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Biomedical subjects

F Aigner

Publications and source records attributed to F Aigner.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of postoperative respiratory function after laparoscopy or open laparotomy for cholecystectomy.

Cholecystectomy performed via laparotomy is associated with reduction of lung volumes including functional residual capacity that may lead to postoperative hypoxia and atelectasis. Laparoscopic cholecystectomy is associated with faster recovery compared to open laparotomy and cholecystectomy. To determine whether laparoscopic cholecystectomy was associated with less pulmonary dysfunction, 20 patients (ASA Physical Status I) undergoing elective cholecystectomy were randomly assigned to surgical teams performing either laparoscopy or open laparotomy for cholecystectomy. Patients in whom one or the other surgical technique had to be performed for medical or psychologic indications were excluded from the study. A standardized anesthetic technique and postoperative analgesic regimen were used. Forced vital capacity and forced expiratory volume in 1 s; functional residual capacity determined by a closed-circuit, constant volume helium dilution technique; and arterial O2 and CO2 tensions were measured preoperatively and at 6, 24, and 72 h postcholecystectomy. Forced vital capacity and forced expiratory volume in 1 s were significantly greater (P less than 0.05) in the laparoscopy compared to the laparotomy group at 6, 24, and 72 h postoperatively. Forced vital capacity relative to preoperative values was significantly (P less than 0.05) greater in patients with laparoscopy (24 h, 70 +/- 14%; 72 h, 91 +/- 6%) compared to open laparotomy (24 h, 57 +/- 23%; 72 h, 77 +/- 14%). Similarly, forced expiratory volumes in 1 s relative to preoperative values were significantly (P less than 0.05) greater in patients with laparoscopy (24 h, 85 +/- 13%; 72 h, 92 +/- 9%) compared to open laparotomy (24 h, 54 +/- 22%; 72 h, 77 +/- 11%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Intestinal angiodysplasia as a cause of severe intestinal hemorrhage--report of 4 cases].

Angiodysplasia of the small intestine alone cannot be differentiated histologically from hereditary hemorrhagic telangiectasia (Morbus Rendu-Osler-Weber). Isolated localisation in the small intestine is rare and requires surgery in the event of massive bleeding. Four cases of bleeding from angiodysplasias of the small intestine in patients having undergone surgery at our institution over a ten-year period are presented. In three patients the particular intestine was resected. Two of these patients had an uneventful follow-up of even and ten years, one patient relapsed and was rehospitalized for surgical treatment. The fourth patient, who showed angiodysplasias scattered over the entire small intestine, had no further bleeding over a three-year period after transmural ligations of the lesions found by intraoperative endoscopical diaphany.

Adult↗
PubMed1990

[Clinical experiences with 50 pancreas transplantations].

Between 1979 and December 1987 a total of 50 pancreas transplants were performed, 41 of them together with a kidney from the same donor. End-stage diabetic nephropathy was the indication for the combined procedure, and progressive pre-proliferative retinopathy for a single pancreas transplant. A segment consisting of body, tail but also major parts of the head of the gland was used. Technique-related complications or prolonged hospitalization prompted three changes in surgical technique. In the first five patients the pancreatic duct was occluded at the time of transplantation and in the subsequent eleven cases the graft was anastomosed to a Roux-Y-loop of jejunum. In a series of 17 patients thereafter the pancreatic duct was occluded after stabilization of graft function, and in the most recent 17 patients the pancreatic juice was drained into the urinary bladder. Prophylactic immunosuppression consisted of steroids and azathioprine for the first two patients. From 1981 to 1986 cyclosporin and prednisolone were given and from then on azathioprine was added as a third drug. Patient survival at one year was 25% in the first group, 80% in group II, 97% in group III and 88% in group IV. Cardiovascular and septic complications were the main causes of death. None of the group I transplants functioned at one year. Graft survival rates at one year for the pancreas and the kidney in groups II, III and IV were calculated at 30%, 70%, 58.8% and 77%, 86%, 72% respectively. In 16% of the long-term survivors significant amelioration and in another 50% stabilization of diabetic retinopathy occurred.

