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Biomedical subjects

H Pichlmaier

Publications and source records attributed to H Pichlmaier.

At least 199 records · Page 11Linked to original sources
PubMed1978

[Total parenteral nutrition as primary therapy in Crohn's disease (author's transl)].

Total parenteral nutrition was given to 10 patients with acute regional enteritis for 3--12 weeks. The rationale of this therapy is elimination of potential food allergens and decrease of intestinal irritation. Complete remission of the disease could be achieved in 8 patients, thus surgical removal of the intestine involved could be avoided. One entero-cutaneous and two perinal fistulas healed spontaneously; two other perianal fistulas improved so much, that local surgical treatment was sufficient. If well planned, total parenteral nutrition can be performed without disturbance of metabolism and septicemia caused by the catheter can be avoided. No final judgement about recurrence of regional enteritis after total parenteral nutrition is possible at present due to as yet limited experience.

Adult↗
PubMed1977

The immediate function of the kidney after 24-to 72-hr preservation. Hypothermic storage versus mechanical perfusion.

Seventy-two dog kidneys were stored under hypothermia as described by Collins and Sacks between 24 and 72 hr and then transplanted. The immediate function of the kidneys was measured by p-aminohippuric acid and inulin clearances. Twenty-four hr proved to be the maximum safe preservation time with both methods. The immediate function of the kidneys stored under hypothermia could not be improved by the addition of furosemide to the flushing solution. These results were compared with those gained by mechanical perfusion of the organ. Kidney function after 72 hr of hypothermic mechanical perfusion was significantly better than after 24 hr of hypothermic storage.

Animals↗
PubMed1977

Relationship between the prolongation of warm ischemia and the maximum available preservation period.

Fifty dog kidneys had hypothermic perfusion for 12 to 72 hours and then were transplanted. Prior to perfusion the kidneys were subjected to 15, 30, 45, and 60 minutes of warm ischemia. Fifteen minutes of warm ischemia was well tolerated (successful 72 hour preservation), but after 30 minutes successful preservation could be achieved for 24 hours only. Enzyme release and lactate formation were related to the prolongation of warm ischemia, and the highly significant concentration differences of these substances, between well functioning kidneys and those with small or no function, indicated the viability of the organ.

Animals↗
PubMed1977

[Possibilities of controlling blood less in liver resection].

The methods are described by which blood loss can be reduced during hepatic surgery. This requires the proper surgical techniques (control method of hepatic lobectomy and occasionally the atypical resection with the use of a clamp- "crush" method). In additions clamping of the liver hilus and resection under hypothermia, the resection of the isolated bloodless organ under hypothermia, the application of an internal caval shunt, intraoperative autotransfusion, and acute preoperative hemodilution should be performed. The internal caval shunt can be successfully used in the case of emergency as well as during excision of large tumors which have involved the liver tissue adjacent to the vena cava. In these cases the method of complete vascular isolation and hypothermic perfusion should be performed additionally. Acute preoperative hemodilution should be widely applied with hepatic surgery; blood clotting is not impaired by this method.

Blood Transfusion, Autologous↗
PubMed1977

[Kidney preservation by mechanical perfusion and by hypothermic storage: a comparative study].

72 dog kidneys were stored under hypothermia as described by COLLINS and SACKS between 24 and 72 hrs and then transplanted. The immediate function of the kidneys was measured by PAH and inulin clearances. 24 hrs proved to be the maximum safe preservation time with both methods. The immediate function of the kidneys stored under hypothermia could not be improved by the addition of furosemide to the flushing solution. These results were compared with those gained by mechanical perfusion of the organ: kidney function after 72 hrs of hypothermic mechanical perfusion was significantly better than after 24 hrs of hypothermic storage.

Animals↗
PubMed1977

[Preoperative reduction of intestinal bacteria through orthograde lavage of the large intestine].

The orthograde colon lavage, suggested by Crapp, is a new method for the preoperative preparation of the colon. On the day prior to surgery, the sitting patient receives for 4 h through a stomach probe, 101 of physiological saline solution warmed up to 37 degrees C. The result is a complete evacuation of the bowel. If a bactericidal antibiotic with a broad spectrum of activity (neomycin) is added, the suppression of the microflora amounts to 92%. The regeneration of the intestinal flora could be observed after a few days. A complete evacuation of the colon is guaranteed by this procedure, so that all operations can be performed under optimal conditions. From the clinical as well as from the microbiological point of view this method is without any risk. -- The orthograde colon lavage is indicated in every case of colon, rectum and anal surgery, but it is contraindicated in patients with highly stenosing tumors.

