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Biomedical subjects

M Köcher

Publications and source records attributed to M Köcher.

28 records · Page 2Linked to original sources
PubMed1991

[Surgical treatment of patients with paraesophageal and mixed hiatal hernias].

During the years from 1948-90, we operated on 112 patients with paraesophageal and mixed hiatal hernias. One hundred patients who had been operated on up to the year 1988 were followed up over a long period. Preoperatively gastroesophageal reflux occurred in 52%, hemorrhage in 18%, riding ulcer in 7%, and incarceration and obstruction in 9%. Up to the beginning of the seventies, hiatoraphy and gastropexy were carried out. In these patients, the checking showed the occurrence of the relapse of hernias in 47%, reflux in 43% and subjective complaints in 26%. This finding induced us to change the surgical procedure and, in the following years, we performed hiatoraphy, fundoplicatio, fundophrenopexy and anterior gastropexy. The checking showed a decrease in the occurrence of the relapse of hernias to 21%, gastroesophageal reflux to 9% and subjective complaints to 10%. The period of the follow-up ranged from 1 to 19 years. The operative letality was 3%.

Adolescent↗
PubMed1990

[Ossification of the posterior longitudinal ligament in the cervical spine].

Ossification of the ligamentum longitudinale posterius is a rare disease found in particular in Japan and southeastern Asia. In the literature it is described as the so-called Japanese disease or OPLL syndrome. The disease takes a slow, frequently asymptomatic, course but may cause severe stenosis of the spinal canal with neurological disorders, OPLL occurs frequently concurrently with ankylosing spondylitis, hypertrophic spondylosis, diffuse idiopathic hyperostosis of the skeleton. Own observation: a 68-year-old man with a long history of cervicalgia, subsequently paraesthesias of the upper extremities, without a spastic atactic symptomatology of the lower extremities. An X-ray extremities, of the skeleton was made, tomograms and CT of the cervical spine. In the Cl-6 area major ossifications of the posterior longitudinal ligament were found which caused stenosis of the spinal canal of an extent of up to two thirds.

Aged↗
PubMed1989

Effects of adenosine analogues on force and cAMP in the heart. Influence of adenosine deaminase.

The effects of the adenosine receptor agonists (-)-N6-phenylisopropyladenosine (PIA) and 5'-N-ethylcarboxamideadenosine (NECA) on the force of contraction, adenylate cyclase activity and cAMP content in the presence of isoprenaline (Iso) were studied in ventricular preparations of the guinea-pig heart. Only in the presence of adenosine deaminase (ADA) and 50 mM sodium chloride, i.e. under 'optimal' conditions, did PIA and NECA reduce the Iso-stimulated adenylate cyclase activity in broken cell preparations, with a maximal effect of about 25%. In electrically driven (1 Hz) papillary muscles from guinea-pigs, both compounds concentration dependently reduced the Iso-stimulated force of contraction maximally by about 50% in the presence of ADA (1 microgram/ml). cAMP was measured in the same preparations. Low concentrations (0.1-1 microM) of PIA reduced the cyclic AMP content while higher concentrations increased the cyclic AMP content. The negative inotropic effect of NECA was accompanied by a concentration-dependent increase in the cyclic AMP content. We conclude that the negative inotropic effect of PIA in the presence of Iso is only in part due to a decrease in the cyclic AMP content resulting from inhibition of adenylate cyclase activity. Such an effect was only detected in the presence of ADA so that endogenous adenosine can obviously mask small effects of PIA on adenylate cyclase activity or the cyclic AMP content. In addition, the negative inotropic effect of NECA in the presence of isoprenaline was not accompanied by a reduction but an increase in the cyclic AMP content.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMedDate not supplied

Multi-site interventional real-time procedure demonstrations with the use of integrated services digital network connections.

PURPOSE: To evaluate the effectiveness and cost of commercially available video conferencing units and standard Integrated Services Digital Network (ISDN) connections for real-time multi-site transmissions of interventional procedures. METHODS: A network of five separate interventional radiology departments-three in the Czech Republic and one each in Austria and the USA-was established using Polyspan (Polycom in the USA) View Stations and ISDN connections. This network was used for transmissions of 16 live interventional procedures to the Sixth International Workshop on Interventional Radiology in Prague, Czech Republic in June 2000. RESULTS: The transmissions were successful and of sufficient quality to contribute to the educational success of the workshop. The cost of the ISDN transmissions was a fraction of satellite transmission costs. CONCLUSION: Multi-site real-time interventional procedure transmissions using video conferencing Polyspan (Polycom) View Stations and ISDN connections are a promising means of improving interventional tele-education and decreasing its cost.

Austria↗
PubMedDate not supplied

Esophageal stent with antireflux valve for tumors involving the cardia: work in progress.

PURPOSE: To describe an esophageal stent with a polyester mesh cover and an antireflux valve, and to assess its efficacy in the treatment of patients with inoperable tumors of the gastric cardia. MATERIALS AND METHODS: Thirteen patients with adenocarcinoma of the cardia, two patients with squamous cell carcinoma, and three patients with recurrent carcinoma of the gastric fundus after surgery were treated by placement of an esophageal stent with an antireflux valve. The spiral Z stent has a porous, polyester mesh cover and an antireflux sleeve made of pliable polyurethane at its lower end. RESULTS: Placement of the stent was successful in all patients, and their dysphagia disappeared or significantly improved. All were able to swallow solid food, and no patient reported significant reflux or "gas bloat" syndrome prior to death or the end of follow-up. Two patients only complained of minor heartburn. Follow-up barium swallow studies showed the absence of significant gastroesophageal reflux in all patients. No stent migration occurred. CONCLUSION: The esophageal stent with antireflux valve has been effective in the treatment of malignant obstruction of the cardia and allowed good esophageal passage without migration and major gastroesophageal reflux.

Adenocarcinoma↗
PubMedDate not supplied

[Pelvic type of chronic recurrent multifocal osteomyelitis].

We report about the juvenile and adolescent pelvic type of CRMO in 7 girls and 4 boys. The results show from solitary up to 7 pelvic lesions (average 3 lesions) predominantly in the acetabular and paraacetabular region (sometimes with hip joint effusion as a sign for concomitant coxitis).Tc99m-bone-scan is helpful to evaluate exactly the pattern of bone affection. We find 3 stages of an primarily chronic, non-purulent osteomyelitis going along with a "plasma-cell-sclerotic process", leading to a Garrè-type sclerosing end-stage, which probably heals after some years spontaneously, projecting on clinical symptoms and radiological appearance. The concomitant coxitis ("sympathetic coxitis") is clinically often in the foreground, but reversible. Pain in case of CRMO responds surprisingly well on medication with acithromycine. Knowing about CRMO in its different clinical appearances - especially concerning what we call "sympathetic coxitis" - can be a useful for pediatric rheumatologists and orthopedic surgeons, as well as MRI-focused radiologists and pathologists. Therapy might find a useful drug in acithromycine. In conclusion we d like to point out, that CRMO is one entity under the "roof" of the so called SAPHO-syndrome, which again shows us, that SAPHO-syndrome ist not a diagnosis itself but more a sign-post on the way to a correct diagnosis.

Acquired Hyperostosis Syndrome↗