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Biomedical subjects

C Seiler

Publications and source records attributed to C Seiler.

At least 127 records · Page 7Linked to original sources
PubMed1993

[Cholecysto-cholangiography as an alternative to cystic duct cholangiography in laparoscopic cholecystectomy].

Intraoperative cholangiography may be an important adjunct to laparoscopic cholecystectomy in order to prevent bile duct lesions. Laparoscopic cannulation of the cystic duct can be very difficult and time consuming. We therefore developed a simple technique of cholecystocholangiography. The gallbladder is punctured and filled with contrast medium after having localised the cystic duct and put a metal clip as a landmark. The study included 52 patients having either cholecystocholangiography or cystic duct cholangiography. In 13 out of 26 patients (50%) cholecystocholangiography failed because of obstruction of the cystic duct. The cholangiograms showed complete filling of the bile ducts in 5 (19%) and incomplete visualisation in 8 cases (31%). Cystic duct cholangiography showed significantly better results with good delineation of the biliary tree in 19 cases (73%). Five cholangiograms were suboptimal (19%) and only 2 studies failed (8%). The relation between cystic duct and common bile duct was clearly visible in 24 cases (92%) with cystic duct cholangiography compared with 13 cases (50%) with cholecystocholangiography. Cystic duct cholangiography has better success rates in delineating biliary anatomy in order to prevent bile duct injury. Cholecystocholangiography is a good alternative in cases where the cystic duct cannot be initially visualized.

Adult↗
PubMed1993

[Value of laparotomy in massive lower gastrointestinal hemorrhage].

A study of ninety-four patients admitted with massive lower gastro-intestinal bleeding (LGIB) is presented using a systematic diagnostic work-up including angiography, colonoscopy and various investigations, such as scintigraphy, small bowel series and ultrasonography. The bleeding source was identified preoperatively in eighty-five patients. 9 patients had a diagnostic laparotomy and a pathology was found in additional seven. No source was identified in two patients (2.1%) at exploration and "blind" subtotal colectomy was not performed in these two cases as proposed by others. We conclude that a thorough systematic assessment of patients with LGIB is important to localize the bleeding source. Exploratory laparotomy is the final step in few cases (10%) and if no intraoperative source can be identified a "blind" colonic resection should not be performed.

Adult↗
PubMed1993

[Saethre-Chötzen syndrome. A study apropos of 17 cases].

Case reports of seventeen patients with the Saethre-Chötzen syndrome treated at the Stomatology and Maxillofacial Surgery Clinic, Nantes, France are analyzed, together with clinical and paraclinical signs of this syndrome, included within the framework of the acrocephalosyndactylies. Results of cases reported in the published literature are reviewed and compared with those of the present series. The characteristic craniofacial equilibrium of the Saethre-Chötzen syndrome is discussed, together with findings of a teleradiographic study performed according to Delaire's analysis. A discussion on the differential diagnosis of this syndrome is enlarge to include all acrocephalosyndactylies.

Acrocephalosyndactylia↗
PubMed1993

[Biliary pancreatitis--a good indication for laparoscopic cholecystectomy].

Recently the indication for laparoscopic cholecystectomy has been enlarged to include biliary pancreatitis. While a majority of reports recommend early open cholecystectomy for biliary pancreatitis the use of laparoscopic cholecystectomy in this disease has not yet been discussed. We retrospectively reviewed 52 patients with biliary pancreatitis being admitted to our ward in the last five years. Cholecystectomy was performed in 48 patients. Ten had undergone laparoscopic cholecystectomy. Postoperative complications occurred in 8 of the 48 patients (16.6%). Four patients (8.3%) died due to necrotizing pancreatitis or rupture of pseudocysts. We found a correlation between morbidity and mortality and the prognostic score as well as the presence of pseudocysts. We conclude that biliary pancreatitis is a good indication for laparoscopic cholecystectomy in patients with a low prognostic score. The presence of pseudocysts in our view is no contraindication for laparoscopy. Although it may increase postoperative morbidity. Choledocholithiasis has to be ruled out either by preoperative ERCP or during laparoscopy with intraoperative cholangiography.

Acute Disease↗
PubMed1992

Basic structure-function relations of the epicardial coronary vascular tree. Basis of quantitative coronary arteriography for diffuse coronary artery disease.

