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Biomedical subjects

E Moritz

Publications and source records attributed to E Moritz.

At least 37 records · Page 2Linked to original sources
PubMed1988

Results and prognostic factors after resection of pulmonary metastases.

One hundred and fifty-nine thoracotomies were performed in 122 patients with pulmonary metastases. The patients' ages ranged from 2 to 76 years, and 13 patients were younger than 18 years. The primary tumour was carcinoma in 83 cases, sarcoma in 29 cases and melanoma in 10 cases. The primary tumour in children was osteogenic sarcoma (6 patients), Ewing's sarcoma (2 patients) and Wilms' tumour (2 patients). With a minimum follow-up of 2 years, an actuarial 5-year survival rate of 38% was observed for carcinoma and 28% for sarcoma. Four of the children survived disease-free for 3 years or more after pulmonary metastasectomy. The primary tumour in these cases was osteogenic sarcoma and Ewing's sarcoma. A statistically significant difference in survival was found between the groups of carcinoma and sarcoma, but the prognosis for melanoma patients was markedly worse. In carcinoma patients the main prognostic factor was the duration of the disease-free interval. The actuarial postthoracotomy survival in patients with osteogenic sarcomas was 31% at 5 years, and 18% at 5 years in soft-tissue sarcomas. The size of the lesions, activity and disease-free interval correlated with survival in the osteogenic sarcoma group, and the number of lesions in the soft-tissue sarcoma group. An aggressive surgical approach towards pulmonary metastatic disease thus appears to be justified.

Adolescent↗
PubMed1987

Circumferential tracheal replacement with costal cartilage.

Long-term incorporation of foreign material or tissue in circumferential tracheal replacement will lead to progressive growth of granulation tissue, provoking either airway stenosis or a reduction of subepithelial blood supply and thereby preventing the appearance of functioning ciliated epithelium in the replaced segment. In experience with dogs, a 5 cm length of the thoracic trachea was replaced circumferentially with fresh autogenous untreated circularly positioned cartilage-perichrondrium strips. During the period of strengthening of this neotracheal wall, a temporary tracheal prosthesis made of tubular silicone rubber with absorbable sewing rings of polyglactin 910 placed 3 mm from the end of the tube served as a tracheal replacement. Six months after the cartilage transplantation, the neotracheal wall had stabilized sufficiently for the silicone rubber tube to be extracted with an endoscope. Four weeks after extraction of the silicone rubber tube the neotracheal segment was completely covered with ciliated epithelium over a thin subepithelial, well-vascularized layer. Subepithelial vessels had a diameter of 180 microm. They were a continuation of the intercartilaginous main vessels of the neotracheal wall. The presence of normal cilia on the epithelium was proved through transmission electron microscopy. Even the tubules of the cilia were arranged in the right order. In the ink test, movement of the transport marker across the neotracheal segment at a speed of 18 to 21 mm/min was proof of mucociliary clearance. In a process of migration starting from the margin of the trachea, the ciliated epithelium pervaded and replaced the preexisting temporary one-layer stratified squamous epithelium. This completely new technique of circumferential tracheal replacement with autogenous cartilage, avoiding permanent incorporation of foreign material, succeeds within the observation period of up to 7 months.

Animals↗
PubMed1985

[Mediastinal CT-staging of bronchial carcinomas].

Forty-three patients with proven bronchogenic carcinoma were evaluated with computed tomography (CT) to search for mediastinal and broncho-pulmonary nodal metastases. Definitive staging was achieved by thoracotomy (34 patients) and mediastinoscopy or transbronchial nodal sampling (9 patients). Three parameters of lymph node appearance on CT were studied to improve the sensitivity and specificity of CT in detecting malignancy in bronchogenic carcinoma: 1) node size, 2) node location and 3) border regularity and definition. 762 clearly defined nodes were studied by CT - 391 metastatic and 371 non metastatic. The most useful CT parameters were node size over 10 mm, and node location, which results in a sensitivity of 80% and a specificity of 88%. A combination of all 3 CT parameters increased sensitivity to 82% and specificity to 90%. These results show clearly, that size is not the only relevant CT-parameter in successful preoperative identification of mediastinal nodal metastases.

Aged↗
PubMed1984

Intraoperative application of high-frequency ventilation.

High-frequency pulsation (HFP), a modified high-frequency jet ventilation (HFJV) technique, was applied intraoperatively as an alternative to conventional inter mittent positive-pressure ventilation in 16 patients undergoing major thoracic operations. Gas exchange and hemodynamic stability were maintained at a frequency of 300 cycle/min. Surgical maneuvers were easier because the lungs were almost completely immobilized.

Adult↗
PubMed1982

[Small cell carcinoma of the lung (author's transl)].

Of the various types of bronchogenic carcinoma small cell carcinoma has the poorest prognosis. It is the most malignant of the histological subtypes of lung cancer owing to its rapid growth and early, widespread metastases. Small cell carcinomas are radiosensitive and respond to cytotoxic therapy. In the Second Surgical Department of the Vienna University Hospital, 70 "early-stage" small cell carcinomas were resected between 1955 and 1974. 27.5% of the patients with stage I and II carcinomas survived for more than 5 years without symptoms. "Curative" surgery is selected cases leads to prolonged survival in patients with localized lesions.

Biopsy↗
PubMed1982

[Automatic suturing devices in lung surgery (author's transl)].

Automatic stapling devices can be used for suturing the bronchus, pulmonary parenchyma and pulmonary vessels in lung resections. In particular, TA staplers have proved of great value in suturing the bronchial stump, helping to prevent the feared complication of stump insufficiency. No bronchopleural fistulae were recorded in a series of 220 lung resections.

Bronchial Fistula↗
PubMed1982

[Intraoperative application of forced diffusion-ventilation (FDV)].

Forced diffusion ventilation (FDV), a modified high frequency jet ventilation (HFJV), was applied intraoperatively (mean duration: 126 min) in 14 patients (7 thoracic, 7 major abdominal surgery patients). Sufficient gas exchange could be achieved with extremely low tidal volumes (10-30 ml) at frequencies up to 1500/min. This resulted in an almost complete immobilization of the lungs allowing an excellent surgical exposure.

Abdomen↗
PubMed1982

[Intralobar pulmonary sequestration].

14 cases of intralobar sequestration of the lung are reviewed. There are 3 different patterns of clinical and radiological symptoms. Angiography is of great value in establishing the diagnosis and defining the anatomic details of the anomalous blood supply, allowing careful planning of the surgical procedure, which was a lower lobectomy in 12 cases. Segmental resections were feasible in 2 cases. No significant complications were observed.

Adolescent↗