Adult↗
PubMed1989

[Endoscopic sclerotherapy of bleeding Mallory-Weiss mucosal tear].

Based on a review of 66 patients with the Mallory-Weiss syndrome, the problems of diagnosis and treatment in general, and the application of sclerotherapy in particular in patients with bleeding tears is discussed. At emergency endoscopy 32 patients (48.4%) had an acute bleeding episode which could be stopped by sclerotherapy in 26 of 27 cases. The importance of control endoscopy after 48 hours and its influence on prognosis are emphasized.

Adolescent↗
PubMed1989

[Peptic ulcer with a visible non-bleeding vascular wall--early elective surgery or endoscopic therapy?].

The records of 71 patients with the endoscopic finding of a peptic ulcer with a non-bleeding visible vessel, treated between 1982 and 1987 were retrospectively analysed. 16 patients underwent early surgical treatment (group I), 15 patients were treated conservatively (group II) and 40 patients by endoscopic haemostasis (group III). Recurrent bleeding was observed in 6.25% patients in group I, in 53.3% in group II and in 25% in group III, in which case endoscopy was performed again. The patients with arterial bleeding underwent early elective operation after endoscopic haemostasis. Deaths occurred only in the postoperative period: group I 6.25%, group II 13%, and group III 5%. These findings indicate that primary endoscopic treatment in selected patients leads to results equal to those achieved with early surgery. Conservative therapy cannot, however, be recommended.

Adult↗
PubMed1989

[Endoscopic percutaneous placement of a guide thread for bouginage treatment of the esophagus following 3d degree chemical burn: a new method without laparotomy].

For successful treatment of third degree caustic burns of the esophagus, early bouginage and cortisone medication are mandatory. We use Rehbein bougies under guidance of a orogastric thread. To place this, laparotomy had been required so far. A new procedure for endoscopic gastrostomy is described to avoid the laparotomy. This method was performed in 7 children and one adult. There were no complications. The introduced procedure is recommended as a simple and safe technique, using endoscopy for thread placement as well as for diagnostic evaluation.

Burns, Chemical↗
PubMed1989

Indirect immunofluorescence test and enzyme-linked immunosorbent assay for detection of Campylobacter pylori.

An indirect immunofluorescence test (IIF) has been developed for detecting Campylobacter pylori in gastroduodenal biopsies. This test was compared with standard methods of C. pylori diagnosis, namely Gram staining and urease test, in a study population of 226 patients; 121 of the biopsy specimens were cultured for C. pylori as well. C. pylori colonization was detected in 154 of 226 patients (68%) by at least one of these methods (IIF, 96%; Gram staining, 78%; urease test, 60%; cultivation, 55%). Serum samples from 191 patients of the study population were screened for circulating antibodies to C. pylori by an indirect enzyme-linked immunosorbent assay with whole, untreated bacteria as antigen. Of these serum specimens, 140 (73%) revealed absorbance readings above the limit of positivity, which was determined as an optical density of greater than 0.35 at 405/620 nm. Of 132 serum specimens, 128 (97%) from patients with C. pylori detected in biopsies, but only 12 (20%) of 59 specimens from those without C. pylori detection showed elevated specific antibody levels. Our data revealed that IIF proved to be the superior rapid, sensitive, and specific diagnostic method. The correlation between microbiological findings and the immune response favors our enzyme-linked immunosorbent assay as an additional tool in C. pylori diagnosis.

Adolescent↗
PubMed1988

[Our therapy concept in nonresectable liver metastases].

