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T Frick

Publications and source records attributed to T Frick.

33 records · Page 2Linked to original sources
PubMed1991

[Electron microscopy of the exocrine pancreas in experimental acute hypercalcemia].

Hypercalcemia has been associated with acute pancreatitis clinically and in the experimental animal. We studied the pancreatic ultrastructure in acute experimental hypercalcemia. Anesthetized cats (Pentobarbital, 0.55 mg/kg) received Ca++ (Calcium-Gluconate: 0.6 mmol/kgh; n = 4), K+ (KCl: 1.1 mmol/kgh; n = 4) or NaCl (0.9%; n = 4) locally through retrograde infusion into the splenic artery. Biopsies for electron microscopy (EM) were taken at three hours. Eight cats received intravenous Ca++ (0.6 mmol/kgh, 0.3 mmol/kgh after three hours) or NaCl (0.9%) for 12 hours. Biopsies were collected in two animals in three-hour intervals, and in all animals at twelve hours. After local calcium infusion necrotizing pancreatitis was seen macroscopically in the body of the pancreas. Biopsies for EM showed acinar cell necrosis, hydrops of nuclei and mitochondria and needle-like precipitates in the cytoplasma in the center of calcium perfusion. Biopsies taken from the peripheral region of the macroscopically altered tissue revealed desorganisation of the acinar polarisation and the endoplasmic reticulum, with zymogen granules appearing in the basolateral cell-portion. After intravenous calcium administration no macroscopical changes were seen. In EM acinar cells showed dilatation and proliferation of the golgi apparatus and increased number of condensing vacuoles indicating stimulation. Again, disorganisation of acinar cell polarisation was present. Control animals treated with K+ or NaCl showed normal pancreatic ultrastructure. The morphological changes after calcium infusion indicate direct damage to the acinar cell. Our results suggest that hypercalcemia induced pancreatitis could originate in the acinar cell.

Acute Disease↗
PubMed1991

[Gallbladder morphology after extracorporeal shockwave lithotripsy of gallstones with the MPL-9000].

The effects of extracorporeal spark-gap shockwave lithotripsy (ESWL) on human gallbladder-morphology are barely known. We studied the gallbladders of nine patients cholecystectomized 5 to 166 days after ESWL. Patients were treated one to three times receiving a mean of 1928 +/- 693 shockwaves per treatment, with a total of 3375 +/- 1307 per patient. Control gallbladders were of randomly selected patients after plain cholecystectomy (age and sex-matched). There was no difference in pathomorphology of the two groups. No signs of trauma related damage (hemorrhage, necrosis, ulceration, scar, or hemosiderin deposits) other than from surgical manipulation were found. Predominant pathomorphological changes were signs of chronic cholecystitis due to gallstone disease. In conclusion, spark-gap ESWL did not induce deleterious morphological damage to the gallbladder, although large numbers of shock waves were applied.

Adult↗
PubMed1991

[Bassini or Shouldice operation?].

Between October 1988 and March 1990 a controlled, prospective study was conducted comparing the operative methods of Bassini and Shouldice for hernia repair. On 100 patients (11 female, 89 male) the Shouldice-technique was used, on 55 patients (6 female, 49 male) the Bassini-technique. Most patients were operated under local anesthesia. No significant difference was noted between the two groups regarding the postoperative complication rate (hematoma, wound infection). However, patients had a shorter hospital stay after the Shouldice operation. Six patients (10.9%) had recurrent hernia after the Bassini procedure, one patient (1%) after the Shouldice procedure. An increased risk for recurrent disease was found in patients with the Bassini operation who already had recurrent hernia. Because of the significant shorter hospital stay and the significant lower incidence of recurrent hernia, we abandoned the operative method of Bassini in favour of the Shouldice procedure.

Female↗
PubMed1990

[Typical nosocomial infection with an unusual cause: Hafnia alvei. Report of 2 cases and literature review].

The route of infection and the course of two typical nosocomial infections are described in two patients infected with a rare gram-negative bacterium. Both patients underwent cardiovascular surgery. They were placed close to each other in the intensive care unit for several days and suffered from pneumonia and from wound infection respectively. In both patients bacterial culture grew Hafnia alvei. Successful antibiotic treatment was achieved with Netilmicin and Imipenem. Urinary tract, respiratory tract and wound infections are the most frequent nosocomial infections according to the literature. Risk factors are duration of stay in the intensive care unit, shock, poor general condition and advanced age.

