Langenbecks Archiv fur Chirurgie最新文献

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[Laparoscopy-assisted aortoiliac reconstructions]. 腹腔镜辅助主动脉髂重建。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01 DOI: 10.1007/S004230050038
R. Kolvenbach, O. Deling, K. Wellmann
{"title":"[Laparoscopy-assisted aortoiliac reconstructions].","authors":"R. Kolvenbach, O. Deling, K. Wellmann","doi":"10.1007/S004230050038","DOIUrl":"https://doi.org/10.1007/S004230050038","url":null,"abstract":"","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"9 1","pages":"119-22"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81350487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
[Rare differential diagnosis of breast tumor. Giant cell tumor of the ribs]. 乳腺肿瘤的罕见鉴别诊断。肋骨巨细胞瘤]。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01
P Brenner, F K Warbanow, A Krause-Bergmann, M Kuske, A Berger
{"title":"[Rare differential diagnosis of breast tumor. Giant cell tumor of the ribs].","authors":"P Brenner, F K Warbanow, A Krause-Bergmann, M Kuske, A Berger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a case of a breast tumor. As carcinoma of the breast was suspected, a biopsy was taken and a very rare osteoclastoma originating in the rib was identified. Semimalignant bone tumors tend to recur locally. The symptoms are nonspecific; the initial diagnosis is often made late. To differentiate the diagnosis, one should think about primary and secondary bone diseases and tumors of the organs of the thorax. In our case, the tumor was completely resected, including the ribs, and the defect was covered with a corium plasty. In this way, we are able to save the breast. We discuss different methods for covering chest wall defects.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 2","pages":"64-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20143948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Aspects relevant for abdominal surgery of attempted suicide]. [企图自杀的腹部手术的相关方面]。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01
E Nagel, J Jähne, K Obermann, J Lotz, A Meyer zu Vilsendorf, R Pichlmayr
{"title":"[Aspects relevant for abdominal surgery of attempted suicide].","authors":"E Nagel, J Jähne, K Obermann, J Lotz, A Meyer zu Vilsendorf, R Pichlmayr","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this retrospective study of 24 patients who were treated at our clinic during the last 22 years after having attempted suicide, we evaluated aspects concerning abdominal- and transplantation surgery. There was a predominance of \"hard\" (70%) versus \"soft\" (30%) methods for suicide attempt. Intra-abdominal injuries resulting from attempted suicide by stabbing or shooting should lead to laparotomy-the prognosis is then good. Surgical treatment after intoxication, especially caustic ingestion, depends on endoscopic and clinical findings. The highly increased rates of suicide in patients with end-stage renal disease can be reduced significantly by kidney transplantation. The risk of suicide after transplantation is further diminished with improved immunosuppressive treatment. Only in a few cases there is an indication for liver transplantation-in some cases of fulminant hepatic failure caused by self-administered paracetamol overdose. Auxiliary liver transplantation may then be considered.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20104846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Biomechanics of femoral interlocking nails at the bone-implant transition]. [股骨交锁钉在骨-种植体过渡中的生物力学]。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01
P Schandelmaier, O Farouk, C Krettek, J Mannss, H Tscherne
{"title":"[Biomechanics of femoral interlocking nails at the bone-implant transition].","authors":"P Schandelmaier, O Farouk, C Krettek, J Mannss, H Tscherne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Today there is a variety of different interlocking intramedullary nail designs available for the femur-each designed with a different approach to achieve stability for fracture fixation. We compared different nail types in the bone-implant complex (BIC) of four unreamed solid nails and a slotted, reamed nail to see if there are major differences in stiffness for axial load, bending and torsion. We simulated comminuted mid-shaft fractures by a 2 cm defect osteotomy in paired human cadaver femora. Each bone was tested intact in a Universal testing machine. The results were recorded, osteotomy and osteosynthesis were performed, and the BIC was tested. Relative stiffness was calculated for each individual bone. For P-values less than 0.01 ('least significance difference test') the difference between groups was considered to be significant. In torque testing the unslotted solid nails showed significantly more stiffness (0.6-1.8 Nm/degree) compared to the slotted nail (0.2 Nm/degree). Compared to intact bone (6.9 Nm/degree), both groups of nails were significantly less stiff (relative stiffness 2-20%). In axial load and bending testing, the large-diameter unreamed nail showed greater higher stiffness (32-68%). This study shows that stiffness of the BIC in interlocking femoral nails is more dependent on nail profile than on the press-fit of nails in the medullary canal. For torque stiffness the absence of a slot is of special importance. According to our study, all of the unslotted nails tested give adequate stability for fracture fixation.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 3","pages":"167-72"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20258615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Results of selective venous site-specific catheterization in occult C-cell carcinoma of the thyroid gland]. 【隐匿性甲状腺c细胞癌选择性静脉定点置管的结果】。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01 DOI: 10.1007/s004230050070
K Cupisti, D Simon, C Dotzenrath, P E Goretzki, H D Röher
