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Biomedical subjects

A Rotzer

Publications and source records attributed to A Rotzer.

10 recordsLinked to original sources
PubMed1998

[Post-traumatic osteoid osteoma of the hand. A rare cause of chronic pain. Case report and review of the literature].

One year after a nonspecific trauma and with a history of pain of four weeks only, an osteoid osteoma of the first phalanx of the left thumb was diagnosed in a 31-year-old man. The radiologic appearance as well as a bone scan were suggestive for an osteoid osteoma. The diagnosis was confirmed histologically after resection of the tumor. As indicated in the literature, osteoid osteoma of the hand is relatively rare. The symptoms and radiologic features (osteolytic nidus and sclerosis) of osteoid osteomas are independent of the tumor location. Surgery with resection of the nidus is the only known curative therapy. The etiological role of trauma is discussed and a review of the literature is done with 15 other cases of posttraumatic osteoid osteoma having been reported.

Adult↗
PubMed1996

[Small-caliber polyurethane arterial prosthesis: clinical and angiomorphological follow-up of 20 patients in a prospective study].

The five year patency rate for femoropopliteal vein bypass grafts is around 70% according to the literature. Patency rates for synthetic grafts (eg PTFE, Dacron) range between 43 and 57%. If a vein is not available there is a new polyurethane 6 mm artery substitute on the market, that has shown in vitro promising physical characteristics and good long term results after implantation in dogs. In a prospective, randomized trial the results of the new polyurethane graft (PUR) were compared with those of a Dacron graft of the same diameter. Included in the study were 20 patients with lower limb ischemia stage Fontaine II B, III and IV, 10 in each group. Patency rates, handling of the graft and complications were analysed. During the one year follow up 7 PUR grafts had to be changed due to recurrent bypass occlusion within the first 3 months. At the end of the year there were only one PUR-bypass but 8 Dacron grafts open. 5 PUR grafts were examined histologically and no morphological reason for the occlusion, especially no myointimal hyperplasia, was found. A special regard was brought to the arterial run-off in both groups. It was confirmed to be comparable with only slightly better data for the PUR group. The exact reasons for the astonishing bad results of the PUR graft for femoropopliteal above knee bypass cannot be explained in our study. Due to the unexpected high occlusion rate the study was stopped earlier then planned.

Aged↗
PubMed1995

[Integration, organization and results of ambulatory surgery in a central hospital].

Principally driven by economic necessity, i.e. reduction of health care personnel and beds, a significant increase in number of major operations for in-patients and a general attempt to reduce costs, a day-surgery unit was established for the Surgical Department at the Kantonsspital St. Gallen. Several requirements have to be met: Standardized techniques have to be applied by experienced surgeons and strict selection criteria for patients as well as intensive preoperative patient information and consenting have to be observed. During a two year period (September 1992 to August 1994) 389 patients were evaluated for ambulatory surgery. 106 patients (27.2%) had to be rejected for social, medical and financial reasons. Eventually operations were carried out on 283 patients. The majority of procedures performed were for herniae (37.8%) followed by varicose vein-surgery (22.6%). Only 8 patients had to be admitted for observation as in-patients, this was mainly due to difficulties in postoperative mobilisation and micturition problems. To monitor our quality of care, questionnaires were sent to patients and general practitioners (GP's). 98% of patients were satisfied with the preoperative information standards. Difficulties in adapting to a postoperative daily routine was stated by 13% of patients. 80% of patients would again opt for surgery on a day-care basis in future. 81% of GP's reported a positive benefit for their patients from ambulatory surgery. All GP's were prepared to undertake preoperative patient evaluation according to standardized selection criteria. A significant reduction in costs can be expected. With the current health-insurance system this is unfortunately achieved with an increased financial burdening for the patient.

Ambulatory Surgical Procedures↗
PubMed1994

[Results in surgery of bronchus carcinoma].

During a 6-year period from 1986 to 1991, 119 patients with lung cancer underwent thoracotomy. 112 underwent surgical resection with lymphadenectomy. The mean age of the 97 male patients was 62.7 years, and of the 15 female patients was 62.7 years, and of the 15 female patients 57.1 years. 54 patients were in stage I, 23 stage II, 21 stage IIIa, 8 stage IIIb and 6 stage IV. Pneumonectomy was performed in 20 cases, bilobectomy in 2, lobectomy in 81, segmentectomy in 3 and sleeve lobectomy in 6. Perioperative death occurred in 2.7% of all patients, 5% of patients who underwent pneumonectomy and 2.2% of patients who underwent lobectomy. Serious complications occurred in 19% of all thoracotomy patients. The re-thoracotomy rate was 6% and mortality 0.8%. The cumulative 5-year survival rate in all 112 patients with surgical resection was 54.6%, and for the 54 patients with radical resection 60.3%.

