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Biomedical subjects

W Peitsch

Publications and source records attributed to W Peitsch.

At least 19 recordsLinked to original sources
PubMed1992

Budd-Chiari syndrome as the primary manifestation of a fibrolamellar hepatocellular carcinoma.

An 18-year-old female patient was admitted with ascites, right upper abdominal tenderness and peripheral edema. Angiography showed complete occlusion of the vena cava inferior up to the level of the right atrium. By open heart surgery, masses of thrombotic material were pulled out of the v. cava inferior/vv. iliacae which histologically contained tumor cell populations consistent with a hepatocellular carcinoma. Celiacography showed a highly vascularized tumor in the right hepatic lobe. Histologically, it proved to be fibrolamellar subtype hepatocellular carcinoma.

Adolescent↗
PubMed1989

[Balloon catheter arterial occlusion before high-risk splenectomy and nephrectomy].

Balloon catheter occlusion of the splenic or renal artery was undertaken in 10 patients (7 men and 3 women, aged 20-76 years) 30 to 120 min before a splenectomy (n = 8) or nephrectomy (n = 2), for the purpose of preventing a high intra- and post-operative blood loss and facilitating the technical procedure of removing an often markedly enlarged spleen. The operation time after balloon catheter occlusion was only 60-140 min; intra- and post-operative complications did not occur, other than one instance of pneumonia and one of subcutaneous haematoma. This method would seem to be suitable for reducing the operative risk of splenectomy or nephrectomy in the presence of a giant spleen or reduced tolerance of operation.

Adult↗
PubMed1988

[Indications for subtotal thyroidectomy in patients with amiodarone- (iodine-) induced hyperthyroidism].

Therapy with the antiarrhythmic drug amiodarone implies administration of free iodine in dosages between 6 and 36 mg/day. Especially patients from areas with low iodine intake are at risk to develop iodine-related hyperthyroidism. In 2 case reports the indication of subtotal thyroidectomy is discussed. In 1 patient decision for operation was made after 7 weeks of inefficient therapy with high-dose methimazole. For another patient decision for operation was made but performance had to be postponed because of acute myocardial infarction. Surgical therapy has the advantage of immediate and safe effectivity, low risk of relapse and provides the possibility of further iodine administration without major problems. The risk of operation has to be evaluated against the risk of a long-term treatment with antithyroid drugs preferentially from the thiomide type or against the risk of persistent hyperthyroidism.

Amiodarone↗
PubMed1987

[Dieulafoy's exulceratio simplex. A rare but serious cause of acute upper gastrointestinal bleeding].

Twelve patients suffering from haemorrhages from a superficial exulceration (Dieulafoy's disease) were treated on an emergency basis during the period from 1981 to 1987. Preoperative diagnosis by means of gastroscopy was possible in 3 cases only. The sites of predilection within the cardia and near to it, except the curvatures, determined the surgical access by means of high gastrotomy-independent of a verification of the diagnosis. In 11 cases the therapy consisted of the purse-string ligature, in one case endoscopic sclerosing was successful. The mortality rate was 16.6%.

Aged↗
PubMed1987

[Initial interventions in ulcer disease: indications--choice of procedure--results].

Routine use of H2 receptor blockers in the therapy of chronic gastroduodenal ulcers reduced the number of ulcer operations. The ulcer recurrence rate in postpyloric and duodenal ulcer seems to be lower after highly selective vagotomies than during long term maintenance treatment, prepyloric ulcers are treated best by gastric vagotomy and antrectomy. In the absence of risk factors perforated gastroduodenal ulcers are treated better by definitive surgery (suture plus vagotomy) than by simple suture.

Combined Modality Therapy↗
PubMed1986

[Gastroduodenal ulcer--changes in surgical therapy by long-term drug treatment].

Routine use of H2 receptor blockers has helped to reduce the rate of selective vagotomies and has brought down the range of surgical ulcer patients. For peptic ulcer therapeutic medication has proved to be superior to surgery. Various studies were evaluated and have brought into focus questions of decision-making between medicamentous and surgical treatment of ulcer. Therapeutic approaches are recommended for emergency treatment of bleeding duodenal ulcer and recurrent ulcer.

