Search PubMed⌕ Search

Biomedical subjects

W J Stelter

Publications and source records attributed to W J Stelter.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Thoracic surgical interventions].

Thoracic surgery necessitates more intensive care postoperatively than general surgery. For elective lung resections mortality was significantly higher in patients older than 70 years. Operative risk has to be considered very thoroughly versus natural history of the diseases involved. Vascular reconstructions in the chest, however, were performed mainly in symptomatic patients, when increased operative risk must be accepted because of an increased threat by symptomatic disease. For surgery of the trachea or esophagus techniques are preferred which avoid thoracotomy.

Aged↗
PubMed1980

Extracranial aneurysms of the carotid artery.

Aneurysms of the extracranial carotid artery represent a serious disease because of possible cerebral embolism and aneurysm rupture. Between 1960 and 1979, 28 aneurysms of the extracranial carotid artery were seen in 27 patients at our institution. Twenty-six of these patients noticed a pulsating tumor, 12 patients had neurological symptoms; 2 aneurysms were ruptured. Five times the external carotid artery, and 3 times the internal carotid artery were ligated without neurological symptoms. After aneurysm resection, the carotid artery was reconstructed in 4 cases by direct suture, and in 2 cases by patch angioplasty. Reconstruction was accomplished with a tube-graft in 9 instances, once an extra-intracranial shunt had to be performed in advance. Two patients developed neurological deficiencies after the operation (8.7%), in one of them these were permanent. In the follow-up, 20 patients were without symptoms (87%), 3 patients died after the operation (peri-operative mortality 13%). Out of the 5 non-operated patients 2 died after a short time: one of an acute myocardial infarction and one of an extensive cerebro-vascular infarction. Two patients with asymptomatic internal carotid aneurysm refused the operation and are without symptoms for 2 and 40 years respectively. Because of the potential risks of cerebro-vascular infarction and aneurysm rupture, good results of operative treatment call for an aggressive surgical approach in dealing with extracranial carotid aneurysms.

Adult↗
PubMed1980

[Trachea reconstruction in inflammatory stenosis and tumors].

Primary resection of the trachea and direct anastomosis is indicated whenever inflammatory stenoses and tumors of the trachea are present. In our own series of 27 patients operated upon there were 17 stenoses by scars, two malacias of the trachea, six adenoid-cystic carcinomas, one adenoma of the bronchus and one chondroma. One patient died on the 16th postoperative day from stress-ulcer bleeding. Another patient died three months after the resection of the trachea following reoperation from a recurrence of the stenosis. There was bleeding out of the tracheostoma with aspiration. One patient had a stenosis of the cricoid three years after the tracheal resection had been performed. The stenosis could be treated successfully by reconstructive surgery. None of the other 24 patients had complications. Data on the late results are given. New reports in the literature and our own experience indicate that a tracheal resection with a direct anastomosis seems to be a standardized procedure. Using the right indication for the operation good early and late results can be achieved.

Adult↗
PubMed1979

[Diagnosis and treatment of acute injuries to the heart and intrathoracic vessels (author's transl)].

The massive blood loss that accompanies penetrating chest wounds involving the heart or intrathoracic vessels generally leaves no option but to act immediately. Blunt chest trauma in combination with other injuries makes particularly stringent demands on diagnostic and therapeutic skills. Most injuries to the intrathoracic aorta are in the form of intiially closed tears of the descending part; but rupture is an ever-present threat. The symptoms are: enlargement of the mediastinum in the chest roentgenogram, differences in blood pressure between the upper and lower half of the body and haemothorax. Whenever possible aortography should be performed to locate the site of the rupture. The therapeutic measures are determined by the extent and severity of the various injuries.

Aortic Rupture↗
PubMed1978

[Vascular surgery in arterial occlusive disease. Possibilities and indications (author's transl)].

Besides amputation and resection of the sympathetic trunk, vascular reconstructive operations are among the most important surgical possibilities for the treatment of arterial occlusive disease. Disobliteration and bypass procedures come into consideration. Depending on the localization of the obstruction and the affected organ, one or the other method will be given preference. The indication for vascular reconstruction is principally governed by the disease complex, the danger to the organ due to the reduced blood supply and finally the extent of the arterial obstruction. The lethality of the intervention, the results, complications and follow-up are discussed in detail.

Amputation, Surgical↗
PubMed1978

Sodium nitroprusside-induced hypotension in dogs. Drug sensitivity and resistance experimentally provoked by circulating blood volume alterations.

The effects of small circulating blood volume alterations on the SNP dosage required to maintain the mean arterial pressure at 70 mm Hg were studied in 6 anesthetized dogs; (A) normovolemia, (B) hypovolemia by arterial bleeding 7 ml/kg, and (C) hypervolemia by infusing 7 ml/kg whole blood. The animals became extremely SNP sensitive during hypovolemia and resistant during hypervolemia (SNP dosage A: 25.8, B: 14.7, C: 70.0 microgram/kg/min); these changes were accompanied by significant changes in cardiac output (A: 193, B: 142, C: 249 ml/kg/min). The intravenous administration of SNP with the aim of inducing hypotension generally causes a balanced pre- and afterload reduction. This balance is rather delicate and easily disturbed by small intravascular fluid changes leading to cardiac output and thus to SNP sensitivity changes. Slowly developing tachyphylaxis can be explained on the basis of such intercompartimental fluid shifts and a case of SNP tachyphylaxis reported in literature is discussed on the basis of overinfusion. SNP tachyphylaxis or resistance might be treated by preload reducing measures like phlebotomy or the administration of nitroglycerin.

Animals↗