Biomedical subjects

F Glaser

Publications and source records attributed to F Glaser.

At least 19 recordsLinked to original sources

PubMed1998

Measurement of blood flow in the main arteriole of the villi in rat small intestine with FITC-labeled erythrocytes.

Changes of blood flow in the intestine occur under various pathological conditions. The mucosa of the intestine is especially sensitive to tissue damage resulting in swelling, loss of tissue integrity, and ulceration. Changes of blood supply to the mucosa may contribute to local tissue damage. Therefore, the quantification of the perfusion of the intestinal mucosa in an animal model may help to elucidate the involved pathophysiological mechanisms. In our study, autologous erythrocytes were labeled with fluorescein-isothiocyanate and used for the evaluation of erythrocyte velocity in the main arteriole of the villi in the distal part of the ileum using intravital microscopy. In addition, the arteriolar diameter was determined, and the arteriolar blood flow was calculated. Under stable cardiovascular and respiratory conditions, blood flow ranged between 6.6 +/- 0.3 and 5.9 +/- 0.3 nl/min (means +/- SEM) during the observation period of 120 min. Our results suggest that this approach is a feasible method to quantify blood flow in the main arteriole of the villi and is therefore a suitable method for further investigating changes of mucosal blood flow in acute and chronic states of bowel disease.

Animals↗

PubMed1998

Prospective randomized study of stress and immune response after laparoscopic vs conventional colonic resection.

METHODS: In order to evaluate the stress and immunological response to laparoscopic and conventional colon resection we operated on male Wistar rats (350-380 g), performing either laparoscopic (n = 15) or open colon resection (n = 15). A third group (n = 10) underwent anesthesia only. Immediately before and after surgery as well as 1 and 7 days postoperatively a 1 ml sample of blood was taken from the retrobulbar veinous plexus. Stress (corticosterone) and immune parameters (neopterin and interleukin [IL] 1-beta) were measured. Furthermore, the body weight as a parameter of postoperative recovery was monitored. RESULTS: The analysis of variance showed significant differences between the three groups over a period of 1 week (p < 0.0001 for corticosterone, p = 0.0854 for IL 1-beta, p = 0. 0045 for neopterin). Additionally in a t-test significant differences were found between the laparoscopic and conventional group with regard to corticosterone (p = 0.08), to neopterin (p = 0. 045), and to IL 1-beta (p = 0.0043) at the end of the operation. One week after the operation the stress and immune parameters were back to normal levels in each group except IL 1-beta, but the recovery indicated by body weight was different according to the kind of the applied operative procedure: 7 days postoperatively the rats lost 5. 99% of their body weight after open surgery and only 2.4% after laparoscopic surgery. After anesthesia only the body weight increased by about 4.8%. CONCLUSION: Laparoscopic colon resection alters the stress and immune system of healthy rats less than open colon resection. This observation is confirmed by the quicker recovery in laparoscopically operated rats.

Animals↗

PubMed1998

[Pseudo-abnormal venous lung blood flow in trained endurance athletes].

Pulmonary venous flow was recorded by transthoracic pulsed Doppler echocardiography in 10 endurance trained male athletes and in 10 age matched sedentary male controls. The ratio of peak systolic (S) to peak diastolic (D) flow velocity was much lower in athletes than in controls (0.8 +/- 0.22 vs. 1.13 +/- 0.37 p < 0.05). 5 out of 10 athletes had values less than 0.82 which was the lowest value in the control group. Athletes also hat significantly higher mitral flow E/A ratios and lower heart rates. Physical fitness caused by endurance training should be acknowledged one of the causes for an abnormally low S/D ratio.

Adult↗

PubMed1998

[Rectovaginal fistulas in patients with Crohn disease--therapy and prognosis].

Perianal and especially rectovaginal fistulas in Crohn's disease represent a great therapeutic dilemma. Surgical intervention is mandatory in the impending destruction of the anal sphincter mechanism, weighed against the efficacy of the methods available. We report on the surgical approach in 25 women with rectovaginal fistula, concluding that either levator plasty or mucosal flap is the procedure of choice.

Crohn Disease↗

PubMed1997

Structure of the human type I iodothyronine 5'-deiodinase gene and localization to chromosome 1p32-p33.

