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Biomedical subjects

J Phillip

Publications and source records attributed to J Phillip.

At least 19 recordsLinked to original sources
PubMed1996

[Surgical outcome in subtrochanteric fractures. A study over 15 years].

During the past 15 years new methods for the surgical approach to subtrochanteric fractures have been developed, e.g. the dynamic hip screw (DHS) and the gamma-nail (GN). Reviewing the results of this change in methods, we report on 102 patients after subtrochanteric fractures of the femur. We divided them into three groups according to the time of operation (1980-1984, period I; 1986-1989, period II; 1991-1993, period III). During period I, 74% of the fractures were stabilized using angle plates. During period III, more than 30% were operated on using the DHS and nearly 50% using the GN. The total hospital stay (department of surgery as well as geriatric hospital) decreased from 107.5 +/- 46.5 days to 78.9 +/- 24.3 days (P < 0.001). During period I, 86.2% of patients could be discharged home, during period III, 100%. Serious complications decreased during these 15 years. In conclusion, as observed in pertrochanteric fractures, the introduction of new operative techniques for the treatment of subtrochanteric fractures in the elderly was followed by a shortened hospital stay, a decreased complication rate and an increased rate of discharge home.

Activities of Daily Living↗
PubMed1995

[Surgical results of pertrochanteric fractures. A 15-year study].

During the last 15 years new methods for the surgical treatment of pertrochanteric fractures have been developed [e.g. the dynamic hip screw (DHS) and the gamma-nail (GN)]. We report on the results obtained in 450 patients operated on between 1979 and 1984 (period I), from 1986 to 1989 (period II), and between 1991 and 1993 (period III); we reviewed the results with the intension of finding whether application of the new methods led to better results, shorter stay in hospital and fewer complications. The mean age of all patients was 79 years and was 4 years higher in period I to than in period III (77.5 +/- 9.2 vs 81.5 +/- 8.4). During period I, 65% of the fractures were stabilized using Ender rods, while during period III the DHS was used in nearly 60% and the GN, in 22%. The total hospital stay (department of surgery and geriatric hospital) decreased from 80.4 +/- 31.7 in period I to 66.6 +/- 24 days in period III (P < 0.001). Serious complications decreased by 80% during this time. During period I 86.2% of patients could be discharged home, as against 89.0% in period II and 94.7% during period III. The introduction of new operative techniques for the treatment of pertrochanteric fractures in the elderly was followed by a dramatic shortening of hospital stay, a reduced incidence of complications, early weight-bearing and an increased rate of discharge home.

Aged↗
PubMed1990

[Preparation for colonoscopy using Golytely--a sure method? Comparative histological and clinical study between lavage and saline laxatives].

UNLABELLED: Looking at clinical side-effects, effectiveness and tolerability, we compared the salinic solution "Golytely" vs. a conventional preparatory procedure (Cascara-Salax) in a prospective study including 28 patients with macroscopic normal mucosa. Mucosal changes in colonic step biopsies were investigated according to prefixed criteria. RESULTS: There was no significant difference concerning weight, blood pressure, pulse rate, body temperature or essential laboratory findings. Whereas preparation using Cascara-Salax was less molesting stated by the patients, there was no difference in the way colonoscopy itself was tolerated in both groups. The performing doctor's evaluation of the colonic cleaning effect and examination conditions showed "Golytely" significantly ahead of Cascara-Salax. Histologically, colonic mucous layers depicted changes in the control groups in 63% vs. 40% in the "Golytely" group. "Golytely" seems to provide a safe and effective method of preparation for colonoscopy.

Colon↗
PubMed1990

[Time factors in endoscopic studies. A survey in West Germany].

