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Biomedical subjects

K Schwemmle

Publications and source records attributed to K Schwemmle.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Isolated echinococcosis of the lung].

This is a report of a 81 year old women with a cyst of echinococcus granulosus, that was almost completely taking over the lower lobe of the left lung. This case study shows on one hand the diagnosis of echinococcosis is a part of the differential diagnosis even for an elderly patient. On the other hand we were able to demonstrate, that elderly patients can benefit from the surgical treatment especially since medication has a lot of side effects and a fairly high rate of failures.

Aged↗
PubMed1995

[Principles of primary and secondary wound management].

Wound management includes treatment of injuries, chronically open wounds of various origin, and incisions. Despite successful primary wound healing has good functional and cosmetic results, primarily closure should not be forced by raising wound tension or in wounds with increased risk of infection, respectively. Standards of trauma wound debridement according to location and type of wound are still in force. Anatomically incorrect type of surgical incisions may disturb wound healing. Sutures of the subcutaneous tissue are associated with increased risk of infection and should therefore be avoided. Alternatively, vacuum drainages may be used. Antibiotics should only be given exceptionally and if so, not as a local application. In case of chronically open wounds, underlying diseases should be treated, respectively. Moist wound healing using occlusive dressings has been established successfully in local management of chronic wounds.

Adult↗
PubMed1994

[Follow-up of heterotopic autotransplantation of splenic tissue after traumatic splenic rupture in childhood].

Children and adolescents, who received an autologous reimplant of the spleen because of traumatic injury between 1979 and 1986 were matched to a cohort of patients, splenectomized because of traumatic injury of the spleen as well and to a control group of healthy age matched individuals. In addition to a physical check-up, markers of humoral and cellular immunity (e.g. lymphocyte subpopulations and phagocytosis of pneumococcy) as well as the coagulatory and fibrinolytic system were examined. All parameters tested, were found to between results from splenectomized and healthy individuals. Our studies stress the fundamental ability of autologous spleen transplants to take over part of the splenic function on the basis of a largerly histomorphologic restitution. Thus autologous reimplantation of the spleen in children and adolescents is an excellent choice as compared to otherwise necessary splenectomy, if preservation of the organ is impossible.

Adolescent↗
PubMed1993

[Pancreatic pseudocysts after blunt abdominal trauma].

Pancreatic pseudocyst caused by trauma is rare. Only in 5 of 98 patients on whom we operated between 1977 and 1991 for pancreatic pseudocyst were we able to detect previous blunt abdominal trauma. In a 4-year-old girl just a slight abdominal trauma had given rise to a cyst, while in 2 other patients (aged 9 and 26 years) pancreatitis occurred after trauma that was treated medically. Two patients had to undergo laparotomy immediately after suffering serious abdominal blunt injury. Diagnosis was established sonographically, except in one case, in which a large cyst was determined to originate from the pancreas, but only intraoperatively. The time-span between trauma and treatment of the pseudocyst ranged from 3 months to 1 year. Thus, continuous percutaneous suction, which is basically considered a promising therapy for cysts in their early stages of development, was obviously not feasible in our patients. We therefore carried out cysto-jejunostomy with formation of a Roux-en-Y jejunum loop. At follow up 1-10 years after operation, all patients were asymptomatic and no cyst formation could be detected sonographically.

Abdominal Injuries↗
PubMed1993

Closure of acute bronchial stump insufficiency with a musculus latissimus dorsi flap.

We describe a successful closure of an acute bronchial stump insufficiency after pneumonectomy by intrathoracic transposition of the pedunculated latissimus dorsi muscle: A 56-year-old patient with a necrotizing bronchial carcinoma developed a stump insufficiency after right pneumonectomy. Repeated resection and renewed closure of the completely dehiscent stump was not possible, as the stem bronchus had been separated close to the tracheal bifurcation in the preceding operation. Therefore we transposed the pedunculated musculus latissimus dorsi into the thoracic cavity. The closure of the bronchial stump insufficiency was achieved by fixation of the muscle on to the open stump and surrounding tissue of the mediastinal pleura with fibrin glue. The postoperative course was without complications, no further insufficiency or empyema developed.

Acute Disease↗
PubMed1993

[Surgical treatment and regional chemotherapy in melanoma of the extremities].

