PubMed Health⌕ Search

Biomedical subjects

K Dinstl

Publications and source records attributed to K Dinstl.

At least 19 recordsLinked to original sources
PubMed1998

[Surgical therapy of severe obesity].

Severely obese patients are vitally endangered by their overweight. Non operative therapies achieve less than 10% of persistent weight reductions in this high-risk group of patients. On condition of correct indications and adequate preoperative information gastric bypass, vertical banded gastroplasty or implantation of the adjustable gastric band represent effective surgical procedures enabling persistent reductions of at least 50% of overweight in 85% of patients.

Adolescent↗
PubMed1993

[Immunoscintigraphy for detection of inflammatory perioperative foci].

The aim of our study was to evaluate the clinical usefulness of a monoclonal antibody (MAB; BW 250/183; Behringwerke, Germany) in patients with suspected perioperative septic foci. The MAB is directed against the nonspecific crossreacting antigen (NCA 95) which has been found on the surface of human neutrophil granulocytes and which represents a murine immunoglobulin isotype of IgG1. Immunoscintigraphy was performed by labelling the MAB with 740 MBq (20mCi) Tc-99m. Data acquisition followed 4 and 18 to 24 hours after administration by a digital Anger camera (APEX 409A, Elscint). 53 patients were investigated (31 female, 22 male; average age 39 years), 4 patients were twice, 1 patient was 3 times evaluated, which results in a total of 59 studies. 45 patients experienced operation within 12 hours after our investigation, which resulted in 36 true positive, 5 true negative, 3 false negative, and 1 false positive findings. This means a sensitivity of 92%, and specificity of 83%. Immunoscintigraphy with granulocyte antibodies can be performed at any time, the preparation of the radiopharmaceutical is simple, the image quality is high; the obtained information concerning localization and size of perioperative septic infections permits the determination of the optimal point of time for surgical intervention. The accumulation of activity was visible as early as 4 hours post application. SPECT would enhance the diagnostic accuracy, but this technique cannot be applied in all such patients.

Abscess↗
PubMed1992

Nd:YAG laser treatment of colorectal malignancies: an experience of 4 1/2 years.

Between 1985 and 1990, 517 patients were treated for colorectal malignancies at our department of surgery. Nd:YAG laser therapy was used in 37 cases (7.1%). The mean age of these 22 men and 15 women was 71.4 years (range: 22-96 years). One hundred-twenty-nine Nd:YAG laser treatments were performed. Indications for laser treatment were (1) palliative tumor reduction (n = 21), (2) preresectional laser recanalization for obstructing carcinoma (n = 6), and (3) curative treatment (n = 10). Laser related complications included one perforation of the rectum and one rectovaginal fistula. One fatal pulmonary embolism occurred. After palliative treatment, five patients died because of tumor progression (mean survival time: 16 months), two because of other reasons. All patients with obstructing tumors could be recanalized successfully. After curative treatment, eight patients are still alive without tumor recurrence (mean survival time: 25.5 months), and two died of other causes. Palliative Nd:YAG laser treatment of colorectal malignancies is a competitive alternative to conventional surgery. Recanalization of obstructing tumors is an excellent treatment for large bowel obstruction, making one-stage resections possible. Curative treatment should be reserved for special cases only.

Adenocarcinoma↗
PubMed1990

Hepatic artery infusion chemotherapy.

Hepatic artery chemotherapy was given to 36 patients, using totally implantable devices consisting of a port and external pump. Twenty-seven patients had inoperable liver metastases of colorectal origin. The infusion system was inserted by laparotomy into the hepatic artery via the gastroduodenal artery. There was no operative mortality. Thirteen infusion systems could not be used for chemotherapy due to dislodgement, early death and lack of follow-up. FUdR was infused every two weeks. There were minor local complications like thrombosis of the system and dislodgement of the port. Toxic effects could be managed by reducing the dose. Response to chemotherapy was evaluated by survival, clinical condition, CEA, ultrasound and CT six months after onset of arterial chemotherapy. Ten/twenty-three patients (43%) responded to therapy, eight of them died on the average 19 months after initial chemotherapy. Six patients were non-responders, seven had stable disease. Five/ten patients developed extrahepatic metastases. Mean survival time was 13.1 months, mean interval until relapse 10.6 months.

