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Biomedical subjects

T Junginger

Publications and source records attributed to T Junginger.

At least 289 records · Page 16Linked to original sources
PubMed1989

Endoluminal ultrasonic examination of sessile polyps and early carcinomas of the rectum.

The results of conventional endosonographic techniques in the assessment of early carcinomas and sessile polyps of the rectum have been unsatisfactory. We therefore developed a new technique in which the rectal cavity is filled directly with water. Using this technique, the anatomy of small rectal tumors is preserved and the layers of the rectal wall are easier to differentiate, especially with a 10-MHz scanner. The clinical results in 66 patients demonstrate that this new technique is very accurate in the preoperative staging of adenomas and T1-carcinomas of the rectum.

Carcinoma↗
PubMed1989

[Surgical treatment of early stomach cancer].

At the department of surgery at the university hospital in Cologne 94 patients suffering from early gastric cancer of the stomach were operated in the years between 1968 and 1983. From 1972 till 1987 the department of surgery at the university hospital Mainz has had 74 patients. Survival rates and times without recurrence were calculated dependent on the surgical treatment carried out. In both collectives the prognosis for the patients with mucosal carcinoma was good no matter which operation was carried out. In the case of submucosal infiltration the frequency of recurrence was smaller and the survival rates significantly higher in those patients who subjected to a cancer operation than in those on whom only a resection of two third of the stomach was performed. The results indicate a radical approach in the treatment of early gastric cancer. At least in the case of submucosal carcinoma a dissection of the N2 lymph nodes is advisable.

Female↗
PubMed1989

[Primary mediastinal seminoma].

Primary mediastinal seminoma is an uncommon lesion and should be included in the differential diagnosis of mediastinal tumors. Symptoms and signs may not be clear and in most cases the diagnosis is made by sternotomy or thoracotomy. Our recommendation is that patients with primary mediastinal seminoma should undergo curative resection or reductive surgery. Curative resection should be followed by radiation therapy. Chemotherapy with cisplatin-containing combinations should be reserved for patients who have metastases at the time of diagnosis.

Adult↗
PubMed1989

[Stapler and manual bronchial anastomosis--results of a consecutive trial series].

After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections-performed at Surgical University Clinic Köln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universität Mainz--were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1% after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of their use, the speed and the uniformity of the closure. Thereby stapling devices are valuable completions in pulmonary surgery.

Bronchi↗
PubMed1989

[Prognostically relevant factors in cancer of Vater's ampulla].

In order to evaluate the relevant factors for prognosis for patients with cancer of Vater's papilla our own patient material between 1. 1. 1978 and 31. 12. 1987 was studied retrospectively. The influence of age, sex, duration of anamnesis, tumor size, tumor morphology and tumor stage on the prognosis were analyzed in 32 patients with cancer of Vater's papilla. The 5 year survival rate after Whipple procedure was 56.1%. Statistically significant factors for prognosis were tumor size, lymph node metastases and tumor stage.

Adult↗
PubMed1989

Endoluminal sonography in follow-up of rectal carcinoma.

Fourteen patients who had undergone local excision, anterior resection or low anterior resection for rectal carcinoma were examined by endoscopic ultrasonography. In two of three cases of local recurrent carcinomas, endoscopic sonography was superior to computed tomography in determining the depth of tumor infiltration. There were difficulties in differentiating scar tissue from local tumor formation when the mucosa appeared normal upon endoscopic examination. Only repeated follow-up examinations starting in the postoperative period, will allow a differentiation between scar tissue and local tumor recurrence.

Adenocarcinoma↗
PubMed1989

[The results and complications of 616 percutaneous transhepatic biliary drainages].

During nine years, percutaneous transhepatic biliary drainage was carried out 616 times on 563 patients in the Department of Radiology, University of Mainz Medical School. 50.3% were pre-operative and 39% were palliative. More than 80% were necessitated by malignant lesions. Subsequent improvements in biochemical measurements were observed in 82.4% of patients. Complications of the procedure led to the death of five patients (0.8%) and required surgery in nine patients (1.5%). The following complications were observed: biliary peritonitis in 0.6%, sepsis in 1.9%, bleeding in 1.9% and fever higher than 38 degrees C in 16.2%.

Biliary Tract↗
PubMed1989

Electromagnetically generated extracorporeal shock waves for gallstone lithotripsy: in vitro experiments and clinical relevance.

First generation shock wave sources have been proved to disintegrate gallstones effectively, but they require the immersion of the patient's body in a tank of water. A recently developed second generation shock wave source (Siemens-Lithostar, Erlangen, FRG) generates shock waves electromagnetically. It presents several novel features. In particular the waterbath can be omitted and due to lower shock wave pressure general anaesthesia is not required. In vitro studies showed that 36 out of 38 gallstones (11-30 mm in diameter) could be disintegrated. Two concrements resisting lithotripsy were pure white cholesterol stones. Independent of shape, size, and composition (cholesterol or pigment) the maximum diameter of remaining fragments after lithotripsy was between 1 and 8 mm. For sufficient disintegration precise focusing (+/- 1 cm) of the stones and maximum power of the shock wave generator were required.

Cholelithiasis↗
PubMed1989

[Prognostically relevant factors in ductal pancreatic cancer].

