Biomedical subjects
H Kivelitz
Publications and source records attributed to H Kivelitz.
[Mechanical sutures in esophageal surgery (author's transl)].
Hospital lethality in patients with esophagoenteral anastomosis is high: in carcinoma of the esophagus, it is about 30%; in total gastrectomy for carcinoma, it is 43.6%. In both cases, sutureline insufficiency is responsible for more than 43%. As our results indicate, anastomosis with the EEA is the fastest and most secure in all esophagoenteral junctions if it is secured by invagination or covered by serosa. This is shown by our results in patients with carcinoma of the esophagus and stomach, as well as in dissecting procedures in patients with esophagus varices.
[Surgery of esophageal cancer].
In the last 12 months 40 patients underwent surgery for carcinoma of the esophagus. In 18 cases the tumor was located in the lower third of the esophagus. An abdomino-thoracic approach was employed and a 2/3 resection of the esophagus and an esophagogastrostomy were performed. The resected area was bridged by an isoperistaltic gastric tissue tube and anastomosis was carried out using the EEA stapler. A telescope antirefluxplasty was performed to protect the anastomosis and to prevent a gastroesophageal reflux. One patient died of pneumonia. In all cases a secure anastomosis was achieved and in most cases gastroesophageal reflux was prevented.
[Anus praeternaturalis--complications and care].
Explore the source record for details and available documents.
Hypertension--pathophysiology of renal artery stenosis: clinical experimental investigations.
Explore the source record for details and available documents.
[Experimental findings in liver perfusion measurements using an ultransonic Doppler flowmeter].
1. The ultrasonic doubling method of bloodflow measurement is an experimental easily practicable and very exactly recording measurement arrangement. By this method data of other methods were extended and ensured. 2. Early inquested finding is attested that after inhibition of portal vein bloodflow and after portocaval anastomosis an increased arterial perfusion of liver through a. hepatica is following. Increasing bloodflow of a. hepatica is independent of cardiac output. 3. After diminution of arterial perfusion by occlusion of a. hepatica no increased portal bloodflow is following. 4. It is to suppose an "intrahepatic regulation of liver bloodflow". It seems economical that the perfusion part of the a. hepatica with her higher oxygen content is increasing when the general perfusion is decreasing by diminished portal bloodflow or diminished blood pressure. So far it is impossible to interpret whether this accomodation is based on a difficult "auto-regulation" or is originated pressure passive from the flow together of two systems are staying under different pressure.
[Surgical treatment of hypertension in renal artery stenosis].
Explore the source record for details and available documents.
[Experimental and clinical investigations in pathophysiology of renal artery stenosis (author's transl)].
The effect of renal artery stenosis on the poststenotic hemodynamics is demonstrated and evaluated in the presented experimental and clinical investigation. It is shown that the resistance of a medium sized stenosis is small compared to the total renal resistance. The peripheral resistance which is induced by the stenosis is the essential characteristic in the pathophysiology of the renal artery stenosis and the resulting hypertension. The increasing pressure can be measured primarily in the stenosed artery and later also in the not stenosed side and is seen as an effect of the renin-angiotensin-mechanism. The renal artery flow returns to normal after removal of the experimental stenosis. Likewise the reduction in renal artery flow is normalized by resection of the stenosis in the initial phase of the clinical renal artery stenosis. The induced hypertension is reversed to normal. Since the resistance in the initial phase is essentially limited to the stenosed side the global renal resistance is only little increased. Increased total renal resistance is due to morphological changes in the peripheral vessels. The removal of the stenosis will not be followed by a decrease in bloodpressure. This is to be seen in the data of our clinical cases. The critical limit for an effective operation followed by a decrease in artery pressure is to be seen in a total renal resistance of over 0.25 mm Hg/ml min-1.
[Surgical management of the gastroduodenal ulcer].
Explore the source record for details and available documents.
Comparative study of in vitro flow characteristics between a human aortic valve and a designed aortic valve and six corresponding types of prosthetic heart valves.
A model of a pulsatile cardiovascular system is described including an electronic control, a hydraulic driving unit, a volume storage, a peripheral resistance and measuring equipment. Six different artificial heart valves, a designed aortic valve (Aachen pockett valve II) and a human aortic valve have been tested in the outflow position of the pump. Three of them are presently being used in clinical applications. Measurements of pressure and volume flow have been obtained for different frequencies n, pump volumes Vp and time ratios between pressure and suction phase. From the experimental results a comparative evaluation was deducted for different working conditions. In comparison to natural human aortic valve (NK) large volume flow is verified by the Aachen pocket valve II (AT), the Gott-Dagget value (GD), the Starr-Edwards valve (SE) and the Lillehei-Kaster valve (LK). The Gott-Daggett valve has the smallest back flow volume. The Smeloff-Cutter and in particular the Wada-Cutter valve have the largest regurgitation. This is to be expected since the Cutter valves are purposely so designed that they do not close tightly in order to avoid blood sedimentation. The human aortic valve, the Gott-Daggett valve and the Aachen pocket valve demonstrate the most favourable opening-closing characteristics. The human aortic valve achieves a negligible pressure loss, followed by the Björk-Shiley and the Lillehei-Kaster valve.
[Experimental surgery in pancreas/autotransplantation (author's transl)].
We have described to technique of one stage intraabdominal heterotopic pancreaticduodenal autotransplantation which has resulted in long term survival of dogs in good health. Malnutrition related to pancreatic exocrine hypofunction occurs initially but gradual recovery by 3 months nutrition is normal. In contrast, endocrine function is well preserved throughout the postoperative period except for a few days immediately after transplantation. Tolbutamide testing showed a significant prolongation of hypoglycemia as compared to controls although glucose tolerance curves were normal. There was no fibrosis after pancreas-autotransplantation. This experimental model is useful for long term evaluation of heterotopic transplantation of the pancreas. Denervation and lymphatic interruption of the pancreas may cause a transient but not definitive influence on pancreatic endocrine or exocrine function.
[Experiences in the management of patients with ileo- and colostomy (author's transl)].
In the presented paper the management of stoma-patients has been discussed. Two topics had to be seen, first the psychological guidance of the patient and his reentry into society and second the management of the stoma itself. Beside of the sometimes unavoidable complications the patients are often molested by preventable inconviences as skin-irritation, soiling, and odors. New progresses have been made by the development of scentless skin pelottes and adhesive folias. With a new adhesive tissue which avoids the contact between the skin and the adhesive folia we can prevent the skin irritations previously nearly unavoidable.
[Experimental studies on the circulation of the vascular area of the subdiaphragm using a newly developed pulse-wave pump].
A new developed partial artificial heart system is presented, which allows pulsatile perfusion of vital organs. The results presented reveal the possibility to duplicate pressure curves and peak systolic pressure in the perfused area-similar to physiological preoperative measurements. The kidney function remains intact. Angiographically there is no damage of the kidney vessels evident. The results are compared with datas of other investigators. Especially there opinion about the disturbance of renal flow and function under nonpulsatile conditions are critically evaluated. A possible connnection between the postoperative renal failure after cardio-pulmonary bypass and non-pulsatile perfusion and other pathophysiological mechanisms are discussed.
[Comparative studies on blood damage with the use of a pulse wave tube pump and a roller pump (author's transl)].
Explore the source record for details and available documents.
[Comparative studies of in vitro pulsatile flow characteristics with prosthetic heart valves (author's transl)].
Explore the source record for details and available documents.
[Carcinoma of the residual stomach following ulcer resection].
Explore the source record for details and available documents.
[Surgery of neurogenic stomach tumors].
Explore the source record for details and available documents.