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Biomedical subjects

H Lippert

Publications and source records attributed to H Lippert.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Monstrous extracranial aneurysm of the carotid artery].

Differential diagnosis of uncertain swelling of the neck has a limited number of possibilities. Thyreoideal processes, lymphatic adenomatosis and abscesses are in most of these cases prevent. However, vascular diseases should be also considered. It is current practice to perform a sonography, completed by computertomography for establishing a diagnosis. If vascular disease is suspected also an angiography is indicated. During the diagnostic procedure we discovered a major aneurysm of the left external carotid artery. The aneurysm was resected and vascular continuity restored by PTFE patchplasty. In case of tumorous processes of the neck extracranial aneurysms of the carotid artery have to be included into the differential diagnosis in order to guarantee adequate therapy.

Aneurysm↗
PubMed1995

[Chylous ascites, a rare complication of aortic surgery].

Less than 1% of all complications following vascular surgery of the abdominal aorta involve the lymphatic system. We report on a case of Chylous ascites following the operation of a ruptured infrarenal aortic aneurysm. The primary therapy, administered over a period of five weeks, consistent of diuretics and substitution by human albumin. However, the chylous flow did not decrease. A surgical intervention by a retroperitoneal ligation to try to stop the lymph flow also failed. Finally a total parental nutrition was followed by decrease and arrest of the lymph flow. Conservative treatment of this complication is considered as therapy of choice.

Aortic Aneurysm, Abdominal↗
PubMed1994

Cystic dilatation of the common bile duct: surgical treatment and long-term results.

Twelve patients (11 female) with an extrahepatic biliary cyst (six type I, three type II and three type III according to the classification of Todani) are reviewed with emphasis on aetiology, clinical features and long-term results at follow-up of 3-10 years. The clinical manifestations were abdominal pain, cholestasis with jaundice, fever and episodes of pancreatitis. The diagnosis was established before surgery in all cases by ultrasonography, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography and computed tomography. An abnormally long common channel was found in four patients. Three patients had had cysts drained internally in the 1970s. Of these three patients, one developed carcinoma of the cyst 23 years later. Radical excision of the dilated bile duct and reconstruction by Roux-en-Y hepaticojejunostomy was performed in nine cases. Two patients, each with a small choledochocele, were treated successfully by endoscopic sphincterotomy and stone extraction. There were no serious postoperative complications. All nine patients operated on remained in good health for 3-10 years. These results support radical excision of the cystically dilated bile duct with reconstruction by end-to-side Roux-en-Y hepaticojejunostomy for types I and II cyst. Endoscopic treatment of type III choledochocele should be limited to the management of smaller lesions.

Adolescent↗
PubMed1994

[Injury of the popliteal artery as a complication of knee dislocation].

Dislocation of the knee is rarely seen. Only 15 patients with a knee dislocation were treated in the surgical department of the university hospital in the last 18 years. One patient had bilateral dislocation of the knee. Injury to the popliteal artery is severe and often endangers the extremity. In seven patients with knee dislocation arterial ischemic was detected. Five patients were treated for arterial damage (31.25%).

Adult↗
PubMed1992

[Current treatment status in juvenile appendicitis. A quality assessment].

The diagnosis of appendicitis in 1989 admitted patients with an age of 1 to 14 years was prospectively investigated. In 82.6% acute inflammatory changes were found. Rate of perforation was 9.9%. Between 2 and 5 years old patients 28.5% had a perforated appendix. In two cases a colon disease and in one case a malignant carcinoid was found. No death was registered after appendectomy.

Adolescent↗
PubMed1990

Mediastinal tumours. A report of 129 cases.

Primary mediastinal tumour or cyst was surgically treated in 129 patients (including 19 younger than 12 years) during a 16-year period. All histologic specimens and smears from fine-needle aspiration biopsy were reviewed. Intrathoracic goitre, neurogenic lesions and thymomas comprised 62% of all the tumours. Fifty lesions (39%) were found at routine radiographic examination and were asymptomatic. Eight of these 50 lesions were malignant. Chest pain, fatigue, weight loss and fever were significantly more common in malignant than in benign disease. Despite extensive investigations, the diagnosis was not established preoperatively in 32% of the cases. Chest radiography, CT-scanning and fine-needle aspiration biopsy usually provide satisfactory diagnostic information, thereby substantially reducing the need for other preoperative procedures. Early operative intervention is mandatory in these cases.

Adolescent↗
PubMed1990

[Diagnosis of rejection after pancreatic transplantation in the minipig model].

An allogenic transplantation of the total-pancreas with duodenum was carried out in the minipig model. The oral duodenum was closed blindly and the aboral part was led out as a stoma. The portal vein of the transplant was anastomosed end-to-side in the inferior vena cava and the celiac artery of the transplant in the distal aorta. Investigations for early diagnosis of rejection were carried out in this model parallelly respectively one by one. CT/MRT, selective angiography, laboratory chemical parameters were unsuitable for early detection. The pancreatic succus cytology and nuclear medical investigations show reproducible changes caused by rejection before the blood-sugar level was increased.

