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Biomedical subjects

R Häring

Publications and source records attributed to R Häring.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Where and when does surgery achieve cancer prevention? Precancerous conditions of the stomach].

The early diagnosis of stomach diseases, that are high risk factors for cancer is of paramount importance, because the early cancer can be healed nowadays. Distinguish between precancerous lesions (adenoma, borderline-lesion, dysplasia III) and precancerous conditions (chronical atrophic gastritis, pernicious anemia, Ménétrier syndrome, hyperplasiogene polyps, the operated stomach, rarely ulcus ventriculi). Whereas precancerous lesions must be removed by diathermy-biopsy or operation, precancerous conditions need thorough endoscopic control. In operations for ulcerous disease the operation tactics must be chosen with the aim to avoid a carcinoma after gastric resection.

Biopsy↗
PubMed1985

Antibiotic infection prophylaxis in gallbladder surgery--a prospective randomized study.

In the course of 1 year, 180 patients undergoing elective surgery for confirmed cholelithiasis were included in a prospective randomized study in which they either received 2 g of preoperatively applied ceftriaxon intravenously at the beginning of anesthesia or, as an alternative, no antibiotic at all. Infectious wound-healing disturbances occurred postoperatively in 11% in the control group and in no case in the prophylaxis group. The difference is statistically significant.

Adolescent↗
PubMed1984

[Stress tolerance of the patient in abdominal surgery: stomach cancer].

Patients with gastric cancer undergoing surgery have much to endure and are accompanied by many risks. These risks depend on localization and extent of the tumor, the patients' general condition (nutritional and immune status), age, coexistent diseases and the extent of the required operation. In view of these facts, the principle of radical surgery must be weighed against the tolerance capability of the patient, especially in old people. Extensive diagnostic procedures are necessary to explore those risks. The preoperative treatment (hyperalimentation), the well considered indication for surgery, the choice of operation with lowest risk and the perioperative measurements are of great importance in limiting the risk for the patient.

Gastrectomy↗
PubMed1984

[Complications of percutaneous transluminal angioplasty (PTA)].

PTA can be regarded as an enrichment of the treatment alternatives used for chronic arterial vascular disease. Complications requiring corrective vascular surgery arose in 6% of 194 catheter dilatations. They could be observed at the sites of puncture, recanalization and dilatation. The complications associated with PTA do not constitute any burden for emergency surgery. The complication rate is justifiable within the treatment concept.

Angioplasty, Balloon↗
PubMed1984

[Thyroid function after peritoneal lavage with polivinylpyrrolidone-iodine solution in diffuse peritonitis].

In 36 patients, intraoperative peritoneal lavage with PVP-iodine solution (26 patients) or with the iodine free chemotherapeutic agent Taurolin (10 patients) was performed because of peritonitis. Total iodine serum levels increased considerably after peritoneal lavage with PVP-iodine. In the early postoperative phase, the resorbed iodine was mostly present as iodide in serum. Iodine serum values returned to normal after 30 days. A decrease in T4 and T3 could be observed with a concomitant reciprocal increase of rT3 in the acute phase of peritonitis. Normalization of the thyroid hormone took place after 8 days. A stronger increase in T4 occurred temporarily in 2 of 5 patients known to have thyroid function disorders. These changes in thyroid hormone may also be considered as the consequence of the severe primary disease. Normalization of hormone values was clearly delayed after PVP iodine lavage. The possible risk of an iodine-induced thyrotoxicosis after intraperitoneal application of PVP-iodine is pointed out, and objections are made to using this therapy.

Adult↗
PubMed1984

[Peritoneovenous shunt in the treatment of therapy resistant ascites. Results of 7 years' experience].

In recent years, implantation of a peritoneo-venous shunt has proven effective in the treatment of therapy-resistant ascites. From 1976 till 1983, a total of 63 shunt systems (Le Veen-, Agishi -, Denver system) were implanted in 55 patients with a mean age of 52.3 years. The most common cause for ascites was hepatic cirrhosis. The average functional period amounted to 21.7 months and the longest implantation time to nearly 7 years. The postoperative complication rate is considerable: 19 patients died in the postoperative course. The most dreaded complication is shunt infection and intravascular thrombopathy . In spite of the high complication rate, the establishment of a peritoneo-venous shunt is recommendable for combatting therapy-resistant ascites.

Adult↗
PubMed1983

[Prevention of postoperative thrombotic complications with heparin and dihydroergotamine. A randomized double-blind study].

In a randomized double-blind study of 660 patients with predominantly abdominal-surgical procedures the thrombosis-preventing effect of the following was compared: heparin 5000 (low-dose heparin), heparin 2500, a combination of heparin 2500 and 0.5 mg dihydroergotamine (HDHE 2500), 0.5 mg dihydroergotamine (DHE), and placebo. All preparations were administered three times daily. Radiofibrinogen test gave the following thrombosis incidence: heparin 5000-15.4%; heparin 2500-24%; HDHE 2500-13.2%; DHE-24.6%; placebo-28.9%. Bleeding complications, included postoperative blood loss (more than 500 ml), unusually marked bleeding from drains, seroma, wound haematoma, and re-operation. The rate of these complications was 18.5% with heparin 5000, 7.8% with placebo, 5.6% with DHE, 4% with heparin 2500 and 3.1% with HDHE 2500. The non-specific tolerance to the various preparations was good, especially in that there was no increased risk of coronary complications with HDHE or DHE, and there was no pointer to peripheral vasospasms. This study confirms the synergistic thrombosis-preventing effect of combined heparin-dihydroergotamine.

