Search PubMed⌕ Search

Biomedical subjects

K Buhl

Publications and source records attributed to K Buhl.

At least 37 records · Page 2Linked to original sources
PubMed1991

Percutaneous endoscopic gastrostomy for postoperative rehabilitation after maxillofacial tumor surgery.

Despite the progress made in tumor and reconstructive surgery of the maxillofacial region, postoperative problems, such as malnutrition and dysfunction of the oral-oesophageal tract are still encountered. Nutrition via a nasogastric tube often complicates the rehabilitation process of these patients. Percutaneous endoscopic gastronomy (PEG), as opposed to nasogastral feeding, is presented. The technique, possible long-term complications, and the easy usage of the mechanical pump system, are presented. In our study of 40 patients, PEG, objectively, proved useful for functional, esthetic, practical, economical, and psychological reasons.

Body Weight↗
PubMed1990

[The stabilization of malleolar fractures and flake injuries using absorbable polyglycolide pins (Biofix)].

In a one year period 15 ankle fractures (13 B-type, two fractures of the medial malleolus) and six flake fractures were operated using biodegradable pins and documented prospectively. These are made of polyglycol acid fibrils compressed by use of a melting technique. They are available in different lengths and strengths. The shear strength is decreasing about half of the initial value within four weeks. The ankle fractures were stabilized with two systems of PGS-pins and PDS or Maxon figure-of-0 tension bands. Postoperative functional treatment was applied. The ankle fractures had healed after six weeks in twelve patients, after seven weeks in two, and in one patient only after nine weeks. Osseous healing of the flake fractures took more time. After six weeks was only one, after seven weeks were two and after nine weeks three fractures healed. Full load bearing was achieved after 8.9 weeks in the malleolar fracture group and after 10.8 weeks in the flake fracture group. Total duration of treatment was 10.2 weeks, respectively 12.4 weeks. It could be shown with this study that osteosynthesis of the ankle with biodegradable pins and functional postoperative treatment is basically possible. Furthermore these pins are apted ideally for fixation of flake fractures due to their high stiffness and simple application technique.

Adult↗
PubMed1990

Palliative endoscopic therapy for rectal cancer with neodymium:YAG laser.

Neodymium: YAG laser has become an alternative to conventional palliative therapy for rectal cancer. Between January 1986 and December 1989, 31 patients were treated with endoscopic laser evaporation for rectal cancers with obstruction (n = 17), bleeding (n = 3) and non-obstructive luminal narrowing (n = 11). Contraindications against surgery were multiple metastases (n = 16), poor general health (n = 7), refusal by patient (n = 5) and extensive local invasion (n = 3). Laser treatment was tolerated well with an initially good response in 29 patients. Palliation could be maintained in 20 patients with laser only; two patients had an unsatisfactory control of symptoms and in eight cases a diverting colostomy was eventually required, largely due to extramural tumor growth. Complications were limited to one stenotic scar. There were no laser-related deaths. Patients survived on average 10.8 (0.1-49) months, 2-year survival was 26%. We conclude that endoscopic neodymium: YAG laser therapy is an efficient and safe palliative method to control intraluminal, obstructing or bleeding rectal cancers.

Adult↗
PubMed1990

Omeprazole: a new approach to gastric acid suppression.

Omeprazole, one of a new group of antisecretory drugs, is a substituted benzimidazole that does not exhibit the anticholinergic or histamine H2 antagonistic properties of drugs such as cimetidine. This agent suppresses gastric acid secretion by inhibiting the proton pump mechanism, thereby blocking the final step of acid secretion. Omeprazole is significantly more effective than the histamine H2 receptor antagonists in eliminating acid secretion; thus, it may be beneficial in patients who are resistant to these agents. Omeprazole is indicated for severe erosive esophagitis, gastroesophageal reflux disease that does not respond to H2 receptor antagonists, and hypersecretory diseases such as Zollinger-Ellison syndrome and systemic mastocytosis. Because of the theoretic risk of carcinogenesis, short-term therapy is recommended, although long-term therapy is required for hypersecretory diseases.

