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K Rückert

Publications and source records attributed to K Rückert.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Morphologic criteria of the growth behavior of pancreatic cancers. Experimental and clinico-pathologic studies].

In order to improve the individual characterization of ductal adenocarcinoma of the pancreas histologic and cytologic criteria of tumour differentiation were correlated with tumour growth. The most relevant parameters of grading were glandular differentiation, nuclear polymorphism and frequency of mitoses (number of mitoses per ten visual fields with magnification through the 40 objective). Using these criteria three grades of tumour (G) were separated. In 7 human adenocarcinomas of the pancreas transplanted onto nude mice GIII tumours showed a tumour replication time of approximately half of that of GI tumours. In an additional clinico-pathological study in 75 partial or total pancreas resection preparations with carcinoma of the head of the pancreas a significantly longer symptomatic time until diagnosis was found in GI tumours (n = 34) than in GII (n = 33) and GIII tumours (n = 8). Besides, GI tumours showed a generally lower staging at the time of operation than did GII and GIII tumours. The median values of postoperative survival time for GI (n = 12) and GII tumours (n = 12) with identical staging was 10.5 and 7 months, respectively. The results indicate that the suggested grading of ductal adenocarcinomas of the pancreas reflects the biological behaviour of these tumours and can thus be used as an additional prognostic parameter in staging.

Adult↗
PubMed1984

[Intraoperative sonography following endarterectomy of the carotid artery].

The application of intraoperative sonography during carotid endarterectomy will give additional information in vascular diseases, in control of vascular anastomoses in localization of residual arterioma, intima flaps and instrumental damage. Intraoperative sonography is a new device for the vascular surgeon, and should be used to reduce the risk of early restenosis after carotid endarterectomy.

Arteriosclerosis↗
PubMed1983

[Intraoperative ultrasound studies in pancreatic surgery].

In 32 patients with benign or malignant disease of the pancreas direct ultrasound imaging of the pancreas was performed during the operative procedure. Benign could be distinguished from malignant lesions on the basis of different ultrasound patterns, changes in the pancreatic duct and size of the organ. A further improvement in diagnostic accuracy was obtained by intraoperative staging with ultrasound-directed small-needle biopsy of that part of the pancreas which looked suspicious macroscopically and by ultrasound. Previously unknown tumour infiltration was also revealed by ultrasound imaging. Intraoperative ultrasound is a new helpful method for the surgeon. Since it is easy it should be used in all doubtful instances, even though the interpretation requires considerable experience.

Humans↗
PubMed1983

[Application possibilities of intraoperative sonography].

Preoperative ultrasound, CT-scanning, arteriography and endoscopic retrograde cholangiopancreaticography have improved the diagnostic approach to abdominal and vascular diseases. The correlation between preoperative imaging and intraoperative findings sometimes is difficult. In these cases intraoperative ultrasound can be helpful. The application of B-Scan-Realtime-Ultrasonography during surgery will give additional information on vascular diseases, control of vascular anastomoses, on intraoperative flow-measurement, localization of tumors in the liver and pancreas and on defining margins of resection. Intraoperative sonography is a new device for the surgeon, which should be used to control the site of abdominal tumors as well as vascular anastomoses.

Adult↗
PubMed1983

Islet-cell tumors: detection of small lesions with computed tomography and ultrasound.

Fifteen patients with a total of 16 islet-cell tumors 7-20 mm in diameter (average, 12 mm) were examined preoperatively by computed tomography (CT) and ultrasound. Seven out of 16 tumors were detected by CT and 9 out of 15 by ultrasound. Marked contrast enhancement was seen on dynamic CT scans following a bolus injection, while a circumscribed, hypoechoic mass was seen on ultrasound. Tumors of the tail of the pancreas and those outside the pancreas were difficult to detect. Ultrasound is recommended as the initial step for locating islet-cell tumors, followed by CT; angiography and transhepatic venous sampling should be restricted to tumors which are not detectable by other methods. Intraoperative ultrasound was successful in 3 patients and may facilitate the operative search.

Adenoma, Islet Cell↗
PubMed1983

[Intraoperative sonographic localization of insulinomas].

Intraoperative Real-time scanning of the pancreas is described as a method of localizing insulinomas. In 3 cases small but palpable insulinomas are demonstrated as well-defined, incapsulated, hypoechoeic structures in surrounding normal pancreatic tissue. The pancreatic duct and the splenic vessels can be differentiated in the neighbourhood of the tumour. Real-time, high resolution, intraoperative sonography of the pancreas is suggested as a simple adjunct to the methods of intraoperative localization of occult insulinomas.

Adenoma, Islet Cell↗
PubMed1983

[Microcystic pancreas adenoma].

The microcystic adenoma of the pancreas is a very rare benign pancreatic tumour. This tumour, which is usually large and grows slowly, results in displacement and compression of the adjacent organs. Angiography reveals hypervascularisation. The characteristic structure of the tumour can be recognized both in the sonogram and in the computer tomogram.

Aged↗
PubMed1982

[Solid-cystic acinar cell tumour of the pancreas (author's transl)].

A solid-cystic acinar cell tumour of the pancreas was found in four female patients. This particular form of benign pancreatic tumour is characteristically found in young women, often reaches a large size (2.5-10 cm), presents as a spherical mass in computed tomography or ultrasonography and does not show infiltrative growth or metastases. Tumours can be readily enucleated or resected. This type of tumour does not yet appear in the WHO classification of epithelial pancreatic tumours. It probably arises from the acinar cells. Accurate differentiation from previously known highly malignant acinar tumours is absolutely necessary on account of the good prognosis of this type of tumour.

