Biomedical subjects

B Stinner

Publications and source records attributed to B Stinner.

57 records · Page 4Linked to original sources

PubMedDate not supplied

Are covered stents really effective at closing esophagotracheal fistulas? Results of an animal study.

PURPOSE: To determine whether covered self-expanding metal stents successfully exclude experimentally created esophagotracheal fistulas. METHODS: Esophagotracheal fistulas were surgically created in the upper third of the esophagus in 12 minipigs and immediately sealed by implantation of a covered self-expanding metal stent (20 mm expanded diameter) in the esophagus. Before the animals were killed, after 3, 7, 14, 28, 30, and 36 days, the position of the stent and the sealing of the fistula were monitored fluoroscopically. The esophagus, trachea, and both lungs were examined histologically. RESULTS: Creation of an esophagotracheal fistula was successful in all cases. All fistulas were widely patent at autopsy. The technical success rate for stent deployment and initial sealing of the fistula was 100%. During follow-up, five stents migrated distally, but none into the stomach. Therefore, the fistula was no longer excluded in five animals. In seven animals the stent sealed the fistula until the death of the animal. Tracheal narrowing necessitated additional tracheal stenting in three animals. Two minipigs died due to aspiration of food. Histologic examination showed signs of aspiration in all animals with stents in place for longer than 2 weeks. CONCLUSION: This experimental animal study revealed worse results for sealing of esophagotracheal fistulas with covered self-expanding metal stents than have been reported for the clinical use of these devices.

Animals↗

PubMedDate not supplied

Nitinol prostheses for the treatment of inoperable malignant esophageal obstruction.

PURPOSE: This uncontrolled prospective study was undertaken to evaluate a new nitinol stent in the treatment of dysphagia due to inoperable malignant esophageal obstruction. PATIENTS AND METHODS: Eighteen consecutive patients (15 men, three women; mean age, 66 years +/- 15) with inoperable malignant obstructions of the esophagus or esophagogastric junction due to esophageal carcinoma (n = 14) or extrinsic obstruction (n = 4) were treated with self-expanding nitinol endoprostheses (diameter, 18 mm). Dysphagia score and activity index were assessed before and every 4 weeks after stent insertion. RESULTS: Eighteen stents were deployed successfully. One stent expanded insufficiently and was removed inadvertently during retrieval of the application system. Mean time until complete expansion of the stent was 7.1 days +/- 5. Stent placement resulted in a significant decrease in the dysphagia score (2.7 +/- 0.7 before vs 0.6 +/- 0.7 after stent placement, P < .00005 by Wilcoxon matched-pairs test) and a significant increase in the activity index (2.6 +/- 1 before vs 1.7 +/- 0.9 after stent insertion; P < .005). There were no procedure-related complications. Follow-up period (mean, 155 days +/- 100) revealed recurrent dysphagia in four patients. Two patients experienced food bolus impaction, another two had tumor ingrowth through the mesh after 170 and 186 days. Fourteen patients died after a mean survival time of 158 days +/- 106, all with patent stents. CONCLUSIONS: Self-expanding nitinol esophageal stents are safe and effective in the treatment of malignant esophageal obstructions.

Aged↗

PubMedDate not supplied

[Pattern of distribution of apolipoproteins A and B in the lipoprotein fractions of serum in pregnant patients and post partum].

Investigating the for gestationally caused changes and their restitution p. partum we determined in 104 women without metabolic disorders the apolipoproteins A and B respectively in serum, in the main lipoprotein fractions VLDL, IDL, LDL, HDL and in the "rest protein" remaining after separation of the lipoproteins from the serum. In gestation there is an increase in the serum level of apo A of about 30% (p less than 0.001) reaching its maximum in the middle period of pregnancy. The post partal restitution of these changes takes more than 5 weeks happening faster at primarily delactated women. Gestational changes concerning apo A are only caused by a 30% higher concentration of apo A in HDL (p less than 0.001). The serum level of apo B seems to increase continuously meanwhile gestation reaching its maximum from about 60% (p less than 0.001) at the term. The restitution of the gestational changes concerning apo B also requires more than 5 weeks showing no dependence from lactation. The changes of serum apo B are quantitatively most influenced by the 45% higher concentration of apo B in LDL (p less than 0.001), despite the marked changes of apo B in relation to the nonpregnant comparative group found in VLDL and IDL respectively with either 270% (each p less than 0.001). Hyperbetalipoproteinemia in pregnancy was proved in 32%, but in no case the ratio apo B/apo A showed pathological values, because of also raised levels of apo A in these women. By this astonishing phenomenon the gestational hyperlipoproteinemia is characterized as an autonomic metabolic situation, which represents no earlier described type according to the Fredrickson classification.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