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Biomedical subjects

M Rothmund

Publications and source records attributed to M Rothmund.

At least 271 records · Page 15Linked to original sources
PubMed1985

[Perforation: which therapy is proven in stomach ulcer and duodenal ulcer?].

Simple suture as standard treatment of perforated ulcer has been doubted because of high postoperative morbidity and reoperation-rate due to recurrent disease. Prospective studies showed that definitive surgery can decrease morbidity without increasing mortality. Selection is the important point. Patients with risk factors and perforation of acute ulcer should be treated by simple suture, patients without risk factors and perforation of chronic ulcer by definitive surgery (SPV + suture).

Duodenal Ulcer↗
PubMed1985

[Intraoperative sonography in surgical diseases of the liver].

Intraoperative ultrasonography was performed in 24 patients with single or multiple liver metastases of colorectal cancer, in 4 patients with a hepatocellular carcinoma, in 2 patients with an hepatic abscess and in one patient with a focal nodular hyperplasia and one with a liver hemangioma. In 9 of 32 patients with inflammatory or malignant liver disease the tumors were not palpable or visible. These hepatic lesions were localized by intraoperative ultrasound. In 5 cases preoperative unknown hepatic tumors were diagnosed by intraoperative sonography.

Carcinoma, Hepatocellular↗
PubMed1985

[Percutaneous drainage of abdominal abscesses. I. Technic and results].

88 intraabdominal abscesses in 77 patients were treated by percutaneous drainage. Patients were cured in 63 percent. Complications were observed in 11 percent followed by surgery in two instances. Ten out of 75 patients (13 percent) died in the postprocedural course from multiple organ failure or postoperative complications. A fatal outcome, however, was never attributable to the percutaneous procedure. Technical considerations of percutaneous abscess drainage are described in detail. Its similarities with open drainage and advantages over septic surgery are discussed.

Abdomen↗
PubMed1985

[Autotransplantation of cold preserved human parathyroid gland tissue. Indications--technic--results].

Autotransplantation of cryopreserved tissue is of increasing clinical value after parathyroid surgery became more common. The results in the literature show a high rate of non functioning grafts after autotransplantation of cryopreserved tissue in comparison to fresh autografted tissue. The reason for that is a partial necrosis of the tissue caused by the freezing and thawing process. To obtain better results after autotransplantation of cryopreserved tissue the rate of necrosis should be estimated. The loss of functioning cells should be compensated by autografting a greater amount of tissue fragments.

Adenoma↗
PubMed1985

[Percutaneous drainage of abdominal abscesses. II. Value in comparison with septic surgery].

Based on the review of the literature and experience with own cases the current status of the therapy of abdominal abscesses by percutaneous catheter drainage is described. Indications, reasons for failure, complications, and mortality are presented in detail. Compared with surgery percutaneous abscess drainage (PAD) seems to have better results; however, this statement should be viewed with caution since the input of modern imaging techniques might have improved current surgical success rates. A trial of PAD can be recommended in all feasible cases because it offers high curability with little morbidity.

Abdomen↗
PubMed1984

[Angiomyolipoma of the kidneys in Bourneville-Pringle disease].

Three cases with renal angiomyolipoma in Bourneville's disease are reported. In two patients advanced renal insufficiency developed, one being treated by chronic intermittent hemodialysis. In the third patient rupture of angiomyolipoma with severe retroperitoneal bleeding occurred. In one patient, tumorous enlargement initially was diagnosed only in the right kidney and preceded angiomyolipoma of the left kidney for several years. In this patient nephrectomy was performed because malignancy was assumed before diagnosis of Bourneville's disease was established. Occasionally, histology may suggest sarcomatous changes. However, the absence of distant metastasis and the overall long survival of patients with renal angiomyolipoma in Bourneville's disease underline the benign character of the tumor. Treatment should be conservative because surgical intervention with loss of kidney parenchyma may enhance progression to end-stage renal failure.

Adult↗
PubMed1984

[Standardized surgery of esophageal cancer].

Surgery was performed in 63 out of 143 patients admitted with oesophageal carcinoma (44%) between 1977 and 1983. The tumour-affected oesophagus was resected in 47 patients (33%). For resection the abdomino-thoracic approach with removal of the oesophagus under sight was done in 26 patients, blunt transmediastinal oesophageal dissection in 21 and palliative gastric bypass without tumour removal in 16 patients. The mortality in the group with abdomino-thoracic resection was 31%, in blunt resection 10%, and in gastric bypass 12,5%. The main cause of mortality was pulmonary complications. As the mean survival time after blunt dissection is not different from the one after abdomino-thoracic resection the former is considered as method of choice due to the lower mortality. Abdomino-thoracic resection should be reserved only for a few patients with stringent indication.

Adenocarcinoma↗
PubMed1984

[Local infusion therapy in liver metastases of colorectal cancers. Results of a phase-II study].

