PubMed Health⌕ Search

Biomedical subjects

H Brünner

Publications and source records attributed to H Brünner.

At least 37 records · Page 2Linked to original sources
PubMed1979

[Evaluation of liver haemodynamics by spleno-portography in portal hypertension (author's transl)].

In 68 patients arterial and portal blood flow were measured by angiodensitometry in the course of routine, indirect splenoportography. Results were compared with those already published, with investigations of a model and with animal experiments. It was shown that, given certain underlying conditions, reliable results can be obtained even in the presence of a pulsatile flow and incomplete contrast mixing. Compared with other procedures, the method has the advantage of providing a complete picture of liver haemodynamics in the course of routine splenoportography in a simple way and without affecting the patient further. As a result the indications for performing a shunt and the choice of the shunt technique can be more accurately determined.

Blood Flow Velocity↗
PubMed1978

[Possibilities of splenorenal anastomosis in portal hypertension].

The classical splenorenal shunt of Linton modified by Clatworthy is definitely superior to portocaval anastomosis. Between 1968 and 1976 in 225 patients with bleeding oesophageal varices a splenorenal anastomosis was performed in 47 cases, a portocaval in 30 cases and a mesentericocaval in 2 cases. There were 55 palliative operations as compared with 91 conservative therapeutic approaches. Over the last five years central termino-lateral splenorenal anastomses have been performed almost exclusively.

Esophageal and Gastric Varices↗
PubMed1978

[Adhesive prophylaxis: Noble's intestine plication (author's transl)].

By chronic recidivating ileus with massive extensive adhesions, small intestine plications according to Noble or Childs and Philipps, respectively, have stood the test of time. In view of the total lethality rate of 5%, no plication should be attempted for acute ileus syndrome or for local or diffuse peritonitis. Serious complications include fistulization, intestinal perforation, recurring ileus, and peritonitis. Prophylactic plication is not recommended. The cases treated by the surgical department of the university clinic in Mainz, which include a total of 233 laparotomies for chronic adhesions of the ileus, reflect strict adherence to indications for small intestine plication. Among our own cases, we had no postoperative lethality.

Humans↗
PubMed1977

[Esophageal varices hemorrhage in portal hypertension (author's transl)].

Diagnostic and therapeutic possibilities for esophageal varices hemorrhage in portal hypertension are indicated with reference to 149 patients. In the acute phase, operative measures are to be rejected because the lethality is too high. Conservative treatment with a Blakemore-Sengstaken probe should always be introduced at first. After confirmation of the conditions in the liver, a pressure-reducing anastomosis operation (delayed emergency shunt) must be performed. For this purpose we prefer the terminolateral splenorenal anastomosis.

Adult↗
PubMed1977

[Clinical feature, treatment and prognosis of carcinoid tumors (author's transl)].

14 cases of carcinoid tumors over a period of 16 years are reported. There are 7 carcinoids of the vermiforme appendix, 3 of the small bowel, 1 of the rectum, and 2 carcinoids of the bronchus. No carcinoid syndrom was observed. Three patients with carcinoid tumors, localized in the small intestine died immediately post operationem. All others are still alife and followed up between 6 month and 13 years, are free of symptoms or rezidives. Poor prognosis of the carcinoids of the small intestine seems to depend on late diagnosis, complications already occured at the moment of operation, and advanced age of these patients. Different malignance is not considered to be an important factor of prognosis.

Adolescent↗
PubMed1977

[Splenorenal anastomoses in portal hypertension (author's transl)].

The classical splenorenal shunt of Linton modified by Clatworthy is definitely superior to portocaval anastomosis. Between 1968 and 1976 in 225 patients with bleeding oesophageal varices a splenorenal anastomosis was performed in 47 cases, a portocaval in 30 cases and a mesentericocaval in 2 cases. There were 55 palliative operations as compared with 91 conservative therapeutic approaches. Over the last five years central termino-lateral splenorenal anastomoses have been performed almost exclusively.

Esophageal and Gastric Varices↗
PubMed1977

[Preliminary results of preoperative radiotherapy in carcinoma of the rectum (author's transl)].

Preliminary results were evaluated in patients with carcinoma of the rectum of whom 33 had preoperative radiotherapy and 23 were treated by operation only. The tumour stage was T2-4 NX MO in all patients. There was no significant difference between the groups as to postoperative mortality, would healing, and postoperative admission time. However, the recurrence rate was significantly lower in pre-irradiated patients than in those treated by operation only. The combination of radiotherapy and radical operation appears to be a possible means of significantly improving the survival rate of patients with carcinoma of the rectum.

