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Biomedical subjects

M Thermann

Publications and source records attributed to M Thermann.

At least 19 recordsLinked to original sources
PubMed1992

[Possibilities and limits of reconstructive surgery of the recurrent laryngeal nerve].

The authors report on possibilities and borderlines of reconstructive microsurgery of the recurrent laryngeal nerve. When paralysis of the vocal cord is proved after thyreoidectomy exploration and control of the nerve should be done immediately. This must be done as fast as possible, latest at the 7th day after thyreoidectomy. If there is found nerve injury caused by intraneural hematoma or compressing sutures microneurosurgical neurolysis and decompression can be done very successful. 8 of 10 neurolysis of the recurrent laryngeal nerve reported by the authors were successful. Because of consecutive autoparalysis nerve suture is possible but not effective.

Follow-Up Studies↗
PubMed1992

[Incidence of carcinoma in follicular neoplasia of the thyroid gland].

Within four years 1376 thyroid operations were performed. In 152 = 11% a follicular or oncocytic tumor was found, 20 = 13% of these were classified as carcinoma. Seven of these were of the grossly invading type, raising suspicion of malignancy already pre- and intraoperatively while 13 encapsulated tumors were found by the pathologist only. If preoperatively a cold nodule or a nodular goitre was described, the carcinoma incidence was about 16%, while warm or hot nodes showed a carcinoma in 2%. Besides tumors of < 1 cm in diameter where we found no carcinoma the size of follicular tumors had no influence on the incidence of carcinomas.

Adenocarcinoma↗
PubMed1990

[Mediastinal lymphadenectomy in bronchus carcinoma--techniques and problems].

Mediastinal lymph node dissection in bronchial carcinoma patients means an additional procedure to the tumor resection. The en-bloc dissection is only possible if an upper lobe resection or a pneumonectomy is performed; otherwise, an isolated lymph node mapping is necessary. According to the different anatomical structures, mediastinal lymph node dissection is more easily performed on the right than on the left side, where mobilisation of the aortic arch or a longitudinal sternotomy is mandatory to sample the pre- and paratracheal lymph nodes. Up to now it is uncertain whether lymph node dissection improves the prognosis. But undoubtedly it is the basis for an exact staging.

Bronchial Neoplasms↗
PubMed1990

The importance of surgery as the first step in multimodality treatment of small cell bronchial carcinoma. The ISC Lung Cancer Study Group.

For patients with small cell lung cancer (SCLC) in their early stages (TNM I, II), surgery for cure was used to eliminate the primary tumour and its regional lymph-nodes followed by intermittent chemotherapy and radiotherapy within the first six postoperative months. After the pathohistological examination of the operation-specimen a two-arm-randomization was performed: standard chemotherapy (1000 mg/m2 cyclophosphamide, 50 mg/m2 doxorubicin, 1.4 mg/m2 vincristine) compared with sequential chemotherapy using three different drug-combinations (A: 1500 mg/m2 cyclophosphamide, 100 mg/m2 lomustine, 15 mg/m2 methotrexate; B: 1000 mg/m2 cyclophosphamide, 40 mg/m2 doxorubicin, 1 mg/m2 vincristine; C: 5 x 1.6 g/m2 ifosfamide plus mesna, 5 x 120 mg/m2 etopside). Thereafter disease-free patients only received prophylactic cranial irradiation (PCI: administering 3600 TD Gy/18 fractions) according to the protocols of the International Society of Chemotherapy Studies I and II. Preliminary evaluations in March 1990 of 170 patients from 24 cooperating departments for thoracic surgery showed that the projected life-table four-year-survival rate of 63 patients with SCLC at pTNM-stage I was 61%, of 54 patients at pTNM-stage II was 35%, of 13 patients at stage pT3, 4 NO, 1 MO was 59% and of 40 patients at stage pT N2 MO was 35%. The indication for surgery is emphasized for pTNM-stages I + II. For N2-lesions surgery would not be recommended in general, but the survival rate seems to indicate that this treatment was not detrimental, being rather more favourable compared with chemotherapy or radiotherapy alone. The continuation and enlargement of these studies seem not only justified, but emphatically indicated.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

The role of ifosfamide and cyclophosphamide in the multi-modality treatment after surgery for cure for small-cell bronchial carcinomas (SCLC).