Amylases↗
PubMed1990

[Diagnosis and therapy of hyperinsulinism].

The diagnosis of hyperinsulinism in our 47 patients could be confirmed by clinical signs, blood sugar, insulin and C-peptide estimation. The preoperative localisation of the insulinoma was reached by angiography in 60%, by CT in 50% and by sonography in 10%. Intraoperative tumor localisation by measurement of incorporated P32 was effective in 70%. In 37 patients we enucleated one or more adenomas. In 5 children with Nesidioblastosis the left sided pancreas resection was performed. 5 patients with islet cell carcinoma were treated by duodenopancreatectomy and Streptozotocin. The longest survival time was 6 years.

Adolescent↗
PubMed1990

[Experiences with fibrin glue-coated collagen fleece].

Fibrin-adhesive coated collagen fleece (Tachocomb) was used for haemostasis on 57 patients on whom different types of operations had been performed. These had been partial hepatectomies (21 cases), liver transplantations (six), and partial pancreatectomies (nine). Haemostatic effect on diffuse oozing haemorrhage was satisfactory. However, collagen fleece patches were only 8 cm X 4 cm in size and should be available in larger dimensions, particularly when it comes to larger sealing areas.

Collagen↗
PubMed1990

[Surgery of pancreatic necrosis].

Surgical intervention in the presence of pancreatic necrosis was indicated if infection of necrosis developed. The demonstration of necrosis by CT, without clinical evidence of infection was not sufficient for operation. From 155 patients with necrotizing pancreatitis 134 had an operation upon. Surgical technique was the necrotectomy, drainage formation of a compartment and the periodic local lavage of the pancreatic cavum. 53 (39%) of 134 operated patients died.

Acute Disease↗
PubMed1989

Effect of proximal selective vagotomy on gastric prostaglandin content in the Shay-rat ulcer model.

During Shay-ulcer formation damages to the barrier of the gastric mucosa develop even before the appearance of macroscopic ulceration. Proximal selective vagotomy prevents these damages. Following pyloric ligation the prostaglandin content of the mucosa changes in parallel with the injuries of the mucosal barrier: TXB2 content of the forestomach increases, while PGF2 alpha content of both the forestomach and the antrum decreases. Following PSV operation the 6-keto-PGF1 alpha content of the mucosa decreases, whereas PGF2 alpha and TXB2 contents exhibit no alteration. As a combined effect of proximal selective vagotomy pretreatment and pyloric ligation the 6-keto-PGF1 alpha and PGF2 alpha contents of the mucosa remain low and the TXB2 increase, otherwise detectable after pyloric ligation, does not take place.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

[Pancreatoduodenal transplantation with and without the spleen in an animal experiment].

It is a report on the heterotop transplantation of the pancreas with duodenum with or without spleen to diabetic mini-pigs. 7 days after a total resection of the pancreas the truncus coeliacus of the transplant is anastomosed end-to-side with the distal aorta. The same is done with the vena cava inferior. After having closed the duodenum orally the pancreatic juice is drained through on anus praeter. The immunosuppression is reached by giving Cyclosporin A and prednisolone after having analyzed the blood picture. The postoperative laboratory tests as well as affection tests including selective angiographic and nuclear medical in vivo controls show the efficiency of this transplantation variant to control a diabetic metabolic level for several weeks without an external insulin supply. The transplantation model described is technically uncomplicated and it is the basis for further studies.

Anastomosis, Surgical↗
PubMed1989

[Initial results of a new method of pancreatic transplantation].

A new method of intraperitoneal transplantation of the whole pancreas as donor-pancreaticoduodeno/recipient-cholecystostomy is described. The pancreas with duodenal segment is placed into the dorsal peritoneal cavity and the portal vein is anastomosed with the subhepatic vena cava and the long aortic segment of the graft with the distal aorta of the recipient. An anastomosis between the donor's duodenal segment and the recipient's gallbladder ensures exocrine pancreatic secretion drainage.

Anastomosis, Surgical↗
PubMed1989

[Experimental animal studies of the effect of selective proximal vagotomy on the prostaglandin content of the gastric mucosa in the Shay ulcer model].

Mucosa damage, these appear in the Shay ulcer model before the macroscopic ulceration, can be prevented by the selective proximal vagotomy. Changes of the potential difference and the prostaglandin content were discovered after pylorus ligation, and Thromboxane was increased, PGF2 alpha and TXB2 were nearly constant, whereas 6-keto-PGF1 alpha increased clearly in the rumen. The 6-keto-PGF1 alpha and the PGF2 alpha content and Thromboxane remained unchanged and the potential difference was normalized in case of selective proximal vagotomy and pylorus ligation. The SPV is significant as you know for the secretion of H+ion and bicarbonate, but also for the normalization of increased TXB2 on the basis of our investigation results.

6-Ketoprostaglandin F1 alpha↗