PubMed Health⌕ Search

Biomedical subjects

W Seitz

Publications and source records attributed to W Seitz.

At least 109 records · Page 6Linked to original sources

[Instrumental esophageal perforations--diagnosis and treatment (author's transl)].

In the last 6 years 16 patients with an iatrogenic esophageal lesion have been treated. Most frequently this lesion results from esophagoscopies and bouginages. Laying of a gastric tube, extraction of a foreign body or dilatation of a cardiospasm are rare reasons for a lesion. Only three patients suffered from cancer. The early diagnosis and immediately operation is decisive for the therapy's success. The operation with primary closure of the defect and drainage should be aspired. After this the best results are levelled. If the surgical operation is carried on after the 24-hours limit, the operation itself is of minor importance as the lethality of these patients is very high and does not depend on the kind of therapy.

Adult↗

[Cardiovascular effects of flunitrazepam (rohypnol, RO-5-4200) (author's transl)].

We reported on the haemodynamic effects of 0.03 mg/kg flunitrazepam during surgical procedures in neuroleptanalgesia in 39 patients with congenital or acquired heart diseases, functional class II-IV. The benzodiazepine derivative did not cause any relevant effect on the inotropic state of the myocardium. There were only minor changes in cardiac index, stroke index, right and left atrial pressure. Changes in arterial pressure and left ventricular pressure during and immediately after surgical procedures, and in arterial perfusion pressure during extracorporeal circulation, as well as an only short lasting increase in heart rate were demonstrative a peripheral vasodilator effect. The decrease in ventricular work and myocardial oxygen consumption are of value in patients with coronary heart disease, especially immediately after surgical procedures. Flunitrazepam is considered an additional drug during neuroleptanalgesia, when hypertension is causing some problems.

Adolescent↗

[Technical failures in small bowel surgery (author's transl)].

A certain amount of relaparotomies after small bowel surgery is caused by technical failures, such as the technique of suturing the anastomosis and the kind of re-establishing the continuity of the bowel. An end-to-end-anastomosis with sufficient vascularisation at the cut ends, tension free, and without an overdone inversion will guarantee a more successful suturing of the bowel than a side-to-side-anastomosis. At first the whole small bowel should be explored to recognize multiple lesions. Postoperative malabsorption due to the exclusion of more less extended segments of the bowel--by bypass anastomoses or construction of blind loops--can be repaired successfully by corrective laparotomies. Special problems in operative tactics and technique of Crohn's disease are discussed.

Blind Loop Syndrome↗

[Hemobilia, a rare and dangerous postoperative complication].

3 cases of severe postoperative hemobilia are reported, one patient with an echinococcus cysticus of the liver, two others after surgical procedures on biliary tract. Diagnostic means as cholangiography, coeliacography, scanning of the liver and endoscopic retrograde cholangiography were not possible because of the massive bleeding. In those cases, if no other sources of bleeding are found, only esophago-gastro-duodenoscopy can leed to the correct diagnosis. In gastrointestinal bleeding after surgical manipulation on the biliary tract, the duodenum and the pancreas, hemobilia is a possible cause.

Adult↗

Changes in hemodynamic parameters, inotropic state, and myocardial oxygen consumption owing to intravenous application of nitroglycerin.

Changes in hemodynamics, inotropic state, and myocardial oxygen consumptom were investigated in a total of 70 patients with coronary disease after intravenous application of nitroglycerin (0.4 mg., 0.2 mg., and 2 mg. per hour). The results demonstrate that nitroglycerin enlarges therapeutic possibilities during and immediately after operations in patients with limited coronary reserve. The decrease in myocardial oxygen consumption, dependent on dose, ranged between 15.8 and 22.9 per cent.

Adult↗

[Carcinoma of the anus - clinical signs and symptoms, therapy and prognosis (author's transl)].

Case reports are given of 37 patients treated between 1964 and 1976 because of carcinoma of the anus, and clinical signs and symptoms, therapy and prognosis are discussed. Most of the patients were 50-70 years old, women being more often afficted then men. Often the carcinoma was misdiagnosed as a benign disease. Hemorrhage and pain were the presenting symptoms in most of the case. Therapy depends upon the localization and the stage of the tumor. Carcinoma localizad distally of the linea dentata were excised locally; infiltrating carcinomas received radiotherapy postoperatively. Abdominal amputation of the rectum was performed if the linea dentata or regional lymph-nodes were involved. Bilateral dissection of inguinal lymph-nodes was performed only if inguinal metastases were suspected. No patients surviving 5 years were observed in the group with lymph-node metastases. On the contrary all patients survived, if carcinoma was localized distally to the linea dentata and had been excised locally. Recurrent malignancy was found only in 3 of these cases. On the basis of these findings it can be concluded that local excision is the therapy of choice in selected cases.

Aged↗

[Cystadenomas of the common bile duct as the cause of relapsing mechanical jaundice].

Two cases of benign tumors of the extrahepatic biliary ducts with relapsing jaundice are reported. In both cases operation with conservation of natural draining of bile could be performed. Benign tumors of the bile ducts should be taken into consideration, if relapsing jaundice is combined with negative cholangiography or is noticed long time after cholecystecomy of on gallbladder without gallstones. Primary origin of cystadenomas from the extra hepatic biliary ducts is demonstrated.

Adult↗

[The blind-loop syndrome after side-to-side anastomoses of the gut (author's transl)].

The postoperative blind-loop syndrome can occur after side-to-side, end-to side or by-pass anastomoses of the gut and presents clinically as malabsorption syndrome. Pathogenetically, stasis or slowing of the bowel movements will cause a rapid increase of pathogenic bacteria in the small intestine. Malabsorption is characterized by 3 symptoms: Loss of weight, anemia, steatorrhoea. The method of choice for therapy is to perform a new, end-to-end, anastomosis of the intestine in order to re-establish a physiological situation. During the last 6 years 14 patients with malabsorption syndromes of varying degrees were operated upon: 6 had pure small intestinal anastomoses, 7 anastomoses between the small and large intestine and 1 patient had a side-to-side sigmoidal anastomosis. In all patients the side-to-side or by-pass anastomoses could be reversed.

Adolescent↗

[Combination of etomidate and fentanyl. Haemodynamics, inotropic state, myocardial oxygen consumption, and vascular reactions (author's transl)].

The influence of a combination of fentanyl (0.1 mg) and etomidate (0,15 mg/kg and 0.3 mg/kg) on haemodynamics, inotropic state, myocardial oxygen consumption and vascular reaction has been investigated in 60 patients with congenital or acquired heart diseases--mostly functional class III according to NYHAC. Because of minor changes in haemodynamics (decrease in mean arterial pressure, left ventricular pressure, peak dp/dt, cardiac index, stroke index) the combination of 0.15 mg/kg etomidate and 0.1 mg fentanyl seems to be of great value for induction of anaesthesia in patients with cardiac disease compared to other intravenous induction agents such as propanidid, thiopentone or althesin. In accordance with the changes in haemodynamics there was a 12% and 18% decrease in myocardial oxygen consumption, respectively.

Alfaxalone Alfadolone Mixture↗