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W O Bechstein

Publications and source records attributed to W O Bechstein.

At least 289 records · Page 16Linked to original sources
PubMed1989

The role of liver transplantation in hepatobiliary malignancy. A retrospective analysis of 95 patients with particular regard to tumor stage and recurrence.

The role of hepatic transplantation in patients with nonresectable liver or bile duct cancer remains a controversial issue. An analysis of 95 consecutive cases was undertaken to evaluate retrospectively the pathological tumor stage--in accordance with the TNM system--and outcome after transplantation. Included were patients with the following diagnoses: hepatocellular carcinoma (n = 52), cholangiocellular carcinoma (n = 10), hepatoblastoma (n = 2), hemangiosarcoma (n = 2), bile duct carcinoma (n = 20), and liver metastases from different primary tumors (n = 9). The overall actuarial survival rate at 5 years was 20.4%. Median survival improved significantly within the last 4 years as compared to the preceding era (18.06 vs. 4.0 months). Currently 27 patients are alive, with the longest follow-up more than 12 years. The incidences of residual or recurrent tumor were 27 and 28, respectively. Particularly in patients who underwent transplantation for hepatocellular or bile duct carcinoma without extra-hepatic tumor spread, the results were significantly better; median survival time achieved for these two groups were 120 (p less than 0.01) and 35 months (p less than 0.05). Prolonged survival without tumor recurrence was not seen in patients with cholangiocellular carcinoma or liver metastases. These results demonstrate clearly that liver transplantation for hepatobiliary malignancy is still justified on the premises of careful patient selection by adequate tumor staging.

Actuarial Analysis↗
PubMed1989

[Indications and current developments in liver transplantation].

Today, liver transplantation has become a routine treatment in many centres and will be increasingly applied in the future. Principal indications for liver transplantation are endstage chronic liver diseases, namely cirrhoses of various origin, fulminant hepatic failure, metabolic liver disease, and rarely non-resectable malignant tumors of the liver. Clinical and biochemical parameters indicative of the indication for liver transplantation can be stated with greater confidence. Advances in organ preservation with a new cold storage solution (University of Wisconsin solution) and further refinements in surgical technique and immunosuppression with application of multimodal protocols have led to a one-year-survival rate of 70%-80% in experienced centers. Since October 1988, 32 patients underwent liver transplantation in Berlin, currently, 31 patients are alive, while one patient died due to systemic fungal infection.

Carcinoma, Hepatocellular↗
PubMed1989

[Hepatitis B in established cardiac cirrhosis--a rare indication for liver transplantation].

A 34 year old patient was diagnosed as suffering from congestive cirrhosis due to constrictive pericarditis 18 years ago. A terminal dystrophic episode of additionally acquired chronic aggressive hepatitis B led to rapidly progressive liver failure. Orthotopic liver transplantation was carried out. 10 months after transplantation the patient is alive and well. Presence of HBsAg and HBcAg can again be demonstrated in the liver graft, however, without histologic evidence of hepatitis. Problems of prognosis after liver transplantation for hepatitis B virus infection are discussed.

Adult↗
PubMed1989

[Percutaneous transtracheal ventilation using Nu-Trake cricothyreotomy instruments and tracheoscopic follow-up examination].

Practicability and efficiency of the cricothyreotomy set Nu-Trake was investigated in corpses (n = 10) in the institute of Pathology and clinically in laryngectomy patients (n = 5) including endoscopical controls. The practicability proved to be good, the time needed to perform the coniotomy did not last longer than 2 minutes. But complications in the investigation on the corpses could not be avoided. These were missing the lumen of the trachea, perforation of the pars membranacea tracheae and fracture of the cricoid. The clinical investigation demonstrated a sufficient oxygenation and ventilation in all patients during the whole investigation period (30 min). This can be explained by the diameter of 7.2 mm of the used tube. Endoscopic controls showed a sufficient distance of the tip of the tubes from the pars membranacea tracheae and almost no bleeding within the trachea. Similar as with other coniotomy-technics the cricothyreotomy with the Nu-Trake set bears the risk of typical complications which have to be overcome by training of this important measure of emergency.

Aged↗
PubMed1986

Current clinical management of organoprotection in hepatic surgery.

Ischemia of the liver in hepatic resection under inflow occlusion is tolerable for at least up to 60 min. For protection of the liver from ischemic injury, steroids are frequently used. In liver transplantation, cold ischemia of 6-8 h for the graft is considered to be acceptable. Organ preservation is most frequently accomplished by in situ perfusion of the liver with Euro Collins solution in the donor and consecutive hypothermic storage after hepatectomy, resulting in 96% of all grafts in primary function.

Humans↗
PubMed1984

[Evaluation of palmar collateral circulation with the Oxygenmet oxygen saturation measurement device].

Assessment of collateral circulation of the palmar arcade prior to percutaneous radial artery cannulation is necessary because a thrombosing radial artery together with insufficient collateral circulation may lead to gangrene of the hand. A new method for assessment of collateral circulation of the palmar arcade by use of a spectrophotometric monitoring device for arterial oxygen saturation is described. This method is contrasted with current methods (Allen's test, Brodsky's test, ultrasound Doppler).

Arteries↗