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Biomedical subjects

P Kujath

Publications and source records attributed to P Kujath.

At least 73 records · Page 4Linked to original sources
PubMed1988

The pharmacokinetic properties of cefotetan and its relevance for prophylaxis in elective colorectal surgery.

In an open, prospective, non-randomised study involving 112 patients undergoing elective colorectal surgery, the effect of perioperative prophylaxis with cefotetan was investigated. Cefotetan (2g) was administered, pre- and intra-operatively only. Preoperative bowel preparation was done by the standardised "Würzburg Method" i.e. oral metronidazole pre and post orthograde lavage. Mucosal biopsies were obtained from the resected colon and simultaneously serum samples were taken to determine tissue and serum levels respectively. Antibiotic serum and gut mucosal levels were well in excess of the minimum inhibitory concentration (MIC90) levels of the isolated bacteria. Wound infections occurred in only 2 patients. Cefotetan was well tolerated and no adverse events were noted. In prolonged colorectal surgery, an antibiotic such as cefotetan with a long half-life is to be recommended.

Adult↗
PubMed1987

[Pseudomonas aeruginosa: pathogenicity, prevention and therapeutic approaches].

Pseudomonas aeruginosa has proved to be a dangerous nosocomial pathogen is growing importance. Its pathogenicity is attributable to its great variety of toxic mechanisms which are capable of attacking all parts of the organism, primarily organs with impaired resistance. Antibiotics had been found to yield little lasting success. Therefore, an attempt was made to apply to 30 patients three-per-cent boric acid to cope with locally delimited Pseudomonas wound infections. Therapy could be completed with good success in less than six days on average. Only germ reduction was achievable on three patients with chronic osteomyelitis. Toxic side-effects were not recordable.

Anti-Bacterial Agents↗
PubMed1986

[Indications status and surgical strategy in cold struma nodule].

Scintigraphy, sonography and fine needle cytology have the best accuracy in the evaluation of a cold nodular goitre. In 2,100 investigations on nodular goitre, it could be found that the incidence of the prophylactic operation for histological diagnosis decreased more than half. On the other hand, with the precise diagnosis the surgeon was able to perform thyroidectomy for thyroid cancer in the first operation. Thus complications of thyroidectomy (paralysis of the recurrent laryngeal nerve, tetany, residual thyroid tissue) could be reduced.

Diagnosis, Differential↗
PubMed1986

[Radiogenic damage of the intestine--diagnosis and therapy].

62 patients underwent surgery for intestinal radiation injuries during the past 15 years. 34 patients had previous abdominal surgery. Preoperative investigations must clarify if there is only the radiation lesion or a recurrent process of the originally radiated tumor. Rectovaginal fistulas occurred 28 times, 19 of which could only be treated by continent colostomy. 5 patients had been curatively resected with low anastomosis. A progressive stenosis leading to an ileus symptomatology appeared in 24 patients. The injured intestinal part was resected. As intestinal radiation injuries are combined with an ischemic enteropathy, anastomosis will be extremely problematic. Thus, second-look operations are recommendable for the third and seventh postoperative day. So lethality could be decreased.

Abdominal Neoplasms↗
PubMed1986

[Peritoneal lavage as a standard therapeutic principle in diffuse purulent peritonitis].

Programmed peritoneal lavage was performed on 72 patients with diffuse purulent peritonitis. The intervals up to planned relaparotomy were one to two days. An average of 4.2 lavages was conducted. The abdominal cavity was provisionally closed. Eleven of 34 patients with incurable trias survived. Histological and bacteriological follow-up checks produced evidence to rapid healing of peritonitis in the course of the lavage programme.

Adolescent↗
PubMed1985

[Nonocclusive ischemic enteropathy--a rare cause of ileus].

The cause for a nonocclusive ischemic enteropathy seems to be a low cardiac output syndrome. There are often signs of a paralytic intestinal obstruction. Parameters of the blood chemistry offer no conclusive data. The angiogram of the mesenteric vessels demonstrates extensive arterial vasoconstriction as well as an obstructed venous outflow. Experimental findings disclose that this venous obstruction may be a result of an ischemic contracture in the course of a low flow state. This rigor initiates finally a thrombosis of the venoles. The rigor can be effectually mastered by energy-rich compounds.

Calcium↗
PubMed1985

[Histologic studies in the course of programmed peritoneal lavage].

A programmed peritoneal lavage was done in 20 patients. During this lavage, tissue samples were withdrawn for histological control. During the therapeutical lavage, the morphological signs of inflammation decreased. For the sanitation of peritonitis, the cause of the disease must be eliminated. The morphological signs of healing start during the first three days postoperatively. Peritoneal repair prevails after the second or third postoperative day. Peritonitis will be lethal without focus sanitation and with microorganisms resisting any therapy, although lavage having been done.

Biopsy↗
PubMed1984

[Perioperative prophylaxis in elective colorectal surgery].

The effects of perioperative antibiotic prophylaxis in elective colon surgery was evaluated in a prospective study on 100 patients. Bowel cleansing was done by orthograde lavage. The patients were divided into 5 groups receiving equally cefotaxime 3 x 2 g, lamoxactam 3 x 2 g, cefmenoxime 3 x 1 g, mezlocillin 3 x 5 g an piperacillin 3 x 4 g. Mucosa biopsies of the resected colon were taken for aerobic and anaerobic cultures. Further mucosal serum probes were frozen immediately for determination of tissue and serum levels of the antibiotics. Our results show that bacterial growth of the colon mucosa was significantly reduced. Anaerobes were identified in only 8%. The tissue concentrations exceeded the MIC-levels of the identified bowel organisms many times over. The clinical infection rate was 4%. All administered antibiotics can be recommended without reservation.