Adult↗
PubMed1977

[Anal and perianal complications of Crohn's disease (author's transl)].

Anal and perianal lesions in Crohn's disease such as fistulae, fissures, abscesses and proliferative ulcerous proctitis are often misinterpreted and consequently unsatisfactorily treated. They always indicate a florid intestinal attack or a relapse after previous intestinal resection. Out of 153 patients with Crohn's disease in the last 11 years we have had 59 cases (= 38.6%) with a history of anal changes or such changes were demonstrable on admission to hospital. Only after subtle diagnosis in which the nature and extent of these complications and the location of the intestinal disease focus are determined, the most promising therapy, after all possibilities of conservative treatment have been exhausted, is intestinal resection. Local surgical measures which would often endanger continence, are reserved for the individual case.

Crohn Disease↗
PubMed1977

[Liver blood flow studies using cineangiodensitometry].

In 12 anesthetized beagle dogs breathing spontaneously flow in the hepatic artery (168 ml/min + 10 SEM) and portal vein (576 ml/min +/- 20 SEM) was measured by means of angiodensitometry. Total hepatic blood flow (THBF) was 185 ml/100 g/min +/- 11 SEM. In our opinion this relatively high THBF depends upon the method used.

Animals↗
PubMed1977

[Recidivism of Crohn's diseases. Indication and therapeutic problems of reintervention].

The recurrence of Crohn's disease often presents problems in the indication for surgery. Reoperation is indicated in all recurrent complicated cases and in postoperative complication not specific for Crohn's disease. However relaparotomy should be performed only after conservative measures have proved unavoiding. In the Department of Surgery at the University Hospital in Mainz 153 patients with Crohn's diseases were treated over an 11-year-period. Of 310 patients operated for Crohn's disease 153 reoperations were performed in 73 patients. The aim of reoperation should be the prevention of further complications. In view of the individually differing courses of the disease no general guidelines can be laid down for the indications for laparotomy.

Crohn Disease↗
PubMed1977

[Malignant obstructive jaundice. Current status of surgical therapy].

424 patients with malignant jaundice were treated from 1964 to 1976. 152 carcinomas of the extrahepatic biliary tract and 272 carcinomas of the duodenopancreatic region were reported. Initial symptoms of cancer of this region are often vague, so that physicians must employ a high index of suspicion if earlier diagnosis is to be effected. Most of the carcinomas of pancreas and the biliary tract are unresectable because of the early dissemination. The dismal of the malignant tumors of the biliary tract is unchanged during the last 50 years but survival rates are better in carcinoma of the duodeno-pancreatic region.

Bile Duct Neoplasms↗
PubMed1977

[Surgical and medical treatment of Crohn's disease (author's transl)].

Regional enteritis does present therapeutical problems because of the unpredictable course of this disease. 162 patients were operated upon in the Surgical Department of the University of Mainz Medical School between 1964 and 1976. Medical and surgical treatment of these patients has been rather different due to the heterogenity of the patient group. Curative therapy of regional enteritis does not exist. Medical treatment is aimed at converting the active form of the disease into an inactive, 'burnt out' form. One therapeutic regimen widely used is the combination of salazosulfapyridin and corticosteroids, another regimen is the combination of azathioprine and prednisolone. Surgery is indicated when complications arise and after medical treatment has failed. The optimal approach is resection of the afflicted part of the intestine. Even after surgery prognosis is doubtful and depends upon the activity of the disease in each individual case.

Acute Disease↗
PubMed1976

[Splenorenal anastomoses].

Of the operative procedures that can be used to relieve the pressure in portal hypertension, the authors prefer the terminolateral splenorenal anastomosis if the assessment of relative anatomical positions and the patient's hemodynamic situation has shown that these are adequate for the procedure. In contrast to portacaval shunting, after splenorenal anastomosis portal blood supply to the liver is partially maintained. Therefore less patients suffer from hepatic failure or encephalopathy. In addition a lower short-and long-term postoperative mortality has been observed. The risk of thrombosis and recurrent bleeding are the drawback of the method, occurring in about 15% of the patients. A meticulous technique can reduce this percentage.

Esophageal and Gastric Varices↗
PubMed1976

[Sclerosing of bleeding oesophageal varices (author's transl)].

Bleeding from oesophageal varices was stopped in two patients by percutaneous transhepatic transportal injection of 50% glucose and thrombin into the gastric coronary vein and the gastro-oesophageal varices draining into it. The only complication was a right-sided pleural effusion in one of the patients.

Esophageal and Gastric Varices↗