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Biomedical subjects

H D Becker

Publications and source records attributed to H D Becker.

At least 235 records · Page 13Linked to original sources
PubMed1985

[Stelzner self-healing cecal fistula--course of healing and complications].

A retrospective study of 83 patients who underwent caecal fistula as described by Stelzner during the five-year period between 1979 to 1984 was carried out. 26 fistulas were performed after low anterior resection, 54 after anterior resection and 3 after left hemicolectomy. In 10.8% the operative closure of the fistula was necessary. An anastomotic insufficiency could be recognized clinically in 3.8%. The overall complication rate was 21.7%. The caecal fistula seems to be an effective procedure with a lower complication rate than the temporary colostomy.

Cecum↗
PubMed1985

[Results of therapy of acute mesenteric vascular occlusion].

From 1979 to 1984 39 patients were operated on for acute mesenteric ischemia. The purpose of this retrospective study was the documentation of the therapeutic results and discussion of the value of a second-look operation and postoperative angiography. Proximal occlusion of SMA in 33 patients (85%) resulted in extended bowel infarction, whereas segmental infarction due to peripheral occlusion was found in 15%. The hospital mortality was 85%. Operative procedure consisted of revascularisation (18%), bowel resection (18%), revascularisation and resection (10%) and explorative laparotomy (18%). The second-look operation as a routine procedure has been replaced by a postoperative angiogram. Laparotomy was performed in case of reocclusion of SMA or clinical signs.

Aged↗
PubMed1985

[Value of the gastrografin enema in the diagnosis of ileus].

From 1978-1984 421 patients were examined by colon enema with gastrografin. The indication in 246 cases was an acute abdomen, in 172 patients the procedure has been performed postoperatively, 3 patients suffered from gastrointestinal bleeding. 81 of 236 pathological findings showed an ileus. 58 of them underwent an operation. The cause of the ileus were tumors of the colon, extraluminal tumors as well as performations and inflammations. In 55 cases the findings of the gastrografin enema were confirmed by the operation, one was proved to be false negative, one uncertain and one false positive. Therefore the diagnostic accuracy of this procedure amounted to 96%.

Colonic Diseases↗
PubMed1985

Bilateral virilizing adrenal tumor in a 17 year old woman.

We report on a 17 year old female patient with amenorrhea, hirsutism and slight acne. Hormonal blood analyses showed markedly increased levels for dehydroepiandrosteronesulfate, testosterone and androstenedione. Ultrasound investigation revealed a large tumor above the left kidney and a small area above the right kidney, suspicious for a tumor on the contralateral side. This was confirmed by angiography. During surgery, bilateral tumors were removed. Pathological diagnosis was made as bilateral adenomas of the adrenal cortex. Postoperatively, an impressive normalization was observed, accompanied by a rapid decrease of the elevated hormone concentrations. This case is the first report of a bilateral occurrence of a virilizing tumor of the adrenal cortex.

Adenoma↗
PubMed1985

Chemical and immunochemical characterisation of substance P-like immunoreactivity and physalaemin-like immunoreactivity in a carcinoid tumour.

Extracts of a carcinoid tumour, resected from the mid-portion of the ileum of a patient with no symptoms of endocrine disorder, were associated with a high concentration of substance P-like immunoreactivity. Using reverse-phase high performance liquid chromatography and antisera specifically directed against the C-terminal and N-terminal regions of substance P and against the N-terminal region of physalaemin, the following components were isolated and identified: substance P and its oxidised form, [pGlu5]substance P-(5-11) peptide and its oxidised form, and the oxidised form of physalaemin. The identity of tumour substance P with the undecapeptide was confirmed by amino acid analysis and high performance ion-exchange chromatography. In vitro incubation of tumour tissue from a lymph node metastasis from the same patient with [3H]leucine resulted in incorporation of radioactivity into newly synthesised substance P.

Carcinoid Tumor↗
PubMed1985

Plasma cholecystokinin levels in patients with chronic pancreatitis.

Using a sensitive and specific radioimmunoassay for cholecystokinin (CCK) we have measured plasma CCK levels in patients with and without chronic pancreatitis. All patients suffered from steatorrhea. The basal plasma values in patients with chronic pancreatitis (n = 10) were significantly higher compared with a control group of 40 normal subjects. After ingestion of a test meal peak plasma levels of CCK were significantly higher than in controls, but the integrated CCK release did not differ from the normal subjects. The findings indicate a close relationship between plasma CCK concentration and exocrine pancreatic function.