Anal Canal↗
PubMed1976

[Rubber band ligation--an alternative treatment for haemorrhoids (author's transl)].

Rubber band ligation, first described by Blaisdell, is an effective way of treating internal haemorrhoids. Treatment is ambulatory, thus saving time and costs. Experiences with 72 patients show this method to be superior to injection therapy and haemorrhoidectomy because of the simplicity of technique, the short period of treatment and the minimal discomfort for the patients. In our opinion rubber band ligation is the treatment of choice in managing internal haemorrhoids.

Adult↗
PubMed1976

[Results of operative treatment of bronchial carcinoma (author's transl)].

Between 1960 and 1974 a total of 14 937 patients were treated in 16 German surgical departments for bronchial carcinoma. 70% proved to be inoperable. In 30% the tumour was resected, the five-year survival rate of those patients operated on before 1969 being 23%. In suitable cases, lobectomy proved to be a satisfactory radical method of resection in parallel with pneumonectomy, while the operative risk of the latter was twice as high. The operative risk decreased by half during the period of observation. Best results of tumour resection were achieved when in the early stage. The prognosis of anaplastic carcinoma was not significantly worse than that of other histological types. Further improvement in the results of surgical treatment of bronchial carcinoma are to be expected if the operative risk can be decreased further and more patients can be operated on at an earlier stage.

Adult↗
PubMed1976

[The influence of warm ischaemic time on the results of hypothermic kidney perfusion (author's transl)].

50 dog kidneys were mechanically perfused under hypothermia for between 12 and 72 h and then transplanted. Before perfusion the kidneys were subjected to 15,30,45 and 60 min of warm ischaemia: 15 min of warm ischaemia were well tolerated (successful 72-h preservation), but after 30 min preservation was successful for only 24 h. Enzyme release and lactate formation depended on the duration of warm ischaemia. Furthermore, these perfusate concentrations indicated the viability of the organ (highly significant differences between well functioning kidneys and those with little or no function.

Animals↗
PubMed1976

[Surgical management of gastric carcinoma (author's transl)].

The treatment of choice of gastric carcinoma is still radical surgery which has to be tried in all cases which are not proven to be untreatable by this method. During surgery the tumor as well as regional lymph nodes and neighboring structures have to be removed; in special cases subtotal gastrectomy carrying a lower risk at surgery does allow complete removal of the tumor. Replacing the stomach by interposition of a long loop of the small intestine has proven to yield good results. The overall bad results of management of gastric carcinoma cannot be improved to any considerable extent by surgical means, e.g. by lowering the risk of surgery or by increasing the number of patients operated upon. Early diagnosis is of outmost importance since patients with tumors of an early stage have a rather good chance of being completely cured.

Gastrectomy↗
PubMed1976

[Surgery of gastric and duodenal ulcer].

The variety of surgical techniques to deal with gastric and duodenal ulcers has been increased by non-resecting methods (truncular, selective, selective proximal vagotomy with or without pyloroplasty). Selective proximal vagotomy has proved its worth in uncomplicated chronic duodenal ulcer. Additional drainage is needed when there is pyloric stenosis. In 309 patients of the surgical department of Cologne-Lindenthal in the years 1970 to June 1975 selective proximal vagotomy for chronic duodenal ulcer had an operative mortality of 0.7%. 1-5 years later 88% of patients had no recurrence. The main cause of recurrence is incomplete vagotomy which could be avoided by the routine intra-operative use of the electrostimulator of Burge. In chronic gastric ulcer removal of the ulcer is needed because of the danger of malignant degreneration. Two third resection is the standard technique. In patients at risk vagotomy, pyloroplasty and excision of the ulcer are indicated.

Duodenal Ulcer↗
PubMed1975

[Technique and results of hepatic resection (author's transl)].

12 major hepatic resections are described. There were two postoperative deaths. 4 patients received more than two blood units intra- or immediately postoperatively (maximal blood loss 5000 and 4400 ml resp.). In 5 patients the operative procedure was performed in hemodilution, in these patients the maximal transfusion rate ranged to one blood unit. In nearly all patients a subphrenic collection of bile, blood and secretion was observed, but this was well treated conservatively. The various operative procedures, the possibility to avoid blood loss during hepatic resection and the concept of biliary drainage are discussed.

Bile Duct Neoplasms↗