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Biomedical subjects

A Türler

Publications and source records attributed to A Türler.

At least 19 recordsLinked to original sources
PubMed2006

[Helical computed tomography in penetrating injury to the torso. Diagnostic value in emergent use].

BACKGROUND: Nontherapeutic laparotomy and thoracotomy rates in penetrating torso trauma remain high. The aim of this study was to define the value of helical computed tomography (CT) in this emergency situation. MATERIAL AND METHODS: Retrospectively, we studied 11 hemodynamically stable patients with penetrating injury to the torso admitted to our trauma center over a 3-year period who underwent intravenous contrasted helical CT immediately after admission. A positive CT scan was defined as showing any evidence of intrathoracal or intra-abdominal injury necessitating immediate operation. Patients with positive CT underwent laparotomy and/or thoracotomy. Patients with negative CT were observed. RESULTS: Eleven consecutive patients were studied: nine male, two female; mean age 39 years (range 19-62). Nine stab wounds and two shotgun wounds were seen. Seven patients had positive helical CT findings, and four patients were negative. All patients with positive CT findings were operated on; those with negative scans recovered uneventfully. This imaging method accurately predicted whether thoracotomy or laparotomy was needed in 10/11 cases. CONCLUSION: In penetrating torso trauma, helical CT can clarify the need for thoracotomy or laparotomy vs nonoperative treatment.

Abdominal Injuries↗
PubMed2002

Chemical investigation of hassium (element 108).

The periodic table provides a classification of the chemical properties of the elements. But for the heaviest elements, the transactinides, this role of the periodic table reaches its limits because increasingly strong relativistic effects on the valence electron shells can induce deviations from known trends in chemical properties. In the case of the first two transactinides, elements 104 and 105, relativistic effects do indeed influence their chemical properties, whereas elements 106 and 107 both behave as expected from their position within the periodic table. Here we report the chemical separation and characterization of only seven detected atoms of element 108 (hassium, Hs), which were generated as isotopes (269)Hs (refs 8, 9) and (270)Hs (ref. 10) in the fusion reaction between (26)Mg and (248)Cm. The hassium atoms are immediately oxidized to a highly volatile oxide, presumably HsO(4), for which we determine an enthalpy of adsorption on our detector surface that is comparable to the adsorption enthalpy determined under identical conditions for the osmium oxide OsO(4). These results provide evidence that the chemical properties of hassium and its lighter homologue osmium are similar, thus confirming that hassium exhibits properties as expected from its position in group 8 of the periodic table.

Journal Article↗
PubMed2001

Prostanoid production via COX-2 as a causative mechanism of rodent postoperative ileus.

BACKGROUND & AIMS: This study demonstrates a significant role for cyclooxygenase (COX)-2 and prostanoid production as mechanisms for surgically induced postoperative ileus. METHODS: Rats, COX-2+/+, and COX-2-/- mice underwent simple intestinal manipulation. Reverse-transcription polymerase chain reaction and immunohistochemistry were used to detect and localize COX-2 expression. Prostaglandin levels were measured from serum, peritoneal lavage fluid, and muscularis culture media. Jejunal circular muscle contractions were measured in an organ bath, and gastrointestinal transit was measured in vivo. RESULTS: The data show that intestinal manipulation induces COX-2 messenger RNA and protein within resident muscularis macrophages, a discrete subpopulation of myenteric neurons and recruited monocytes. The manipulation-induced increase in COX-2 expression resulted in significantly elevated prostaglandin levels within the circulation and peritoneal cavity. The source of these prostanoids could be directly attributed to their release from the inflamed muscularis externa. As a consequence of the molecular up-regulation of COX-2, we observed a decrease in in vitro jejunal circular muscle contractility and gastrointestinal transit, both of which could be alleviated pharmacologically with selective COX-2 inhibition. These studies were corroborated with the use of COX-2-/- mice. CONCLUSIONS: Prostaglandins, through the induction of COX-2, are major participants in rodent postoperative ileus induced by intestinal manipulation.

