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Biomedical subjects

R Kasperk

Publications and source records attributed to R Kasperk.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Intraoperative risks and early postoperative complications in surgery of chronic pancreatitis].

69 patients (1986-1991) who underwent conventional surgery for chronic pancreatitis (n = 42) or related pseudocysts (n = 27) were analyzed retrospectively. 17 patients underwent partial duodenopancreatectomy (pDPE), 13 pancreaticojejunostomy (PJ), 20 cystojejunostomy (CJ), 9 resection of the left pancreas and 10 other procedures. We evaluated especially time spent in hospital (pDPE:28,5d (mean), PJ:29d, CJ:22,3d, others:28,8d), duration of operation (pDPE:6h, PJ:4,6h, CJ:2,6h, others:2,6h), requirement for blood substitution (pDPE:3,2 units, PJ:3, CJ:0,8, others:1,9), postoperative surgical (pDPE:6%, PJ:15%, CJ:5%, others:29%) and nonsurgical (pDPE:0, PJ:0, CJ:15%, others:14%) complications, and operative mortality (0 in all groups). Conventional surgery for chronic pancreatitis and pseudocysts carries a very low mortality risk but may cause prolonged morbidity in a minority of cases.

Adult↗
PubMed1994

Morphometric study of centrilobular vessels in the rat liver after continuous hypothermic perfusion with Euro-Collins and University of Wisconsin solution.

Damage to the hepatic microcirculation plays an important part in the preservation-related loss of graft viability. In a study on the isolated, hypothermically preserved rat liver perfused continuously with Euro-Collins and University of Wisconsin solution (gluconate substituted for lactobionate) at different flow rates we determined changes in diameter of central veins and pericentral sinusoids and related them to weight changes. While post-perfusion liver weight increased with Euro-Collins and decreased with University of Wisconsin solution, weight changes did not vary significantly with different flow rates. Changes in sinusoidal diameter depended on the type of solution as well as on the flow rate. Cell swelling under Euro-Collins perfusion leads to compression of pericentral sinusoids, which varies in degree with different flow rates. Perfusion with University of Wisconsin solution under near-normal flow, due to slight shrinking of parenchymal cells, keeps the sinusoidal lumina wide open. We conclude that there is a causal relationship between perfusion-dependent cell swelling and reduction in sectional area of the hepatic microvasculature. Continuous hypothermic perfusion with University of Wisconsin solution at physiologic flow rates excellently preserves the size and trabecular architecture of hepatocytes and thereby the sinusoidal lumina within the hepatic lobules.

Adenosine↗
PubMed1994

[Surgical therapy of chronic pancreatitis: index-assisted evaluation of therapeutic success].

Surgery for chronic pancreatitis is criticized as being too risky to treat an allegedly self-limiting disease. Therefore, analysis of treatment results after surgery is necessary. Relevant parameters are--besides late surgical complications--pain, exocrine and endocrine insufficiency, weight loss, regular medications, general fitness and ability to work, all of which have to be accounted for pre and postoperatively. All parameters were integrated into an outcome score. 64 patients were studied 3.5 years (median) after different surgical procedures for proven chronic pancreatitis. Efficient pain control was achieved with every procedure. Resection caused more often functional deficiencies. However, these patients felt generally fitter after surgery and more often worked full-time. The outcome score demonstrated different results for the various procedures. Especially the risk-benefit ratio of cystoenterostomies can probably be improved by percutaneous drainage techniques.

Adult↗
PubMed1993

[Effect of intraoperative radiotherapy on postoperative follow-up of pancreas cancer].

Surgical therapy alone has not been able to improve significantly long-term survival in cases of pancreatic carcinoma. Improvement can only be expected by more successful local and systemic tumor control. To achieve the former intraoperative radiotherapy (IORT) with high-energy electrons has recently been introduced into clinical practice. Between June 1989 und June 1991 23 patients underwent IORT while receiving palliative (n = 16) and curative (n = 7) procedures. During the same period 36 patients were operated upon without IORT. Irradiated patients suffered far more complications. A positive effect on survival or pain control in palliatively operated cases could not be demonstrated. Prolonged survival after curative resections with IORT seems probable but can not be proven due to small number of patients. Further progress requires combination of IORT with postoperative radiochemotherapy.

Adenocarcinoma↗
PubMed1992

The significance of multiple trauma in children.

Accident-related injuries, mainly traffic-connected, are the most serious threat to health and most-frequent cause of death in the pediatric age group. Usually these are multi-system injuries. While the total number of accidents has decreased over the last 20 years, traffic accidents have become more serious. Conventional prognostic scores are not applicable in children with multiple injuries because of their essential pathophysiologic differences with adults. The Pediatric Trauma Score closes this gap. It is simple to use and provides high reliability.

Accidents, Traffic↗
PubMed1992

[Long-term follow-up of polytrauma].

While there are numerous scoring systems for assessment of the immediate period after multiple trauma, hardly any studies exist on the long-term sequels of these serious injuries. We interviewed and examined 104 patients who had sustained such an injury 1-6 years previously (median 4.3 years). Our study revealed that the long-term outcome cannot be correlated with the ratings in a typical polytrauma scoring system. Therefore, we suggest a new scoring system that allows assessment of long-term results by taking into account accident-related limitations in three essential areas of everyday life: school/profession; basic abilities; leisure time/hobby/sports.