Abdomen↗
PubMed1983

[Functional evaluation of islet cells following pancreatic duct occlusion--a long-term study].

The transduodenal occlusion of the pancreatic duct with Prolamin (Ethibloc) was carried out in an experiment with 38 Göttinger minipigs. Occlusion of the pancreatic duct leads to selective atrophy of the excretory pancreatic parenchyma. Up until now it has not been clear whether the endocrine functional capacity of the gland stays intact in a long-term experiment or whether the islands of Langerhans are also altered by the pancreatic duct occlusion. The following tests were carried out by us to determine the endocrine status: 1. Intravenous glucose tolerance test (i.v. GTT); 2. Glucose assimilation analysis after CONARD (K-value); 3. Insulin analysis during i.v. GTT; 4. Intravenous Tolbutamid test. Twelve months after the occlusion, reduced glucose tolerance and a reduction in insulin secretion were detected in the intravenous glucose tolerance test. Glucose assimilation (K-value) was not changed significantly. Fasting blood sugar and basic insulin level remained unchanged. Only a small blood-sugar decrease was measured after selective B-cell stimulation with Tolbutamid. The fibrosclerosis produced by the occlusion of the pancreatic duct with Prolamin also seemed to attack the cells of the islands and lead to their partial destruction.

Animals↗
PubMed1983

Effects of angiotensin II and ACTH on normal and tumourous human adrenocortical cells.

Isolated adrenocortical cells from 6 patients with a 'normal' zona fasciculata, 4 patients with a 'normal' zona glomerulosa, and tumour cells from 1 adrenocortical adenoma and 1 carcinoma were incubated with and without increasing concentrations of ACTH 1-24 (10(-13) M to 10(-9) M) or Asp1-Ile5-angiotensin II (10(-11) M to 10(-7) M). In 4/5 'normal' cases, cortisol was clearly stimulated by 10(-13) M ACTH. The maximum of the dose-response curve (5-fold stimulation) was reached at 10(-10) M ACTH. Angiotensin II (AII) started to stimulate 'normal' cells at 10(-11) M with a maximum (2-fold stimulation) at 10(-9) M. Aldosterone production by 'normal' cells was less markedly stimulated by ACTH and AII, although the threshold doses for both peptides were similar to those of the cortisol response curves. The cells of the adrenocortical adenoma from a patient with Cushing's syndrome produced large amounts of cortisol and small amounts of aldosterone, both steroids being clearly stimulated by ACTH and AII. The adrenocortical carcinoma cells produced small amounts of cortisol and no aldosterone. Cortisol production responded to ACTH, but not to AII. The results suggest that an activated renin-angiotensin system may stimulate the zona fasciculata, since 10(-11) M AII (= 10 pg AII/ml) is a normal plasma AII concentration on an unrestricted diet. Clinical evidence supporting this thesis is reviewed. However, cortisol production itself will rarely be increased by AII in vivo, since a down-regulation of ACTH would occur.

Adenoma↗
PubMed1983

[Gastroduodenal surgery in patients over 80].

Between 1969 and 1981 surgery was performed in 118 patients over eighty years old with gastroduodenal diseases. The main indications were carcinomas and ulcers. The combined mortality amounted to 34.8%. One of the main problems of surgery in elder patients turned out to be the simultaneous presence of accompanying diseases. Whenever possible surgery should be performed before the onset of complications.

Age Factors↗
PubMed1982

[Percutaneous transluminal angioplasty before exposure in stage IV of arteriosclerotic occlusion disease (author's transl)].

In 1979 and 80, 34 stage IV patients, whose vascular situation could not be sufficiently visualized by angiography, underwent exploratory exposure. In 15 patients primary amputation had to be performed, in 19 patients reconstruction was possible. 7 of these patients had to undergo secondary amputation. During the same period of time, we performed PTA in 29 stage IV patients, in whom vascular reconstruction was not practicable. In 14 patients PTA was successful, in 15 patients its performance was technically impossible or rethrombosis occurred. Although the two patient groups are not comparable because of different vascular situation, on the basis of positive experience, we recommend that a PTA be performed before exploratory exposure or amputation in stage IV.

Aged↗
PubMed1982

[Diagnosis of suture insufficiency--clinical, laboratory and x-ray findings and special examinations].

Early recognition of a suture insufficiency in the small or large intestine is important for systematic therapy. Apart from consideration of drainage secretion, assessment of general condition and of the abdomen are the most important diagnostic measures. These can be supplemented by laboratory findings of leucocytosis, thrombocytopenia, and respiratory alkalosis. Additional measures are Gastrografin tests, endoradiography, digital and rectoscopic examination, and possibly also computer tomography and sonography.

Diatrizoate Meglumine↗