Animals↗
PubMed2001

[Local therapy of liver metastases of colorectal carcinomas. Laser therapy vs. direct current treatment in the rat model].

PURPOSE: Evaluation of the efficacy of direct current and laser therapy in the treatment of colorectal liver metastases in a rat model. MATERIALS AND METHODS: Liver metastases in 49 rats were induced by subcapsular injection of cells of a colorectal tumor cell line. 3 weeks after inoculation 41 tumors were treated by laser and 56 tumors by direct current therapy. 17 tumors served as a control in the direct current group, 12 in the laser therapy group. The inoculation rate and the tumor size 3 and 5 weeks after therapy were determined by MRI. RESULTS: The MR-tomographically determined inoculation rate was 133 tumors after 151 tumor cell injections (88%). Three and five weeks after laser therapy, tumor growth rates of 15% and 18% were documented (maximum tumor diameter). This represented a significant reduction in growth (p < or = 0.01 and p < or = 0.001) compared to the control group (growth rate 230% and 280%). In the direct current therapy group, growth rates were 40% after 3 and 60% after 5 weeks. Compared to the control group (210% and 290%), this also represented a significant reduction (p < or = 0.001). CONCLUSIONS: This animal study is the first to demonstrate an antitumor effect of direct-current therapy on liver metastases of colorectal cancer in rats. Nevertheless, the laser therapy proved to be more effective.

Animals↗
PubMed2000

[Surgical gowns and patient drapes in routine practice: discrepancy between requirements and reality]].

BACKGROUND: Since the law regulating medical devices was introduced, hospital staff can only use surgical textiles that can guarantee 100% protection against infection. Conventional cotton products have shown themselves to be unsuitable, and must be replaced with barrier textiles. However, the changeover to innovative barrier textiles has turned out to be more difficult than expected. There is uncertainty among the qualified staff regarding the choice of material because of a lack of legal standardization. The objective of our study was to uncover the existing discrepancies between clinical practice and the legal requirements. METHODS: Based on a literature review we examined the suitability of the available surgical textiles with regard to the requirements. We then analyzed the situation based on standardized questionnaires, which were sent out to basic care and maximum care hospitals. RESULTS: According to the currently published data, barrier textiles best fulfill the requirement criteria. In contrast, the hospital staff questioned in our situation analysis noticeably preferred cotton textiles for the surgical gowns. The most common reason given was comfort. The laminates were considered most suitable as coverage material. Forty-four percent of those responding to the survey proved to have large gaps in their knowledge of the law regulating medical devices. Furthermore, only 41% of the hospital personnel were aware of the plan to standardize the requirement criteria. CONCLUSION: We were able to confirm that there is considerable discrepancy between the requirements and practice. The reasons for this are ignorance and lack of enforcement of the existing requirements. In this respect we stress that a quick introduction of the planned European standards is urgently necessary.

Cross Infection↗
PubMed1999

First Measurement of a Thermochemical Property of a Seaborgium Compound.

With only a few atoms of seaborgium (Sg, element 106), in the form of volatile SgO(2)Cl(2), it was possible to determine the sublimation enthalpy of this compound using gas chromatography. Furthermore, it was demonstrated that in Group 6 Sg is chemically more similar to W than to Mo.

Journal Article↗
PubMed1998

[Treatment strategies in malignant pleural effusion of breast carcinoma].

Symptoms are dyspnea, pain and reduced common feeling. Aine of the study was, to compare our results of talc pleurodesis with the literature. In a prospective trial we performed talc pleurodesis via a chest tube in 41 patients. All patients had radiologically proven pleural effusions. No additional therapy was permitted 30 days before or after entry into the study. Response was assessed monthly. Seven patients dies because of tumor progress. We examined 34 patients. Treatment was successful in 31 patients adverse effects we saw only a few times. Application of iodized talc for therapy of malignant pleural effusions is effective and cheep. We did not see major adverse effects or complications.

Adult↗
PubMed1998

[Pilot study of effectiveness of electrotherapy in the experimental liver metastasis model].

