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Biomedical subjects

M Neher

Publications and source records attributed to M Neher.

At least 55 records · Page 3Linked to original sources
PubMed1977

[Pathology, clinical appearance and therapy of Ménétrier's disease (author's transl)].

Clinical pathology of Ménétrier's disease is reviewed and 3 own cases are presented. All symptoms are unspecific exception made for the enteral protein loss. Roentgenologic and endoscopic appearance contribute to the diagnostic but only histologic examination is decisive. Gastrointestinal bleeding, acute pyloric stenosis, profuse albumin loss are all clear indications for an operation, but also the possibility of malignancy should be kept in mind. Resection should include all abnormal parts of the stomach. Recurrency of the Ménétrier's disease is only known after incomplete resection.

Adult↗
PubMed1977

[Postoperative alkaline reflux gastritis (author's transl)].

Postoperative alkaline reflux gastritis is a distinct clinical entity occuring after operations enlarging, bypassing or resecting the pylorus. Reflux of alkaline duodenal content into the stomach is the causative factor. Primarily bile acids have an aggressive effect and lead to a destruction of the gastric mucosal barrier. Epigastric pain, fullness after meals and bile vomiting are the main symptoms. Gastroscopy with biopsy reveals a severe chronic atrophic gastritis and bile reflux. In most cases an achlorhydria that can be histamin-resistant is present. For adequate treatment surgical procedures diverting the bile flow from the stomach should be performed.

Achlorhydria↗
PubMed1977

[Results of resection treatment of chronic pancreatitis (author's transl)].

A total of 201 patients with chronic pancreatitis were treated surgically between 1964 and 1975. In 116 cases (57,7%) resection was done at operation: 44 partial and 18 total duodenopancreatectomies, 37 partial and 17 subtotal left pancreatic resections. The mortality rate of the operation was 12.9%. The late mortality was 9.4% based on an average observation period of 2 7/12 years. Three quarters of the patients became completely asymptomatic. Preoperative diabetes was observed in 21% rising to 38% postoperatively. Satisfactory long-term results were mainly seen after partial duodeno-pancreatectomy and subtotal left resection. However, continued alcohol abuse limits the success rate.

Adult↗
PubMed1977

[Acute pancreatitis--the current state of surgical treatment].

In the beginning of this century the "early operation" in acute pancreatitis was widely used. The irreversibility of the local necrosis and the failure of conservative treatment again lead to the application of this procedure. Early operation is indicated when the pancreatitis shows a more severe degree and when there is no success on conservative therapy or even deterioration in the patient's condition. Early operation means digital removal of the necrosis and/or resection of the pancreas, procedures on the biliary tract, methods for suppression of the secretory activity and installation of jejunal fistulas for external feeding. The mortality rate of partial necrotizing pancreatitis was lowered by this means. In case of total necrosis the mortality was still about 100%. In the postacute stage complications such as sequestration, abscess formation, sepsis, hemorrhage, fistulas can arise. In some of these complications only a "delayed operation" is successful. If a biliary acute pancreatitis was not early and definitively treated, the causative diseases of the biliary tract have to be cured in the postacute stage.

Acute Disease↗
PubMed1977

[Treatment of chronic recurrent necrotic pancreatitis].

22 out of 180 patients with chronic relapsing pancreatitis showed an acute hemorrhagic-necrotizing exacerbation. in 11 out of these there was an indication for operative management of the chronic pancreatitis before onset of the acute exacerbation. The clinical picture is similar to that of the acute hemorrhagic-necrotizing pancreatitis. The surgical procedure consisted in digital removal of necrotic tissue and left-sided resection. 13 out of the 22 patients survived.

Acute Disease↗
PubMed1977

[Delayed surgery in acute pancreatitis].

In 32 patients with acute pancreatitis, delayed operation was performed between 13 and 44 days after onset of the illness. The indications for the operation were development of a palpable mass together with clinical deterioation and other complications. In all patients we found a necrotizing pancreatitis and/or abscesses of the pancreas. The surgical procedure consisted of digital removal of necrotic tissue (sequestrotomy) and/or abscess incision in 20 patients, of left-sided resection in 11 patients and partial duodenopancreatectomy in 1 patient. Twenty-three patients survived, 9 died.

Acute Disease↗
PubMed1976

[Early operation in acute hemorrhagic necrotizing pancreatitis].

Between 1973 and 1975, the "early" operation was carried out in 15 patients suffering from acute haemorrhagic-necrotizing pancreatitis to eliminate necrotic parts. Partially necrotizing pancreatitis was identified in 10 patients: 7 survived. All patients with total pancreatic necrosis died. Surgery consisted of digital removal of the necrosis (digitoclasia) and in left resection with adequate drainage. Patients with partially necrotizing acute pancreatitis can be saved by "early" surgery while in patients with total necrosis surgery must be undertaken even earlier, namely before fatal complications set in.

Acute Disease↗
PubMed1976

[Recto-vaginal fistulae: causes, treatment, results (author's transl)].

