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O Thetter

Publications and source records attributed to O Thetter.

At least 19 recordsLinked to original sources
PubMed1992

Accuracy of computed tomographic scan and surgical assessment for staging of bronchial carcinoma. A prospective study.

There is an increasing demand for accurate preoperative and intraoperative staging of bronchial carcinoma with respect to neoadjuvant therapy protocols and parenchyma-sparing operations. This study prospectively evaluated accuracy of computed tomographic scan and surgical assessment for staging of bronchial carcinoma in 108 consecutive patients. The stage of the primary tumor (T stage) was correctly determined in 85% of the patients, and surgical evaluation correctly determined the T stage in 92%. Invasion of major mediastinal structures posed a major problem for computed tomographic scan. On a node-by-node basis, computed tomographic scan predicted involvement of lymph nodes in 81% (sensitivity 29%, specificity 93%, positive predictive value 49%, negative predictive value 85%). The surgeon correctly determined the lymph node status in 69% of lymph nodes (sensitivity 90%, specificity 63%, positive predictive value 39%, negative predictive value 96%). On a patient-by-patient basis, computed tomographic scan correctly predicted the nodal status in 58% of patients. Accuracy of computed tomographic scan and surgical assessment in determination of the lymph node status strongly depended on tumor type and lymph node region (hilar or mediastinal region) studied. This was partly due to the fact that adenocarcinomas exhibited a high proportion of tumor-positive normal-sized lymph nodes, whereas squamous cell carcinomas showed a high proportion of enlarged tumor-free lymph nodes. In conclusion, computed tomographic scan and surgical assessment are sufficiently accurate for determination of the tumor stage but are insufficient in determining the nodal status.

Carcinoma, Bronchogenic↗
PubMed1992

[The value of extended resection in locally advanced bronchial carcinoma].

A retrospective study on 68 patients with non-small-cell lung cancer (NSCLC) treated by extended resections is presented. Compared to simple resections extended resections carried a higher risk for postoperative complications, whereas 30-days-mortality was not influenced by type of resection. Analysis of survival rates after extended resections revealed no influence by T- or N-stage, whereas a residual tumor lowered the survival rates significantly. Overall, a 2-year-survival rate of 35% was observed after extended resections. In conclusion, even in locally advanced cases of NSCLC a resection with curative intent seems to be warranted, provided that a R0-stage can be achieved by surgery.

Carcinoma, Bronchogenic↗
PubMed1991

Growth-hormone releasing hormone in a bronchial carcinoid.

The case is reported of a 43-year-old patient with a peripherally located bronchial carcinoid tumor containing large amounts of immunoreactive and bioactive growth-hormone releasing hormone (GHRH). Because no GHRH was found in the peripheral circulation, there was no quantitative or qualitative derangement of growth-hormone secretion. The tumor was excised completely by thoracotomy.

Adult↗
PubMed1991

[Rethoracotomy after lung resection].

Postoperative complications after lung resection necessitating rethoracotomy are rare. The most common early complication is hemorrhage. Reintervention is indicated if bloody secretion of more than 250 ml/h persists over a period of hours. Any large intrapleural hematoma should be removed to avoid infection or development of pleural callosity. Further indications for rethoracotomy are: persistent parenchyma fistula, pneumothorax, residual cavity, pleural empyema, leakage of the bronchial stump and mechanical bronchial obstruction.

Bronchial Fistula↗
PubMed1991

[The value of computerized tomography and of the surgical assessment for lymph node staging in bronchial carcinoma. A prospective study].

We evaluated the accuracy of computed tomography (CT) and of surgical assessment for lymph node staging prospectively in 108 patients with bronchogenic carcinoma. For CT/surgical assessment a sensitivity of 29/90%, a specificity of 93/63%, a positive predictive value of 49/39% and a negative predictive value of 85/96% were calculated on a node-by-node basis. Sensitivity and specificity of CT were highly influenced by the lymph node region studied and by typing of the tumor. Adenocarcinomas showed a high proportion of normal-sized metastatic lymph nodes whereas squamous cell carcinomas exhibited a high proportion of enlarged tumor-free lymph nodes. The diagnostic accuracy in predicting the correct N-stage by CT was determined with 54% for squamous cell carcinoma and 56% for adenocarcinoma. The surgeon predicted the N-stage correctly in 39% of squamous cell carcinoma and 69% of adenocarcinoma. In conclusion, accuracy of CT-scan is too low to renounce mediastinoscopy for routine use in preoperative staging of bronchogenic carcinoma.

Adenocarcinoma↗
PubMed1991

[Fibrin-coated collagen fleece in thoracic surgery. Initial clinical experience].

After resecting procedures to the parenchyma of the lung the resection site was sealed with a collagen vleece combined with fibrin glue in 26 patients. No patient exhibited rebleeding. An air leak was present up to the first postoperative day in 19 patients, up to the third postoperative day in 5 patients. In two patients, duration of air leak extended beyond the third postoperative day, this was defined as therapeutic failure. The use of collagen vleece combined with fibrin glue represents a valuable contribution in thoracic surgery.

Adolescent↗
PubMed1990

[Morphology and clinical picture of thymus carcinoid].

