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Biomedical subjects

P Eckert

Publications and source records attributed to P Eckert.

At least 19 recordsLinked to original sources
PubMed1979

Incidental splenectomy: early and late postoperative complications.

Of 542 splenectomies performed from 1964 to 1977, 242 were incidental to gastrointestinal surgery. The highest rate of complications was observed in these patients as opposed to those who underwent splenectomy for trauma or Hodgkin's disease. Eighteen laboratory studies did not show significant changes 1.5 to 10 years postoperatively in 96 patients. Ninety-three patients questioned because of late symptoms had the highest rate of complaints after incidental splenectomy.

Blood Cell Count↗
PubMed1979

Effect of intraperitoneal aprotinin treatment in acute and chronic peritonitis.

Our results demonstrate that peritoneal absorption even of large amounts of fluid is not restricted in either acute or chronic peritonitis. According to investigations reported elsewhere, antibiotics administered intraperitonealy can be found quantitatively in the serum, if peritoneal absorption is not impaired. The retardation effect of proteinase inhibitor TRASYLOL on peritoneal absorption in peritonitis may indicate that proteolytic processes are necessary to break up the protein binding of antibiotics which only then are able to permeate the peritoneal wall. This may also pertain to other substances of pharmacologic activity, like toxins -lipoproteins, lipopolysaccharides- and medicaments. With respect to the clinical relevance of this effect it should be regarded as beneficial. Alternatively, the role of kallikrein/kinin-system for transmembranous absorption of proteins and protein split products has to be considered.

Acute Disease↗
PubMed1979

[Man in old age: from the viewpoint of the surgeon].

The most important problems of surgery in the aged patient are: immediate recognition of risk factor (few, but reliable laboratory parameters in the sense of "searching tactics": status of blood, blood sugar, urea-N, creatinine, cholinesterase), careful procedural choice, immediate mobilisation postoperatively, subsequent rehabilitation, if necessary. The operation itself must be fast but careful and as restricted as possible.

Aged↗
PubMed1978

[Transperitoneal resorption in acute and chronic peritonitis (author's transl)].

Two forms of peritonitis have been examined on 60 rats (Wistar) in three groups. Group 1 = acute peritonitis, group 2 = chronic peritonitis and group 3 = control. All animals have had an injection of an aminoglycosid antibiotic and a proteinase inhibitor into the peritoneal cavity. One intended to measure the influence of the proteinase inhibitor for different kinds of inflammation of the function of resorption of the peritoneum. Serum concentration of the antibiotic after 30, 60, and 90 min was measured. In clinical dosage the resorption of protein-bonded aminoglycosid antibiotics was decreased. The healthy control animals didn't show any effects. Connections concerning molecule size of protein-bonded substances and proteolytic ferments are in discussion. The practical relevance of these results could be found in an retarding effect of the resorption of protein-bonded toxines.

Acute Disease↗
PubMed1978

Altered metabolism of phospholipids in the lung of rats with peritonitis.

Pulmonary alterations after shock and sepsis, described clinically as shock lung or adult respiratory distress syndrome, are of great importance in intensive care. Pathogenetically an alteration of the surfactant system of the lung is often discussed. Since phospholipids are constituents of lung surfactants, phospholipid metabolism is investigated in experimental peritonitis in rats in our laboratory. 15 hours after inducing a peritonitis, the lung incorporates more oleic acid than that in animals of the reference group. 33 hours after inducing peritonitis, the capacity of the lung to incorporate choline and fatty acids is markedly reduced, histologically the lungs represent morphological equivalents of the so-called shock lung at this time. Therefore we conclude, that an alteration of phospholipid metabolism with a diminished and/or altered synthesis of lung surfactant plays, at least in part, an important role in the pathogenesis of respiratory distress in sepsis and peritonitis.

Animals↗
PubMed1978

[Postoperative peritonitis: intraperitoneal lavage with antibiotics (author's transl)].