Aged↗
PubMed1994

[Ambulatory surgery--a sensible future perspective].

Increasing costs in health system, reduction of bed capacities and lack of nurses force to search for solution. To prove that day surgery may be a kind of solution, a pilot project was analysed during 8 months. This project was fully integrated in normal clinical management. Operated patients (n = 100; hernias, varicosis, proctological and other indications), preoperatively selected by specific criterias, and the family doctors were questioned retrospectively of their experiences. The results were very encouraging. Moreover we stated that day surgery is cost-covering. So day surgery is to consider as an important factor to cost-reduction.

Adolescent↗
PubMed1991

[Emergency hospitalization for acute, non-accidental abdominal pain. Prospective data of a surgical university clinic].

During a 19-month period 549 patients (278 women, 271 men) suffering from abdominal pain unrelated to trauma (mean age 48.2 years) entered the emergency room of the Department of Surgery of the University Hospital Zürich. 43% presented during business hours, whereas 57% were admitted during nighttime and/or weekends. Clinical examination, abdominal roentgenograms (upright and supine) as well as sonography were the most commonly used diagnostic tools. 40% suffered from abdominal pain of unknown cause. The most common diagnosis on admission was appendicitis. Only half of these cases really proved to be an appendicitis. In 36% the diagnosis on admission corresponds both to the initial diagnosis made by a member of staff during his first visit, as well as to the final diagnosis. The initial diagnosis agrees in 57% with the final diagnosis. In 10% of the patients the cause of pain was not elucidated despite extensive diagnostic procedures. High technology and sophisticated diagnostics are less important than the clinical evaluation. The decision between operative or nonoperative treatment was mainly based on clinical findings.

Abdomen, Acute↗
PubMed1991

Emergency room patients with abdominal pain unrelated to trauma: prospective analysis in a surgical university hospital.

During an 8-month-period, 241 patients suffering from abdominal pain unrelated to trauma (mean age 48 years) attended the emergency room of the Department of Surgery of the University Hospital, Zürich. Forty-three percent presented during working hours, while 57% were admitted during the night or at the weekend. Clinical examination, abdominal roentgenograms (upright and supine) and sonography were the most commonly used diagnostic tools. Forty percent suffered from abdominal pain of unknown origin. The most common diagnosis on admission was appendicitis, but only half of these cases proved to be appendicitis. In 36% the diagnosis on admission corresponded both to the initial diagnosis made by a member of staff during his first visit, and to the final diagnosis. The initial diagnosis agreed with the final diagnosis in 57%. In 10% of the patients the cause of pain was not elucidated despite extensive diagnostic procedures. High technology and sophisticated diagnostic evaluation are less important than the clinical evaluation. The decision between operative and nonoperative treatment was based mainly on clinical findings.

Abdominal Pain↗
PubMed1989

[Transplantation of kidneys from children].

During an 11-year period from 1978 to 1988, 720 cadaver kidneys were transplanted at the University Hospital of Zurich. 103 of the kidney grafts were from donors 16 years old or younger. The mean age of these donors was 11 years (range 2 1/3 to 16 years). There were 3 donors under 5 years, where we preserved and transplanted both kidneys en bloc. Only 3 recipients were less than 16 years old. After 1 year, 67 out of 103 recipients had a functioning pediatric graft. In the cyclosporine-treated group, the 1-year graft survival was even 80%, similar to kidney transplants from adult donors. Graft loss was observed in 48 cases. 33 patients rejected the transplant and 10 grafts were lost after recurrence of the primary renal disease. Only 5 grafts had a vascular complication. We conclude that kidneys from pediatric donors can successfully be transplanted into adults.

Adolescent↗
PubMed1982

Sensitivity of the parietal cell to pentagastrin in health and duodenal ulcer disease: a reappraisal.

In view of the conflicting results on whether pentagastrin sensitivity is genuinely increased in duodenal ulcer (DU) patients, the pentagastrin-gastric acid relationship was restudied in 17 normal subjects and 15 DU patients. In a reproducibility study performed on nine healthy subjects the mean pentagastrin responses obtained on 2 different study days, using a step technique (range, 0.025-6.4 micrograms kg-1h-1), were congruent at each of the five measuring points. Analysis of variance revealed no significant overall differences. However, ED50 values showed a large within- and between-subject variation and failed to correlate significantly, this because a plateau response was not regularly obtained with the top dose. Consequently, ED50 values in normal subjects and DU patients showed a large scatter and were not significantly different, although the potency ratio calculated from the linear parts of the respective dose-response curves was significantly different (2.6; 95% confidence limits, 1.8-3.9). This study thus supplies further evidence that the parietal cell of DU patients has a higher sensitivity to pentagastrin and demonstrates that the reliability of individual ED50 estimations obtained in pentagastrin dose-response studied should not be overrated.

Adult↗