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Biomedical subjects

M H Seelig

Publications and source records attributed to M H Seelig.

At least 37 records · Page 2Linked to original sources
PubMed1999

Tension fecopneumothorax due to colonic perforation in a diaphragmatic hernia.

A traumatic diaphragmatic hernia is a well-known complication following blunt abdominal or penetrating thoracic trauma. Although the majority of cases are diagnosed immediately, some patients may present later with a diaphragmatic hernia. A tension fecopneumothorax, however, is a rarity. We report on a patient who, 2 years after being treated for a stab wound to the chest, presented with an acute tension fecopneumothorax caused by the incarceration of the large bowel in the thoracic cavity after an intrathoracic perforation. The etiology and management of this condition are discussed.

Adult↗
PubMed1999

Endovascular repair of abdominal aortic aneurysms: where do we stand?

Endovascular repair of abdominal aortic aneurysms has evolved dramatically within the past few years. In light of the potential to reduce morbidity and mortality associated with open surgical repair, endoluminal grafting offers therapeutic options to patients who are not surgical candidates because of comorbidities. With the development of bifurcated devices, more complex aneurysms may be treated by endovascular grafting. Although successful placement of endovascular grafts requires a pronounced learning curve, including appropriate patient selection, midterm results seem consistent with those of traditional open repair of aneurysms. This review describes the current indications, minimal requirements, different devices and associated techniques, and potential complications of endoluminal repair of abdominal aortic aneurysms. Future aspects of endoluminal grafting are also discussed.

Aortic Aneurysm, Abdominal↗
PubMed1999

Arteriovenous fistula of the thyroid gland associated with spontaneous bleeding from a flow-induced aneurysm of the inferior thyroid artery.

A case of acute, spontaneous cervical hemorrhage caused by a ruptured aneurysm of the inferior thyroid artery is described. This lesion was accompanied by an arteriovenous fistula within the thyroid gland that caused a flow-induced aneurysm. Diagnosis and treatment were successfully performed by selective angiography with endovascular occlusion and embolization. Both diagnostic and therapeutic management are discussed, and the related literature is reviewed. To our knowledge, this is the first reported case of an aneurysm of a thyroid artery in conjunction with an intraparenchymatous arteriovenous fistula of the thyroid gland.

Aged↗
PubMed1999

Use of intraoperative duplex ultrasonography and routine patch angioplasty in patients undergoing carotid endarterectomy.

OBJECTIVE: To determine the value of routine patch angioplasty and intraoperative duplex ultrasonography (US) during carotid endarterectomy (CEA) for high-grade internal carotid artery stenosis. PATIENTS AND METHODS: The charts of 102 consecutive patients who underwent CEA with routine patching and intraoperative duplex US for treatment of high-grade carotid stenosis between June 1991 and January 1997 were reviewed retrospectively. Recurrent stenosis was defined as a narrowing in the common or internal carotid artery of more than 40%. RESULTS: Of 102 patients, 65 (63.7%) were men, and 37 (36.3%) were women (mean age, 72.4 years). Thirteen patients (12.7%) had bilateral CEAs. Intraoperative duplex US revealed abnormalities during 29 (25.2%) of 115 CEAs; 14 abnormalities (12.2%) were major and underwent immediate revision. No perioperative neurologic events or deaths occurred. Mean length of follow-up was 21.3 months (range, 1.3-72.6 months). Late neurologic events occurred in 2 patients, and 5 patients died during follow-up. All neurologic events and deaths were unrelated to the patients' carotid surgery. Twelve patients (11.8%) developed moderate restenosis (40%-69%). In 4 of these patients restenosis resolved during further follow-up. No patient developed severe recurrent carotid stenosis. CONCLUSION: Morbidity and mortality following CEA with routine patch angioplasty and intraoperative duplex US appear to be low. Routine intraoperative duplex US detects correctable technical problems that subsequently lead to a low incidence of symptomatic stenosis. The low incidence of recurrent stenosis suggests that routine postoperative follow-up may not be necessary or cost-effective unless the patient has symptoms or a contralateral stenosis.