In order to obtain representative data for the orientation of personal requirements in endoscopic units, 650 hospitals in the FRG were asked to have an exact look at the times they needed for endoscopic procedures during an period of 14 days. 25% of the contacted hospitals answered to this request and thus the times required for more than 14,000 endoscopic procedures for both, doctors and medical staff, could be analysed. Results revealed that most of the sophisticated procedures such as colonoscopy, ERCP (especially when they included therapeutic endoscopical methods) varied largely in time. This was caused by different factors such as the patient dependent variables, and the course of the procedure including observation of safety and hygiene standards. Average values of times needed for endoscopic procedures were as follows (time in minutes): (Table: see text). The data given above might be of value for the estimation of actual personal and time requirements in endoscopic units.

Endoscopy↗
PubMed1985

[Rectoscopy: rigid or flexible? A comparative study].

The customary rigid rectoscope was compared prospectively, with a new, flexible one (prototypes of Olympus Opt. and Fuji) in each of 114 patients selected at random. Maximal depth of introduction was reached on average after 1 min with the rigid instruments, after 1 min 40 sec with the flexible one. Mean depth of introduction was 16 cm for the rigid and 33 cm for the flexible one. In 21 patients (18.4%) additional information was obtained with the flexible rectoscope. 80% of patients reported that the flexible instrument caused them no or only slight discomfort. Skill in using the flexible instrument can be quickly acquired.

Fiber Optic Technology↗
PubMed1985

[Endotherapy of gallstones].

Choledocholithiasis is treated endoscopically by papillotomy and subsequent stone extraction. In 10% of cases this procedure does not succeed. mechanical lithotripsy has reached the stage of clinical applicability, it can be performed easily, has a high success rate, and equipment is relatively inexpensive. Alternative methods are electrohydraulic lithotripsy and chemical litholysis. Laser-, ultrasound- and jet-cutting-lithotripsy are still in a developmental stage, the latter two methods not yet having been applied in man. Endoscopic probing of the gall bladder for stone extraction or chemical litholysis with methyl-tert-butyl aether up to now have succeeded only in very few cases. Therapy of gall bladder stones by pulsed waves is already in clinical testing.

Ampulla of Vater↗
PubMed1984

[Endoscopic intraductal radiotherapy of high bile-duct carcinoma].

A new method for palliative intraductal radiotherapy of high malignant bile duct occlusion was used in three patients. It consists of insertion of a 4 cm x 0,6 mm iridium-192 wire into the stenosis caused by the tumour. It uses a modified nasobiliary probe which is guided endoscopically retrograde transpapillary. A radiation output of 0.85 Gy/min (85 rd/min) and a requested therapeutic dosage of 60 Gy (6000 rd) at a distance of 0.5 cm lead to in situ position of the wire for about 70 hours. During that time bile flow is effected via the nasobiliary probe. The advantage over previously described methods (percutaneous transhepatic, surgical after installation of U-drainage) lies in a smaller complication rate and improved follow-up treatment as change of the endoprosthesis or repeat irradiation is not associated with renewed tissue trauma.

Adenocarcinoma↗
PubMed1984

Electronic endoscopy of the gastrointestinal tract. Initial experience with a new type of endoscope that has no fiberoptic bundle for imaging.

We report on 31 endoscopic investigations using a new type of electronic endoscope which has no fiberoptic bundle for imaging. The device carries on its tip a light-sensitive CCD chip which functions as a TV camera. The signals received are transformed by a processor and displayed on a TV monitor. The upper digestive tract was inspected in 23 patients with the electronic endoscope and in the same session, a fiberoptic-endoscopic esophagogastroduodenoscopy was carried out on 16 of them. The information obtained using the 2 systems differed neither quantitatively nor qualitatively. Because of its external diameter, it was not possible to introduce the electronic endoscope past esophageal stenoses in 2 patients. Preliminary experience with 2 types of colonoscopes in 8 patients strongly indicates that these devices are equivalent, in respect of optical quality, to the fiberoptic endoscopes. The quality and color reproduction of the TV image of the upper and lower digestive tract are excellent. Electronic endoscopy offers great potential for consultation, training and documentation. The patients tolerated the procedure very well.

Adult↗