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Biomedical subjects

F Eckersberger

Publications and source records attributed to F Eckersberger.

At least 19 recordsLinked to original sources
PubMed1992

[Video-endoscopic interventions in thoracic surgery].

Between October and December 1991 we performed videoendoscopic procedures, including resection of lung tissue, on 9 patients in our thoracic surgery unit. A lung measuring 15 x 18 was extirpated in 1 patient and parietal pleurectomy was performed after complicated pneumothorax in 4 patients. In one of these cases it was necessary to close a parenchymal leak and in 3 cases bullae had to be removed. Resection was undertaken in 4 patients for peripheral lung nodules, in one of them for metastases. Two patients proceeded to conventional lobectomy immediately after the frozen section results came through. Closure of lung parenchyma was carried out by means of the new ENDO-GIA stapler. Duration of the procedure was less than one hour except in the case of one patient. In one case it was necessary to use three cannulae. In the other cases two cannulae (one for videoendoscopy and fixating instrument, one for preparation instrument and stapler) sufficed for the operation to be undertaken without difficulty. This new technique brings all the known advantages of minimal invasive intervention to patients requiring thoracic surgery.

Adult↗
PubMed1991

Contrast-enhanced MRI for the staging of bronchogenic carcinoma: comparison with CT and histopathologic staging--preliminary results.

Nineteen patients with potentially operable bronchial carcinoma were included in a prospective study to assess the staging capabilities of plain and contrast-enhanced magnetic resonance imaging (MRI) in comparison with computed tomography (CT) and to compare the results to post-operative histopathological staging (HS). The evaluation focused on the following T-staging criteria: (i) direct invasion of the pleura; (ii) neoplastic invasion of the mediastinum; (iii) differentiation of the primary tumour from alterations of the surrounding lung parenchyma such as inflammation or atelectasis; and (iv) intrathoracic lymph node involvement by tumour. MRI and CT produced similar results for pleural invasion (sensitivity of 0.4 and 0.75 respectively and a specificity of 0.86 and 0.93 respectively). Mediastinal invasion was overdiagnosed in four patients (no false negatives), whereas CT had only one false positive result (two false negatives). Our results showed CT to be superior to MRI for the preoperative evaluation of patients suffering from bronchogenic carcinoma.

Adult↗
PubMed1991

CT and MRI in benign mediastinal haemangioma.

We report the findings of computed tomography and magnetic resonance imaging in two cases of surgically proven benign cavernous haemangiomas of the mediastinum. Both techniques produced similar results, although both were non-diagnostic for haemangioma as was percutaneous needle biopsy, which was performed in one patient.

Adolescent↗
PubMed1991

[Results of transverse tracheal resection in post-intubation tracheal stenoses].

Tracheal problems in form of stenosis and malacia are a calculated risk of long-term tracheal intubation. Results with conservative treatment of such problems by bougienage, laser therapy, biopsy, cryotherapy, local steroids, tracheal stenting, and tracheostomy are not satisfactory in a higher percentage of cases. Resectional therapy of benign tracheal lesions has become an established technique, which combines excellent functional results with a low complication incidence. We have treated 40 patients of 17 to 76 years of age with postintubation tracheal lesions by cross resection of the affected segment. Of these patients 40% had received conservative therapeutical steps preoperatively. The mean resection length was 3.0 cm (1.5 to 6.5 cm). The perioperative morbidity was 7.8%, mortality was 2.5%. 85% of the patients operated between 1970 and 1989 were reached for a follow-up examination with x-ray, pulmonary function test and endoscopy. The patients subjective satisfaction with the operative result was good in 85%, minor in 12% and less in 3%. The objective investigations proved very good results in 90%. Our experience confirm the good results of other authors and recommend the resection treatment for cases of postintubation tracheal lesions.

Adolescent↗
PubMed1991

[Resection of lung metastases. Results and prognostic factors].

249 thoracotomies for lung-metastases were performed in 202 patients at the 2nd Dept. of Surgery of the Vienna University Clinic till 1989. Age ranged from 2 to 78 years, 14 patients were younger than 18 years. The primary tumour was a carcinoma in 143 cases, a sarcoma in 45 cases and a melanoma in 14 patients. The primary tumour in the young patients was osteosarcoma in 8 cases, Ewing sarcoma in 2 cases and Wilms tumour in 2 patients. With a minimal follow up period of 2.5 years the 5-years-survival after metastasectomy was 42% for patients with carcinoma and 29% for the sarcoma patients. None of the patients with melanoma survived 5 years. A significant difference was found between the carcinoma and sarcoma groups with respect to survival rate. A prognostic factor was the disease-free interval in carcinoma patients. Actuarial post-thoracotomy survival in patients with osteogenic sarcoma was 34% at 5 years and 18% in the soft-tissue sarcoma group. Size of lesion, vitality of the metastases and the disease free interval correlated with survival in the osteogenic group, whilst the number of lesions was of importance in the soft-tissue group. On account of the lesser functional morbidity and the enablement to assess both lungs for treatment, the median sternotomy is recommended for cases with bilateral lung metastases. The results justify an aggressive surgical approach for the treatment of lung metastases.