Adult↗
PubMed1985

[Subtotal thyroid resection in severe, iodine-induced hyperthyroidism].

Iodine-induced thyrotoxicosis due to iodine application in high amounts in patients with circumscript or disseminated thyroid autonomy, is complicated by a prolonged course, mainly due to a resistance to conservative therapy with thiourea derivates. We therefore decided to perform an early subtotal thyroidectomy in 24 thyrotoxic patients. This measure is in contrast to the common opinion that surgery should only be performed after normalization of thyroid hormones. In all 24 patients with severe hyperthyroidism, including three patients with thyroid storm, hormone levels decreased within a few days after surgery to normal or subnormal values and the clinical picture of thyrotoxicosis disappeared. In the case of thyroid storm the signs of disorientation normalized within 1-3 days. One patient died five weeks after surgery due to severe concomitant diseases. One patient exhibited transitory respiration distress and another had postoperative hypocalcemia. In 13 patients L-thyroxine replacement became necessary due to subclinical or clinical hypothyroidism. Surgery as a early treatment for thyrotoxicosis should be reserved for patients with severe illness where conservative treatment has been shown to be ineffective. In rare selected cases, when a rapid normalization is required, surgery without preoperative treatment seems to be justified. The effect of surgery was impressive in all our cases and there were only minor perioperative complications.

Adult↗
PubMed1984

[Zollinger-Ellison syndrome].

The Zollinger-Ellison syndrome (ZES) is caused by mainly pancreatic, gastrin-producing tumours, which show a high rate of malignancy. The clinical picture is dominated by gastric hypersecretion, which results in the development of peptic ulcerations of the stomach and duodenum, reflux esophagitis, or diarrhea. The differentiation from other types of hypergastrinemia is done by provocative tests, mainly the secretin-test. Because of the high malignancy rate, therapeutically, a symptomatic treatment of gastric hypersecretion by H2-receptor antagonists or in cases of ineffective conservative treatment total gastrectomy is performed. In patients with duodenal gastrinomas or in the rare cases with benign pancreatic tumours resection of the tumours is the therapy of choice.

Benzimidazoles↗
PubMed1984

Release of radioimmunologic cholecystokinin in human subjects.

After the development of reliable, highly sensitive, specific radioimmunologic methods for measuring physiologic CCK concentrations in human plasma, we have been able to study the importance of CCK in the postprandial activation of pancreatic enzyme secretion. In man, food causes a threefold increase in the basal plasma CCK concentration with a peak at about 60 minutes. The highest CCK concentrations are observed after intraduodenal fat infusion. Selective proximal vagotomy results in a significant increase in basal CCK concentrations in duodenal ulcer patients without altering the postprandial CCK output. After gastric resection (Billroth I or Billroth II) an initial greater postprandial CCK output is observed. In patients with chronic pancreatic insufficiency without enzyme substitution, basal plasma CCK concentrations and the early postprandial CCK output were elevated which indicated a feedback mechanism between pancreatic enzyme secretion and CCK release from the mucosa of the upper small intestine.

Cholecystokinin↗
PubMed1984

Elevated plasma cholecystokinin concentrations in exocrine pancreatic atrophy in the rat.

Rats were fed with a copper-deficient diet combined with penicillamine to produce an atrophy of the exocrine pancreas by selective destruction of the acinar cells, which are replaced by fat cells. Plasma cholecystokinin (CCK) concentrations in animals with exocrine pancreatic atrophy were 250% higher compared to control animals (21.7 +/- 7.8 vs. 6.1 +/- 1.07 pmol/l; p less than 0.001). Plasma concentrations of gastrin were significantly decreased by 44% and of gastric inhibitory polypeptide (GIP) significantly increased by 24%, while the decrease of the plasma insulin did not reach the level of significance. In the proximal duodenum a significant decrease of the CCK concentration could be observed, whereas tissue concentrations of GIP in duodenum and jejunum and gastrin in the gastric antrum remained unaltered. These data suggest that the negative feedback control of pancreatic enzyme secretion is mediated by the release of CCK.

Animals↗