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Biomedical subjects

V Lange

Publications and source records attributed to V Lange.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Video-thoracoscopic atypical lung resection].

A new era in thoracoscopy within the framework of minimal invasive thoracic surgery was introduced due to the possibilities of video-endoscopy, the development of an accordingly advanced and suitable instrumentarium as well as the production of an endoscopically applicable linear stapler. The introduction of the endo-staplers has made the thoracoscopic resection even of larger parts of lung parenchyme possible. Just as in laparoscopy a clear reduction of post-operative pain, a reduced impairment of post-operative pulmonary function, a shorter in hospital stay and an earlier return to normal activities are advantages of thoracoscopy when compared to the severely more traumatising thoracotomy. Good indications for this procedure are the spontaneous pneumothorax and the resection biopsy in the quest of finding the diagnosis of unclear pulmonary disease. For the diagnostic and should the situation arise therapeutic resection of solitary pulmonary nodules in contrast a stricter selection and handling of indications is imperative. The method however proved worthwhile under such conditions. The technique and results are reported of video thoracoscopies in 73 patients as well as 51 atypical lung resections carried out thoracoscopically with the Endo-GIA 30. A switch to open thoracotomy became necessary in 16.4%. Indications were pneumothorax (35.6%), hemothorax (1.3%), diagnostic resection of solitary nodule (42.5%), pneumopathy (11.0%), and extrapulmonary tumor (9.6%). Atypical resections were carried out only in the case of solitary nodule (51.7%), pneumothorax (39.7%), and pneumopathy (8.6%). A histological diagnosis was obtained in all cases. The average operating time for solitary nodule and pneumothorax was 1 hour, for pneumopathy 1/2 hour. Chest drains could be removed after 1.6-2.6 days. The postoperative complication rate amounted to 3.9%. There was no mortality. The introduced procedure represents a new and promising alternative in thoracic surgery.

Adult↗
PubMed1993

Laparoscopic stenting for protection of common bile duct sutures.

Laparoscopic common bile duct exploration is comparable with the open operation and it is usually finished with the insertion of external bile drainage such as a T-tube. We performed an antegrade placement of a biliary stent with primary suture of the common bile duct following common bile duct exploration. We thereby avoided the acquisition of the additional expensive equipment required for the transcystic approach and the placement of a T-tube, which in our eyes contradicts the idea of minimized discomfort in minimally invasive surgery.

Adult↗
PubMed1993

Headache--defined.

Headache is one of man's most common afflictions. Increasing interest from the general population has contributed to the recent surge in research. This research relates to etiology or pathophysiology, treatment and impact of society. Headache can be a minor symptom or a symptom of serious underlying disease. As nurses, either in a health care facility or in our communities, we have a responsibility to keep abreast of current theories and treatments. Both presenters are currently involved in clinical trials of new headache medications for both children and adults. Behavioural Objectives: 1. Understand when a headache is a serious symptom and warrants further investigation. 2. Identify the different types of headache. 3. Describe the etiology of headache and its physical and psychological manifestations in child and adults with a particular emphasis on migraine. 4. Gain appreciation for the role of the clinical trials nurse.

Adult↗
PubMed1993

[Various techniques for laparoscopic small intestinal anastomosis. A preliminary report].

Three groups with n = 6 pigs were subjected to different techniques of endoscopic small bowel anastomosis. In Group I connection of the gut endings was done, using an all layer stapler-device, otherwise employed as hernia-stapler. Two thirds of the circumference became inverted, one third was everted. Anastomosis of Group II was done with the same stapler device, but all clips were set to evert the wound-endings. Group III consisted of triangularly shaped anastomosis, for which a linear stapler device was being used. All animals survived the investigation period (14 days) and were postmortally examined. Technical aspects and clinical results are being discussed.

Anastomosis, Surgical↗
PubMed1993

[Current status of gallstone surgery in Germany. Results of a survey and retrospective analysis of 27,403 interventions--open vs. laparoscopic surgery].

Based on a representative poll, which included a retrospective data analysis, the current surgical approach to gallstone disease in Germany is presented. A total of 25,955 procedures in 1991 is analysed. 24.9% of all cholecystectomies were done laparoscopically. In 1992, already 81.4% of all surgeons reported own experiences with this new technique. Comparing open procedures with laparoscopic cholecystectomy the latter showed a lower incidence of complications (6.8 vs 8.7%) and perioperative death (0.14 vs. 0.43%). In contrast, relaparotomies were more frequent in the laparoscopy group (1.48 vs. 0.84%). The diagnostic and therapeutic approach for common bile duct stones is currently changing. There is a tendency towards less invasive endoscopic and laparoscopic procedures and towards their combination, respectively.

Cholecystectomy↗
PubMed1992

Surgical interventions for bile duct stones.

Based on our experience of 420 common bile duct procedures for stone disease and a literature review, it is evident that treatment of common duct stones today is based on a wide variety of non-operative and surgical methods which are still being developed. The mode of treatment is basically related to the time of diagnosis. Methods also differ depending on the localization of calculi, on inflammatory complications of stone disease, and whether combined or isolated cholecystocholedocholithiasis is present. At the moment, traditional operative methods as well as newly developed advanced techniques have to be evaluated. Selection of patients and their appropriate surgical and non-surgical treatment is an important issue to be further developed in the next few years. Therefore, therapeutic indications and definitive therapy present a much more demanding challenge for the surgeon than in the period when only open surgery was available.

