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Biomedical subjects

I Joppich

Publications and source records attributed to I Joppich.

At least 19 recordsLinked to original sources
PubMed1992

Indication for using extracorporeal membrane oxygenation in congenital diaphragmatic hernias and pulmonary hypoplasia.

Despite the apparent surgical simplicity of the anatomic defect, congenital diaphragmatic hernia continues to be a critical problem in neonatal surgery, so that survival is still uncertain. Therefore, we must realize that the barriers to survival are pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persisting fetal circulation. However, new treatment methods, such as extracorporeal membrane oxygenation (ECMO), although controversial, may improve survival. We believe that no infant should be excluded from diaphragmatic repair or consideration for ECMO-support before accurate predictive parameters have been developed that take both pulmonary hypoplasia and pulmonary hypertension into account. ECMO additionally enables us to postpone the operation until stabilization of the newborn (Late Operation Protocol). Apart from this, we can probably improve the long-term results after ECMO by reconstructing the common carotid artery.

Combined Modality Therapy↗
PubMed1992

[Experiences with funnel and pigeon chest correction with the modified Ravitch method].

We present 843 operations of chest wall deformities performed from 1971 to 1991 using the modified technique of Ravitch. We discuss the indication for operation, the perioperative management, and the early and late complications. In 54% we found a good result, and in up to 91% an acceptable one. In 9%, the result was poor. Furthermore we report our interview of 184 patients about their opinion on the perioperative situation and the result.

Adolescent↗
PubMed1990

[Surgical aspects of bone tumors in children].

The combination of surgical procedures with chemotherapy and radiotherapy has improved the disease-free 3-year survival rate in children treated for malignant bone tumors, and it is now 80%. As far as the quality of life is concerned, limb-conserving technique should be preferred whenever possible. The rate of local recurrence is equal to that after amputation, while the rate of pulmonary metastasis somewhat higher, for reasons that are still unknown. It is shown that the decision for amputation or segmental resection has to be considered strictly individually for each patient.

Amputation, Surgical↗
PubMed1989

[Abnormalities of the common bile duct and Vater's papilla in various forms of duodenal atresia].

Associated anomalies are often found in newborn with duodenal obstruction. Anomalies of the biliary tract are of special interest. Malformations of the terminal common bile duct and the papilla of Vater are the most common ones. The recognition of the possible anatomical variations is most important to avoid inadvertent injuries in the correction of duodenal obstruction.

Abnormalities, Multiple↗
PubMed1989

[Pleural empyema in childhood].

Empyema is a rare parapneumonic complication in children. The use of antibiotics and closed-tube thoracostomy drainage has superseded operative procedures like decortication even in anaerobic infections. Only a few authors still recommend early decortication. However empyemas based on malformations such as lobar emphysema or cystic lung should be treated surgically.

Child↗
PubMed1988

[Accomplishments of tumor surgery in bone sarcoma in childhood].

Neither chemotherapy nor surgery alone provided satisfactory treatment of bone sarcomas in children. However, their combination improved the 3-year-survival rate by up to 80% in the last decade. For better life quality, limb-sparing techniques like en-bloc-resection, rotation plasty or endoprosthesis should be preferred instead of amputation, if they are possible within the demands of radical oncological surgery. The significantly higher incidence of pulmonary metastasis of en-bloc-resection compared to that of ablative surgery as shown in the COSS-80-study points out that limb-sparing surgery is still problematic and needs further technical improvement in the future.

Bone Neoplasms↗
PubMed1986

[Acute abdominal pain in childhood].

According to the difficulties in communication with babies and very young children there often are problems in the early diagnosis of abdominal pain or symptoms. This is demonstrated in the example of appendicitis in children and meconium peritonitis in the newborns. The possibilities of pain measuring in newborn or preterm babies are shortly discussed.

Abdomen↗
PubMed1983

Thyroid carcinoma in childhood.

About 50% of children with thyroid carcinoma present with regional lymph node metastases as the leading symptom. The "cold nodule" is the typical scintigraphic finding in thyroid cancer in infants. Papillary carcinoma is the predominating histologic type (80%) and has a good prognosis. Radical removal of the thyroid lobe with the primary lesion and subtotal resection of the opposite lobe, combined with selective neck dissection if necessary, seems to improve the results. Postoperative scintigraphic examinations detect remnants of malignant tissue requiring 131-iodine treatment and, finally, TSH-suppressive hormone is administered. In our own cases, the survival rate in 25 children was over 90%.

