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Biomedical subjects

R Bötticher

Publications and source records attributed to R Bötticher.

12 recordsLinked to original sources
PubMed1986

Arterial reconstructions of the lower limbs in diabetics and nondiabetics. Comparative late results.

1,261 arterial reconstructions concerning the pelvis level and the lower limbs were performed in our department between 1970 and 1981. 510 of all patients (35.4%) were diabetics, a vascular reconstruction could be performed in 337 diabetic patients, in 173 an amputation was unavoidable. 62% of all diabetics underwent a bypass operation, 38% an aorto-iliac reconstruction. There were one and a half more females than in nondiabetics. The diabetics were operated five years later than nondiabetics. The numbers of risk factors was more frequent. The onset of vascular disorders was not dependent on duration or treatment of the diabetes. The clinical stage IV preponderated. Immediate limb salvage rate was 87.7% in our diabetics. The hospital mortality was 7.4%, in nondiabetics 3.8%. Comparative results between diabetics and nondiabetics concerning the five-, eight- and ten year patency and limb salvage rate for different graft materials were demonstrated. In diabetics the possibility of a deterioration after surgery is three times more frequent and the amputation rate is three times higher than in nondiabetics. The five year patency rate is 12% and the five year limb salvage rate 7% lesser in diabetics after femorotibial bypass.

Aged↗
PubMed1978

[Evaluation of renal cyclic adenosine monophosphate, serum parathyroid hormone and phosphate reabsorption in recurrent calcium urolithiasis, healthy controls and hyperparathyroidism (author's transl)].

In three groups (n = 12 each) of male controls (22--43 years), patients with recurring calcium urolithiasis (21--36 years) and hyperparathyroidism (HPT; 17--71 years) proven by surgery renal cyclic adenosine monophosphate (RcAMP), fractional tubular phosphate reabsorption and serum parathyroid hormone (PTH) were measured during endogenous creatinine clearance. RcAMP (muMol/g creatinine) was: controls 1.48 +/- SEM 0.27; stone formers 2.037 +/- 0.343 (not significantly different); HPT 6.234 +/- 0.454 (p less than 0.001). There is no overlap between HPT and controls. Phosphate reabsorption is least in HPT (0.84 +/- 0.015), higher in controls (0.924 +/- 0.004) and stone formers (0.941 +/- 0.007). All differences are statistically significant. Under the conditions selected (moderate hydration of individuals) Serum PHT (pg-equiv/ml) is lowest in stome formers (less than 100--339), higher in controls (less than 100--933) and HPT (400--1150). there is no overlap in PHT between the former and the latter group but a marked one between controls and HPT. For clinical purposes the resulting diagnostic uncertainty in a given patient can be overcome by additional determinations of RcAMP and ionised serum calcium: when referring to serum PTH HPT patients fall outside, RCU patients within 2 standard deviations of either parameter in control subjects. This procedure presently appears superior to those proposed in the past (urinary cAMP etc.) but requires confirmation in larger patient populations. Moreover, since HPT prevails in middle and upper age decades, their RcAMP values and those of RCU patients should be related to a range seen in closely age- and sex-matched controls.

Adult↗
PubMed1977

Secretin-induced histamine release in duodenal-ulcer patients.

Because a majority of duodenal-ulcer patients responded locally to intradermal secretin, skin samples from 7 patients with duodenal ulceration and 6 patients with goitre or cholelithiasis were incubated with "tris" buffer alone and with tris buffer containing 20 C.U./ml synthetic secretin or 100 microng/ml compound 48/80. Skin from duodenal-ulcer patients released significantly more histamine than did that of controls (p less 0-01). Histological examination of skin samples from these patients showed that the number of histamine-containing mast-cells averaged 5-7 per field and dropped to 1-2 per field after incubation with secretin. It is concluded that in a certain type of duodenal ulceration intradermal secretin releases histamine from mast-cells and thus induces a local anaphylactic reaction. This might prove suitable for preclinical ulcer diagnosis and/or for detection of patients at risk of acquiring that disease.

Adult↗
PubMed1977

[Urologic complications od chronic inflammatory intestinal diseases].

The three most common inflammatory diseases of the bowel, colonic diverticulitis, regional enteritis and ulcerative colitis, involve the bladder or ureter in the advanced stage in about 10%. The colovesical fistula is found more frequently with diverticulitis and less often with regional enteritis, which penetrates predominantly from the ileum into the bladder. On the other hand, if an ureteric stenosis develops, it will be caused on the right side mainly by regional enteritis and on the other side by ulcerative colitis. The vesicointestinal fistulae will close without sequelae after resection of the involved bowel segment. However, the ureteric stenosis will often be followed by nephrectomy despite bowel resection and ureterolysis, if the operation is not undertaken early enough. Frequent rechecks with infusion urography should help to prevent this. Nephrolithiasis, amyloidosis, and a contracted bladder are futher, yet less common complications of chronic inflammatory disease of the bowel.

Chronic Disease↗
PubMed1975

[Emergency endoscopy].

We prefer emergency-endoscopy in case of acute hemorrhage of the upper gastro-intestinal-tract, in case of perforation no endoscopy. Within the last two years 122 patients were treated by endoscopy and more than half of them must be treated by operation.

Endoscopy↗
PubMed1975

[Gastric polyps: prognosis and treatment].

49 patients, previously treated for epithelial gastric polyps by resection or excision, were re-examined up to 22 years later. Except for those who had died of other diseases, in five histologically confirmed and in one a probable (radiologically) gastric carcinoma had been found. Three cases of gastric carcinoma without symptoms were discovered in the course of endoscopic follow-up examination. Two of these patients underwent radical operation (early carcinoma), while the third one proved to be inoperable. It is concluded that gastric polyps must be removed endoscopically or operatively and examined histologically: simple observation must be rejected. If the polyp is hyperplastic, local removal is sufficient. If there is a pure adenoma, two-third resection is essential. This is also true of hyperplasiogenic polyps if they are present in large numbers, while polypectomy is sufficient if solitary. Polyposis usually requires subtotal or total resection. Each patient with such polyps is exposed to a higher risk of gastric carcinoma. For this reason annual endoscopic control is necessary even if there are no symptoms.

Biopsy↗