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Biomedical subjects

G Heberer

Publications and source records attributed to G Heberer.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Treatment of the polytraumatized patient in a clinic].

433 patients (mean age 33.3 years) with multiple injuries were treated from 1978 to 8/1982. Classification of the injuries was done according the S(skeleton)A(abdomen)T(thorax)scheme. The overall mortality was 18%. The cause of death were CNS-injuries in 50% of the patients. Besides CNS-injuries single and multiple organ failure were limiting the prognosis. In all cases of organ failure the lung was affected. Two patterns of multiple organ failure were found. Significant factors were shock, massive blood transfusions and abdominal trauma--but as well as errors in the treatment. Still improvement of the survival rate of the polytraumatised patients must be achieved in the future. Besides aggressive shock therapy and prevention of posttraumatic pulmonary insufficiency through earliest respiratory support we emphasize a strict strategy of treatment priorities. Based upon an intensive training especially in trauma care the surgeon will be able to recognize complications earlier and thus increase the chance of survival of the polytraumatised patient.

Adolescent↗
PubMed1982

Intraoperative biochemical localization of insulinomas by quick radioimmunoassay.

In patients with organic hyperinsulinism, intraoperative determination of insulin concentrations in veins draining the pancreas might help localize the tumor. We have developed a radioimmunoassay measuring insulin within 30 minutes. At operation, blood samples are taken at various sites in the splenic, superior mesenteric and portal veins for insulin determinations. In all six patients, the highest insulin concentrations correlated with the site of the tumor. Also, small insulinomas less than 1 cm in diameter could be found. In one patient the tumor appeared to secrete mainly proinsulin. By this procedure we hope to avoid blind distal resection of the pancreas and possibly invasive preoperative diagnostic procedures.

Adenoma, Islet Cell↗
PubMed1982

[Hemostasis with a new infrared-sapphire-coagulator (ISC-81). First clinical studies].

A new infrared sapphire coagulator (ISC-81) has been developed for the hemostasis of parenchymatous hemorrhage. Upon absorption by the bleeding tissue, light is converted into thermal energy thus causing coagulation and hemostasis. The light is transmitted to the bleeding tissue via a sapphire crystal, which is nonadhesive and of high thermal resistance. For application on flat surfaces or in ruptured tissues, either a cylindrical or a wedge-shaped crystal can be used. Up to now the ISC-81 has been used successfully on 22 patients, most of whom had hemorrhages from ruptured spleens or livers.

Adult↗
PubMed1980

[Disease picture and operative therapy in multiple endocrine adenomatoses (MEA sydrome)].

We have outlined the symptoms, diagnostic procedures and operative treatment of "multiple endocrine adenomatosis" (MEA I, IIa und IIb). The priority of the operative procedure whenever two or more clinical syndromes in a patient with MEA are present and the possibility of multiple tumors has to be considered carefully. When there is a tumor of an endocrine organ, it should always bethought about the MEA-syndrome. We report about 9 patients seen in our hospital.

Adrenal Gland Neoplasms↗
PubMed1980

[Surgery of rectal carcinoma (author's transl)].

The absolute number of deaths caused by rectal carcinomas has greatly increased in the FRG within the last 10 years. However in relation to the age of the patients the rate per 100 000 inhabitants did not change. The results of an operative treatment could only be improved slightly because there is still a delay in diagnosis. Despite a high rate of false negative results (34,1%) the hemoccult-test has been used most frequently as a preoperative diagnostic test. Other biochemical parameters could not replace this test. Nowadays orthograde lavage can be considered as the best preoperative treatment of the bowel. As to the comparison of the prognosis after reaction of the rectum or exstirpation, there remains the problem of preselecting the patients. The indication for resection seems to increase by using staplers. New operative techniques for colostomy and its postoperative care after exstirpating the rectum may provide further improvement for the patients. In nonoperable carcinomas a colostomy can be avoided by using cryosurgery in 2/3 of all patients. So far, surgical results could not be improved by early additional chemotherapy.