Adolescent↗
PubMed1990

Failure to detect IL-3-binding sites on human mast cells.

IL-3, a pleiotropic lymphokine, has been termed mast cell growth factor because it promotes growth and differentiation of murine mast cells. Murine mast cells, in turn, express cell surface receptors for IL-3. Human rIL-3 has been shown to induce proliferation and differentiation of human basophils and to activate basophils via high affinity binding sites. To investigate whether human mast cells express IL-3R, binding studies with 125I-radiolabeled human rIL-3 were performed on HMC-1, a novel human mast cell line, and on pure populations (i.e., 93 to 99% purity) of human tissue mast cells obtained with mAb and C from dispersed lung (n = 2). Unexpectedly, neither enriched human lung mast cells nor HMC-1 cells bound radiolabeled human rIL-3 specifically. Moreover, human rIL-3 failed to promote uptake of [3H]thymidine, synthesis of histamine, histamine releasability, or changes in expression of mast cell differentiation Ag (YB5B8, CD54/ICAM-1, CD9/p24, CD33/gp67) on either human lung mast cells or HMC-1 cells. It is hypothesized that the fundamental difference in the biologic response to IL-3 between human and murine mast cells is due to a loss during evolution of mast cell high affinity IL-3 binding sites.

Antigens, CD↗
PubMed1990

Treatment of postpneumonectomy empyema.

Postpneumonectomy empyema with or without (bronchopleural) fistula is an infrequent but serious, and often life-threatening complication. In 20 of our patients postpneumonectomy empyema was discovered. The time interval between original operation and discovery of the empyema varied from 9 days to 9 years. In two cases, the empyema had been found and treated initially at another hospital but not adequately, so that at the time of treatment by us the bronchopleural fistula had already been present for 8 and 19 years. In 13 cases a bronchial stump fistula was discovered. In five patients the fistula was successfully closed endoscopically with glue. In one patient closure was performed by transmediastinal stump resection, in three patients with a fistula thoracoplasty was performed. In three patients we achieved closure by transposition of pedicled muscle flaps. In one of these patients a septic condition could be mastered by performing window thoracotomy. Two patients without fistula were successfully treated with irrigation, and two further patients with thoracostomy. In one patient recovery was achieved by medication after puncture. Two patients died of sepsis and after thoracoplasty. If a fistula is present, drainage with irrigation and endoscopical glueing should be the initial treatment. This should be followed by resection of the bronchial stump. If there is no fistula or if the stump is too short thoracostomy is the treatment of choice. If it is not successful thoracoplasty has to be performed.

Adhesives↗
PubMed1990

Pulmonary surfactant in bronchoalveolar lavage after canine lung transplantation: effect of L-carnitine application.

Pulmonary surfactant during lung transplantation was investigated in the control group of a canine single lung transplantation model by measuring dipalmitoyl-phosphatidylcholine, the main phosphocholine fraction of surfactant in bronchoalveolar lavage. In a second group of dogs, L-carnitine, an essential cofactor for transfer of long-chain fatty acids into the mitochondria, was applied. Organ function after pulmonary artery flushing with modified Euro-Collins solution and hypothermic storage for 4 hours was adequate in both groups, with significantly higher arterial oxygen pressure levels in the L-carnitine group after 12 (p less than 0.05) and 24 (p less than 0.025) hours, respectively. In the control group, a reduction of the dipalmitoyl-phosphotidylcholine portion on total phosphotidylcholines was observed 4 and 12 hours after transplantation of the left lung (p less than 0.005 and p less than 0.01, respectively, both specified by Student's t test for dependent data, not significant by Bonferroni correction). In the simultaneously stored right lungs, a constant fall of the dipalmitoyl-phosphotidylcholine portion was demonstrated. In the L-carnitine group, significantly higher dipalmitoyl-phosphotidylcholine levels were observed in the transplanted left lungs after 4 hours (p less than 0.01) and in the continuously stored right lungs after 24 hours (p less than 0.005), when compared with the control group. These results suggest that dipalmitoyl-phosphotidylcholine portion on total phosphotidylcholine decreases parallel to the extent of the ischemic damage. Furthermore, the application of L-carnitine improved pulmonary function after transplantation, possibly by reducing the impairing effect of ischemia on alveolar type II cell metabolism and thereby on pulmonary surfactant system.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1989

Mast cell typing: demonstration of a distinct hematopoietic cell type and evidence for immunophenotypic relationship to mononuclear phagocytes.

