diagnosis and were recalculated for validation: residual pressure, flow per minute, choledochal width, and possible probing of the papilla. A comparison was made between 189 cases of papillary stenosis without accompanying choledocholithiasis, on the one hand, and cases with non-contributory choledochus, on the other, for the period from 1970 to 1984. Probabilities by which presence of papillary stenosis could be established were 83 per cent by debitomanometry or 91 per cent by enlargement of choledochus in conjunction with possible probing of the papilla. With all four criteria tested, the probability went up to 99.9 per cent. Diagnosis of papillary stenosis thus proved to be possible with high probability by combination of several examination methods.

Ampulla of Vater↗
PubMed1988

[Is dilatation of the papilla a differential diagnostic or therapeutic intervention?].

Calculations were made to establish the action of probes of different thickness on both cicatric tissue and unstriated muscles of the major duodenal papilla. The findings are graphically represented. These calculations were based on histopathological findings recorded from the major duodenal papilla, expandibility, of collagenic fibres and unstriated muscles, and morphometric measurements. The conclusion was drawn that passage of a probe of more than 3 mm in diameter through a cicatrically narrowed papilla constituted an act of therapy or at least had a therapeutic component in addition to probing. The therapeutic range of papillary dilatation is limited to something from three to six millimetres.

Ampulla of Vater↗
PubMed1988

[Incidence of complications and surgical risk in biliary tract surgery].

Locally delimited complications originating from the surgically treated organ were recorded in 7.8 per cent of 7,640 bile duct operations, between 1970 and 1984, while systemic complications accounted for 4.6 per cent. Overall lethality was 0.8 per cent. Inflammatory gall bladder as well as choledochus findings calling for therapeutic action and advanced age together with age-related diseases were factors of relevance to prognosis. Lethality among males was higher with significance than that among females. Postoperative pancreas necrosis, pulmonary embolism, and cardiac failure were predominant causes of death. Target-oriented perioperative antibiotic prophylaxis, broader postoperative use of medicamentous thrombosis prophylaxis, and limitation of papillary dilatation to widths up to 6 mm are considered to be possible approaches to reducing the surgical risk.

Cause of Death↗
PubMed1987

[Diagnostic problems of extrapulmonary tuberculosis in a surgical infected patient sample].

Reported in this paper are 20 cases of extrapulmonary tuberculosis, following septic surgery, between 1983 and 1987. It seems to be as important as ever before to consider tuberculosis for differential diagnosis of abscesses and fistulae. Treatment was rendered to patients with osteoarticular, renal, and lymph node tuberculosis forms. Tuberculosis should be considered as a possibility particularly in the context of periarticular accumulation of pus and therapy-resistant fistulae. The use of pus cultures from tuberculotic abscesses is considered to be a promising approach to bacteriological verification. However, in cases of poly-infected fistulae, bacteriological verification was obtainable solely from animal experiments.

Abscess↗
PubMed1986

[Iatrogenic pneumothorax and its forensic evaluation].

Forty-three cases of iatrogenic pneumothorax were kept under follow-up observation, against the background of subclavia puncture, infiltration of dorsal muscles, pleural puncture, stellatum blockage, and Menghini puncture. Complications were successfully eliminated by intercostal pleural drainage in the majority of the above cases. It might be recommendable for lesser complications to prefer puncture of the internal jugular vein to puncture of the subclavian vein. The pneumothorax complication following infiltration of the dorsal musculature was attributable to inadequate technique, which would justify a compensation claim against the hospital.

Germany, West↗
PubMed1986

[Acute appendicitis in pregnancy].

Appendectomy was performed on 34 pregnant women between 1977 and 1984. These accounted for 1.1 per cent of appendectomies and 1.8% of all deliveries in the above period under review. The incidence of appendicitis during pregnancy did not appear to be very much below that outside gravidity. The foetus is endangered by hypoxaemico-toxic conditions in all phases but primarily during the last three months. Caesarean section should be precedent to appendectomy, at least in cases of advanced appendicitis and when the foetus is viable. With non-viable foetus, appendectomy should be performed alone.

Acute Disease↗
PubMed1983

[Treatment results in surgery of gastroduodenal ulcers].

From 1969 to 1980, 1316 patients underwent surgery for gastric and duodenal ulceration. In 302 cases (23%) the indication was a vital one (158 times [12%] perforation and 144 times [11%] heavy bleeding). 1014 operations (77%) were of selective character: 1159 times partial gastrectomy, 60 times vagotomy and 97 times nonresective emergency procedures. The rate of complications following perforation was 2 1/2 times and after bleeding 3 times higher than after selective operations. The mortality rate after perforation came up to 9.5%, after hemorrhage to 13.2%, but in selective cases only to 0.6%. The total mortality rate came up to 3.0%. Our results demonstrate the fact that surgery for gastric and duodenal ulcer is mainly burdened by mortality following perforation and haemorrhage.

Adult↗
PubMed1980

[Experiences with AV shunts for long-term dialysis with special reference to elbow shunts].

From 1968 until 1977 in 148 patients 202 arterio-venous fistulas for chronic hemodialysis were performed 41 out of them in the angle of the elbow. By the fistula in the angle of the elbow the V. mediana basilica is sutured end to side of the A. brachialis. This fistula is recommended, when the performance of a fistula in the forearm is failed.

Arteriovenous Shunt, Surgical↗
PubMed1978

[Postoperative haemorrhage in gastric ulceration and gallstone surgery (author's transl)].

5463 operations for gallstone disease were followed eleven times (0,2%) by haemorrhage. 16 intragastric (1,2%) and 11 haemorrhages into the peritoneal cavity (0,8%) could be observed after a total of 1370 operations for gastric or duodenal ulcer. For the most part haemorrhage into the peritoneal cavity frequently occurred within the first 24 hours, whereas the intragastric bleeding appeared later. Both manifestations showed the signs of haemorrhagic shock. While haemorrhage into the peritoneal cavity had to be treated mostly by secondary laparotomy after adequate shock therapy, intragastric haemorrhage could be cured most without surgical treatment.

Adult↗
PubMed1978

[More effective surgical care and its regional organisation (author's transl)].

The decrease of the number of surgical cases within the past few years was not essentially due to the decrease of the number of hospital surgeons or to the decrease of the number of beds in surgical units. Decrease in the length of stay and increase in bed occupancy rate might effectively respond to increasing demands. A community comprising about 60 000 inhabitants will occupy a fulltime outpatient surgeon. Smaller communities should be served by an integrate inpatient-outpatient service. There is no need for each surgical unit to run a separate emergency service of its own.

Ambulatory Care↗
PubMed1977

[Early operation in biliary surgery? (author's transl)].

In the last 15 years from 1961 to 1975 the number of operations caused by cholelithiasis increased three- and fourfold. This phenomenon is more due to the increase of the morbidity than to the extending of indication for operation. Reduction of letality from 2,4% to 0,7% and limitation of the acute complications can be considered as important results during this time. The pathological findings reveal a small improvement only. A correlation between the duration of the disease and the increase of serious pathological findings at the time of operation could not be found. During this period neither a shortening of the history of illness nor a reduction of the patients age at operation could be observed.

Cholelithiasis↗