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Biomedical subjects

T Manger

Publications and source records attributed to T Manger.

At least 37 records · Page 2Linked to original sources
PubMed2000

On the relationship between locus of control, level of ability and gender.

In a sample of Norwegian 14- and 15-year-old students no significant relationship was found between total externality-internality score and level of ability. However, a significant relationship was found between ability and a subscale of locus of control related to degree of belief in the impact of school effort. The analyses of gender differences showed that girls had significantly higher total internal locus of control scores than boys. Boys were, however, significantly more internally oriented than girls on a subscale related to the respondents' general belief in luck, while girls were significantly more internally oriented than boys on a school effort scale. The present study does not support the notion that girls develop an attributional pattern which is more closely related to their abilities while boys may develop a broader attributional pattern.

Achievement↗
PubMed2000

Malignant peripheral nerve sheath tumor of the esophagus.

BACKGROUND: Sarcomas of the esophagus are rare representing 0.1-1.5% of all esophageal tumors. We report a case of malignant peripheral nerve sheath tumor (MPNST) of the esophagus in a 60-year-old woman. METHODS: The diagnosis was made preoperatively on endoscopic biopsy and confirmed after tumor resection by immunohistochemistry as well as electron microscopy. The patient underwent abdominal-thoracicen bloc esophagectomy with mediastinal lymphadenectomy and intrathoracic esophagogastrostomy. RESULTS: Our therapeutic concept for the first case of a high-grade MPNST (malignant schwannoma) of the esophagus resulted in a recurrence-free interval of 4 years. CONCLUSION: The therapy of choice was abdominal-thoracic en bloc esophagectomy with tumor-free resection margins and esophageal reconstruction with the stomach. After R0-resection we found no indication for adjuvant radio- and/or chemotherapy.

Esophageal Neoplasms↗
PubMed2000

Solid pseudopapillary tumor of the pancreas.

BACKGROUND: Its considerable size at the time of diagnosis and low grade of malignancy are typical features of the solid-pseudopapillary tumor, which has a tendency to predominantly affect young females. A relationship to the long-term intake of oral contraceptives is discussed. Invasive tumor growth or metastases have been observed only rarely until now. METHODS: The 53-yr-old female patient we report on here was treated by radical partial pancreatoduodenectomy for a nonmetastasizing solid-pseudopapillary tumor of the pancreatic head (T1bN0M0) 19 mo ago. RESULTS: Histopathological studies made a definitive diagnosis of solid-pseudopapillary tumor. The patient is recurrence-free, and there are no signs of metastases at present. Since a microscopically invasive tumor growth is assumed, oncologically curative resection should be preferred vs the less radical enucleation. CONCLUSION: In this report, a case of the rare solid-pseudopapillary tumor of the pancreas is described. In contrast to other pancreatic tumors, the semimalignant solid-pseudopapillary tumor has a favorable prognosis.

Female↗
PubMed1999

[Gastrointestinal stromal tumors--problems in diagnosis and therapy].

Gastrointestinal stromal tumors (GIST), which form a rare group of neoplasias of the gastrointestinal tract, have not yet been fully investigated. Although good progress has been made in their diagnosis, classification of these lesions with regard to their histogenesis and biological behavior remains problematic. Between 1994 and 1998, 18 GIST patients underwere operation in the Department of Surgery. Twelve of these patients (67%) had stromal tumors in the stomach, and six (33%) had intestinal stromal tumors. The primary tumor could be removed in all patients with R0 resection. Six patients developed hematogenous liver metastasis, with the size of their primary tumor exceeding 10 cm. Extrahepatic distant metastases were not found in any case. Lymphadenectomy showed that lymph node metastases did not occur. Histological evaluation was made according to the guidelines of Lewin, Weinstein and Riddell. Currently established therapy is limited to complete surgical resection of the primary tumor and its metastases. Adjuvant or neoadjuvant chemotherapy approaches have failed.

Adult↗
PubMed1999

Hepatic angiomyolipoma in a 26-year-old Caucasian woman with a history of tibial osteosarcoma.

We report on a 26-year-old Caucasian woman who was referred to the Department of Surgery complaining of general malaise, feeling of fullness with occasional vomiting and intermittent jaundice. The patient had previously suffered from tibial osteosarcoma of the left leg which was resected 13 years ago and subsequently treated with radiation and chemotherapy. During clinical investigations a 12 x 12 x 6.5 cm large mass was found in the left lobe of the liver. This was resected, and subsequently shown to be a sporadic hepatic angiomyolipoma. In order to investigate a possible link between the two tumours, we investigated mutations in the p53-gene, loss of heterozygosity (LOH) at p53, Rb and p16, c-Myc expression, and the telomerase activity of the angiomyolipoma and the osteosarcoma. Whilst the tibial osteosarcoma showed LOH at p16, no genetic alterations or increased telomerase activity were found in the angiomyolipoma. The occurrence of both these tumours in this patient is therefore probably a coincidence.

