Biomedical subjects
G A Melcher
Publications and source records attributed to G A Melcher.
[Vascular injuries--management in a non-university central hospital].
In a retrospective study the surgically treated vascular injuries (n = 35) of the last 10 years were evaluated. One third of the patients had multiple trauma and in 57% of the cases vascular injury was accompanied by a fracture. All patients (n = 28) except those who underwent delayed amputation (amputation rate 14%) have been followed personally for an average of 5.1 years. 90% of these patients showed an excellent or acceptable longtime result in regard to vascularity, nobody complained of claudication. Diagnosis of a vascular injury was mostly confirmed by direct surgical exploration, only one third of the lesions were diagnosed by arteriogram. A positive signal in Doppler examination does not exclude vascular injury and therefore cannot replace arteriography or exact clinical evaluation.
[Colorectal cancers: surgical therapy].
Successful treatment of colorectal cancer is still founded on surgical resection. Therefore the indication for an operative treatment is generally given. During the last years surgical improvements were especially made in sphincter-saving procedures of the rectum. Although improvement in anaesthetic methods and perioperative care have reduced operative mortalities, the reports of the overall five-year survival rates are not very encouraging and essentially depend on the primary tumor staging. Unfortunately 10 to 25% of the potentially curable patients develop local recurrence within two years of operation.
Patterns of morphologic variation among isolates of Trichosporon beigelii.
We observed considerable variability in colony and microscopic morphology among isolates of Trichosporon beigelii. Deeply invasive clinical isolates showed four distinct morphotypes and spontaneous conversions among certain morphotypes and grew well at 37 degrees C. In contrast, superficial clinical and environmental isolates did not demonstrate such morphotypes or conversions, and most grew poorly at 37 degrees C. Thus, the morphologic and physiologic features of invasive clinical isolates of T. beigelii follow certain patterns distinct from those of superficial clinical and environmental isolates.
[Diagnosis of lung embolism. Prospective study].
In a prospective study over the years 1983-1985, 300 cases of acute pulmonary embolism were analyzed in relation to predisposing factors, clinical signs, arterial blood gas analysis and isotope perfusion scanning. Comparison of this prospective study with an earlier retrospective one showed similar results, with the exception of isotope scanning, an investigation which has gained increasing diagnostic reliability (highly suggestive results in 94% of patients with massive pulmonary embolism and in 64% with submassive pulmonary embolism). In two thirds of the cases the diagnosis was established during the first day after hospitalisation. In 10% of the patients pulmonary embolism occurred despite anticoagulant therapy.