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Biomedical subjects

P Sperling

Publications and source records attributed to P Sperling.

30 records · Page 2Linked to original sources

[Surgical therapy of parenchymatous liver cysts].

An account is given of therapeutic approaches to 70 cases of non-parasitic cystic, parenchymatous liver diseases handled at the Surgical Department of Charité (Berlin), with reference being made also to indications for surgery, surgical techniques used, and therapeutic results. Twenty-six of 41 patients with solitary liver cysts, some of them with ventriculation, received surgical treatment. Extirpation of cysts and removal of cystic walls were the preferred therapeutic approaches to avoid recurrence. Postoperative complications were not recorded. Conservative therapy is preferred in the majority of cases of liver cysts, often combined with cystic alterations to kidneys and rarely associated with pancreatic lesions. The largest cysts were removed from eight of 29 patients to improve their quality of life. Subjectively perceived improvement of usually compression-related symptoms is paralleled by protracted clinical courses with temporary development of liver insufficiency. None of the patients, operated on and conservatively treated, died in the course of follow-up care.

Cysts↗

[Results of treatment of pyogenic liver abscesses].

In the last 7 years 53 patients with liver abscesses were treated at surgical clinic of Charité. Since November 1982 we treated in 27 cases with solitary and multiloculary liver abscesses by percutaneous drainage of the abscess diameter more than 3 to 4 cm. 12 patients with multiloculary small biliary liver abscesses were treated by antibiotics. The bacteriological examination were performed after CT-supported puncture of the abscess. Seven patients with complicated abscesses could not be healed with CT-drainage. Surgical drainage via laparotomy was necessary. The diagnostic clarification of the dignity is important in every case. The lethality of all treated liver abscesses was 5.6% and the causes of death were the existing basic diseases.

Adolescent↗

CT diagnosis of hepatic adenoma.

Only few publication have so far been known on case histories in the context of CT-findings of hepatic adenoma (HA). An analysis was, therefore, made of the findings of ten patients with HA. Precontrast and postcontrast scans (dynamic CT), densitometric evaluations (gamma-fit) and "profile" determination were taken into consideration. Diagnostic relevance is attributed to two types of features (with and without tumour haemorrhage) as well as to complementary findings (capsule-like structure and fat-ring around the tumour, island-like areas).

Absorptiometry, Photon↗

[Surgical therapy of liver cancer].

An account is given in this paper of surgical treatment of malignant tumors of the liver of patients in the Surgical Department of Charité over the past six years, with reference being made to both indications for surgery and therapeutic results. - In the period under review, treatment was applied to 335 patients with malignant tumors of the liver, among them 168 with liver metastases. Thirty-eight per cent of all tumours treated were localised in the right lobe and 19 per cent in the left. The portal hilum was affected in 15 per cent of all cases and the entire liver in 28 per cent. Promising curative therapy was considered practicable for 67 patients, whereas three underwent palliative surgery. Liver transplantation was performed on 21 patients with malignant tumours not accessible to meaningful surgical approach. The resection rate in cases of liver malignoma was 14.6 per cent. The record included 14 hemihepatectomies on the right side and eleven on the left as well as 24 instances of atypical or segment removal, primarily in cases of liver metastasation. Surgical lethality amounted to 6.1 per cent, while the three-year survival rate was 55 per cent, with the most favourable results being recorded from hepatocellular carcinoma with 81 per cent. Only seven per cent of 265 patients with inoperable malignant liver tumours were left alive after one year. Impaired wound healing, the most common postoperative complication, had to be coped with in 21 per cent of all cases. The rate of complications proved to be substantially controllable by pre-operative conditioning and careful postoperative intensive care.

Adenoma, Bile Duct↗

[Surgical treatment of benign liver tumors].

We reviewed the records of 105 patients treated for benign hepatic disease at the Department of Surgery of the Charité since 1979. Treatment has to be tailored to the different pathological processes. Modern imaging techniques are of utmost importance for diagnosis and follow up of all patients regardless if they underwent operative therapy or were treated conservatively. Indications and contraindications in the treatment of benign liver tumours are developed on the basis of 44 liver resections with special reference to adenomas and hemangiomas. In all cases a hemihepatectomy seemed justified inspite of the benign disease process. Postoperative complications were mostly related to the surgical incision and caused by abnormalities of protein synthesis and coagulation, frequently observed after major hepatic surgery. Close monitoring and immediate correction of all clinical and biochemical parameters are essential in the postoperative period.

Adenoma↗

[Epidemiology of burn injuries in the GDR (author's transl)].

Burn injuries in GDR have a slight decreasing tendency concerning both morbidity and mortality. The distribution of injuries to the districts of GDR can be explained by the distribution of population, not by distribution of industry. The overwhelming share of injuries consists of children with small scalds. Therapeutical results are comparable with results from international literature. Owing to the fact that in last years no further decisive improvement could be achieved, more attention must be devoted to the problem of primary prevention especially to target groups, resulting from anamnestic and clinical data analysis.

Adolescent↗

[A delayed life-threatening complication after uneventful varicella infection: transient complete heart block].

A 9 year old boy presented with uncharacteristic gastroenteric complaints due to a complete heart block 9 days after an uneventful varicella infection. Echocardiographically there were no signs of gross myocardial involvement. Bradydysrhythmia necessitated isoproterenol application however without the need for temporary transvenous cardiac pacing. After a short period of second-degree atrioventricular block and transient left bundle branch block the rhythm recovered completely and sinus rhythm is maintained so far. Worrying is the delayed onset of this complication after an uneventful course of a typically undangerous children's disease. Presumably a remaining inflammatory reaction in different parts of the specific conducting system has to be assumed. The long lasting prognosis of the atrioventricular conduction properties remains to be seen.

Bradycardia↗