The aim of the present was to assess the effectiveness of low level direct current therapy in liver metastases and the influence of polarity (anode or cathode in the center of the tumor) or current dose (60 or 80 C/cm3). Colorectal metastases were established in 25 BD IX rats by injection of DHD/K12 colon cancer cells under the liver capsule. After 3 weeks the tumors were treated by low level direct current therapy (applied with five platinum electrodes). Histological examination of the removed livers on postoperative day 7 revealed significant destruction of the metastases with localized necroses. The best treatment results were obtained in the group with an anode in the center and a current dose of 80 C/cm3. We conclude that low level direct current therapy may offer an alternative minimal invasive method in the treatment of liver metastases.

Animals↗
PubMed1997

[Problems in diagnosis and therapy of malignant pleural mesothelioma].

The incidence of malignant pleural mesothelioma increased continuously during recent years. This is related to widespread use and processing of asbestos in the last decades. Characteristical symptoms like dyspnea, cough and thoracic pain are common in almost all pulmonal diseases. Therefore the possible occurrence of a pleural tumor is often neglected. This leads to a delay between onset of symptoms and the establishment of diagnosis. With X-ray and computed tomography 80% of the pleural tumors can be proved. Only in few cases the histopathological analysis of the pleural fluid leads to diagnosis. However, thoracoscopy or thoracotomy remain the most reliable means of obtaining a definitive tissue diagnosis. At the time of operation advanced stages are found in many cases, therefore palliative surgery is indicated. Due to high morbidity and mortality pleuropneumonectomy should be done only in selected patients. Pleurectomy or pleurodesis is often sufficient to release patients' symptoms. Chemotherapy and radiation have not proven effective in controlling malignant mesothelioma. In conclusion pleural mesothelioma remains a tumor with a very poor prognosis. Long term survival is occasional even in case of multimodal treatment.

Adult↗
PubMed1997

Palliative iodized talc pleurodesis with instillation via tube thoracostomy.

Pleural effusions are a severe complication of advanced malignant disease. Palliative treatment strategies should be simple and effective. We investigated iodized talc pleurodesis through tube thoracostomy for this purpose. A total of 43 patients received a suspension of 5 g talc with 3 g thymol iodine via chest tube. The procedure was well tolerated without major complications in all cases. Unfortunately, 4 patients died of disease within the 1st month after treatment, so that only 39 patients were evaluable for treatment outcome. Follow-up ranged from 1 to 14 months. The success rate after 3 months was 92.5%. In conclusion, iodized talc pleurodesis is an excellent tool in the palliative management of malignant pleural effusions. Administration via chest tube is sufficient for treatment success.

Adult↗
PubMed1997

Role of transanal endoscopic microsurgery in the palliative treatment of rectal cancer.

BACKGROUND: Palliative, minimal invasive treatment of rectal cancer is advocated in patients with advanced and incurable disease or poor clinical condition and in those who refuse radical surgery. Several methods have been used during recent years. We report our experience with palliative transanal endoscopic microsurgery. MATERIALS: Between 1983 and 1995, 29 patients underwent transanal endoscopic microsurgery for palliation. Eleven patients had advanced malignant disease, nine were in poor clinical condition, and nine repeatedly refused radical surgery. RESULTS: Intraoperatively one severe complication, an intra-abdominal perforation, occurred. The morbidity rate was 14%. Postoperatively, clinical signs were abolished or improved in all cases. Only three patients required further palliative resections after initial symptom relief. CONCLUSIONS: Transanal endoscopic microsurgery is a successful approach in the palliative treatment of rectal cancer. The technique enables complete resection of rectal tumors. Although anesthesia is needed, the morbidity is low, even in patients with poor clinical condition.

Abdominal Pain↗
PubMed1996

[Functional relevance of the type I arteria proatlantica in carotid disobliteration].

