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Morbidity and mortality after neoadjuvant therapy and sleeve lobectomyin N2-disease

中国肺癌杂志 2008年第5期11卷 668-671页

作者： Corinna LUDWIG Walburga ENGEL-RIEDEL Erich STOELBEN Thoracic Surgery Lungenklinik Merheim kliniken der stadt kln ggmbh

Background and objective Sleeve resections were introduced to preserve lung function in patients with limited pulmonary *** experience with sleeve resection has reduced the rate of pneumonectomy below 10%.The aim of the study was to assess the outcome after neoadjuvant chemo-or chemoradiotherapy and sleeve resection in patients with N2 non-small cell lung *** Retrospective analysis of 41 patient records between 01.01.2005 and 31.12.2007 underwent induction therapy in N2-disease followed by tracheobronchial sleeve *** patients were compared to the overall results after sleeve resection in our *** analysed were;length of chest tube drainage in days,length of hospital stay,complications,morbidity and hospital *** In 178 patients,an anatomical bronchoplastic resection was *** chemotherapy in N2-disease(n=42) was given in 30 patients and radiochemotherapy in 11 *** length of the operation was between 94 min-493 min(average 143 min).Chest tubes were removed on average after 5 *** were discharged after 10 days.R0-resection was possible in 90%.The overall complication rate was 27%(11/41).The rate of bronchial anastomotic leakage was 9.7%(4/41).Two patients with postoperative respiratory insufficiency and mechanical ventilation,1 patient with technical failure required early correction of the suture and one patient with a necrosis of the anastomosis.30-day hospital mortality rate was 2.4%(1/41).Conclusion Sleeve resection after neoadjuvant therapy has a higher local morbidity(anastomotic insufficiency 9.7% vs 2.8%).This may be explained by the quality of the surrounding tissue after neoadjuvant therapy,which compromises healing of the ***,the results are comparable to those without induction therapy in terms of radicality,and 30-d mortality rate(P>0.05).We therefore believe that sleeve resection after neoadjuvant therapy should be performed whenever possible

关键词： Lung neoplasms Neoplasm staging Chemotherapy

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Diagnosis of obscure gastrointestinal bleeding by intraoperative enteroscopy in 81 consecutive patients

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World Journal of Gastroenterology 2006年第2期12卷 313-316页

作者： Ralf Jakobs Dirk Hartmann Claus Benz Dieter Schilling Uwe Weickert Axel Eickhoff klaus Schoenleben Juergen F Riemann Department of Medicine C Klinikum der Stadt Ludwigshafen gGmbHLudwigshafenGermany Department of Internal Medicine Evangelisches Krankenhaus Koeln-WeyerthalKoelnGermany Department of Surgery Klinikum der Stadt Ludwigshafen gGmbHLudwigshafenGermany

AIM： To analyze the results and complications of intraoperative enteroscopy （IOE） by investigating a series of selected patients with bleeding suspected to originate from the small intestine. METHODS： Eighty-one patients （mean age： 65 years） including 40 males （49.4%） and 41 females （50.6%） with obscure gastrointestinal bleeding underwent IOE between 1990 and 2004. The patients were identified from a database and data were selected from the patients＇ charts retrospectively. All the patients had undergone at least one non-diagnostic esophagogastroduodenoscopy, colonoscopy, standard enteroscopy and a negative abdominal ultrasound scan before IOE. RESULTS： The median minimal hemoglobin level in the patients was 59＋15g/L and 72.8% of the patients required transfusion of packed erythrOoltes previously. A bleeding source was detected in 68 （84%） of the patients during IOE. Angiodysplasiae were found in 44 patients （54.3%） and 9 patients （11.1%） were affected by ulcers in the small intestine. A tumor in the small intestine was detected in another 6 patients. The treatment consisted of argon-plasma-coagulation, surgical suture or limited resection in most of the patients. CONCLUSION： Intra-operative enteroscopy is still used for the diagnosis of suspected small bowel bleeding. Recent developments such as wireless capsule endoscopy and double balloon enteroscopy, may lead to the replacement of IOE in the future.

