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Biomedical subjects

A Thiede

Publications and source records attributed to A Thiede.

At least 235 records · Page 13Linked to original sources
PubMed1989

[Methods for the analysis of the psychosocial behavior of the quality of life index in rats with different reconstructions after gastrectomy].

Standardized behaviour monitoring in rats is a well-suited method for the evaluation of behavioral und nutritional effects following reconstruction surgery. Using an experimental design possible side effects resulting from the original disease can be excluded, which is an important advantage compared to clinical studies. Behavioural effects can be related to changes in biological functions following surgery. After gastrectomy 10 rats were reconstructed by Roux-Y-technique and 10 other animals by oesophagoduodenal interposition. In an open-field-behaviour-test they were compared with 10 sham operated and 10 untreated controls. Differential effects can be shown by special behavioural indices.

Anastomosis, Roux-en-Y↗
PubMed1988

[Surgical possibilities in recurrence of colorectal carcinoma].

Locoregional recurrences occur in 10 to 15% of curatively operated rectal carcinomas. Technically conditioned relapses can be largely avoided by proper procedure, such as taking into consideration the localisation, staging, grading, safety zones and step-by-step procedure, e.g. "no-touch-isolation" technique, radicular approach and rinsing with cytocides. In this manner, locoregional relapses can be reduced to about 10%. Only technically conditioned relapses can be cured by surgery, but, as already stated above, these should be avoided by an appropriate technique. It is quite out of place to indulge in euphoria in respect of treating locoregional recurrences, as shown by long-term examination of actual survival rates; calculated survival rates are certainly inappropriate for spreading euphoria. Such locoregional relapses can be recognised relatively early and reoperated "curatively" only if aftercare follow-up is regular and intensive. It seems that endorectal sonography is of special diagnostic importance for the early detection of relapses while being a relatively simple method. It must be stated quite clearly that efficient preventive measures during the first operation will be much more effective than any efforts put into follow-up or aftercare. Every surgeon should therefore know that it is imperative to proceed subtly and carefully during the first operation so as to avoid any relapses due to faulty technique, the more so since all relapses have a poor prognosis even with so-called "curative" operations.

Colonic Neoplasms↗
PubMed1987

Pouch and Roux-en-Y reconstruction after gastrectomy.

We evaluated a reconstruction procedure of the upper gastrointestinal tract after total gastrectomy with the exclusive use of the EEA, GIA, and TA surgical stapling devices (United States Surgical Corp, Norwalk, Conn). Twenty patients with gastric carcinoma entered the study. A total gastrectomy and lymphadenectomy was performed in each patient and the upper gastrointestinal tract was reconstructed by the Roux-en-Y technique with the creation of a Hunt-Lawrence-Rodino pouch. For all operational steps, surgical staplers were used exclusively, as follows: (1) duodenal closure, GIA or TA; (2) Roux-en-Y anastomosis, EEA 25; (3) pouch construction, GIA (three to four times); (4) esophagojejunostomy, EEA 25; and (5) pouch closure, TA 55 or 90. There was a one-hour difference in operating time between patients operated on exclusively by the staple technique and TNM-matched patients operated on manually. Four patients suffered from general complications. Two patients had clinically relevant suture deficiencies. We concluded that current reconstruction methods after gastrectomy that fulfill the reservoir function (pouch) and reflux prevention (Roux-en-Y reconstruction) can be achieved by the combination and systematic use of straight and circular staplers. The advantages are intraoperative time saving and a relaxation of limitations imposed on an abdominal intervention by age and localization of the tumor.

Adult↗
PubMed1987

[Maxon and PDS--evaluation and physical and biologic properties of monofilament absorbable suture materials].