Adult↗
PubMed1999

Multimodal treatment of neuroendocrine tumors of the pancreas and the ampulla of Vater.

Neuroendocrine tumors are not seen frequently. They are most commonly located in the small bowel including the vermiform appendix. Neuroendocrine tumors of pancreatic origin are extremely rare. Symptoms caused by excessive hormone production by large liver metastases often lead to their diagnosis. Preoperative diagnostics include analysis of specific hormones in serum and urine, ultrasound, CT and somatostatin receptor scintigraphy. Liver metastases of neuroendocrine tumors of the pancreas are common at the time of diagnosis. Curative resection should be performed whenever possible, although patients often benefit from debulking procedures, too. Liver metastases can be subjected to surgical resection, embolization, regional chemotherapy or local procedures such as alcohol injection or cryoablation. As an exception, liver transplantation can be considered in selected cases where radical surgery for the primary tumor could be performed and extrahepatic metastases are not present. Supplementary or alternative options include octreotide and/or interferon-alpha administration. In this article, we report on 6 patients suffering from primary neuroendocrine tumors of the pancreas or the ampulla of Vater who were treated at our department over the past 5 years. In addition, we discuss our own experience with this rare condition in the light of the recent literature.

Adult↗
PubMed1999

[Peritonitis models in the rat with special reference to laparoscopic therapy options].

With ongoing development of minimally invasive surgery the laparoscopic techniques are increasingly used also in patients with intra-abdominal inflammatory diseases. The systemic sequelae of laparoscopy are not yet clear. In this study, we investigated three experimental models of peritonitis in rats (cecal ligation and puncture n = 14, cecal stent peritonitis n = 14, implantation of a standardized fecal inoculum n = 18) concerning the therapeutic potential of laparoscopy, reproducibility of the results and clinical relevance (elimination of the inflammatory focus, intraperitoneal modulation of inflammation). The peritonitis model of implantation of a standardized fecal inoculum was shown to be the experimental model with the closest clinical relevance. In this technically simple, reproducible model, the primary inflammatory focus can be eliminated by laparoscopic lavage. A significant difference (p < 0.002) of survival between the groups with and without laparoscopic lavage was found. In addition, the intraperitoneal application of drugs is possible in order to modulate peritoneal and systemic inflammation.

Animals↗
PubMed1999

[Laparoscopic stoma technique].

If the sole aim of an operation is to empty the bowel, we are presented with an indication for laparoskopic enterostomy. This intervention is technically simple, safe and may be performed with little or no complications. In comparison to the conventional technique, laparosopy offers important advantages concerning the patients' postoperative comfort. Laparoscopic stoma creation is recommended in current literature as an alternative to the conventional procedure.

Enterostomy↗
PubMed1999

[Therapy options for postoperative fistulas of the upper gastrointestinal tract].

The mortality of anastomotic leakage following esophageal reconstruction has been reported to be as high as 60%. For the treatment of these dehiscences the use of endoscopy is a tempting option. The standard treatment consisted of endoscopic lavage, drainage and subsequent closure of the leak by application of fibrin glue. 2 patients was tried with a novel approach permitting rapid closure by plugging the fistula with a vicryl cylinder. Endoscopic management of postoperative leaks of the upper gastrointestinal tract represents a safe and relatively gentle therapeutic option.

Anastomosis, Surgical↗
PubMed1999

[Laparoscopic cholecystectomy. A recommendable indication in acute cholecystitis?].

While laparoscopic cholecystectomy has become the procedure of choice for the elective treatment of symptomatic cholecystolithiasis the question whether patients with acute cholecystitis should be operated laparoscopically or conventionally is still debated. Nevertheless, more and more surgeons tend to use the laparoscopic approach even in patients with acute cholecystitis. Of 1006 laparoscopic cholecystectomies performed at our hospital 42 were done for acute cholecystitis. Conversion to an open procedure was necessary in only one patient because of severe inflammatory changes. The overall mortality was zero. The average age was 45.9 years for all patients and 50.4 years for those with acute cholecystitis. The average operating time in patients with acute cholecystitis was 81 minutes compared to 62 minutes in patients who underwent elective laparoscopic cholecystectomy. The complication rate and the average hospitalization time did not differ significantly between the two groups. Our own data as well as the data retrieved from the literature seem to indicate that laparoscopic cholecystectomy is superior to the open procedure in the treatment of acute cholecystitis. Prerequisite is that the operation is performed less than 72 hours after the onset of the symptoms by an experienced operating team and the readiness to convert to open procedure if necessary. Under those circumstances laparoscopic cholecystectomy seems to be the treatment of choice for acute cholecystitis.

Acute Disease↗
PubMed1998

Alterations of the p16/MTS1-tumor suppressor gene in gastric cancer.