BACKGROUND: Quantitative coronary arteriography has been validated for stenotic segments of coronary arteries. However, it does not currently account for diffuse coronary artery disease, because the normal size of the coronary artery for its distal myocardial bed size is not known and cannot be measured directly with diffuse involvement of the artery. METHODS AND RESULTS: From clinical coronary arteriograms of 12 patients without coronary artery disease (group 1) and in 17 patients with coronary artery disease (group 2), we determined by quantitative coronary arteriography 1) the relations among measured coronary artery cross-sectional lumen area, summed distal branch lengths, and regional myocardial mass distal to each point in each coronary artery; 2) the ratio of coronary artery lumen area between parent and daughter vessels at 50 bifurcations; and 3) which of three different theoretical physical principles could underlie the tree structure of the human coronary artery system, by comparing the coronary artery size, branch lengths, regional mass, and relations between parent-to-daughter lumen area ratios with those for the different theoretical physical principles to test which principle best fit the observed data and therefore which principle most probably characterizes the human coronary artery tree structure. The results showed that 1) there is a close correlation between the lumen area of a coronary artery at each point along its length and the corresponding summed distal branch lengths and regional myocardial mass in patients without and with coronary artery disease; 2) measured coronary artery lumen area in patients with coronary artery disease is diffusely 30-50% too small for distal myocardial bed size compared with normal subjects; and 3) the observed relations among coronary artery size, distal summed lengths, myocardial bed size, and parent-to-daughter size ratios are not consistent with the theoretical principle of constant mean blood flow velocity in the coronary circulation but are consistent with the principles of minimum viscous energy loss and of limited/adaptive vascular wall shear stress characterized by a 2/3 power law relating coronary artery lumen area to distal summed branch lengths and regional mass or parent-to-daughter branching ratios. CONCLUSIONS: These observations provide a basis for quantifying diffuse coronary artery disease on clinical arteriograms.

Coronary Angiography↗
PubMed1992

Acute mesenteric ischaemia.

To identify any differences in presentation among the four types of acute mesenteric ischaemia, and to correlate time between presentation and treatment with outcome, we retrospectively analysed 100 cases of acute mesenteric ischaemia at a University hospital diagnosed by radiography (n = 21), at laparotomy (n = 61), or at necropsy (n = 18). A total of 68 patients died. Mortality was 50% when the aetiology was embolic occlusion of the superior mesenteric artery and 95% when the occlusion was thrombotic; 67% when the disease was "non"-occlusive; and 30% in cases of splanchnic vein thrombosis. We conclude that early diagnosis is critical for successful management of acute mesenteric ischaemia, but outcome is also influenced by the aetiology.

Acute Disease↗
PubMed1992

[Surgery of chronic pancreatitis].

Surgery for chronic pancreatitis may be indicated for local complications, or if the differential diagnosis between cancer and pancreatitis is uncertain, or if pain does not respond to conservative treatment. Local complications of chronic pancreatitis are the most frequent indications for operation. Pseudocysts are often associated with other local complications, and a high mortality rate is observed when haemorrhage occurs. Duodenopancreatectomy can be performed with low mortality, and is indicated if malignancy cannot be excluded, or in the patient with medically intractable pain in whom a pancreatico-jejunostomy is technically not feasible.

Chronic Disease↗
PubMed1992

[Splenic complications in inflammatory pancreatic diseases].

Pancreatitis in combination with splenic and vascular complications is dangerous and potentially lethal. The most common complications are intestinal or intraperitoneal hemorrhage resulting directly from either vascular changes, such as erosion of the splenic artery, formation of a pseudoaneurysm, hemorrhage into a pseudocyst, or rupture of a pseudocyst with perforation into the colon, or complications in the spleen, such as anemic or hemorrhagic infarction, abscess or rupture. CT is the method of choice for the diagnosis of splenic complications of pancreatitis. Angiography is indicated in every severe hemorrhage in the presence of pancreatitis, to demonstrate vascular changes and to localize the source of hemorrhage. In addition, acute arterial bleeding can be successfully treated with catheter embolization.

Acute Disease↗
PubMed1991

Long-term follow-up of medical versus surgical therapy for hypertrophic cardiomyopathy: a retrospective study.

In a retrospective analysis 139 patients with hypertrophic cardiomyopathy were followed up for 8.9 years (range 1 to 28 years). Patients were divided into two groups: Group 1 consisted of 60 patients with medical therapy and Group 2 of 79 patients with surgical therapy (septal myectomy). Groups 1 and 2 were subdivided according to the medical treatment. Group 1a received propranolol, 160 mg/day (n = 20); Group 1b verapamil, 360 mg/day (n = 18); and Group 1c, no therapy (n = 22). Group 2a received verapamil, 120 to 360 mg/day, after septal myectomy (n = 17) and Group 2b had no medical therapy after surgery (n = 62). In Group 1, 19 patients died (annual mortality rate 3.6%) and in Group 2, 17 patients died (mortality rate 2.4%, p = NS). Of the patients who died, approximately one half to two thirds in both Groups 1 and 2 died suddenly and the other one half to one third died because of congestive heart failure. The 10 year cumulative survival rate was 67% in Group 1, significantly smaller than that in Group 2 (84%, p less than 0.05). In the subgroups, the 10 year survival rate was 67% in Group 1a, 80% in 1b (p less than 0.05 versus 1a) and 65% in 1c (p less than 0.05 versus 1b). The 10 year survival rate was 100% in Group 2a (p less than 0.05 versus 1a, 1b, 1c) and 78% in Group 2b (p less than 0.05 versus 2a). It is concluded that cumulative survival rate is significantly better in surgically than in medically treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Quantitative Doppler echocardiography in the evaluation of heart diseases].