Despite antibiotics, mortality in postoperative peritonitis has increased in the last 50 years. The main reasons are: modern medical technology and different types of patients. Operations are an unphysiologic intervention into the peritoneal cavity. The peritoneum is part of an immunologic defense system against bacterial growth and penetration into the peritoneal cavity. Circulatory and lymphatic vessels are in close contact. RES of the liver and spleen is stopped directly and indirectly by antibiotic drugs, and there is no pharmacodynamic direction after intraperitoneal injection. There is clinical improvement in mortality following lavage with antibiotics.

Anti-Bacterial Agents↗
PubMed1978

Surgical emergency cases--endoscopic treatment.

For gastrointestinal surgery endoscopy gains more and more importance. Besides the desired improvement of pre-, intra- and postoperative diagnosis multiple therapeutic procedures proved to be practicable. Of special interest are those methods, which can be used successfully in emergency cases. Here the foreign body dislodgement, the stopping of hemorrhage and the introduction of tubes in cases of ileus or dehiscence of the suture have to be mentioned. The endoscopic treatment is very often a complementary or palliative one and not so much an alternative. These methods are applied to patients at high risk.

Adolescent↗
PubMed1978

[Haemodynamics and shock prevention in acute haemorrhage from the upper intestinal tract (author's transl)].

Acute haemorrhages in the upper intestinal tract derive mainly from smaller low-pressure vessels. Bleeding is generally protracted and is often clinically occult. The clinical signs are a more reliable indicator of the severity of the haemorrhage than are measurements of the central venous pressure, shock index and cardiac output. The considerable tolerance of man to blood loss is probably attributable to the erect standing position. It has the advantage that it provides a large measure of counter-regulatory possibilities; but has the disadvantage that there is only a very narrow margin of safety as regards the development of irreversible shock. Close and consistent co-ordination of diagnosis and therapy is essential in all cases of gastro-intestinal haemorrhage.

Animals↗
PubMed1978

[Early relaparatomy].

Of 3682 patients with abdominal surgery, 142 (3.86%) had emergency early reoperation. The average lethality was 43%. The highest lethality, 60%, was found in those with severe peritonitis; the lowest, 30%, in those with local infection. In comparison with the results of other authors and with previous evaluations, our results demonstrate that despite altered operative indications, increased age of patients, and high-risk operations, the lethality has not increased. The causes and reasons of this positive tendency are discussed.

Drainage↗
PubMed1978

[Acute haemorrhage from ulcers of the stomach and duodenum; rate of transfusion and complications (author's transl)].

It has been shown in 35 patients with severe acute gastrointestinal haemorrhage that there is a limit regarding the amount of transfused blood needed for substitution. Whereas patients over 65 years had a 100% mortality rate after more than 10 units., the limit in younger patient was 15 units. The time of the beginning of surgical therapy is decisive for the chance of survival. After 4 transfusions in few hours the surgical intervention should be started. Under these conditions even older patients have a better chance of survival. The number of transfusions given and the time is directly proportional to the rate of complications.

Adult↗
PubMed1977

[Hemorrhage in portal hypertension (author's transl)].

The increasing number of toxic cirrhoses of the liver and their concomitant diseases demands differentiation in the choice of surgical technique in acute hemorrhage. The characteristics of the habitually orthostatic human circulation give some indications on the formation of varices. Experience offers new approaches to the prevention of reflux in the esophagus. Diagnostic and therapeutic procedures in the different types of bleeding in the acute hemorrhage of portal hypertension and intrahepatic block are discussed.

Esophageal and Gastric Varices↗
PubMed1977

[Islet cell tumors. Diagnostic and operative aspects (author's transl)].

Islet cell tumors have been described the past 25 years in frequent series. Multiple symptoms lead often to prolongation of disease and misinterpretation of diagnosis. Because of its rarity most authors report only few cases. We had the chance to observe 24 patients of which four had carcinoma within 12 years. Symptoms, clinic, different surgical procedures are described. Clinical difference seems to exists between benigne and malignant islet cell tumors.

Adenoma, Islet Cell↗