Adult↗
PubMed1980

[Trachea reconstruction in inflammatory stenosis and tumors].

Primary resection of the trachea and direct anastomosis is indicated whenever inflammatory stenoses and tumors of the trachea are present. In our own series of 27 patients operated upon there were 17 stenoses by scars, two malacias of the trachea, six adenoid-cystic carcinomas, one adenoma of the bronchus and one chondroma. One patient died on the 16th postoperative day from stress-ulcer bleeding. Another patient died three months after the resection of the trachea following reoperation from a recurrence of the stenosis. There was bleeding out of the tracheostoma with aspiration. One patient had a stenosis of the cricoid three years after the tracheal resection had been performed. The stenosis could be treated successfully by reconstructive surgery. None of the other 24 patients had complications. Data on the late results are given. New reports in the literature and our own experience indicate that a tracheal resection with a direct anastomosis seems to be a standardized procedure. Using the right indication for the operation good early and late results can be achieved.

Adult↗
PubMed1979

[Diagnosis and treatment of acute injuries to the heart and intrathoracic vessels (author's transl)].

The massive blood loss that accompanies penetrating chest wounds involving the heart or intrathoracic vessels generally leaves no option but to act immediately. Blunt chest trauma in combination with other injuries makes particularly stringent demands on diagnostic and therapeutic skills. Most injuries to the intrathoracic aorta are in the form of intiially closed tears of the descending part; but rupture is an ever-present threat. The symptoms are: enlargement of the mediastinum in the chest roentgenogram, differences in blood pressure between the upper and lower half of the body and haemothorax. Whenever possible aortography should be performed to locate the site of the rupture. The therapeutic measures are determined by the extent and severity of the various injuries.

Aortic Rupture↗
PubMed1979

[Tracheoesophageal fistula after blunt thoracic trauma: recognition and treatment].

Three cases of tracheoesophageal fistula as a result of nonpenetrating chest trauma were surgically repaired. Another 31 cases were found in the literature. 'Thrown against a steering wheel' was the cause of injury in the majority of patients. Though the fistula became characteristically symptomatic 3 to 7 days after the accident, the diagnosis was often delayed for several months. No patient recovered without operation. After demarcation of the area of contusion and necrosis, especially in the esophagus wall, surgical repair is the therapy of choice.

Accidents, Traffic↗
PubMed1978

[Surgical treatment of inflammatory diseases of the colon : ulcerative colitis, Crohn's disease, diverticulitis].

Operations and follow-up examinations were conducted on 106 patients with ulcerative colitis, 33 with colitis Crohn, and 163 with diverticulitis, at the University Clinics of Cologne and Munich. Overall mortality rates were 24.5% (n = 26), 6.1% (n = 2) and 16% (n = 26), respectively. In the surgical treatment of ulcerative colitis the possibility of malignant degeneration and, in the case of Crohn's disease, prevention of recurrences must be taken into consideration. Whether Crohn's disease is a precancerous conditions remains to be clarified. Choosing the optimal time for operative intervention is as important in diverticulitis as in ulcerative colitis. Because of the possibility of complications and the high risk of operation, early intervention is recommended for diverticulitis.

Adult↗
PubMed1978

[Clinical aspects, diagnosis and treatment of organic hyperinsulinism. Experience with 46 operated patients (author's transl)].

The clinical picture of organic hyperinsulinism is presented with reference to experience in 46 operated patients. For the recognition of disease, a careful history is a decisive contribution. The hunger test showed a characteristic hypoglycemic reaction in 100%; the tolbutamide test gave a positive result in 92%. Insulinomas could be localized angiographically in 71%; in one patient this could only be done with an ERCT. The treatment of choice is operation as soon as possible. If possible, enucleation is to be given preference over pancreas resection because of the low complication rate. A search for ectopic (2%) and multiple (12%) adenomas is important. A cure was achieved in 76% of all those operated on. The hospital mortality was about 4%.

Adenoma↗