Adult↗
PubMed1990

[Prevention of adhesions in abdominal surgery. A dose finding study with streptokinase/streptodornase].

UNLABELLED: Measurement of intraperitoneal fibrinolytic activity on 50 patients having undergone abdominal surgery (four of them controls). Instillation of streptokinase/streptodornase (Varidase) into the abdominal cavity. Determination of total protein, plasminogen, antiplasmin, alpha 2 Mx-plasmin-complex, spontaneous fibrinolysis and fibrinolysis + activator at different points in time p.op. RESULTS: Intraperitoneal fibrinolysis may be stimulated by local substitution of a plasminogen activator (Varidase). Systemic effects are confined to a high dose. No impaired wound healing nor increased propensity to hemorrhaging occurred.

Abdomen↗
PubMed1989

Below-knee femoropopliteal bypass using externally supported polytetrafluoroethylene (PTFE) grafts.

Twenty-seven externally supported polytetrafluoroethylene (PTFE) grafts were implanted in the femoropopliteal position crossing the knee joint. All patients underwent surgery because of limb threatening ischemia (rest pain or gangrene). There was one early graft failure (successful thrombectomy). No patient died postoperatively. The mean follow-up period was 17.32 months (range 3-44 months). Cumulative patency rate for this follow-up period was 73%. Absence of kinking when bending the knee joint was determined by ankle Doppler pressure measurements and arteriography. If an adequate saphenous vein is not available for knee-crossing femoropopliteal bypass, externally supported PTFE can be used, yielding short-term patency rates comparable to those obtained with autologous venous bypasses.

Aged↗
PubMed1989

[Laser surgery of parenchymatous organs].

Several physical methods of cutting and/or coagulating are available in addition to CO2 or Nd:-YAG-lasertechnology for surgery of the parenchymal organs. The promising experimental results obtained in partial hepatectomies were not reduplicated in clinical situations. Exceptions are the contact Nd-YAG laser which had good or excellent results and the use of lasers in pediatric surgery of parenchymal organs, depending on the patient's physiological condition. If the corresponding technological requirement are realized, new applications of lasers will emerge, above all those using sonographic or endoscopic techniques.

Animals↗
PubMed1989

[Indications for primary anastomosis following resection of acute diverticulitis of the large intestine].

A retrospective review of 102 patients (1979-1987) was performed to evaluate the surgical management of complicated diverticulitis. The following operative strategy was found to be effective: 1. the Hartmann procedure in free perforation and diffuse peritonitis; 2. resection with primary anastomosis in free perforation and localized peritonitis, covered perforation, inflammatory tumor and fistulas, if healthy bowel ends could be used for anastomosis.

Acute Disease↗
PubMed1986

[Scalpel and CO2 laser in the animal experiment. A comparative study of inoculation tumors of the mouse].

The study hereby submitted has been designed to show whether there are any differences between using a conventional knife or a CO2-laser when excising and grafting tumors in animal experiments. The animals were C57Bl/6 mice, the tumor was the Lewis lung carcinoma. Eight days after tumor inoculation into the subcutaneous layer of the back, 213 mice were treated by tumor excision either with a conventional knife or a CO2-laser. 86 excised tumors were cut and the tumor surface was swabbed into the subcutaneous layer on the nape of 86 tumor-free mice. Survival times of the laser-operated animals were insignificantly longer. However, small tumors showed markedly longer survival times. The interval without recurrence was longer for all tumor sizes when the laser was used (p less than 0.005). The laser method yielded lower growth rates when the tumor surface was swabbed into tumor-free mice (p less than 0.0001). Histological and cytological tests of the laser-excised and -swabbed specimen demonstrated a high rate of cell destruction. Therefore, the CO2-laser seems to have some importance in cases where the incision is made close to the tumor or where the tumor surface may be lesioned.