关键词： Obscure bleeding Enteroscopy Intraoperative Small intestine

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Self-expanding metal stents for the palliation of malignant gastric outlet obstruction in patients with peritoneal carcinomatosis

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World Journal of Gastroenterology 2016年第43期22卷 9554-9561页

作者： Christoph Rademacher Matthias Bechtler Steffen Schneider Bettina Hartmann Johannes Striegel Ralf Jakobs Medizinische klinik C Klinikum der Stadt Ludwigshafen Department of Statistics/Stiftung IHF Institut für Herzinfarktforschung

AIM To evaluate the efficacy of self-expanding metal stents(SEMS) for the palliation of malignant gastric outlet obstruction in patients with and without peritoneal carcinomatosis(PC).METHODS We performed a retrospective analysis of 62 patients who underwent SEMS placement for treatment of malignant gastroduodenal obstruction at our hospital over a six-year period. Stents were deployed through the scope under combined fluoroscopic and endoscopic guidance. Technical success was defined as successful stent placement and expansion. Clinical success was defined as an improvement in the obstructive symptoms and discharge from hospital without additional parenteral nutrition. According to carcinomatosis status, patients were assigned into groups with or without evidence of peritoneal *** In most cases, obstruction was caused by pancreatic(47%) or gastric cancer(23%). Technical success was achieved in 96.8%(60/62), clinical success in 79%(49/62) of all patients. Signs of carcinomatosis were identified in 27 patients(43.5%). The diagnosis was confirmed by pathology or previous operation in 7 patients(11.2%) and suspected by CT, MRI or ultrasound in 20 patients(32.2%). Presence of carcinomatosis was associated with a significantly lower clinical success rate compared to patients with no evidence of peritoneal disease(66.7% vs 88.6%, P = 0.036). There was no significant difference in overall survival between patients with or without PC(median 48 d vs 70 d, P = 0.21), but patients showed significantly longer survival after clinical success of SEMS placement compared to those experiencing clinical failure(median 14.5 d vs 75 d, P = 0.0003).CONCLUSION Given the limited therapeutic options and a clinical success rate of at least 66.7%, we believe that SEMS are a reasonable treatment option in patients with malignant gastric outlet obstruction with peritoneal carcinomatosis.

关键词： Gastric outlet obstruction Self-expanding metal stents Peritoneal carcinomatosis Palliation Endoscopy

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脾切除术后的反复性肺炎球菌脑膜炎

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德国医学 1996年第2期13卷 89-90页

作者： M.Gerwig A.Wittkmper U.Liebetrau J.-N.Petrovici 武忠弼 Neurologische klinik Kliniken der Stadt KlnOstmerheimer Str.200D-51109 KlnGermany 同济医科大学

特发性血小板减少性紫癜(Werlhof 病)、何杰金病和系统性红斑狼疮(LED)为脾切除的适应证。在 Werlhof 病时,80%患者可由此获得缓解,但对于 LED 时的自身免疫性血小板减少症则尚有争论。脾切除后的并发症之一为暴发性的、往往致命的败血... 详细信息

特发性血小板减少性紫癜(Werlhof 病)、何杰金病和系统性红斑狼疮(LED)为脾切除的适应证。在 Werlhof 病时,80%患者可由此获得缓解,但对于 LED 时的自身免疫性血小板减少症则尚有争论。脾切除后的并发症之一为暴发性的、往往致命的败血症,亦称为 Opsi 综合征。此时由于血中含菌量甚高,故病程呈极急性经过。80%患者的致病菌为肺炎链球菌,最常见的感染为肺炎、脑膜炎及耳炎。预后险恶,20%患者以菌血症告终,至今仍然如此。

关键词：脾切除手术后脑膜炎肺炎球菌

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Girvanella grabaui *** dem unterpermischen Chuanshan-kalk Südchinas

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地质学报 1938年第Z1期 211-214页

作者： HENRY PAUL Ruhrlandmuseum der stadt Essen

Mit 1 Abbildung Nach Abfassung des Manuskriptes meiner Arbeit über"Unterkar-bonische kalkalgen und Calcisphaeren Deutschlands",die sich ***

关键词： der dchinas Girvanella grabaui sp.nov.aus dem unterpermischen Chuanshan-kalk S

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腰椎间盘切除应用ADCON-L凝胶出现慢性脑脊液渗漏导致双侧硬膜下血肿和腰神经假性脊膜膨出

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世界核心医学期刊文摘（神经病学分册） 2005年第10期1卷 35-36页

作者： kuhn J. Hofmann B. knitelius H.O. 方伯言 J. kuhn Department of Neurology Kliniken der Stadt Kln Krankenhaus Merheim Ostmerheimerstrasse 200 D-51109 Cologne Germany Dr.