Aged↗
PubMed1999

Endo-organ and laparoscopic management of gastric leiomyomas.

Various techniques have been reported for the laparoscopic treatment of benign gastric lesions, depending on the site of the lesion. Recently, a new technique of endo-organ gastric surgery has been developed that is particular useful for the treatment of lesions on the posterior gastric wall. We report on two patients with submucosal gastric tumors. A 79-year-old man was found to have a submucosal tumor near the esophagogastric junction in the posterior wall of the stomach. Endosonography suggested that the tumor was a gastric leiomyoma. Under endoscopic guidance, three ports were inserted into the stomach and the tumor could be successfully enucleated. A 78-year-old woman was found to have a 2 x 1-cm submucosal tumor at the anterior wall of the antrum. The tumor was successfully removed by laparoscopic gastrotomy and resection. The various laparoscopic techniques for the treatment of gastric lesions are discussed.

Aged↗
PubMed1998

[Laparoscopic antireflux procedures].

Laparoscopic antireflux surgery is rapidly replacing traditional operations for the treatment of medically refractory gastroesophageal reflux disease. These procedures are technically demanding. Troublesome side effects can be minimized by carefully selecting patients and using a meticulous and appropriate technique. Extensive follow-up data are now emerging and indicate that these procedures can offer long-term control of symptoms with few permanent side effects.

Equipment Design↗
PubMed1998

Treatment of a postoperative cervical chylous lymphocele by percutaneous sclerosing with povidone-iodine.

The development of postoperative leaks of the thoracic duct after neck dissection or vascular surgery of the subclavian and vertebral artery is a well-known but rare complication. Usually, an injury of the duct manifests immediately after the operation with chylous drainage. Presentation as a postoperative lymphocele is rare. Operative treatment may be an option, but identification of the leak often is impossible, resulting in a high rate of failure. Percutaneous catheter drainage in combination with sclerosis with povidone-iodine has proved to be highly effective in obliterating pelvic lymphoceles but has not been reported in patients who have undergone vascular surgery in the neck. We present a case in which a povidone-iodine solution was used successfully in percutaneous sclerosis of a cervical lymphocele after transposition of the left subclavian artery to the left common carotid artery.

Aged↗
PubMed1998

Angiosarcoma of the aorta: report of a case and review of the literature.

Primary malignant tumors of the thoracic and abdominal aortas are extremely rare. In most cases, a diagnosis is established either postmortem or after an emergency operation for embolic complications. We present the case of a thoracic aortic angiosarcoma in a 71-year-old man who initially was seen with peripheral embolization. The management of these tumors and the world literature are reviewed.

Aged↗
PubMed1998

Superior vena cava syndrome caused by chronic hemodialysis catheters: autologous reconstruction with a pericardial tube graft.

Superior vena cava (SVC) syndrome caused by long-term use of indwelling catheters is an infrequent but increasingly common complication. Because collateralization often is sufficient, surgical treatment rarely is indicated. We present a case of a patient with severe symptomatic SVC syndrome as a result of the long-term use of indwelling hemodialysis catheters. The SVC was reconstructed with a pericardial tube graft. Magnetic resonance angiography performed 13 months after the operation showed patency of the graft. The patient continues to be free of symptoms.

Adolescent↗
PubMed1997

Laparoscopic cholecystectomy for a metastasis of a malignant melanoma in the gallbladder.

In a 25-year-old woman who was operated for superficial spreading malignant melanoma two years ago a slowly growing tumor in the gallbladder was detected sonographically. Since further screening for metastatic disease was negative the gallbladder was removed laparoscopically. To our knowledge this is the first laparoscopic cholecystectomy for a metastasis of a malignant melanoma in the gallbladder.

Adult↗
PubMed1996

Efficacy of dinaline and its methyl and acetyl derivatives against colorectal cancer in vivo and in vitro.

