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H Siebert

Publications and source records attributed to H Siebert.

At least 37 records · Page 2Linked to original sources
PubMed1998

Results after surgery in stage-I bronchogenic carcinoma.

BACKGROUND: The aim of this retrospective study was to evaluate prognostic factors for recurrence-free survival in stage-I non-small-cell bronchogenic carcinoma. METHODS: During 9 years, 338 consecutive patients were operated on for stage-I bronchogenic carcinoma. Patients with small-cell carcinoma (n = 14), prior malignancies in locations other than pulmonary (n = 41), and patients with incomplete data on prognostic factors (n = 11) were excluded. Of the remaining 272 patients 226 were men. Mean age was 63 years (40 to 81 years). The resections performed comprised 215 lobectomies and bilobectomies, 36 segmentectomies and wedge resections, and 21 pneumonectomies. According to the number of sites of dissected lymph nodes 3 subgroups were formed: group A with 0 to 4 (n = 71), B with 5 to 6 (n = 118), and C with 7 to 10 sites (n = 83). Median follow-up was 46 months. RESULTS: Three patients (1.1 %) died within 30 days of operation. In 3 patients the resection was revealed to be not radical (R1). At the end of follow-up, 191 patients were alive, 174 of these without recurrence. Eighty-one patients had died, 53 associated with tumor recurrence. Four patients had died of non-pulmonary malignancies. Twenty-two patients died of causes not related to tumor disease. In 2 patients the cause of death could not be determined retrospectively. Overall 5-year survival was 65% (95% confidence interval [CI] 58-72%), recurrence-free survival 59% (CI 51-66%). Significant prognostic factors for recurrence-free survival were T stage (relative risk [RR] 1.7 for T2 vs. T1, CI 1.0-3.0), age (RR 1.9 for >70 years vs. < or =70 years, CI 1.1-3.1), adeno cell type (RR 2.3 vs. squamous cell, CI 1.4-4.0), as well as lymphangiosis carcinomatosa (RR 2.3, CI 1.2-4.4). Extent of operative resection, extent of lymphadenectomy, and sex did not influence survival. CONCLUSION: 5-year survival of our patients was in the range reported in literature. Most patients died of distant metastases. Our retrospective study probably underestimated the occurrence of second primary cancers of the lung. Limited resection in poor-risk patients showed equivalent results to lobectomy. The extent of lymph-node resections had no influence on survival of stage-I patients, however, it must be remembered that positive results in lymph nodes shift patients to higher stages.

Carcinoma, Bronchogenic↗
PubMed1998

Lectin ligands: new insights into their conformations and their dynamic behavior and the discovery of conformer selection by lectins.

The mysteries of the functions of complex glycoconjugates have enthralled scientists over decades. Theoretical considerations have ascribed an enormous capacity to store information to oligosaccharides. In the interplay with lectins sugar-code words of complex carbohydrate structures can be deciphered. To capitalize on knowledge about this type of molecular recognition for rational marker/drug design, the intimate details of the recognition process must be delineated. To this aim the required approach is garnered from several fields, profiting from advances primarily in X-ray crystallography, nuclear magnetic resonance spectroscopy and computational calculations encompassing molecular mechanics, molecular dynamics and homology modeling. Collectively considered, the results force us to jettison the preconception of a rigid ligand structure. On the contrary, a carbohydrate ligand may move rather freely between two or even more low-energy positions, affording the basis for conformer selection by a lectin. By an exemplary illustration of the interdisciplinary approach including up-to-date refinements in carbohydrate modeling it is underscored why this combination is considered to show promise of fostering innovative strategies in rational marker/drug design.

Crystallography↗
PubMed1998

[AO-classification of fractures of the hand bones].

The AO classification of fractures has gained worldwide acceptance regarding usefulness of typification, therapeutic consequences and assessment of results. Following these principles, we developed a classification draft for fractures of the hand, using an alphanumerical code.

Fracture Healing↗
PubMed1996

[Requirements and provision of services for severely handicapped patients according to SGBV regulations 1991-1993].