Aged↗
PubMed1990

[The organization of gallstone lithotripsy using the MPL-9000 at the Zurich University Hospital, successes and failures. Initial results].

At Zurich fragmentation of gallstones is a joint venture between the Visceral Surgery Clinic, the Medical Clinic, Medical Policlinic, Radiodiagnostic Central Institute and Urologic Clinic. Lithotripsy is performed by a team from the Visceral Surgery Clinic with apparatus placed at their disposal by the Urologic Clinic. Indications for lithotripsy include symptomatic cholecystolithiasis, functioning gallbladder, and up to 3 gallstones of at least 10 mm and at most 30 mm diameter. Bile duct stones, acute cholecystitis, coagulopathy, pregnancy, aortic aneurysm and pacemakers are exclusion criteria. Patients spend two days in hospital, lithotripsy is performed without anesthesia, and outpatient follow-up is performed 1, 3, 6 and 12 months afterwards. Our experiences show that lithotripsy is more difficult and more treatments are needed if multiple gallstones are present. We had to perform cholecystectomy in 6 of a total 48 patients, mainly because of therapy resistant biliary pain due to stone fragments. The intraoperative findings did not correspond to the ultrasonic examination before lithotripsy in two of the patients who underwent cholecystectomy. Histologic examination of the six gallbladders in the surgical cases showed no abnormality. After an average treatment duration of 209 days, 9 of 48 patients are stone-free, 15 patients show improvement, in 14 patients no distinct reduction of fragments could yet be shown in recent follow-ups and 4 patients have not yet been reached for follow-up. Of the 230 patients examined lithotripsy was indicated only in 48 (21%) cases.

Adult↗
PubMed1990

[Experience with thoracoscopic pleurodesis in the treatment of idiopathic spontaneous pneumothorax].

Between January 1987 and December 1988 thoracoscopic pleurodesis has been used as a standard treatment for idiopathic spontaneous pneumothorax. Bullae were electrocoagulated, and visceral and parietal pleurae were cauterized. Chemical pleurodesis with 50% glucose-solution was added. 34 procedures were performed on 32 patients. The average hospital stay was 8 +/- 2 days. One patient suffered from postoperative Horner-syndrome. No other complications occurred. Patients were re-evaluated 11 +/- 8 months after the operation. Recurrence was found in four patients within 30 days. These patients underwent pleurectomy. Another patient had recurrence after two months. He was again and successfully treated by thoracoscopic pleurodesis. Our data show improvement of the results as compared with simple chemical pleurodesis.

Adolescent↗
PubMed1990

[Organization of gallbladder lithotripsy with the MPL-9000 at the Zurich university hospital. Initial results].

Gallstone shock wave therapy at the University Hospital of Zurich is a joint venture between the Medical Clinic, Medical Policlinic and Surgical Clinic. Patients with symptomatic cholecystolithiasis willing to submit themselves to a long period of treatment, were accepted for ESWL, should no contraindications be present. From October 1988 through May 1989 we treated 48 patients. In approximately two thirds of our patients we were successful with one ESWL alone, in one third 2 sessions and in two patients even 3 sessions were needed. In 42 patients course after therapy was as planned. Six had to be cholecystectomized later on. Best results were achieved in patients with single gallstones. In 2 of 5 cases there was disagreement between the number of gallstones found sonographically and the intraoperative findings. Histologic examination of gallbladders after ESWL showed no pathologic changes.

Adult↗
PubMed1989

[Rate of perioperative complications of thyroid surgery].

Mortality and complication rate of thyroid surgery was evaluated between 1980 and 1987. Patients undergoing thyroidectomy during parathyroidectomy, tracheotomy or tumor operation in the anterior mediastinum were excluded. 548 thyroidectomies were performed in 536 patients. There were no mortalities. The incidence of local complications was 16% with paralysis of the recurrent nerve being the most frequent (6.2%). Other complications were hematoma or hemorrhage (4.9%), hypocalcemia (2.1%), allergic skin reaction (1.3%), or wound infection (0.7%). 2.2% of the patients needed reoperation because of false negative interpretation of a frozen section, or carcinoma in final histology. Systemic complications were found in 13 patients (2%), 6 of whom required intensive care treatment. Statistical analysis revealed that patients undergoing total thyroidectomy or re-thyroidectomy, and patients older than 50 years are at higher risk for local complications.

