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Biomedical subjects

P Merkle

Publications and source records attributed to P Merkle.

At least 19 recordsLinked to original sources
PubMed1991

[Strategy in acute abdomen].

The most important measure in assessing the acute abdomen is the selection of the patients requiring urgent operation. Hitherto, the patient's history and careful physical examination by an experienced surgeon have formed the basis for decision making and management. Provided adequate experience is available, ultrasonography is considered helpful in certain cases. Special laboratory tests and extensive equipment-related measures should be applied only following specific questioning.

Abdomen, Acute↗
PubMed1990

[Differential diagnosis of spontaneous pneumothorax--pulmonary lymphangioleiomyomatosis. Clinical aspects, diagnosis and therapy].

As a case report, lymphangioleiomyomatosis is presented--a rare disease that only affects women and up to now with a poor prognosis. It results from a tumorlike proliferation of smooth muscle in the thoracic and retroperitoneal lymphatics. Prominent clinical findings are dyspnea, spontaneous pneumothorax, chylous pleural effusions and chylous ascites. The diagnosis results from typical chest X-rays and is established by open lung biopsy. Treatment should primarily start with medroxyprogesteronacetat (respectively tamoxifen), if necessary with consideration of the hormonal receptors. In an early stage the oophorectomy can be helpful. Surgical intervention is necessary in complications (thoracic drainage, pleurectomy for recurrent pneumothorax, Le Veen-shunt for chylous ascites). If hormonal therapy is not successful, a combined heart and lung transplantation should be attempted in ultima ratio.

Adult↗
PubMed1988

[Proctomucosectomy and colo-anal anastomosis in rectovaginal fistula following the use of suppositories containing ergotamine].

We observed a rectovaginal fistula in 2 patients who had applied ergotamine suppositories against migraine headaches. The local effect of ergotamine on the rectum mucosa as well as the higher systemic concentration after rectal application seem to promote the development of a rectovaginal fistula. Different methods for the surgical fistula repair are discussed, depending on location and diameter of the fistula. In our patients we have carried out the abdomino-transanal resection of the rectum with sutured colo-anal anastomosis.

Adult↗
PubMed1986

[Cancer of the large intestine--a sequela of ureterosigmoidostomy].

Carcinoma or polyps of the colon as a late complication of ureterosigmoidostomia (USS) have been reported with increasing frequency. Three patients are presented, two of them developed a signet-ring cell carcinoma after USS; one patient showed, 6 years after rediversion of the ureter, a carcinoma at the anastomotic site. Changes in the secretion patterns of sialo- and sulphomucines of the tumor and mucosa are histochemically demonstrated and, together with an appraisal of etiologic factors, discussed. We suggest a careful follow-up of patients with USS, particularly of those performed many years ago.

Adenocarcinoma, Mucinous↗
PubMed1979

[Prognostic aspects of early gastric carcinoma (author's transl)].

The results of treatment of early gastric carcinoma were analysed in 65 patients. In 33 patients the operation was performed 5 years ago. The 5-year-survival rate was 70%. Prognosis was predominantly influenced by the histology of the tumour. Signet ring cell and anaplastic early carcinomas (diffuse type) had a worse prognosis than intestinal (differentiated) forms. Carcinomas localised wholly in the mucosa had no better prognosis than those penetrating into the submucosa. There is no choice of surgical method according to prognostic criteria as the diagnosis "early gastric carcinoma" can be made only postoperatively from the resection material. Bioptic proof of carcinomatous gastric mucosal changes requires full observation of the rules of cancer surgery.

Biopsy↗
PubMed1979

Incorporation studies of nucleic acid precursors in gastric cancer: an attempt in individualized chemotherapy.

Measurements of the rate of incorporation of radioactively labeled nucleic acid precursors into the DNA and RNA of gastric carcinoma cell suspensions indicated variable rates of proliferation for the tumors. The rate of incorporation generally correlates to the cytological level of differentiation of the carcinoma. Reduced differentiation of the tumors showed a corresponding increase in the rate of proliferation. Knowing the proliferation-dependent effect of most cytostatica, this results in a resistance to cytostatica of highly differentiated gastric cancers. The nucleic acid synthesis of proliferatively active tumors could only be partially inhibited by the cytostatica tested (5-fluorouracil, adriamycin). Carcinomas with metabolic possibility for compensation of the active mechanism of the cytostatica were biochemically resistant. Due to the resulting methodical problems and unaccountable patient-dependent causes of resistance, a conclusive statement about cytostatica-sensitive tumors is difficult to make in incorporation studies.

Antineoplastic Agents↗
PubMed1979

[Studies on the modification of wound healing by a lack of essential fatty acids].

A fat-free diet produces a deficiency of essential fatty acids in Wistar rats. This is associated with disturbances of wound healing in the colon and skin due to an impaired collagen metabolism, since hydroxyproline content in the wound area is decreased. The results are of clinical significance with regard to total parenteral nutrition in surgical patients.

Animals↗
PubMed1979

[New aspects in the concept of adjuvant and after-care therapy for gastric carcinoma?].

Basis and current possibilities of adjuvant therapy in gastric cancer are discussed. The response rate with 5-FU und nitrosoureas for advanced gastric cancer is significantly superior to all other regimens. Based on Japanese experiences a higher survival rate is observed in the curatively resected patients treated with postoperative prophylactic chemotherapy. The drawing of reliable conclusions must await the results of further studies. Efforts for individual chemotherapy by measurement of cell production of recurrences and the necessity of aftercare in gastric cancer patients are explained.

Aftercare↗
PubMed1979

[Animal experiments in stagnant loop syndrome].

Using the perfusion technique, the absorption of water, sodium, and glucose was studied in a partial occlusion of the intestine. In this study we investigated the mucosal enzyme, the metabolic changes of the small bowel wall, and the morphology of the mucosa. The reason for the decreased absorption of glucose, sodium, and water in the prestenotic phase may be the increased proliferation of the mucosa. The decreased absorption of the glucose, sodium and water in the poststenotic phase may be caused by an atrophy of the mucosa.

Afferent Loop Syndrome↗
PubMed1979

[Current therapeutical aspects in gastric carcinoma (author's transl)].

The poor prognosis of gastric carcinoma can be improved by intensification of early diagnostics and adequate surgical measures. To avoid local recurrent tumour growth at the resection lines total gastrectomy is necessary if the tumour is located in the upper and middle third of the stomach as well in the case of diffusely infiltrating tumours in the distal third. To prevent relapses in the regional lymphatics radical lymph node dissection should be performed. Remission rates in advanced gastric cancer are high after combination chemotherapy with 5-fluorouracil and nitrosourea. Postoperative adjuvant chemotherapy seems to be successful according to newer communications. Basic problems of adjuvant chemotherapy in gastric cancer are discussed.

Humans↗