Sequential tests for survival data of breast cancer patients.
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Biomedical subjects
Publications and source records attributed to H D Klein.
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In conscious fullgrown minipigs simple SPV alone, SPV and pyloric stenosis and SPV and pyloroplasty were performed. After a liquid test meal the motoric and secretory function of the stomach were examined simultaneously by a modified method of intestinal perfusion and aspiration. After simple SPV initially a marked decrease of gastric volume and normal emptying into the duodenum were found. With additional pyloric stenosis no significant change was found. The pyloroplasty lead to an increase of gastric volume and delayed emptying. The acid secretion after feeding reduced by SPV was not changed significantly neither by pyloroplasty nor by pyloric stenosis. The baseline values of serum gastrin were elevated after SPV as well as after SPV in combination with pyloric stenosis or pyloroplasty. After food stimulation there was a delayed increase of gastrin after SPV which differed from that after SPV with pyloric stenosis or pyloroplasty only during the first hour. These results show that after SPV no further improvement of the motoric and secretory function can be achieved by an additional pyloroplasty. Furthermore these findings permit the conclusion that even after SPV with additional artificial pyloric stenosis no delayed gastric emptying occurs and that there is no negative effect postoperatively on the acid secretion and gastrin production.
The design of a modified Thomas canula is described. It's possible applications for investigation of exocrine pancreatic function and gastric secretion as well as gastric emptying in minipigs are discussed. The advantages of this modified canula are that it can be simply manufactured, that it is well tolerated by the tissue and that there is no risk for the animal and no need for the construction of a pouch.
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The results of selective proximal vagotomy and pyloroplasty for duodenal and gastric ulcer in 464 patients over the last 5 years were evaluated in 438 cases. More than 75% of the patients were observed for 2 years after the operation. More than 25% were emergency cases, the incidence of intraoperative complications like splenic lesions or perforation of the esophagus was 3.2%. Postoperative complications like leakage of the pyloroplasty, peritonitis, hemorrhage from the pyloroplasty or disruption of the laparotomy closure occurred in 14,4%. The overall mortality was 4.6%, the elective mortality 1.6%. Recurrent ulcers were seen after 1/2-2 1/4 years with an overall rate of 3.2%. Over half of these cases required relaparotomy. In 5.3% relaparotomy had to be done for peritonitis, GI-bleeding, bleeding from the lesser curvature of the stomach, ileus or carcinoma. The Pentagastrin stimulated gastric secretion remained constantly reduced for more then 2 years in over 60%. Following the Visick-grading system the results were good in 61-65% of the patients and bad in 16-22% depending on the time of observation.
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