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Biomedical subjects

E Schippers

Publications and source records attributed to E Schippers.

51 records · Page 3Linked to original sources
PubMed1991

[Electromyographic and manometric studies of stomach motility after vagotomy].

Vagotomy coincides not only with a reduction of the cephalic phase of secretion but also with a significant reduction of the motor activity of the stomach. Electrical and mechanical activity of the gastric wall after truncal vagotomy were verified in animal experiments (dog n = 5) by means of implanted electrodes and pressure transducers. Longlasting motility disturbances expressed as a disorganisation of the basic electrical rhythm occurred in the gastric wall. According to the pattern periods of tachygastria and tachyarrhythmia were identified. Those periods interrupted the regular fasted motility and persisted in the postprandial period. Simultaneous registration of the mechanical activity of the gastric wall during disorders of the electrical rhythm revealed a complete absence of contractility which probably is the pathophysiological correlate for the frequently described delayed gastric emptying after vagotomy.

Animals↗
PubMed1991

[Cholecystectomy: laparoscopic or conventional?].

Cholecystectomy remains the gold standard in the treatment of cholelithiasis. With the emerging of laparoscopic techniques a new modality in the surgical therapy is available. However efficacy, morbidity and pretended advantages have to be judged in comparison to the conventional technique. Indications for cholecystectomy are not altered by the new technique. Beside some few preoperative contraindications, the definite choice of the operative procedure is determined intraoperatively according to the anatomical facts and the experience of the surgeon. The frequency of the laparoscopic approach varies between 67 and 97%. A conversion to open cholecystectomy is necessary in 3.6-4.7%. The overall complication rate is 2.6-5.1%. Outstanding from those are the iatrogenic lesions of the bile-duct, especially in the initial learning period with 1-2%. The hospital stay is dramatically reduced to 1.2-3 days as well as the postoperative recovery period with 7-14 days. Thus resulting in a cost saving up to $1200 per patient. Because of the obvious advantages of less pain, early mobilisation, less scars and an enormous cost saving the laparoscopic cholecystectomy will be the gold standard in the future. Open cholecystectomy will be restricted to complicated cases. However, in order to prevent serious injuries of the bile-duct an appropriate training in laparoscopic surgery is necessary.

Bile Ducts↗
PubMed1991

[Results of Parks postanal repair in idiopathic anal insufficiency].

To assess the functional results of postanal repair of faecal incontinence we carried out clinical, physiological and radiological studies in 31 patients. Continence was improved in 26 (84%) patients, 19 (62%) of whom regained normal continence at a minimum of 12 months follow-up. A successful clinical outcome after postanal repair does appear to be related more to an improvement in sphincter pressures than to any reduction of the anorectal angle.

Anal Canal↗
PubMed1990

[Early postoperative intestinal motility following abdominal surgery in an animal experiment].

Gastrointestinal myoelectrical activity was registered in 6 dogs after different surgical procedures such as laparotomy, segmental resection of the jejunum and right hemicolectomy. Animals were studied in the fasted- and fed state and after pharmacological stimulation with Ceruletide. The electrical activity was recorded by means of 6 bipolar electrodes implanted along the intestinal wall. Abdominal surgery abolished normal motility in the stomach and small intestine only for a short period of time. The time for the reappearance of regularly recurring activity fronts varied with the type of the surgical procedure from 3 h after segmental resection of the jejunum to 49 h after colon resection. Severe disturbances of the BER (basic electrical rhythm) in the stomach as tachygastria and tachyarrhythmia persist even after restoration of the MMC (migrating motor complex) in the small intestine. Feeding induced a typical fedpattern but never before restoration of the MMC. Stimulation of the intestine during postoperative ileus with Ceruletide increases segmental myoelectrical activity. The period of postoperative ileus was not reduced.

Animals↗
PubMed1989

Multiple hollow organ dysplasia in Ehlers-Danlos syndrome.

We report a case of Ehlers-Danlos syndrome with a number of rare, hazard-creating organ dysplasias such as colon diverticula causing spontaneous perforation, bladder diverticula, bile duct diverticula, and multiple aneurysma formations of the arteries.

Abnormalities, Multiple↗
PubMed1988

Local nerve blockade by tetrodotoxin induces ectopic phase 3 of the migrating myoelectric complex in dogs.

The effect on the migrating myoelectric complex (MMC) of local nerve blockade in the jejunum was studied in five unanesthetized dogs. A silastic catheter was implanted in a terminal branch of a jejunal artery, perfusing a 5- to 10-cm segment, 45 cm below the ligament of Treitz. Small-bowel motor activity was studied electromyographically with implanted electrodes. Three different doses of tetrodotoxin (166, 333, 500 ng/kg/h) were administered intra-arterially for 5 h. During the 333- and 500-ng but not during the 166-ng/kg/h perfusions ectopic activity fronts started just below the perfused segment. At this time no phase-3 activity was observed in the proximal bowel. In addition to ectopic fronts normal MMCs were observed during the perfusions. These observations show that local nerve blockade induces phase-3 activity, probably by inhibiting an inhibitory nerve action.

Animals↗
PubMed1986

Somatostatin induces ectopic activity fronts via a local intestinal mechanism during fed state or pentagastrin.

