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Biomedical subjects

E Mühe

Publications and source records attributed to E Mühe.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Hepatico-jejunostomy by the R. Smith-technique for the repair of central biliary ducts (author's transl)].

In order to repair a lesion of the proximal biliary duct, a wide anastomosis without tension and without reflux of intestinal content is required. If a biliary-intestinal anastomosis is technically not possible the R. Smith-procedure may be applied. For this purpose a segment of jejunum without serosal layer is pulled over a catheter into the biliary duct and the catheter fixed outside the abdomen. 11 good long-term results and 2 recurrences of stenoses could be observed by this method.

Cholangiography↗
PubMed1980

Fasting blood values of glucose, insulin, glucagon, gastrin following highly selective vagotomy in duodenal ulcer patients.

Changes in fasting blood levels of glucose, insulin, glucagon and gastrin were determined in duodenal ulcer patients (n equal to 59) before and up to 1 year after highly selective vagotomy (HSV). There was an increase in glucose values after HSV by approximately 6 mg/dl. The rise in gastrin levels was variable depending on the maximal preoperative acid secretion during pentagastrin stimulation. Insulin values remained unchanged after HSV while there was a significant drop of glucagon levels after 1 year. There is no relationship between the extent of post-HSV gastrinemia and glucose or between the latter and glucagon. It can be assumed that HSV causes additional metabolic changes besides reducing acid production.

Adolescent↗
PubMed1980

Gastrinemia, serum minerals and calciotropic hormones following highly selective vagotomy in duodenal ulcer patients. Results of a 1-year study.

Duodenal ulcer patients with normal (n = 36) or increased (n = 24) gastric acid production during maximal pentagastrin stimulation, were examined preoperatively and at different intervals (up to 1 year) after highly selective vagotomy (HSV). Fasting levels of gastrin, parathormone, calcitonin, proteins, calcium and magnesium fractions, inorganic phosphate and alkaline phosphatase were determined in serum, those of glucagon in plasma. Both types of patients have the same gastrin levels preoperatively (approx. 36 pg-equiv./ml). Magnesium and alkaline phosphatase are significantly higher in patients with a normal secretory response than in those with hypersecretion. The postoperative gastrin increase is significantly higher in the former than in the latter, while postoperative glucagon levels drop in both groups. The analysis of calcium fractions and the dissociation constant did not show any HSV-mediated change in calcium metabolism. The magnesium levels, however, are lower one year after the operation than in the pre-operative period in patients with normosecretion. In this group parathormone and calcitonin remain unchanged while in patients with a hypersecretory response a slight (parathormone) or moderate (calcitonin) tendency towards low values can be recognized in the post-operative period. We conclude that the duodenal ulcer patients probably belong to groups with different pathophysiological behaviour which do not have identical reactions to HSV. Imbalances in the metabolism of minerals and that of related hormones could not be demonstrated up to one year after HSV.

Adult↗
PubMed1979

[Selective proximal vagotomy without drainage in uncomplicated duodenal ulcer. Technic and frequency of recurrence].

899 cases of slective promimal vagotomy were operated between 1974-1978 in the Surgical University Hospital Erlangen. The underlying disease was in all cases a chronical duodenal ulcer. The primary operative mortality was 0,6%. Intraopeatively measurements to control the sufficiency of the vagotomy Burge and Grassi proved to be necessary. We could verify by endoscopy a recurrence rate of 5,8-16,5% in the 1.-4. postoperative year. Only 58% of the recurrences could be found by x-ray investigations. 75-82% of the patients had a clinically perfect and good result. In patients with a proven recurrent ulcer there was nevertheless a good clinical result in 64%. Clinical results and complaints of the patients are therefore not sufficient as follow-up after selective proximal vagotomy and early detection of a recurrent ulcer. We believe, that one endoscopy per year is necessary.

Duodenal Ulcer↗
PubMed1979

[Surgical treatment of pulmonary metastases (author's transl)].

120 pulmonary metastases were resected in 67 patients. The five year survival rate is 42.3% after surgical removal and only 2.6% without surgery. Up to 4 resected pulmonary metastases have no influence on the prognosis. In cases with several metastases resection should be strictly limited. Lobectomy had the best five year survival rate (58%); wedge excision and pneumonectomy fared clearly worse (25% each). When the lung is the first filtre of haematogenous metastases the five year survival rate is better (48%) than when the liver filters first (18.5%). A prolonged interval before recurrence improves prognosis. Intervals of less than a year lead to survival after 4 years in only 14.5%, intervals of more than two years are accompanied by survival of 65%.