Dinaline [4-amino-N-(2'-aminophenyl)-benzamide, Din], p-N-methyldinaline (Me-Din) and p-N-acetyldinaline (Ac-Din) were evaluated for their antineoplastic efficacy in acetoxymethylmethylnitrosamine-induced colorectal carcinomas in Sprague-Dawley rats and in two human colon cancer cell lines. Din was very effective at all dosages (10, 7.7 and 5.9 mg/kg) as indicated by the ratio of median tumour volume of treated and control groups (T/C%) values of 0.4, 16 and 10.6, respectively, but also caused a corresponding mortality of 87, 47 and 13%, respectively, as opposed to 15% in the control group. Me-Din also showed significant tumour growth inhibition at all dosages (13.8, 10.6, 8.2 and 6.2 mg/kg), as evidenced by T/C% values of 2, 5.7, 8.4 and 25, respectively. The corresponding mortality was 47, 20, 27 and 30%, respectively. Ac-Din showed the lowest mortality with 20, 13 and 20% at dosages of 9.1, 7.0 and 5.3 mg/kg, respectively, whereas application of 11.9 mg/kg resulted in 100% mortality. T/C values of 18.3, 11.1 and 21.6%, respectively, demonstrated again high anticancer efficacy. Compared to the combination therapy with 5-FU and leucovorin (25 mg/kg each), p-N-acetyldinaline (7.0 mg/kg) was 4-fold more effective as indicated by T/C% values of 81.4 versus 21.9 at similar toxicity. In vitro, all three compounds were similarly active with IC50 concentrations between 1 and 2.2 micrograms/ml after 48 h of exposure and 0.6 to 1.6 micrograms/ml after 72 h of incubation. The MTT dye conversion assay correlated well with cell counts obtained by cell counting except for low dosages after short incubation periods when it stimulated cell proliferation. These results suggest that dinaline and its derivatives have clinical potential.

Animals↗
PubMed1996

[Surgical treatment of intra-abdominal abscesses].

To define the role of operative treatment of intraabdominal abscesses, we retrospectively reviewed 106 patients, who were operated for intraabdominal abscesses between January 1988 and October 1994. 49 patients had had a primary abscess, 57 patients had an anteceding operation. In both groups appendix and bilio-pancreatic tract were the mostly involved organs. 81 (76,4%) abscesses were single, whereas 17 patients had 2 and 8 patients had 3 synchronous abscesses. All abscesses fulfilled the criteria of complicated abscesses. Successful drainage was achieved in 83%, 17% of cases had to be reoperated or percutaneously drained for recurrence of abscess or abscess related complications. The procedure related morbidity was 37,7% (40/106), half of these were minor complications. 5 patients died, conferring to a mortality of 4,7%. We conclude, that operative drainage plays an important role in the therapeutic regimes of intraabdominal complicated abscesses and can be performed with low morbidity and mortality.

Abdominal Abscess↗
PubMed1996

[Surgical therapy of severe colitis].

Severe colitis, eventually complicated by toxic megacolon, perforation or massive hemorrhage still represents a potentially life threatening complication during the course of inflammatory bowel disease reaching a mortality of almost 40% if not operated in time. From 1.1.1973 until 30.4.1994 22 patients (13 men, 9 women, mean age 29 years) with either ulcerative colitis or Crohn's disease of the colon were operated on for severe colitis. Indications for operative treatment were as follows: 7 patients relapsed conservative medical treatment, 8 developed toxic megacolon and in 7 patients perforation occurred. Diagnosis was based on the clinical criterias first described by Turnbull. In 11 (50%) cases subtotal colectomy with an ileostomy and intrapelvic Hartmann's pouch was performed, in 4 (18%) patients a Turnbull's procedure was carried out with loop ileostomy and colostomies and in 3 (14%) cases a left hemicolectomy and transversostomy was applied. In two patients with Crohn's disease an ileocolic resection was done because of perforation, one received a subtotal colectomy and ileorectal anastomosis and one patient was operated by a right hemicolectomy and ileostomy. One patient with ulcerative colitis died, reaching a post-operative mortality of 4.5%. After an intervall of approximately 18 months in the 16 surviving patients with ulcerative colitis an ileal pouch-anal procedure could be done. Of the 5 patients with Crohn's disease one had to be operated on for recurrence, the other patients have been free of recurrent Crohn's disease for a follow-up time between 3 and 11 years. We conclude, provided early operative treatment is intended, that subtotal colectomy with Hartmann's pouch and ileostomy is the procedure of choice in patients with severe colitis.

