Biomedical subjects
Publications and source records attributed to G Klepp.
In severely emphysematous or otherwise destroyed lung parenchyma, staples often cut through, which causes prolonged postoperative air leakage. A mechanical suture line reinforced by a polydioxanone ribbon is a simple, safe, and effective method for closure of air leaks, resection, or biopsy in such cases.
Fiberendoscopic paravasal sclerotherapy of esophageal varices with Polidocanol at concentration of 1%, is a palliative therapy of a serious sickness. Due to the location of esophageal varices, paravasal sclerotherapy with all its alteration of the esophageal wall takes place in the lower third with its lower sphincter. Twenty middle-aged patients, both sex, with esophageal varices (stadium II-IV due to Paquet) underwent clinical, endoscopic and esophagomanometric control after completion of sclerotherapy. By reaching the therapeutic goal--the subepithelial layers--no pathologic change of the motility of the esophagus has been seen.
Haemorrhage caused by oesophageal varices, will produce the highest complication rate of portal hypertension. Fiberendoscopic sclerotherapy has been widely introduced for treating those oesophageal varices. Two methods which are technically different are applied: intravariceal injection of the sclerosing solution and paravariceal injection inducing subepithelial fibrosis of the oesophageal wall. Twenty-five patients with oesophageal varices were subjected to 103 fiberendoscopic sclerotherapy sessions. Before every session a Sengstaken-Blakemore tube was inserted in the oesophagus. Sclerotherapy took place along this tube. This modified technique of paravariceal sclerotherapy of the oesophageal wall provides the possibility of secure sclerotherapy by using no specially adapted fiberoptic endoscopes.
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Pulmonary sequestration is a relatively rare condition in which a part of lung tissue has no or only a secondary connection with the tracheobronchial tree. Blood supply comes from the aorta in anomalous branches. Sequestrations may be intra- or extralobar. Gerle et al. include both types in the general term congenital bronchopulmonary foregut malformation. Two surgically confirmed observations of bilateral intralobar pulmonary sequestrations are reported. The clinical features are recurrent respiratory infections with cough, fever and purulent sputum. X-rays only show nonspecific alterations. Chronic changes in the lower lobes should draw attention to pulmonary sequestration. Thoracic aortography is the procedure of choice in establishing the diagnosis and should always be carried out preoperatively. Segmental resection or lobectomy is the indicated treatment.
Hyperbaric Oxygenation has been used routinely with 503 persons (1100 compressions) in a large walk-in hyperbaric chamber. An optimal interdisciplinary teamwork and mastering of the transportation problems by helicopter is mandatory to make this treatment accessible for patients in distant hospitals as an additional conservative management. In 51 operations under pressure (28 congenital heart disease cases) the luxury oxygenation was a protective measure. The procedure can be done safely with plenty of working time.
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Based on 5 individual cases over a period of 8 years (1 fibroma, 1 angiofibroma, 2 adenofibromas, 1 xanthous neurofibroma) the characteristics of the rare intrapulmonary fibroma and the therapeutic consequences are discussed. Any suspicious tumor demands a thoracotomy with careful preoperative treatment and the subsegment or segment resection depending on the histological diagnosis reported during the procedure.
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