The effect of local intra-arterial infusions of somatostatin on small bowel motility in the postprandial period and during an intravenous pentagastrin infusion was studied in five dogs. A Silastic catheter was implanted in a small branch of the superior mesenteric artery perfusing a 5-to 10-cm jejunal segment located 30-40 cm distally to Treitz. Small bowel myoelectric activity was recorded by means of a series of bipolar electrodes implanted subserosally along the small intestine. Experiments were started 2 wk after surgery and were performed in conscious animals. Intra-arterial infusion of somatostatin induced activity fronts in the fed state and during intravenous pentagastrin infusion in a dose-dependent manner. These activity fronts always started at or just below the perfused segment, migrated distally over the remaining small bowel, and were superimposed on the fed pattern. We conclude that local administration of somatostatin is able to initiate normally migrating ectopic activity fronts, despite the presence of neural and hormonal factors that control the fed state. Local release of somatostatin might be involved in the initiation of spontaneously occurring activity fronts.

Animals↗
PubMed1983

[Pseudo-obstruction of the colon].

Pseudoobstruction of the colon is characterized by clinical and radiological findings suggesting a mechanical obstruction of the large intestine without any organic cause. 11 of our patients and 344 cases reported in the literature have been reviewed. 90% of the patients have an associated major system disorder, most of them (40%) are localized in the pelvis. An imbalance in sympathetic-parasympathetic innervation as an aetiological factor is discussed. Diagnosis is generally made on the basis of the plain roentgenogram of the abdomen and a barium enema of the colon. Surgical decompression is indicated when no improvement can be achieved by conservative treatment within 72 hours. Immediate surgical intervention becomes mandatory in case of the cecal diameter being greater than 12 cm or an evident perforation. Cecostomy is of crucial benefit. Extensive necrosis requires a colonic resection.

Adult↗
PubMed1982

[Lymphatic pseudocyst as complication of a petty injury].

Diagnosis in another hospital primary failed; preliminary treatment unsuccessful; punction, operatively revision for 3 times and attempt at obliteration gave no improvement; systematically diagnostic procedure after the fourth relapse with lymphography and presentation of a lymphatic pseudocyst; identification of the feeding vessels; colouring with blue solution; operation with medial incision, ligature of the lymphatic vessels and exstirpation of the cyst wall; histologically investigation shows synovial cells; healing with solid cicatricial tissue.

Aged↗
PubMed1982

[Primary small intestine malignancies].

The frequency of malign tumors in the small intestine was 1% of all malign tumors of the digestive tract. 4% of malign tumors found by autopsy in the digestive tract were located in the small intestine. 12 months passed between first symptoms and operative therapy. In 80% we found local or distant metastases. In only 5 of 11 cases a curative resection was attempted. A great number pf small intestine tumors were identified by autopsy for the first time. A curative resection depends on an early diagnosis. Ileus, massive bleeding, extreme weight loss and palpable mass are late physical findings. Obstipation, diarrhea, occult intestinal bleeding and abdominal pain indicate after subtle inquiry X-ray of the small intestine, gastroduodenoscopy and angiography. If there is no result an early laparotomy should be performed.

Adenocarcinoma↗
PubMed1978

Serum erythropoietin concentration in anephric patients.

In 13 bilateral nephrectomized patients serum erythropoietin (SEp) activity could be measured quantitatively by use of the highly sensitive fetal mouse liver cell assay. SEp concentration in the majority of the cases was below the mean of normal controls. There was a significant positive correlation between SEp levels and hematocrits, suggesting erythropoietin (Ep) deficiency to be a causative factor in the anemia of the anephric state. Androgen therapy stimulated extrarenal Ep production in all of 5 anephric patients studied.

Adolescent↗
PubMedDate not supplied

Local versus general anesthesia for Shouldice repair of the inguinal hernia.

Since February 1992 local anesthesia (LA) has been used routinely for repair of inguinal hernias at our surgical department. All patients undergoing Shouldice repair of primary uncomplicated inguinal hernia between January 1990 and March 1993 were analyzed retrospectively concerning the need for analgesics, length of stay in hospital, and rate of complications. In addition 50 patients after LA and 50 patients after general anesthesia underwent prospective pain analysis using a visual analogous score and spirometric tests (FEV1 and peak flow). After LA we found less need of analgesics, shorter hospital stays, and fewer complications. The pain level was lower, and ventilatory function was less affected. Repair of the inguinal hernia using LA is a safe method to lower the risk of the operation and to improve the patient's comfort without increasing complications.

Adolescent↗
PubMedDate not supplied

Laparoscopic cholecystectomy: a minor abdominal trauma?

Clinical observations following laparoscopic surgery indicate a shorter period of postoperative ileus than after conventional surgery. The aim of our study was to verify disorders of postoperative motility of the small intestine by means of implanted electrodes after laparoscopic and conventional cholecystectomy (CHE) in an animal model. Four weeks after implantation of three electrodes on the jejunum, CHE was performed laparoscopically in 5 dogs and in an additional 5 dogs by laparotomy. Independent of the type of operation, normal motility (especially the migrating motility complex) was abolished during the early postoperative period. Electrical activity was characterized by the basic electrical rhythm. Time to the occurrence of the first postoperative activity front, indicating restoration of motility, varied significantly depending on the type of operation: It was 5.5 +/- 1.0 hours after laparoscopic CHE and 46 +/- 5 hours after conventional CHE. These results support the hypothesis that small peritoneal incisions and less manipulation of the intestine during laparoscopic surgery result in reduced abdominal trauma.

Animals↗