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Biomedical subjects

J Kussmann

Publications and source records attributed to J Kussmann.

17 recordsLinked to original sources
PubMed1997

[Malignant non-epithelial tumors of the pancreas].

Nonepithelial malignant tumors of the pancreas are extremely rare neoplasms with a frequency of approximately 0.6%. They are always explored because of a suspected diagnosis of pancreatic carcinoma. Amongst the more than 600 primary pancreatic neoplasms in our pancreatic tumor archive only 5 neoplasms were of nonepithelial origin (one was a malignant peripheral nerve sheath tumor [MPNST], one a leiomyosarcoma, one a malignant mesothelioma, and two were peripheral neuroectodermal tumors [PNET]. The differential diagnosis includes secondary infiltration of the pancreas by mesenchymal tumors of the retroperitoneum, undifferentiated pancreatic carcinoma and, especially in the case of PNET, malignant lymphoma. Preoperative chemotherapy and down-staging can improve the operability and prognosis, especially in PNET.

Adolescent↗
PubMed1996

[Radiological thorax monitoring in ventilated intensive-care patients].

PURPOSE: At many institutions chest x-rays (CXR) are routinely performed on mechanically ventilated patients on a daily basis. Among the aims of this study was the assessment of a) frequency of clinically relevant findings from routine CXR in surgical patients under mechanical ventilation, b) comparison of expectations of clinically important CXR findings with estimation of clinical relevance of findings once films were obtained, c) indications and clinical consequences of findings from CXR requested in addition to routine films. METHODS: Prospective study, 40 patients with 741 CXR. Standardised film reporting. Daily recording of clinical data by means of an evaluation score. Interview of intensive-care physicians for assessment of: what information was expected from any routine CXR? did CXR offer helpful information for further treatment planning? RESULTS: 26% of routine CXR had a considerable therapeutical impact. 43% of all routine CXR were expected to have an influence on patient management, 57% were not. 16% of those CXR that had been expected not to offer essential information, disclosed relevant findings. Of the additionally obtained CXR, 53% were performed to check position of endotracheal tube and catheters and 47% related to other indications. CONCLUSION: Critically ill surgical patients under mechanical ventilation should have daily CXR follow-up, as one-fourth of these films has an impact on the patient's management.

APACHE↗
PubMed1996

[Anticoagulation after vascular surgery interventions].

Questionnaires regarding postoperative antiplatelet and anticoagulant therapy were answered by personal interviews with 35 German vascular surgeons. A 3/4 majority follow the recommendations of literature by anticoagulation after embolectomy in patients with persistent atrial fibrillation. Antiplatelet therapy is common in patients after thrombendarteriectomy and justified by improving the natural history of atherosclerotic disease. Considerable differences exist in postoperative therapy following peripheral bypass surgery. Controlled clinical trials are rare and present contradicting results. Prospective randomized multicenter studies are necessary.

Aged↗
PubMed1994

[Blood-saving surgery].

Trauma, blood loss and autologous blood transfusions induce a variety of changes in the reactivity of patients' immune systems. In clinical studies the differentiation of these effects is difficult. Association between autologous blood transfusion and postoperative infection is highly likely. In surgical oncology blood transfusions are associated with poor prognosis, but probably this is more because of the circumstances that necessitate them.

Animals↗
PubMed1994

[Measuring quality of life in after-care of tumor surgery. Methods, problems and applications].

The present paper deals with the feasibility and applications of quality of life measurement in the routine of a tumor follow-up clinic. 61 patients filled out the EORTC-30 questionnaire plus additional scales. Filling out the questionnaire constituted no burden for patients. Patients' responses were computed in a way as to allow for graphically presenting individual QL-profiles, as well as to compare different groups of patients. Considerations concerning the role of QL-measurement in clinical practice, in medical decision making, and in future research endeavours were brought forward.

Adaptation, Psychological↗
PubMed1993

[Daily "routine chest x-ray" in ventilated surgical intensive care patients].

We investigated the relevance of daily routine chest x-ray in intensive care for therapeutical decision. A special emphasis was put on clinical laboratory parameters according to the APACHE-II-score. Within a prospective study we investigated 40 intubated patients of our surgical intensive care unit with a total of 609 x-ray films. 26% of all pictures gained influence on therapeutical procedure. Analysis of different patient subgroups showed only between those under 50 and those above 70 years of age an important discrepancy quote of relevant films (19 vs. 31%).

Adult↗
PubMed1991

[Manifestations of ruptured liver hematoma as a severe complication of HELLP syndrome].

A case of a ruptured haematoma of the liver with intra-abdominal bleeding is reported. The 26-year old primigravida was admitted in the 31st week of gestation because of a HELLP syndrome. She presented additional symptoms, that are considered typical for a HELLP syndrome, complicated by a ruptured haematoma of the liver: severe right upper-quadrant pain, decrease of haemoglobin content, enlarged liver with structural irregularities and free fluid in the abdominal cavity as examined by sonography. During Caesarean section, a subcapsular haematoma of the liver, combined with a 5 cm laceration of the organ surface, was found. The defect was closed with collagen gauze and clotted with fibrin. Additionally the liver was compressed by abdominal compression towels, which were removed 2 days later. The postoperative development was, in the main, complication free.

Adult↗
PubMed1987

[Unusual dilatation of the colon in idiopathic megacolon in adulthood].

This is a report on a 20-year old patient who had been suffering from chronic constipation from her childhood. After radiography of the colon in double contrast in December 1986 the patient was admitted to hospital under suspicion of a perforation of the colon. The radiographic demonstration of the abdomen showed an exceptional dilatation of some segments of the colon but without any signs of perforation by free intraperitoneal gas. Subsequent examination led to the diagnosis of an idiopathic megacolon whereas a congenital as well as symptomatic and toxic megacolon could be excluded.

Adult↗
PubMed1986

[Prevention of thromboembolism with low-dose heparin].

With an amidolytic assay plasma heparin activity is measured in patients undergoing elective abdominal surgery and general surgery under LDH-prophylaxis. The data obtained suggest that the response of the hemostatic system to 3 X 5000 U. heparin is individual and unpredictable. In 82 patients undergoing hip fracture surgery it could be demonstrated that there is a correlation between anticoagulant heparin activity and the incidence of DVT.

Aged↗
PubMed1983

[Perioperative plasma antithrombin activity with "low-dose" heparin prophylaxis. Perioperatively acquired antithrombin III deficiency as a cause for the failure of heparin prophylaxis?].

Antithrombin III activity was estimated using a chromogenic substrate perioperatively in the plasma of 200 patients undergoing major elective abdominal surgery during low-dose heparin prophylaxis. With an initial value of 10.9 +/- 2 IU/ml there was a mean postoperative lowering of plasma antithrombin activity in all patients with a minimum on the second postoperative day. In patients with empirically established increased risk of thromboembolism the postoperative depression of antithrombin was significantly more pronounced (P less than 0.01) than in the control groups. An increased risk prevailed particularly in patients with malignant diseases and in major surgery, i.e. of prolonged duration. In such cases with increased risk of thromboembolism routine assessment of antithrombin III is recommended.

Abdomen↗