The human type I iodothyronine 5'-deiodinase gene encodes a member of the family of selenocysteine-containing deiodinases. These enzymes catalyze the activation of the prohormone thyroxine to 3,3',5-triiodothyronine or the degradation of thyroxine and triiodothyronine to inactive metabolites. Here we report the isolation of two genomic type I 5'-deiodinase clones from a chromosome 1-specific gridded cosmid library, the localization of the gene to chromosome 1p32-p33 by fluorescence in situ hybridization, and the determination of the complete structure of the 17.5-kb gene.

Base Sequence↗

PubMed1997

[Endosonographic diagnosis in preoperative radiotherapy of locally advanced rectal carcinoma].

Endorectal ultrasound (EUS) is important for the indication of preoperative radio(chemo)therapy of locally advanced rectal carcinomas. Preoperative radio(chemo)therapy causes an increased echogenity of the ultrasound, which histologically corresponds with increased fibrosis. After preoperative radio(chemo)therapy, the accuracy rate of EUS of tumor infiltration depth (T) and lymph-node status (N) is 75% compared with postoperative histology. With the help of EUS before and after radio(chemo)therapy (n = 28 patients) "downstaging" was noticed endosonographically in 10 patients (3 times in T and 7 times in N staging) and "upstaging" in 3 patients (3 times in T and 1 times in N staging). There was no "understaging" of local tumor infiltration depth after preoperative radio(chemo)therapy.

Adenocarcinoma↗

PubMed1997

Flexible endoscopic ultrasonography of colonic tumors: indications and results.

BACKGROUND AND STUDY AIMS: Based on the positive results of endorectal ultrasound we evaluated flexible colonic endosonography for colonic tumors. At present there are no generally accepted indications for this procedure. Moreover, it is unclear whether the results are valid enough to warrant specific therapeutic interventions. PATIENTS AND METHODS: Over a one-year period we performed flexible colonic endosonography (12 MHz rotating scanner) on 31 patients with colonic tumors. The examination was only performed when therapeutic implications were expected (e.g. endoscopic procedure when there was no sign of malignancy; oncological resection when there were signs of malignancy in ulcerative colitis or familial polyposis). RESULTS: Of 40 tumors examined, 36 were correctly staged by endosonography, compared to postoperative histology as the gold standard (16 of 17 adenomas, 5 of 5 pT1 carcinomas, 8 of 8 pT3 carcinomas). In two cases pT4 carcinomas were wrongly classified endosonographically as uT3 carcinomas, because the infiltration of the visceral peritoneum was technically not recognizable. Overall the accuracy rate of staging was 85%. Lymph node staging was correct in 36 of 40 patients, amounting to an accuracy rate of 90%. CONCLUSION: Because of its high accuracy rate flexible colonic endosonography has a place in the preoperative staging of colonic tumors in selected patients, especially those with ulcerative colitis, familial adenomatous polyposis or macroscopically suspicious adenomas. It helps to clarify the extent (oncological resection, lymphadenectomy) of resection required in conventional surgery and helps to avoid laparoscopic procedures in advanced colonic cancer.

Colonic Neoplasms↗

PubMed1997

[Endosonography, CT and MRI in the diagnostic concept of rectal carcinoma].

The stage-adapted operative treatment of rectal cancer in the context of adjuvant therapy regimes necessitates accurate and, in times of diminishing financial resources, cost-effective preoperative staging. From January 1988, 424 patients with rectal cancer were examined by endosonography. In the same period 28 additional patients were staged by hydro-CT within a prospective study as the endorectal sonography probe could not be passed through the tumor stenosis. Sensitivity and specificity for T and N staging were equal or superior in the endosonography group. Compiled data in the literature for MRI staging of rectal cancer show results similar to those with endosonography. Therefore we see no indication for preoperative rectal staging methods other than endosonography unless the latter examination is technically impossible.

Cost-Benefit Analysis↗

PubMed1996

[General stress response in laparoscopic and conventional cholecystectomy].

To objectify perioperative stress response to laparoscopic (LCE) and conventional cholecystectomy (CCE) a prospective, controlled trial was planned and biochemical stress parameters were measured in the blood of patients, who underwent elective surgery because of symptomatic cholecystolithiasis. Patients with acute cholecystitis, pancreatitis, choledocholithiasis or malignant disease were excluded from the study. Values from 40 patients after LCE and from 18 patients after CCE were compared. Both groups had statistically similar patient characteristics and perioperative care. The LCE group showed a significantly lower stress response with respect to interleukin 1 beta, interleukin 6, epinephrine, norepinephrine and glucose.

Adult↗

PubMed1995

General stress response to conventional and laparoscopic cholecystectomy.