Deletions, mutations and the functional inactivation of tumor suppressor gene p16 are involved in the genesis of different neoplasias. Little is known about the role of p16 gene alterations in the genesis of gastric carcinomas. This study aimed to detect genetic alterations of the p16 gene in gastric carcinomas. We analyzed p16 gene mutations and the frequency of loss of heterozygosity (LOH) at the p16 locus in 43 gastric carcinomas. PCR-SSCP analysis of exons 1 and 2 revealed only one gene mutation in a carcinoma of the diffuse type. Besides carcinomas of the diffuse, intestinal and the mixed type, we also investigated a small-cell primary gastric carcinoma, which was the only one to show a deletion in the p16 gene. LOH analysis was performed using two polymorphic markers located near the p16 gene (D9S171, D9S162) and a sequence-tagged-site marker (c5.1). Allelic loss was noted in two carcinomas of the diffuse type and in one carcinoma of the intestinal type. Allelic instabilities were found in one tumor of the intestinal type and diffuse type each. Although only five of 43 (11.6%) gastric carcinomas had p16 alterations, tumors of the diffuse type tend to show a higher number of genetic alterations near the p16 locus.

Adenocarcinoma↗
PubMed1998

The effects of spatial visualization and students' sex on mathematical achievement.

Sex differences in mathematical achievement and spatial visualization skill were examined in a sample of 724 Norwegian sixth-grade students. Boys had significantly higher mean mathematics scores than girls. Significant sex differences favouring boys were found in the subsamples of most difficult tasks, but not in the subsamples of easiest tasks. No significant sex difference in spatial visualization was found. The hypothesis that boys' superior achievement in mathematics is due to a superior ability in spatial visualization was not supported. Although the effect of spatial visualization on mathematical achievement increased significantly up to a certain level of mathematics task difficulty, the hypothesis that the effect of spatial visualization on mathematical achievement increases with increasing task difficulty was not fully supported. With increasing mathematics task difficulty, it is hypothesized that boys, more than girls, will benefit from spatial visualization. This hypothesis was not supported by the present elementary school data.

Achievement↗
PubMed1998

[Combination of diathermy and argon plasma coagulation in treatment of cicatricial esophageal stenoses].

Scar stenoses of the esophagus are caused by peptic reflux or following surgery of the upper gastrointestinal tract. Short scar cicatricial stenoses are difficult to treat and have a high recurrence rate. Pneumatic dilatations show a short term success. We treated 5 patients with a short scar esophageal stenosis after esophagogastrostomy (n = 3) and after esophagojejunostomy (n = 2). The main symptom was dysphagia. X-ray shows the length of the stenosis (max. 1.5 cm). The stenosis was cutted by diathermy in a starshape. In all 5 cases it was possible to achieve the wide lumen. There were no complications. The combination of diathermy and argon-plasma-coagulation is a safe method, rare of complications in the treatment of short scar stenosis of the esophagus.

Adult↗
PubMed1997

[Venous angiomatous hamartoma of the mesenteric root. Therapy of chylous ascites abd chylothorax--case report].

Hamartomas are rare benign tumors appearing very often without any symptoms. In case of diagnostic detection the operative exploration is indicated for a correct histological diagnosis and resection. In this report we describe a very rare case of mesenterial hamartoma. During the late postoperative course a refilling chylothorax and chylous ascites occurred. With total parenteral nutrition, excluding short- and long-chain fatty acids, chylous leakage was successfully treated. The chylous exudation was stopped totally; only intraabdominally did minimal ascites persist. The therapy was continued by a oral Ceres diet nutrition. The conservative therapy involving total parenteral nutrition permitted us to avoid the peritoneovenous Le Veen shunt and the associated complications.

Adult↗
PubMed1997

The effect of social comparison on mathematics self-concept.

Implicit in the frame of reference hypothesis is the assumption that social comparison is one of the causal determinants of self-concept. The present study of Norwegian sixth-grade elementary school students showed that students of low-, medium-, and high-achievement classes did not differ in mathematics self-concept. Mathematics self-concept was, however, significantly influenced by the students' within-classroom position in mathematics. The results support the frame of reference hypothesis, and the support was consistent over gender.

Achievement↗
PubMed1997

[Bilateral laparoscopic transperitoneal adrenalectomy in pheochromocytoma].

Laparoscopic transperitoneal and endoscopic extraperitoneal adrenalectomy are two safe options in minimally invasive surgery associated with a very low morbidity. Comparative studies with the conventional access to the adrenal gland demonstrated the advantages of the endoscopic technique. The anterior transperitoneal approach yields a better exposure of the anatomic structures and allows the surgeon to orient himself more easily, while at the same time he may perform additional laparoscopic maneuvers. In two cases of bilateral pheochromocytoma a bilateral laparoscopic adrenalectomy was performed simultaneously by employing the transperitoneal approach. The duration of surgery was approximately 210 and 270 min, respectively, with an intraoperative blood loss of about 350 and 400 ml. There were no complications following this procedure. Already on the 1st postoperative day, the patients could be fully mobilized. Furthermore, immunological data obtained perioperatively support the minimal invasiveness of this technique.

Adrenal Gland Neoplasms↗