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Biomedical subjects

M Neher

Publications and source records attributed to M Neher.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Necrotising pancreatitis after ultrasonically guided fine-needle aspiration biopsy].

Complications after transcutaneous ultrasonically-guided fine-needle aspiration biopsy of the pancreas are exceedingly rare, although published reports mention transitory changes in pancreatic enzymes. Acute necrotising pancreatitis has not previously been reported. It developed in a 40-year-old woman after out-patient fine-needle biopsy because of a space-occupying lesion in the head of the pancreas. Immediate conservative treatment favourably affected the course of the disease, as documented by serial ultrasound and computer tomography. This serious complication suggests that strictest indications for this procedure must be used, together with careful technique of biopsy and strict observation of the patient, if necessary with a brief period of hospitalisation.

Acute Disease↗
PubMed1982

[The influence of sonography and computer tomography on the operative treatment of acute pancreatitis (author's transl)].

Adequate stage-depending therapy of acute pancreatitis includes basic conservative treatment, intensive care measurements, and operative interventions depending on the grade of severity. Prerequisites are early diagnosis and accurate clinical assessment of the stage of severity. Beside clinical and laboratory findings, as well as the development of acute pancreatitis under conservative treatment, sonography and computed tomography allow a better prediction of the underlying morphological changes, thus leading to an exact staging of the patient's individual situation. Sonography is regarded a screening procedure of high accuracy in mild forms of acute pancreatitis. Computed tomography is the method of choice in all severe forms of this disease. The indication for immediate or delayed operative treatment of hemorrhagic-necrotising pancreatitis, heretofore depending on clinical findings solely, is supported by these new-invasive diagnostic modalities.

Acute Disease↗
PubMed1981

Serum DNase activity after experimental, acute hemorrhagic-necrotizing pancreatitis in dogs: detection of a serum DNase isoenzyme.

The activity of a neutral serum DNase has been determined in dogs before and after experimental, acute hemorrhagic-necrotizing pancreatitis. Dog serum DNase corresponds in its conditions of activity and in its isoelectric point with the DNase I. Electrophoretically three DNase isoenzymes can be distinguished. 30 min after induction, an increase of DNase activity was observed. This activity increase is related to only one of the three DNase isoenzymes. After induction a DNase with an isoelectric point of 5.6 occurs. This enzyme is not found in healthy animals.

Acute Disease↗
PubMed1979

[Long-term results after operative treatment of acute haemorrhagic necrotising pancreatitis (author's transl)].

A follow-up investigation of 20 patients, surgically treated for acute haemorrhagic necrotising pancreatitis, was performed in an average of 2 3/4 years after the operation. Twelve patients showed manifest diabetes mellitus, four further cases had a suspicious oral glucose tolerance test. Only one patient was insulin dependent. A secretin-pancreozymin test performed in 15 patients showed a dissociated or global pancreatic insufficiency in 13 cases. The extent of the endocrine and exocrine functional disturbance did not correlate with the extent of surgery. Postoperative functional defects were readily improved therapeutically in most cases. Only in patients who continued to consume alcohol were there digestive disturbances. The results indicate that the functional state of the remaining pancreas does not only depend on the extent of surgery but also on the extent of already existing or persisting toxic inflammatory damage and on the regenerative capacity of the remaining parenchyma.

Acute Disease↗
PubMed1979

[Indication of delayed surgery in the postacute phase of hemorrhagic necrotizing pancreatitis].

In acute hemorrhagic-necrotizing pancreatitis partial necrosis with good response to conservative therapy can be differentiated from extensive necrosis with no response to conservative therapy. In case of surviving the acute phase sequester and abscess are often to be seen in the "postacute phase", after 10-14 days. The indications for the "delayed operation" in this postacute phase are development of a palpable mass together with clinical deterioration and other complications. The surgical procedure consists of digital removal of necrotic tissue (sequestrotomy), abscess incision and resection. Since 1971 84 of 93 patients with a postacute pancreatitis were operated, two third survived.

Acute Disease↗
PubMed1978

[Gastrointestinal complications of acute pancreatitis (author's transl)].

Gastrointestinal complications, such as ileus, bleeding, stenosis and fistula formation, were retrospectively analysed on 180 patients with acute pancreatitis. Paralytic ileus occurred in only a quarter of patients with acute oedematous pancreatitis and only one had bleeding from a gastric ulcer. Complications occurred in the early but also postacute stage in patients with the haemorrhagic-necrotizing form. Even with early and delayed operation and adequate treatment of most complications, renewed gastrointestinal complications were not uncommon and required re-operations.

Acute Disease↗
PubMed1978

[Differential therapy of vesico-intestinal fistulas].

40 patients with vesico-intestinal fistulas (50% inflammatory, 30% traumatic, 20% neoplastic) were treated within 10 years. Closure was achieved in 97% of 31 patients operated on with curative intention. The remaining 9 patients had palliative surgery, i.e. colostomy or cystostomy. The decision single- or multiple-stage procedure depends upon the etiology, localization and extent of the fistula.

Colostomy↗
PubMed1977

[Causes and treatment of jaundice associated with inflammatory pancreatic disease (author's transl)].

Jaundice or biliary stasis occurred in 32 of 82 patients with acute and 58 of 152 patients with chronic pancreatitis. A biliary cause was present in only 12 patients with acute and 19 with chronic pancreatitis. In the case of mild acute pancreatitis the cause of the jaundice lay in oedema of the head of the pancreas, while in the severe forms there was necrosis of the head. In chronic pancreatitis the jaundice is caused by tube-like, long stenosis of the choledochal duct or its compression by a cyst within the head of the pancreas. In acute pancreatitis treatment depends on the severity of the inflammation; in the biliary form the biliary tracts are attended to. In chronic pancreatitis resection of the head of the pancreas is preferred, biliodigestive anastomosis being practised if there is likely to be poor cooperation by the patient.

Acute Disease↗