Aged↗
PubMed1983

[Combined disease picture of an autonomous thyroid adenoma with acute and chronic thyroiditis].

This is a case report of a 20 year old woman suffering from a single toxic hot nodule of the thyroid gland. Following inflammation of the neck a cystic nodule with a thick fibrotic capsule was resected. Histology revealed a follicular adenoma with central necrosis surrounded by chronic fibrosing thyroiditis with intima proliferation of the blood vessels similar to Riedels thyroiditis.

Adenoma↗
PubMed1982

[Microangiographic studies on the revascularization of free smooth muscle grafts].

The aim of the investigations was to find out exactly how and when revascularization of free transplanted smooth muscle took place. For this purpose a continent colostomy was performed on 15 dogs by sphincter plastics with a free autologous transplant. The dogs were killed between postoperative day 1 and 5, and their blood vessels were perfused with mixture of Indian ink and Ringers solution. The microangiographic observations of the microscopic section showed the following results. On postoperative day 1 at the edge of the transplant the vessels of the intestinal serosa were distinctly seen to have ellipsoid dilatation. On day 2 tiny filamentary branches of the vessels proliferated into the transplant and connected with the original vessels of the sphincter plastic. By days 4 and 5 this process was apparent.

Angiography↗
PubMed1982

[Differential diagnosis of pancreatitis: metastasis to the pancreas].

A case report is given of a patient with a metastasizing teratocarcinoma of the testis (ripe teratoma and embryonal carcinoma), which was misinterpreted in the beginning as acute pancreatitis. At post mortem, metastases of this tumour were found in the pancreas, which apparently had led to inflammatory lesions of this organ, which could not explain however all of the clinical symptoms seen before. The literature dealing with cases suffering from acute pancreatitis induced by tumours is reviewed. A list of possible associations between pancreatitis and tumours is given.

Acute Disease↗
PubMed1982

[Dorsal scapho-lunate bone dislocation].

A dorsal scapho-lunate dislocation resulted from a forced hyperflexion of the right wrist. X-rays demonstrated a dorsally displaced lunate bone and a palmar displacement of the distal carpus with respect to the radius. The dorsal dislocation of the lunate and the palmar perilunate dislocation were combined. Treatment consisted of closed reduction, a gauntlet cast and physical therapy. A follow-up radiological examination six years later revealed a palmar form of carpal instability. No subjective complaints were made on the part of the patient.

Adult↗
PubMed1980

Continent valve ileostomy.

2 years of experience with the sphincteroplasty in colostomy as well as intensive histological studies have shown that gastrointestinal smooth muscle can be autotransplanted without loosing functional or histological integrity. The following conclusions are based on experimental studies in dogs: (1) the sphincteroplasty technique can be successfully applied in ileostomy, and (2) the sphincteroplasty must, however, be combined with a pre-sphincter valve and an omega loop with Braun's anastomosis. The first clinical results confirm this concept.

Animals↗
PubMed1980

[A technique for continent feeding jejunostomy (author's transl)].

Nutrition is the main problem with inoperable gastroesophageal tumors. In 15 mongrel dogs the topmost jejunal loop was disconnected in a 'y' shape after Roux and diverted outwards, the small intestine anastomosed end-to-side. A sphincter plastic made of autologous small intestine muscles after the Würzburg method was wrapped as a sleeve around the thigh diverted to the epigastrium. The jejunostomy was absolutely continent; the dogs could be fed an elementary diet by means of a probe without their loss of weight or malaise. The mobility and the uncomplicated application signify improvement on the gastric fistula and parenteral feeding.

Animals↗
PubMed1980

[Replacement of the urinary bladder sphincter by autotransplantation of smooth intestinal muscle. (author's transl)].

It was demonstrated by histologic, electronmicroscopic, perfusionmanometric and microangiographic examinations, that smooth muscle of the intestinal tract can be successfully autotransplanted and functions as a sphincter after healing. The sphincter of the urinary bladder was removed in 20 mongrel dogs. The sphincter was replaced by a smooth muscle autotransplant from the intestinal tract. Perfusionmanometry, micturation-urograms and histology showed the uncomplicated healing and the function of the transplants.

Animals↗
PubMed1980

[Biomechanics and histological examinations on the pathogenesis of appendicitis].

After appendectomy 60 appendices were examined for their biomechanical characteristics. The active contraction capability and the relaxation after noradrenaline were registered in Tyrode's solution by a tension recorder, and a length/tension graph was drawn up. After histological examination of the appendices, the findings were classified as the classical inflammation stadium. It was shown that the appendix wall can retain its physiological properties up to an advanced stage of inflammation. Physiological decomposition and paralysis of the appendix wall occur only when gangrene sets. Examination also showed that in the subacute inflammation stage scars are formed which cause motility disorders which, in their turn, also cause inflammation.

Appendectomy↗
PubMed1978

[Impairment of adrenergic innervation in achalasia (author's transl)].

Length tension diagrams and diagrams of isometrically developed active tension were set up for normal and aganglionic cardia-circular muscles. The effects of acetylcholin, adrenergic stimulating and inhibiting drugs were examined. The physiological parameters in healthy cardia and the cardia muscle system in achalasia did not vary significantly from one another. The acetylcholin threshold was higher in aganglionic cardia, while the maximum effective dose in healthy and aganglionic cardia remained the same. In achalasia no sensitisation to acetylcholine was detectable. There was a marked impairment in the balance between adrenergic alpha- and beta-receptors, with the contraction-inducing alpha-receptors obviously predominating.

Acetylcholine↗