Adenocarcinoma↗
PubMed1983

[Fibrin gluing of congenital esophageal malformations].

Gluing of oesophageal anastomoses in atresia effected by means of three or four sutures will definitely produce better results than suturing alone. The results of endoscopic closure of tracheo-oesophageal fistulas by gluing with fibrin are excellent. Furthermore, it is possible with fibrin gluing alone to treat iatrogenic perforations of the oesophagus in the newborn, following a false passage of nasogastric tubes from the hypopharynx into the mediastinum or pleural cavity.

Drug Combinations↗
PubMed1982

[A contribution to congenital segmental intestinal dilatation (author's transl)].

Segmental intestinal dilatation is rare and has so far been described for 26 patients only. The article presents three own observations. The clinical symptoms correspond to those of intestinal obstruction and are in most cases manifest in infancy and early childhood. The affected section of the intestine is dilated regionally to 3 to 4 times the normal value and can be situated both in the small intestine and in the colon. The intestinal wall is thickened or thinned; all intestinal wall layers are preserved and the ganglionic cells are regular. A characteristic feature is the histological finding of heterotopic tissue such as gastric mucosa and tissue of pancreas, lung or cartilage. The mesenterial veins are markedly congested. In 50% of all patients association with other malformations is seen.

Abnormalities, Multiple↗
PubMed1982

[Use of highly concentrated human fibrinogen in paediatric surgery - a new therapeutic principle (author's transl)].

When using fibrin glue we must distinguish, on the basis of the clinical results obtained, between an obsolute and a relative indication for glueing. Glueing of the oesophageal anastomosis in atresia effected by means of three of four fibres only definitely produces better results than suturing alone. Likewise, fixation of skin grafts and treatment of ruptured spleen are an exclusive indication for fibrin glueing. Endoscopic glueing of oesophagotracheal fistulas and treatment of rupture of the kidneys, liver and pancreas are essential indications for glueing, alone or together with suturing. Intestinal anastomoses which are in danger of becoming detached can be secured by means of fibrin, thus improving the results. This applies equally to all fields of plastic surgery. In bone surgery, small detached parts of cartilage or of bone can be fixed atraumatically by glueing. Finally, improved and accelerated reconstruction e.g. of removed bone cysts can be expected by inserting fibrin-spongiosa fillings.

Arteriovenous Shunt, Surgical↗
PubMed1981

[Ultrasonics in the differential diagnosis of space-occupying lesions of the kidney in children].

During the last few years the coordination of ultrasound, radiology and urologic surgery led to the diagnosis and treatment of numerous diseases of the kidney. From 1976 till the beginning of 1979 we were able to diagnose 50 expanding retroperitoneal processes. These were hydronephroses, malignant tumors and enlargement of the kidney due to inflammatory affections ensuing nephrolithiasis as well as urosepsis and shock. The fact that sonography is a harmless, non invasive, simple and often repeatable examination is the most important advantage. Provided that ultrasound diagnosing is performed by an experienced person, there is a good correlation to the common x-ray methods and specially recommended for postoperative controls.

Child↗
PubMed1981

[Late postoperative complications in Hirschsprung's disease (author's transl)].

In more than 5,500 patients operated upon for Hirschsprung's disease which were obtained from the literature, the late complications following the 4 principal operative procedures of Swenson, Duhamel, Rehbein and Soave were compared. After Duhamel's operation, there was a lower incidence of postoperative constipation: 6.7%, compared with an average rate of 9.3%. Rehbein's resection showed the best results in relation to incontinence with a complication rate of 2.1% while the average was 9.8%, also in enterocolitis and diarrhoea (2.4%, average 7.8%) and enuresis (5.1% compared with 9.7%). We found the lowest incidence of late ileus (2.2% to 4.4%) and mortality with the Rehbein method. Judging by the frequency of late complications, the technique of Rehbein's anterior resection seems to be the most commendable.

Constipation↗