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Biomedical subjects

H D Saeger

Publications and source records attributed to H D Saeger.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Peripheral vein requirement-adjusted parenteral feeding: renaissance of maltose?].

A requirement-adapted peripheral-venous parenteral nutrition was developed by exchanging the conventional carbohydrates like glucose, etc., for disaccharide maltose in combination with a fat emulsion (650 mosm/l; 2,000 kcal). In a clinical randomised study, we compared this nutrition regimen with a common requirement-adapted parenteral nutrition regimen, which was applicated by central-venous catheter (2,000 mosm/l; 2,000 kcal). All results, including the results of tracer-investigations with the strable isotope 13C-leucine, showed no metabolic difference between these two nutrition regimens.

Blood Glucose↗
PubMed1987

[Results of surgical therapy of esophageal cancer].

Between 1973 and 1986, 141 patients with esophageal carcinoma have been operated. The overall resection rate was 59% (83/141). We preferred the operative resection by abdominal and right-sided thoracic approach. Only in 4 patients with generally high risk an abdomino-cervical blind dissection of the esophagus was performed. Reconstruction was done in all cases by oesophago-gastrostomy. During the last 14 years hospital mortality decreased from 36.4% (n = 8/22) in the first 7 years period to 7% (n = 3/43) during the last 4 years. Resection rate increased from 47% in the first to 65% in the second period. The 5 years survival rate of all resected patients was 23.5%.

Adenocarcinoma↗
PubMed1987

[Continent proctocolectomy--difficulties caused by previous operation].

Since 1981 23 Patients (19 with adenomatosis coli, 4 with colitis ulcerosa) underwent proctocolectomy with preservation of continence: total colectomy, proctomucosectomy, ileo-anal anastomosis with formation of an ileal S-pouch, and protective loop ileostomy. In 3 patients previous operations caused difficulties in performing the procedure. Critical points of the operative technique are explained, with special regard to the possibility of previous surgery. Postoperative complications and functional results are presented.

Adenomatous Polyposis Coli↗
PubMed1986

[Computed tomographic study of portal venous contrast medium perfusion of the liver].

Contrast medium was injected in the portal vein at a low flow rate via a transumbilical catheter in twelve patients. The distribution of the contrast medium in the liver was investigated by computed tomography. The results of this study demonstrate an incomplete mixture of splenic and mesenteric venous blood in the portal vein. In addition, there is layering of the contrast medium and blood in the portal vein, causing inhomogeneous contrast medium perfusion of the liver.

Aged↗
PubMed1986

[Amino acid uptake and release by colorectal cancer in man].

Little information is available regarding the amino acid exchange by human tumors. To characterize this exchange in vivo, 21 patients with resectable colorectal carcinomas were studied during curative operations. Concerning the amino acid uptake and release by peripheral tissues, 20 non-cancer patients served as controls. Both groups of subjects were well-nourished, as indicated by anthropometric and biochemical variables. In the cancer patients, we cannulated a peripheral artery and vein as well as a central tumor-draining vein and the portal vein. Plasma concentrations and concentration differences were determined in mumol/l and in percentages of the total amino acid amounts. Peripheral glutamate uptake per liter plasma was reduced in the cancer patients (p = 0.02). In these patients, the central tumor-draining vein contained less glutamine (p = 0.002) and more glutamate (p = 0.002) than the peripheral vein. Glutamine uptake by the tumor occurred more often than glutamine release, while glutamate had a negative balance across the tumor in all but three cases. The qualitative differences between the peripheral tissues and the tumors with respect to glutamine and glutamate exchange reached high levels of significance (p = 0.002 for both of the amino acids). In addition, the tumors released more glycine, ornithine, and tyrosine than the periphery. As to glutamine and glutamate metabolism, there was a significant difference between the tumors and the portal-drained organs (p greater than or equal to 0.05). The discussion of the results emphasizes the contributions made by the periphery and the tumor to the plasma amino pattern. The role of glutamine as a potential high importance energy source for neoplastic tissues is delineated.

Aged↗
PubMed1985

[Experiences with ileoanal anastomosis and ileal pouch formation following colectomy and proctomucosectomy].

Since 1981 12 patients (11 adenomatosis coli = AC/1 ulcerative colitis = CU) had a colectomy and mucosal proctectomy with ileo-anal anastomosis (IA) and formation of an ileal-S-pouch (IP). The mean age of 7 men and 5 women was 33 years (21-46 yrs). We preferred the synchronous abdomino-peranal operation. Protective ileostomy was closed after a mean of 4.6 months in 11 patients. Postoperative complications: IA-insufficiency = 4, sacral abscess = 1, stenosis = 3, ileus and reoperation = 2). Late results: spontaneous defecation: 11/11, continence 10/11, evacuation 6-8/day. This operative procedure seems to be good for AC and CU.

Adult↗
PubMed1983

[Preoperative intra-arterial digital subtraction angiography in aortoiliac vascular occlusion].

Sixteen patients with advanced aorto-iliac occlusive disease were examined with digital subtraction angiography (DSA) using intraarterial injection of contrast medium. The preoperative evaluation of the vessels distal to the occlusion and the visualization of the femoral and popliteal arteries were successfully performed with intraarterial DSA. As compared to conventional angiography the marked contrast enhancement of DSA is demonstrated. Less spatial resolution of DSA lacks importance as the herein discussed topic is concerned. The limited size (23 cm) of the image intensifier of the X-ray equipment used was a major drawback of the method. Using intravenous DSA aorto-iliac occlusion can be shown. In patients with long range vascular occlusion and sparse development of collaterals only intraarterial DSA can demonstrate the run-off vessels including the trifurcation of the popliteal artery.

