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Biomedical subjects

G Feifel

Publications and source records attributed to G Feifel.

At least 127 records · Page 7Linked to original sources
PubMed1986

Endorectal ultrasound: instrumentation and clinical aspects.

During the period 1983 to April 1986, 129 patients with rectal cancer were treated. In 76 of these depth of penetration of the rectal wall by tumour was assessed by ultrasound. T stage determined by ultrasound (uT) corresponded with the pathological stages (pT) in 67 patients. In the remaining 9 cases, ultrasound overstaged the tumour and in only one patient was the growth understaged. Lymph nodes could be visualised in 12 out of 27 patients in whom nodes were looked for but only six cases were found to be positive on histological examination. Of 22 recurrences detected or proven by ultrasound there was a group of 6 patients who had no other sign of recurrence.

Female↗
PubMed1985

Tests for the absorption of 75Se-labelled homocholic acid conjugated with taurine (75Se-HCAT).

The absorption of selenomethionine Se 75-labelled homocholic acid conjugated with taurine (75-SE-HCAT) was tested in 46 patients. Retention measurements using (1) an uncollimated gamma camera and (2) a measuring arrangement similar to a human-body counter were compared in order to obtain a quantitative assessment of the absorption capacity of the terminal ileum for bile acids. The retention curve obtained after the oral administration of the 75Se-labelled bile-acid analogue showed a monoexponential decline; in the case of unimpaired absorption, the half-life was greater than 2.5 days. When more than 30 cm of the ileum had been eliminated by inflammatory infection or resection, the measured half-life was below 0.5 days due to malabsorption. We also performed a quantitative determination of the hepatic secretion of 75-Se-HCAT into the gall bladder. If more than 80% of the activity administered is found in the gall bladder, disturbed absorption of bile acids in the terminal ileum can be excluded. Values smaller than 80%, however, do not provide proof of disturbed absorption.

Crohn Disease↗
PubMed1985

[Pathophysiology and morbidity of mechanical ileus].

Bowel obstruction by adhesion and tumor is the most common cause of mechanical ileus. The major alteration of obstructed bowels is distention. Microcirculation is hampered by raising the intraluminar pressure to 30 mm Hg. The high losses of water and electrolytes are not only due to lower resorption but also to secretion of liquid caused by enterotoxin. Therefore, perioperative antibiotics are necessary in addition to other therapeutic steps like decompression, parenteral nutrition and early operative intervention.

Enterotoxins↗
PubMed1985

Preoperative staging of rectal cancer by intrarectal ultrasound.

Digital examination and computed tomography are the current modalities employed to assess the depth of invasion of rectal cancer. Each technique has limitations in that high rectal tumors cannot be examined digitally and CT is unable to detect small tumors. However, preoperative diagnostic capability can be improved with the use of intrarectal ultrasound. We have examined 25 patients with rectal cancer preoperatively with digital examination and intrarectal ultrasound. In order to determine the accuracy of the ultrasonic method, we compared the results to the histopathologic findings of the excised specimen. Digital examination was essentially impossible in eight of the 25 rectal tumors because the tumors were either unreachable or could not be palpated in their full longitudinal extent. Of the remaining 17, digital examination corresponded with pathologic findings in 15, while tumor spread was overestimated in two patients. Sonography corresponded with pathologic findings in 23 of the 25 tumors. Two had been overstaged. Analogous to the TNM classification for postoperative pathologic tumor staging, we propose a preoperative tumor staging based on ultrasonic determination of the infiltrative depth of tumor, which we call uTNM.

Humans↗
PubMed1985

[Endorectal sonography in rectal carcinoma].

In the period from 1983 to 1985 forty-two of sixty patients with rectal cancer were examined in a prospective trial by endorectal ultrasound. The infiltration depth of the tumor was evaluated against the pathological findings of the excised specimen. The assessment of tumor infiltration depth by digital examination (clinical staging) was impossible or incomplete in 18 cases. Endorectal ultrasound was not correct in 14.2 per cent. In none of the patients examined infiltration depth was underestimated sonographically. Technics and criteria for interpretation are discussed. Endorectal ultrasound seems promising in pretherapeutic staging of rectal cancer.

Adenocarcinoma↗
PubMed1983

[Surgical correction of prostato-rectal fistulas].

A recto-prostatic fistula is a rare complication of prostatic operations and the literature on the subject is scanty. Three men were treated for recto-prostatic fistulas representing complications of prostatic surgery. York Masons trans-sphincteric trans-rectal operation resulted in prompt, primary healing of the fistula. Subsequent colostomy closure left all three patients with normal urinary and fecal control. A systematic 3-step sequence of operation is advocated for the treatment of recto-prostatic fistulas. The York Mason operation provides excellent exposure and reliable closure of recto-urinary fistulas.

Aged↗
PubMed1982

[Splenic abscess. Clinical aspects and therapy].

