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Biomedical subjects

A Thiede

Publications and source records attributed to A Thiede.

At least 181 records · Page 10Linked to original sources
PubMed1996

[Endo-anal sonography in diagnosis of fecal incontinence].

Endoanal ultrasound is a new imaging technique in the diagnostic work-up of patients suffering from anal incontinence. A standardised examination as well as hardware specific reference values for the sphincter muscles are of paramount importance to allow correct interpretation of the continence organ. At the University Hospital of Würzburg from 1.2.1993 to 31.7.1994 90 patients (50 male, 40 female; age: 16-81 y.) with normal continence underwent endosonographic assessment of their sphincter complex. We measured the internal anal sphincter (IAS), puborectalis muscle as well as the three separate parts of the external anal muscle (EAS). Apart from establishing reference values we found a significant increase in thickness of both EAS and IAS with increasing age. However, no correlation was seen between muscle thickness, sex, height or weight. We also examined 29 patients with a history of incontinence. 13 (45%) had a morphological sphincter defect, most of which were due to obstetric trauma or previous proctological operations. 10 (35%) patients suffered from so called idiopathic incontinence. Anal ultrasound in these patients revealed muscle hypotrophy of the structurally intact sphincters.

Adolescent↗
PubMed1996

[Anorectal pull-through and vector volume manometry].

Anorectal manometry has been developed from an object of clinic oriented scientific interest to an established tool within the spectrum of proctologic diagnostics. At present it represents the only objective diagnostic method with regards to continence disorders; it is routinely applied in the evaluation of constipation, of incontinence, of pre- and postoperative conditions in diseases of the anorectum as well as in the indication and therapeutic control investigations during biofeedback training of the anal sphincter. The new technique of determination of the anal sphincter pressure vector volume allows for the most sensitive functional separation of patients with different degrees of continence; this method delivers a 3-dimensional graphic imaging of the sphincter pressure profile, thus allowing for an objective visualisation of the present mechanic defect and an aid in planning a surgical correction.

Anal Canal↗
PubMed1996

[Surgical therapy of rectal prolapse].

A review of literature and own clinical studies confirm that best postoperative functional results in complete rectal prolapse may be reached with rectopexy in combination with partial resection of the colon. Incontinence may be improved in 38% to 93%, depending on the author. Constipation may be reduced in 41% to 83% of the cases. In comparison, rectopexy without resection resulted in a reduction of constipation of only 11% to 28%, with even a change to the worse in 60% of the patients. Improved operative and anesthesiological conditions cause an acceptable perioperative morbidity (7-13%) and mortality (0-2%) after rectopexy with partial resection of the colon.

Colon↗
PubMed1996

[160 years St. Mark's Hospital in London--a brief historical excursion].

The St. Mark's Hospital in London is one of the oldest and most renown centers of colorectal surgery and science. The historical building in the City Road was inaugurated by Frederick Salmon in 1835 who founded the "St. Mark's Hospital for Fistula". In the summer of 1995 the institution left City Road to be relocated on the modern and spacious premises of Northwick Park north of London. The author and scholar of the Coloplast Foundation at St. Mark's, takes the opportunity of the 160th anniversary to review the hospital's history and some of its famous physicians.

Colorectal Surgery↗
PubMed1996

[Anorectal endosonography in tumor after-care].

Due to its high resolution and the possibility to compare the images with previous examinations the transrectal ultrasound (TRUS) can lead to an earlier diagnosis of locally recurrent rectal cancers. Using TRUS we were able to correctly identify ten of 12 local recurrences. In four cases TRUS was the only diagnostic tool as neither the alternative imaging technique nor endoscopy were able to show the recurrence.

Endosonography↗
PubMed1995

Peritoneal seeding of gallbladder cancer after laparoscopic cholecystectomy.

We report a case of peritoneal seeding of an unsuspected adenocarcinoma of the gallbladder following laparoscopic cholecystectomy despite the use of a retrieval bag. The metastasis developed at the umbilical trocar site, which was also used to extract the resected gallbladder. There was no evidence foe a leak of the retrieval bag. Most likely malignant cells became desquamated during the operation, implanting themselves in the tissue during the removal of the bag. Taking into consideration previous reports and the dismal prognosis of the disease, we discuss the management in the case of an incidental carcinoma.

Adenocarcinoma↗
PubMed1995

[Is ion-selective measurement of the liver surface for detection of cell damage suitable?--A study of the rat liver transplantation model].

