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Biomedical subjects

R Broll

Publications and source records attributed to R Broll.

50 records · Page 3Linked to original sources
PubMed1991

[Hiatal hernia. Symptoms, diagnosis and therapy].

Forty-eight patients with a mean age of 53 years were treated for hiatal hernia at the University of Würzburg Department of Surgery between 1983 and 1989. The cohort was subdivided according to type of herniation, age and sex, and symptoms. Conservative treatment sufficed in 22%, but the majority (78%) underwent surgery. Nissen's fundoplication predominated (48%); other methods used were gastropexy (17%), antrectomy with Roux's Y-gastrojejunostomy (6%) and Angelchik's prosthesis (6%). Intra- and postoperative complications included 5 splenectomies following iatrogenic trauma to the spleen, 2 cases of subphrenic abscess, and 2 with pleural effusions. The extensive discussion stresses the various operative treatment procedures and their respective advantages and drawbacks.

Adolescent↗
PubMed1990

[Motility disorders of the esophagus after surgery on the stomach].

Oesophagus manometry with a small catheter transducer was performed in 20 patients after total gastrectomy (13 males and 7 females; mean age 60 [35-79] years) and four after partial gastric resection (2 males and 2 females; mean age 70 [60-78] years). All patients were also questioned about any symptoms. Thirteen of the 20 patients reported symptoms of reflux and of abnormal peristalsis (dysphagia, odynophagia). All but one of the 20 patients after total gastrectomy had manometrically abnormal contraction patterns (repetitive, simultaneous, deformed multiple-peak contractions), especially in the distal oesophagus. On average the contractions were diminished by 9 mmHg; resting pressure in the upper oesophagus was reduced by the same amount. These changes were probably due to increased reflux as well as changed biomechanics from the operation (decreased longitudinal tension, absent lower sphincter and postoperative adhesions). The four patients after subtotal resection (with preservation of the lower oesophageal sphincter) had hardly any reflux symptoms, even though the lower sphincter was insufficient in two patients (abdominal compression test), with a corresponding abnormal contraction pattern. Force of contraction in the body of the oesophagus and resting pressures of the two sphincters were also normal.

Adult↗
PubMed1989

[Non-occlusive ischemia enteropathy. Diagnosis, therapy and prognosis].

Reduced cardiac output is the pathogenetic cause of non-occlusive ischemic enteropathia. The abdominal symptoms develop latently and surgery prevalently ensues during the stage of intestinal wall necrosis or perambulating peritonitis. There is a lethality of 50-100% and 50% at this clinic. Prerequisites of early diagnosis are: anamnesis and clinical finding, - laboratory constellation, - sonography, - mesentericography. In early stages, conservative treatment by vasodilators is promising. The laparotomy, however, is indicated in most cases in order to identify necrosis or perforation and to allow surgery according to its stages.

Diagnostic Imaging↗
PubMed1987

[Inguinal hernia in old age].

By retrospective analysis of the medical records from 1978-1985, the rates of incarceration, postoperative complications and lethality were determined with particular consideration of elective and emergency operations. The proportion of over 60 year old patients with inguinal hernia was 37.3%. The rate of incarceration in these patients (9.8%) was more than five times as high as in patients under 60 years old (1.8%); with increasing age, it rose from 3% to 36%. The Bassini technique predominated in the surgical treatment of the hernia. The rate of postoperative complications was 7.5%, wound infections (3.35%) and hematomas (3.07%) being the most frequent. Four patients died postoperatively, mostly of pulmonary complications; this corresponds to a lethality of 1.1% as compared to this corresponds to a lethality of 1.1% as compared to 0% in patients under 60 years old. Emergency operations in incarcerated hernia display a lethality (5.71%) which is more than nine times as high as in elective operations (0.62%). The indication for surgery is hence to be established rather extensively in the elderly, since the danger of incarceration rises.

Aged↗
PubMed1987

[Aortic replacement with autologous free transplanted small intestine muscle in the dog].

Free transplantation of 60 grafts from muscle of small intestine has proved to work well for adequate replacement of larger vessels even in cases in which vessel beds were affected by infections. Patency of implants for smooth blood flow was angiographically verified in 86.7 per cent of all cases, whereas aneurysms occurred in only 15 per cent and septic complications in 11.7 per cent. With due consideration given to some technical aspects in preparation and implantation of transplants (complete removal of mucosa and pretension by something between 30 and 60 per cent), new therapeutic approaches might come to the fore to cope with infected synthetic protheses in vascular surgery.

Animals↗
PubMed1986

Replacement of dog's aorta by autologous intestinal muscle in the infected retroperitoneum.

The free transplant of intestinal muscle lacking mucosa into an infected vascular bed has been shown to be a suitable replacement for the aorta in dogs. This type of transplant is incorporated into the infected area and shows a high tolerance against progressive infection. Therefore, an autologous transplant may be suitable to ensure continuous blood flow during the healing phase of a deep infection when a synthetic prosthesis is unsuccessful.

Animals↗
PubMed1981

[Segmental colonic atresia - a contribution to the differential diagnosis of ileus in the newborn (author's transl)].

Segmental atresia of the colon is regarded as an urgent emergency in the neonatal period and quick diagnosis and surgical interference are necessary. In spite of the rarity of this condition it could be thought about in the differential diagnosis in infants with relevant symptoms and can be diagnosed by simple means. The author's own technique is described in relation to the case of atresia of the transverse colon. The aetiology, classification, clinical picture, diagnosis and treatment are discussed. The prognosis depends very much on early diagnosis.

Colon↗
PubMed1981

[The effect of AR-L 115 BS on contractility dynamics of the isolated, metabolically supported dog heart (author's transl)].

