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Biomedical subjects

M Allgöwer

Publications and source records attributed to M Allgöwer.

At least 19 recordsLinked to original sources
PubMed1992

Survival in major burn injuries treated by one bathing in cerium nitrate.

Sixty-four patients aged 16-74 years with total body surface area burns (TBSA) ranging from 30 to 90 per cent, were given one bathing in 0.04 M cerium nitrate within 4 h of admission to hospital. Of 21 patients aged 16-30 years, one died (aged 28 with 90 per cent TBSA), and of those aged 31-74 years, two died, one (aged 50 years with 55 per cent TBSA) had multiple internal injuries, the other (aged 51 years with 55 per cent TBSA) had a pulmonary embolism at day 19. Two risk scores, developed from data on 11,200 burn patients treated by standard methods (Roi et al. 1983), were applied to the analysis of risk for 59 patients for whom both total burn surface (TB) and full thickness (FT) areas had been recorded. About 20 patients bore risk of 0.8 or greater on the FT scale and 1.0 on the TB scale, yet instead of 80 per cent deaths among these, only two died. No FT assessment had been made on the multiple injury death whose TB risk score was 0.66. Such survival results in high-risk patients should encourage the use of cerium nitrate for treating serious burn injury.

Adolescent↗
PubMed1992

The floating shoulder: ipsilateral clavicle and scapular neck fractures.

In ipsilateral mid-clavicular and scapular-neck fractures, the mechanical stability of the suspensory structures is disrupted and muscle forces and the weight of the arm pull the glenoid fragment distally and anteromedially. To prevent late deformity we recommend internal fixation of the fractured clavicle by a plate and screws. We treated seven patients with this unusual injury; all achieved an excellent functional result without deformity.

Adolescent↗
PubMed1992

[Relations of Theodor Kocher with the "International Society of Surgery". His role as the 1st congress president].

With the aim of promoting progress in surgery through the friendly exchange of views and experience, the first International Society of Surgery was founded at Brussels in 1902, hereby helping to overcome the narrow boundaries of that times' nationalism. At its first congress, the "International Society of Surgery (ISS)", otherwise known by its French name "Société Internationale de Chirurgie (SIC)", numbered already 638 members, amongst them the most important surgeons from all over the world. Theodor Kocher was the president of the first congress, held at Brussels in 1905, and was also responsible for the choice of topics. His presidential address clearly reflected the high aims the Society set itself. Kocher's personal and professional authority, his surgical skill, which he liked so much to communicate to his colleagues, and his internationally minded thinking shaped the young society. He remained in the international committee of the ISS until his death in 1917.

Europe↗
PubMed1991

Trauma systems in Europe.

For prehospital care, Switzerland developed the first helicopter air rescue system but it has been surpassed by the Federal Republic of Germany, where a coordinated rescue system of physician-equipped air and terrestrial transport has been developed. With regard to hospital care of trauma victims, three systems have evolved. In Austria and the Federal Republic of Germany, the "general surgeon-traumatologist" is in charge. In these countries, the Workmen's Compensation Board restricts treatment privileges to trauma surgeons. In Switzerland and Holland, general surgeons in regional hospitals and to some extent also in university centers have largely remained responsible for trauma, including fractures. In Great Britain, as in other major European countries like France, Italy, and Spain, trauma of the locomotor system is the domain of orthopedic surgeons, with multiple trauma and body cavities remaining the responsibility of general surgeons. Overall, there is a general tendency to create integrated trauma care systems within large hospital settings. Although an experienced general surgeon can function as the leader of the trauma team, such implementation has, for the most part, not occurred.

Emergency Medical Services↗
PubMed1991

Influence of burn-induced lipid-protein complex on IL1 secretion by PBMC in vitro.

The lipid-protein complex (LPC) formed by thermal injury to skin, which has been shown to have a toxic effect on mice, and which suppresses the immune response, was tested for its specific influence on monocytes. Growth of bacterial endotoxin-stimulated peripheral blood mononuclear cells (PBMC) was inhibited in the presence of LPC, however, the inhibition was less at the time of the optimal rate of cell proliferation. Inhibition was proportional to LPC concentration. ConA-stimulated PBMC were also inhibited by LPC in a dose-related manner. PBMC, in the presence of LPC, secreted interleukin 1 (IL1) at an increasing rate as LPC concentration rose from 5 to 40 micrograms/ml, and the levels of IL1 which could be induced by endotoxin were increasingly amplified in the presence of LPC. In comparison to LPC, the native tissue proteins which were isolated from unburned skin by the same techniques which produced LPC from burned skin, were tested for their effect on PBMC. Native proteins had no effect on IL1 secretion, whether on background or endotoxin-stimulated levels. Thus, the thermally induced change in skin proteins has a specific effect on monocyte IL1 secretion which is not matched by the native proteins, indicating that burn injury to skin specifically affects the lymphokine cascade and consequent immune function.

