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Biomedical subjects

G Gaebel

Publications and source records attributed to G Gaebel.

13 recordsLinked to original sources
PubMed1991

[Results of organ saving splenic surgery].

The charts of the 24 patients we treated in the past 7 years with spleen conserving methods after trauma and of the 13 patients we treated with splenic autotransplants were reviewed for this study. The results demonstrate, that the conservation of an injured spleen, desirable in adults too, is possible in appropriate cases without greater risk. Infrared coagulation and fibrin sealing proved as safe techniques, that can be augmented by others. Patients with subcapsular hematomas of the spleen can be left normally without operation in absence of other intraabdominal injuries; in these cases meticulous surveillance with the possibility of operations and ultrasound examinations at any time is necessary because of the risk of delayed bleeding. In the meantime we gave up the autotransplantation of splenic tissue after splenectomy for complications and doubts in the efficiency.

Adolescent↗
PubMed1989

The effect of low mucosal pH on sodium and chloride movement across the isolated rumen mucosa of sheep.

Isolated sheets of sheep rumen mucosa were studied in vitro by using the Ussing chamber technique. The pH of the mucosal solution was altered by adding HCl. Using 22Na and 36Cl unidirectional fluxes of sodium and chloride were measured across the short-circuited and voltage-clamped rumen mucosa at mucosal pH 7.4 and 5.5. Lowering mucosal pH to 5.5 caused a rapid decline in the short-circuit current (Isc). The conductance (Gt) increased about 10 min after the drop in Isc. At pH 5.5, mucosal-to-serosal movement of Na+ and Cl- was decreased thus leading to a decreased net transport. These alterations were seen 30 min after mucosal acidification. They were intensified 120 min thereafter. Further studies showed that a clamped transmural potential difference (20 mV) influenced Na+ and Cl- transport only slightly more in acidified epithelia. Light and electron microscopy showed a swelling of the cells and especially of their mitochondria after acid exposure. These data indicate that lowering mucosal pH causes alterations in transepithelial Na+ and Cl- transport. We suggest a predominant effect on cellular transport mechanisms.

Animals↗
PubMed1989

[Observations on post-traumatic osteitis].

The following study reports the frequency, the promoting factors, the therapy and her results of the 32 patients with posttraumatic osteitis we treated between 1984 and 1986 in the Surgical University Clinic Tübingen. Most of the primary injuries were caused by traffic-accidents; especially dangerous were those with motor-bikes, which led frequently via open fractures of the shank to osteitis. We saw the highest infection-rates after plate-osteosyntheses. The infects became obvious in most cases either about one month after the accident or a year later coinciding with the increased use of the limb. The most frequent bacterium was Staph. aureus both in the mono-infections and in the mixed-infections forming a third of the group. We always performed an operative therapy with the intention to stabilize the bone and to clean the infection-site. The strict performance of this management led to infect-suppression in all cases with the need of only one amputation.

Adult↗
PubMed1989

[Incidence of recurrence following surgery of perforating and non-perforating complications in Crohn disease].

From 1980-1987 131 patients were operated for Crohn's disease. Among these 73 patients had perforated (PC) free perforation, abscess, fistula, and 47 had nonperforating complications (NC). Ileums, bleeding, stenosis reoperations (58 pts, 44%) were seen more often in the PC-group (57%) compared to 31% in the NC-group. Furthermore there was a high concordance in the indication for the initial and subsequent operations.

Adult↗
PubMed1987

[Results of the treatment of pathologic fractures of long tubular bones].

The treatment of pathological bone fractures will be analysed by 53 patients of the Surgical Clinic of the University of Tübingen in view of fractures reason, operative providing and prognosis. The first aim consist in correction or preservation of live quality. Fractures nearly joints can be treated by endoprothetics. With the help of compound osteosynthesis most fractures can be stabilized. Conservative treatment only in final phase is legitimated.

Adult↗
PubMed1987

The effect of diet, intraruminal pH and osmolarity on sodium, chloride and magnesium absorption from the temporarily isolated and washed reticulo-rumen of sheep.