The course of 32 patients with liver metastases of colorectal carcinoma, treated with liver infusions (5-fluorouracil, 500 mg/m2, or floxuridine, 12 mg/m2 daily) was compared with that of 40 regularly examined but untreated patients (control group) in whom, at most three months after a previous negative examination, non-resectable bilateral metastases with initially less than 25% liver involvement had been found. The two groups were comparable with respect to onset pattern and volume of liver metastases. CEA values, ultrasound and computer tomography were obtained in both groups within three months. Mean survival time in the control group was 7.3 (4-14) months. In the treatment group the catheter had been placed either transvenously or transarterially. Mean survival time in this group is at present 17 (4-46) months, with a remission rate of 81%; 18 of the 32 patients are still alive. The high catheter complication rate with the external systems has recently been completely avoided by using implantable pump systems. Liver infusion treatment is judged to be a hopeful measure in liver metastases from colo-rectal carcinoma, with respect to survival time, tumour regression and quality of life.

Catheters, Indwelling↗
PubMed1984

Effect of cimetidine on basal and histamine-induced secretion of parathyroid hormone in vitro.

The effect of cimetidine on basal and histamine-induced PTH secretion was tested using single cell suspensions obtained from (a) primary parathyroid adenomas, and (b) secondary hyperplastic parathyroid tissue from patients undergoing chronic hemodialysis. The histamine-stimulated hormone secretion was dose-dependent. Cimetidine suppressed both basal and histamine-stimulated hormone secretion. Within the therapeutic range the suppressive effect was identical for adenoma and hyperplasia. Both adenomata and secondary hyperplastic glands showed a histamine H2-receptor-related response. The role of histamine in the pathogenesis of hyperparathyroidism is not quite clear so that the possible benefits of cimetidine for medical treatment of primary and secondary hyperparathyroidism will have to be proven by careful clinical trials.

Adenoma↗
PubMed1984

[Palliative surgical therapy of incurable esophagus cancer by stomach bypass and endotube].

Palliative treatment plays an important role in the management of esophageal carcinoma. On the whole there are more than 50% of the patients where the tumour is already inoperable at the time of diagnosis. From 1977 to 1983 we treated a total of 132 patients affected with esophageal carcinoma. It was only in 44 patients that the tumour could be resected. In 26 cases the approach was thoraco-abdominal, in 18 patients thoracotomy was unnecessary. Only palliative measures were possible for the rest. In recent years we have favoured gastric bypass or endoscopically and radiologically guided intubation for palliative treatment of esophageal carcinomas. In 17 patients a Celestin tube was placed surgically. During the last 2 years we exclusively inserted the tube endoscopically using the Nottingham introducer (n = 32). According to our results the best palliative treatment could be achieved by gastric bypass, restoring normal swallowing. Only 1 of 16 patients died postoperatively. Endoscopic insertion of an esophageal tube should be considered as a second choice treatment. A review of our mortality statistics and complication rate suggest that the Celestin tube should rather not be introduced by open surgery. Radiological and endoscopic investigation preoperatively is strictly advised. Furthermore, the indication for a Celestin tube depends on the localisation of the obstruction. In our view, the commercially available tubes (Medoc, Medinex Ltd.) supplied in 3 standard lengths are perfectly satisfying.

Esophageal Neoplasms↗
PubMed1984

[Perioperative antibiotic prophylaxis (single or multiple dose) in elective colorectal surgery. A randomized study].

In a randomized trial in 60 patients undergoing elective colorectal surgery the efficiency of intravenous antibiotic short time prophylaxis was determined. We compared single dose application with multiple dose prophylaxis for 24 h. The substance used was cefotaxime. The rate of wound infections was comparable in both groups (16.6 vs. 13.3%) as well as postoperative infections of the urinary tract (33.3 vs. 23.3%). The results of the study suggest that single dose prophylaxis is as efficient as multiple dose application to reduce postoperative infections in elective colorectal surgery.

Aged↗
PubMed1984

[Retroperitoneal cyst: a little known internal medicine problem].

Retroperitoneal cysts are often a differential diagnostic problem. The diagnosis is not infrequently made only by laparotomy. Our experience with a 33 year old patient with pain localized in the left upper part of the abdomen and "cyst of the spleen" confirms this rule. The diagnosis of a lymphatic cyst of the retroperitoneum was made after the surgical enucleation.

Adult↗
PubMed1983

[Incidence of hospitalizations and operations for ulcer disease 1970-1981].

Since 1970 there has been a slight reduction, since 1977 a marked one, in the number of admissions for peptic ulcer at the two medical and the surgical clinics of the University of Mainz. This trend was interrupted by a peak from 1975-77, due to an increase of overall admissions at that time, after vagotomy procedures had been started at the surgical clinic. The reduction in admissions only related to uncomplicated ulcer and the admissions to the surgical clinic. Admissions for ulcer complications and to the medical clinics remained unchanged. The reduction in the number of operations for uncomplicated duodenal ulcer was 62%, for uncomplicated gastric ulcer 60%. Operative mortality rate for the former was 1.6%, for the latter 1.86%, while it was 10-25% for ulcer complications.

Duodenal Ulcer↗