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Biomedical subjects

M Clemens

Publications and source records attributed to M Clemens.

At least 19 recordsLinked to original sources
PubMed1979

[Relaparotomy or endoscopic surgery in complications after bile duct surgery].

The number of cases in bile duct surgery has continuously increased since second world war. Correcting operation is necessary in 5 to 7% after cholecystectomy. Since 1973 more and more the endoscopic treatment takes place of surgery. Typical complications can be divided into two groups belonging to their manifestation. Early complications are due to an insufficient intraoperative diagnosis or injuries of bile tract. Late complications comprehend successive development of duct stenosis and cholangitis. The therapeutic possibilities of endoscopic papillotomy are directed only to the papilla and near-by sections of the choledochus, while surgical treatment is due to the more difficult performance of iatrogenic lesions. The indications to each method are shown and discussed by 138 surgical and 714 endoscopic treatments.

Biliary Tract Diseases↗
PubMed1979

[Acute pancreatitis in animal experiments - a new method].

Acute pancreatitis was induced in 30 minipigs (Göttingen) by implantation of a T-drain into the Ductus Wirsungianus. The distal part of the T-drain, which led into the duodenum was stenosed to 1/3 of the original diameter. The inflammation was caused by stenosis of the Ductus Wirsungianus additionally by application of contrast medium. The course of the inflammation was demonstrated by biochemical, roentgenological and histological examinations.

Acute Disease↗
PubMed1979

[Echinococcus cysticus (author's transl)].

Echinococcus cysticus is a parasite; the human organism is invaded by cysticercus of the dog tape worm. In liver 60% of all viable embryos are retained, 30% in the lung, the last 10% spread via the arterial system into all other organs. Diagnosis can be established by serology, sonography, scintigraphy as well as invasive and non-invasive radiological examinations. Case reports of 20 patients with Echinococcus cysticus are given; the disease was localized 16 times in the liver, 3 times in the lung and once in the spleen. Drugs or x-ray treatment have no sufficient therapeutical effect. Trivial trauma can cause rupture of the cysts; therefore surgery is indicated.

Adult↗
PubMed1979

[Experimentally induced pancreatitis (author's transl)].

Pancreatitis was produced in 29 mini-pigs by partial occlusion of the pancreatic duct; occlusion was performed by implanting a T-drain into the duct. Inflammatory changes were induced additionally by applying radiopaque material in excess. Acute and chronic pancreatitic lesions could be diagnosed by X-ray examination, evaluation of blood chemistry and by histology.

Amylases↗
PubMed1979

[Surgery in patients with obstructive jaundice caused by carcinoma (author's transl)].

Malignant disease obstructing the bile ducts is diagnosed in most cases at a time, when radical surgery is not possibly any more. Diagnostic procedures applied up to now are not suited for early diagnosis. 5 years survival rates of patients with carcinoma of the bile ducts are maximally 6%, in patients with carcinoma of the papilla 36%. In the Department of Surgery of the Münster University, 126 such patients have been treated in the recent time; in 104 cases jaundice was apparent clinically. Radical pancreatoduodenectomy could be done only in 24 patients.

Adult↗
PubMed1978

[Replacement of the common bile duct by an autologous vein (author's transl)].

3 cm of the common bile duct was removed in 19 dogs and the defect was bridged by an autologous vein. The interposition of a vein graft was performed with a double end-to-end anastomosis. In four cases a T-drain was additionally placed into the transplant. GOT, GPT, LDH, AP and bilirubin were tested in regular intervals. The patency of the transplant was proved by radiography with dogs which survived longer than 6 weeks. 5 dogs died within the first 4 weeks, 4 were killed after 2 months, because of incrustation of the T-drain for a regular percutaneous rinsing of the drainage was not possible. 10 dogs survived for 6 to 12 months. These animals showed increasing laboratory results up to two months, then the tests normalized. The function of the transplanted vein was without complication and the liver histology did not show any pathological alteration. After two months the transplanted vein was bridged by bile duct epithelium.

Alanine Transaminase↗
PubMed1978

Endoscopic retrograde cholangiography (ERC) in surgical emergencies.

Twelve patients, presenting with an acute abdomen of suspected biliary tract origin, had endoscopic retrograde cholangiography performed. Eight patients had either traumatic, spontaneous, or postoperative biliary tract fistulas with five leading to the peritoneal cavity, one to the colon, one to the bronchial tree, and one to the liver parenchyma from a ruptured gall-bladder. Each was confirmed by endoscopic retrograde cholangiography. Four patients with jaundice, following traumatic rupture of the liver, had a pathological communication between the intrahepatic biliary tracts and the hepatic vascular system. It is concluded that ERC is a reliable method for obtaining precise localization of biliary tract problems in surgical emergencies both pre- and post-operatively.

Adolescent↗
PubMed1978

[The multiple stomach carcinoid].

Carcinoid tumors can be found in the entire alimentary tract. Stomach carcinoids make up about 3% of all carcinoids; 0.39% of all stomach tumors are carcinoids. Multiple stomach carcinoid is a medical rarity. In spite of an invasive growth, carcinoids with a diameter of less than 1 cm are considered semimalignant, those with a diameter of more than 1 cm are considered sure malignant. There are 8 cases of multiple gastric carcinoids described in the literature. In our case we found macroscopically 31 polyps with a diameter of between 0.4 and 2 cm in the stomach. Histologically they were growing invasively with small tumor groups in the lymph ducts. Therapeutically total gastrectomy was necessary.

Carcinoid Tumor↗