In this study the contractility dynamics of the left ventricle are analysed independent of respiration, pre- and afterload, heart rate and perfusion pressure. These parameters alter varyingly following the administration of 2-[(2-methoxy-4-methylsufinyl)phenyl]-1H-imidazo[4,5-b]pyridine (AR-L 115 BS) so that the study plan selected must take these factors into account. The model employed consisted of a metabolically supported isolated pulsating dog's heart. The dose of AR-L 115 Bs used was 0.125 mg/kg body weight and it was infused over a period of 30 min. Altogether the study demonstrates that AR-L 115 BS has a marked positive inotropic effect on the isolated heart even under the conditions of infusion. The coronary resistance diminishes and the cardiac output increases.

Animals↗
PubMed1977

[Effects of colchicine treatment on rat intestinal disaccharidase activities].

UNLABELLED: The changes in morphology and proliferation kinetics produced by colchicine in the intestinal mucosa are known. Contrarily, the functional changes have yet not been investigated systematically. The aim of this study is to investigate the effects of colchicine treatment on rat intestinal disaccharidase activities. MATERIAL AND METHODS: For the experiments male SPF-Wistar rats, body weight 180--200 g (supplied by Mus-Rattus AG, 8011 Brunnthal, FRG) were used. The animals were kept under constant conditions (6 rats per cage) and fed Altromin (Altromin Gmb H,Lage/Lippe), tap water ad libitum. Per day 6 animals of each test group were scarificed by cervical dislocation at defined time. About 3 cm of the intestine were removed 8--10 cm distally of the pylorus and cut longitudinally. After cautious cleaning the mucosa was detached using a scalpel. The thus obtained specimens of the mucosa were frozen at -- 20 degrees C in an air-tight humidity chamber and preserved there until further handling. For histological examination the correspondent parts of the intestine were fixed in 10% formol. From each specimen 4 different stainings were made (haematoxylin-eosin, Giemsa, PAS and Feulgen stain). Per test series 60--66 rats were used. The following doses of colchicine were applied: 1 X 1.0 mg/kg body weight, 1 X 0.5 mg/kg body weight, 5 X 0.1 mg/kg body weight within 24 hours. The single doses were dissolved in about 0.5 physiological saline and applied intraperitoneally. In each 6 rats per group the activities of the following diasccharidases were measured at 24 hours intervals from the 1st to 10th or 14th day: sucrase, maltase, lactase, and cellobiase. The enzyme activities were determined after the two-step method developed by DAHLQVIST (5,6) which can be used as micromethod. The ascertained enzyme activities were always related to the protein content. Protein determination was done after the method of Folin-Ciocalteu as modified by LOWRY et al. (14). The enzyme activities were expressed in international units per g protein (U/g protein). the results obtained were statistically ascertained by the non-parametric test after Kruskal-Wallis, variance analysis with linear contrasts after Scheffe as well as by double variance analyses (26).

Analysis of Variance↗
PubMedDate not supplied

Prognostic significance of p21 and p27 protein, apoptosis, clinical and histologic factors in rectal cancer without lymph node metastases.

The aim of this study was to evaluate the prognostic role of clinical and histopathologic factors, cell-cycle regulator proteins (p21(Waf1/Cip1), p27(Kip1)), and apoptotic index in lymph node-negative rectal cancer. Formalin-fixed, paraffin-embedded tissue samples of 97 rectal carcinomas (UICC stages I and II) resected curatively within five years were used. Immunohistochemical analysis of protein expression was performed by monoclonal antibodies: p21 (clone SX118), p27 (clone SX53G8). Apoptosis was assessed by the TUNEL method. Clinical, surgical, histopathologic, and follow-up data were prospectively recorded in a computerized registry. To assess prognostic significance (end points: metachronous distant metastases, 5-year disease-free and overall survival), statistics included univariate and multivariate analysis (p < 0.05 statistically significant). Of the 97 rectal carcinomas without lymph node metastases, 46.4% (45/97) were p21-positive, 49.5% were p27-positive (48/97), whereas 27.8% (27/97) showed a high apoptotic index. Within a median follow-up of 54 months, 4 patients developed local recurrence (4.1%). Distant metastases occurred in 12 patients (12.4%). Univariate analysis showed that gender, UICC stage, p21 and p27 were significantly associated with the incidence of distant metastases (p < 0.05). UICC stage and p21 were the only factors to be significantly related to 5-year disease-free survival by univariate analysis (p < 0.05). Only UICC stage was significantly related to 5-year overall survival (p < 0.05). The apoptotic index was correlated neither to recurrence nor to survival (p > 0.05). Multivariate analysis demonstrated that gender, UICC stage and p21 were independently related to the incidence of distant metastases; however, UICC stage was the only independent factor predictive of 5-year disease-free survival and overall survival (p < 0.05).

Apoptosis↗
PubMedDate not supplied

Disturbed esophageal motility after total gastrectomy.

Esophageal manometry with a catheter microtransducer was performed as a functional diagnostic method on 30 patients after total gastrectomy because of gastric cancer (18 men, 12 women with a mean age of 64 +/- 3.7 years). Subsequently their symptoms were recorded. 21 of the patients (70%) complained of reflux discomfort and symptoms of disturbed peristalsis (dysphagia, odynophagia). 29 patients (93%) showed pathological patterns of contraction (repetitive, simultaneous, deformed, multipeak contractions) especially in the distal part of the esophagus. The contractile force was decreased on average by 10 mmHg in that area. The resting pressure of the upper sphincter was also decreased by about 10 mmHg. These results can be explained by an increased postoperative reflux (absence of the lower sphincter) and the changed biomechanics of the esophagus (decreased longitudinal tension) caused by the operation. The results of this study demonstrate the importance of postoperative manometry in total gastrectomized patients.

Adenocarcinoma↗