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Biomedical subjects

G Fröschle

Publications and source records attributed to G Fröschle.

At least 19 recordsLinked to original sources
PubMed1998

[Attempted suicide--a challenge for the trauma surgeon?].

The data from 767 patients after a suicide attempt or suicide were analyzed retrospectively. Skeletal damage was present in 52% of the patients. This was also the highest percentage in the breakdown of the injury patterns, followed by damage of the central nervous system (26.6%). Injuries to parenchymatous organs (20.1%) took third place. Extensive soft tissue injuries were diagnosed in 18.1% and relevant vascular lesions in 16% of suicide cases. At the same time, the high percentage of multiple trauma patients (22.9%) reflects the severity and the extent of injuries suffered in the application of "violent methods". Injuries of suicide cases involving violence often resemble those of serious road traffic accidents. In contrast to unselected patients, the injury pattern of suicide cases with multiple trauma is dominated by jumps from a great height and being run over by a train. However, when unusual suicide techniques are used, the surgeon's experience may soon become insufficient. To our knowledge, special traumatology wards provide the best available diagnosis and emergency care for these patients unless they have suffered purely trivial injuries.

Adolescent↗
PubMed1998

Combined modality treatment of bone metastases: response of the rhabdomyosarcoma R1H of the rat to postoperative irradiation combined with local release of daunorubicin from acrylic cement.

Reconstruction techniques for pathological fractures caused by bone metastases often include acrylic cement to stabilise defects. The aim of this study was to test in a rodent model, whether outcome could be improved by local chemotherapy from an anticancer drug added to the acrylic cement. Tumour excision 17 days after transplantation into the femur was followed by fractionated irradiation. Supplementation of acrylic cement with daunorubicin led to a considerable reduction of TCD37% from 72.9 Gy (62.2-82.8) to 29.3 Gy (21.8-37.5) (P = 0.0007). Local chemotherapy diffusing from bone cement combined with postoperative radiotherapy was highly effective in the experimental system studied.

Animals↗
PubMed1998

Expression of the novel mitoxantrone resistance associated gene MXR7 in colorectal malignancies.

It was shown previously that a glypican encoding gene (MXR7/GPC3/OCl-5) was associated with mitoxantrone resistance in vitro. This study describes and investigation of an association between multidrug resistance and MXR7 in surgical cryo-specimens of 51 gastrointestinal tumors. The mRNA expression levels differ widely according to tumor species. In primary colorectal cancers, the level of MXR7 mRNA expression correlated loosely with the mRNA expression level of the multidrug-resistance-associated protein (MRP). In colorectal metastases an elevated MXR7 mRNkA expression level was observed when compared to primary colorectal carcinomas.

ATP-Binding Cassette Transporters↗
PubMed1998

[Etiology of cerebral perfusion disorder in patients with severe craniocerebral trauma].

In 53 patients with severe head injury, a decline of the cerebral perfusion pressure (CPP) was distinguished related to its cause, i.e., by a rise in intracranial pressure (ICP), a decline in the mean arterial pressure (MAP) or both. The mean Glasgow Outcome Scale (GOS) was 1.6 in patients with elevated ICP, 3.8 in those with decreased MAP and 2.7 when impaired CPP was due to both. It is concluded that in cases of decreased CPP, elevated ICP is the main cause of secondary brain injury and poor outcome, independent of the circulatory condition, whereas an isolated decline in the MAP does not show any influence on functional outcome.

Adolescent↗
PubMed1997

Asymptomatic HIV infection is characterized by rapid turnover of HIV RNA in plasma and lymph nodes but not of latently infected lymph-node CD4+ T cells.

