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Biomedical subjects

W Kozuschek

Publications and source records attributed to W Kozuschek.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Treatment of pancreatic injuries. Study of a series of 34 patients].

Routine retrograde imaging of Wirsung's duct, an essential investigation of pancreatic injuries, should be carried out preoperatively and, in case of failure of the intervention, intraoperatively. Whereas simple drainage is sufficient treatment for injuries to the pancreatic parenchyma, lesions of Wirsung's duct require either duodeno-cephalic pancreatectomy or left pancreatic resection, depending on the site of the ductal wound, conservative treatment carrying the major risk of a post-traumatic acute pancreatitis with its particularly elevated mortality rate. Of the 34 cases, reported: 24 (70.6%) were treated by resection: 3 by duodenocephalic pancreatectomy and 21 by left pancreas resection, 6 (17.6%) by suture of the parenchyma and contact drainage and 4 (11.8%) by drainage of Wirsung's duct by catheter or excluded loop in Y. Mortality was 14.7% (5 of the 34 patients). Complications included pseudocysts requiring operative removal in 3 of the 6 patients treated by suture-drainage, and severe sepsis in 5 patients with a fatal outcome in 3 cases. Treatment was unsuccessful in 2 of the 4 patients treated by drainage by catheter or excluded loop in Y, whereas mortality was nil after pancreatic resection.

Adult↗
PubMed1991

[Cephalic duodenopancreatectomy with pylorus preservation. An experience of 52 surgically-treated cases].

From february, 1985, to december, 1990, we carried out 52 pylorus preserving duodenopancreatecomies (41 times for cancerous lesions, 11 times for chronic pancreatitits). Our current observations suggest that PPDP is better than the conventional Whipple's procedure as far as nutrition and digestion are concerned, this being confirmed by digestive and endocrine functional tests. The procedure also has the advantage of being confined to the supramesocolic level, thus being less traumatising and more rapidly carried out. Postoperative nutrition and digestion are less disturbed, owing to the conservation of the gastroduodenal functional entity. The endocrine potential of the pancreas seems also to benefit from this procedure.

Adult↗
PubMed1991

[Diagnosis and interdisciplinary therapy of spinal cord compression caused by spinal metastases].

Metastatic tumours of the bone system occur up to 60% in the spinal cord. The epidural spinal cord compression is also found by metastatic tumour, so patients with metastatic disease in this localisation carry a poor prognosis. From 1986 to 1988 35 patients with symptomatic spine metastasis are operated upon. 43% of these patients recover their capability of walking. 90% from the operated collective show a reduction of pain. The primary tumour is first found from cancer of the lung and second from the kidneys. The most common localisation of metastatic tumour is the thoracic spine. The ratio from male to female is 2:1. If the risk of operation and differential therapy is discussed, the decompression and tumour resection will be the first. The concept for postoperative mobilisation and therapy concludes the stabilisation of spinal cord with internal fixation. Treatment of metastatic tumours takes aim at the improvement of life quality.

Adenocarcinoma↗
PubMed1991

[Operated mechanical ileus of the small intestine].

Causes, pathophysiology, diagnosis, therapy and a retrospective analysis of small bowel obstruction were reviewed. 85 patients were operated during a 5-year period. The etiology of obstruction were adhesions (45 cases), hernia (20 cases) and 20 other cases. The mortality rate for the series was 8%. The most important factor of prognosis is the early operative treatment.

Diagnosis, Differential↗
PubMed1989

[The value of sonography in assessing bone transplants--an experimental study].

The ultrasound control after spongiosa substance plasty is, as described, a supportive method to x-ray measurement. The clinical experience and results are most encouraging. Therefore an experimental proof of this method is necessary. The model is the complete lower leg after amputation. The tibia is prepared with autologous and homologous spongiosa substance with and without gradual decalcification. For fresh spongiosa there is an ultrasound examination from three to five mm and to a higher rate for decalcified spongiosa substance. The experimental results are the verification of clinical assessment.

Bone Transplantation↗
PubMed1989

[Ultrasound control of spongiosa transplant--support of radiologic diagnosis].

The x-ray control is standard for spongiosa substance plasty and shows three periods of healing. In the first two periods (vascularisation and osteogenic reaction) the examination is restricted. Ultrasound control is a simple handling method although a hyporesonance or non-resonance of calcareous bone exists. The follow-ups concerning spongiosa substance plasty are made by ultrasound and x-ray control, and more exact assessments are possible. Advantages and disadvantages of ultrasound in extremities are discussed.

Bone Transplantation↗
PubMed1989

[Rare pancreatic tumors from the viewpoint of our own patient sample].

Four less common tumours of the pancreas are being presented with histological findings (malignant haemangiopericytoma, small cell type anaplastic carcinoma, microcystic cystadenoma, dysontogenetic cyst) from our own patient data. The discussion includes general considerations about preoperative staging and grading as well as the differential diagnosis of the kind of tumours.

Aged↗
PubMed1989

[Early functional treatment of rupture of the fibular ligament with a personally developed ankle splint].

The inversion trauma of the ankle joint is one of the most important and frequent injuries. The treatment of recent rupture of the fibular ligament is now a point for discussion. Operative or conservative treatment is possible. The clinical evaluation of instability requires radiological control and stress test. With a new ankle splint we reduce pathological inversion of the ankle joint, so that we introduce a functional treatment. Our experience with this method will be demonstrated. 45 patients more than a half year after trauma reported good-to-excellent results. The objective evaluation shows in 95% good-to-excellent results. A secondary ligament reconstruction was not necessary.

Adult↗
PubMed1988

[The external ring fixation--experimental studies of bending stability in distraction osteosyntheses].

