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Biomedical subjects

A Lampel

Publications and source records attributed to A Lampel.

24 records · Page 2Linked to original sources
PubMed1995

In situ tunneled bowel flap tubes: 2 new techniques of a continent outlet for Mainz pouch cutaneous diversion.

In Mainz pouch continent cutaneous urinary diversion, introduction of the in situ tunneled appendix as the continent outlet in 1990 has simplified the surgical technique and greatly increased the acceptance of the procedure. Based on the results of long-term animal studies, 2 new techniques of a continent outlet were randomly used with a Mainz pouch 1 procedure (ileocecal pouch) in 17 patients in whom the appendix was not available or usable for construction of a continent outlet. According to the flap valve principle of the tunneled appendix, in 17 patients a small caliber conduit was created from large bowel wall at the lower pole of the cecum and was tunneled in situ under the mucosa. In technique 1 (seromuscular bowel flap tube), a tube lined by serosa was created from a pedicled island flap of large bowel wall in 11 patients. In technique 2 (full thickness bowel flap tube), a tube lined by mucosa was created from a pedicled flap of large bowel wall in 6 patients. After a mean followup of 8 months (range 2 to 17) 16 of 17 patients catheterize the reservoir at intervals of 4 to more than 6 hours using 14 to 16F catheters and are continent day and night without leakage. The only major complication in this series was incontinence in 1 patient with a seromuscular bowel flap tube who died of metastatic tumor 6 months postoperatively.

Dermatologic Surgical Procedures↗
PubMed1993

Reservoir characteristics of Mainz pouch studied in animal model. Osmolality of filling solution and effect of oxybutynin.

In a canine model of the Mainz pouch, intracavitary pressure and compliance were measured during instillation of isosmotic and hyperosmotic (900 mmol/kg water) solutions of saline. Wall properties of small- and large-bowel segments of the pouch were assessed individually by sonomicrometry. Intraluminal pressures increased more steeply during filling with hyperosmotic solution, resulting in reduced distensibility of small- and large-bowel segments. Additionally, instillation of the hyperosmotic solution resulted in increased amplitudes and frequency of intracavitary pressure waves. The results indicate that this was the result of a combination of intensified bowel contractions and an increased mural tension. Topical application of oxybutynin abolished these effects. These findings are reviewed in light of the nocturnal increase in urine osmolality, its correlation with nocturnal incontinence in patients with enterocystoplasty, and possible treatment choices.

Animals↗
PubMed1993

Management of ureteral strictures by different modalities and effect of stents on upper tract drainage.

Ureteral strictures were induced experimentally by unilateral partial ligation of the upper ureter on the left side in 56 female rabbits. Six weeks later, stricture stability was documented by intravenous urography. In all cases, there was fibrosis of the muscular wall of the ureter. The lumen, although narrowed to various degrees, was preserved in most animals, and moderate to marked hydronephrosis resulted. Control animals were not treated in order to study the natural progress of the stricture. The other strictures were treated either by dilation (catheter or balloon) with or without ureteral stenting, by intubated external ureterotomy, or by excision of the strictured segment and stented end-to-end anastomosis. Follow-up studies consisted of intravenous urography, renography, and histologic examination for 24 weeks. Ureteral dilation without and with 2 weeks of stenting could be an adequate treatment of strictures associated with a moderate degree of hydronephrosis. Intubated external ureterotomy did not give satisfactory results in any animal. Excision of the strictured segment with a stented anastomosis produced satisfactory results and has a great role in the treatment of the strictured ureter in comparison with the variable outcome of endourologic treatment. Stenting of the unobstructed ureter, tested in six rabbits, showed a positive correlation between renal obstruction and long-term ureteral stenting.

Animals↗
PubMed1992

Interstitial cystitis: increased sympathetic innervation and related neuropeptide synthesis.

To investigate the possibility of a neural deterioration of the bladder wall in interstitial cystitis, bladder tissue from 10 patients with interstitial cystitis was compared with that from 10 control subjects by means of immunohistochemistry. An enhanced innervation of the bladder in the submucosa and detrusor muscle was found to represent an increase of sympathetic but not cholinergic neurons. In interstitial cystitis the number of neurons positive for vasoactive intestinal polypeptide and neuropeptide Y was higher and carried a larger number of axonal varicosities, whereas the number of neurons positive for substance P and calcitonin-gene-related peptide was not significantly different in both groups. We conclude that interstitial cystitis is associated with increased sympathetic outflow into the bladder and altered metabolism of vasoactive intestinal polypeptide and neuropeptide Y. Since similar changes have been observed in other inflammatory diseases of a presumably autoimmune nature, such as rheumatoid arthritis, Crohn's disease and colitis ulcerosa, the pathophysiology of interstitial cystitis may share common pathways with the latter. Experience in these diseases may facilitate a better understanding of the pathophysiology of interstitial cystitis and suggest new therapeutic concepts.

Adrenergic Fibers↗
PubMed1992

Tumor in the horseshoe kidney: clinical implications and review of embryogenesis.

We report on 3 patients with tumor in a horseshoe kidney, 1 of whom had bilateral tumor (renal cell cancer on the right side and urothelial cancer on the left side). Tumors that arise predominantly in the bridge of a horseshoe kidney can mimic the symptoms of an intra-abdominal disease process. Besides routine diagnostic procedures, angiography is essential to plan the surgical approach, which in principle should be organ-sparing. The literature of the embryology of the horseshoe kidney was reviewed for a relationship between the abnormal renal development and the site of tumorigenesis, and for development of a key for the wide variation of blood supply. Recently reported data suggest that the theory of a mechanical fusion is valid only for horseshoe kidneys with a fibrous isthmus but that an abnormal migration of the posterior nephrogenic area causes the majority of horseshoe kidneys in which the isthmus consists of parenchyma. Development of the isthmus through abnormal migration could predispose this location for renal cell cancer and would explain the varying forms of blood supply. Additionally, this hypothesis supports the previously raised assumption that horseshoe kidneys may be the result of teratogenic factors, which also may be responsible for the known increased incidence of related congenital anomalies and of nephroblastoma.

Adult↗