Six mature sheep fitted with rumen fistulae underwent four consecutive feeding periods, of 15 weeks each, i.e. (1) hay only; (2) 36% hay, 64% concentrate; (3) 10% hay, 90% concentrate; and (4) hay only again. The net absorption of sodium, chloride and magnesium from the washed rumen filled with artificial rumen fluids was tested during each feeding period. The artificial rumen fluids varied either in osmolarity (315 and 422 mosmol l-1) or in pH (6.78 and 4.79). Further, the surface area of rumen papillae was determined. The feeding of increasing proportions of concentrate resulted in an increase of the surface area of rumen papillae and in an elevated net absorption of sodium, chloride and magnesium. Hypertonicity (422 mosmol l-1) of the artificial rumen fluid caused net influx of water into the rumen but did not influence net absorption of the electrolytes irrespective of the feeding regimen. When the pH was lowered this led to a decrease in net absorption of sodium, chloride and magnesium and in transmural potential difference. The extent of the pH-induced decrease in net ion transport and potential difference was less in sheep receiving high-concentrate diets. When only hay was fed after the period of feeding 90% concentrate diets the surface area of the papillae, the absorptive capacity of the rumen epithelium and the resistance against low pH returned to control levels. The findings show a reversible adaptive response of rumen epithelial functions to different diets.

Adaptation, Physiological↗
PubMed1986

[Effect of L-carnitine on post-stress metabolism in surgical patients].

The positive influence of L-carnitine administration on postaggression metabolism was investigated. Clinical examinations were executed on three groups of patients K1, K2, K3). Comparable surgical operations like stomach- and intestinal- resections were performed on these groups of patients. During the first three days after operation a nutritional diet (parenteral, standardized hypocaloric) with (K2: 2 g; K3: 4g) and without L-carnitine (K1) was given. The effects of L-carnitine administration were evaluated by the following parameters: free fatty acids (FFS), triglycerides (TG), beta-hydroxybutyric acid (beta-OH-BS), acetacetate (ACAC), blood sugar (BZ), insulin (INS), lactate (LAK), pyruvate (PYR), total protein (GE), cholinesterase (CHE), urea production rate (PU), nitrogen of alpha-aminogroups (alpha-AN), nitrogen balance (NB), catabolic index (KI), BUN-Creatinine-quotient (B/K), total carnitine (GC), free carnitine (FC), acetyl carnitine (AC) and also the ratio between acetyl carnitine and free carnitine (AC/FC) in serum and urine. The results show no statistical significance. But they could lead to the following conclusions: Carnitine obviously reduces the insulin resistance. But it does not influence the post-operative perturbation of glucose-utilization. Carnitine reinforces the utilization of long chain fatty acids and thus improves the energy conversion. Carnitine leads to an earlier positive nitrogen balance. By giving 4 g of carnitine a day, already after three days a repletion of tissue deposits is possible, and a dose dependence for carnitine administration exists for the utilization of long chain fatty acids and the repletion of tissue deposits.

Adult↗
PubMed1985

[Surgical therapy of liver echinococcosis].

There is still no other therapeutic management for echinococcosis of the liver than surgical treatment. Indeed, drug therapy with Mebendazol prevents parasitosis from spreading. However, a complete regression has not been observed hitherto. Surgical procedure is dependent on expansion, localisation and type of echinococcosis. Generally, cystectomy is possible and adequate in case of Echinococcus granulosus, in case of Echinococcus multilocularis with its infiltrating growth, a complete healing can only be attained by lobectomy. With the hilus being invaded and obstructive jaundice proceeding, an improvement can be reached by Mebendazol or a palliative endless drainage tube.

Combined Modality Therapy↗
PubMed1980

[Surgical treatment results in Crohn disease].

Between 1957 and 1978 122 patients with Crohn's disease were operated in the Surgical Department of the University of Tübingen. Follow-up examination showed a high recurrence of nearly 45%. 13 patients died during this time. A change of primary localisation from small intestine to colon was found. Surgery took place when drug therapy failed or complications like perforation, ileus or fistulae made it necessary. Resection must be radical. Immediate section for microscopic examination under surgery is seen as a possibility to reduce the relapse rate and avoid a more extensive intestinal resection. No malignant degeneration was noticed.

Adult↗