Cytotoxic chemotherapy was performed in a total of 18 patients (12 men, 6 women): 5 patients with colonic carcinoma and 1 patient with unknown primary lesion received 5 x 1000 mg 5-Fluorouracil (5-FU) at 4 week interval. The 5 following patients primarily suffering from colonic carcinoma were treated with 0.5 mg/kg BW FUDR continuously at 2 week interval. 5 further patients with colonic carcinoma sequential received Mitomycin C (8 mg/m2) and 4 x 1000 mg 5-FU. 2 patients with breast cancer were treated with 500 mg/m2 Cyclophosphamide, the same amount of 5-FU and 40 mg/m2 Methotrexate every 4 weeks. Chemotherapy was well tolerated by all patients. A clinically significant response, however, was seen in only 2 patients with breast cancer. In 8 patients a liver transplantat was performed, which was followed in 3 cases by ultra-high dose Cyclosphosphamide, lethal total body irradiation and autologous bone marrow transplantation. 1 further patient received polychemotherapy. At the time of this analysis only 3 patients were still alive at 61, 30 and 26 months with only 1 perioperative death. All 3 had meanwhile developed recurrent or metastatic disease. Because of these sobering results, liver transplantation for the treatment of non-resectable liver metastases has been abandoned, and regional chemotherapy is now only applied in patients with liver metastases from breast cancer and after resection of metastases in an adjuvant setting.

Adult↗
PubMed1988

[Experiences with kidney transplantation in elderly patients].

Despite a significant increase in the number of elderly patients with end stage renal disease, these patients still represent a minority of renal transplant recipients in many countries. Roughly the recipients in the present study were older than 50 years of age. Infection was a more common complication in these patients than in the younger patients. However, the incidence of cerebrovascular and cardiovascular complications was found to be lower than expected. Patient-graft survival in 110 renal transplants in 106 patients aged 50 years or older were 87% and 76% respectively. These results suggest that cadaveric renal transplantation represents a relatively safe form of therapy also for older patients.

Aged↗
PubMed1986

[Treatment of gastroduodenal ulcers in children].

Gastroduodenal ulcers are probably no rarity in children. Clinically relevant are only those showing complications: either bleeding or perforation. They should be taken into consideration in the differential diagnosis of vague or chronic abdominal pain. Endoscopy is a reliable way of examination. Treatment should be conservative, leaving surgical therapy only for unmitigable bleeding, perforation and failing conservative management. The treatment of 34 children (in an age between one day and 14 years) is discussed. 26-17 of whom had bleeding ulcers--were treated conservatively, 8 had to be operated upon. 5 children suffered from a relapse (2 with bleeding), but conservative therapy led to the lesion's healing in these cases.

Adolescent↗
PubMed1986

[Results of studies in 165 patients following selective proximal vagotomy].

Selective proximal vagotomy was performed on 165 patients at the I. Surgical Clinic of Innsbruck University, between 1970 and 1984. Results of 90 patients were retrospectively evaluated. Lethality was 0.6 per cent, while the rate of recurrence amounted to 14.4 per cent and average acid reduction to 50 per cent. 65 per cent of the above 90 patients were almost without any postoperative complaint, when rated by the I. and II. degree according to Visick. Results were particularly favourable in cases of perforated ulcer, combined ulcer (Type II according to Johnson), hyperacid gastroduodenitis, and in cases of duodenal ulcer of women.

Adolescent↗
PubMed1984

[Initial clinical experiences with allotransplantation of the pancreas].

Since 1979 7 pancreas transplantations have been performed in 8 type I diabetics. 5 of these 7 recipients had already been dialysed; 2 were awaiting their first dialysis. Furthermore, diabetes had caused severe retinopathy in 5 patients. The pancreas was transplanted simultaneously with a kidney from the same donor in 5 recipients; in 3 cases the pancreas was grafted 16 to 230 days after successful renal transplantation. 1 pancreas graft was removed immediately after revascularisation because of ischaemic damage. While the pancreatic duct was occluded in the first 4 patients, enteric diversion of the pancreatic juice was applied in the next 3 recipients. The first two patients were treated with conventional immunosuppression, whilst all the others received cyclosporin A and low-dose steroids. Small amounts of insulin had to be given initially for a few days in 2 cases, only. 2 grafts were lost due to surgical complications and 3 for immunological reasons. 1 functioning graft had to be removed because the patient was not willing to continue immunosuppression after irreversible rejection of her renal transplant. There was no perioperative death. 2 pancreatic and 5 renal grafts are functioning well at the present time. Technical aspects and problems in the diagnosis of rejection are discussed.

Adult↗