A large mediastinal tumour was discovered radiologically in a 50-year-old man, with at times blood-tinged sputum and dyspnoea. Parasternal needle biopsy revealed a thymic carcinoid. After surgical excision of the tumour, which had argyrophilic foci (total weight of tumour 1,605 g), histochemical analysis demonstrated neuron-specific enolase, synaptophysin and chromogranin, as well as calcitonin (as the only hormone). For the first time in a thymic carcinoid, radioimmunoassay demonstrated growth-hormone-releasing hormone (2 micrograms/g tumour tissue). Post-operative radiotherapy (total dosage 50.5 Gy) was instituted because histological examination had shown invasion of the capsule and blood vessels. There has been no local recurrence or metastases after three years.

Biopsy, Needle↗
PubMed1990

[Perioperative preventive use of antibiotics in thoracic surgery--results of a controlled randomized study with optocillin].

There seems to be general agreement that antibiotic prophylaxis should be provided for patients undergoing resections of the lung. In order to obtain further information about the extent of resection beyond which this is necessary, and also to establish the type of prophylaxis that is meaningful over the long term, we carried out a controlled study involving two groups of 100 patients each. In the first group, who received minor resections, ultrashort-term prophylaxis was compared with an 0 group. We were able to show that in high-risk patients with prior pulmonary diseases, prophylaxis is indeed meaningful. In the second group of patients undergoing major resections, antibiotic prophylaxis must be provided; a one-day administration suffices, and long-term administration fails to offer any further advantages.

Drug Administration Schedule↗
PubMed1990

[Perioperative management of thoracic surgery patients].

Immediate postoperative extubation of patients submitted to chest surgery is possible in almost all cases. The intensive care unit responsible for these patients should have good facilities for bronchoscopy, and the indication for this procedure should be made, postoperatively, on a broad basis. The introduction of peri-operative antibiotic prophylaxis has led to a substantial decline in disturbances of wound healing. Due to the use of autologous blood transfusion, the need for homologous blood transfusions has been reduced significantly.

Aged↗
PubMed1988

Dynamic angioplasty--a milling catheter for transcutaneous and intraoperative treatment of vascular occlusive disease.

Balloon angioplasty and bypass graft surgery are common procedures for treating vascular occlusive disease. The purpose of this preliminary investigation was to evaluate the effectiveness and the safety of a new catheter system, first introduced by KR Kensey. The system involves a flexible catheter with a high speed rotating tip, driven by an electrical motor. The tip is cooled by a continuous flow of sterile saline containing dextran 40, heparin and urokinase. Radiopaque contrast medium may be infused through the catheter to allow the device to be guided and to detect lesions and to evaluate the efficacy of treatment. The system was applied in three patients with occlusive vascular disease (Stage IIb) and segmental or total occlusion of the superficial femoral artery (SFA). The milling catheter was introduced percutaneously into the common femoral artery and guided to the area of occlusion under DSA control. In two patients total recanalisation was achieved after passage of the milling catheter. In one patient the totally occluded SFA could not be cannulated and a femoro-popliteal bypass was performed one week later. Complications such as perforation of the vessel or peripheral embolisation were not observed. Pedal pulses were improved significantly in one patient. Further investigations will be necessary to demonstrate whether the milling catheter can be safely used to revascularise patients with limb threatening peripheral vascular disease.

Angioplasty, Balloon↗
PubMed1987

Influence of the lysosomal elastase inhibitor eglin on the development of interstitial lung edema in E. coli bacteremia in pigs.

Infusion of 3 X 10(10) live E. coli cells into anesthetized piglets induced severe septicemia with characteristic alterations in systemic and pulmonary circulation, lung function and morphology, blood cell counts and plasma protein composition. The simultaneous infusion of the elastase-cathepsin G inhibitor, r-eglin c, in a doses of 3.85 mg/kg X h for 4 hrs, reduced mortality, plasma protein consumption, and accumulation of interstitial fluid in the lungs. These findings are in favour of the concept that during septicemia the balance between liberated lysosomal proteinases and their extracellular inhibitors is severely disturbed. It can be at least partially restored by administration of an exogenous elastase inhibitor.

Animals↗
PubMed1987

Evaluation of the kinin-induced pathomechanisms in the development of ARDS by kallikrein inhibition in vivo.

Our findings indicate that the kallikrein-kinin system might participate in the development of acute respiratory failure. They were assessed by measurements of plasma kininogen levels, blood pressure recordings and lung morphology. Aprotinin plasma concentrations ranging from 4 to 7 KIU/ml proved sufficient to inhibit effectively the hemodynamic and morphologic effects caused by tissue kallikrein infusion.

Animals↗
PubMed1987

Effect of aprotinin and C1-esterase inhibitor on activation of the plasma kallikrein-kinin system in vivo.

Infusion of dextran sulfate in pigs rapidly activates the intrinsic cascade of the coagulation system including plasma prokallikrein and leads to release of kinin by limited proteolysis of kininogen. In this model, strong suppression of the DXS-induced activation of the plasma kallikrein-kinin system is seen at plasma aprotinin levels above 400 KIU/ml and C1INH levels above 4 U/ml.

Animals↗
PubMed1987

[Thoracic outlet compression syndrome].

In patients suffering from chronic, therapy-resistant shoulder and arm pains, the thoracic outlet compression syndrome (TOS) should be included in the differential diagnosis. It is very important to look out for neurogenic disorders as well as early signs of vascular compression in order to prevent ischaemic injuries. Although the initial complaints appear slight and can in some cases be treated successfully by conservative methods, neurogenic disorders due to TOS as well as arterial and venous manifestations of the syndrome should be treated by resection of the first rib. Only in this way can irreversible neurogenic lesions and arterial or venous complications be prevented.

Arm↗