OBJECTIVE: In many retrospective and prospective observational studies, laparoscopic cholecystectomy (LC) compares favorably with conventional cholecystectomy (CC), with respect to length of hospital stay, postoperative pain, and pulmonary function, indicating a diminished operative trauma. Comparison of laboratory findings (stress hormones, blood glucose, interleukins) are a possibility to objectify stress and tissue trauma of laparoscopic and conventional cholecystectomy. SUMMARY BACKGROUND DATA: Major body injury, surgical or accidental, evokes reproducible hormonal and immunologic responses. The magnitude of many of these changes essentially is proportional to the extent of the injury. METHODS: In a prospective study, biochemical stress parameters were measured in the blood of patients undergoing elective cholecystectomy because of symptomatic cholecystolithiasis. Patients with acute cholecystitis, pancreatitis, choledocholithiasis, or malignant disease were excluded. Values from 40 patients after LC and from 18 patients after CC were compared. Both groups had similar patient characteristics, baseline values, and perioperative care, except for deeper anesthesia during CC. RESULTS: On postoperative day 1, epinephrine (p = 0,05), norepinephrine (p = 0.02), and glucose (p = 0.02) responses were higher after CC. Two days postoperatively, norepinephrine remained higher after CC (p < 0.01). Interleukin-1 beta responses were higher during (p < 0.01) and 6 hours after CC (p = 0.03). Interleukin-6 responses were higher 6 hours (p = 0.03), 1 day (p = 0.02), and 2 days (p < 0.01) after CC. CONCLUSIONS: The results show significant lower values of intraoperatively and postoperatively measured epinephrine, norepinephrine, interleukin-1 beta, and interleukin-6 in patients with laparoscopic cholecystectomy, indicating a minor stress response and tissue trauma in this group of patients. The results correspond to the favorable results of most other trials evaluating clinical aspects of laparoscopic cholecystectomy.

Adult↗

PubMed1994

Endorectal ultrasound and leiomyosarcoma of the rectum.

Leiomyosarcomas of the rectum are uncommon neoplasms accounting for fewer than 1% of all malignancies of the colon and rectum. Approximately 215 cases have been described in the literature. Distinction from leiomyoma is often difficult, but regarding dignity is important. The case reported is that of a 68-year-old man in whom a 2.2-cm rectal mass covered by mucosa was diagnosed by rectoscopy and endorectal ultrasound. After treatment by wide local excision the histological specimen revealed a low-grade, highly differentiated leiomyosarcoma. Due to the lack of a large series of this disease, there is disagreement over the therapeutic strategy. At the moment a selective treatment approach seems to be the most frequently advocated. Large tumors and those extending beyond the rectal wall are treated by radical surgical resection. Leiomyosarcomas less than 2.5 cm in size and confined to the bowel wall can be treated by wide local excision. Endosonography can provide exact assessment of tumor size and expansion and is of great value in selecting the appropriate treatment.

Aged↗

PubMed1994

[Transesophageal echocardiography in non-rheumatic atrial fibrillation: a moderately sensitive method for assessment of risk of cerebrovascular complications].

120 consecutive unselected patients with chronic non-rheumatic atrial fibrillation without anticoagulant therapy were examined by transthoracic and transoesophageal echocardiography. Patients with a history of an ischaemic cerebrovascular event (n = 4) had left atrial thrombi, spontaneous contrast or both significantly more often (n = 25, 61%) than patients in the control group (24/79 = 30%). However, when compared with controls, patients with a history of cerebrovascular events were also older, and had hypertension and left ventricular disease (ejection fraction < 45%) more often. Abnormal carotid duplex scans were also very common in this group (71%). Transoesophageal echocardiography is useful for evaluating the risk of cerebrovascular complications in non-rheumatic atrial fibrillation. However, the method is quite insensitive (61%) and therefore insufficient as the sole parameter for deciding the need for anticoagulation. It is likely that cerebrovascular complications in these polymorbid patients are partially caused by other factors than embolism from the left atrium.

Adult↗

PubMed1994

[Endo-anal ultrasound. Indications and results].