For the optimisation of the therapy for small cell bronchial carcinomas (SCLC), surgery is used to eliminate the primary tumor and its regional lymph nodes and chemo- and radiotherapy for the general treatment of micrometastasis. After patho-histological examination of the operation specimen, randomization for two arms is performed for a standard chemotherapy (CAV) or a sequential chemotherapy using three different drug combinations. Thereafter all disease-free patients receive prophylactic cranial irradiation (PCI). Preliminary evaluations in December 1987, of 112 patients from 19 cooperating departments show that the survival rate projected for 2 yr of 43 patients at stage pT1-3 N0 M0 is 76%, of 43 patients at stage pT1-3 N1 M0 it is 63% and of 26 patients at stage pT1-3 N2 M0 it is 38%.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Efficacy and benefit of mediastinal computed tomography as a selection method for mediastinoscopy.

In 95 consecutive patients with proven or suspected bronchial carcinoma, computed tomographic evaluation of the upper mediastinum for N2 disease was performed prospectively. Patients with positive results underwent mediastinoscopy. Patients with perinodal N2 or N3 disease at mediastinoscopy were not considered candidates for operation. The mediastinum was declared negative only when intraoperative mediastinal lymph node dissection showed tumor-free nodes. Of the 95 patients, 12 had benign lesions, 14 were excluded from further evaluation because the lymph node status of the mediastinum was not proven intraoperatively, and 6 others were excluded from the final evaluation because of violation of the protocol. Twenty-two of the 75 remaining patients had a positive computed tomographic scan and underwent mediastinoscopy. Fourteen patients with positive results were considered to have inoperable disease. Fifty-three patients (70.7%) did not undergo mediastinoscopy. We performed seven probably incomplete resections, two for palliative reasons, and two thoracotomies without resection in patients with N2 disease. A policy of routine mediastinoscopy would have prevented only 5% of the thoracotomies performed in patients with lung cancer.

Aged↗
PubMed1988

Surgery for cure followed by combined modality treatment for small cell bronchial carcinoma. ISC Lung Cancer Study Group.

For patients with small cell lung cancer (SCLC) at early stages (TNM I, II) surgery for cure is used to eliminate the primary tumour and its regional lymph-nodes followed by intermittent chemotherapy and radiotherapy within the first six postoperative months. After the pathohistological examination of the operation-specimen a two-arm-randomization is performed: standard chemotherapy compared with sequential chemotherapy using three different drug-combinations. Thereafter tumour-free patients only receive prophylactic cranial irradiation. In preliminary evaluations of March 1988, of 121 patients from 20 cooperating departments it was found that the projected life-table survival rate, three years postoperatively, of 47 patients with SCLC at stages pT1-3 N0 M0 was 65%, of 46 patients at stages pT1-3 N1 M0, 56% and of 28 patients at stages pT1-3 N2 M0, 34%. The indication for surgery were emphasized for pTNM-stages I+II. For N2-lesions surgery would not be recommended in general, but the survival rate seemed to indicate that this treatment was not detrimental, but rather more favourable compared with chemotherapy or radiotherapy only. The continuation and enlargement of these studies seem not only justified but emphatically indicated. Multicentre cooperation has to be organized to collect within a reasonable period of time a sufficient number of patients to enable subdivisions to be made according to various prognostic factors.

Aged↗
PubMed1978

Hemodynamic parameters and blood gas analyses in the normal and the cirrhotic rat.

Thioacetamide-fed rats developed cirrhosis with portal hypertension (P portal=23.0 +/- 5.2 cm H2O, controls: 14.4 +/- 1.0 cm H2O). The PO2 of liver tissue was markedly reduced in cirrhosis (PO2=7.6 +/- 3.4 torr, controls 22.3 +/- 5.8 torr), and the aortal pH was significantly lower as well. No correlation was found between portal hypertension, development of large--nodular cirrhosis, and ascites.

Animals↗
PubMed1978

[The early urogram in experimental acute stenosis of a renal artery (author's transl)].