Adult↗
PubMed1995

[Rare manifestation of actinomycosis as retroperitoneal space-occupying lesion].

Actinomycosis has to be included in the differential diagnosis of retroperitoneal masses especially when surrounding tissue is infiltrated. We present a 40 year old male patient with the rare manifestation of retroperitoneal actinomycosis. The definitive treatment consisted of surgical drainage and long-term penicillin therapy resulting in complete healing. Special features in clinical symptomatology and problems concerning diagnosis of actinomycosis are discussed.

Abscess↗
PubMed1995

[Enterocutaneous fistula after Marlex net implantation. A rare complication after incisional hernia repair].

Erosions of intraabdominal hollow viscus are possible complications following reconstructive surgery of the abdominal wall after hernia repair with non-absorbable biomaterials. A rare case of manifestation of a enterocutaneous fistula by chronical erosion of a Marlex mesh after repair of an incisional hernia is presented. Successful treatment was achieved by fistulectomy, small bowel segmental resection and limited resection of the implanted Marlex mesh.

Cutaneous Fistula↗
PubMed1992

Antineoplastic activity of three ruthenium derivatives against chemically induced colorectal carcinoma in rats.

The antineoplastic activity of the ruthenium complexes trans-imidazolium[tetracholorobisimidazole-ruthenate(III)], HIm(RuIm2Cl4), trans-indazolium-[tetrachlorobis(1H-indazole)ruthenate (III, N2)], HInd [RuInd2Cl4(N2)], and trans-indazolium[tetrachloro-bis(2H-indazole)ruthenate(III,N 1)], HInd[RuInd2Cl4-(N1)] was assessed in acetoxymethylmethylnitrosamine-induced autochthonous colorectal carcinomas of Sprague-Dawley rats. The model is not sensitive to clinically established antineoplastic agents, including cisplatin. An exception is the combination therapy with 5-fluorouracil/leucovorin, which shows moderate activity against the tumour model. In contrast to this general trend, the new substances were all active against this tumour. HIm(RuIm2Cl4) was very effective at all dosages applied (7.5 mg/kg, 5.3 mg/kg, and 3.8 mg/kg), as indicated by percentage treated/control (T/C values of 23%, 34.5%, and 44%. Toxicity was considerable as shown by a body weight change of -30%, -19%, and -9%. Nevertheless, the medium dose seems to be the optimum in terms of mortality (0% vs 15% in the control group), whereas at the highest dose, mortality increased as a result of substance toxicity, and at the lowest dose mortality increased through tumor growth combined with substance toxicity. HInd[RuInd2Cl4(N2)] showed high efficacy at the highest dosage of 13 mg/kg, reaching a T/C value of 27% combined with 0% mortality versus 15% in the control group. In equimolar dosages (10 mg/kg, 7.1 mg/kg and 5.1 mg/kg), the compound is not as active as HIm-(RuIm2Cl4), as indicated by T/C values of 50.2%, 45.7%, and 38.6%. HInd[RuInd2Cl4(N1)] was slightly but not significantly better than HInd[RuInd2Cl4(N2)] at a dosage of 7.1 mg/kg and is advantageous over combination therapy with 5-fluorouracil and leucovorin (20/20 mg/kg) in terms of efficacy (T/C = 37.6% versus 44.7%) and mortality (6% versus 33.3%).

Animals↗