The immunologic surface marker profile of human mast cells (MCs) was established using a combined toluidine/immunofluorescence staining procedure [49 monoclonal antibodies (MoAbs) tested]. Ascites (n = 9) MCs as well as enzymatically dispersed MCs from all organs tested (lung n = 11, skin n = 7, intestinum n = 10) exhibited an identical marker profile. MCs were recognized by MoAbs clustered as CD9 (anti-gp24), CD33 (anti-gp67), and CD45 (anti-gp220) as well as by MoAbs directed against membrane-bound IgE. MoAB YB5B8 (anti-gp145) selectively recognized MCs. Most significantly, however, MCs were stained by MoAbs MAX1 (anti-gp65), MAX3 (anti-gp68), MAX11 (anti-gp65), and MAX24 (anti-gp65). These antibodies bind to surface membrane antigens associated with a late stage of monocyte/macrophage differentiation. Thus, our results provide definite evidence that MCs share surface membrane markers with mononuclear phagocytes. In contrast, MCs are stained neither by lymphatic markers (CD1-8, 10, 19-24) nor by myelomonocytic markers (CD11-17). MCs also lack the interleukin-2 (IL-2) receptor (CD25), the T10 antigen (CD38), and most of the myelocytic markers expressed on peripheral blood (PB) basophils. Thus, MCs displayed a unique phenotype within the hematopoietic system. This new approach enabled us to enrich human lung MCs to a purity greater than 95% by means of negative selection with complement-mediated cell lysis. Purified MCs were subsequently stained with MoAbs and analyzed by flow cytometry, which confirmed the results obtained from the double-staining experiments. We next examined cultured metachromatic cells derived from bone marrow (BM) and peripheral blood colony-forming units (CFU). These metachromatic cells previously could not be classified by morphologic criteria alone and have therefore been termed basophil-like/MC-like cells. In this study, toluidine blue-positive cells obtained from either pooled multipotential colonies (day 14-CFU-GEM) or pooled myelocytic colonies (day 16/17-CFU-GM/G/M) were recognized by MoAbs MY7 (CD13), VIM12 (CD11b), and VIM2, as well as by an anti-IgE MoAb, after preincubation with IgE. In contrast, CFU-derived metachromatic cells were not stained by MoAb YB5B8. This marker profile corresponds to the immunologic phenotype of blood basophils and excluded a detectable formation of mature MCs in colonies derived from cultured hematopoietic stem cells.

Antigens, Surface↗
PubMed1989

[Resection of pulmonary metastases: indications, surgical technic, results and prognostic factors].

One hundred and ninety six thoracotomies were performed on 152 patients with pulmonary metastases up to 1988 in the Second Surgical Department, University of Vienna. Age ranged from 2 to 78 years, 13 patients were younger than 18 years. The primary tumour was carcinoma in 103 cases, sarcoma in 38 cases and melanoma in 11 cases. The primary tumour in young patients was osteosarcoma in 7 cases, Ewing sarcoma in 2 and Wilms tumour in 2 cases. With a minimal follow-up period of 2.5 years the actuarial 5 years survival rate of 37% was observed for carcinoma, and 29% for sarcoma patients. A statistical difference was found between the carcinoma and sarcoma groups with respect to survival rate; the prognosis for patients with melanoma was markedly worse. A prognostic factor was the duration of disease-free interval in carcinoma patients. Actuarial post-thoracotomy survival in patients with osteogenic sarcoma was 32% at 5 years and only 10% in the soft-tissue sarcoma group. Size of lesions, vitality of the metastases and disease-free interval correlated with survival in the osteogenic group, whilst the number of lesions was of importance in the soft-tissue group. On account of the lesser functional morbidity and the ability to assess both lungs for exploration, palpation and resections, the importance of median sternotomy is constantly increasing for the treatment of pulmonary metastatic disease and the results justify an aggressive approach. In those cases which the primary tumour is sensitive to chemotherapy the procedure of metastatic resection must be incorporated into the general scheme of oncological therapy.

Adolescent↗
PubMed1989

Changes in activities performed in leisure time after open heart surgery.

To assess any changes made in the leisure activities performed after open heart surgery, 94 patients (48 with aortocoronary bypass operation, 46 with valve replacements) were asked exactly one year postoperatively whether activities, collected in a list of 21 items, had increased, decreased or remained equal since their operation. In spite of the fact that most leisure activities seemed to have remained unchanged, after operation patients seem to undertake activities quite contrary to their motivations for undergoing surgery in the first place: active participation (such as involvement in some kind of sport, going out to cinema, theatre, restaurants,...) decreases, whereas passive activities (such as watching sports on television, listening to music,...) increases significantly. Although 90% of the patients stated their physical, and 67% their emotional status, as being clearly improved compared to preoperative values, the experience of body limitations as well as of fear and anxiety seems to be so durable that the patients, now in good condition, become passive onlookers and cease to participate in social life.