Animals↗
PubMed1986

[Local recurrence following surgery for breast cancer and its relation to the primary intervention].

UNLABELLED: 32 cases of local recurrence following curative mastectomy were operated between 1975 and 1984. The primary operation was: radical mastectomy n = 20, simple mastectomy n = 6, lumpectomy with axillary dissection n = 6. The rate of local recurrence amounted to: 4.8% (20 patients out of 416) after radical mastectomy; 6 out of 15 patients after simple mastectomy (2 were N1-cases); 6 out of 15 patients after lumpectomy (one case: N1). CONCLUSION: With regard to local recurrence radical mastectomy showed significant better results when compared with less radical operations.

Breast Neoplasms↗
PubMed1986

Comparative study of conventional scalpel and CO2-laser in experimental tumor surgery.

The study hereby submitted has been designed to show whether there are any differences between using a conventional knife or a CO2-laser when excising and grafting tumors in animal experiments. The animals were C57B1/6 mice, the tumor was the Lewis lung carcinoma. Eight days after tumor inoculation into the s.c. layer of the back, 213 mice were treated by tumor excision either with a conventional knife or a CO2-laser. Eighty-six excised tumors were cut, and the tumor surface was swabbed into the s.c. layer on the nape of 86 tumor-free mice. Survival times of the laser-operated animals were insignificantly longer. However, small tumors showed markedly longer survival times. The interval without recurrence was longer for all tumor sizes when the laser was used (P less than 0.005). The laser method yielded lower growth rates when the tumor surface was swabbed into tumor-free mice (P less than 0.0001). Histological and cytologic tests of the laser-excised and- swabbed specimen demonstrated a high rate of cell destruction. Therefore, the CO2-laser seems to have some significance in cases where the incision is made close to the tumor or where tumor surfaces may be lesioned.

Animals↗
PubMed1986

Effect of infusion of salmon calcitonin on the secretion of somatostatin and gastrin in man.

In vitro and animal studies have pointed out complex interrelations between gastrointestinal hormones and calcitonin. To analyse the acute effects of calcitonin in more detail, patients undergoing surgery were infused intravenously with synthetic salmon calcitonin, a potent analog of the human hormone. Samples were taken after 0, 30 and 60 minutes from the hepatic, portal and a peripheral vein. Somatostatin and gastrin were determined by radioimmunoassay. The mean basal levels of somatostatin in peripheral and hepatic venous plasma (14.2 and 15.6 pg/ml) were significantly lower than in portal plasma (45.6 pg/ml), indicating effective removal by the liver. After infusion of calcitonin there was a general rise in somatostatin levels and an increase in the gradient between hepatic and portal blood. Basal gastrin levels were highest in the portal vein when compared intraindividually. The differences disappeared after calcitonin infusion with a concomitant systemic reduction of gastrin levels. Thus, calcitonin is able to stimulate the secretion of somatostatin from the gastrointestinal tract and does reduce gastrin secretion, possibly via the stimulation of somatostatin secretion.

Adult↗
PubMed1984

[Indications and results of gastric bypass in the treatment of extreme obesity].

A report is presented on gastric bypass (n = 27) and gastroplasty (n = 2) in patients with morbid obesity. One patient died postoperatively (mortality 3.4%). Mean weight prior to operation was 129 kg (96 to 205 kg), i.e. 117% (63 to 253%) in excess of the ideal weight. During a follow-up period of 6 to 46 months, the mean loss of weight amounted to 38 kg (3 to 77 kg). 86% of the patients judged their condition as being very good to good. Diseases related to obesity were reduced to a remarkable degree: hypertension from 43 to 5%, hypertriglyceridaemia from 50 to 5% and diabetes mellitus from 52 to 13%. Two patients had to be reoperated on due to a peptic jejunal ulcer, five because of an incisional hernia. No patient suffered from diarrhoea, calculi of the biliary or urinary tract or electrolyte disorders. On the basis of these results gastric bypass would appear to be indicated for the treatment of obesity not amenable to conventional therapy.

Adult↗