The physical parameters of monofilament absorbable sutures (Maxon and PDS) were studied. Compared to PDS Maxon proved somewhat more unwieldy, however, it required less complicated knot combinations for a secure placement than PDS did. In vivo experiments on rats showed a slight tissue reaction and a dissolution time of 120-180 days for Maxon and 180-240 days for PDS. With Maxon, tensile strength was measurable for 42-49 days, while the period for PDS amounted to 65-80 days. New indications for these materials are discussed, two parameters, easy knot formation and atraumatic passage through the tissue, especially favor the use of Maxon for one-row all-layer sutures in the gastrointestinal tract.

Animals↗
PubMed1987

[Manual suture versus/or mechanical suture from the German viewpoint].

There is a definite increase in the application of stapled sutures in the gastrointestinal tract and the lung. This is due to high level of technical perfection of modern staplers whose preceding models were actually already developed at the beginning of this century. The introduction of circular staplers since approx. 1978/79 has resulted in a true breakthrough for gastrointestinal tract surgery. Thanks to these circular staplers surgeons have been especially innovative regarding the principles of reconstruction. Thus the procedures for the formation of substitute stomachs (Roux-Y and pouch, interposition and pouch) allow an unprecedented degree of standardization and offer new physiological perspectives. The use of circular staplers in the rectum is generally accepted. However, a recent development concerning manual sutures using medium-term absorbable suture material should not be disregarded.

Gastrointestinal Diseases↗
PubMed1987

Distribution of gastrointestinal hormones in the adaptive response after small bowel transplantation.

Enteroendocrine regulatory peptides may play an important role in the adaptation of small bowel mucosa, and it is likely that they act interdependently with neural and luminal stimuli. We assessed their action in rats by morphometric evaluation of enteroendocrine cells after heterotopic accessory small bowel transplantation (SBT), in which the graft is shunted off from the intestinal passage and is entirely deprived of neural connections, and after orthotopic SBT with normal intestinal passage. Sections of the jejunum and the ileum of the graft were immunostained with antibodies to cholecystokinin (CKK), neurotensin (NT) and vasoactive intestinal peptide (VIP). The amount and distribution of positive cells was assessed semiquantitatively. Three weeks after SBT in the heterotopic graft there was a marked decrease in CCK and NT positive cells and VIP positive fibres in the entire organ, compared with the controls. Histological examination revealed that villi and crypts had atrophied. After orthotopic SBT the number of CCK and NT positive cells increased and exceeded normal values by 20-40%. VIP positive fibres did not reach normal amounts. No mucosal atrophy was detected. These findings support the view that the intrinsic neurohormonal system is reestablished in the grafted small bowel and that enteroendocrine regulatory peptides may act as trophic factors that are responsible for adaptation after SBT.

Adaptation, Physiological↗
PubMed1987

Absorptive capacity of the transplanted small bowel.

Small bowel transplantation (SBT) has been carried out in man in several cases without success, because immunologic problems were unsolved. In experimental SBT a 'two step' model was developed, which enables long term observation of immunologic phenomena. In this model the graft is in a heterotopic position to the recipient's own small bowel. After 35 days the recipient's own bowel is removed and replaced by the graft, now in orthotopic position and again in contact with luminal chymus. To investigate functional and morphological changes, which result from the procedure, the resorption of glucose and water was measured in syngeneic transplanted rats by an in vivo recirculation system and the mucosa was evaluated three dimensionally. The graft mucosa showed a significant reduction in villus height, crypt length and villus surface and a corresponding decrease in glucose and water absorption during heterotopic position. If the graft came into the orthotopic position, the mucosa did regenerate which was expressed by the significant longer crypts of the graft compared with those of the controls, although the graft's villus height and surface are still smaller. Glucose and water absorption increased and were higher in orthotopic transplanted animals, when absorption was expressed per unit intestinal length. The results indicate that in the 'two step' model of SBT the absorption of water and glucose is influenced to such an extent, that recovery is possible after three weeks, thus enabling orthotopic SBT. This almost complete recovery of the mucosa is further evidence of the regeneratory capacity of the small bowel, which enables clinical small bowel transplantation.

Animals↗