Activities of Daily Living↗
PubMed1992

Obstructive colorectal carcinoma. Principles and technique in 134 cases.

In order to define the influence of intestinal obstruction on therapy and prognosis of colorectal carcinoma, we analyzed retrospectively the records of 1756 patients with this type of malignancy (1966-1990). The incidence of obstruction was 8% among our patients (n = 134), 3% of which suffered perforation (n = 4). Operative mortality was 30% as compared to 7% after elective surgery. Curative resections could be performed in only 34%, while this was possible in 75% of non-obstructive cancers. 5-year survival dropped from 51% to 23% in cases with obstruction. The choice of operative procedure depends mostly on tumor localization. Tumor obstructions of the right colon benefit from primary resection, while this advantage could not be demonstrated for left-sided lesions. Still, we consider it in any case desirable to remove the malignancy during the initial operation. In recent years, the number of one-stage procedures has increased dramatically, while mortality was reduced.

Colorectal Neoplasms↗
PubMed1991

[Does performance of a stress roentgen image of the upper ankle joint in acute fibular capsule ligament lesion entail an operation? An experimental study].

In an experimental study the sequelae of performing stress films on the ruptured lateral ligaments of the ankle joint are documented. It is shown that stress films may cause further damage on the ankle capsule when there is ligamentous disruption. After performance of stress studies a sufficient realignment of the interrupted ligaments by immobilization of the foot in a neutral (right angle) position can not be achieved. This makes, at least for younger patients, operative therapy after positive stress films advisable.

Ankle Injuries↗
PubMed1991

[The polytraumatized child. Pattern of injuries, characteristics of therapeutic management and prognosis].

Accident-related injuries account for a major part of childhood morbidity and mortality. More than 25% of the patients treated at the University Clinic Aachen for severe multiple trauma are below 16 years of age. The younger the children are, the more the pattern of injuries as well as the therapeutic approach differ from the well-known standard in adults. This is due to the anatomic and physiologic differences encountered in children. A reliable and practical triage instrument is needed to overcome the problem of estimating the severity of injuries in a child. The Pediatric Trauma Score seems to fulfill these requirements.

Brain Injuries↗
PubMed1990

[Plate osteosynthesis of the femur in patients with multiple and mono-trauma].

In multiple trauma patients successful treatment of femur shaft fractures depends more on timing of osteosynthesis than on choosing a specific type of fracture stabilization. Because of theoretical and practical reasons early osteosynthesis within 24 to 48 hours seems to be advantageous. In our experience it led to a significant decrease in complications. However, concomitant thorax trauma mandates special consideration. The two fatalities in our study belonged to this subgroup. With adequate indication for therapeutic intervention, correct operative technique and consideration of the patient's general status good results can be expected with every type of fracture treatment available (external fixation, plate fixation, intramedullary nailing).

Adult↗
PubMed1990

[Strategy of the interdisciplinary early intervention in unstable pelvic injuries and concomitant urogenital lesions].

Among our polytrauma patients, 36.3% suffered combination injuries of the pelvic ring and the urogenital tract, and 8 of the patients with this type of lesion underwent orthopedic and urological surgery in a single session on the day of the accident. One patient died of multiple organ failure, but otherwise we did not observe any complications; in particular, no infections occurred. By an average of 11 months after the operation, all patients were continent for urine and had normal urethrocystograms. In 3 cases the pelvic ring lesion was treated by plate fixation and in a further 3 cases by plate fixation with additional temporary external fixation. Definitive stabilization was achieved in all cases by an average of 2 weeks postoperatively.

Bone Plates↗
PubMed1988

Algae-derived (phycogene) hydroxylapatite. A comparative histological study [corrected and issued with original paging in Int J Oral Maxillofac Surg 1988 Oct;17(5)].

3 granular hydroxylapatite (HA) biomaterials, solid, coralline and phycogene HA (obtained from calcifying algae), differing widely in their relative amounts of specific surfaces and their origin, were examined with regard to their effects on bone healing in rats. Trephine drill holes were produced in the rat femur and filled with the HA granules. Each biomaterial produced a characteristic pattern of bone healing. Bioceramics with a small surface area showed random bone-implant contacts. Biomaterials offering large surface areas showed a dense bone-implant interface. Evidence is presented to suggest that a large specific surface favours osteoneogenesis and cell spreading on and into an implant.

Animals↗
PubMed1985

[Esophagus resection without thoracotomy in cancer. Report of experiences with 100 cases].

Between 1980 and 1984 126 patients were admitted to the surgical department of the University of Düsseldorf for cancer of the esophagus. 100 (= 79%) patients were operated upon. In the majority of cases we dealt with advanced tumors (76% stage III and IV UICC). In 87 patients the esophagus was removed by transhiatal blunt dissection. In 13 patients the tumor bearing esophagus was bypassed by the substernally transferred stomach. Overall mortality was 20%. Varying with tumor stage the median time of survival was 5,5 months, again with wide variation depending of tumor stage. Only in stage I and II tumors there is a chance of significant prolongation of life or even cure. The majority of our patients and their relatives considered the outcome of the operation as a success, even if the time of survival was only short.

Adult↗