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Biomedical subjects

A Thiede

Publications and source records attributed to A Thiede.

At least 253 records · Page 14Linked to original sources
PubMed1986

[Roux-Y reconstruction following distal stomach resection using only staplers].

The spreading of stapled suture techniques has also entailed the utilization of staplers in gastric surgery. A functional, up-to-date, and exclusively stapled reconstruction procedure, Roux-Y-reconstruction, after subtotal gastrectomy was established and analyzed in a pilot study (n = 25). In doing so, one proceeded as follows after subtotal gastrectomy and systematic lymphadenectomy in cases of carcinoma: duodenal closure (GIA or TA30), gastric resection (TA90), jejunojejunostomy (EEA25), gastrojejunostomy (EEA25/28), closure of the projecting efferent loop (GIA). This study intended to achieve the following advantages: increased suture safety, saving of time, reduction of complications, and especially the extension of indications regarding age and localization of the tumor. A special program to eliminate mistakes in handling is required for the sole and systematic application of staplers in the upper gastrointestinal tract. Every complication occurring during and after surgery was carefully recorded in this study and the attainable quality of life after subtotal gastrectomy was assessed.

Adult↗
PubMed1986

Graft-versus-host reaction in small bowel transplantation and possibilities for its circumvention.

To describe GVHR in small bowel transplantation and its underlying mechanisms and to find methods for circumventing that response, accessory small bowel transplantation was carried out in the rat model. Animals not treated with cyclosporine, irradiation, or removal of the mesenteric lymph nodes of the graft died within 22 days postoperatively due to graft versus host disease. Mesenteric lymph nodes of the graft and recipient spleen and peripheral lymph nodes showed strong immunologic stimulation histologically and high antihost T-cell-mediated cytotoxic antihost reactivity. Seventy-one percent of the animals that had received 15 mg of cyclosporine per kilogram body weight orally survived 150 days after transplantation. After donor irradiation with 50 rads, 77 percent of the recipients survived 120 days. After microsurgical removal of the mesenteric lymph nodes of the graft, 89 percent survived 120 days. We conclude that GVHR plays an important role in small bowel transplantation and that the experimental regimens of donor, graft, and recipient treatment described herein have proved their efficacy for circumventing GVHR.

Animals↗
PubMed1986

[Effectiveness of tetrachlorodecaoxide (TCDO) in the treatment of complicated disorders of wound healing. A controlled study: TCDO versus PVP-iodine complex].

In a controlled study on the treatment of wound-healing impairments 29 patients underwent local treatment with TCDO (Oxoferin) while Beta-isodona was used in 31 cases. Regarding the criterion of reducing the wound area, i.e. epithelization, a highly significant superiority of Oxoferin could be demonstrated in the treatment of complicated wounds. The evaluation of the state of granulation, that was documented by a semiquantitative procedure, indicated that Oxoferin tends to be slightly superior. However, the following observations have to be emphasized: Oxoferin induces a development of granulation tissue on exposed tendons, bones, and fasciae and the granular tissue is of much better quality than after treatment with Betaisodona. Concerning its effect on the degree of contamination, Oxoferin proved to be at least as efficacious as the established and effective antiseptic Betaisodona. Both substances are tolerated well and the application is simple, they do not differ here.

Adolescent↗
PubMed1986

[Review of the physical and surgical technical properties of modern monofilament suture materials].

This paper documents the differences among 8 monofile sutures in important functions such as linear tensile strength, bending stiffness, knot security and irreversible elongation. The results show that two materials (Prolene and Gore-Tex) do not seem to be as suitable as the other materials for long-term tensile loads. The lowest bending stiffness was that of Seralon. The highest knot security can already be reached with three loops of Novafil. Novafil has also got the highest maximal elongation. The knowledge of the different applications of suture materials tested in important practical functions, is the supposition to the right and secure use of suture materials.

Elasticity↗
PubMed1985

[Models and perspectives of pancreas transplantation in the rat. I. Comparison of various transplantation models in the syngeneic system].

Pancreas transplants were grafted in rats using five different microsurgical techniques. Three of the techniques allowed exocrine drainage, namely pancreaticoduodenal transplantation, grafts with a duodenal patch, and grafts with exocrine drainage via a Roux-en-y-loop. Segmental transplants in which the duct system was ligated or occluded with Ethibloc were used as models without exocrine drainage. Donors and recipients were Lewis rats. Diabetes was induced in the recipients with streptozocin. Regular measurements of serum glucose and body weight served as functional controls. At the end of the observation period, the grafts were examined macroscopically and microscopically. Basically, all types of grafts allowed normalization of the blood sugar level. In grafts with ligated or occluded ducts, however, we observed functional failure due to fibrosis or abscesses. It became obvious that all grafts without exocrine drainage are subject to alternative processes that lead to the loss of exocrine tissue, to proliferation of the pancreatic ducts and to morphological changes in the islets. In successfully drained grafts, the morphology of the organ is lastingly preserved. In the rat model the most reliable management of exocrine drainage is afforded by pancreaticoduodenal grafts.