{"title":"[Results of selective venous site-specific catheterization in occult C-cell carcinoma of the thyroid gland].","authors":"K Cupisti,&nbsp;D Simon,&nbsp;C Dotzenrath,&nbsp;P E Goretzki,&nbsp;H D Röher","doi":"10.1007/s004230050070","DOIUrl":"https://doi.org/10.1007/s004230050070","url":null,"abstract":"<p><strong>Background: </strong>Medullary thyroid carcinoma (MTC) can--even in recurrent cases--only be treated surgically. Therefore, preoperative localization of the tumor is essential.</p><p><strong>Methods: </strong>From April 1986 through April 1997, 137 patients with MTC were operated on at our clinic. In 22 patients with recurrent tumor which had not been radiologically localized, 28 selective venous catheterizations (SVC) with determination of calcitonin levels were carried out.</p><p><strong>Results: </strong>In 23 examinations a suspected tumor could be identified (nine cervical unilateral, seven mediastinal, four cervical unilateral and mediastinal, one cervical bilateral and mediastinal, one liver, one cervical unilateral and liver). In 18 cases surgery was performed for recurrence (nine cervical revisions, one mediastinal dissection, six cervicomediastinal dissections, two laparotomies). In 15 of 18 cases, tumor tissue was found in the previously suspected area. In ten cases serum calcitonin levels dropped postoperatively by 6%-75%. A normalization of the hormone level was achieved only once by yet another operation. During further follow-up, five of the reoperated patients died from their disease. The other 17 patients are being followed up, whereby calcitonin levels are elevated but there is no clinical or radiological evidence of tumor.</p><p><strong>Conclusions: </strong>Although in the patient cohort presented a normalization of serum calcitonin could be achieved only once, the authors consider SVC useful because it is the only means of localization of tumor tissue in cases of negative radiologic studies and therefore allows a planned approach to the operation procedure in these cases.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 6","pages":"295-301"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20421120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Medical treatment of gastroesophageal reflux disease does not prevent the development of Barrett's metaplasia and poor esophageal body motility. 胃食管反流病的药物治疗并不能预防巴雷特化生的发展和食管体运动性差。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01 DOI: 10.1007/BF02465096
G J Wetscher, C Profanter, M Gadenstätter, G Perdikis, K Glaser, R A Hinder
{"title":"Medical treatment of gastroesophageal reflux disease does not prevent the development of Barrett's metaplasia and poor esophageal body motility.","authors":"G J Wetscher,&nbsp;C Profanter,&nbsp;M Gadenstätter,&nbsp;G Perdikis,&nbsp;K Glaser,&nbsp;R A Hinder","doi":"10.1007/BF02465096","DOIUrl":"https://doi.org/10.1007/BF02465096","url":null,"abstract":"<p><strong>Objective: </strong>Duodenal contents refluxing into the esophagus may be involved in the pathophysiology of gastroesophageal reflux disease (GERD). This study was performed to investigate whether medical treatment of GERD aimed at suppression of gastric acid production can prevent the development of complications, such as Barrett's metaplasia or poor esophageal body motility.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>University hospital.</p><p><strong>Patients: </strong>138 GERD patients were analyzed regarding the development of Barrett's metaplasia or poor esophageal body motility, despite intermittent or continuous treatment with H2 blockers or omeprazole.</p><p><strong>Main outcome measures: </strong>The rate of patients with Barrett's metaplasia or poor esophageal body motility with or without effective medical treatment.</p><p><strong>Results: </strong>Barrett's metaplasia was found in 33.8% of patients receiving medical treatment, although it was not present when treatment was induced. This rate was 21.9% among patients who were not receiving therapy (not significant). In all, 41.9% of patients with medication had impaired esophageal body motility compared with 59.3% of patients not receiving treatment (P < 0.05), but these patients had a significantly shorter history of GERD.</p><p><strong>Conclusions: </strong>Medical treatment with H2 blockers or omeprazole does not prevent the development of Barrett's metaplasia or poor esophageal body motility.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 2","pages":"95-9"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02465096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20077135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
[ICPM-independent documentation of new reimbursement forms--method and 1995 results]. [独立于icpm的新报销表文件-方法和1995年结果]。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01 DOI: 10.1007/BF02465091
F X Huber, R Schall, C Fritz-Krieglstein, U Gleim, C Herfarth
{"title":"[ICPM-independent documentation of new reimbursement forms--method and 1995 results].","authors":"F X Huber,&nbsp;R Schall,&nbsp;C Fritz-Krieglstein,&nbsp;U Gleim,&nbsp;C Herfarth","doi":"10.1007/BF02465091","DOIUrl":"https://doi.org/10.1007/BF02465091","url":null,"abstract":"<p><p>The structural health care law (known as the Gesundheitsstrukturgesetz or GSG) of the Federal Republic of Germany has been enacted to replace the covering cost prices by various forms of payment. On the basis of the Godesberg Diagnosis and Therapy Catalogue, a new system has been developed that assesses all new implications of the care benefit law. With the help of intelligent plausibility tests, a particular case (PC) or a special rate (SR) is suggested. The documentation system works without ICPM numbers. The conversion of diagnosis and therapies to ICD-10/ICPM numbers is possible. The results of the first half of 1995 and the second half of 1995 show that only two-fifths of operations can be assessed with PC or SR. Neither emphasis on certain operations nor the more differentiated illnesses are recognised as extra costs by the GSG regulations. Complete and correct documentation is achieved by a strict and stratified control system.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 2","pages":"69-73"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02465091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20143949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Importance of mycoses in intra-abdominal infections]. 【真菌病在腹腔感染中的重要性】。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01 DOI: 10.1007/pl00014644
