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H Pitz

Publications and source records attributed to H Pitz.

14 recordsLinked to original sources

SAP and partners: IS-H and IS-H* MED.

OBJECTIVES: The Styrian Hospital Organization with 21 hospitals including the Graz University Hospital, and the Heidelberg University Hospital implemented a new HIS based on SAP/R3, ISH, ISH* MED with the objective to have an integrated system to support patient administration and management, patient care, clinical documentation, research etc. METHODS: Heidelberg University Hospital chose a step by step method for the introduction of the system, beginning with patient administration (ISH) and proceeding with clinical functions (ISH* MED). In Styria, the full functionality was implemented--as part of the selection process--in one peripheral hospital and in the Ear, Nose and Throat (ENT) Department of the Graz University Hospital, including special documents to support the processes in the highly specialized ENTunits. RESULTS AND CONCLUSIONS: The standard modules are performant, stable and basically well accepted. Particularly in Graz, it has been shown that the requirements of highly specialized departments for work flow management, documentation and integration of subsystems and data from different sources can be fulfilled by special documents and programs--although at the expense of additional workload particularly in the initial phases of such a project.

Austria↗

A comparison of radical and conservative neck dissection.

A review is presented of the confusing terminology applied to the various types of neck dissection. It is recommended that the terms "conservative" and "radical" be based on clear definitions. The fourth prospective, randomized DOSAK therapy study deals with the controversial issue of radical as compared with conservative neck dissection. Patients with squamous cell carcinoma (SCC) of the oral cavity who had not been treated before were randomized and stratified according to the DOSAK treatment-dependent prognostic index (TPI). At present, 104 patients have been evaluated, of whom 48 had radical neck dissection, and 56 conservative neck dissection. Tumor location and patient age and sex are equally divided in both therapy groups. After an average follow-up time of 460 days, the relative mortality for both therapy groups is 23%. At this stage, there is no difference between the two groups in the percentage of patients with complete remission or in the percentage of patients alive. At this stage, there appears to be no difference between the two groups with regard to patient survival or recurrent disease.

Carcinoma, Squamous Cell↗

Proposal for a modified T-classification for oral cancer. The DOSAK.

The UICC plans to publish a modification of the TNM system. A proposal for a T category is calculated out of the data from the DOSAK tumour registry containing more than 3000 cases of primary squamous cell carcinomas of the oral cavity & oropharynx. By adding tumour thickness as a factor of the T component, the prognostic relevance of the classification is enhanced.

Carcinoma, Squamous Cell↗

[The elimination of hydroxyethyl starch 200/0.5, dextran 40 and oxypolygelatine (author's transl)].

After withdrawal of 400 ml whole blood and subsequent infusion of 500 ml of a colloidal plasma substituent, the intravascular and renal colloid elimination was investigated in 40 test subjects. The individual colloidal solutions could no longer be demonstrated in the intravascular space after the following times: 10% hydroxyethyl starch 200/0.5 (anthrone method) after six weeks, 10% dextran 40 (anthrone method) after two weeks, 6% hydroxyethyl starch 200/0.5 (anthrone method) after four weeks and 5.5% oxypolygelatine (hydroxyproline method) after two days. Colloidal plasma substitutes are polydisperse solutions with various molecular weights and degree of hydroxyethylation and therefore, also have a large number of different elimination constants. With repeated application, the intravascular colloid concentration shifts in favour of the molecules with a longer half life which are difficult to eliminate. The elimination of the clinically employed dextran 40 and oxypolygelatine solution could be best described with an open two-compartment model. As a result of its greater heterogeneity, the elimination of the moderately high molecular weight hydroxyethyl starch 200/0.5 could only be characterized approximately even assuming three elimination constants. In the first four days, the hydroxyethyl starch 200/0.5 was more rapidly eliminated compared to dextran 40. However, subsequently a very much lower elimination from the intravascular space was found for about 3% of the administered hydroxyethyl starch 200/0.5. Oxypolygelatine was eliminated especially rapidly. Accordingly, the greatest renal clearance was found for oxypolygelatine, which showed a close relation to the molecular weight. On the other hand, a rapid elimination simultaneously is followed by a correspondingly lower volume effect.

Adult↗

[Second increase in plasma volume after single infusion of hydroxyethyl starch (author's transl)].

6 patients without evidence for renal, hepatic or pancreatic disease were treated with intravenous infusions of 500 ml hydroxyethyl starch (6%) over a period of 60 min. In the course of the infusion we observed an increase in plasma volume from 2.72 +/- 0.101 to 3.36 +/- 0.141. After 2 h plasma volume decreased to 3.02 +/- 0.101 but showed a second peak of 3.23 +/- 0.121 after 4 h (p less than 0.01). 24 h following infusion an increase in plasma volume of 4,8% was found as compared to preinfusion values. The second increase in plasma volume cannot be explained by the total concentration of hydroxyethyl starch since the latter decreased continuously. The increase in plasma volume was accompanied by a decrease in average molecular weight (-Mw and -Mn). It is suggested that serum amylase produces small osmotic active molecules by degradation of hydroxyethyl starch, thus leading to an increase in plasma volume. 12--24 h after the infusion of hydroxyethyl starch serum amylase was more than twice as high basal values. This is caused by the formation of a high molecular hydroxyethyl starch-amylase-complex which cannot be eliminated easily. When hydroxyethyl starch is given repeatedly to normovolemic patients, the second increase in plasma volume should be considered as a possible cause for acute hypervolemia. This is especially true for patients with myocardial insufficiency.

Adult↗

[On precipitation in clinical dextran solutions (author's transl)].

Dextran precipitation has the same molecular weight distribution as the raw material. However, there are also high molecular shares of associates (aggregates). Precipitation which can be caused by change of temperature passes three stages: 1. Formation of dextran associated. 2. Growth of a dextran film (micro gel) 3. Exsiccation and precipitation.

Chemical Precipitation↗

[Computer documentation of malignomas of the mouth, jaws and face using the BAIK system].

The computer-supported documentation of head and neck tumors by means of the BAIK-system is presented. The experience after introducing the project to clinical routine use in patient's treatment is outlined. The subsystems of BAIK are critically reviewed for this purpose. Although we realize some drawbacks of BAIK the system proved to be useful for our application, mainly because of its strong retrieval functions, combining coded and free text data manipulation.

Computer Systems↗