The anti- adhesion gel ADCON- L has been available since the end of the 199 0s. During disc surgery it can be applied to the spinal nerve roots and the dura mater spinalis in order to inhibit fibroblast migration and thus avoid postoper ative adhesions or excessive keloids, respectively. Due to the way ADCON- L wor ks, inadvertent, intraoperational dural lesions may stay open much longer than u sual because ADCON- L inhibits the natural healing process. Possible consequenc es are a chronic leakage of cerebrospinal fluid in combination with intracranial hypotension syndrome. We report on a patient who underwent lumbar disc surgery with application of ADCON- L gel. Postoperatively he suffered from acute headac he, nausea, and vomiting. A lumbar pseudomeningocele was demonstrated on magneti c resonance imaging (MRI). Furthermore, cranial MRI revealed bilateral, chronic subdural haematomata which indicated intracranial hypotension syndrome or contin uous leakage of cerebrospinal fluid at the lumbar site. With conservative treatm ent the problems were gradually reduced and eventually the subdural haematomata were no longer detected. The pseudomeningocele persisted over a 4 month period o f observation. Because of the complications we found, the local application of A DCON- L during lumbar disc surgery should be critically evaluated.

关键词：椎间盘切除 ADCON-L 硬膜下血肿假性脊膜膨出腰神经腰椎间盘手术颅内低压综合征硬脊膜愈合过程术后粘连

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Is correction of severe hypoalbuminemia necessary in the critically ill？

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Chinese Medical Journal 2008年第22期121卷 2360-2362页

作者： Joachim Boldt Department of Anesthesiology and Intensive Care Medicine Klinikum der Stadt Ludwigshafen Bremserstr. 79 D-67063 Ludwigshafen Germany

The rationale for using albumin in the critically ill intensive care unit （ICU） patient showing hypoalbuminemia is to increase colloid oncotic pressure （COP） to prevent extravasation of fluid from the intra- to the extravascular space. Correction of low albumin plasma levels is also justified by the role of albumin for binding and transportation of drugs and for its possibly beneficial role as an oxygen radical scavenger.

关键词： hypoalbuminemia critically ill volume replacement hydroxyethyl starch hypovolemia

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结肠癌的早期发现和内镜检查预防之现状

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德国医学 2001年第2期18卷 115-117页

作者：黄葵 A.Eickhoff J.F.Riemann 华中科技大学同济医学院附属同济医院 Medizinische klinik C Klinikum der Stadt Ludwigshafen gGmbH

在德国结肠癌是各类肿瘤中第二位致死性病因,仅次于支气管癌。这类肿瘤通常有10～15年的发病历程,腺瘤恶变所需的时间也是如此。疾病的预防有赖于对肿瘤诊断的研究由于缺乏适宜的早期警示征象,对无症状人群的筛查就显得相当重要。仅仅... 详细信息

在德国结肠癌是各类肿瘤中第二位致死性病因,仅次于支气管癌。这类肿瘤通常有10～15年的发病历程,腺瘤恶变所需的时间也是如此。疾病的预防有赖于对肿瘤诊断的研究由于缺乏适宜的早期警示征象,对无症状人群的筛查就显得相当重要。仅仅通过大便隐血试验和内镜检查是有可能识别癌症及其早期征象的;或者用内镜切除腺瘤,它们都可以避免癌症的发生。以下是一篇关于结肠癌预防的各种筛查方法适合性的综述。

关键词：结肠癌筛查早期发现内镜预防

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男性骨盆的磁共振解剖

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放射学实践 1990年第1期5卷 33-37页

作者： VonH.G.Zilch 汪其祥 Radiologische Abteilung des stadt.krankenhauses Passau Lehrkrankenhaus der Technischen Universitat Munchen 空军东湖疗养院

磁共振这种新的影象方法能显示解剖形态结构。为此,我们进行了回顾性研究,对150多例男性骨盆磁共振检查有关解剖细微结构的成象敏感性进行评价。

关键词：男性骨盆磁共振解剖

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1例颈动脉痛患者的MRI和超声影像

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世界核心医学期刊文摘（神经病学分册） 2006年第9期2卷 45-45页

作者： kuhn J. Harzheim A. Horz R. Bewermeyer H. 方伯言 Department of Neurology Kliniken der Stadt KlnKrankenhaus MerheimOstmerheimerstrasse 200D-51109 Cologne Germany Dr.

A patient presented with a painful, pulsating nodosity with marked tenderness on the right side of her neck. Cervical magnetic resonance imaging (MRI) exhibited pathological signal changes in the perivascular tissue of the carotid bifurcation area and around the external carotid artery. Similarly, Doppler sonography revealed an echo-poor wall change with outward bulging and slight narrowing of the affected vessel lumen. The clinical symptoms and our findings led to the diagnosis of carotidynia. We proposed that cervical MRI and Doppler sonography could be used for diagnosing carotidynia.

关键词：颈动脉痛 MRI 超声影像多普勒超声颈部疼痛周围组织颈动脉分叉患者表现

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