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Biomedical subjects

K Nagel

Publications and source records attributed to K Nagel.

51 records · Page 3Linked to original sources
PubMed1982

[A new method for isolated regional perfusion of the liver in vivo. Experimental studies (author's transl)].

The canine liver was isolated from its blood supply and perfused for one hour normothermically be means of a new catheter and a perfusion system consisting of oxygenator, pump and heat-exchanger. Hemodynamic parameters, blood gas analyses, and tissue metabolites were evaluated during experiments. The venous return from the lower body and portal vein (1.113/1min) could be maintained with the catheter system so that the mean systemic arterial pressure was within normal limits. With a perfusion rate through the liver 0,55 ml/min/g and perfusion pressure of 10 cm H2O there was an adequate tissue perfusion; this was also shown by blood gas analyses and tissue metabolite concentrations. Using dye dilution methods the isolation of the liver was tested. This showed a leakage of 6-7% of the total perfusion volume. This new method makes it possible to carry out an isolated, normothermic, liver perfusion for one hour without irreversible tissue damage.

Animals↗
PubMed1982

[A modified dye dilution method to estimate leakage during regional isolated perfusion of the extremity (author's transl)].

In experiments on dogs (n=13) we tested a procedure for estimating leakage during regional perfusion of the extremity by means of a dye dilution method. After systematic application of 0.5% Evans blue solution (0.1 ml/kg b.w.) we measured the dye concentration in plasma by means of a spectral photometer. The plasma volume (5.5 ml/100 gb.w.) and the disappearance rate of the dye (10%/h) were calculated. In a second procedure the supplying artery and vein of the extremity were proximally clamped and distally connected to an extracorporeal circulation unit consisting of oxygenator, pump, and heat exchanger, and the isolation of the extremity was tested. By simulated of leakage it was possible to detect a little amount of shunt of about 1% escaping from isolated region into the systemic circulation. There were no hints to toxicity when the same dye concentration. There were no hints to toxicity when the same dye concentration was applied. The standardized method was using during 132 cytostatic hyperthermic perfusion in man. In 20 patients we determined shunts of less than 5%, in 104 patients shunts between 5 and 10%, and in eight patients shunts of 10-20% of the extracorporeal circulation. The benefits of the described method are simplicity to carry out and missing of toxicity or radiation.

Animals↗
PubMed1981

[Regional hyperthermic perfusion with cytostatic agents in malignant melanoma of the extremities (author's transl)].

From December 1978 to February 1981 91 regional hyperthermic perfusions with melphalan (1.0 or 1.5 mg/kg body weight) were performed in 87 patients with malignant melanoma of the extremities. During a one-hour perfusion with whole blood at an intramuscular temperature of 42 degrees C the flow rate was 264 +/- 62 ml/min in the upper and 495 +/- 42 ml/min in the lower limb. Apart from one intima dissection there were no serious intraoperative complications. Postoperatively one female patient died on the 19th day from acute right heart failure with severe bone marrow suppression. In six patients intransigent metastases appeared after an average of six months. One patient developed lung metastases 7 months postoperatively from which he died. Seventy-nine patients remained free of tumour during the observation period.

Adult↗
PubMed1981

[Regional perfusion of the extremity - experience in 81 patients with malignant melanomas (author's transl)].

From December 1978 through December 1980 a total of 81 patients with malignant melanoma of the extremities were treated by local excision, isolated regional hyperthermic perfusion and regional lymphadenectomy. The extracorporeal circuit was primed with 650 ml whole blood. Flow rates for the lower extremity were 494 +/- 38 ml/min. and 273 +/- 66 ml/min. For the upper extremity. The systemic pressure was 80 +/- 15 mm Hg. Limb temperatures were elevated to 42 degrees C. Intraoperatively there was one case of intima dissection, but no other serious complications. Post operatively one patient died one the 19th day due to congestive heart failure and in one patient a temporary loss of peroneal nerve function was noted. Delay in wound-healing was seen in five patients and 70 patients developed transitory erythema of the extremities. 75 patients are alive and free of disease. Of the 33 patients who underwent more than one operation prior to perfusion, six developed local recurrences or in-transit lesions.

Adult↗
PubMed1981

[Clinical aspects and therapy of hemangiopericytoma].

Hemangiopericytomas are soft tissue sarcomas of vascular origin consisting of pericytes. 484 cases from the literature and 6 from the University Surgical Clinic, Cologne, were studied with regard to age, sex, organ distribution, symptoms and course of disease. The age ranged from 3.5 to 92 years, with a peak in the fifth and sixth decades. Females predominated only slightly. Hemangiopericytomas were most common in the extremities (35%). The symptoms were not characteristic. A painless mass was the first symptom in 60% of patients. The frequency of recurrence was high (32%) and metastases developed in 39% of patients. Wide local excision is the treatment of choice. Hemangiopericytoma appears to be a radioresistant neoplasm, nor is there evidence that chemotherapy is a useful adjunct in its treatment.

Adult↗