There is a high axial load for lower leg distractive osteosyntheses with external fixation systems. In searching for a high rigidity comparative investigations on the stability with different external fixators were carried out by an own-developed material testing machine. Our anular fixator showed more rigidity than a three-dimensional ASIF-external fixateur. The use for infected fractures by changing the treatment, pseudarthrosis and also distractive osteosyntheses with weight bearing (for example Ilisarov-method) is possible.

Biomechanical Phenomena↗
PubMed1988

[Gallstone ileus--is it possible to reduce the still high mortality rate? An analysis of personal cases and review of the literature].

Acute intestinal obstruction caused by gallstones: we report about our own experience with 13 patients and discuss this topic by referring to the current literature. Since there is indeed a tendency towards multimorbidity in our high-aged population, a gallstone ileus should always be included in the differential diagnosis of acute intestinal obstruction in the elderly. We put emphasis on a less traumatic operative procedure (enterolithotomy). Good results can be achieved (in terms of postoperative mortality) by operating at the early onset of symptoms.

Aged↗
PubMed1987

Treatment of abdominothoracic actinomycosis with imipenem.

The probably successful treatment of a 42 year old diabetic patient suffering from relapsing abdominothoracic actinomycosis with imipenem is reported. Several earlier attempts to cure the patient by combination of surgical procedures (including cysto-jejunostomy and pancreatic tail resection) in combination with four or six week courses of intravenously administered penicillin G had failed.

Abdomen↗
PubMed1987

[Treatment of tibial fractures with external ring fixation--I].

Notwithstanding the generally known principles of therapy, indications can be enlarged by use of an annular fixator to cover the following applications: 1. stage fractures of the tibia, 2. stabilisation of fractures of polytraumatised patients with no need for anatomic reposition in the first place, 3. closed lower limb fractures with soft tissue lesions. Possible unlimited correction of primary and secondary dislocations without the need for transposition of Steinmann pins already implanted, compatibility with AO external fixation systems for supplementary use of annular fixator elements for possible management of secondary dislocations and variable placeability of pins or screws for subsequent wound debridement and muscle flap transposition are major advantages of the annular fixator. Results so far obtained from use of the annular fixator are described by clinical examples.

Adolescent↗
PubMed1987

[Transfixation method--treatment of tibial fracture with external ring fixation--II].

The transfixation method first introduced by Böhler has been modified by means of a self-devised annular fixator and has thus been re-introduced by the authors of this paper, with the view to reducing the drawbacks of conservative and surgical treatment of closed lower leg fractures. Reposition of the fracture is achieved by means of this paper, with the view to reducing the drawbacks of conservative and surgical low. Retention is followed by application of a plaster cast up to the knee, with the Steinmann pins covered. Technique, indication, and results are described. Successful fracture consolidation was achieved in good position and with good functional results in all cases.

Bone Nails↗
PubMed1986

Leukotriene synthesis by human gastrointestinal tissues.

The prostaglandin and leukotriene synthesizing capacity of human gastrointestinal tissues obtained at surgery was investigated using radioimmunoassay for prostaglandin E2, leukotriene B4 and sulfidopeptide leukotrienes. The leukotriene immunoassay data were validated by high-pressure liquid chromatography (HPLC). During incubation at 37 degrees C, fragments of human gastric, jejuno-ileal and colonic mucosa released considerably larger amounts of prostaglandin E2 than of leukotriene B4 and sulfidopeptide leukotrienes. Gastrointestinal smooth muscle tissues released even larger amounts of prostaglandin E2, but smaller amounts of leukotrienes than the corresponding mucosal tissues. Adenocarcinoma tissue released larger amounts of leukotriene B4, sulfidopeptide leukotrienes and prostaglandin E2 than normal colonic mucosa. Ionophore A23187 (5 micrograms/ml) did not stimulate release of prostaglandin E2 from any of the tissues investigated, but enhanced release of leukotriene B4 and sulfidopeptide leukotrienes. HPLC analysis demonstrated that immunoreactive leukotriene B4 co-chromatographed almost exclusively with standard leukotriene B4, while immunoreactive sulfidopeptide leukotrienes consisted of a mixture of leukotrienes C4, D4 and E4. Leukotriene synthesis by human gastrointestinal tissues was inhibited by the lipoxygenase inhibitor nordihydroguaiaretic acid (NDGA) and the dual enzyme inhibitor BW755C (3-amino-1-(trifluoromethylphenyl)-2-pyrazoline hydrochloride). Synthesis of prostaglandin E2 was inhibited by the cyclooxygenase inhibitor indomethacin as well as by BW755C. Incubation of gastrointestinal tissues in the presence of glutathione decreased the amounts of leukotrienes D4 and E4, while release of leukotriene C4 was simultaneously increased. On the other hand, incubation of tritiated leukotriene C4 with incubation media from human gastric or colonic mucosa resulted in conversion of the substrate to [3H]leukotriene D4 and [3H]leukotriene E4. The results indicate the capacity of human gastrointestinal tissues to synthesize the 5-lipoxygenase-derived products of arachidonate metabolism, leukotriene B4 and sulfidopeptide leukotrienes, in addition to larger amounts of prostaglandin E2. Furthermore, considerable activities of the sulfidopeptide leukotriene-metabolizing enzymes gamma-glutamyl transpeptidase and dipeptidase were detected in human gastrointestinal tissues. These enzymes might play an important role in biological inactivation and/or change of biological profile of sulfidopeptide leukotrienes generated in the human gastrointestinal tract.

4,5-Dihydro-1-(3-(trifluoromethyl)phenyl)-1H-pyraz↗