PubMed Health⌕ Search

Biomedical subjects

T Lesser

Publications and source records attributed to T Lesser.

26 records · Page 2Linked to original sources
PubMed1993

Ketamine-diazepam N2O combination anesthesia--a new "circulatory-system-sparing" type of anesthetic in experimental surgery.

For studying the hemodynamics of the greater and lesser circulatory system in animals, the impact of general anesthesia upon cardiovascular functions should be as small, as possible. The marked circulation-depressing effect of halothane, which has so far been given preference for experiments on large animals, was confirmed by the present study of the miniature pig. There was a significant decrease in MAP, cardiac index and dp/dtmax/IP, and an increase in PAPp. Useful insights into hemodynamics, derived from experiments modeling the heart, lungs or vascular system cannot be gained for a cardiovascular system, the functions of which are greatly altered by such an anesthesia. As a new form of anesthesia with minimal cardiovascular influence, the ketamine-diazepam N2O combination, which has already been successfully applied in operations on the open human heart, is introduced into experimental surgery.

Anesthesia, General↗
PubMed1992

[Primary hyperparathyroidism. Pathogenesis--diagnosis--therapy].

A report is given on 33 patients with primary hyperparathyroidism who underwent surgical treatment in our institution in the period from 1980 to 1989. In 57 per cent of the cases a hypercalcaemic syndrome was present. The primary hyperparathyroidism manifested itself in 75 per cent at the kidneys in the form of nephrolithiasis. One third of the patients showed a renal manifestation form exclusively. Remarkable is the relatively high number of exclusively gastrointestinal manifestations (11 per cent). In all patients the diagnosis was established on the coincidence of hypercalcaemia and increased parathormone in the serum. Preoperative localization diagnostics by means of parathyroid sonography, computed tomography and scintigraphy yielded unsatisfactory results. A satisfactory accuracy with regard to the lateral localization of the hyperfunctioning parathyroid tissue can presently be achieved only by selective catheterization of the cervical vein with determination of the parathormone. 35 patients clinically suspected of having primary hyperparathyroidism were subjected to a total of 44 operative interventions, i.e., apart from 35 primary operations, 7 secondary and 2 tertiary interventions. Of the 35 primary operations, 10 (28.6 per cent) were without success. This was due to 2 misdiagnoses and 8 cases with insufficient intraoperative exploration and premature discontinuation of the operation. In 67 per cent of the cases, there was a predominance of the solitary parathyroid adenoma, which was chiefly located at the dorsal lower thyroid poles. In order to reduce the number of unsuccessful primary interventions, a surgically-tactical approach is recommended.

Adenoma↗
PubMed1989

[The hemodynamics of the lung circulation of minipigs after experimentally-caused Sedlarik's pulmonary embolism. II. Modification of the hemodynamics of the heart and circulation by thoracotomy].

The systolic, diastolic, and the mean arterial systemic blood pressure decreased after thoracotomy (by -12%). The systolic, diastolic, and the mean pulmonary arterial pressure showed an immediate decrease (by 25%). The central venous pressure was not changed. The cardiac output (HMV) and the stroke volume could not be measured before the thoracotomy. However, the HMV (+17%), the HMV-index (+30%), and the stroke volume (+60%) increased from the 10th to the 30th min after the thoracotomy. The heart rate decreased continuously (by -19%). The maximum rate of pressure rise (dp/dtmax) increased primarily insignificantly and decreased afterwards (by -10%). The quotient dp/dt/p decreased immediately (by -10%). All measures were carried out until the 30th min after thoracotomy.

Animals↗
PubMed1989

[The hemodynamics of the lung circulation of minipigs after experimentally-caused Sedlarik's pulmonary embolism. III. Sedlarik's embolization of the lung circulation by electrically-activated blood].

Pulmonary embolisms of different clinical degree of severity can be produced by means of the pulmonary embolism model according to Sedlarik by application of electrically activated blood as a thrombogenic substance. An unambiguous influence of the size and the consistency of the thrombus exists concerning the severity of the hemodynamic changes. However, the hemodynamics seems to adapt to the changed conditions of the circulation, because a tendency to normalization was observed in short-term experiments. The morphologic changes after embolisation are more typical for the severity of the clinical picture in this acute phase than the hemodynamics. A testing of the animal model in long-term experiments seem to be ingenious for that reason.

Animals↗
PubMed1989

[The hemodynamics of the lung circulation of minipigs after experimentally-caused Sedlarik's pulmonary embolism. I. Sedlarik's pulmonary embolism model in comparison to existing embolism models].

The necessity of a clinical relevant pulmonary embolism model is described because of the international importance and the consequence for certain special branches. The multifarious pathophysiologic mechanism in the human requires an approximation of the model. The pulmonary embolism model according to Sedlarik approaches these demands and it became the basis of this study.

Animals↗
PubMed1988

Laryngographic investigation of postoperative hoarseness.

This study investigates postoperative hoarseness by comparing the patient's subjective assessment of change in voice following intubation with objective measures made using the laryngograph. Twenty-five patients admitted for routine surgery were assessed pre- and postoperatively. An Fx histogram was recorded on the laryngograph. A linear analogue self-assessment scale was used to quantify hoarseness subjectively. The objective measure of hoarseness (spread or standard deviation of Fx histogram) correlated well with the patients' subjective assessment of hoarseness. Six patients showed a bi- or trimodal histogram following intubation. This is known to represent asymmetric muscular activity. It is concluded that change in voice following intubation correlates well with the measures of vocal fold trauma. These measures can be recorded as the change in spread, standard deviation of the Fx histogram. The transient postoperative hoarseness following intubation is due to laryngeal damage. This damage has 2 mechanisms; in most cases it is due to direct mucosal trauma but in other cases a deeper muscular damage occurs.

Adolescent↗