Search PubMed⌕ Search

Biomedical subjects

K Meissner

Publications and source records attributed to K Meissner.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Stomach wall necrosis following selective proximal vagotomy].

A personal observation and the analysis of the pertinent literature form the basis of this comprehensive report of gastric wall necrosis (GWN) following selective proximal vagotomy (SPV). The incidence of this specific and ischemic sequel of SPV is 0.25%. GWN carries specific morphological criteria, shows certain predisposing risk factors of general and local type, characteristic symptoms and well defined types of clinical courses. Technical failures and delay of operative therapy contribute mainly to the present mortality of approximately 50%. The efficacy of prophylactic measures appears to be limited, whereas immediate and adequate reoperation yields a good prognosis.

Female↗
PubMed1984

Primary open wound management after emergency laparotomies for conditions associated with bacterial contamination. Reappraisal of a historical tradition.

In emergency abdominal surgery associated with bacterial contamination, primary skin suture resulted in a 39 percent wound sepsis rate. After subcutaneous approximation and open skin treatment in 85 patients, healing occurred without complication. After completely open wound management in five obese patients, wound healing occurred without wound sepsis, but did result in scars necessitating correction. No difference could be found with regard to body temperature, wound healing time, and hospital stay in patients who had primary skin closure followed by primary healing and those who had open wound treatment. The patients' evaluations of the cosmetic result of open wound management using subcutaneous sutures were favorable. The study herein constitutes the rationale for our decision to institute open wound treatment routinely in pertinent cases.

Adolescent↗
PubMed1983

[Acrodermatitis induced by zinc deficiency].

A patient with acrodermatitis as a result of zinc deficiency is reported. In spite of the characteristic signs the required substitution of zinc is often delayed, because the entity is confused with other, more common forms of dermatitis.

Acrodermatitis↗
PubMed1983

[A successfully treated gall stone ileus in a patient 91 years old. Pathophysiology and clinical aspects].

The - at least to our knowledge - oldest surviving patient with gall stone ileus is reported, pertinent data concerning clinical symptoms, pathogenesis, pathophysiology and therapy discussed. In establishing the diagnosis, the analysis of previous diseases is helpful, a changing clinical course typical, air in the biliary tract upon plain X-ray a proof. Diagnosis means immediate operation, which alone may interrupt a fatal pathophysiologic chain reaction.

Aged↗
PubMed1983

Predominant cutaneous infiltration by OKT6- and OKT8-positive cells in a case of Sézary syndrome.

Using an immunoperoxidase (skin biopsy) and an immunofluorescence (peripheral blood, bone marrow punctate) technique, and monoclonal antibodies raised against peripheral mature lymphocytes, T helper subsets, T suppressor subsets, and Langerhans cells, we found a predominant dermal infiltration with lymphocytes of the suppressor phenotype and a predominant epidermal infiltration with Langerhans cells in a patient with Sézary syndrome (cutaneous T-cell lymphoma, CTCL). Repeated peripheral blood examinations showed an increased percentage of lymphocytes of the helper phenotype. A bone marrow examination revealed a ratio of suppressor/helper subsets of 1:4. The findings in the skin seem to be inconsistent with most of the results of previous studies in patients with CTCL; the significance of these findings is discussed.

Aged↗
PubMed1983

A second look at intraepithelial Langerhans cells in mycosis fungoides and related disorders. Ultrastructural study with special reference to Langerhans granules and virus-like particles.

Skin biopsies of patients with small and large plaque parapsoriasis, premycotic lesions and mycosis fungoides in different stages were examined. Special attention was paid to the relationships between Langerhans cells (LC) and the neighbouring keratinocytes and lymphocytes. At the contact areas of LC and keratinocytes as well as LC and lymphocytes, particular cell membrane phenomena were observed. Aggregations of Langerhans granules and fusions of granules with LC plasma membranes were found exclusively at LC-keratinocyte interfaces. At LC-lymphocyte contact zones cell membrane appositions were seen. In all cases investigated, virus-like particles were mainly found in LC and indeterminate cells (IDC). In 3 cases lymphocytes also contained these particles. It was of particular interest that virus-like particles were observed in skin specimens of all diseases investigated. Discrimination of these particles from other cellular organelles - especially lysosomes - was difficult, however. The significance of our findings, particularly regarding to the supposed virus aetiology of cutaneous T cell lymphomas, is discussed.

Adult↗
PubMed1983

[Sonographic evaluation of early, radiologically negative intestinal obstruction].

Four cases of complete intestinal obstruction were diagnosed by sonography in an early, radiologically negative stage. The clinical benefit of this diagnostic procedure was assessed by comparison with 48 patients suffering from ileus and diagnosed by plain X-ray. Pertinent sonographic parameters are described and related to pathophysiological disorders occurring in obstructed bowel segments. When gaseous distention makes plain X-ray diagnosis feasable, the clinical condition of the patients deteriorates with synchronous disappearance of sonographic evidence of the disease. Thus, sonographic diagnosis may contribute to earlier treatment of this emergency situation.

Diagnosis, Differential↗
PubMed1982

[Mysterious segmental stenosis of the small intestine (author's transl)].