Esophagitis, Peptic↗
PubMed1990

Hepatic arterial infusion (HAI) chemotherapy for liver metastases of colorectal cancer using 5-FU.

Thirty-three patients with liver metastases of colorectal cancer were treated by intra-arterial 5-FU chemotherapy. The median survival time of all patients was 14 months. A partial remission could be observed in nine patients, and a further 15 patients had stable disease. Patients were treated on an outpatient basis and the toxicity of treatment was mild. We observed no case of sclerosing cholangitis or chemical hepatitis. Intra-arterial 5-FU chemotherapy provided treatment results similar to those reported for FUdR but with less hepatobiliary toxicity.

Colorectal Neoplasms↗
PubMed1990

Quality of life and functional results following different types of resection for gastric carcinoma.

In order to evaluate quality of life and functional results following surgery for gastric cancer we studied 89 patients with no evidence of disease at a minimum of 12 months postoperatively. Patients were treated with total gastrectomy and jejunal pouch reconstruction according to Hunt-Lawrence-Rodino (n = 59), distal gastric resection (n = 21) or proximal gastric resection (n = 9). No significant differences were found between total gastrectomy or distal gastric resection with respect to dumping or heartburn, while patients with proximal gastric resection suffered from both. The latter group of patients reported both reduced feelings of hunger and appetite, resulting in a reduced nutritional status. Similar differences were observed when patients were assessed for quality of life; feeling well, feeling ill and capacity to work were all reduced in patients with proximal gastric resection, and their scores were lower when scoring systems according to Visick, Karnofsky, Spitzer and Troidl were applied. Psychological-rating scales measuring complaints and distress confirmed the superiority of total gastrectomy with pouch reconstruction or distal gastrectomy compared to proximal gastric resection. We conclude that in terms of postoperative quality of life, distal gastric resection has no advantage over total gastrectomy with pouch reconstruction. Proximal gastric resection incurs bothersome sequelae and should, therefore, be avoided.

Aged↗
PubMed1988

[Small intestine pouches as a therapeutic principle in stomach and large intestine replacement].

Small bowel pouches are being utilized in several versions as substitute reservoirs after total gastrectomy and after continence preserving proctocolectomy. Throughout the world, most frequently the pouch is formed by simple duplication of the gut. The principles of reservoir formation, the special functional requirement in the upper and lower GI-tract are delineated. Follow-up studies prove the successful use of gastric and ileoanal pouches.

Adenomatous Polyposis Coli↗
PubMed1987

[Home treatment of cancer: experiences with ambulatory intra-arterial chemotherapy of liver metastases].

We have attempted to determine how far it would be feasible to administer intraarterial chemotherapy in patients with colorectal liver metastases on a domiciliary basis. Care of the patients was in the hands of a permanent team consisting of a doctor, a nurse and a psychologist. So far 43 patients have been treated this way. An increased complication rate has not been found during the 225 chemotherapy cycles carried out to date. The median survival of the patients was 14 months, with enhanced quality of life through chemotherapy performed at home.

Adult↗
PubMed1975

[Early and late results after coating intracranial aneurysms with biobond (author's transl)].

Fifteen patients with intracranial aneurysms have been treated by coating the aneurysms with Biobond. Three patients died in the postoperative period. Only one patient had recurrent haemorrhage one year after operation. In this case the sac had not been wrapped completely at operation. Histological examination of this aneurysm revealed macrophage reaction and signs of slow disappearance of the plastic. Ten patients, who were followed up for a period of 3 to 8 years after operation, had no recurrent haemorrhage and were in good clinical condition, 8 of them doing full-time work. No complications caused by the material have been encountered. In 5 patients carotid angiography was performed after operation. In 2 cases the size of the aneurysm was diminished and in 3 cases was unchanged. There were no signs of thrombosis or narrowing of the adjacent arteries. We believe that Biobond is suitable for coating intracranial aneurysms that cannot be treated by clipping or ligature. As Biobond in vivo seems partially to disappear after long periods, it should be applied in thick layers.

Adult↗