OBJECTIVES: To study the kinetics of plasma viraemia and HIV-infected lymph-node cells in stable asymptomatic HIV infection with high CD4+ T-cell counts. METHODS: Nine asymptomatic HIV-infected patients with stable CD4+ T-cell counts (510-1350 x 10(6)/l) were treated with a triple-drug combination. Plasma viraemia was determined at days 0, 3, 7, 10, 14, 21 and 28 of treatment [Roche polymerase chain reaction (PCR) and ultrasensitive PCR assay]. Sequential lymph-node biopsies were examined in four patients before and after 4 weeks of treatment. Productively infected cells were counted in lymph-node sections (in situ hybridization). The infection rates of FACS-sorted CD4+ lymph-node T cells and the expression of single-spliced, double-spliced and full-length HIV transcripts were determined. RESULTS: HIV plasma RNA half-lives ranged from 1.4 to 2.7 days. Viral turnover varied between 0.07 and 7.54 x 10(8) copies per day. The number of productively infected lymph-node cells as well as the amount of extracellular virus in germinal centres was markedly reduced during treatment, paralleled by a clearance of single-spliced, double-spliced and full-length HIV transcripts from CD4+ lymph-node T cells. Plasma viraemia remained detectable with an ultrasensitive PCR assay in three out of four patients. The percentage of lymph-node CD4+ T cells harbouring proviral DNA decreased only slightly. CONCLUSIONS: The kinetics of HIV replication are rapid in stable asymptomatic infection, and the magnitude of replication varies considerably. Productively infected lymph-node cells and extracellular virus in germinal centres undergo a rapid turnover, whereas latently infected CD4+ T cells have a lower rate of turnover. The latter may contribute substantially to viral persistence during therapy.

Adult↗
PubMed1997

[Intracranial pressure monitoring in patients with severe craniocerebral injury].

After severe head injury intracranial pressure (ICP) must be measured continuously for management to assess and maintain the cerebral perfusion. Therefore in our hospital epidural transducers are used. To prove the efficiency of this method in a 12-month period the clinical courses of 23 patients with intracranial pressure transducers were analysed retrospectively. Eighteen patients survived, 5 of them without residuals, 13 with residuals and 2 remained in coma. In 14 patients secondary rises of intracranial pressure were observed between days 3 and 6 post injury. The mean ICP value of the survivors revealed 25 mm Hg. whereas the expired showed 60 mm Hg. In 17 patients the measurements were considered as reliable, 6 measurements were not reliable, which included 1 of the 5 patients who died. One transduce was displaced, another one showed a hemorrhage at the drill hole. There was no infection.

Adolescent↗
PubMed1997

[Measuring epidural intracranial pressure in patients with severe craniocerebral trauma].

In 30 patients with severe head injury (SHI), intracranial pressure (ICP) was monitored using epidural transducers. In 22 patients, the measurements were reliable, with average values of 19.4 mmHg in the survivors and 64.6 mmHg in those who died. It is concluded that epidural measurement of ICP provides a helpful method for the management of SHI and to control the indication for CT scans.

Adult↗
PubMed1996

One year of experience with extended application and modified techniques of split liver transplantation.

As organ donation rates decreased in Europe, the authors started a systematic approach of liver splitting in their center in 1994. During this 1-year experience, 73 cadaveric liver transplantations were performed in 66 patients. Sixteen of these transplantations were the result of split-liver transplantation (21.9% of grafts, 24.2% of patients). Patient and graft survival rates at 3 months were 81.2% and 75%, compared with 89.1% and 76.9 % for whole organs. Two modified techniques were developed, based on the technique of living related liver procurement, and applied in 10 cases. With these new techniques, patient and graft survival rates were 90% and 90%. This systematic approach allowed the total number of transplantations in our program to be maintained, despite the decrease in organ availability.

Graft Survival↗
PubMed1996

[Inflammatory pseudotumor of the liver--rare differential diagnosis of undetermined hepatic space-occupying lesion. Case report and review of the literature].

