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Biomedical subjects

G Kliems

Publications and source records attributed to G Kliems.

At least 19 recordsLinked to original sources
PubMed1985

[Traumatic bronchial rupture].

Two cases of complete broncho-ruptures are reported. The diagnosis was established after admission to the clinic, the immediate dressing and reanastomosis of the ruptured bronchi had no essential effects on the function of the lungs. All parameters were in the region of the lower standard. The bronchus or tracheal rupture concerns mainly young patients with an elastic thorax. As regards older patients with a rigid thorax, this group is to a large extent prone to a series of fractured ribs and grave injuries of the organs. A series of fractured ribs in juvenile patients can be completely non-existent. It should be noted that the indication for a bronchoscopy is meeting with too great a reserve. Three quarters of all broncho-ruptures thus are not diagnosed. Even if after a number of years a successful reanastomosis is still possible, the functional detriments of delayed anastomoses are not always reversible. In the hands of a skilled surgeon the emergency bronchoscopy with rigid and flexible instruments is also possible in the case of very severely injured patients.

Accidents, Traffic↗
PubMed1983

[Liver cirrhosis and duodenogastric reflux--on the problem of the hepatogenic ulcer].

Patients suffering from liver cirrhosis and patients showing no signs of liver or stomach disease (control group) were quantitatively examined for duodenogastric reflux. The duodenogastric reflux was measured by means of bile tracers. The bile tracer used in this study was the tricarbocyanin dye indocyningreen (ICG). The intra-gastric concentration of ICG was photometrically measured after gastric acid was suctioned through a stomach tube. The duodenogastric reflux was calculated in percent in terms of the infused and the biliary secreted ICG amount respectively. Bromthalein was used as an additional tracer in order to control the efficiency of peptic acid removal. A total of 15 patients suffering from liver cirrhosis and 6 patients who showed no signs of stomach or liver disease (control group) were examined. The patients with liver disease showed a reflux of 2.85% +/- 0.76%, the control group (n = 6) showed a reflux of 0.45% +/- 0.39%. The difference is statistically significant (P less than 0.05). Bromthalein aspiration by all patients with liver cirrhosis was 87.95 +/- 2.78% of the amount infused.

Adult↗
PubMed1983

[Surgical treatment of parenchymal metastases of germinal testicular tumors].

This report concerns 18 patients with germinal testicular tumors in whom the resection of pulmonary metastases was indicated following resection of the primary tumor and combined cytostatic therapy. Nine patients underwent a retroperitoneal lymphadenectomy immediately after semi-castration. Upon follow-up examination, circular pulmonary foci were visualized by conventional films or computerized tomography. These patients developed pulmonary metastases on the average 8 months after the first operation (semi-castration and lymphadenectomy). Since 1978, a combined cytostatic treatment has preceded the lymphadenectomy and resection of parenchymal metastases. No evidence of disease (NED) could be achieved in 9 patients by resection of pulmonary metastases, with an average follow-up period of 30 months. The results in surgery of metastases are judged as the more advantageous, the longer the free interval is between initial disease onset and the occurrence of metastases.

Adolescent↗
PubMed1981

[Indications and results of Y-gastrojejunostomy after gastric resection (author's transl)].

The Y-gastrojejunostomy with a long jejunal loop is advantageous in the treatment of recurrent ulcer after gastric resection and in the treatment of persistent peptic esophageal stricture. The peptic damage of esophageal mucosa by gastric juice and bile is thus prevented, and the stricture can heal. In regard to the pathogenicity of duodenogastric bile reflux, the routine Y-technique in gastric resection seems reasonable.

Adult↗
PubMed1981

[Quantification of duodenogastric reflux in patients with different gastric resections (author's transl)].

