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Biomedical subjects

R Merkle

Publications and source records attributed to R Merkle.

6 recordsLinked to original sources
PubMed2002

[Postoperative endoscopy for the diagnosis and therapy of complications].

A variety of endoscopic methods are available as the main tools in the diagnostics and therapy of various complications after visceral and thoracic surgery. Indications for endoscopic interventions are anastomotic leaks, stenoses, Gl-tract bleedings, biliary lesions and functional problems after surgical procedures. The most common are fibrin sealing of fistulas, dilatation and bougienage, injection therapy for bleeding, bile duct interventions and stent implantations. In most cases operative revisions can be avoided by using endoscopic methods with an overall good success rate. No disadvantages are foreseen following conventional operative interventions if the endoscopic treatment is not successful.

Adult↗
PubMed1994

[Conventional or laparoscopic cholecystectomy in treatment of acute cholecystitis?].

Elective laparoscopic cholecystectomy has become established as the procedure of choice for the treatment of symptomatic cholecystolithiasis while the application of this method for acute cholecystitis has been propagated with restrainment. In a prospective study 114 conventional (right subcostal incision) and 102 laparoscopic cholecystectomies for this indication were compared. The overall complication rate amounted 10.7% for conventional cholecystectomy and 8.9% for laparoscopic cholecystectomy. The rate of conversion was 9.2%. Due to the fact that intraoperative cholangiography was carried out in 60% of conventional cholecystectomies and in only one of laparoscopic procedures the arithmetic advantage of minimally invasive technique with respect to blood loss and operating time does not allow final conclusions. These patients however recovered clearly faster and could be discharged after an average of 5.2 +/- 4.2 postoperative days, while the hospitalisation after conventional operations amounted to 7.6 +/- 3.8 days (p < 0.001).

Acute Disease↗
PubMed1994

The alpha-mannosidase of Trypanosoma cruzi: structure and function.

Trypanosoma cruzi alpha-mannosidase has been purified to apparent homogeneity. It is a 240,000-Da tetramer composed of four identical subunits (58,000 Da). Each subunit contains one N-linked high-mannose oligosaccharide. Based on pH optimum and sensitivity to inhibition by swainsonine, we suggest it to be lysosomal, but this has yet to be demonstrated directly. The enzyme appears to be developmentally regulated and may be a key enzyme in the degradation of the lipopeptidophosphoglycan (LPPG) during transformation from epimastigote to trypomastigote. Preliminary experiments suggest T. cruzi does not utilize the mannose 6-phosphate recognition system for sorting alpha-mannosidase (or other acid hydrolases) to the lysosome. To clone the alpha-mannosidase from T. cruzi we have used the same approach that has been used for other alpha-mannosidases. The cDNA amplification product was subcloned and sequenced. Comparison of the T. cruzi alpha-mannosidase sequence with the alpha-mannosidases that were used in the original primer design demonstrated a greater similarity to murine lysosomal and Dictyostelium alpha-mannosidases than to Golgi alpha-mannosidases.

Animals↗
PubMed1989

[Does the lithotripter change gallstone surgery?].

Extracorporeal shock-wave lithotripsy (ESWL) is a new method for treating gallstones. ESWL is an alternative method to cholecystectomy for treating symptomatic gallbladder stones--complicated cases excluded--in about 15% of all cases. The risk of stone recurrence with all its consequences (symptoms, complications, late mortality) has to be weighed against the higher morbidity and mortality of surgical treatment. ESWL can be used for bile duct stones instead of endoscopy. Concrements cannot be removed mechanically (10-20%) have been treated with a high success rate (80%) using ESWL. In summary, at present ESWL is restricted to a small number of selected cases.

Cholecystectomy↗