Biomedical subjects
Publications and source records attributed to M Hinkel.
The resection of lung metastases as a component of a multistep therapeutic concept is an established treatment approach. 5-year survival rates of 30% are attainable in combination with a low postoperative lethality. We performed 99 operations on 89 patients with lung metastases between 1977 and 1997 in the Department of Thoracic Surgery on the Carl-Thiem-Klinikum Cottbus. No postoperative lethality was observed.
Based on animal trials the presented study results describe a method of abdomino-thoracoscopic oesophagectomy for the treatment of oesophageal carcinoma of the middle and lower third. Technical details and the advantages of the surgical procedure, including the avoidance of thoracotomy and the practicability of the thoracoscopic dissection of the oesophagus are shown. Problems exist in the salvage of the specimen, especially in the transcervical passage of the tumorbearing oesophageal part. A final evaluation of the importance of the minimally invasive techniques in oesophageal surgery should not be given until the results of clinical studies are available.
The influence of the agricultural use of sewage sludge on the concentrations of PCBs and PCDD/Fs in soil, feed and milk was investigated on four dairy farms. Evidence of contaminant accumulation in the soil was found on both farms that fertilized with sewage sludge. The concentrations in feed and milk from one of these farms were similar to the concentrations in the matched control, while the concentrations in the samples from the second sludge user were elevated. The study demonstrates that the agricultural use of sewage sludge does under some conditions lead to higher levels of PCBs and PCDD/Fs in food products.
When evaluating 4232 appendectomies between 1977-1986 there were 12.5% perforations and in 19.3% the diagnosis was not justified. In 5.1% surgical intervention was done without acute appendicitis. The overall lethality was 0.5%, the cases of perforation 2.3%. The diagnosis of lethality was cardiopulmonary disease. In this follow up study we discuss possibilities of giving a secure diagnosis.
A combination of radiotherapy and chemotherapy was applied to 13 patients for non-operable oesophageal carcinoma. Included in the twelve-week treatment were radiation doses between 43 and 60 Gy and five FU infusions. Only six patients responded at all to the therapy. Eleven patients died of progressing tumour growth, within two to nine months from diagnosis. One committed suicide with evidence of progressing deterioration. Only one has so far survided without recurrence for 36 months. The study was discontinued for the poor results recorded from those 13 patients. Different cytostatic combinations may, perhaps, yield better results.
Appendectomy was performed on 34 pregnant women between 1977 and 1984. These accounted for 1.1 per cent of appendectomies and 1.8% of all deliveries in the above period under review. The incidence of appendicitis during pregnancy did not appear to be very much below that outside gravidity. The foetus is endangered by hypoxaemico-toxic conditions in all phases but primarily during the last three months. Caesarean section should be precedent to appendectomy, at least in cases of advanced appendicitis and when the foetus is viable. With non-viable foetus, appendectomy should be performed alone.
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