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Biomedical subjects

K Manncke

Publications and source records attributed to K Manncke.

9 recordsLinked to original sources
PubMed1992

[Laparoscopic cholecystectomy].

Laparoscopic cholecystectomy has been accepted clinically in a very short time. Following an intensive training-course for manual dexterity clinical experience should be achieved in carefully selected cases. After a certain number of cholecystectomies the majority of cholecystectomies can be performed laparoscopically. The complication rate of laparoscopic cholecystectomy in the hand of a well trained surgeon seams to be comparable or even smaller than in conventional procedure. The patients have significantly less pain and bodily activity starts early. The postoperative time in hospital in our clinic is two to three days. The rehabilitation-time could be shortened.

Cholecystectomy↗
PubMed1992

Technique and results of transanal endoscopic microsurgery in early rectal cancer.

The anatomy of the pelvis makes it difficult to perform local excisions in the rectum when the tumor is some distance from the anal verge. We have, therefore, developed a new minimally invasive technique for tumor resection. A rectoscope with a 40-mm diameter permits tumor resection under stereoscopic control in the gas-dilated rectal cavity. Excisions in full-thickness technique up to segmental resections with end-to-end anastomosis can be performed. In selected cases, local excision of a small rectal cancer can be regarded as appropriate treatment. However, most local resections of carcinomas are performed when removal of an adenoma is planned, and the postoperative histology shows a carcinoma. Since 1983, we have operated on 326 patients, 274 who have been enrolled in a prospective clinical trial. Definitive histologic examination proved that 74 of these tumors were carcinomas. The rate of severe complications in patients with carcinomas was 9%, and the mortality rate was 0%. The advantages of this new technique are: The stereoscopic magnified view in the gas-dilated rectum allows precise surgery in an operative field that is otherwise difficult to reach. During the postoperative period, minimal discomfort and pain result in a short hospitalization.

Adenoma↗
PubMed1991

[Sulbactam in combination with mezlocillin, piperacillin or cefotaxime. Clinical and bacteriological results in the treatment of severe bacterial infections].

An open multicenter study on inpatients of 12 german hospitals was performed to investigate efficacy and safety of sulbactam in combination with mezlocillin, piperacillin or cefotaxim in severe bacterial infections. In total 155 patients were enrolled. The following infections were diagnosed: 48 lower respiratory tract infections, 66 intraabdominal infections, 34 skin/soft tissue infections including post operative wound infections and 5 complicated urinary tract infections. 55 patients received 3 daily doses of 4 g mezlocillin + 1 g sulbactam, 52 patients received 3 daily doses of 4 g piperacillin + 1 g sulbactam and 48 patients received 3 daily doses of 2 g cefotaxim + 1 g sulbactam. Antibiotics and sulbactam were administered concomitantly via intravenous short infusion. Mean duration of therapy was 8 days. Endpoints for assessment of therapeutic efficacy were cure (complete resolution of pretreatment signs and symptoms of the infection) or improvement (marked reduction or partial disappearance or pretreatment signs and symptoms, no further antibiotic therapy required) as well as eradication of pretreatment pathogens. 141 (92%) of 153 evaluable patients were successfully treated (98 cures and 43 improvements), therapy failed in 12 patients (7.8%). Success rates of the 3 sulbactam combinations were almost identical: 91% for mezlocillin/sulbactam, 92% for piperacillin/sulbactam and 93% for cefotaxim/sulbactam. 106 patients (68.4%) were also bacteriologically evaluable. In these patients 192 bacterial pathogens were isolated prior to study therapy, 55 patients had mixed infections. In 96 patients (90%) pretreatment pathogens were eradicated (180 strains = 94%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Massive hemorrhage from an "esophageal tumor": thoracic aortic aneurysm rupturing into the esophagus].

We report on an arteriosclerotic aneurysm of the descending aorta penetrating into the esophagus. On endoscopy it mimicked a bleeding esophageal tumour. The typical clinical course of aortoesophageal fistulas (AEF) exhibits Chiari's triad of midthoracic pain, sentinel arterial hemorrhage, usually hematomesis, and final exsanguination after a symptom-free interval. The various causes of AEF are discussed together with the respective diagnostic and therapeutic problems.

