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Biomedical subjects

E Bodner

Publications and source records attributed to E Bodner.

At least 37 records · Page 2Linked to original sources

Late complication after laparoscopic fenestration of a liver cyst.

We report the case of a serious complication resulting from laparoscopic fenestration of a hepatic cyst. Seven months after the procedure had been performed, the cyst had recurred and ruptured, leading to massive bleeding. Bleeding control and enucleation of the cyst were carried out successfully by conventional surgery. The patient recovered rapidly after an uneventful postoperative period, and no recurrence of the liver cyst was found 20 months after our intervention. This case emphasizes the importance of a strict follow-up and determination of the outcome for this new application of laparoscopic surgery.

Abdomen, Acute↗

Purification and characterization of diamine oxidase from porcine kidney and intestine.

Diamine oxidase, the enzyme catalyzing the oxidative deamination of histamine and other diamines, was purified from porcine kidney and porcine intestine. During all purification steps the enzymes from both tissues showed identical binding and elution characteristics. The native enzymes are homodimeric glycoproteins with an apparent molecular weight of 186 kDa. Under reducing conditions the subunits migrate at 104 kDa on SDS polyacrylamide gels and the deglycosylated subunits migrate at 93 kDa which corresponds to a carbohydrate content of 11%. The native and deglycosylated forms of kidney and intestinal diamine oxidase migrate to the same positions, respectively, on two-dimensional isoelectric focussing/SDS polyacrylamide gels. The sequences of the 21 N-terminal amino acids of both proteins are identical. A polyclonal antibody raised against the kidney enzyme binds equally well to diamine oxidase from both kidney and intestine, inhibits the enzymatic activity, and precipitates all diamine oxidase activity from tissue homogenates. The kidney and intestinal enzymes have identical substrate specificities, efficiently converting aliphatic diamines, histamine, and spermidine. For both enzymes the Km values for histamine, putrescine, and spermidine are 0.02 mM, 0.35 mM, and 3.3 mM, respectively. Spermine, aliphatic monoamines, and aromatic mono- and diamines are poor substrates. In conclusion, the diamine oxidase proteins from porcine kidney and intestine are very likely identical and constitute the only diamine oxidase activity present in these tissues. The structural identity implies identical functions of the proteins in these organs, namely the protection of the organism against high concentrations of diamines.

Amine Oxidase (Copper-Containing)↗

Obstructive ileus of large bowel is associated with low tissue levels of neuropeptides in prestenotic bowel segment.

The neuropeptides substance P, vasoactive intestinal polypeptide, and the recently discovered peptide secretoneurin are neurotransmitters of the intrinsic nervous system of the gut and effect gut motility. The aim of this study was to investigate whether these neuropeptides are involved in the pathophysiology of large bowel ileus. Five patients underwent colonic resections for obstructive cancer of the colon. Full-thickness specimens of the resected colon were taken 10 cm proximal and 10 cm distal to the site of tumor obstruction. Substance P-, vasoactive intestinal polypeptide-, and secretoneurin-like immunoreactivities were measured in the specimens by radioimmunoassay. In addition immunocytochemistry was performed. Tissue levels of substance P, vasoactive intestinal polypeptide, and secretoneurin were lower in the prestenotic than in the poststenotic bowel segment. In accordance, immunocytochemistry revealed a denser staining of ganglion cells and fibers for all three neuropeptides in the poststenotic bowel. The decreased tissue levels of substance P, vasoactive intestinal polypeptide, and secretoneurin in the prestenotic bowel segment may contribute to the final decompensation of obstructive ileus.

Aged↗

Gastro-oesophageal reflux disease: medical or surgical treatment? Report of an interactive workshop.

Gastroesophageal reflux disease (GERD) is the most common disease of the upper gastrointestinal tract. With the introduction of proton pump inhibitors medical treatment of GERD has been significantly improved. However, the development of laparoscopic antireflux surgery resulted in an increasing interest of surgeons in this disease. An interactive meeting was organized in order to develop an agreement between gastoenterologists and surgeons regarding therapeutic decisions and this is the main topic of this paper.

Barrett Esophagus↗

Treatment of hepatic cysts in the era of laparoscopic surgery.

BACKGROUND: Liver cysts are not uncommon. Rarely, they become symptomatic and require intervention. Surgery is the usual form of treatment; laparoscopic cyst unroofing has recently been introduced. METHODS: The current status of diagnosis and conventional therapy of hepatic cysts was summarized. The surgical literature was surveyed to collect all reported cases of minimally invasive treatment of these lesions, and the advantages and limitations of the methods were evaluated. RESULTS AND CONCLUSION: The general application of the minimally invasive technique should await a thorough evaluation of the operative complications and the outcome in terms of cyst recurrence in larger series of patients. However, laparoscopic wide cyst unroofing and laparoscopic cyst excision will probably become the methods of choice for the treatment of symptomatic liver cysts in carefully selected patients.

Cysts↗

Survival and local recurrence after anterior resection and abdominoperineal excision for rectal cancer.