1. Renal excretion as seen in the urogram does not parallel changes in blood flow. The significance of the early urogram as a test of function is therefore very limited. 2. Following acute stenosis of one renal artery, there is simultaneous excretion by both kidneys until flow is reduced to 60%; exretion is delayed, with values of 0.5 to 7.5 minutes, following reduction to 30 to 60% of the original; there is no excretion below 30%. 3. Unilateral delay in excretion occurs at about the level of "critical occlusion pressure". 4. Delayed excretion is observed at the level of the so-called "critical stenosis" of the renal artery. A reduction of flow above 20% follows a reduction of the artery in excess of 66%, corresponding with a reduction of the lumen of more than 90%. 5. These findings indicate that delayed excretion in the early urogram is to be expected only as a result of severe stenosis of the renal artery and represents a late feature of renal vascular disease.

Acute Disease↗
PubMed1978

[The haemodynamic effects of renal artery stenosis (author's transl)].

Three reasons are suggested for the difficulty of judging the haemodynamic effects of renal artery stenosis: 1. The flow characteristics in the renal arteries of dogs indicate that, at the critical level of reduction to one third of normal diameter, a further change of only 0.5 mm. will cause a 50% alteration in flow volume. Variations of this order of magnitude cannot be reliably measured on the angiogram. 2. The production of turbulence, which can increase the effect of a stenosis considerably, depends, amongst other things, on the nature of the surface of the stenosis and this cannot be judged. 3. The effect of a stenosis depends on peripheral resistance in the kidney.

Animals↗
PubMed1978

[Manometric studies of the anal canal in chronic primary fissure before and after management using dilatation or sphincterotomy].

Manometric investigations in patients with primary chronic fissure in ano were performed before and after stretching or sphincterotomy in a randomized clinical trial. Length of the functional anal canal was not influenced by the procedures. At a six-month follow-up, the maximum resting anal pressure was significantly lower in both groups. After stretching and sphincterotomy, the site of maximum pressure in the anal canal had moved orally. This demonstrates that an elevated resting anal pressure is one of the pathogenetic mechanisms for the development of a primary chronic fissure. It is successfully cut off by either stretching or sphincterotomy.

Adult↗
PubMed1978

[Plasma histamine level during and following kidney allotransplantation in man].

In human kidney allotransplantation, elevated plasma histamine levels were measured before surgery, following revascularization, and in single cases also several days after surgery. The maximum extent of this histamine release must be tested with respect to time and to localization. Its significance must be established. The intermittently increasing plasma histamine levels (greater than 1 ng/ml) must be considered as a possible risk regarding stress ulcer pathogenesis.

Adult↗
PubMed1977

Influence of H1- and H2-receptor antagonists on the circulatory system and on the endogenous plasma histamine concentrations in dogs.

The effects of the H1-receptor antagonist dimethpyrindene and the H2-receptor antagonist burimamide on circulatory and respiratory parameters and on plasma histamine levels were tested in 21 mongrel dogs. Both drugs released histamine. The incidence for this effect was 10/11 in the case of dimethpyrindene and 5/10 in the case of burimamide. Following dimethpyrindene all animals showed arterial hypotension, pulmonal hypertension, decrease in peripheral resistance and hyperventilation. The portal venous pressure was increased in dogs reacting by a histamine release. Following burimamide both an initial arterial hypertension and a subsequent hypotension were observed the latter being more pronounced in the group with histamine release. In this group the portal venous pressure raised considerably. In the non-reacting animals cardiac output was elevated, probably due to a release of catecholamines. It seemed remarkable that the effect of exogenous histamine on portal venous pressure was completely blocked by dimethpyrindene, but not the action of histamine released by the drug itself. It is concluded that the effects of anti-histaminic drugs on possibly histamine-induced physiological and pathophysiological processes should be interpreted very carefully as far as their specificity is concerned.

Animals↗
PubMed1977

[Histamine concentration and diamine oxidase activity in the small intestine in superior mesenteric artery occlusion].

During intestinal ischemia in rabbits histamine concentration and diamine oxidase activity were altered in the intestinal wall and in the perfusate of mesenteric vessels. The results were interpreted as a histamine release and an increased catabolism of diamine oxidase. Thus, the combination of release of vasoactive histamine and partial elimination of a protective enzyme may contribute to the fatal outcome after mesenteric ischemia.

Amine Oxidase (Copper-Containing)↗