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C Gebhardt

Publications and source records attributed to C Gebhardt.

At least 145 records · Page 8Linked to original sources
PubMed1979

[A new concept in the surgery of chronic pancreatitis (author's transl)].

There is an obvious advantage to partial duodenopancreatectomy with occlusion of the pancreatic duct by prolamine (a rapidly solidifying aminoacid solution) for the prevention of recurrences, while preserving the stomach and proximal duodenum, in the treatment of severe destruction of the pancreas, localised to the head or generalised. The death rate of partial duodenopancreactectomy has been lowered from 8.5 to 2.3% since using this method. Compared with total duodenopancreatectomy which--according to the authors' earlier results carried a postoperative mortality of 20%--the operative risk has been reduced to a tenth. Taking into account the benign nature of chronic pancreatitis, on the other hand, and the extent of the operative operation, on the other, the present death-rate of 2.3% would appear reasonable. Occlusion of the pancreatic duct with prolamine in order to exclude any still present excretory pancreatic function in the residual pancreatic tissue has made all patients pain-free. No early recurrence has been observed.

Amino Acids↗
PubMed1979

Three dimensional microscopic surface profiles of membranes reconstructed from freeze etching electrol micrographs.

A method of three-dimensional reconstruction of the surface profile of artificial and natural membranes from freeze quenched electron micrographs is presented. The method is based on the analysis of the variation in thickness of platinum layers, deposited under an oblique angle. In essence, it is reminiscent of the method of Eratosthenes to measure the earth's radius. The thickness of etch-like protrusions of membranes could be determined to an accuracy of about 3 A. True distances on curved surfaces rather than projections of distances are obtained. The method has been applied to both model membranes and biological membranes. The essential results are: 1. Detailed information on the symmetry and the molecular structure of the crystalline phases of dimyristoyl phosphatidylcholine was obtained. The microscopic surface profile of the ripple structure observed between the pretransition and the main transition was analysed. In accordance with a previous model we found that the ripple structure is caused by the spontaneous curvature of the monolayers. The surface profiles of the ripple structure and of the low temperature biaxial phase could be clearly distinguished. 2. The sizes and shapes of lipid domains formed by both thermically and charge-induced lateral phase separation were determined. This showed that the visual inspection of electron micrographs may lead to a considerable underestimation of the domain size. Conclusions may be drawn concerning the different phases formed upon lateral phase separation. 3. As a biological example, yeast cell membranes were studied. The method allows one to distinguish between different membrane-bound proteins by measuring the width-to-height ratio of the particles. The deformation of the lipid layer in the environment of the proteins may be determined. This deformation contains information about lipid-mediated long-range interactions between membrane proteins.

Freeze Etching↗
PubMed1979

[Is total pancreatectomy still responsible treatment for chronic pancreatitis? (author's transl)].

A total of 61 pancreatectomies for chronic pancreatitis are reported. The operative mortality rate was 21% and the later mortality rate 29%, although caused by diabetes. The results are so poor that this method should only be performed in extreme situations. Left or right resection of the main inflammation site is proposed as an alternative. To prevent recurrence of the pancreatitis, the in situ remaining part of the pancreas should be sclerosed by occlusion of the pancreatic duct system.

Adult↗
PubMed1979

Endoscopic duct obstruction in chronic pancreatitis.

Ligation of Wirsung's duct or obstruction with a glue may be an alternative to pancreatectomy in patients with intractable pain due to chronic relapsing pancreatitis. In 10 patients obstruction of Wirsung's duct was performed via endoscopic retrograde instillation of an alcoholic aminoacid solution into the ductal system. All patients became free of symptoms within one week; no complications were seen. Long-term follow-up data, however, suggest that clinical improvement may be persistent in only about 50 per cent of the patients. Further data are necessary before endoscopic obstruction of Wirsung's duct can be recommended as a conservative method in the treatment of chronic pancreatitis.

Alcoholism↗
PubMed1979

Physical map of PM2 DNA.

The cleavage sites of the restriction nucleases HpaI, HpaII, HindII, HindIII, and PstI have been mapped on the DNA of the bacteriophage PM2. This map has been used for the localization of two strong binding sites of Escherichia coli RNA polymerase on PM2 DNA.

Bacteriophages↗
PubMed1978

[Occlusion of pancreatic duct system by injection of a fast-solidifying amino acid solution (author's transl)].

The effect of the occlusion of the pancreatic duct system with a new alcoholic solution of amino acids has been studied in animal experiments. The solution becomes solid in the duct system, is microbiologically indifferent and becomes disintegrated within 11 days. This time, however, is sufficient to keep a high-grade atrophy of the exocrine parenchyma. With this method one doesn't risk the provocation of an acute pancreatitis. The development of fistulas following exploratory excision is prevented by the filling of the duct system. The solution could be qualified for a therapeutical acceleration of the "burning-out" of the chronic pancreatitis.

Amino Acids↗
PubMed1977

[The treatment to the high gastric ulcer (author's transl)].

This is a report on 64 patients, who were operated on because of gastric ulcer situated near the cardia. We found the best results after the so-called step-like resection, which is preferable to selective vagotomy with excision of the ulcer and pyloroplasty because of the special conditions of the secretion of gastric juice in the case of high ulcers. Because of the danger of the development of a cancer in a B-II-stomach we prefer the B-I-anastomosis. For ulcers with stenosis of the esophagus a cardiofundectomy should be performed. Ulcers high on the greater curvature and in the fundus should be excised and a distal gastrectomy (B-I) should follow. The sole excision of the ulcer or the operation according to Kelling-Madlener are not recommended.

Adult↗
PubMed1977

[Blocking of pancreatic exocrine function in the treatment of chronic pancreatitis (author's transl)].

In 6 patients with chronic pancreatitis the exocrine function was inhibited by occlusion of the pancreatic exocrine ducts leading to atrophy of the glands. The function of the pancreatic islets remained intact. This procedure can be combined to advantage with partial resections. Preliminary clinical results are promising and in all cases pancreatic pains disappeared immediately after the operation.

Adult↗
PubMed1977

[Ulcerocancer of the stomach (author's transl)].

46 patients were operated upon for an ulcerocancer of the stomach. In detail the differential diagnosis and the possibilities for preoperatively establishing an exact diagnosis are described. The good results after resection of the tumor (5-year-survival rates are for early cancer 100% and for the other tumors 67.7%) demonstrate, that usually for the ulcerocancer a total gastrectomy is unnecessary. Depending on the localisation of the tumor a proximal or distal resection of the stomach is sufficient. The results indicate that tumors, in which the ulcer floor shows a partial infiltration of carcinomatous cells, are not to be called as ulcerocancer. It is suggested to speak of these cases of "primary" carcinoma of the stomach.

Adult↗
PubMed1975

[The penetrating duodenal ulcer. Operative technique and postoperative complications (author's transl)].

The results of 133 gastric resections for penetrating duodenal ulcer are reported. Because of the postoperative complications (acute hemorrhagic pancreatitis, duodenal stump insufficiency, icterus and intraluminal postoperative bleeding) in future only the atypical closure of the duodenal stump according to the method of Nissen-Bsteh should be carried out. A bleeding ulcer should be operated within 48 hrs. If the bleeding needs more than 2500 ml blood substitute, this means a indication for a immediate operation.

Acute Disease↗