Aorta, Abdominal↗
PubMed1982

[Comparative treatment of gastroduodenal haemorrhage with secretin and cimetidine].

In a prospective multicenter study 71 patients with acute, non-arterial gastroduodenal haemorrhage from ulcers or stress lesions were treated alternately with synthetic secretin (Hoe 0690 (n = 35) or with cimetidine (n = 36). Both medications were given by infusion over 48 hours. Prior to commencement of treatment the haemorrhage was verified gastroscopically. During infusion of secretin cessation of hemorrhage was achieved without recurrence in 30 out of the 35 patients within the 48-hour infusion time and in 3 patients with recurrence within the same period. Two patients failed to obtain discontinuation of haemorrhage within the infusion period. Cimetidine led to cessation of haemorrhage without recurrence within 48 hours in 20 out of 3 patients, 3 patients had recurrences. Haemorrhages could not be arrested in 13 patients within the two-day treatment period. Differences between success of treatment among the two groups are significant (P less than 0.01) favouring secretin.

Adult↗
PubMed1982

[Radiologic differential diagnosis of adrenal gland cysts].

Cystic diseases of the adrenal glands, which were thought to be rare, are being found more frequently nowadays by means of sonography and computer tomography. Our experience of fifteen cases is reported; of these, ten were confirmed at operation. Contrary to expectations based on the relevant literature, only one of the operated cases proved to be an endothelial cyst of lymphangiomatous origin. All other patients had pseudo-cysts of the adrenals. These are due to bleeding into a normal or tumour-containing gland. About one quarter of the pseudo cysts showed circular calcification on the plain films, although the incidence of this is given as 8-15% in the literature. The cystic nature of these lesions can be readily demonstrated by ultrasound or CT. The latter also provided information concerning the wall of the cyst and of the remaining adrenal tissue. An aspiration biopsy of the cyst can be carried out under ultrasound or CT control; cytological examination will confirm the benign nature of the lesion. A benign lesion without symptoms requires no further diagnostic or therapeutic measures. If there is hypertension, as may occur with a cystic phäeochromocytoma or lymphangioma, angiography is still indicated. Hormone assays are possible following catheterisation of the vena cava combined with adrenal phlebography. The origin and extent of a malignant pseudo-cyst can be demonstrated by arteriography, if this information is lacking following CT.

Adrenal Gland Diseases↗
PubMed1981

[Primary duodenal tumors].

Duodenal tumors are rare. The symptoms are mostly uncharacteristic upper abdominal pain or chronic anemia on account of occult blood loss. Tumors of mesenchymal or neurogenic origin may lead to dangerous bleeding from ulceration of the mucosa. Malignant tumors of the duodenum are often histologically adenocarcinomas and should be treated by partial or total pancreatectomy. If located below the papilla or at the duodenojejunal flexure, sometimes partial duodenal resection with end-to-end anastomosis may be performed. Benign tumors should be removed by local excision. In cases of duodenal malignancy, early detection and radical resection should help to increase the survival rate of the patients.

Adenocarcinoma↗
PubMed1980

Lack of correlation between carcinoembryonic antigen content of tumor extracts and leukocyte migration reactivity of tumor patients.

Tumor extracts varying in carcinoembryonic antigen (CEA) content (0.4--2,280 ng/mg protein) did not affect the reactivity of cancer patients' leukocytes in the leukocyte migration inhibition test (LMIT). In addition, variations in the plasma CEA levels of tumor-bearing leukocyte donors did not influence the frequency of significant LMIT reactivity.

Adenocarcinoma↗
PubMed1980

[Postoperative metabolism--differences between pre- and postoperative start of total parenteral nutrition (author's transl)].

We investigated the postoperative metabolism of patients undergoing gastric operation by beginning total parenteral nutrition pre- (group 1) and postoperatively (group 2). A third group remained fasting until 3 h after the surgical intervention. Because of the high serum glucose concentrations and the high glucose losses in the 24-h-urine on the operation day in group 1 and 2 only the basic glucose requirement (150--250 mg/24h) should be given in the early postoperative period. The low blood glucose concentration in group 3 and the elevated lactate values in group 2 underline this recommendation. Compared with group 2 and 3 group 1 had low free fatty acid concentrations of 250 muVal/l because of the continuous pre-, intra-, and postoperative infusion. Compared with normal metabolic conditions the free fatty acids don't seem to have the same insulinantagonising effect in the posttraumatic state. The fall of cholesterol after the surgical trauma reached its maximum after 12--15 h and amounted to about 40mg% in the first two groups. Albumin and total protein fell continuously in group 1 and 2. The electrophoresis in group 1 showed a rise of alpha 1-, and alpha 2-globulin to more than double the initial value, the beta-globulin showed only slight changes, the gamma-globulin dropped only slightly up to the 4th postoperative day. As a sign of an augmented catabolism the serum urea concentration rose during the postoperative state. Group 1 and 2 had a favourable nitrogen balance. The postoperative bilirubin rise could be held lower in group 1 compared to group 2.

Bilirubin↗