Since 1979, our treatment protocol for extremity melanoma includes wide local excision, regional lymph node dissection and hyperthermic limb perfusion. We report on the results of a follow-up of the patients treated in the first decade (n = 451). According to the UICC Classification of 1987, 4% of our patients were in stage I, 36% in stage II, 50% in stage III and 9% in stage IV. The respective 5-year survival rates were 93%, 91%, 49%, and 20%. We conclude that regional chemotherapy appears to be beneficial even for stage II patients, as 5-year survival rates of more than 90% can be achieved.

Adolescent↗
PubMed1993

[Lung resections for pulmonary infections in intensive care patients].

Pneumonia occurs in about 60% of ventilated patients with a lethality of approximately 40%. Since 1980 we performed a thoracotomy in 16 patients of an intensive care unit suffering from a lung infection (mean age 34 years). In all patients an adequate antibiotic therapy was unsuccessful. By means of the computed tomography we could ascertain a lung infection limited to one part of the lung, mostly combined by an abscess. We performed 14 lobectomies and one atypical wedge resection and segment resection each. Postoperatively 8 patients died: Three of them because of a persisting septic shock and five because of their multiple injuries. Lung resection is a good treatment in case of a lung infection with septic complications.

Adult↗
PubMed1992

[Locoregional chemotherapy in the treatment of liver metastasis of breast carcinoma].

Locoregional chemotherapy enables specific treatment of organ metastases by using a dosage of medication that is maximally effective but only has minimal side effects on other organs. Since 1983, we have applied this procedure in patients whose liver represented the only target-organ of metastases. Between 1983 and 1990, locoregional chemotherapy was performed in 59 women suffering from liver metastases of breast cancer. The average age of our patients was 52 years. 4 patients were treated for solitary metastases that could not be resected, in 5 patients the infiltration of hepatic parenchyma with metastases accounted to 25%, in 32 patients hepatic infiltration ranged between 25% and 75% and in 18 patients it surpassed 75%. In 39% of our patients, a partial remission occurred. The mean period of survival after beginning of treatment was 149 days, whereas the longest survival time lasted 1009 days. We conclude that the locoregional chemotherapy, destined for treatment of liver-metastases of breast cancer, with a mean survival time of only five months could insufficiently satisfy our expectations. Therefore, a decision to administer such palliative therapy should be made on an individual basis. In our opinion, one indication represents solitary metastases that are not resectable, a further indication is pain due to expansion of the liver capsule because of diffuse metastases.

Adult↗
PubMed1990

[Causes for adhesions in the abdomen].

About one-third of the intraabdominal adhesions that lead to mechanical obstacles are caused by inflammatory or congenital alterations. Two-thirds derive from previous surgical interventions. Besides foreign-body reactions to glove powder, textile fibres, intestinal contents, necroses, drugs, or drainages, the most important mechanism seems to be reduced fibrinolytic activity of the peritoneum. This prevents the disolution of fibrin adhesions and causes its fibrous organization. Local ischaemia caused by ligations and sutures is of decisive importance.

Abdomen↗
PubMed1990

[Chemoembolization of colorectal liver metastases].

In the Center of Surgery of the Justus-Liebig-University Giessen and in the General Hospital in Nuremberg from 1983 to 1987 21 patients with metastases of a colorectal carcinoma were treated with chemoembolization (CHE). The on average survival period of patients treated with chemoembolization after non-successful application of regional chemotherapy amounted to 6 months. The total survival period of these patients amounted to 17.4 months. Since March 1987 chemoembolization has been applied as initial therapy. The on average survival period of the patients, initially treated with cheomoembolization at present amounts to 14 months. 4 of these patients additionally got chemotherapy by the portal vein after CHE. The survival period of 2 patients, having been resected several times after CHE, at present comes to 27 months. These results are the base for a clinical study, in which CHE is combined with the portal venous infusion of a cytostatic agent (Folin acid 5-FU).

Adult↗
PubMed1989

[Combined oncologic methods in primary tumors and metastases of the liver].

In the past ten years 74 patients with carcinomas of the liver and 575 patients with liver metastases have been treated at the surgical clinic in Giessen. The median survival time of patients suffering from primary liver cancer was 364 days with combined treatment, but only 123 days with monotherapy. Similar results were obtained in patients with metastases (median survival time 365 days after combined therapy, 216 days after monotherapy). The results of this retrospective study suggest that a combined therapy is superior to single treatment regimen.

Aged↗