Among recto-vaginal fistulae in 41 patients 22 were due to radiotherapy, 6 to inflammatory disease, 4 occurred as a postoperative complication and 9 were carcinomatous fistulous tracts. Passage of stool or air per vaginam is a pathognomonic sign. The fistula can usually be diagnosed by routine gynaecological examination. Barium enema, barium meal with follow-through or colpography often demonstrate the fistula. Except for a few cases in which the fistula closes spontaneously (most frequently those which occur postoperatively), treatment is surgical. Intestinal resection is often necessary in the inflammatory fistulae and those after radiotherapy. In fistulae due to carcinoma colostomy will improve symptoms: radical removal of the tumour is rarely possible. 31 of the 44 women are cured, while in two a fistula has persisted.

Adolescent↗
PubMed1976

[Massive gastrointestinal hemorrhage following internal drainage of pancreatic pseudocysts].

In operative treatment of pancreatic pseudocysts by inner drainage there is a risk of massive gastrointestinal bleeding particularly following an anastomosis to the stomach. In 10 patients in whom cystogastrostomy or cystoduodenostomy had been performed elsewhere a second laparotomy was necessary because of acute bleeding. In one patient a cystadenoma of the pancreas had been anastomosed to the duodenum by mistake at the previous operation. The leak of obliteration of the cyst is suggested to be the most important factor in the pathophysiology of bleeding. Inner pseudocyst drainage in a disconnected small bowel loop therefore principally should be performed at the lowest point of the cyst. The indication for an inner cyst drainage, however, must be closely examined since simultaneous pathologic changes in the pancreas often justify a resection to remove the origin of the cyst and, further, averting the complications of an inadequate inner pancreatic cyst drainage.

Adult↗
PubMed1976

[Stimulation and differentiation of lymphocytes after injuries].

In seven patients who underwent major trauma, stimulation of lymphocytes with phytohaemagglutinin, pokeweed mitogen, and concanavalin A was investigated. Furthermore the differentiation of lymphocytes into T- and B-cells was studied. The synthesis rates of DNA (3H-thymidine incorporation) and RNA (3H-uridine incorporation) are qualitatively depressed at different time intervals. The T- and B-cell relation is altered in favor of the B-lymphocytes.

B-Lymphocytes↗
PubMed1976

[Immunopathological genesis of pancreatitides].

Antinuclear factors in serum were determined in 37 patients with acute and 50 with chronic pancreatitis. Of the 5 with acute pancreatitis of unknown etiology, 4 had serum antinuclear factors in high titers; of the 16 with chronic pancreatitis of unknown etiology, 10 had serum antinuclear factors in high titers and 4 in low titers.

Acute Disease↗
PubMed1975

[Early operation in acute haemorrhagic-necotizing pancreatitis. (author transl)].

Between 1973 and 1975, "early" operation with removal of necrotic tissue was performed on 15 patients with acute haemorrhagic-necrotizing pancreatitis. Partial necrotizing pancreatitis was found in ten patients, of whom seven survived. But all patients with total pancreatic necrosis died. Two early operations in patients with a necrotizing bout in the course of chronic recurrent pancreatitis were successful. The surgical procedure consisted of digital removal of necrotic tissue (greater than digitoclasia less than) and left-sided resection, combined with adequate drainage. Patients with acute, partial necrotizing pancreatitis can be saved by early operation, while those with total necrosis would require almost immediate surgical intervention, before the onset of lethal complications.

Acute Disease↗
PubMed1975

[Vesico-intestinal fistulae].

Vesico-intestinal fistulae were observed in 14 patients within a period of 10 years (vesico-colonic: ten; vesico-rectal: two; vesico-ileal and vesico-rectal-ileal: one each). The causes were diverticulitis in five, carcinoma of the sigmoid in two, radiation damage after prostatic or cervical carcinoma in two, and Crohn's disease, abscess of Douglas's pouch after perforated appendicitis, ileal carcinoma, sarcoma of the pelvis, and ovarian carcinoma, one each. Pneumaturia, faecaluria and dysuria were the most frequent symptoms, treatment-resistant cystitis was present in three. Cystoscopy, intravenous pyelogram, retrograde cystogram, barium meal, barium swallow with follow-through, and rectosigmoidoscopy proved to be the best methods of diagnosis. Four patients had multiple operations, three one operation, with a cure in all. In the neoplastic fistulae the underlying carcinoma could not be radically operated on: colostomy or colostomy with palliative resection was performed. In four of these the fistulae then closed, once it remained open. One woman with a vesicorectal fistula due to ovarian carcinoma died of tumor cachexia 16 days after a colostomy had been made.

Abscess↗
PubMed1975

[Parathyroid carcinoma (author's transl)].

Carcinoma of the parathyroid glands is a rare disease which occurs only in 0.5 to 4 percent as the cause of a primary hyperparathyroidism. One third of the tumors are hormonally inactive. A review of the diagnosis, course and possibilities of treatment of this disease is given with reference to the literature. Observations of 2 cases show the special problems of diagnosis and simple possibilities for the satisfactory treatment of small tumors. Followup examinations of both patients after a year showed no evidence of a relapse.

Adult↗