Between July 1991 and November 1993 106 patients have been examined by endoanal ultrasound with a 7.0 MHz transducer and a special hard plastic cone which is attached over the transducer. Indications for endoanal ultrasound have been anal carcinoma, perirectal or perianal fistulas, perianal abscesses and sphincter insufficiencies. All anal carcinomas and 2 anal cancer recurrences could be visualized with regard to their size and extension as well as the lymphnode infiltration. 28 of 35 fistulas have been seen by endoanal ultrasound. Endosonographical differentiation in inter- (10), trans- (12) extra- (1) or suprasphincteric (5) was possible in all detected fistulas and confirmed by operation in 27 of 28 cases. 34 cryptogen abscesses could be detected (15 intersphincteric, 12 ischiorectal, 7 pelvirectal) and confirmed by the operative situs with regard to their size and localisation. In 9 patients with a myogen sphincter insufficiency the morphological defect of the sphincter muscle could be localized by endoanal ultrasound and confirmed by the operative situs in all cases.

Abscess↗

PubMed1993

Endorectal ultrasound for control of preoperative radiotherapy of rectal cancer.

Endorectal ultrasound (EUS) is known to be a reliable method for preoperative staging of rectal tumors. In this study, EUS was used to select patients with rectal cancer suitable for preoperative radiation therapy. By performing EUS before and after radiation, the aim of the study was to evaluate the role of EUS in monitoring the effects of preoperative radiation therapy. In 17 patients with large T3 or T4 rectal tumors, a complete staging by EUS was done before and after radiation therapy. Beside a shrinkage of the tumor, there was a change of echopattern to more hyperechoic gray levels to be observed in the irradiated tumor. The rectal wall lost its normal architecture, and lymph nodes disappeared or changed their echopattern from echopoor to echorich. There was no down-staging of a tumor seen by EUS. Complete preoperative staging was correct in 13 of 17 patients because of endosonographic examination before and after preoperative radiation therapy. New interpretation criteria are given for evaluation of patients with rectal cancer treated by radiation therapy.

Adult↗

PubMed1993

[Influence of sonography on indications for laparoscopic cholecystectomy].

Because of therapeutic consequences preoperative sonography should be performed with a check list. Nevertheless false positive and false negative findings result in cases of gall-stones in the ductus cysticus, of acute cholecystitis and thickness of the gall-bladder wall. Therefore where sonographic findings differ from the intraoperative laparoscopic situs the operating surgeon should change to conventional cholecystectomy early enough to avoid complications.

Cholangitis↗

PubMed1993

[Biliary cystadenoma].

Biliary cystadenomas are rare biliary ductal neoplasms of congenital origin. There is an excellent correlation between CT and sonographic findings for number, size and location of the lesions. However, sonography can demonstrate better morphologic features such as thickened wall, mural nodules and septations. CT shows more clearly the accurate size and location of the neoplasm to surrounding structures. Angiography is not diagnostic; however, it can help to distinguish between benign and malignant lesions. MRI provides useful information for surgical planning, demonstrating well the relationship of the tumor to vascular structures and other organ systems. Complete excision is the treatment of choice to prevent recurrence or malignant transformation of biliary cystadenomas.

Adolescent↗

PubMed1993

[Endorectal ultrasound in diagnosis and therapy planning of broad-base rectal adenomas].

In this study the value of endorectal ultrasound in diagnosis and therapy of large rectal adenomas is shown. Between January 1988 and August 1992 93 patients with the primary diagnosis of adenoma proven by biopsy were examined by endorectal ultrasound. Sonographical differentiation of adenoma and carcinoma was done by echo-structure. Enlarged lymph nodes can be detected too. In 34 of 91 patients carcinoma was found by endorectal ultrasound and 28 were verified histologically. Sensitivity of endorectal ultrasound in detection of carcinoma in enlarged adenomas is 96%. Only preoperative endorectal ultrasound could give decisive criteria to take a second biopsy, to avoid mucosectomy in case of a malignoma or give the advice for a radical operation according to the tumor stage. Further staging of adenomas and small carcinomas is excellent by endorectal ultrasound and the right indication of local therapy can be confirmed.

Diagnosis, Differential↗

PubMed1992

[Analgesic consumption--laparoscopic versus conventional cholecystectomy].

We compared two groups of 50 patients each with symptomatic cholecystolithiasis treated by either conventional or by laparoscopic cholecystectomy with regard to duration of postoperative pain and sort and amount of analgetics. Laparoscopic operation time was on an average 115.4 min (65-180 min), conventionally operated 78.1 min (35-140 min). Eight patients with laparoscopic cholecystectomy did not need analgetics at all. The average number of days of postoperative pain was 2.7 days for conventional operation and 1.13 days for laparoscopic cholecystectomy. In this time the conventionally operated patients needed four to five times the amount of analgetics as well morphin analogues as low-potency analgetics.

Analgesics↗