During a period of five years seven patients suffering from splenic abscess have been treated successfully. It is anticipated that due to computerized tomography this location of an abscess is now detected more frequently. As we have seen in our patients splenic abscess occurred mostly in cases of salmonella infection or endocarditis. Therapy includes splenectomy and antibiotic treatment. We have been able to differentiate preoperatively the organisms which caused infection and splenic abscess.

Abscess↗
PubMed1982

[Heart transplantation: successful treatment of postoperative complications. Case report with 19 months' follow-up].

In March, 1981, a 37-year old patient underwent cardiac transplantation, the first to be performed in Germany since 1969. Subsequent to the successful procedure, the patient has now been followed for more than 19 months. The indication for the intervention was established on the basis of endstage coronary artery disease. The operation was performed according to the technique of Lower and Shumway. Immunosuppression, in the early postoperative phase, was carried out with antithymocyte globulin, azathioprine and corticosteroids with administration oriented on the T-lymphocyte and total leukocyte counts as well as analysis of myocardial biopsies. In the late postoperative course, dosage of immunosuppressive agents was based almost exclusively on biopsy findings. Within the course of immunosuppressive therapy for cardiac transplantation, in particular, initial experience was gained with the use of antithymocyte globulin which was given in dosages of up to 12 mg/kg daily. The antithymocyte globulin proved effective for more than six weeks postoperatively. The alterations in immunosuppressive treatment necessitated by two gastrointestinal complications (perforated gastric ulcer, perforation of the small intestine) enabled a comparative analysis of the results of therapy with cyclosporin A given orally, intravascularly and intravenously. The Patient continues to be maintained on a regimen of cyclosporin A and corticosteroids and his general condition is good. For future cardiac transplantations, in the early postoperative course, alternating treatment with antithymocyte globulin, azathioprine and corticosteroids, on the one hand, with cyclosporin A and corticosteroids, on the other hand, would seem meaningful both to minimize adverse reactions as well as to provide effective immunosuppression. The experience rendered would promise to facilitate management of patients after cardiac transplantation.

Adolescent↗
PubMed1982

[Postoperative syndromes after surgery for termination of esophageal reflux (author's transl)].

Postoperative syndromes after surgery for termination of esophageal reflux may be due to false indication for surgery, technical faults, functional disturbance after other surgical procedures, non-related accompanying disease, or relapse of reflux esophagitis. Only an exact analysis of the factors causing the syndrome will allow in the individual case an appropriate therapy. Management should be medical in most cases; only such patients should be operated upon again, which do have symptoms of distinct severeness and long duration. In patients, which had an anatomical reconstruction done during the first surgical procedure, the therapy of choice is establishing a valvuloplasty. Has this been done as the first surgical procedure, the fundoplication must be untied, and a new surgical trial to terminate esophageal reflux has to be done.

Deglutition Disorders↗
PubMed1981

[Controversial viewpoints on the use of historical controls: Is there an all-or-nothing law?].

In the field of clinical trials the choice of appropriate controls has often given rise to controversy. Historical controls rely too often on biased, incomplete, and inappropriate information. Historical controls may be suitable if the natural history of the illness is known and stable or for planning prospective studies. The minimal requirement for use of historical controls is to explain the methods by which the data were collected. When the goal of clinical investigation is to test for a true difference, a randomized clinical study should be performed.

Clinical Trials as Topic↗
PubMed1980

[Hemostatic properties of gastric juice under basal conditions and after stimulation with pentagastrin or secretin-pancreozymin (author's transl)].

Unsoluble gastric mucus and gastric juice from 11 normal volunteers were separated by centrifugation and investigated for hemostatic properties. Unsoluble gastric mucus added to citrated blood shortened reaction time and increased duration of maximum amplitude of thrombelastographic recordings, indicating an acceleration of hemostatic processes. On the other hand gastric juice inhibited coagulation and enhanced fibrinolytic activities, as shown by thrombelastographic recordings, prothrombin time, partial thromboplastin time, and euglobulin lysis time. Unsoluble gastric mucus accelerated hemostasis even more after stimulation by secretin-pancreozymin, as evidenced by thrombelastographic recordings. Gastric juice of patients with duodenal ulcers showed a significant change of these parameters to the opposite after pentagastrin. We conclude, that stimulation respectively inhibition of HCl and proteases, following pentagastrin respectively secretin-pancreazymin may influence hemostatic properties of gastric juice and gastric mucus as well.

Blood Coagulation Tests↗
PubMed1979

[Sensitivity of the haemoccult test in colorectal tumours (author's transl)].

157 patients with histologically investigated colorectal tumours from 5 hospitals of the University of Munich were tested with the Haemoccult test. In 30 (35.7%) of 84 patients with malignancy of the colon and in 31 (58.5%) of 53 patients with adenomas or polyps the correctly performed test was negative. The test result showed no dependency on age or sex of the patient, nor on size, stage or localisation of the tumour. A problem-orientated history lowered the rate of false negative tests to 2.4%. The high rate of false negative results was not attributable to organisational or technical errors.

Adenoma↗