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Biomedical subjects

E Frimberger

Publications and source records attributed to E Frimberger.

At least 37 records · Page 2Linked to original sources

Sedimentation of biliary sludge: effect on composition of gallbladder bile from patients with cholesterol, mixed, or pigment stones.

BACKGROUND: Ultracentrifugation of bile has been used extensively to remove insoluble material such as sludge from bile before further studies of cholesterol nucleation. Although it has been recognized that this procedure may affect the composition of gallbladder bile, it has not been studied systematically in different gallstone populations. Therefore, we investigated the concentration of biliary lipids, protein, mucin, and bilirubin before and after ultracentrifugation. METHODS: Gallbladder bile samples were aspirated during laparoscopic surgery from 66 patients (35 with cholesterol, 16 with mixed, and 15 with pigment stones). RESULTS: Whereas the concentrations of bile acids, phospholipids, protein, and bilirubin in gallbladder bile did not change significantly after ultracentrifugation, cholesterol (20.6 +/- 1.6 to 14.8 +/- 1.2 mmol/l) and mucin concentrations (0.99 +/- 0.2 to 0.67 +/- 0.1 mg/ml) and the cholesterol saturation index (1.68 +/- 0.12 to 1.31 +/- 0.10) decreased significantly in gallbladder bile from patients with cholesterol stones. CONCLUSIONS: Sedimentation of biliary sludge may profoundly affect the composition of gallbladder bile, which has to be considered in studies of cholesterol saturation and nucleation. The cholesterol concentration difference between native and ultracentrifuged bile reflects the insoluble crystalline fraction of cholesterol and may be useful for quantitation of the mass of cholesterol crystals in gallstone-associated bile samples.

Bile↗

[Percutaneous endoscopic gastrostomy].

Probes for the percutaneous endoscopic gastrostomy (PEG) are placed by pull-through methods or by direct puncture of the stomach. Depending on the length of the interior branch of the probe, gastral or (duodeno-) jejunal feeding is possible; the latter may also be achieved by direct percutaneous endoscopic jejunostomy (PEJ). Small calibre endoscopes can be introduced via large-bore PEG probes; after the extraction of such a probe the resulting fistulous tract itself may also be used für percutaneous endoscopy by using pediatric endoscopes. The usual external fixation of the probes with compresses fixed by sticking plaster creates a humid chamber favouring the growth of bacteria. This can be avoided by an open well-aired fixation using a ring. Indications for the probes are prolonged enteral feeding in patients enable to swallow or to consume adequate nutrition orally, decompression in gastrointestinal obstruction, instillation of percutaneously drained bile and percutaneous endoscopy, e.g. for repeated retrograde laser application as a palliative treatment in patients with tumour obstruction of the oesophagus. Complications due to PEG/PEJ probes are relatively rare; severe are aspiration in cases of gastro-oesophageal reflux and peritonitis.

Endoscopes↗

Evaluation of laparoscopic cholecystotomy in the treatment of gallbladder stones.

Laparoscopic cholecystotomy (LCT) was attempted in 34 patients with biliary type symptoms; 33 patients suffered from gallbladder stones and one patient from gallbladder polyps. In one patient the gallbladder was not accessible with the laparoscope due to extensive adhesions. In the other patients endoscopic removal of stones and polyps was possible in all cases. In the first five patients the gallbladder was drained with a Foley type catheter at the end of the procedure; in the other patients the incision of the gallbladder was closed primarily with clips and fibrin glue. At the beginning of the series two cases of complications were observed: balloon catheter deflation due to material defect and postoperative bleeding into the gallbladder; after conventional cholecystectomy the two patients made an uneventful recovery. LCT is a one-session procedure suitable for removal of symptomatic stones in well functioning gallbladders with no restrictions concerning the composition, number or size of the stones.

Adult↗

A new pull-through trocar technique for percutaneous operative endoscopy.

A pull-through trocar is described which establishes a percutaneous access to the stomach and may immediately be used for endoscopy. The trocar is placed in a similar fashion to PEG probes. The technique was evaluated in animals. Using rigid endoscopes and instruments introduced through the trocar operative manipulations of the gastric wall were carried out. There were no severe complications. The new method extends the scope of percutaneous therapeutic endoscopy (minimal invasive surgery) by permitting direct access to the interior of the stomach.

Animals↗

Structure of the gene for cartilage matrix protein, a modular protein of the extracellular matrix. Exon/intron organization, unusual splice sites, and relation to alpha chains of beta 2 integrins, von Willebrand factor, complement factors B and C2, and epidermal growth factor.

The entire gene for chicken cartilage matrix protein (CMP) has been isolated and characterized by restriction mapping, electron microscopy, nuclease S1 mapping, and sequence analysis. The gene, which is present in a single copy in the chicken genome, is 18 kilobase pairs long and comprises eight exons and seven introns. It has two transcription initiation sites, 8 base pairs from each other. A sequence very homologous to the consensus nuclear factor III binding-site sequence, a CAT- and a TATA-like sequence are found in the promoter region and ATTAAA is used as a polyadenylation signal. The nucleotide sequence defines a primary translation product of 493 amino acids which consists of a 23-amino acid signal peptide and two large repeated domains connected by an epidermal growth factor module. Amino acid sequences homologous to those of the repeated domains are present in the type A repeats of von Willebrand factor, complement factors B and C2, and in the alpha chains of the integrins Mac-1, p150,95, and LFA-1. The exon-intron structure indicates that the CMP gene may have arisen by exon duplication and exon shuffling during evolution. The GT-AG splice rule cannot be applied for the excision of the last intron of the CMP pre-mRNA. The donor splice site of intron G is basically different from the consensus sequence indicating that a novel type of splicing mechanism might exist in cartilage.

Amino Acid Sequence↗

Endostomy: a new approach to small-bowel endoscopy.

A percutaneous access to the gastrointestinal hollow organs created by new endostomy tubes permits diagnostic and therapeutic endoscopy in particular of the small intestine. A case of a patient with chronic gastrointestinal bleeding of hitherto unknown origin, in whom enteroscopy and electrocoagulation of an angioma in the lower jejunum was performed, is presented.

Chronic Disease↗

[Device for a single-operator resuscitation].

A simple type of reanimation equipment is described which - independent of energy supply - makes it possible for a single operator to perform complete mechanical cardiopulmonary resuscitation. The apparatus is placed on the distal half of the sternum of the supine patient and connected to the respiratory tract via a connecting tube. Inspiration occurs by depressing the apparatus, while the subsequent expiration is followed by cardiac massage by means of depressing the apparatus. This new method has proved itself effective in three patients with acute cardiocirculatory arrest.

Aged↗