Humans↗
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

[Has the calculation of the rate of tumor growth clinical significance?].

In 142 circular lung foci of 78 patients we determined the tumor doubling times (13 bronchial carcinomas, 7 benign pulmonary tumors, and 122 pulmonary metastases). They fluctuated between + 12 and + 8,863 days of tumor growth and a diminuation of -1,810 days of half-life. 44% of all pulmonary metastases doubled their volumes within 60 to 250 days. During the observation period the times of tumor growth varied not only in different pulmonary metastases of the same patient, but also in solitary circular lung foci of the same person considerably. There is no connexion between tumor doubling time and histological tumor type as well as the interval between surgery of the primary tumor and occurrence of pulmonary metastases. Though we found in patients of 10 to 30 years of age only quickly growing pulmonary metastases with a tumor doubling time of less than 60 days a corrlation between time of tumor growth and age could not be proved. By the determination of the tumor doubling time neither binding statements on the nature of a circular lung focus can be made nor clinical consequences for diagnostics or therapy be drawn.

Adolescent↗
PubMed1978

[Fibrin glue protection of digestive anastomoses (author's transl)].

In animal experiments the additional sealing of colonic anastomoses using fibrin glue resulted in especially fast healing with formation of a delicate scar. Between April 1, 1976 and March 31, 1977, this method was used in 118 out of 355 patients undergoing extensive abdominal procedures. Suture line leakage was seven times less frequent than in the control group. This resulted in a considerable decrease of postoperative mortality.

Animals↗
PubMed1978

[Fibrin glue. A new treatment technic in persistent recurrent spontaneous pneumothorax].

The treatment of choice in idiopathic spontaneous pneumothorax is continuous suction drainage by chest tube for 8--10 days. If this method is not successful, i.e., in patients with a persistent or recurrent pneumothorax, an attempt can be made to produce local pleural adhesions by means of a special fibrin glue, especially in patients with poor general condition. This fibrin glue pleurodesis was performed successfully in seven patients, four of them having a persistent, two a recurrent, and one an iatrogenic pneumothorax. Six of them are now, 3--10 months after therapy, without a recurrence and free of discomfort. One patient died 6 days after treatment from a cerebral stroke. Autopsy showed fibrinous adhesions in the area of the upper lobe. Good tissue compatibility was confirmed histologically.

Adult↗
PubMed1977

[Proximal selective vagotomy: results of a prospective study (author's transl)].

In 728 patients operated on because of gastroduodenal ulcers there were early complications in 7.6% and a lethality of 0.13%. Primary drainage operation was performed in 9.5%, secondary drainage in 0.9%. One year after operation, reduction of BAO was 60% and of PAO 50%, in cases of recurrence only 35 and 30%. Postoperative recurrence of duodenal ulcer was seen in 3.1% after one year and in 5.5% after two years. Recurrence of gastric ulcer became apparent in 9.3% after one year and in 3.4% after two years. Reoperation for recurrence was performed in 1.3%.

Drainage↗
PubMed1977

[Physical possibilities for the prophylaxis of deep vein thrombosis (author's transl)].

The optimal physical prophylaxis for deep vein thrombosis is to ride a "bed bicycle" with elevated legs and elastic stockings, when lying in bed. The venous velocities achieved in legs and pelvis are 3--4 times faster than those evoked by walking, the method usually used. The incidence of thrombosis (125I fibrinogen test) up to the 5th postoperative day was 7.7%; in the control group, 38.5%. In patients who were weak, paralyzed, unconscious, relaxed, or with one leg, we obtained with "motor cycle" exercises the same success. The frequency of pulmonary embolism (autopsy findings) was reduced from 2.5 to 0.2%.

Blood Coagulation↗
PubMed1976

[Extirpation of metastases (author's transl)].

Seventy-two lung and 25 liver metastases were excised after radical local removal of the primary tumor. The 5-year survival rate was 41% and the 10-year survival rate 22% for patients in whom lung metastases had been excised. After the removal of liver metastases the 5-year and 10-year survival rates were 36% and 29% respectively. It is concluded that lung or liver metastases should be excised in certain defined cases. Pathologic fractures caused by bone metastases are stabilized by palliative internal fixation. In the cases of bone metastases, cure can only be expected when they are caused by hypernephroid and thyroid carcinomas.

Adenocarcinoma↗