The duodenogastric reflux was measured quantitatively in patients with classic gastric resections (Billroth I, Billroth II with and without enteroanastomosis) as well as in patients without gastric operations. A total of 43 patients with gastric resection and 6 without gastric operation were studied. Patients operated according to B II without Braun's enteroanastomosis (n = 10) had a bile reflux of 50.4 +/- 4.1% (SEM) during the study. Patients having been operated according to B II- and Braun's-enteroanastomosis (n = 15) and those having undergone B I-operation (n = 17) had a duodenogastric reflux of 21.5 +/- 3.7% (SEM) and 23.1 +/- 3.5% (SEM), respectively. In 6 control subjects without gastric operation bile reflux into the stomach averaged 0.5 +/- 0.4% (SEM).

Adult↗
PubMed1981

Pharmacokinetics, bioavailability and ECG response of verapamil in patients with liver cirrhosis.

1 The pharmacokinetics, bioavailability and ECG response of verapamil was investigated in seven patients with liver cirrhosis and compared with six normal subjects, using stable labelled techniques whereby both the intravenous and oral dose are given simultaneously. 2 After intravenous administration, plasma concentrations were much higher in the patient group such that the total plasma clearance was reduced from a mean of 1258 ml/min in normals to 616 ml/min in the patient group (P less than 0.0025). The apparent volume of distribution nearly doubled (6.76 v 12.05 l/kg, P less than 0.025) and the terminal half-life was prolonged four fold (3.7 v 14.2 h, P less than 0.001). 3 Given orally, the peak plasma concentration was higher and occurred earlier in the liver cirrhotic patients. The absolute bioavailability more than doubled (22.0% normals v 52.3% liver cirrhotics, P less than 0.001) and apparent oral clearance was reduced to only 20% of normal (6.38 v 1.30 l/min, P less than 0.001). 4 The delta P-R interval in the patient group lagged behind the plasma concentration, in contrast to normal subjects. The maximum effect was much greater in the patients (15.4 v 41.6% increase, P less than 0.005) and persisted for a longer period of time. The slope of the plasma concentration-response curve was the same as in normals after intravenous administration. Plasma protein binding remained unchanged. 5 It is recommended that in liver cirrhotic patients the intravenous dose of verapamil be halved and the oral dose decreased by a factor of five in order to prevent untoward effects. As well as a steady-state plasma concentration will not be reached until approximately 2 days after the beginning of therapy.

Adult↗
PubMed1980

[Bioavailability of cimetidine after partial gastrectomy (author's transl)].

Absorption characteristics of cimetidine were studied in 10 patients after Billroth I and 12 patients after Billroth II gastrectomy and compared with 9 patients without gastric disease. The onset of absorption after 400 mg cimetidine was identical in all groups, but peak plasma concentrations occurred somewhat (18%) later in B I and significantly (42%) later in B II patients (p less than 0.05). Plasma half life was not different between the 3 groups. The area under the plasma level curve as a measure for bioavailability was significantly increased in the two gastrectomy groups (17% and 23%, resp.). In addition, the duration of effective plasma concentrations above 0.5 microgram/ml was significantly prolonged in the two groups.

Biological Availability↗
PubMed1979

Atrophic gastritis after Billroth I gastrectomy.

The gastric mucosa of a stomach resected according to Billroth I operation is subject to a process of aging twice as intense as that of a non-resected one. Atrophy after Billroth I gastrectomy increased by 3% on an average per annum. As a result, a typical distribution of degrees of inflammation in the region of the greater curvature became evident. Atrophic gastritis occurres especially near the anastomosis and decreases in the direction of the fornix. The possibility is discussed that resected patients--in contrast to non-resected--are afflicted with stomach cancer primarily on account of the more intense and earlier mucosal atrophy.

Atrophy↗
PubMed1979

[Disease of metalgrinding workers (author's transl)].

It is a specific clinical picture with extensive soft tissue gas and swelling of the forearm. Usually, the clinical course is without any other symptoms. Therapy is not necessary because gas disappears in few days. The etiology of the disease is not clear. Gas can be generated by the chemical reaction between a metallic foreign body and tissue fluid. Spread of benzine evaporation has been considered as a possible source as well. The disease is very rare and its knowledge is important in differential diagnosis of gas gangrene.

Adult↗