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Biomedical subjects

W Krautzberger

Publications and source records attributed to W Krautzberger.

10 recordsLinked to original sources

CA 19-9 and pancreatic adenocarcinoma.

The diagnostic place value of CA 19-9, a tumor-associated antigen, was tested in 611 patients. This group of patients included 273 patients who suffered from a malignant disease (48 patients with pancreatic carcinomas and 225 patients with extrapancreatic malignant growths) and 338 patients with benign diseases (66 patients with chronic pancreatitis, 36 patients with acute pancreatitis, and 236 patients with general surgical diseases). In 93% of the patients with pancreatic carcinoma (media value, 528 U/ml), in 37% and 19% of the patients with carcinoma of the stomach and colorectal carcinomas (median value 8 U/ml), respectively, the CA 19-9 value was estimated as being above the normal limits of 6 to 37 U/ml. A sensitivity of 93% and a specificity of 85%, as well as a total accuracy of 82%, were established in pancreatic carcinoma during preoperative observation. The preoperatively raised CA 19-9 concentration in patients with pancreatic carcinomas dropped after curative resection of the carcinoma to within normal limits. However, a serum concentration of less than 37 U/ml was not recorded in any CA 19-9 estimation after a palliative surgical intervention, or in any case of inoperable carcinomas.

Adenocarcinoma

Total gastrectomy. A 15-year experience with particular reference to the patient over 70 years of age.

Between 1969 and 1984, a total of 186 patients underwent total gastrectomy. Seventy-four patients were more than 70 years of age. Surgical mortality was 13.4%, with only minor differences between those patients younger than 70 years and older patients--12.5% and 14.8%, respectively. Moreover, there was no major difference if surgery was curative or merely palliative. Of 27 patients with tumors at TNM stage IV, only one died. Of the 100 patients who were operated on during the five-year period between 1979 and 1984, only four died, for an operative mortality of 4%. These results suggest that this remarkable decline of mortality is due to a precise standardization of surgical technique and improvements in preoperative patient management and aftercare. The five-year survival was 15.9%; again, there was no major difference between the group of patients older than 70 years and those younger than 70 years (19.4% and 14.5%, respectively). The ten-year survival was 4.9%.

Age Factors

A metastatic endocrine-neurogenic tumor of the ampulla of Vater with multiple endocrine immunoreaction--malignant paraganglioma?

The present case report demonstrates the history of a 50-year-old man with a mixed endocrine-neurogenous tumor of the ampulla of Vater. The tumor was localized endoscopically after an attack of melena. There were no signs of endocrinopathy. A local resection with suturing of the pancreatic duct was performed. Morphologically, there were two different tissue types (neurogenous and carcinoid-like) with numerous cells and nerve fibers reacting immunohistochemically with somatostatin and neurotensin antisera: some immunoreactivity to PP-antibodies was observed. Still, after 20 months, the patient seems to have been cured by local resection.

Ampulla of Vater

Duodenum-preserving resection of the head of the pancreas in patients with severe chronic pancreatitis.

A duodenum-preserving resection of the head of the pancreas was carried out in 57 patients with chronic pancreatitis and a benign tumorous enlargement of the head of the pancreas. The resected tissue showed a diameter of more than 5 cm in 64% of the patients. The postoperative mortality rate was 1.8%. The postoperative hospitalization period was 19 days (median). In a follow-up period of 2.0 years (median) with a minimum of 1 month and a maximum of 10.5 years, the late mortality rate was 3.6%. Of the patients, 85.7% are completely rehabilitated occupationally. In contrast to the Whipple procedure, the duodenum-preserving resection of the head of the pancreas preserves stomach, duodenum, jejunum, and extrahepatic bile ducts in an advantageous way. The subtotal resection of the head of the pancreas decompresses the common bile duct without disturbance of the blood flow to the duodenum.

Adult

Arterio-venous shunt with percutaneous leads in calves for long-term in vivo testing of blood-contact materials.

In six calves an extracorporeal arteriovenous shunt in combination with a successful type of percutaneous lead has been implanted. Flow chambers with various test materials can be inserted. Preliminary results show that this shunt can be used for long term tests for evaluation of blood contact material and studies about thrombus formation in an ex vivo setting as well as for permanent blood access for the purpose of various measurements, drug application and for hemodialysis.

Animals

[Controlling of artificial blood pumps after total heart replacement - an example of disregulation (author's transl)].

This is a report on the special regulation problem of the left blood pump after replacement of the natural heart by incorporated extracorporally driven blood pumps in an animal experiment. The consequence of the peripheral self-regulation on the transporting capacity of the bloodpumps considering the driving pressure and the systemic pressure losses has been investigated. Two possible controlling principles and the respective fields of application are discussed on the example of a lung oedema.

Animals

[Observation in 10 calves with a survival time of more than 100 hours after total heart replacement (author's transl)].

It is reported on 10 calves surviving total artificial heart replacement more than 100 hours. Pneumatically driven double-chambered blood pumps made of silastic were implanted. During the experiments an increase of the right atrial pressure as well as a rise of the perfusion volumes (CO) and of the blood volumes could be found regularly. At autopsy congestion of the organs especially of the liver was a regular finding. The changed hemodynamic is first seen as possible reason for this developments. The influence of anemia and the possible disturbances in the neurohumoral autoregulation of the animals by unphysiologic pressure curves are discussed.

Animals