Aged↗
PubMed1989

[Uses and advantages of a computer-assisted microbiologic diagnosis and database system for antibiotic therapy in surgery].

To demonstrate the value of a computer assisted microbiological diagnosis and database system for clinical use, epidemiological aspects of three important infections were investigated: urinary tract, respiratory tract and wound infections. The first two examples presented revealed significant differences in incidence of pathogens between a single patient group and the overall statistic. The third example demonstrates that even within a department susceptibility patterns of staphylococcus epidermidis were changing in dependence of the ward investigated. In the last example the evaluation of susceptibility testing revealed changing patterns of some pathogens during the observation periods. By means of a computer assisted diagnosis and database on file at the moment of diagnosis thus allowing statistical evaluations at every time within a few hours. The clinician provided with actual data concerning his ward or department may administer an empiric therapy according to the real situation. Besides this, automated susceptibility testing may shorten the time required for diagnosis up to 24 h, thus further contributing to a more rational antimicrobial therapy. In conclusion computer assisted diagnosis and automated instruments support the clinician by means of actual epidemiological data and rapid reporting in choosing and controlling antimicrobial therapy.

Anti-Bacterial Agents↗
PubMed1979

[Comparative investigations on the organotropic carcinogenic effect of different N-nitroso compounds with rat after single and chronic treatment (author's transl)].

After the gavage of 200 mg N-nitrosodiethylamine per kg body weight only kidney tumors developed while long-term administration of 10 ppm N-nitrosodiethylamine induced esophageal tumors and hepatocellular carcinomas in female rats (SIV 50). This change of the organ-specific carcinogenic effect is not observed in experiments with N-methyl-N-nitrosobenzylamines substituted with a methyl group at the phenyl moiety. Both chronic treatment and single doses induced tumors of the esophagus and the pharynx.

Animals↗
PubMed1978

[Change of toxicity and carcinogenicity of n-methyl-n-nitrosobenzylamine in rats by methylsubstitution at the c-atoms adjacent to nitrogen (author's transl)].

Substitution with a methyl group at the C-atoms adjacent to nitrogen of N-nitroso-N-methylbenzylamine (NMBA) results in a considerable reduction LD 50: N-nitroso-N-methylbenzylamine : 18 mg/kg (Druckrey et al., 1967) N-nitroso-N-methyl-(1-phenyl)-ethylamine (I) : 600 mg/kg N-nitroso-N-methyl-2-(2-phenyl)-propylamine (II) : 2100 mg/kg N-nitroso-N-ethyl-benzylamine (III) : 250 mg/kg Substitution with a methyl group at the methylene of the moiety of NMBA (NMPEA I) reduces also the carcinogenic activity, but it produces in all animals carcinomas of the oesophagus and the pharynx; the replacement of both H-atoms by methyl groups (NMPPA, II) causes under the condition chosen no development of tumors, because for the activation step no proton is available. The exchange of N-methyl by N-ethyl of NMBA (NEBA, III) however produces no change in the carcinogenicity.

Animals↗
PubMedDate not supplied

LaparoLith. A new instrument for stone fragmentation in laparoscopic cholecystectomy.

Laparoscopic cholecystectomy can be performed with incisions of a maximum diameter of 10 mm. The removal of a stone-filled gallbladder at the end of an operation via the 10-mm port needs often-extensive tissue-consuming manipulations for stone removal or minilaparotomy. Stone fragmentation can be achieved by mechanical crushing and by ultrasound-, electrohydraulic-, and tunable dye laser lithotripsy. The clinical employment of the LaparoLith (Baxter Healthcare Corporation), an instrument which allows mechanical fragmentation of stones inside the gallbladder, is presented here. We have used the LaparoLith in nine patients and have been successful in stone fragmentation in seven of these. The LaparoLith seems to be helpful in laparoscopic cholecystectomy, preventing extension of the subnavel incision.

Cholecystectomy, Laparoscopic↗