Anti-Ulcer Agents↗
PubMed1985

[Value of the gastrografin enema in the diagnosis of ileus].

From 1978-1984 421 patients were examined by colon enema with gastrografin. The indication in 246 cases was an acute abdomen, in 172 patients the procedure has been performed postoperatively, 3 patients suffered from gastrointestinal bleeding. 81 of 236 pathological findings showed an ileus. 58 of them underwent an operation. The cause of the ileus were tumors of the colon, extraluminal tumors as well as performations and inflammations. In 55 cases the findings of the gastrografin enema were confirmed by the operation, one was proved to be false negative, one uncertain and one false positive. Therefore the diagnostic accuracy of this procedure amounted to 96%.

Colonic Diseases↗
PubMed1984

[Peripheral venous parenteral feeding in abdominal surgery].

15 patients with a healthy metabolism, who underwent surgery because of gall stones or duodenal ulcer disease, were submitted to complete peripheral parenteral nutrition for 4 days. The group received 40 ml fluid/kg body weight/day, 1.2 g amino acids and 2.4 g carbohydrates (Sorbitol: Xylitol = 1:1)/kg body weight/day in a fixe combination. There were no disturbances in the electrolyte metabolism; the urine alpha-aminonitrogen loss was lower than 4%. The visceral proteins with a short half-life period (transferrin, C-3c-complement, C-4-complement, retinol-binding protein and prealbumin) stayed within the normal range or increased. 3 of the 15 patients developed minor phlebothrombotic complications, therefore the infusion should be changed routinely to the contralateral arm after an infusion period of 48 hours.

Amino Acids↗
PubMed1982

Mucosal gastrin receptor. VII. Up- and downregulation.

A series of experiments were performed to examine the long-term upregulation of the gastrin receptor and to explore the possibility of a short-term down regulation with regard to the time course of the trophic action of gastrin. Vagotomy or fasting was used to examine upregulation. Elevated serum gastrin levels observed postvagotomy are accompanied by an increase in gastrin binding capacity. Conversely, fasting caused a decline in serum gastrin and receptor levels; refeeding restored both values to normal levels. Cycloheximide was used to study the role of protein synthesis in the upregulation of gastrin receptors in vagotomized and refed rats, and it prevented the rise of gastrin binding capacity to either normal or above-normal values. This indicates that protein synthesis may play an integral part of receptor upregulation. Following the injection of gastrin-17, there was a short-term induction of downregulation. These results coupled with the maximal reduction of gastrin receptor 3 h after cycloheximide injection indicate that the gastrin receptor has a short half-life. Following the gastrin receptor interaction, the cellular response occurs at discrete periods and manifests itself as both down- and upregulation.

Animals↗
PubMed1982

Mucosal gastrin receptor. VIII. Sex-related differences in binding.

The purpose of the current study was to determine whether gastrin binding differed between the sexes and, if so, to ascertain the factors responsible. Male and female rats were killed at various times from 15 to 60 days after birth. Binding capacities in male and female rats were equal until puberty. By day 40 there were significantly more receptors present in males than females. Females had 2.4 fmol receptor/mg prot by day 40, and this value remained constant into adulthood. In male rats the number of receptors continued to increase to 4.0 fmol/mg prot at day 60. Castration did not significantly decrease the number of receptors in male rats. Ovariectomy, however, increased the number of receptors in female rats to a value not significantly different from male controls. Ovariectomized females consumed more food and had higher serum gastrin levels. If ovariectomized rats were pair fed to the level of intact females, the number of receptors and serum gastrin levels decreased over those present in ovariectomized rats fed ad libitum but still remained significantly higher than those in intact females. Adrenalectomy of ovariectomized females caused a further increase in receptor number.

Adrenalectomy↗
PubMed1981

Mucosal gastrin receptor. V. Development in newborn rats.