Bile Duct Diseases↗
PubMed1992

[Haptoglobin polymorphism--not only a genetic marker].

The biological activities of the haptoglobin polymorphism are controlled by continuous DNA sequences coding for the HP alpha and Hp beta polypeptide chains and forming with a linked Hp related gene the haptoglobin gene complex on chromosome 16. Probably, this DNA domain originates from the gene family of the serine proteases after having lost the informations for the proteolytic functions. Instead of this, the haptoglobins have acquired other qualities, among them the hemoglobin binding capacity, inserted into the Hp beta chain. The Hp polymorphism is constituted by the evolutionary progressive DNA sequences for the Hp alpha chains, which probably have activation functions. The haptoglobins display immunoregulative abilities, which can be immunosuppressive by inhibition of the lymphocyte reactivity or immunoinductive by influencing the IgM biosynthesis, adapted to the functional requirements. In this field, Hp 2-2 has a stronger effect than the two other Hp types. Moreover, the haptoglobins inhibit the prostaglandin synthesis and protect against harmful oxidation processes. These qualities are based on the hemoglobin binding ability and can be realized by Hp 1-1 with the comparatively highest efficacy. Further on, the haptoglobins are protease inhibitors. Finally, Hp 2-2 is associated with higher albumin and ceruloplasmin serum levels than Hp 2-1 and Hp 1-1. Evidently, the haptoglobins are inserted into a widely ramified network of biological functions. The selective advantages and disadvantages of the Hp polymorphism are noticeable under pathological conditions in case of malignant tumors, inflammations, autoimmune diseases, allergic illness, affective psychoses and affective lability favouring addiction.

Blood Proteins↗
PubMed1992

[Minimally invasive interventions in solitary liver cysts].

Large intrahepatic cysts need surgical intervention when becoming symptomatic. In case of non-parasitic solitary cysts different surgical treatments are available. We performed three different minimal-invasive procedures in 8 patients. Good results were obtained by laparoscopic extended deroofing of the cyst. Indications and technical performance are presented.

Adult↗
PubMed1991

Laparoscopic creation of a loop colostomy.

A loop colostomy of the sigmoid colon was constructed in a 48-year-old woman because of stool incontinence owing to a severe sphincter lesion. The operation was performed by laparoscopy. A special 3.5 cm trocar was employed for bringing the sigmoid colon through the abdominal wall. This technique allows the surgeon to avoid a lower median laparotomy in selected cases, and allows discharge of the patient within a few days.

Abdominal Muscles↗
PubMed1990

Fistuloscopy--an adjuvant technique for sealing gastrointestinal fistulae.

Endoscopic occlusion of gastrointestinal fistulae can be successfully achieved in a high percentage of patients. In cases where the intestinal opening of the fistula is not accessible, such treatment was hitherto impracticable. Fistuloscopy is a new technique which we have devised, using a flexible endoscope advanced percutaneously along the fistula tract to seal these gastrointestinal fistulae. Eleven out of 17 enterocutaneous fistulae and 5 out of 8 abscesses could be sealed using this technique. The complications in this series were all caused by fibrin glue injection into the fistulae under pressure. One patient died of an air embolism. Provided that elevation of the air pressure in the fistula system is strictly avoided, fistuloscopy is a safe and potent method of occluding gastrointestinal fistulae, which otherwise need prolonged conservative treatment or hazardous surgical intervention.

Aged↗
PubMed1990

[Distribution of serum haptoglobin groups in affective psychoses--more than a genetic marker indication?].

The haptoglobin serum group 2-2 has a preponderance in affective psychoses (p less than 0.0005). This genetic marker trait is extended on unipolar depressions (p less than 0.005) and cycloid psychoses (p less than 0.0005). In addition, it must be assumed that the serum levels of albumin (p less than 0.0001), ceruloplasmin (p less than 0.0001) and haptoglobin (p less than 0.0001) are increased in affective disorders. Besides, the transferrin serum values are decreased in cycloid psychoses (p less than 0.001). As ascertained in a supplementary study, Hp 2-2 is associated within the normal range of variation with the highest albumin serum levels already in healthy controls when compared with Hp 1-1 (p less than 0.05) and Hp 2-1 (p less than 0.001). Even after including the extreme variants, the Hp 2-2 sera display more albumin values above 40.8 g/l than the Hp 2-1 specimens and the summarized samples of Hp 1-1 and Hp 2-1 (p less than 0.02). Furthermore the Hp 2-2 sera exhibit higher ceruloplasmin levels than the samples of Hp 1-1 (p less than 0.01) and Hp 2-1 (p less than 0.005). These differences are persisting too in the same trend after including extreme high ceruloplasmin values (p less than 0.05 and p less than 0.005 respectively). Obviously there are several possibilities for Hp 2-2 to operate on the biological background of affective psychoses as a risk factor. The findings are interpreted with reference to the actual data concerning the activities of the haptoglobin genes and proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Affective Disorders, Psychotic↗
PubMed1989

Laser vaporization of leiomyoma of the esophagus.

We present the case of a 67-year-old man with a stenosing leiomyoma of the esophagus, which led to dysphagia. Because of severe concomitant diseases, thoracotomy was not possible in this patient. Endoscopic laser ablation was a fast and successful treatment; more than 2 years have passed without any sign of recurrence.

Aged↗