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Biomedical subjects

A Knipper

Publications and source records attributed to A Knipper.

At least 37 records · Page 2Linked to original sources
PubMed1989

Extracorporeal shock wave lithotripsy in paediatric patients.

24 children with urolithiasis of the upper urinary tract were treated by extracorporeal shock wave lithotripsy (ESWL). In all patients sufficient stone disintegration could be achieved by an average of 950 shock waves. Percutaneous nephrostomy was required for "Steinstrasse" ureteral obstruction in 2 cases. At discharge from hospital 16 children were considered stone-free. Follow-up showed 90% of the children to be stone-free without recurrence (mean 20 months). The necessary precautions considered, ESWL is the method of choice for treatment of urolithiasis of the upper urinary tract in children. The long term effects of ESWL on the juvenile kidney have yet to be observed.

Child↗
PubMed1989

[BCG in reflux].

Nine patients with radiologically proven vesicorenal reflux (3 bilateral, 4 unilateral, 2 with unilateral double-J stents) received intravesical bacillus Calmette-Guérin (BCG) as prophylactic treatment for recurrent superficial bladder carcinoma. One patient with a double-J stent suffered an attack of high fever, probably following obstruction of the stent. All other patients tolerated one cycle or two cycles (5 of 9 patients) of 6 weekly instillations without significant complications. There was no increased toxicity compared with a control group of 39 patients without reflux who were receiving BCG. Topical intravesical immunotherapy with BCG in patients with vesicorenal reflux can be given without a rise in the complication rate; indeed, in view of the multifocal appearance of urothelial carcinoma in this subgroup, this type of therapy even appears to be desirable.

Administration, Intravesical↗
PubMed1982

Pancreatic duct ligation and pancreatic polypeptide (PP) secretion.

The basal and meal-stimulated secretion of pancreatic polypeptide (PP) were measured before and 4-6 weeks after pancreatic duct ligation in five piglets, in two piglets also after 14 and 16 weeks. In all animals histology revealed the expected extreme atrophy of the exocrine pancreatic tissue. Basal and postprandial PP secretion, however, were not altered after duct ligation.

Animals↗
PubMed1978

Surgical emergency cases--endoscopic treatment.

For gastrointestinal surgery endoscopy gains more and more importance. Besides the desired improvement of pre-, intra- and postoperative diagnosis multiple therapeutic procedures proved to be practicable. Of special interest are those methods, which can be used successfully in emergency cases. Here the foreign body dislodgement, the stopping of hemorrhage and the introduction of tubes in cases of ileus or dehiscence of the suture have to be mentioned. The endoscopic treatment is very often a complementary or palliative one and not so much an alternative. These methods are applied to patients at high risk.

Adolescent↗
PubMed1978

[Haemodynamics and shock prevention in acute haemorrhage from the upper intestinal tract (author's transl)].

Acute haemorrhages in the upper intestinal tract derive mainly from smaller low-pressure vessels. Bleeding is generally protracted and is often clinically occult. The clinical signs are a more reliable indicator of the severity of the haemorrhage than are measurements of the central venous pressure, shock index and cardiac output. The considerable tolerance of man to blood loss is probably attributable to the erect standing position. It has the advantage that it provides a large measure of counter-regulatory possibilities; but has the disadvantage that there is only a very narrow margin of safety as regards the development of irreversible shock. Close and consistent co-ordination of diagnosis and therapy is essential in all cases of gastro-intestinal haemorrhage.

Animals↗
PubMed1978

[Annular pancreas (author's transl].

Eight cases of annular pancreas treated at the University Hospital of Hamburg between 1964 to 1977 are presented. In adults, the disease follows the pattern of chronic duodenal obstruction being often asymptomatic unless complications such as peptic ulceration, acute pancreatitis or bile duct obstruction occur. Preoperative diagnosis is only possible by using endoscopic retrograde pancreatography. Attention is drawn to the frequent co-existence of other malformations of the gastro-intestinal tract. Treatment should consist of relief of any obstruction to the duodenum by a bypass gastrojejunostomy is recommeded in those cases having associated peptic ulcer. The division or resection of the annulus bears the risk of fistula formation. A brief review of the theories of the development of annular pancreas is given.

Adult↗
PubMed1977

Experimental carcinogenesis in the resected colon of the rat.