We determined the development of the oxyntic gland mucosal gastrin receptor in rats killed at various times from 5 to 60 days after birth. Rats were weaned on the 18th day after birth. Newborn animals had no detectable gastrin binding, high serum gastrin levels (800-1,200 pg/ml), low antral gastrin levels (0.5-2.0 micrograms/g tissue), or high pH of gastric contents (pH greater than 5.0) and did not respond to pentagastrin. At the time of weaning, serum gastrin dropped to 600 pg/ml and reached adult levels (300 pg/ml) on day 40. Antral gastrin increased to 7.5 micrograms/g tissue on day 20 and reached adult levels (20 micrograms/g tissue) on day 22. Specific binding of gastrin was first detected on day 20 and reached the adult level of 4 fmol/mg protein on day 60. Pentagastrin significantly stimulated acid secretion on day 20 and DNA synthesis on day 25. Prevention of weaning through day 25 decreased the magnitude but did not prevent or delay the onset of the above changes. These results indicate that 1) the absence of a gastrin response in newborn rats is due to a lack of gastrin receptors, 2) development of gastrin receptor and biological sensitivity to gastrin appear at the time of weaning, and 3) the development that occurs with weaning is enhanced but not triggered by the shift to solid food.

Aging↗
PubMed1981

Mucosal gastrin receptor. VI. Induction by corticosterone in newborn rats.

Serum and antral gastrin levels as well as specific binding of [125I]gastrin-17 to a 270-30,000 g oxyntic gland mucosa crude membrane preparation were measured in rats between 5 and 40 days of age. Rats were normally weaned at day 18, although weaning was prevented in some animals until day 25. The results of these studies confirmed our previous data showing that mucosal gastrin receptors and antral gastrin levels begin to increase at the time of normal weaning and reach adult levels within a few days. Although the shift from liquid to a solid diet enhances the response, it is not essential for it and does not trigger it. In addition, the current studies demonstrated that injection of corticosterone caused a premature increase in both gastrin receptor and antral gastrin levels. Once maturation had occurred, however, corticosterone had no further effect. Adrenalectomy delayed but did not prevent the maturational changes in gastrin receptors and antral gastrin levels. Normal serum gastrin concentrations were necessary for the number of gastrin receptors and the amount of antral gastrin to reach normal levels.

Adrenalectomy↗
PubMed1979

[Calorie requirement after major abdominal surgery (author's transl)].

After major abdominal surgery 32 patients received a parenteral nutrition for 6 days with 360 g of a carbohydrate mixture (levulose:glucose:xylitol = 2:1:1) and 100 g of an L-amino acid mixture/24 h. 16 patients with benign disease showed positive nitrogen balances, 16 patients with malignant diseases balanced or slightly negative nitrogen balances. Postoperatively, blood glucose levels did not require insulin. Less than 1.5% of the infused levulose, 2.0% of glucose and 2.4-4.1% of xylitol were found in urine. C3- and C4- complement levels in serum were below normal, transferrin showed a pathological decrease in carcinoma patients.

Abdomen↗
PubMed1979

[Pneumothorax and haemothorax (author's transl)].

Pneumothorax and haemothorax constitute serious complications of a blunt chest trauma. During 1970-1978 64 persons with pneumothorax and 109 cases of haemothorax were admitted to and treated in the Surgical Unit of the University Hospital, Göttingen. In nearly every case fracture of several ribs had also occurred. The method of choice for treating cases of pneumothorax was by Bülau drainage; surgical closure of the air leakage was rarely necessary. Conservative measures are indicated only if the pneumothorax is narrow or confined to the apical region. It is worth mentioning that in a large number of cases pneumothorax developed during positive pressure ventilation after a chest injury. Complications of Bülau drainage were: damage to the lungs, skin emphysema and bleeding from the intercostal artery. Open application of the Bülau drainage in the 2nd intercostal space is therefore recommended. Treatment of traumatic pleural effusions by Bülau drainage was required in only 14 of 109 cases. Therapy-resistent effusions necessitated thoracotomy and evacuation of the haematoma in 4 persons. If Bülau drainage fails completely to evacuate the haemothorax, it should be promptly followed by thoracotomy to prevent the development of adhesions and the resulting impairment of respiratory function.

Drainage↗