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K Bley

Publications and source records attributed to K Bley.

5 recordsLinked to original sources
PubMed2005

[Open versus laparoscopic operation for perforated appendicitis--a comparative study].

INTRODUCTION: Laparoscopic therapy of complicated appendicitis is still discussed controversially. This retrospective study compared the clinical results of open and laparoscopic appendectomy in a single centre. PATIENTS AND METHODS: Within a period of three years (1999 to 2001) 493 patients with suspected acute appendicitis were operated prospectively at a German district hospital (250 open appendectomies, 243 laparoscopic appendectomies). Twenty percent of the patients in every group had a complicated appendicitis (48 open, 44 laparoscopic appendectomies) and were analysed retrospectively considering demographic data, operative time, body mass index, preoperative inflammatory parameters (white blood cell count, C-reactive protein and body temperature) and postoperative complication rate. RESULTS: Both groups were comparable with regard to demographic data. One patient of the laparoscopic group needed an open operation (conversion rate 2.3 %). The body mass index of the laparoscopic group was significantly higher (26.3 vs. 24.1 kg/m(2)). Preoperative white blood cell count, C-reactive protein, body temperature as well as postoperative antibiotic therapy and analgesics requirement were comparable in both groups. There was no significant difference between the length of operative time (open 48 min, laparoscopic 53.5 min). The postoperative hospital stay was significantly shorter in the laparoscopic group (8 vs. 9 days, p = 0.032). Complication rate was significantly lower in the laparoscopic group (11.5 vs. 35 %, p = 0.014). CONCLUSION: Laparoscopic appendectomy is a safe procedure for the treatment of complicated appendicitis with a significantly decreased complication rate and shorter postoperative stay.

Adolescent↗
PubMed2003

[Minimally invasive video-assisted thyroid resection (MIVAT)--a well accepted operative procedure].

INTRODUCTION: We report on our results of MIVAT operations. METHOD: Nineteen Patients including 15 females and 4 males were operated with MIVAT, corresponding to 11 % of all patients undergoing an operation for benign goitre in our hospital. A single node of the thyroid gland within 30 mm and enlargement of a thyroid lobe up to 25 ml were the selection criteria. The median age was 34 years (range 16-61). We performed 2 thyroidectomies, 6 Hartley-Dunhill resections, 9 hemihyroidectomies and 2 enucleations. Eighteen patients (95 %) were followed-up postoperatively. The median follow-up period was 8 months (range 1 -21). RESULTS: The median operation time was 83 min (range 60-124). The median preoperative thyroid gland volume was 25 ml (range 10-54) measured by ultrasound. The resected thyroid tissue ranged from 12 to 51 g (median 29 g). A statistical significant difference (P = 0.04 paired t-test) between the preoperative and postoperative estimated serum-calcium levels (2.31 vs. 2.25 mM) was observed. But both parameters were inside the physiological range. Paresis of the recurrent laryngeal nerve was not observed. 89 % of the patients rated the postoperative cosmetic result as very good and all patients would prefer this operation procedure once again. CONCLUSION: The MIVAT procedure is a safe operation also in small groups with excellent cosmetic results postoperatively and a high acceptance by the patients.

Adolescent↗
PubMed2002

Meckel's diverticulum: a disease associated with a colored clinical picture.

Meckel's diverticulum is reported in only 1 or 2% of the population. In most cases, it is free of clinical symptoms. The diagnostic modalities are effective in only 60-70% of all cases. The diagnostic laparoscopy is a safe and effective method for patients suffering from unclear abdominal pain with the option of a definitive surgical therapy. We describe the case of a 10-year-old girl with recurrent abdominal pain caused by a chronic subileus due to a Meckel's diverticulum in combination with a fibrous cord from the base of diverticulum to the mesenterial root. Both were resected in a laparoscopic technique.

Abdominal Pain↗
PubMed1993

RS 23597-190: a potent and selective 5-HT4 receptor antagonist.

1. The pharmacological properties of RS 23597-190 (3-(piperdine-1-yl)-propyl-4-amino-5-chloro-2-methoxy benzoate hydrochloride) have been studied in vitro and in vivo. 2. RS 23597-190 competitively antagonized 5-HT4 receptor-mediated relaxations of rat, carbachol precontracted oesophageal muscularis mucosae, (pA2 = 7.8 +/- 0.1; Schild slope = 1.2 +/- 0.2). Affinity estimates (-log KB) at 5-HT4 receptors using either renzapride or SC-53116 as agonists yielded a -log KB value of 8.0 +/- 0.01. In contrast, RS 23597-190 failed to antagonize contractile responses to 5-HT of guinea-pig ileal 5-HT3 receptors, even at concentrations up to 10 microM. 3. Increases in short-circuit current, induced by 5-HT, were studied in guinea-pig ileal mucosal sheets. Concentration-response curves to 5-HT were biphasic, with the high potency phase to 5-HT inhibited by RS 23597-190 and mimicked by 5-methoxytryptamine. The -log KB value for RS 23597-190 at the high potency phase was 7.3 confirming that 5-HT4 receptors mediated the high potency phase. 4. In rat isolated vagus nerve, 5-HT elicited a slow, maintained depolarization at low concentrations and a rapid, transient depolarization at higher concentrations. The high potency, slow depolarizing phase to 5-HT was abolished selectively in the presence of 1 microM RS 23597-190 and the low potency phase was abolished selectively in the presence of 1 microM ondansetron. These data confirm that 5-HT4 and 5-HT3 receptors mediated slow and fast depolarization responses, respectively. 5. At 5-HT3 binding sites in membranes from NG 108-15 cells, labelled by [3H]-quipazine, RS 23597-190 exhibited an apparent affinity (- log Ki) of 5.7 +/- 0.1. At 5-HT3 receptors in membranes from rat cerebral cortex, labelled by [3H]-RS 42358-197, the apparent affinity (- log Ki) of RS 23597-190 was also 5.7 +/- 0.1. In both studies, Hill coefficients were not significantly different from unity. At 5-HT1A, 5-HT2,muscarinic M1, M2, M3, M4 and dopamine D1 and D2 receptors, RS 23597-190 exhibited low apparent affinities, with all - log Ki values less than 5.5.6. Intravenous infusion of RS 23597-190 in the conscious, restrained rat antagonized the von Bezold Jarisch reflex induced by 2-methyl 5-HT, with an ID50 of 300 microg kg-1 min-1, i.v. In the anaesthetized,bilaterally vagotomized micropig, RS 23597-190 (6 mg kg-1, i.v.) antagonized 5-HT-induced tachycardia with a half-life of 77 (63-99) min. Transient arrhythmic effects were noted after administration of the compound.7. In conclusion, RS 23597-190 acts as a high affinity, selective competitive antagonist at 5-HT4 receptors. Thus, the compound appears to be a useful tool for 5-HT4 receptor identification in vitro. In vivo, the compound is rapidly metabolized in pigs such that 5-HT4 blockade is not maintained. However,in the rat, when given by infusion, RS 23597-190 antagonizes 5-HT3 mediated responses, at doses consistent with a low affinity 5-HT3 receptor. These data suggest that, under appropriate experimental conditions, RS 23597-190 may also be used in vivo to characterize further 5-HT4 receptor function.

4-Aminobenzoic Acid↗