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Biomedical subjects

R Kirchner

Publications and source records attributed to R Kirchner.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Roentgen diagnosis in diaphragmatic trauma].

The diagnostic value of roentgenology in 85 patients who had to undergo surgery because of diaphragmatic rupture at the university of Freiburg from 1973 to 1985 is reviewed. The ratio of left- to right-sided diaphragmatic rupture is 62 to 23. Preoperatively the following diagnostic procedures were used: chest film examination in 82, plain film of the abdomen in 64, contrast radiographs of the gastrointestinal tract in 21, ultrasonography in 37, computed tomography in 8 and angiography in 9 patients. Sensitivity and specificity of these diagnostic methods depend on an intrathoracic prolapse of abdominal structures and on the existence of concomitant injuries. The combination of all these procedures improved the diagnostic accuracy. In 11 patients a diaphragmatic rupture was only detected by surgery.

Adolescent↗
PubMed1986

[Surgical indications in struma nodules].

From 1980 to 1985 1,839 patients with thyroid nodules were investigated. 98% of them showed ultrasonic patterns of either echo-poor or complex structures, 85% of the nodules were scintigraphically cold, in 10% (n = 182) cytological findings were positive or at least suspect. Of these 182 patients 60 underwent operation, whereas 122 were followed up continuously. In 35 of 60 patients operated histological examination confirmed thyroid carcinomas. The combination of echo-poor, cold nodules and cytological positive or suspect findings urgently requires operation.

Diagnosis, Differential↗
PubMed1985

[Experiences with directed dynamic group psychotherapy in psychotherapeutic ambulatory care].

The psychotherapeutic situation of public assistance at a district without stationary institution for psychotherapy calls for the ambulant effort of methods personally centered group psychotherapy. The Intended Dynamic Group Psychotherapie was developed on stationary conditions of a therapeutic sommunity. In a practical report about eight therapy groups are discussed possibilities and limits of this method on ambulant conditions.

Adult↗
PubMed1981

[Gastrointestinal hemorrhage].

More than 90% of all acute gastrointestinal bleeding is localized in the upper gastrointestinal tract. Manifestation of bleeding elucidates a life-threatening situation. An immediate planned approach with rapid resuscitation from shock, localization of the source of bleeding, estimation of the intensity of bleeding, and local control is necessary. The outcome is influenced more by patient factors and type of bleeding than by therapy. If local control of the source of bleeding is not feasible, a definitive procedure must be employed rapidly.

Emergencies↗
PubMed1981

[Spontaneous external gallbladder perforation (author's transl)].

Spontaneous perforation of the gallbladder is one complication of cholelithiasis. There is a greater occurrence of free perforation in the peritoneal cavity with biliary peritonitis, followed by the perforation into the stomach, small intestine and colon. A single case of the nowadays rare spontaneous perforation in and through the abdominal wall will be reported. Spontaneous gallbladder perforation appears nearly asymptomatic in its clinical course because of absent biliary peritonitis.

Aged↗
PubMed1980

[The surgical treatment of benign bile duct stenoses].

Eight days after ligation of the common bile duct in the dog the stenosis was removed performing a patch-widening-plasty. Various alloplastic materials (Teflon, Dacron) as well as specially prepared biological tissues (Solcograft, human umbilical cord vein) were used for patches. Thereby knitted Teflon (pore size = 100 micron) was best qualified for bile duct plasty. Under the same conditions three different biliodigestive anastomoses were tested. Although all anastomoses showed free passage, in all animals severe cholangitis and inflammatory infiltration of the liver occurred. These results illustrate the value of the Papilla of Vater and show that bile duct repair with a Teflon graft is possible.

Animals↗
PubMed1980

Reduction of police vehicle accidents through mechaniically aided supervision.

Tachograph recorders were installed in 224 vehicles of a metropolitan police department to monitor vehicle operation in an attempt to reduce the rate of accidents. Police sergeants reviewed each tachograph chart and provided feedback to officers regarding their driving performance. Reliability checks and additional feedback procedures were implemented so that upper level supervisors monitored and controlled the performance of field sergeants. The tachograph intervention and components of the feedback system nearly eliminated personal injury accidents and sharply reduced accidents caused by officer negligence. A cost-benefit analysis revealed that the savings in vehicle repair and injury claims outweighed the equipment and operating costs.

Journal Article↗
PubMed1980

[Diagnosis and therapy of acute pancreatitis (author's transl)].

In the course of acute pancreatitis an edematous and a hemorrhagic necrotizing pattern have to be discerned. Clinical symptoms are upper abdominal pain, shock, and metabolic derangements. Only subtle diagnostic procedures are appropriate as for instance x-ray of the chest and x-ray of the abdomen. Laboratory exams are of little value. For conservative treatment atropin, glucagon, calcitonin and antibiotics are being used nowadays, where as the efficacy of aprotinin is controversial. In the Department of Surgery of the Freiburg University Medical School an attempt at early surgery is made. In edematous pancreatitis the bursa omentalis is drained; in addition a T-drain has to be entered into the ductus choledochus. Seqmental necrosis of the pancreas may require resection of the left part of the pancreas. Necrotic areas of the head of the pancreas have to be removed by ablation. If there is total necrosis only drainage with an irrigation-suction pattern is possible.

Acute Disease↗
PubMed1980

[Experimental results after acute and chronic ligation of bile duct (author's transl)].

The bile duct was ligated in 14 bastard dogs. Bilirubine, alcaline phosphatase, GOT, GPT, GLDH, and gamma GT were measured pre- and postoperatively. On the 8th postoperative day stenosis of the choledochus was eliminated using a patch plasty for dilatation in 7 dogs, whereas the occlusion remained in the other 7 dogs. Laboratory and histological results were characteristic for cholestasis 8 days after occlusion; these changes disappeared within 4 weeks after patch plastic surgery. In the controls these parameters normalized as well within 8 weeks, in spite of the persisting occlusion. These results show, that pathological changes after short term cholestasis are fully reversible; they demonstrate as well, that there are compensatory mechanisms operating in dogs with permanent occlusion of the bile duct.

Alanine Transaminase↗