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Biomedical subjects

P Aeberhard

Publications and source records attributed to P Aeberhard.

At least 91 records · Page 5Linked to original sources
PubMed1982

[Current status of esophageal neoplasms. I].

In Europe, carcinoma of the esophagus is a relatively rare disease with an annual mortality rate of 4-7 deaths per 105 inhabitants. Institution of appropriate therapy for esophageal carcinoma depends mainly on accurate diagnosis and staging. Computed tomography displays the anatomy of the esophagus and mediastinum with a high degree of accuracy and is a good method of assessing extra-esophageal spread of carcinoma. Preoperative nutritional support may reduce operative mortality and morbidity in high-risk patients. Today there is still no alternative to resection of the carcinoma. Esophagogastrectomy with (cervical) esophagogastrostomy with or without thoracotomy is the treatment of choice for patients with squamous cell carcinoma of the esophagus. Prognosis is still poor, with a 5-year survival rate of less than 20%. If resection is technically impossible, an endoesophageal tube can be inserted or a bypass procedure carried out to increase the quality of life with near normal ability to swallow. Radiotherapy can be used when surgery primarily is not applicable for medical reasons or is refused. Preoperative radiotherapy does not produce statistically significant short- or long-term benefit in the management of esophageal squamous cell carcinoma. Chemotherapy or combination chemotherapy have so far been insufficiently tested and cannot be recommended today for routine use. A combined modality approach is promising but needs further evaluation.

Adenocarcinoma↗
PubMed1982

[The problem of metal clip artefacts in computerized tomography].

Ligature clips have proved to exhibit increasing radiodensity from titanium up to silver, steel and tantalum, according to the atomic number. clips of titanium, steel and tantalum attached to the patient's abdominal wall confirmed these findings in a plain film (n = 5), a digital scout view (n = 10) and a transverse CT scan (n = 10). The extent of the radial artefacts caused by the clips is directly related to their imaged intensity, being high for tantalum and low for steel and titanium. Because of the poor visualization of the titanium clips on the plain film, the authors recommend steel clips for the clinical test which appears to be necessary in view of the possible concomitant artefacts that could appear due to vascular pulsation.

Silver↗
PubMed1982

Management of profound accidental hypothermia with cardiorespiratory arrest.

Complete recovery following rapid rewarming is described in three tourists who were admitted in a state of profound hypothermia with total cardiorespiratory arrest (rectal temperature ranging from 19 to 24 C). In all three patients, respiration and circulation had ceased during the rescue operation. Rapid core rewarming was achieved by thoracotomy and continuous irrigation of the pericardial cavity with warm fluids in one patient, whereas in the other two patients rewarming was accomplished with extracorporeal circulation using femoro-femoral bypass. In the first patient, the heart could not be defibrillated earlier than 90 minutes following thoracotomy; in the other patients rewarming was attained very rapidly, and within half an hour after institution of bypass, resuscitation of the heart was successful. The patients fully recovered their intellectual and physical abilities, despite the prolonged periods of circulatory arrest lasting from 2 1/2 to 4 hours. We conclude that rapid core rewarming is the adequate therapy for profound accidental hypothermia with circulatory arrest or low cardiac output. If feasible extracorporeal circulation represents the method of choice because it combines the advantage of immediate central rewarming with the benefit of efficient circulatory support, the heart is rewarmed before the shell, thus preventing the "rewarming shock" due to peripheral vasodilatation. Resuscitative efforts should be promptly initiated and vigorously pursued, even in the state of clinical death; in profound hypothermia neurologic examination is inconclusive regarding prognosis.

Accidents↗
PubMed1982

N-Acetylglutamate synthetase: enzyme assay in human liver.

In the context of diagnostic procedures for congenital hyperammonaemias a methods is described for the determination of N-acetylglutamate synthetase in human liver tissue homogenates. The method uses [14C-U] glutamate and acetyl CoA as substrates. The reaction product, N-acetylglutamate is separated from the substrate L-glutamate by chromatography on Extrelut. In a subsequent step on ITLC-SG ready plates N-acetylglutamate is separated from other labeled metabolites such as Krebs cycle intermediates. The recovery of N-acetylglutamate was 97.8%. The precision within run and between days was 8.5% (CV) and 9.6% (CV) respectively. Reference values were established for adult human liver.

Acetyltransferases↗
PubMed1981

[Parenteral antibiotic prophylaxis or oral antimicrobial bowel preparation for colorectal surgery (author's transl)].

A prospective randomized trial was designed to establish whether parenteral antibiotic prophylaxis was as effective as oral antimicrobial bowel preparation in preventing sepsis after colorectal surgery. Patients scheduled for elective resection of colorectal cancer received metronidazole and kanamycin either orally in the preoperative phase or parenterally as a short-term perioperative prophylaxis. The former regimen resulted in reduction of the microbial concentrations in the bowel contents in the absence of therapeutic serum concentrations at the time of operation, whereas the latter achieved therapeutic intraoperative serum levels without altering the colonic microflora. 72 patients were studied. There was no significant difference in the occurrence of postoperative sepsis between the two groups (a total of 72 patients). These results differ from those obtained at the Birmingham General Hospital using the same protocol, in which postoperative sepsis was significantly more common in the group of patients having oral bowel preparation. This difference was most probably due to an overgrowth of kanamycin-resistant coliforms during the period of oral antibiotic preparation. The presence of resistant organisms did not, however, result in failure of systemic prophylaxis. The authors conclude that short-term parenteral application is the safer method of antibiotic prophylaxis in colorectal surgery and is to be preferred to oral antimicrobial bowel preparation.

Administration, Oral↗
PubMed1980

[Surgical treatment of ulcers].

Since the introduction of cimetidine the number of patients operated upon for peptic ulcer has decreased in most departments of surgery. This is mainly due to a change in attitude towards the indication for surgery in chronic uncomplicated duodenal ulcer. The classic surgical indications of perforation, hemorrhage, and pyloric obstruction remain unchanged, but the criterion of intractability as an indication for elective surgery needs to be redefined. For chronic recurrent uncomplicated duodenal ulcer in the otherwise fit and healthy subject, prolonged treatment with cimetidine is not a suitable alterative to surgery. Proximal gastric vagotomy is the method of choice for elective operation in chronic duodenal ulcer. In gastric ulcer the situation is complicated by the risk of failure to diagnose malignancy and erroneous conservative treatment of cancer taken for benign ulcer disease. Follow-up by repeated endoscopies and biopsies is a sine qua non for conservative management of gastric ulcer. The results of surgical treatment of gastric ulcer are satisfactory. Postsurgical symptoms and recurrent ulcer are less frequent after resection for gastric ulcer than after operations for duodenal ulcer. Resection is still considered the method of choice. The results of prospective studies do not at present support the treatment of gastric ulcer by vagotomy rather than by gastric resection. Reoperation for postoperative recurrent ulcer carries a higher risk than the primary intervention. On the other hand, recurrent ulcer responds quite favorably to cimetidine treatment. Cimetidine may serve as an initial therapeutic approach to obtain healing of the ulcer and postpone corrective surgery to a later, elective date.

Cimetidine↗