Adolescent↗
PubMed1989

[Intestinal necroses in severely injured patients without abdominal trauma].

Bowel necrosis in the critical trauma patient without abdominal involvement or preexisting vascular disease is a known but rare complication. During 1977-1986 we observed 31 cases in 2530 patients. Symptoms were unspecific, and since most of the patients were artificially ventilated, pain and tenderness were of little diagnostic value. Twenty-three patients presented with paralytic ileus, fifteen with diarrhea, and four with melena. In eleven patients diagnosis was made clinically, and in twenty patients at autopsy. Twenty-three patients died from septic shock, six from cerebral complications, and one from myocardial infarction. Risk factors for bowel necrosis were fluid restriction, hypotension, hypoxemia, venous congestion, vasoconstrictive drugs, paralytic ileus, and constipation.

Humans↗
PubMed1988

Incidence and treatment of candida esophagitis in patients undergoing renal transplantation. Data from the Minnesota prospective randomized trial of cyclosporine versus antilymphocyte globulin-azathioprine.

Of 224 consecutive renal transplant patients in a prospective, randomized immunosuppressive trial, candida esophagitis developed in 5 despite nystatin prophylaxis. No differences were noted between cyclosporine and antilymphocyte globulin-azathioprine immunosuppressive treatment. All patients were diabetic, and four were recipients of cadaver kidneys. Candida esophagitis occurred within 6 months after transplantation, and only one patient had recurrence. All patients responded to treatment consisting of 2 to 6 days of intravenous amphotericin B (0.2 to 2 mg/kg total dose). The prevalence of candida esophagitis was not related to rejection episodes. Three of five patients eventually died, one 2 weeks after resolution of candida esophagitis from a hypoglycemic episode, one from acute exacerbation of pulmonary failure and relapsing pancreatitis in association with candida esophagitis and therapy-resistant candidemia, and one 17 months after candida esophagitis from pulmonary edema. Our findings show that candida esophagitis by itself is an easily managed complication, but is also a sign of potentially increased morbidity in these patients.

Adult↗
PubMed1986

Blood units for patients with irregular blood group antibodies: frequency and supply.

Blood banks face significant problems supplying blood units compatible with erythrocyte antigens other than ABO and rhesus D. In this study the number of such units was evaluated between 1973 and 1982, and it was found that 1.5% of the total number of blood units were compatible with other antigens than ABO and rhesus D. Based on data of the number of units requested for each such antigen and the frequency of the antigen in the European population, a logistical system providing sufficient numbers of 'antibody-compatible' blood units is proposed.

ABO Blood-Group System↗
PubMed1976

Mechanism for the interaction of thiols with methylcobalamin.

The reaction between methylcobalamin and ethane-thiol sulfonic acid (Co-enzyme M) has been studied under aerobic conditions. For this reaction evidence is presented for a catalytic cycle which promotes homolytic cleavage of the Cobalt-carbon sigma-bond to give Cob(II)alamin (B12-r) and methylcoenzyme M as the products. This reaction is especially pertinent to our understanding of the mechanism of methane-biosynthesis. In addition, we have used 220 MHZ 1H NMR and 13C NMR to show that thiols do not react with methylcorrinoids by displacing the base trans-axial to the cobalt-carbon bond. This NMR study is especially important since the co-ordination of thiols to cobalt has previously been reported to occur by a number of research groups including our own.

Binding Sites↗
PubMedDate not supplied

Advance directive decision making among medical inpatients.

Per the Patient Self-Determination Act of 1991, hospitals are required to ascertain whether patients have an advance directive (AD). At this point, factors prompting patients to issue ADs have not been studied. The purpose of this study was to describe patients' understanding of ADs as well as the process patients used to arrive at their decisions to implement an AD. A stratified random sample of 26 patients from two intensive care units, one general medical unit, one general cardiac unit, and one acquired immunodeficiency unit were selected for participation. Patients were asked a series of open-ended questions to determine their knowledge and understanding of ADs. The constant comparative method was used to review the transcripts. It was found that only 31 per cent of patients had issued an AD, and 20% had learned of ADs for the first time during their hospitalization. Response analysis showed four phases of AD decision making: evaluation of illness, establishment of priorities, consideration of implications of the directives, and selection or rejection of directives. In conclusion, patients continue to have limited understanding of ADs and their implications. Continued investigation will elucidate the best strategies to educate patients about this topic.

Advance Directives↗