PubMed Health⌕ Search

Biomedical subjects

T M Heimann

Publications and source records attributed to T M Heimann.

42 records · Page 3Linked to original sources
PubMed1984

Surgical complications and skin test reactivity in patients with inflammatory bowel disease.

One hundred patients with inflammatory bowel disease were admitted to the Mount Sinai Hospital, New York, for surgical treatment. These patients were studied to evaluate the association between skin test reactivity and postoperative complications. Skin tests were performed prior to surgery using four recall antigens. Sixty patients were found to be anergic. The postoperative complication rate was significantly higher in the anergic patients when compared with those patients who were able to react to at least one skin test antigen. Twenty-seven anergic patients had 34 complications and almost 60% of these complications were of the septic type. Only 11 patients who responded to the skin tests had postoperative complications. Complications in the anergic patients required longer hospitalization and more frequent operative correction. There were no deaths in this series. Although anergic patients with inflammatory bowel disease are prone to experience septic complications, their prognosis appears to be better than the morbidity and mortality reported in the literature for anergic patients with other conditions.

Adult↗
PubMed1984

Mucosal proctectomy using an ultrasonic scalpel.

Mucosal proctectomy is becoming the operation of choice in the surgical treatment of patients with ulcerative colitis and familial polyposis coli. Dissection of the rectal mucosa and submucosa from the underlying muscularis is often difficult and, in some instances, impossible to perform. The feasibility of using an ultrasonic device to perform mucosal protectomy was studied in eight dogs. This technique produced coagulative necrosis of the mucosa and muscularis mucosa with marked edema and congestion of the submucosa. The muscularis propria remained intact. Complete destruction of the distal 7 cm of rectal mucosa required a total duration of exposure to the ultrasonic probe of at least 12 minutes. In another five dogs, total colectomy was performed above the area of the mucosal proctectomy followed by endorectal pull-through of the ileum. Follow-up studies revealed healing of the ileonal anastomosis without retraction or stricture. This technique should allow mucosal proctectomy to be performed in those patients in whom standard dissection is not possible due to fibrosis of the submucosal plane.

Animals↗
PubMed1983

Gallstone ileus: a diagnostic problem.

A retrospective review of 24 patients with gallstone ileus from our institutions during the period from 1947 through 1981 has been presented. The study was undertaken in an attempt to refine the diagnosis and treatment of this rare entity. The patients ranged in age from 58 to 84 years, and 19 patients were women. The correct preoperative diagnosis was made in 74 percent of the patients using various combinations of clinical history, plain film roentgenograms, and barium contrast upper gastrointestinal series. After an average preoperative hospital stay of 4.5 days, 23 patients required operation. Wound infection developed in nine patients and resulted in wound dehiscence in two. There were four deaths in the patients over 73 years of age (p less than 0.01). Age was the only factor found to correlate with mortality.

Aged↗
PubMed1982

Tissue carcinoembryonic antigen, dysplasia, and disease duration in colonic inflammatory bowel disease.

Tissue carcinoembryonic antigen (CEA) was studied in five groups of patients: eight ulcerative colitis patients with mild or no dysplasia, five ulcerative colitis patients with severe dysplasia, seven Crohn's disease patients with nondiseased colon, nine Crohn's disease patients with diseased colon, and 18 colorectal cancer patients from the noncancerous colon resection margins. CEA levels were significantly lower in the normal colon Crohn's group than all other groups (p less than 0.05). CEA levels were significantly higher in the severe dysplasia ulcerative colitis group than all other groups (p less than 0.05). The Crohn's disease patients with diseased colon, the ulcerative colitis patients with mild or no dysplasia, and the colorectal cancer group with noncancerous colon all had similar intermediate CEA levels.

Carcinoembryonic Antigen↗