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Biomedical subjects

G Breitfellner

Publications and source records attributed to G Breitfellner.

At least 19 recordsLinked to original sources
PubMed1992

[Experiences with total parathyroidectomy and autotransplantation of intraoperatively selected parathyroid tissue in reactive renal hyperparathyroidism].

Surgery is indicated in cases of therapy-resistant reactive renal hyperparathyroidism with clinical symptoms and signs. The method of choice is total parathyroidectomy, with autotransplantation of parathyroid tissue into the forearm musculature. Twenty-two patients were parathyroidectomized. In 19 cases the intraoperative selection of tissue for autotransplantation was made by means of a stereoscopic magnifying glass. With one exception, only fragments of type 1a glands and type 1a-like areas obtained from type 2 glands were transplanted. In 18 of the 22 cases parathyroid hormone levels decreased from 1131 +/- 657 preoperatively to 87 +/- 53 pg/ml postoperatively. In 4 patients with postoperative values over 200 pg/ml a transplant-related recurrence of hyperparathyroidism or a remaining 5th gland in the cervical region was suspected. In all 22 patients serum calcium, as well as alkaline phosphatase levels returned to normal and the clinical signs of hyperparathyroidism disappeared.

Adult↗
PubMed1990

Resistance of gram-negative bacilli and staphylococci from blood cultures to aminoglycoside antibiotics. Comparison of 3 in vitro investigations from Austria 1982-1988.

A total of 790 blood culture isolates was collected during 3 study periods in 1982/83, 1984/85 and 1987/88. Staphylococci were the most frequent bacteria in the first two periods (56.5% and 63%, respectively). During the last period, E. coli was the most frequent of all species (27%). Differences in the distribution of bacteria between the laboratories were considerable. In one laboratory in Vienna, coagulase-negative staphylococci dominated in all 3 study periods (32%, 33% and 47%). Susceptibility against gentamicin, tobramycin and netilmicin (MIC less than or equal to 4 mg/l), as well as against amikacin (MIC less than or equal to 8 mg/l) were determined by a microdilution method. The resistance rates against gentamicin (G) were 25%, 21% and 25%, against tobramycin (T) 27%, 19% and 25%, against netilmicin (N) 6%, 4% and 19%, and against amikacin (A), 5%, 2% and 19%. Most resistant strains were staphylococci (G 26%-41%, T 26%-46%, N 3%-31%, A 3%-36%), whereas gram-negative bacilli were more susceptible (G 12%-14%, T 7%-11%, N 7%-9%, A 1%-7.5%). The increase of resistance against netilmicin and amikacin in staphylococci was most striking. Nearly all those strain could be attributed to one laboratory in Vienna. Most of them were coagulase-negative staphylococci. In the first study period, the most frequent pattern was resistance against gentamicin and tobramycin, whereas in the last period resistance to all 4 aminoglycosides dominated. The study demonstrates considerable local differences in antibiotic resistance. Monitoring of antibiotic resistance in collaborative studies using standardized methods should be a valuable tool in planning strategies for controlling an epidemic spread of resistance.

Amikacin↗
PubMed1989

[Acute cardiac death in chronic-ischemic heart disease (CIHD)].

Ischemic heart disease as a basic disease with accompanying findings and exogenous factors comes to a typical triad of SCD. There is a critical midlife situation due to O2-shortage. Dispositional and situational conditions come to be important, especially in cases in which morphological substrates are absent. The complex incident takes place on three levels (organism, heart, and myocardium). Several dying types may occur. Clinical accuracy and morphological diagnosis are of limited value for the relatively fatal importance of each of the single findings.

Coronary Artery Disease↗
PubMed1986

[Bronchial cancer from the viewpoint of 2 neighboring regional cancer registers].

From follow-up examinations on 460 male and 67 female patients with bronchial cancer during the years 1981 and 1982 in the cantons of St. Gallen and Appenzell/Switzerland, as well as from the region of Vorarlberg/Austria various morphological and clinically registered parameters of importance to oncology were comparatively analysed. These regional clinical cancer registers have existed for many years and are recognized legitimately and clinically as an important partial aspect in diagnostic, therapy and prophylaxis of malignant tumours.

Adenocarcinoma↗
PubMed1986

[Intraoperative rapid biopsy of thyroid neoplasms and surgical procedures in atypical adenoma].