Adolescent↗
PubMed1989

Beneficial effect of iloprost on early pulmonary function after lung preservation with modified eurocollins solution.

Prostacyclin (PGI2) has proven beneficial effects on organ preservation. Iloprost (ZK 36 374), a stable synthetic analogue with a longer half-life of 14 minutes is reported to have less hypotensive effects than PGI2 while offering increased cytoprotective and antiaggregation action. In this study its effects on lung-preservation were investigated. The heart lung block of 12 Beagle dogs was harvested after flushing of the pulmonary artery with 60 ml/kg modified Eurocollins (MEC) solution, the left lung was stored for 4 hours and then transplanted into 12 weight-matched dogs. Prior to operation the animals were randomized into two groups with MEC solution as the only preservative in group A and an additional i.v. infusion of 1 microgram/kg/min Iloprost during 15 minutes prior to flushing and 15 micrograms/kg Iloprost administered to the perfusate in group B. Arterial pO2, alveolo-arterial oxygen difference (AaDO2) and pulmonary artery pressure (PAP) of the transplanted lungs were measured 1, 4, 12, and 24 hours after transplantation during occlusion of the contralateral pulmonal artery. The application of Iloprost resulted in a significant improvement of pO2 (p = 0.047), AaDO2 (p = 0.002) and PAP (p = 0.018) after 1 hour. Results in group B at later time points were improved without reaching statistical significance. Iloprost therefore showed beneficial effects on pulmonary function early after lung preservation with MEC.

Animals↗
PubMed1989

Hemodynamic effects of mexiletine and disopyramide after cardioplegic arrest.

To study the hemodynamic side effects of mexiletine and disopyramide when administered before cardioplegic arrest 15 dogs underwent sham cardiac surgery with a 90-min period of aortic cross-clamping. 5 dogs served as control, 5 were given 8 mg/kg/day mexiletine and another five 11 mg/kg/day disopyramide for 1 week before surgery. On the day of surgery a continuous infusion was started. After reperfusion treated animals exceeded their preischemic blood pressure and regained their preoperative cardiac output. Compared to control animals left ventricular work was higher in the treated animals after reperfusion. The two tested type I antiarrhythmics tend to add to myocardial protection when given before cardioplegic arrest and do not exhibit negative inotropic side effects.

Animals↗
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

[Pre- and postoperative psychosexual status of heart patients].

Discussing the changed quality of life following open heart surgery the psychosexual status of 100 pre- and postoperative patients (aortocoronary bypass operation vs valve replacement) was assessed by standardized interviews. The preoperative interview showed only 9% of the patients having sexual intercourse during the last six months while 91% were sexually abstinent. As main reasons for the latter the patients named voluntary abstinence due to their illness (14%), negative advice of their doctor (22%) and no desire for sexual activity (33%). One year postoperatively the situation changed clearly. Within the last six months 47% of the former patients were sexually active, while 52% remained inactive. The open heart operation which improves life physically can also be seen as improving quality of life in respect to the psychosexual life of the patients. The interview data moreover show the great importance of medical advice in questions relating to sexuality which ought to be an absolutely necessary part of the dialogue with cardiological patients.

Adult↗
PubMed1987

[Change in the quality of life following aortocoronary bypass and heart valve replacement: assessment of subjective surgical success].

Life quality of 100 consecutive male patients, half with coronary heart disease and half with valve diseases, was assessed 2 days prior to operation (A in the Tab.) as well as 1 year postoperatively (B in the Tab.) by standardized interview. The questionnaire included the physical condition and the emotional status, employment status, social interaction and sexuality. By far the majority of the interviewed patients showed a distinct improvement in all fields confirming a clearly positive effect of the heart operation on life quality: The number of persons employed increased by a third. The length of preoperative sick leave seems to be a good indicator for returning to work again: from 52 persons, having been preoperatively on sick leave for more than 2 weeks, 21 retired early after operation, 6 remained on sick leave and only 6 patients returned to full-time work again. On the other hand, 20 of the 24 patients who worked up to the time of operation took up their employment again postoperatively. Postoperative employment status does not seem to be primarily a question of physical improvement. Anxiety and fear of infarction recurrence or economic factors seem to be much more decisive for returning to work. However, the patients reported a distinct improvement of physical and emotional status: 85 described their physical condition, 63 their emotional status as "clearly improved" or "better". Less drugs were used in general, and the use of tranquillizers and soporifics was cut down to a third.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