Animals↗
PubMed1990

Plasma levels of cutaneous burn toxin and lipid peroxides in thermal injury.

Lipid peroxides, formed as a consequence of oxygen free radical formation, are responsible for tissue damage in a great variety of pathological conditions including thermal injury. 'Cutaneous burn toxin', formed by application of heat to skin, is thought to be specific to the burn injury. It causes dose-dependent damage to mitochondrial and red cell membranes, and dose-dependent inhibition of interleukin-2-dependent growth of lymphocytes. The possibility that the toxicity of 'cutaneous burn toxin', a lipid-protein, is exerted through lipid peroxides, was examined by measuring the levels of both agents in plasmas of eight burn patients during the first week after their injury. It was observed that plasma lipid peroxides did not appear in parallel with absorption into the circulation of 'cutaneous burn toxin'. Lipid peroxide levels equally common to very low and very high burn toxin levels, were recorded. The pair of agents correlated negatively (r = -0.26) at a significance of only 0.1. In addition, isolated purified 'cutaneous burn toxin' contained no measurable lipid peroxide. No relationship was therefore demonstrated between plasma levels of 'cutaneous burn toxin' and lipid peroxides.

Adult↗
PubMed1987

Esophagectomy without thoracotomy: is there a risk of intramediastinal bleeding? A study on blood supply of the esophagus.

In transhiatal blunt esophagectomy there is surprisingly little bleeding if no adjacent great vessels are torn. This prompted an investigation by new injection techniques and corrosion on the human esophageal vasculature three-dimensionally. The three main arterial sources were confirmed: the superior thyroid artery, bronchial arteries at the level of the carina, and the left gastric and splenic artery. Two facts became obvious that were not appreciated hitherto. All major vascular trees divide into minute branches at some distance from the esophagus. Those branches go on to form a dense submucosal interconnected network. It appears that such small extraesophageal branches, when torn, will have the benefit of contractile hemostasis. Previous claims made that essential nutritional vessels arise from intercostal phrenic arteries or the aorta directly could not be confirmed. These findings would confirm blunt esophagectomy for tumors within the wall of the organ as a relatively safe procedure in terms of bleeding hazards.

Adult↗
PubMed1987

Anatomy of the pelvic floor for translevatoric-transsphincteric operations.

The parasacral transsphincteric-translevatoric approach has proved of great interest in surgery of the lower rectum and urogenital organs. Due to this experience, anatomic specimens of the pelvic floor and pelvic organs were prepared in order to perfect the operative technique. The anatomic specimens show the pelvic floor and sphincter muscles and the blood supply by the pudendal vessels and nerve, as well as the topography of pelvic organs and fascias from the view of a surgeon performing parasacral surgery. The clinical experience with 118 cases of parasacral translevatoric-transsphincteric interventions at the Departments of Surgery of the University Hospital, Basel, and the Canton Hospital, Luzern, Switzerland, is presented. The results were mainly good. The operation technique is illustrated with selected cases of rectum resection, procedures for treatment of urethrorectal fistulas, reconstruction of pelvic floor for malformations, and reconstruction of injured urethra.

Abnormalities, Multiple↗
PubMed1979

Toxin-specific ultrastructural alterations of the mouse liver after burn injuries and the possibility of a specific antitoxic therapy.

Electron-microscopic studies in mice revealed similar and comparable mitochondrial alterations of the liver cells 5-7 days after either a sublethal controlled burn injury or an i.p. injection of an equivalent dose of a burn toxin. Electron microscopy 5 days after i.p. application of different amounts of the burn toxin in rats showed that the extent of the liver alterations correlates directly to the applied dose (occurrence of: cristolysis--intramitochondrial vacuolization--total vacuolar changes of mitochondria(. Controls with the non-toxic/"native" compound isolated from normal skin or excision of a skin piece identical in size to the sublethal burn showed no ultrastructural changes in the liver of mice or rats. In a 2nd series of experiments the therapeutic effect of an antitoxic IgG raised in sheep was tested. The first 3 days after a standard burn or an i.p. injection of 15 mg burn toxin mice obtained 10 mg of the antitoxic IgG (2x/day). Controls injected with the "native" compound or excised as described were treated in the same way. The results showed a specific complete immunological protection from mitochondrial alterations by either the toxin or the burn injury. These results suggest the possibility of an antitoxic IgG-therapy in severe burns.

Animals↗
PubMed1979

[Shock].

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Hemodynamics↗