Adenoma↗
PubMed1982

[Is "blind left-pancreatic resection" for insulinoma still indicated?].

One of the main problems encountered in the surgical treatment of insulinoma is that of locating them within the pancreas, since about 10% of these tumors are occult. Modern pre- and intraoperative methods of identifying of hormone-producing pancreatic tumors remove the need for 'blind resection'. Complete exploration of the pancreas, biopsy, intraoperative toluidin-blue-0 staining, glucose monitoring, and especially selective pancreatic venous blood sampling with insulin radioimmunoassay make it possible to locate nearly all tumors. Percutaneous transhepatic portal venography and selective portal blood sample collection for insulin analyses should be done routinely before planning a reintervention when organic hyperinsulinism persists.

Adenoma, Islet Cell↗
PubMed1981

[Carcinogenesis in the pancreas].

The pancreatic carcinogen DHPN (dihydroxypropylnitrosamin) was administered to Syrian golden hamsters. By intragastric administration more pancreatic carcinomas in the head of the gland were induced than by subcutaneous injections. After choledochojejunostomy the incidence of carcinomas was only 5--7% and the lesions were similar in multiplicity and distribution without relationship to the way of administration. The importance of biliary reflux in pancreatic tumor induction is discussed and the role of bile concerning the preferred localisation of the tumors in the head of the pancreas. After ligation of the main pancreatic duct in the splenic lobe, the incidence, location and type of proliferative lesions distal and proximal to the ligature were recorded and compared to those of DHPN-treated hamsters without duct ligation. Proliferative duct lesions, including carcinomas, developed on either side of the ligation. While after subcutaneous administration the incidence was similar to the in nonligated animals, a markedly decreased incidence was found in orally treated animals with duct ligation. The findings show that DHPN reaches the pancreatic duct cell via blood circulation. Furthermore, it is suggested that an unimpaired release of pancreatic juice in the duodenum is necessary for the enteral resorption of DHPN. Referring to clinical data and according to the results of these experiments the procedure of choice in pancreatic surgery is total pancreatectomy in case of the local operable malignant pancreatic tumor. Otherwise from the pancreatic remnant after Whipple's procedure pancreatic carcinoma may develop again from precancereous lesions.

Animals↗
PubMed1981

Solid and cystic acinar cell tumour of the pancreas. A tumour in young women with favourable prognosis.

The clinico-pathological features of five cases with a distinctive pancreatic tumour are presented. The tumours, which occurred only in young women and an adolescent girl, were of large size (2.5-10 cm), had an uncharacteristic symptomatology and showed fibrous encapsulation with no evidence of metastases. The histological features include (1) solid areas with a monomorphic cell pattern and intracellular PAS positive globules, and (2) large foci of degeneration with cystic necroses, haemorrhages and cholesterol granulomas. Some tumour cells were positive for alpha1-antitrypsin. The ultrastructural demonstration of zymogen-like granules suggests an acinar origin for the tumours. We therefore propose the term solid and cystic acinar cell tumour. This tumour resembles the so called pancreatoblastomas in small children in some respects. It must be clearly distinguished, on the other hand, from acinar cell carcinoma with its acinic structures and poor prognosis. This lesion is not included in the WHO classification of pancreatic neoplasms.

Adolescent↗
PubMed1981

[Localization of islet cell tumors using sonography, computed tomography, arteriography and selective transhepatic venous sampling for hormone assay (author's transl)].

Of 29 patients examined operation revealed a malignant tumor in 9 and a benign insulinoma in 18, 2 insulinomas were not found. The problems of preoperative tumor localization were limited to small insulinomas (size 7-35 mm). Ultrasound detected all of 3 insulinomas as low echogenic structures (size 7, 8, 17 mm). Computed tomography demonstrated 4 of 5 insulinomas (size 7, 8, 15, 17 mm) due to contrast enhancement following bolus injection. Arteriography localized 12 of 18 insulinomas preoperatively and 14 of 18 retrospectively. Selective transhepatic venous sampling for insulin assay identified 7 of 8 tumors. Real-time ultrasound and dynamic CT are promising in the diagnostics of insulinomas over 7 mm and should precede arteriography. Selective transhepatic venous sampling as the last diagnostic step is a major procedure and most specific, but not always without problems in interpretation.

Adenoma, Islet Cell↗
PubMed1981

Differences in experimental pancreatic carcinogenesis induced by oral or subcutaneous administration of 2,2'-dihydroxydi-n-propylnitrosamine in duct-ligated hamsters.

After ligation of the main pancreatic duct in the splenic lobe, Syrian golden hamsters were treated, either p.o. or s.c., for 15 weeks with dihydroxydi-n-propylnitrosamine for induction of pancreatic duct carcinomas. The incidence, location, and type of proliferative lesions distal and proximal to the ligature were recorded and compared to those of dihydroxydi-n-propylnitrosamine-treated hamsters without duct ligation. Proliferative duct lesions, including carcinomas, developed on either side of the ligation. While after s.c. administration the incidence was similar to that in nonligated animals, a markedly decreased incidence was found in p.o.-treated animals with duct ligation. The data suggest that the blood stream might be one major access route of the carcinogen to the pancreatic duct cell. Furthermore, it is assumed that an umimpaired release of pancreatic juice in the duodenum is necessary for the enteral resorption of dihydroxydi-n-propylnitrosamine.

Adenocarcinoma↗