Prognosis of patients with pancreatic carcinoma is bad. Less than 1% of all patients and even after pancreas resection only 10% survive more than 5 years. To evaluate the factors which influence the prognosis we analyzed retrospectively all patients who were operated on a pancreas cancer (n = 484) from January 1, 1978 to December 31, 1987. Age, sex, perineural invasion and lymphangiosis carcinomatosa had no prognostic influence. The duration of symptoms, degree of cellular differentiation, tumor size, preoperative level of the tumor associated antigen CA-19-9, nodal involvement and stage were statistically significant for prognosis. R1 and R2-resections had no better prognosis than other palliative procedures.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

[Errors and dangers in use of the surgical stapler in lung surgery].

The staple closure of the bronchus, like the manual technique, depends on some essential prerequisites: vascular supply, the length and thickness of the bronchial stump, the resection line, the type of stapler and the size of staples used. GIA 55 or 90 instruments allow safe and simple closure of lung parenchyma. Familiarity with the stapling technique is essential for success.

Anastomosis, Surgical↗
PubMed1989

[New endosonographic examination technic for improving the assessment of small rectal tumors].

Conventional endosonographic techniques of examination in early carcinoma and sessile rectal adenoma have shown unsatisfactory results. We therefore fill the rectal cavity directly with water. Using this technique the anatomy of the rectal polyp is preserved, and the separate layers are easier to differentiate, especially when the 10-MHz scanner is used. The clinical results in 56 patients show an improvement concerning the preoperative staging especially in those tumors which are not palpable.

Carcinoma↗
PubMed1989

[Progressive papillomatosis of the intra- and extrahepatic bile ducts].

The papillomatosis of the bile duct may occur at any age but more often at the age of 40 and 50 with a slight preference for men. The main symptom is an icterus often combined with right-sided epigastric pain. ERC and PTC allows the preoperative diagnosis on the basis of the typical clinical picture. The papillomatosis of the bile duct has to be considered as a disease with cancer risk. The prognosis in case of incomplete removal is unfavorable because of the continuous growth, the intrahepatic spread and the elevated degenerative tendency. Therefore a complete removal should be considered.

Adenocarcinoma↗
PubMed1989

Progressive papillomatosis of the intrahepatic and extrahepatic bile ducts. Case report.

Papillomatosis of the bile ducts is uncommon, with only 26 cases in the available literature. The salient symptom is icterus, often with right-sided abdominal pain. Endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography nowadays permit preoperative diagnosis. Complete removal should be the aim, because of the tendency to continuous growth, intrahepatic spread and malignant degeneration. Four cases are presented.

Adult↗
PubMed1988

A modified prosthesis for the treatment of malignant esophagotracheal fistula.

Esophagotracheal fistula is usually a sequela of irradiation or laser treatment of advanced carcinoma of the esophagus or the tracheobronchial tree. Resection of the tumor in these cases is not possible, and palliative bypass surgery is highly risky. The peroral placement of a prosthesis is less invasive, but conventional prostheses often fail to occlude the fistula. The authors regularly use an endoscopic multiple-diameter bougie for dilation. After dilation, a specially designed prosthesis is pushed through the tumor stenosis to block the fistula. This procedure can be done without general anesthesia. The funnels of conventional prostheses cannot cover the fistula when there is either a wide, proximal esophagus above the fistula or a high fistula. To cope with this particular situation, a special fistula funnel was developed. It perfectly occludes the fistulas in all patients. Of 21 patients, 19 were discharged without further aspiration.

Endoscopes↗
PubMed1988

Intraoperative localization of malignant pheochromocytoma by 123-I-metaiodobenzylguanidine single probe measurement.

Metaiodobenzylguanidine (MIBG) imaging is a well-established method for locating intra- and extraadrenal pheochromocytomas. We investigated whether preoperative injection of 123-I-MIBG might be useful for intraoperative staging of chromaffine tumor cells. This was performed in a 46-year-old patient in whom the diagnosis of a malignant pheochromocytoma had been established by 123-I-MIBG imaging and enhanced catecholamine secretion. The rationale for intraoperative staging in this patient was a discrepancy between computed tomography (CI) of the abdomen and the radionuclide imaging, because scintigraphy revealed a mass with MIBG uptake in the right lower abdomen that could not be visualized by CT. We thus applied a preoperative dose of 4 mCi 123-I-MIBG and determined tissue activity by direct organ measurement. A right abdominal mass was thus identified with an activity of 10 x 10(4) impulses/s as compared to normal tissue (15 x 10(2)). The left-sided tumor was found to be identified correctly by prior CT and MIBG imaging. We thus conclude that intraoperative application of this single probe measurement might help to identify chromaffine tumor cells that have not been located fully by CT.

3-Iodobenzylguanidine↗
PubMed1988

Training program for transanal endoscopic microsurgery.

Televised endoscopy and the concept of the "assisted" endoscopic operation is of great help in teaching surgical endoscopic techniques. The use of training dummies provides a new method of training manual dexterity and surgical skills in special courses or in surgical skill laboratories. We have developed a training system for transanal endoscopic microsurgery. Operations with our technique were performed on 116 patients. Like other microsurgical techniques, our method requires a special introduction and intensive training. This paper presents our multistage, video-supported training course for teaching transanal endoscopic microsurgery. The one-day training session is divided into four steps: (1) becoming acquainted with the technology; (2) training on cloth phantom; (3) training on opened bowel; (4) training on closed bovine bowel distended by gas insufflation. Each step is introduced by a short videotape didactically demonstrating the particular aspects of the method.

Colonoscopy↗