Primitive embryonic anastomotic vessels between the carotid and vertebrobasilar arterial systems occasionally persist into adult live. Coincidence with cerebrovascular disease may be of functional relevance. We report a case of segmental internal carotid occlusion and aplasia of both vertebral arteries in combination with persistence of proatlantal artery type I. Recurrent cerebral ischemia required revascularization of the segmental occluded internal carotid artery. Disobliteration was successfully performed with an uneventful postoperative course. The patient recovered well from his neurological deficits. Clinically, the combination of persistent proatlantal artery with occlusive disease of the carotid arteries may lead to atypical neurological deficits. In cerebrovascular surgery, a persisting proatlantal artery, as a main supply vessel of the vertebrobasilar system, is of great importance if the carotid artery is clamped.

Adult↗
PubMed1996

[Current treatment strategy in malignant pleural effusion].

Malignant pleural effusions are a grave consequence of advanced cancer disease. The successful suppression of pleural fluid reaccumulation can make a major contribution to the management and palliative care of patients with disseminated cancer. Many treatment concepts have been reported in the literature. The recommended therapy in malignant pleural effusions consists of intrapleural instillation of a sclerotic agent to produce pleurodesis. Different substances have been used, including tetracyclines, cytostatic agents, fibrin, talc, Corynebacterium parvum, cytokines and others. We reviewed the most frequently used techniques of pleurodesis in order to define the most effective treatment concept. In 15 prospective randomized trials the success rates varied from 13% with bleomycin to 100% with talc or Corynebacterium parvum. Talc was superior to other agents in 6 of 6, Corynebacterium parvum in 3 of 4 and bleomycin or tetracycline only in 3 of 8 studies. Adverse effects were frequently observed with cytostatic agents, but were very rare in the case of talc or fibrin instillation. Comparing the recently published data pleurodesis with talc appears to be the most effective treatment strategy, followed by Corynebacterium parvum, bleomycin and tetracycline.

Antibiotics, Antineoplastic↗
PubMed1996

[Talc pleurodesis in recurrent malignant pleural effusion--a prospective follow-up study].

Talc pleurodesis was performed in a prospective trial in 38 patients with recurrent malignant pleural effusion. After insertion of a chest tube a slurry containing 8g of iodined talcum, 0.5 ml of 1% xylocain/kg/body weight, and 80 ml of 0.9% NaCl was administered and suction drainage was performed. The chest tube could be removed after 4 +/- 1.7 days. A successful therapy could be achieved in 33/38 patients (86.8%). 2 patients (5.3%) suffered from recurrent pleural effusion which only in 1 case had to be drained. 3 patients died within the first month after talc pleurodesis due to an advanced cancer stage. Complications did not come to evidence in any case.

Adult↗
PubMed1996

[Therapy of renovascular hypertension in neurofibromatosis: surgical revascularization versus percutaneous transluminal angioplasty].

Vasculopathy is a rare and undervalued complication in neurofibromatosis. Histopathological changes of the vascular wall may lead to relevant renal artery stenosis. We report a case of a 17-year-old patient with neurofibromatosis and severe renovascular hypertension resulting from a proximal renal artery stenosis. Attempted percutaneous renal angioplasty was unsuccessful and the patient was referred for operative revascularization. After insertion of an aortorenal bypass with a reversed saphenous vein graft the patient became normotensive without medication. Based on our own experience and a review of the literature we recommend operative reconstruction of stenotic renal arteries in neurofibromatosis.

Adolescent↗
PubMed1995

[Special problems of benign stomach tumors].

Comparing with malignant lesions or peptic ulcers benign gastric tumors are rare. From 916 patients with gastric diseases, who underwent laparatomy between 1980 and 1993 in the Surgical Department at the University of Cologne, we found only 15 cases (1.6%) of benign gastric tumors. The most common benign tumor of the stomach are leiomyomas followed by adenomas. The majority of benign tumors are asymptomatic. Complaints as hemorrhage or pain are seen of large tumors. Gastroscopy is the most important examination in the diagnosis of benign gastric tumors. Endoscopic polypectomy should be carried out in those lesions still benign. Greater lesions or endoscopically incomplete excised polyps should be treated surgically. Mesenchymal tumors are difficult to estimate in their dignity. The treatment of choice is local surgical extirpation. The postoperative results are excellent.

Adenoma↗