L Blinzler, K Fischer, H M Just, D Heuser
{"title":"[Importance of mycoses in intra-abdominal infections].","authors":"L Blinzler,&nbsp;K Fischer,&nbsp;H M Just,&nbsp;D Heuser","doi":"10.1007/pl00014644","DOIUrl":"https://doi.org/10.1007/pl00014644","url":null,"abstract":"<p><p>Although there is a 20% yeast colonization in the gastrointestinal tract of the population, fungal infections appear only rarely in secondary peritonitis. The risk of severe mycosis increases after a major operation and when a patient is taking broad-spectrum antibiotics, is on total parenteral nutrition, is catheterized, and/or is immune-suppressed. In the past years the incidence of nosocomial fungal infections (usually Candida spp.) has risen significantly. Five percent of CAPD-related peritonitis is caused by fungi. In enteral anastomosis breakdown, invasive mycosis occurs more often, with an accompanying lethality of up to 80%. In severe pancreatitis, up to 5% of peripancreatic necrosis is infected with fungi. The clinical course of severe mycosis, like the septic syndrome, is associated with fungemia in up to 50% of cases. As most of the facultative pathogenic fungi are part of the physiological flora, it is difficult to interpret mycological cultures. In order to diagnose invasive fungal infections, histopathological techniques and serologic tests for antigens and antibodies are available. Three antifungal agents (amphotericin B, flucytosine, fluconazole) are available for intravenous administration. Amphotericin B is given at doses of up to 1 mg/kg per day, in liposomal galenism up to 3 mg/kg per day. Combining amphotericin B with flucytosine (150-200 mg/kg per day) a synergistic effect is reached. Fluconazole at a dosage of 200-800 mg per day represents an alternative with similar antifungal activity and lower side effects.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 4 Suppl 1","pages":"S5-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/pl00014644","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20267640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
[Sex differences in neuromodulation of mucosal mast cells in the rat jejunum]. [空肠粘膜肥大细胞神经调节的性别差异]。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01
T Gottwald, H D Becker, R H Stead
{"title":"[Sex differences in neuromodulation of mucosal mast cells in the rat jejunum].","authors":"T Gottwald, H D Becker, R H Stead","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The effect of electrical stimulation of both cervical vagal nerves on mucosal mast cells in the jejunum was investigated in an in vivo animal model with rats of both sexes. Males showed a significant increase of mast cell densities after electrical stimulation (1.0 mA, 5 Hz, 5 ms, 12 min) in the lamina propria. Simultaneously, we observed a significant increase of tissue histamine levels (ANOVA: P < 0.05), whereas serum levels remained unchanged. However, even though females had significantly higher levels throughout compared to males (ANOVA: P < 0.05), they did not show any significant reaction to electrical stimulation. These in vivo data support morphological and in vitro data from other investigators, who hypothesized a functional interaction between mucosal mast cells and nerves. However, degranulation seems to be a poor in situ indicator for mast-cell stimulation, as mast-cell densities increased in males, while the percentage of degranulated cells remained the same in all groups (about 40%). Instead, electrical stimulation of the vagal nerve seems to trigger histamine synthesis, or simply stabilization of mast cells. Interestingly, this phenomenon seems to be sex-dependent, suggesting a regulatory role for sex hormones in this scenario.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 3","pages":"157-63"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20258612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Pancreatic polypeptide secreting endocrine pancreas tumor associated with multiple stomach and duodenal ulcers]. 【胰多肽分泌内分泌胰腺肿瘤合并多发性胃、十二指肠溃疡】。
Langenbecks Archiv fur Chirurgie Pub Date : 1997-01-01
U M Mehring, H J Jäger, G Klöppel, F M Hasse
{"title":"[Pancreatic polypeptide secreting endocrine pancreas tumor associated with multiple stomach and duodenal ulcers].","authors":"U M Mehring, H J Jäger, G Klöppel, F M Hasse","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 58-year-old woman presented with multiple gastroduodenal ulcera caused by a pancreatic polypeptidoma (PPoma) without hypergastrinemia or gastrin-producing tumor cells. After curative resection of the neoplasm, the clinical symptoms disappeared and the patient has now been disease-free for 6 years. We conclude that patients with non-gastrin-producing endocrine pancreatic tumors may demonstrate the clinical features of Zollinger-Ellison syndrome and should be included in the differential diagnosis of this syndrome.</p>","PeriodicalId":17985,"journal":{"name":"Langenbecks Archiv fur Chirurgie","volume":"382 3","pages":"134-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20260669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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