Animals↗
PubMed1985

[Models and perspectives of pancreas transplantation in the rat. II. Course of rejection of pancreaticoduodenal transplants of various histoincompatibility and the effect of temporary therapy with cyclosporin (Sandimmun)].

Pancreaticoduodenal grafts were transplanted into streptozocin-induced diabetic recipients. Recipients of syngeneic grafts survived long term with functioning grafts. To investigate the rejection reaction in pancreaticoduodenal allografts, the organs were grafted in an MHC compatible but non-MHC incompatible strain combination (AS----LEW) and in a combination that is both MHC and non-MHC incompatible (DA----LEW). The functioning times were 12.4 +/- 4.0 days in the AS----LEW group and 8.2 +/- 0.6 days in the DA----LEW group. A histologic study of the course of the rejection process showed that first the exocrine portion of the grafts, then the endocrine tissue, and finally the duodenum was destroyed. After the recipients of allografts were treated with an oral dose of 15 mg/kg/day Ciclosporin (Sandimmun) for 14 days p.op., the functioning times of the grafts increased to 47.5 +/- 14.4 days in the AS-LEW group and 26.0 +/- 0.5 days in the DA-LEW group. Histologic investigations showed that during the period in which Ciclosporin was given, only perivascular round cell infiltrates appeared with no visible destruction of the graft. After discontinuation of the medication basically the same histologic alterations occurred as in untreated allografts, however with a delay.

Animals↗
PubMed1985

[Locoregional recurrence following the operative treatment of rectal cancer. Basic principles of prevention and therapy].

The frequency of local recurrences has been observed in dependence on sex, tumour specific parameters (typing, grading, staging, macroscopical form of growth, level of primary tumour) and technical parameters (method of operation, distal margin of resection). In case of early diagnosis, there is a possibility of differentiating technically caused local recurrences from those caused by the tumour because of their localization. Recurrences caused by the tumour may proceed from incompletely removed primary tumours. Technically caused recurrences may be primarily due to insufficiently resected tumours, which could have been removed completely. Only technically caused recurrences make a curative second operation possible. If the criteria of radicality are strictly observed during the primary operation, there should be no need for the so-called 'surgically curative' local recurrences to be treated anymore.

Adenocarcinoma↗
PubMed1985

[Comparison of the physical parameters and handling properties of short-duration and middle-duration absorbable suture materials].

In recent years the structure and coating of rapidly absorbable suture materials (RAS) have been changed: Dexon S----Dexon plus, Vicryl III----Vicryl IV. Medium fast absorbable sutures (MAS) have been introduced: Maxon and PDS. Being important clinical parameters, the knotting qualities were investigated, for instance knot holding capacity in dry and in NaCl or blood incubated sutures. The newest generations of RAS require more complicated configurations of knots than the initial products. After incubation in blood the knotting qualities improved only with Dexon plus.

Absorption↗
PubMed1985

[Interpretation of results of clinical studies for practical colon and rectum surgery].

Systemic antibiotic prophylaxis in surgery of the colon and rectum is principally useful. It should be administered only on the day of surgery. Stapling makes it possible to enlarge the indication for deeper rectal resection. In cases of deep rectal anastomoses in men bladder dysfunction has to be expected in a considerable percentage. Anal continence does not depend on the anastomotic technique but on the anastomotic level in relation to its distance from the ano-cutaneous line and in consequence on the loss of reservoir capacity.

Cefotaxime↗
PubMed1985

[Significance of the suture technic and anastomosis sites for continence following deep rectum resection].

In a controlled clinical trial of 60 patients who underwent low anterior resection we found no influence of anal continence due to suture technique. Continence depends on the level and healing of anastomosis. Below a level of 6 cm from the anocutaneous line we more frequently found a reduction of functional reservoir in the 'neorectum', especially in cases with suture line leakage at anastomosis. Usually, the weakness of continence due to reduced functional reservoir was a temporary situation which lasted not longer than 6 months, if anastomosis healed without insufficiency.

Fecal Incontinence↗
PubMed1984

[Pathogenesis and morphology of anal fistulas].

In a prospective consecutive study in 80 patients with anal fistulous disease we found characteristics in the morphology of the fistulous tracks, which correspond to the structure of anal glands. The theory of a cryptoglandular infection as the cause of anal fistulous disease seems to be realistic for this reason. The chronic fissure in ano represents likewise a pathogenetic factor in the genesis of anal fistula, especially in the posterior part of the anal canal. In this region we found trans- and suprasphincteric tracks with abscesses in the fossa ischiorectalis. Anal fistulas as a consequence of specific intestinal infections could be found only in 6%, whereas unspecific fistulas with inter- and transsphincteric tracks amounted to 90%.

Abscess↗