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Biomedical subjects

R Bähr

Publications and source records attributed to R Bähr.

At least 91 records · Page 5Linked to original sources
PubMed1978

Morphological and functional adaptation after massive resection of the small intestine: experiments using minipigs of the Göttingen strain.

In order to examine the adaptation processes in young, growing animals, massive resections of the small intestine were carried out in 3-week-old minipigs. The length of the remaining terminal intestine was 65 cm, corresponding to a resection of 85%. Proximal and distal resections of the small intestine were carried out. In some animals simultaneous resection of the ileocecal valve was performed. In some of the animals a reversed intestinal segment of 8 cm in length was interposed in the intestinal tract. The adaptation processes were checked at different times by morphological and functional examinations. It was observed that in animals with proximal intestinal resection and in animals with reversed intestinal segment, the postoperative progress was much more favorable than in animals with distal intestinal resection and animals without a reversed segment. It was further demonstrated that an early oral calorie supply is an important factor in the intestinal adaptation process. Contrary to views previously expressed, calories should be given early by mouth in order to stimulate the intestinal enzymes. After massive intestinal resection, the interposition of a reversed segment should also be considered in children if difficulties are expected with the oral supply of calories caused by a too-short terminal gut or if attempts at oral feeding have failed.

Adaptation, Physiological↗
PubMed1977

[Hyperbaric oxygenation in gas gangrene therapy].

Gas gangrene which is caused by gram-negativ rod-shaped bacilli appeared longtime in war only. Now an increase of infection is noted by heavy traffic accidents. Reporting about 18 patients and treatment results we suggest for therapeutic proceeding: excision of wounds without primary amputation followed by hyperbaric oxygenation. In our opinion, surgical intervention and hyperbaric oxygenation should not be rival but complementary treatment of equal value.

Adolescent↗
PubMed1975

[Problems of extensive resection of small intestine in newborn infants and infants].

Massive resection of the small intestine in neonates and infants is mostly necessitated as a result of atresias, stenosis or circulatory disorders. At this period of life, the term "sub-total resection of the small intestine" is not applied in a standard way. Most authors use it when the residual small intestine is 75 cm or less in lenght. The survival prospects after sub-total resection of the small intestine are determined not only by the absolute length of the remaining small intestine; it is important which part can be preserved. Distal resections lead to a particularly serious malabsorption syndrome. In ileal resections, lipid absorption is disturbed owing to the lack of absorption of bile acids. A chologenous diarrhea results. The absorption functions (which are largely eliminated directly after the operation) recover in a regular pattern. The more orally localized functions (carbohydrate) recover more quickly than the more distally localized (lipid absorption). Surgical measures to slow the passage of intestinal contents have been applied with varying success in animal experiments. Clinical experience is largely lacking (only five cases). Various mechanisms for compensation after extensive resection of the small intestine in neonates (increase in length of the intestine, mucosal hypertrophy or greater cell density) are being discussed. These are only occasionally observed and the factors on which they depend are mostly obscure.

Age Factors↗
PubMed1975

[Subtotal resection of the small intestine in newborn infants and infants. Results of an inquiry].

A circular was sent to eight clinics and 36 cases of children with extensive resections of the small intestine are reported. The reasons for the resections of the intestine were atresia and stenosis in the largest number of cases, then volvulus and lastly necrotizing enteritis. The residual intestine was measured with the measuring tape in only eight cases. The method of measurement in the other cases was not given. Surgery was unilateral in 26 cases and bilateral in ten. Surgical measures to slow passage were not used. The most frequent single causes of death were sepsis or pulmonary complications. The cause of death was a true malabsorption in only two cases. The main difficulties in the postoperative phase are ensuring adequate parenteral uptake of calories and the complications due to cava-catheter sepsis.

Age Factors↗