Doppler ultrasound is an established noninvasive method in cardiology. The most important indications are: 1. stenosis/insufficiencies of atrioventricular/semilunar valves, 2. dysfunction of artificial valves, 3. atrial and ventricular septal defects, 4. intraventricular pressure gradients, e.g. in hypertensive cardiomyopathy, 5. determination of the systolic pulmonary artery pressure. Color Doppler and pulsed wave Doppler as mainly used for quantitative and semiquantitative-, continuous wave Doppler mainly for quantitative analyses. Doppler it can be obtained qualitative and semiquantitative, from continuous wave Doppler quantitative information about the velocity of blood flow.

Cardiomyopathies↗
PubMed1989

[Long-term course of hypertrophic cardiomyopathy: drug versus surgical therapy].

139 patients with hypertrophic cardiomyopathy (HCM) have been followed up for 1-28 years (mean 8.9 years). Group 1 consisted of 60 patients (mean age 38 years) without indication for septal myectomy (SM) (no pressure gradient at rest in 8, pressure gradient less than 50 mm Hg in 52 cases); group 2 consisted of 79 patients (mean age 36 years) who had SM (pressure gradient at rest 70 mm Hg). Management in group 1 was the following: (1a) propranolol (n = 20) (160 mg/d), (1b) verapamil (n = 18) (360 mg/d) and (1c) no therapy (n = 22). 19 patients died in group 1 (mortality 3.6% year); 17 died in group 2 (mortality 2.4%/year). 10 year survival in group 1b was 80% and in groups 1a und 1c 67% and 65% respectively. Patients of group 1b had a higher survival rate (p less than 0.05) than the other subgroups. Surgery patients treated with verapamil (120-360 mg/d) (n = 17) had a 10-year survival rate of 100% compared to 78% for surgery patients (n = 34) without such treatment (p less than 0.05). In summary, it can be said that the overall survival rate after SM is better than that with medical treatment. Under verapamil, however, survival is not different from that after surgery. The most favorable outcome was observed in surgery patients under long-term therapy with verapamil, probably due to the reduction of systolic pressure overload (SM) and improvement in diastolic function (verapamil).

Adult↗
PubMed1989

[Acute intestinal hemorrhage in a pancreatic pseudocyst-colic fistula].

Chronic pancreatitis with a pseudocyst may cause acute massive intestinal bleeding due to simultaneous erosion of the splenic artery and transverse colon. This is a potentially lethal complication, which requires instant diagnosis and treatment. The pathogenesis, diagnosis and treatment of this condition are illustrated by two patients. Exact localisation of the source of bleeding is achieved by selective angiography of the visceral arteries. In shocked and inoperable patients, selective embolisation of the bleeding artery is the treatment of choice.

Acute Disease↗
PubMed1985

Immunohistochemical detection of the Ca antigen in normal and tumor tissues of humans by use of Ca1 monoclonal antibody.

The Ca1 monoclonal antibody was used to detect Ca antigen in paraffin sections with the use of a two-stage indirect immunoperoxidase technique. A range of normal and malignant human tissues was examined. The antibody reacted with squamous cell carcinomas, small cell carcinomas, adenocarcinomas, ductal carcinomas, and anaplastic carcinomas from gastrointestinal, lung, and breast tissues. Melanomas were negative. Reactivity was also observed against normal tissues: urinary transitional epithelium, fallopian tube epithelium, breast ducts, sweat glands, sebaceous glands, alveolar epithelium, bile duct, gallbladder, kidney tubules, and some digestive tract epithelial cells. Although the study confirms earlier reports that Ca1 is a marker for some normal, nonciliated epithelial cells and for epithelial and some other cancers, a more widespread distribution for normal tissues was found.

Antibodies, Monoclonal↗
PubMed1978

Physiological correlates of maternal separation in surrogate-reared infants: a study in altered attachment bonds.

Three pigtail infant monkeys (Macaca nemestrina) were separated from their mothers shortly after birth and raised in social isolation on cloth surrogates. At about 24 weeks of age they were surgically implanted with multichannel biotelemetry systems. Following the collection of baseline behavioral and physiological data, the cloth surrogates were removed for 4 days, then returned. The behavioral and physiological (heart rate, body temperature, sleep patterns) reaction to separation from the surrogate was much less intense than is the case in group-living pigtail infants that are separated from their mothers, suggesting that the attachment bond to a cloth surrogate may be different than the bond to a living mother in a social group. Heart rate mean values and variability were similar in surrogate-reared and mother-reared infants, suggesting a degree of environmental independence in heart rate regulation.

Animals↗