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Biomedical subjects

E Hancke

Publications and source records attributed to E Hancke.

At least 19 recordsLinked to original sources
PubMed1993

[Diagnosis of anorectal fistula using magnetic resonance tomography].

In 17 patients with anorectal fistulae the pelvis was examined by magnetic resonance imaging (MRI). The extent and the course of the fistulae and abscesses could be visualized by proton-density- and T2-weighted images. In 6 of 17 patients fistulae were seen that could not be detected by clinical investigation. In 2 cases additional pelvirectal abscesses were found. Most of the fistulae (5 of 6) had a complicated high suprasphincteric or rectovaginal course. It is concluded that with MRI anorectal fistulae and abscesses can be visualized and that this method is a worthful additional diagnostic tool in patients with complicated fistula-in-ano.

Adult↗
PubMed1992

[Perianal infections in Crohn disease. Results of local surgical treatment in comparison with non-Crohn patients].

In a prospective study the results of local surgery in perianal infections in patients with and without Crohn's disease were compared. In patients with Crohn's disease (CD) the abscesses and fistulas were more extensive and complicated than in patients without Crohn's disease (NCD). The source of infection was cryptoglandular in 81% (CD) resp. 100% (NCD). The wound healing in CD-patients was four weeks longer than in NCD patients. Abscesses or fistulas recurred in 6/18 (CD) resp. 1/25 (NCD). Partial incontinence occurred in 6/18 CD and 5/25 NCD. It is concluded that perianal infections can be treated successful in most of patients with Crohn's disease.

Abscess↗
PubMed1992

Distribution and coexistence of chromogranin A-, serotonin- and pancreastatin-like immunoreactivity in endocrine-like cells of the human anal canal.

The comparative distribution and coexistence of chromogranin A (CGA)-, serotonin (5-hydroxytryptamine; 5-HT)- and pancreastatin (PST)-like immunoreactivity in endocrine-like cells of the human anal canal was investigated by light-microscopic immunocytochemistry. The largest population of colorectal endocrine-like cells consisted of CGA-immunoreactive (ir) cells, followed by the 5-HT-ir and PST-ir cell population. In the anal transitional zone (ATZ), CGA- and 5-HT-immunoreactivity was equally distributed; ir-PST was confined to a smaller endocrine-like cell population. In the squamous zone and the perianal skin, Merkel cells in the basal layer of the epidermis and hair follicles exhibited ir-CGA and ir-PST but no ir-5-HT. Double immunofluorescence on identical sections revealed distinct coexistence patterns. In the colorectal zone, about 2/3 of the CGA-ir endocrine-like cells also stained for 5-HT, whereas in the ATZ epithelium, CGA- and 5-HT-immunoreactivity completely overlapped. No 5-HT-immunoreactivity could be detected in CGA-ir Merkel cells of the squamous zone of the anal canal and the perianal skin. PST-immunoreactivity was present in about 1/3 of the CGA-ir colorectal and anal transitional endocrine-like cells and in about 1/4 of the Merkel-cell population staining for CGA. These chemically heterogeneous phenotypes of the anal endocrine-like and Merkel cells may reflect a specific regulatory role of these cells in the various epithelial linings of the human anal canal and the perianal skin.

Anal Canal↗
PubMed1990

[Repeated kidney transplantation. Surgical technic, results and complications].

Third renal transplants were performed in 31 patients (25 men and 3 women: mean age 33 +/- 11 years) with terminal renal failure. Surgical complications occurred in four of them. Acute rejection crises were frequent (48%). In three cases acute humoral vascular rejection led to loss of the grafted kidney. One patient died within 3 months. The proportion of functioning transplants was 83% at 3 months, 59% at 1 year and 20% at 5 years. Such factors as the concentration of panel-reactive antibodies, a history of previous acute humoral rejection crises or the timing of the previous transplant loss had no influence on the prognosis of the new graft. After a mean observation period of 35, 4 months patients whose HLA-DR antigens matched those of the donor at one or two loci had a markedly higher proportion of functioning renal transplants (69% and 64%, resp.) than patients without HLA-DR compatibility (0%; P less than 0.01). These results indicate that a third renal transplant does not carry any increased perioperative risk, and that the proportion of functioning transplants is good in the short term, though the long-term results are poor. Prolonged survival of the renal transplant can be expected only if there is an optimal HLA-DR match between donor and recipient.

Adult↗
PubMed1990

[Infections following kidney transplantation under threefold or fourfold immunosuppressive treatment].

To determine, whether the infection rate after renal transplantation is influenced by the intensity of immunosuppressive treatment, the postoperative course of 100 consecutive renal transplantations in 64 men and 36 women (mean age 44.1 [18-72] years) was investigated prospectively. 87 patients received threefold basal immunosuppression with low-dose ciclosporin, azathioprine and prednisolone. In 13 risk patients (retransplantation and [or] high panel-reactive antibody titres), poly- or monoclonal antibodies were administered additionally to prevent rejection. Steroid-resistant rejection crises had to be treated with poly- or monoclonal antibodies in 15 patients. Postoperatively there were 10 patients with systemic infections (5 with cytomegalovirus, 4 with herpes simplex virus and 1 with Pneumocystis carinii). The infection rate with three- or fourfold immunosuppression did not differ significantly (5.4% vs. 9.1%). However, infections occurred more frequently after additional antirejection treatment with poly- or monoclonal antibodies (33%). It is concluded from these results that fourfold basal immunosuppression treatment with poly- or monoclonal antibodies is not associated with an increased risk of perioperative infections.

Adolescent↗
PubMed1987

Impaired rectal sensation in idiopathic faecal incontinence.

In 15 patients suffering from idiopathic faecal incontinence and in 15 matched controls, manometric studies of anorectal pressure and studies of the rectoanal reflex and rectal sensitivity were carried out. Patients with idiopathic faecal incontinence had normal resting pressure but reduced squeeze and stress pressures; the anal sphincter relaxed before a sensation of rectal distension occurred. The conclusion is that both reduced voluntary muscle contraction and impairment of rectal sensation are conducive to soiling in idiopathic faecal incontinence.

Adult↗
PubMed1986

[Bacteria in the gallbladder wall and gallstones--indications for cholecystectomy].

After cholecystectomy the bacterial content of the bile, gallbladder wall and gallstones was studied in 40 patients. Bacteria could be found in 9 cases in the gallbladder wall, in 8 cases in the gallstones and in 3 cases in the bile. In chronic inflammatory thickened gallbladder wall bacteria were positive in 8 of 14 cases whereas in normal gallbladders bacteria were found only in 3 of 26 cases (difference statistically significant, P = 0.01). It is concluded that in gallstone disease bacteria are not only present in bile but also in the gallbladder wall and within the gallstones. As bacteria are mostly present in a gallbladder wall with chronical inflammatory changes a thickened gallbladder should be removed even in asymptomatic or slightly symptomatic cases of gallstone disease in order to prevent relapsing cholecystitis.

Adult↗
PubMed1986

[Antimicrobial chemoprevention in colorectal interventions: a single parenteral dose at the start of surgery is adequate].

The effectivity in reducing septic complications after colorectal operations of oral 1 g Neomycin plus 0.25 g Metronidazol t.i.d. on the last preoperative day vs. intravenous single dose 5 g Mezlocillin plus 0.5 g Metronidazole was tested by sequential medical plan. There was no statistically significant difference between both chemoprophylaxis groups (p = 0.10). It is concluded that the intravenous chemoprophylaxis should be preferred because of the lowest dosage and therefore the fewest side-effects.

Administration, Oral↗