Hepatic masses are predominantly malignant, and whereas benign tumors are rare. We report the case of a 65-year-old man who presented with an anomalous hepatic mass. Following explorative laparotomy and left lateral segmentectomy (II/III), the patient was diagnosed as having an inflammatory pseudotumor of the liver. So far only 102 cases of "inflammatory pseudotumor of the liver" have been reported in the literature. Asia is a geographical center for this tumor entity, which mostly affects men. The major symptoms are nonspecific: fever, weight loss and general fatigue. The prognosis of "inflammatory pseudotumor of the liver" is very good. In 98% of the cases, a cure has been obtained after surgical therapy, but conservative therapy approaches also yield good results.

Aged↗
PubMed1996

Prevalence of human immunodeficiency virus in the trauma emergency room.

Over 55,000 human immunodeficiency virus (HIV)-infections had been reported to the German Federal Health Council as of December 1992. More than 60% of a total of over 9000 overt AIDS cases has arisen in the five largest urban areas. Patients with open wounds represent a daily risk of contamination for emergency room personnel. In addition to surgical treatment and after written informed consent, we conducted HIV-antibody studies on patients with open wounds in the trauma emergency room of the University Hospital Eppendorf over a period of 6 months. Of 286 patients 220 (77%) consented to the study, and 6 HIV infections were found, corresponding to a prevalence of 2.7%.

AIDS Serodiagnosis↗
PubMed1996

[Surgery of bone metastases in advanced age?].

Twenty-seven patients over 70 years of age (1990-1995, n = 100) achieved a stabilisation of skeletal metastasis; preventive (10), or after pathological fracture (17). Medullary pins were preferred to compound osteosynthesis. In all cases the operation was of a palliative nature, but resulted in considerable relief from pain, facilitated nursing or even improved ability to walk. Thus old age is not an indication against palliative stabilisation of skeletal metastasis.

Aged↗
PubMed1995

[Is there an increased risk of infection in trauma surgery emergency admission for medial personnel by unknown HIV-positive patient status?].

In the trauma emergency room 212 patients were asked--according to German law--for a blood sample for HIV-testing. Nine (4.2%) victims rejected the test, another 3 (1,4%) did not meet the study criteria since they were previously known to be HIV-positive or suffering from AIDS disease. None of the finally tested 200 patients was HIV-positive. On an anonymous questionnaire that was handed out additionally, 64% of the patients said they would accept HIV-testing without consent prior to operative treatment. 49% would reject HIV-testing without consent in non-operative treatment.

AIDS Serodiagnosis↗
PubMed1994

[Bile duct carcinoma after abdominal irradiation for urologic malignancies].

Malignancies of the biliary tract are rare diseases. Tumor inductions after radiotherapy are reported in several papers. We report about 3 cases with consecutive biliary tract carcinoma 18-32 years after manifestation of an urogenital carcinoma. All 3 patients (52-63 years) were treated with additive radiotherapy after surgical-urological therapy. Icterus was the top-ranging symptom of this secondary carcinoma. In 2 of the 3 cases surgical tumor resection was performed (biliary duct resection with central liver resection; pancreatico-duodenectomy). Because of the bad general condition of health the third patient got only a biopsy of the tumor. All patients died within 2 years after diagnosis. The accidental accumulation of the rare biliary tract carcinoma after urogenital malignancies in our collection of clinical cases (2 seminoma; 1 bladder tumor) give rise the question about the causal association between primary carcinoma, additive therapy and the development of secondary carcinoma.

Adenocarcinoma↗
PubMed1991

[Pancreatic pseudocysts and their interdisciplinary therapy].

A retrospective analysis was performed of 87 patients with pancreatic pseudocysts admitted at the Dept. of Surgery University of Hamburg from 1985 to 1989. Pseudocysts as a result of chronic pancreatitis were found in 54%. 42 patients underwent 49 operations, 35 have been drained endoscopically. In 10 cases there was spontaneous remission. 25 patients were treated by Roux-en-Y cystojejunostomy. In 14 patients a resection of the pancreas was performed. The mean follow-up interval was 26 (operative treated) and 22 months (endoscopic treatment). 50% of all patients in both groups reported pain relief. The mortality in operated patients was 7% and 0% for endoscopic treatment. In ten cases a recurrent disease was observed.

Adult↗