Within a period of four years twelve cases of short small bowel stenoses were seen requiring surgical removal by resection because of acute ileus. Two of these cases were considered examples of an eosinophilic enteritis. The remaining cases were mostly men of an average age of 63 years. With one exception, they had been treated for cardiovascular diseases with various drugs, mostly potassium, digitalis and reserpine preparations. The intestinal stenoses were 1-3.5 cm in length with a constriction down to 1 mm diameter. Obviously, these obstructions develop from an infarct-like necrosis of the mucosa via a circular ulcer; the narrowing of the intestinal lumen is chiefly due to fibromuscular hyperplasia of the submucous coat. The morphological changes agree with the findings known from ischaemic intestinal lesions as well as with those in jejunal ulcus simplex. Hence, it appears justified to interpret them as ischaemic intestinal stricture. However, an additional and as yet unknown damaging factor seems to be involved.

Adult↗
PubMed1982

[The natural history of gall stone disease. An epidemiological study (author's transl)].

This paper presents clinical data elucidating the natural history of gall stone disease, based on observations carried out on a secluded alpine population treated conservatively for generations. Special circumstances corroborating a statistical evaluation are outlined. Pertinent parameters supporting this study are anatomical findings at operation following the introduction of established surgical procedures into the region, with particular attention to age grouping within the collectives of patients. A total of 130 patients, operated on for gall stones for the first time in their lives, were evaluated, 18 patients undergoing incidental cholecystectomy for asymptomatic gall stones were excluded from this series. Of the remaining collective presenting with clinical symptoms of cholelithiasis, 54% were admitted for complications of the disease, i.e. 15% for acute cholecystitis and 39% for choledocholithiasis (including jaundice in 27%). We conclude that the natural history of gall stone disease in this region implicates the incidence of the above-mentioned inherent complications unless cured electively by early cholecystectomy.

Adult↗
PubMed1982

[Experiences with high-dose cisplatin therapy in metastasized malignant melanoma].

14 patients with advanced malignant melanoma were treated in 36 therapy cycles with cisplatin. 8 patients had been pretreated with dacarbazine and 6 had received additional BCG immunotherapy. 4 patients had been irradiated after surgical removal of lymph node metastases. All patients showed significant tumor progression. 4 patients were treated showing ultimately disseminated melanoma with widespread visceral involvement. 5 patients with lymph node metastases had been operated radically and were treated postoperatively. Cisplatin was administered as a 24-h high-dose therapy (200 mg or 120-200 mg/m2) under forced mannitol diuresis, treatment cycles were repeated monthly. Of all the patients, 1 showed complete remission of supraclavicular metastases lasting for 6 months until now. 1 patient showed an initial minor response with subsequent stabilization without appearance of additional metastases for 1 year. 2 patients who had received cisplatin postoperatively showed no reappearance of tumor growth for 8 months up until now. 11 patients showed no change or progression of disease, 6 of them had received only one therapy cycle. Under clinical conditions, side effects of cisplatin treatment can be managed satisfactorily, no irreversible kidney damage could be observed under forced diuresis. As far as the above-mentioned results are concerned, antineoplastic activity of cisplatin as to advanced malignant melanoma must be considered to be of limited benefit using cisplatin as a single-agent treatment. Improvement of results might be obtained using cisplatin in a combination therapy together with other antineoplastic agents, which at the present time are being investigated in several prospective trials.

Adult↗
PubMed1980

[Haemo-cholaskos after percutaneous liver biopsy (author's transl)].

In 6 cases of haemaskos and one case of cholaskos the technical reasons for peritoneal complications after percutaneous liver biopsy are analysed. In all cases of haemaskos longitudinal lacerations of the liver capsule were seen due to respiratory movements during biopsy. Cholaskos was caused by instrumental gallbladder perforation. Appreciation of these facts helps in the prevention as well as identification of patients at risk needing careful monitoring.

Adult↗
PubMed1980

[Trials with therapeutic plasmapheresis in pemphigus vulgaris].

A seventeen year old female with pemphigus vulgaris was treated by exchange plasmapheresis. Plasmapheresis was performed five times over three weeks. Each procedure significantly reduced the serum level of intercellular antibodies. Without immunosuppressive therapy and with only moderate doses of corticosteroids the clinical symptoms had improved after the three weeks period. Plasmapheresis represents an alternative therapeutical possibility in the treatment of pemphigus vulgaris in order to achieve a rapid reduction in circulating levels of the intercellular antibodies.

Antibodies↗
PubMed1980

[Intestinal obstruction: technical and tactical aspects (author's transl)].

A tactical and technical vista of a differentiated surgical approach to intestinal obstruction is presented based on personal experience and literature: 1. For the treatment of early postoperative intestinal obstruction--of paralytic as well as of primarily mechanical origin--intestinal decompression using the long intestinal tube inserted endoscopically is a worthwhile procedure with a high rate of success.--2. Following operations for intestinal obstruction including cases of peritonitis, decompression gastrostomy using the Stamm-Kader or Dragstedt procedure is an important adjunct to therapy aimed at the reduction of morbidity and lethality within a well defined group of patients.--3. For prophylaxis against recurrence of late adhesive obstruction, gastro-entero-cecal intraluminary splinting combined with temporary gastrostomy can be recommended. Clinical results indicate, that standardized application of these procedures will definitely serve to reduce lethality of intestinal obstruction.

Endoscopes↗