UNLABELLED: Aim of the study is to detect a reperfusion injury in rat liver transplantation by the Ion-selective Surface-Measurement (OMS). METHODS: Lewis rats served as models for 30 liver transplantations with 1, 6 or 12 hrs of cold ischemia respectively. Directly before, during and after transplantation potassium- and hydrogen-concentrations were measured with the OMS and compared to transaminase values on day 1, 3 and 7 as well as to biopsies on day 3. RESULTS: Transaminase values and histology show ischemic cell injuries correlating to the length of ischemia, whereas potassium- and hydrogen-concentrations on the organ surface do not. CONCLUSIONS: Ischemic cell injury in the rat liver cannot be detected by the Ion-selective Measurement.

Acid-Base Equilibrium↗
PubMed1995

[Endorectal ultrasound for evaluating perirectal processes].

Between July 1992 and December 1993 we examined 258 patients by endorectal ultrasound at the Surgical Department of the University of Würzburg. In 24 (9.3%) patients we found 27 perirectal lesions. These comprised abscesses, cysts, primary and secondary malignancies, as well as various benign tumours. All lesions but one underwent histological and/or microbiological examination. Endosonographic assessment with regard to size, location and anatomical structure was correct in 24 (89%) cases. We performed ultrasound-guided, transrectal aspiration in six patients. Endorectal ultrasound is a useful complementary imaging device in the assessment of pararectal disease. Owing to its high resolution it may be superior to other methods (e.g. CT or MRI). Another advantage is the possibility of ultrasound-guided aspiration biopsy. Precise knowledge of the topographic anatomy and its endosonographic appearance is of great importance.

Adult↗
PubMed1994

Laparoscopic adhesiolysis.

The aim of this study was the detection of criteria that support the indication for laparoscopic adhesiolysis in patients presenting with unspecific symptoms. A prospective analysis investigates the value of laparoscopic adhesiolysis in patients with chronic abdominal pain after exclusion of other pathologic findings; 58 consecutive patients were followed after laparoscopic adhesiolysis. Endpoints of investigation were extent of adhesions, complications, postoperative hospitalization, and postoperative quality of life. A comparison was drawn to patients following laparoscopic cholecystectomy, laparoscopic cholecystectomy plus adhesiolysis, and conventional cholecystectomy. The results showed that major complications occurred in 10% of cases. In 45% of patients we found a complete remission, in 35% a substantial improvement, and in 20% a persistence of complaints. In a correlation between the preoperative complaints and the extent of adhesions we found small adhesions to cause recurrent abdominal pain without other symptoms while large adhesions produce recurrent abdominal pain in combination with symptoms indicative of intermittent bowel obstruction. Finally, the results of this study indicate a certain "ideal constellation" for an enduring successful adhesiolysis per laparoscopy: it is the subjective complaint of recurrent abdominal pain with a localized and reproducible punctum maximum in combination with a circumscribed area of adhesions at that site.

Abdominal Pain↗
PubMed1994

Motility in the Hunt-Lawrence pouch after total gastrectomy.

PURPOSE: The aim of this study was to evaluate motility patterns of the Hunt-Lawrence pouch and the jejunal limb of patients reconstructed with a pouch after total gastrectomy, and to compare the findings in symptomatic patients to those without symptoms after the operation. PATIENTS AND METHODS: Thirty-three patients who had undergone post-gastrectomy pouch reconstruction were studied using a water-perfused motility system. In 21, the pouch was connected by a Roux-en-Y, and, in 12, by a jejunal interposition. Twenty-eight patients were asymptomatic, including 17 connected by a Roux-en-Y and 11 by a jejunal interposition. Five patients were by a jejunal interposition. Five patients were symptomatic, including 4 connected by Roux-en-Y Y and 1 by jejunal interposition. A control group consisted of 5 healthy volunteers who had not undergone operation. RESULTS: The motility phases in the pouch and jejunal limb of asymptomatic patients were of shorter duration than those of controls, and they followed a random sequence instead of a normal progression from phase I to II to III. Motility features were similar in the pouch and the jejunal limb. Orthograde propagation of phase III-like activity was reduced and may contribute to the pouch storage function. Four of the 5 symptomatic patients showed highly abnormal motility with hypomotile or obstructive patterns. The technique of connecting the pouch--jejunal interposition of Roux-en-Y--did not affect the motility findings. CONCLUSIONS: The altered motility occurs after a Hunt-Lawrence pouch reconstruction in asymptomatic patients. Symptoms after gastrectomy are associated with further disturbed motility that can be differentiated from the motility changes in asymptomatic patients.

Adult↗