Benefits for non-institutionalised severely disabled persons by the German statutory health insurance system were introduced in 1989 and extended in 1991. They were provided depending upon a standardised medical examination. We analysed 4185 examinations carried out in the city and the region of Augsburg in Southern Germany during 1991-1993 with regard to social and medical conditions of applicants. A total of 2706 persons examined (64.7%) were considered to meet the criteria of permanent dependence on nursing. The majority of applicants were more than 75 years of age (56.9%) even though all age groups were represented. The leading cause for dependence on nursing were diseases of the circulatory system (29.4%), followed by diseases of the nervous system (20.5%) and musculoskeletal disorders (14.6%). The main burden of nursing care was borne by the relatives; professional institutions played only a minor role. The degree of dependence with regard to basic activities of daily living, especially "turning in bed", "dressing" and "using toilet" showed the strongest association with the overall assessment of nursing dependence. With the introduction of a new nursing care insurance system in Germany ("Pflegeversicherung") in January 1995, benefits for disabled persons have been extended further. To improve prevention of nursing-care dependence and to ensure the best possible care of patients in need of such care, further investigations are required which should focus on risk factors for both nursing-care dependence and long-term nursing home and hospital admission of disabled persons.

Activities of Daily Living↗
PubMed1996

[Empirical analysis of expert social medicine assessment of disability based on the decision of the Federal social court].

Objective assessment of need for nursing care should be based on well defined criteria. In 1993, the Federal German Social Court ("Bundessozialgericht", BSG) has given criteria for identifying individuals in permanent need of very intensive nursing care ("Schwerpfledgebedürftige"), who qualified for benefits granted by the Germany statutory health insurance system at that time. The criteria were primarily based on the number of activities of daily living for which the applicants were in need of help. The criteria were largely, but not entirely, consistent with previously established criteria employed by the Medical Service of the Health Insurances ("Medizinischer Dienst der Krankenversicherung", MDK), who was responsible for the assessment. An analysis of 4185 examinations carried out by MDK in the region of Augsburg in 1991-1993 showed that the majority of judgments were in agreement with the criteria given by BSG. However, individuals with psychiatric disorders or symptoms were often rated by MDK as being in permanent need of very intensive nursing care even if BSG criteria were not fulfilled. Exclusive judgement of nursing dependency on the basis of single activities of daily living appears to be inadequate for this group of persons.

Activities of Daily Living↗
PubMed1983

[Modification of osteomyelitis with free musculocutaneous transplants].

Twenty two latissimus dorsi free flaps transplanted with microsurgical techniques in infected regions are presented. The guarants of success are the end-end anastomosis, the venous drainage over the deep veins, the muscle with its skin coverage. The indications are: soft tissue infections, early infections after fractures, and the chronic osteitis. The economic, social and psychological effects of microsurgical tissue transfer elevate this technique to the procedure of choice.

Adult↗
PubMed1983

[Post-traumatic hip dysplasia].

At a traffic accident in 1970 a then 6 year old boy got an impacted fracture of the neck of the right femur with persisting subluxation. This was not particularly noticed because of the severity of other injuries. In the meantime the most recent follow-up examination (1981) of the boy (now 17 years old) showed a dysplasia like growth disorder. Various possibilities of interpretation are discussed.

Accidents, Traffic↗
PubMed1982

[Choice of time for the definitive treatment of injuries of the extremities in persons with multiple injuries].

There are still gradually and even fundamentally different opinions about the most favorable moment for the definitive treatment of lesions of extremities in persons with multiple injuries. The immediate definitive treatment or primary treatment within the first 24 to 48 hours is opposed to a therapy method applying a graduated definitive treatment of the lesions of extremities taking into consideration the individual extent of the injury. During the period from January 1st, 1975 to December 31st, 1979, 321 persons with multiple injuries of degrees 2 and 3 have been treated at the Hospital for Accident Surgery of the University of Frankfurt/Main. 290 fractures were treated in 225 surviving persons with lesions of the extremities. Among 136 fractures of the lower extremities, 118 were operated upon--44 of them immediately and 74 until the end of the fourth week. All femur fractures in surviving persons with multiple injuries were surgically stabilized, with the exception of several cases of isolated fractures of the shank diaphysis who received conservative treatment. Although we consider an early surgical treatment of femur fractures in persons with multiple injuries as the most favorable basis for a continuous and uninterrupted recovery, which we also strive for, the experiences made by us hitherto do not demand a general indication of immediate surgical treatment (within the first 24 hours) of closed femur fractures in persons with multiple injuries. We shall continue to apply a graduated therapy method, considering each individual case, for final treatment of fractures of extremities in persons with multiple injuries.

Adolescent↗
PubMed1981

[Principles of therapy and priorities in polytrauma (author's transl)].

Immediate assessment of severe injuries, and instant, effective therapy are the fundamentals of getting good results in the emergency management of trauma victims. A schedule for, if possible, early fracture fixation in multiply traumatized patients is recommended to avoid acute complications and irreversible lesions. Yet cautious and individual timing of internal fixation is mandatory especially in seriously injured patients with concomitant severe cranio-cerebral trauma and long-lasting unconsciousness.

Adult↗