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Biomedical subjects

G Otten

Publications and source records attributed to G Otten.

At least 37 records · Page 2Linked to original sources

[Isolated Crohn disease attack of the stomach--differential diagnostic and therapeutic problems].

There are about 15-30 patients reported in the literature, who suffered from well established, isolated Crohn's disease of the stomach. Another case is reported here, who had gastrectomy, since a diagnosis of gastric carcinoma had been made before and during surgery. When histological findings are negative, very extensive diagnostic procedures have to be performed in order to exclude this entity and to avoid useless gastric surgery. A clearcut recommendation as to surgery in cases of stenosis of the pyloric region cannot be given; the experience from the case described however would tend to favour treatment by gastrectomy.

Crohn Disease↗

[Percutaneous transhepatic portal vein catheterisation in the diagnosis of hormone-producing tumours in the splanchnic area (author's transl)].

During 1980, percutaneous transhepatic portal vein catheterisation was carried out in eight patients with suspected hormone-producing tumours in an attempt to localise these. Seven patients with hyperinsulinism were suspected of having an insulinoma and one a gastrinoma. There were no complications following the catheterisation, and difficulties were reduced by the use of a special catheter. The blood samples were examined by radio-immunological methods for insulin or gastrin. On the basis of localised rise in hormone level, it was possible to diagnose three insulinomas and one gastrinoma in the pancreas. The beta-cell tumours were removed by enucleation or segmental resection, the gastrinoma by a Whipple's operation. Three patients showed an insulin gradient and sub-total pancreatectomies were performed. In one patient there was no definite abnormality in the insulin level and an operation has so far not been performed. Our experience indicates that this technique is difficult, bu is nevertheless a reliable method for localising hormone-producing tumours and surgery should not be carried out without it.

Adenoma↗

[Epidural morphine analgesia. Postoperative period (author's transl)].

50 patients after abdominal surgery received peridural morphine for postoperative pain relief. At the end of operation, 2-3 mg morphine in 10-15 ml 0,9% saline were injected peridurally by a catheter, which was placed preoperatively. The injection was followed by a dissociated analgesia. Diffuse pain and wound pain were diminished. Pin prick and temperature were still perceived. Analgesia started within 2-5 min after injection and lasted 14 h in the mean (range 1-49 h). The degree of analgesia was determined by a visual analogue scoring system. The patients reported a marked pain relief. A new dose of 2 mg morphine was given on demand, when the patients felt pain again. This procedure was continued until the second postoperative day. The overall amount of morphine by peridural application was 8 mg within 3 days. Neither clinically nor by blood gas analyzes here were signs of respiratory depression. There were no severe side effects. The advantages of epidural morphine analgesia are: low dose, long duration, lack of sedation and motor block, lack of respiratory depression, tachyphylaxia and sympathetic block. No pneumonia were seen in the epidural morphine group, whereas 4 cases of pneumonia were seen in the control group (n = 50) with conventional analgetics.

Abdomen↗

[Animal experiments with bile peritonitis].

Contrary observations exist in the publications concerning the bile peritonitis. Therefore the effect of sterile bile in the peritoneal cavity was investigated in the white mouse. We had the following results: 1. The L.D. 50 will be obtained only by high bile concentrations. 2. The chemical bile effect is minimal on the visceral and parietal peritoneum in the early and late phase. 3. The bile peritonitis does not get infected in case of the intact gastrointestinal and biliary tract. There does not exist a so-called passing through peritonitis even with big bile quantities. 4. A reduction of the peritoneal adhesions arises by bile influence and by weak adhesion stimuli.

Animals↗

[Epidural morphine analgesia (author's transl)].

We report our experience with epidural morphine analgesia. Morphine 2-3 mg in 10-15 ml 0.9% saline was given to patients after abdominal surgery, patients with terminal carcinoma and patients with multiple fractured ribs. Mean duration of analgesia was 14 hours and was not accompanied by severe complications.

Aged↗

[Epidural morphine injections for the treatment of pain].

Morphine in epidural application (2-3 mg in 10 cc saline solution 0,9%) gives a long lasting segmental analgesia. In 15 patients after upperabdominal surgery the overall mean dosage of morphine was 8,85 mg within three days. The effect lasted for about 15 hours per application. No other analgetics were needed. All patients were content with this method of postoperative analgesia. There were no side effects or complications.

Adult↗

[Anastomosis prolapse of the gastric mucosa].

X-rays of 91 patients who underwent gastric surgery between 1973 and 1977 were retrospectively evaluated. We found 16 large mucosal prolapses through the gastroduodenal anastomosis and another six with a so-called anastomosis bulge. Of these patients, 77% presented complaints in relation to delayed gastric emptying. When analyzing the prolapse frequency, patient age at the time of surgery, type of surgery, and suture technique, we found that mucosal prolapse occurred mostly in older patients with an extensive gastric resection after oralis-partialis anastomosis and after employing the two-layered suture technique.

Adult↗

[Emptying of the stomach after selective proximal vagotomy (author's transl)].

Cream cheese containing 14C-labelled glutaminic acid was given to patients after proximal selective vagotomy and 14CO2 measured in the expired air in order to test the gastric emptying process. Results do not allow exact quantitative evaluation, however definite changes of gastric emptying for up to 6 month after surgery could be demonstrated.

Carbon Radioisotopes↗

[Increased kidney cell proliferation caused by folic acid treatment after dichromate induced renal failure (author's transl)].

Folic acid is given intravenously to rats 5 to 10 days after a dichromate induced damage of the kidneys. These injection cause an additional damage in the function and structure of the kidneys, but on the other hand, they induce a cell proliferation detected by the increased uptake of thymidine. This cell proliferation in the kidney-tissue seems to be a part of specific reactions to the folic acid.

Animals↗

[Persistent duodenal septum in an adult].

A case of duodenal obstruction by a congenital duodenal web in a 34-year-old woman is presented. A mucosal diaphragm obstructed the duodenum. It showed an excentric opening of 0.8 cm diameter, but the dilated diaphragm caused a total stop during the last months. Despite a typical history, exact X-ray, and endoscopic examination, the correct preoperative diagnosis was not found, because nobody thought it possible, that a mucosal diapharm of the duodenum could persist for 34 years.

Adult↗