For a differential diagnosis of atypical adenoma and highly differentiated follicular carcinoma cryosections are of value only if findings are positive. Between 1977 and 1982 we observed 85 thyroid carcinomas and 47 atypical adenomas. In 5 cases the diagnosis on the basis of a cryosection had failed to detect a carcinoma. In patients with atypical adenoma we performed a subtotal resection; a primary lobectomy was not carried out as it would have meant exposing an unnecessarily high percentage of patients to an increased risk of complications. 3-8 years postoperatively the patients show no pathological findings.

Adenoma↗
PubMed1986

[A so-called atypical adenoma of the thyroid in an endemic struma area].

In view of the benign clinical course of the atypical adenoma and the high diagnostic accuracy of our frozen sections we feel that subtotal strumectomy with in toto removal of the adenoma and closely spaced follow-ups constitutes an adequate treatment of this thyroid neoplasm. In our opinion primary lobectomy means unnecessarily exposing a disproportionately high percentage of patients to the higher complication risk of this more radical surgery. From 1977 to 1982 there were 47 cases of atypical adenoma among our patients. The ratio men: women was 1:3.7, the mean age of the patients was 44 years. The patients underwent subtotal strumectomy. In the period under review "atypical adenoma" diagnosed on the basis of frozen sections turned out to be carcinoma in 5 instances. The follow-up period of the 47 patients that underwent surgery ranges from 1 1/2 to 7 years. None of the patients has had tumor regrowth so far.

Adenoma↗
PubMed1985

[Resistance of blood culture isolates in vitro to 4 aminoglycoside antibiotics in Austria--1982/83].

Over the period September 1982 to February 1983 268 blood culture isolates were consecutively collected in 4 microbiological laboratories in Austria (Linz, Vienna, Graz, Feldkirch) and 251 of these strains (streptococci excluded) were tested for resistance to Gentamicin (G), Tobramycin (T), Netilmicin (N) and Amikacin (A) using a microtitre broth dilution method. This investigation was part of an international study. Of the bacterial strains examined 57% were staphylococci (34% Staphylococcus aureus) and 43% gram-negative rods (18% E. coli, 17% other enterobacteriaceae and 5% Pseudomonas aeruginosa etc.). 25% of all strains tested were resistant to Gentamicin (MIC greater than 4 mg/l), 27% to Tobramycin (MIC greater than 4 mg/l), 6% to Netilmicin (MIC greater than 4 mg/ml) and 5% to Amikacin (MIC greater than 8 mg/l). The resistance rate of staphylococci was markedly greater towards Gentamicin (35%) and Tobramycin (39%) than Netilmicin (4%) and Amikacin (6%). The respective percentages of resistant gram-negative rods were considerably smaller, except in the case of Netilmicin (G 13%, T 11%, N 8%, A 4%). Regional differences were observed between Linz and Vienna in the resistance of staphylococci to Gentamicin (24% versus 49%) and Tobramycin (33% versus 53%). On a weight basis Netilmicin was the most active substance in combating nearly all groups of bacteria. Also in strains sensitive to the other aminoglycosides the MIC values of Netilmicin were considerably lower than for the other substances. A noteworthy feature in comparison with the results of other countries participating in this international study was the distinctly higher incidence of staphylococci among the blood culture isolates and the considerably higher percentage of aminoglycoside-resistant strains in Austria. Analysis of the data suggests that the high resistance rates among staphylococci are a consequence of selection by frequently used antibiotics. Hence, it appears essential to observe the development of aminoglycoside resistance in Austria closely and to recommend that these substances, of extreme value in the treatment of severe infections, should be used solely for the most stringent indications.

Aminoglycosides↗
PubMed1984

[Clinical aspects of pseudomyxoma peritonei].

On the basis of two cases the problems of peritoneal pseudomyxoma (PP) are discussed with respect to pathogenesis, clinical diagnosis and therapy. The abundant quantities of mucus present in the peritoneal cavity in this syndrome originate primarily in ruptured histologically malignant or benign mucous ovarian cystomas or benign mucocele or mucogenic carcinomas of the appendix, respectively. Independent of the histological findings the clinical course and consequently the prognosis of PP basically depends on the amounts of mucus present. Besides extirpation of the primary tumour therapy consists primarily in removing mucus as completely as possible, even in the form of repeated interventions. Additional measures are mainly confined to radiotherapy and cytostatic treatment. Recently new possibilities in preoperative diagnosis and postoperative control have been opened up by ultrasound and computed tomography.

Cystadenoma↗