The aim of this retrospective study is to compare the outcome of abdominoperineal excision (APE) and anterior resection (AR) for rectal cancer in 136 patients. Local recurrence rates and 5-year survival probabilities were estimated for the AR and APE group. Further comparisons were carried out between hand-sewn and stapled anastomoses after AR, and between patients after AR and APE for tumours 2 to 6 cm from the dentate line. Local recurrence after AR occurred in 14% and after APE in 10% of these cases. Five-year survival probabilities and local recurrence frequencies showed no statistically significant difference (P > 0.05). Local recurrence rates were 13.5% after hand-sewn anastomoses and 15% after the stapled procedure. No statistically significant difference was observed in the 5-year survival and recurrence rate (P > 0.05). Seventy-four of 136 patients had tumours located 2 to 6 cm from the dentata line. Local recurrence occurred in 21% after AR and 5% after APE, showing a statistically significant difference in frequency (P < 0.05). No significant difference was found in cumulative 5-year survival probabilities. APE for advanced low rectal cancer showed a significant reduction in local recurrences compared to AR.

Humans↗

Is there a role for laparoscopic ultrasonography (LUS)?

Laparoscopic ultrasound (LUS) was performed in 24 patients undergoing routine laparoscopic cholecystectomy at the Second Surgical Department of the University Hospital of Innsbruck, Austria. After introduction of the ultrasonic probe via the umbilical incision, liver, biliary tract, pancreas, kidneys, stomach, and colon were investigated to assess the sonomorphology of these organs and to judge whether or not LUS is a feasible and reliable means for screening the abdominal organs during routine surgery or laparoscopic staging of upper gastrointestinal (GI) tumors. In all cases, a very accurate investigation of these organs was possible, and the laparoscopic procedure was prolonged for only 15 to 20 min. In eight further patients, LUS was performed to investigate pancreatic pathology (six cases), stomach cancer (one patient), and primary hepatocellular carcinoma (one patient). Three additional patients (pancreatic lesions) who underwent intraoperative ultrasonography with the LUS probe were excluded from this evaluation.

Cholecystectomy, Laparoscopic↗

Gastric remnant cancer has a better prognosis than primary gastric cancer.

OBJECTIVE: To study the prognosis of gastric remnant cancer following radical resection (group 1) compared with that of primary gastric cancer of the upper third of the stomach following radical resection (group 2). DESIGN: Cohort study with a 5-year follow-up. SETTING: A university hospital in Austria. PATIENTS: Group 1 consisted of 43 patients, and group 2, of 61. Postoperative deaths and deaths during the follow-up period that were not related to gastric cancer were excluded. Fifteen patients in group 1 (34.9%) presented with stage I cancer; 10 (23.3%), stage II; 13 (30.2%), stage III; and five (11.6%), stage IV. Twenty patients in group 2 (32.8%) presented with stage I cancer; 12 (19.7%), stage II; 15 (24.6%), stage III; and 14 (22.9%), stage IV (Union Internationale Contre le Cancer staging classification, 1987). MAIN OUTCOME MEASURES: Overall and stage-related 5-year survival rates. RESULTS: The overall 5-year survival rate was 53.5% in group 1 and 32.8% in group 2 (P < .05). The stage-related 5-year survival rate in group 1 was 100% for stage I and 80% for stage II. In group 2, the stage-related 5-year survival rate was 65% for stage I and 25% for stage II (both, P < .01). No significant difference was noted for stages III and IV. CONCLUSIONS: The prognosis of cancer of the gastric remnant presenting as stage I or II is good and is significantly better than that of the equivalent stages of primary cancer of the upper third of the stomach.

Adolescent↗

Ultrasonography in the management of blunt abdominal and thoracic trauma.

OBJECTIVE: To assess the sensitivity, specificity, and predictive value of ultrasonography in patients with blunt abdominal or thoracic trauma in regard to the indication for immediate operation, delayed abdominal exploration, or conservative treatment. DESIGN: A retrospective study was conducted after consecutive sampling of 1151 patients in a nonrandomized control trial. SETTING: The study was conducted at the University Hospital of Innsbruck (Austria), which serves as a general community hospital and a major primary care and referral center. PATIENTS: All patients with blunt abdominal or thoracic trauma with or without polytraumatization were eligible for the study; a total of 1151 patients were observed from 1980 to 1990. According to the ultrasonographic findings, patients were divided into three groups: immediate operation, primary conservative treatment, and conservative treatment (normal ultrasonographic findings). Ultrasonography was repeated when the clinical findings or laboratory test results showed the development of intra-abdominal hemorrhage or signs of organ laceration. INTERVENTION: Ultrasonography in the emergency department or intensive care unit. MAIN OUTCOME MEASURES: Conservative or operative treatment based on ultrasonographic and clinical findings. RESULTS: Ultrasonography showed a sensitivity of 99%, a specificity of 98%, a positive predictive value of 0.97, and a negative predictive value of 0.99 in regard to the indication for surgery in cases of blunt abdominal or thoracic trauma. Ultrasonography is not reliable in patients with intestinal perforation and large retroperitoneal hematomas. CONCLUSION: Ultrasonography saves time and money, can be performed in the emergency department, shows high sensitivity and specificity, and is the method of first choice in the evaluation of blunt trauma.

Abdominal Injuries↗

Lymphangitis carcinomatosis of the lesser omentum: a prognostic factor in gastric cancer.

A series of 126 patients with gastric cancer who underwent radical gastrectomy with systemic lymph node dissection revealed 9 patients who survived for a median time of only 3 months. Of these 9 patients, 4 were classified by the UICC system as stage II and 5 as stage III, all of whom had lymphangitis carcinomatosis of the lesser omentum. These data suggest that although lymphangitis carcinomatosis of the lesser omentum is an uncommon finding, if it is present, curative surgery is impossible and an operation should therefore be limited to tumor palliation.

Adult↗