Until now, carcinoma of the large intestine resected previously for benign disease has not been published. However an increasing number of patients resected for Crohn's disease, diverticulitis or trauma may reach nowadays a high lifespan. On the other hand, it is known that the gastroenteral anastomosis is predisposed to cancer development. In this study, the question of whether the large intestine following colotomy or ileotransversostomy is sensitive to carcinogenesis is examined. Male Wistar rats, subjected to colotomy or resection and ileotransversostomy, were treated weekly by subcutaneous injection of 1,2-dimethylhydrazine (12 mg/kg body weight) for seven weeks. The animals were killed 54 weeks after the first injection. At autopsy, 21 out of 29 operated rats had developed adenocarcinomas of the remaining colon. Intact control animals had the same incidence of malignant degeneration of the large bowel. When the anastomosis is chronically irritated by inflammation or by formation of a diverticulum, development, of carcinoma near the stoma was observed. This was the case in three rats of 28 animals. The results demonstrate that the resected colon of the rat is not more sensitive to experimental carcinogenesis than the intact one.

Adenocarcinoma↗
PubMed1977

[Malignant degeneration of experimental ulcerative colitis of the rat following s.c. injection of 1,2-dimethylhydrazine (author's transl)].

Animal experiments were performed to answer the question whether ulcerative colitis is predisposed to malignant degeneration. Male Wistar rats were given aqueous solutions of degraded Carrageenan (4%; w/v). After induction of ulcerative colitis, 1,2-Dimethylhydrazine (DMH; 132 mg/kg body weight) was applicated during a period of 7 weeks. 17 of 18 rats developed multiple adenocarcinomas in the distal colon 15 weeks after the last injection of DMH. The Carrageenan induced colitis was localized predominantly in the distal part of the large bowel. Only 3 rats of a control group of 18 animals exposed to DMH only showed carcinomas of the colon. The difference is proven significant (P less than 0.01). Carrageenan for itself caused no malignancy. The results of the experiments demonstrate that, during ulcerative colitis, the colon of the rat is more susceptible to induction of cancer than the intact one.

Adenocarcinoma↗
PubMed1977

[Peptic anastomotic ulcer induced by continuous duodenogastrix reflux (author's transl)].

Different types of duodenal by-pass operations with and without duodenogastric reflux were performed on 54 male Wistar rats. The results of our investigation show that following duodenal by-pass with reflux peptic anastomotic ulcer regularly occurs. The constant reflux of bile and pancreas juice is the most important aetiologic factor in the development of ulcer in the vicinity of the anastomosis between the stomach and small intestine. Stasis in the by-passed duodenum (afferent loop syndrome) promotes ulcerogenic action of reflux. In the absence of the pylorus the effects of reflux ans stasis potentiate, resulting in a high frequency of ulcer (greater than 90%). With intact pylorus the incidence is low. Duodenogastric reflux prevents hydrochloric acid secretion significantly (P less than 0.01); hydrochloric acid thus plays a minor role in the development of experimental anastomotic ulcer of the rat. -In considering the prophylaxis against anastomotic ulcer, there findings support the claim of avoiding surgical techniques involving duodenal by-pass and reflux (Billroth II with short loop GE). Gastric resection should, therefore, aim at the reconstruction of the orthograde peristalsis.

Animals↗
PubMed1977

[Duodenogastric reflux and anastomosis abscess. Experimental study].

Different types of duodenal by-pass operations with and without duodenogastric reflux were performed on 54 male Wistar rats. The results of our investigation show that following duodenal by-pass with reflux peptic anastomotic ulcer regularly occurs. The constant reflux of bile and pancreas juice is the most important aetiologic factor in the development of ulcer in the vicinity of the anastomosis between the stomach and small intestine. Stasis in the by-passed duodenum (afferent loop syndrome) promotes ulcerogenic action of reflux. In the absence of the pylorus the effects of reflux and stasis potentiate, resulting in a high frequency of ulcer (greater than 90%). With intact pylorus the incidence is low. Duodenogastric reflux prevents hydrochloric acid secretion significantly (p less than o,o1); hydrochloric acid thus plays a minor role in the development of experimental anastomotic ulcer of the rat. -- In considering the prophylaxis against anastomotic ulcer, these findings support the claim of avoiding surgical techniques involving duodenal by-pass and reflux (Billroth II with short loop GE). Gastric resection should, therefore, aim at the reconstruction of the orthograde peristalsis.

Abscess↗
PubMed1977

[Intussusception of the vermiform appendix (author's transl)].

Intussusception of the vermiform appendix is reported in a frequency of 0.01%. Different aetiologic factors are implicated, a directed hyperperistalsis against intraluminal obstruction is thought to be the pathogenetic mechanism. There is a lack of typical symptoms, very often appendicitis or caecal tumor is diagnosed. Concomitant inflammation renders recognition more difficult. The caecum must be resected if a malignant tumour cannot be ruled out. Appendectomy is performed in definite findings. Our case report may remind of this uncommon occurrence.

Appendectomy↗