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K von Windheim

Publications and source records attributed to K von Windheim.

At least 19 recordsLinked to original sources
PubMed1983

Infections after pleuro-pulmonary surgery.

The incidence and causes of infectious complications after pleuro-pulmonary surgery occurring in our institution before 1968, from 1968 to 1975, and from 1978 to 1979 are compared. Soft tissue infections occurring in the operative region, in the pleural cavity and in the remaining lung tissue are assessed separately. From these data it is concluded, that infections of soft tissue have markedly decreased from 7 to 2% while secondary wound healing without purulent infection has fallen from 21% to 5%. The risk of infection thus has decreased below the average figures of general surgery. A comparatively high number of wound infections however, have to be expected after decortication of thoracic empyema. The incidence of postoperative empyemas predominantly related to postoperative bronchial fistulae after lung resection has decreased from 4% to one percent in segmental or lobar resections. Serious infections of the remaining lung with abscess formation have become rare indeed (0.2%). Inflammatory atelectasis caused by bronchial obstruction has remained at a constance level of one to 2% throughout the years. There were 2 cases of lethal bacterial sepsis in 1,566 pulmonary procedures before 1973, but none thereafter. Increasing attention will have to be paid to mycotic superinfections rather than to primary bacterial infections since such superinfections of the tracheo-bronchial tree and of the pleural cavity have increased from less than one percent to approximately 3% during the recent 10 years.

Bronchial Diseases↗
PubMed1982

[Pulmonary sequestration (author's transl)].

Pulmonary sequestration is a rare condition both in children and as in adults. A portion of the lung malformed during early embryological development receives an anomalous systemic arterial supply. The intralobar form is surrounded by normal lung within the visceral pleura and drains its blood into the pulmonary venous system. Extralobar sequestration has its own pleural investment and a systemic venous drainage. Intermediate forms are only partially embedded in normal lung with otherwise separate pleural embedded in normal lung with otherwise separate pleural investment, and classified as hybrid sequestrations. Clinical symptoms are secondary recurrent pulmonary infections especially with intralobar sequestration. The pathologic changes are regularly discovered already on plain roentgenograms of the chest. Extralobar sequestrations may be detected as incidental radiological findings. Angiography is of great diagnostic value to demonstrate the anomalous arteries. The usual treatment consists of excision of the sequestration, segmental resection, or lobectomy. For thoracotomy for a local and long lasting pulmonary process it is recommended to look for anomalous vessels in order to prevent their accidental cut with possible dangerous hemorrhage.

Adolescent↗
PubMed1980

[The thoracic surgical treatment of tracheal stenoses (author's transl)].

Where possible segmental resection of tracheal stenoses and end-to-end tracheal anastomosis is the treatment of choice. However inflammatory conditions, especially those that are deeply necrotizing, should be allowed to settle first. The main problem in end-to-end anastomoses in the lower as well as in the upper trachea is the tension across the suture line. In resections over 7 cm in length this tension can be up to 1,000 gm. However in those tracheal resections of 7 cm length this tension can be acceptably diminished by flexion of the neck, mobilization of the trachea and especially the right main bronchus, and by suprahyoid mobilization of the larynx (by Montgomery's method). - The resection and end-to-end anastomosis of a tracheal defect first treated by the open groove method is also possible. Some such cases are presented. - The impaired ventilation of one lung, as with paralysis of the diaphragm and with pleural thickening, seems to increase the problems of anastomotic wound healing.

Adult↗
PubMed1980

[Pulmonary abscess].

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Diagnosis, Differential↗
PubMed1979

[Complications following mediastinoscopy. Prevention and therapy].

Mediastinoscopy, being practised since 20 years, is a research method giving a high degree of information and during this time has become indispensable in diagnosis of diseases of the chest. The close neighbourhood of vital organs, small and easily vulnerable blood vessels and nerval tissues of functional importance first seemed to burden this method of investigation with an incalculate risk. But subtle operative technique with its instruments by Carlens and others let the number of complications remain remarkably small even in great collective statistics. The number of lethal complications ranged below 0.2%, more severe ones about 1%. But in these latter ones one almost always succeeds in achieving a restitutio ad integrum bei performance of consequent after-treatment. The more frequent mediastinoscopic investigations are performed in regions of marked pathologic changes, the higher is the number of described complications. But it must be considered that in many cases the more perilous and functionally straining thoracotomy can be avoided using mediastinoscopy. Complications occurring most frequently are described and possibilities of therapy are discussed.

Abscess↗
PubMed1979

[Mismanagement of chest trauma; sequels and the possibility of repair (author's transl)].

60 persons with a chest trauma were treated during the past years. In a number of cases the injuries and the resulting complications were of so serious a nature that their repair was attended by the greatest difficulties. The most serious and initially unrecognized complications comprised: 1) tracheo-bronchial defects, partly of traumatic origin and partly arising during intensive care; 2) failure to detect rupture of the diaphragm with displacement of visceral organs into the thoracic cavity; 3) insufficient evacuation of blood or fluid from the pleural cavity; 4) failure to diagnose irreparable damage to part of the lungs. Means to repair these lesions are reviewed; the necessity for long-term observation of these cases is emphasized.

Adult↗
PubMed1977

[Bronchial carcinoma and paraneoplastic neuromyopathy].

Paraneoplastic neurologic syndromes in patients suffering from bronchial carcinoma were found by Croft and Wilkinson (Croft et al. 1965, Croft and Wilkinson 1965) in 16%. We examined the question whether in patients suffering from bronchial carcinoma neurologic syndromes are as frequent as in a comparative group of patients with different bronchial diseases. Out of 99 patients 61 had histological proof of bronchial carcinoma, 38 were suffering from chronic inflammatory bronchial diseases. The groups were statistically comparable to each other. Cases with carcinoma in situ (TINOMO) showed no significant difference from patients without bronchial carcinoma. In patients who showed intrathoracic metastases of lymphatic ganglions we found neurologic syndromes in 31% (p less than 0.01). Differing from the extension of tumor metastases there was no correlation between duration and frequency of neurologic syndromes. This corresponds to the experience of our hospital in the last 10 years; 5.7% of all patients with extracerebral tumors showed neurologic syndromes, most frequently polyneuropathies. In 10-15% of a normal population one can find these symptoms (Skre 1972), this means they are polygenetic. We did not find frequently an oat cell carcinoma in our material. Cases in which the neuromyopathy preceeded the manifestation of the bronchial carcinoma were not seen. Altogether it can be stated that paraneoplastic neuromyopathies in patients suffering from bronchial carcinoma are more seldom than it was to be assumed from the anglo-saxon literature.

Aged↗