Search PubMed⌕ Search

Biomedical subjects

H Troidl

Publications and source records attributed to H Troidl.

At least 181 records · Page 10Linked to original sources
PubMed1982

[Analysis of therapeutic failures of three surgical concepts for treatment of duodenal ulcer-results of a prospective consecutive study (author's transl)].

In a prospective study 3 surgical concepts were used to treat patients with chronic duodenal ulcer. In concept I 64 patients were treated with "individual ulcer surgery", i.e. depending on the general condition of the patient, the local intraoperative situation and preoperative acid output, either selective vagotomy with pyloroplasty, with antrectomy (B-I) or B-II gastrectomy were used. In concept II 62 patients were treated with selective vagotomy and pyloroplasty. In concept II 110 patients with highly selective vagotomy and treated without drainage. The conditions were diagnosed and the patients were treated in a standardized manner. Follow-up rates were 90% and above and the results were analyzed according to Troidl's definition of operative failures after 1-year follow-up. Lethality was 0% in all concepts (I-III). Recurrent ulcer: I=0%, II=3%, III=4.5%. Complaints with Visick-classifications III and IV: I=14%, II=12.8%, III=45%. Changing symptoms: I=0%, II=0%, III=1%. No acid reduction: I=0%, II=4.9%, III=l6,4%. The lowest recurrence rate and best acid reduction was concept I, the best overall clinical outcome concept III. Highly selective vagotomy without drainage is preferred as the least major and most careful procedure at the moment.

Duodenal Ulcer↗
PubMed1982

[Selective proximal vagotomy with ulcer excision or Billroth I resection in chronic stomach ulcer. A prospective randomized multicenter study].

In a prospective randomised multicenter study in 41 patients with chronic gastric ulcer type I according to Johnston we compared selective proximal vagotomy (SPV) plus ulcerectomy (21 patients) with a standardised Billroth I gastrectomy (20 patients). The follow-up period was at least 2 years. Preoperative characteristics of both groups did not differ. Intraoperatively, in 5 patients of the SPV group technical problems during dissection of the lesser curvature occurred. The main postoperative complaints were pain and epigastric fullness after SPV and bile vomiting, early dumping or diarrhea after Billroth I gastrectomy. 3 of 21 patients after SPV developed recurrent ulceration, whereas after BI resection no recurrence was observed. This study indicates a higher recurrence rate in gastric ulcer patients after SPV compared to Billroth I gastrectomy.

Clinical Trials as Topic↗
PubMed1981

[Value of circular mechanical colon and rectum anastomosis. Prospective study of 91 patients].

A prospective study was carried out on 91 patients to evaluate colonic and rectal anastomoses constructed with an EEA stapling gun. The concept comprises the following: orthograde lavage, cecal fistula or colostomy, intraoperative sufficiency control of the anastomosis, intraoperative direct measurement of the height of the anastomosis, postoperative X-ray control of the anastomosis using standardized techniques, classification of the cases into three groups according to the height of the anastomosis: 3-5 cm, and over 9 cm. Characterization of the patients was accomplished biostatistically using the Median-Quartil system. Primary hospital letality of 2% was due to heart failure. Imparied wound healing occurred in 11%. Secondary suture dehiscence was roentgenologically identified in a total of 18% of which only 7% showed clinical symptoms. Stenosis was determined by X-ray in 11% with only 1% demonstrating a temporary clinical correlation. For especially low rectal anastomoses at 3-5 cm the EEA stapling gun appears to have a great technical advantage over hand-placed sutures, allowing extension of indications for low anastomoses.

Adolescent↗
PubMed1980

[Validity of retro- and prospective data analysis (authors' translation)].

Retrospective chart analysis of 88 operated patients with bronchial carcinoma showed grave deficiencies. In 15% the reason for admission to hospital was not available and the exact smoking habits of 74% were not known. Retrospective TNM-classification was possible in only 59%. It was known in 67% whether a radiotherapy and in 17% whether a cytostatic therapy was additionally performed. Only 13 of the 20 surviving patients participated in the follow-up. In contrast with these figures, a prospective collection of data (44 patients) has an effectiveness of 95% or more for all parameters.

Bronchial Neoplasms↗
PubMed1980

Histamine and peptic ulcer: influence of sample-taking on the precision and accuracy of fluorometric histamine assay in biopsies of human gastric mucosa.

From a methodological point of view the relevance of clinical-biochemical trials depends on the answers to mainly four complexes of questions: (1) the reliability of the assays in the clinical situation to be tested, (2) the precision and accuracy of sample-taking, (3) the qualification of the design and the protocols in the clinical part of the trial and (4) the usefulness of the time concepts in the trial concerning biorhythms, seasonal influences, psychological trauma of diagnostic procedures and treatment. In this study mainly the second complex of questions was studied intensely. The precision of the fluorometric histamine assay in biopsy specimens from human gastric mucosa depended on several conditions: Biochemical technique, sample preparation and removal of biopsies from gastric mucosa via endoscopy. The CV% of the whole procedure was about 8-times higher than that of the biochemical technique. In clinical-biochemical studies on the significance of histamine or any other hormone (such as gastrin) in any disease (uch as duodenal ulcer) it seems therefore useless to describe the precision of an assay only by the variance of the biochemical technique. Calculation of the histamine content as mean of 3 samples reduced the CV% from 27.2 to 14.9% and should therefore be recommended.

Adult↗
PubMed1980

[Auto-suture stapler EEA in surgery of the colon and rectum [author's transl)].

The increasing use of auto-suture staplers for gastrointestinal anastomoses makes it necessary to test the value of this new method of suturing. In a "pilot study" the practicability, the tightness and permeability of the anastomosis and complications were tested and analysed in a total of 30 colon and rectal anastomoses using the EEA-suture gun. The results of 14 colon resections and 16 low anterior resections justify the further use of the EEA auto-suture apparatus and raise the question of a prospective controlled random study in which manual and mechanical machine sutured anastomoses are compared.

Colon↗
PubMed1978

[Management of a systematic follow-up clinic (author's transl)].

The essential differences between the common, irregular medical check-up, as practiced in the follow-up clinics in England and Scandinavia, and the type practiced in the systematic follow-up clinic in the "Marburg experiment" are presented with examples. The necessity of the latter for clinical knowledge, for the attending surgeon, for special patients, and last but not least, for clinical research, is stressed. Based on examples from the Marburg systematic follow-up clinic for duodenal ulcer studies, its practicability is discussed.

Duodenal Ulcer↗
PubMed1978

Histamine content and mast cells in human gastric and duodenal mucosa.

A high histamine content was found in all areas of human gastric and duodenal mucosa. In single subjects there was no general preference of histamine being located predominantly in fundus and corpus. In biopsy specimens of human corpus mucosa many histamine-containing O-PD reactive cells could be identified. In the sections treated previously with O-PD also many toluidine blue staining cells (mast cells) could be visualized. As shown by a transcription technique their place and number was the same as those of O-PD reacting cells. It is concluded that histamine in human corpus mucosa is localized exclusively in mast cells which seem to participate in acid secretion and in duodenal ulcer disease in man.

Duodenum↗
PubMed1978

[Acid reduction and ulcer healing through vagotomy: is an inhibition of histamine release an essential reason for this?].

In a prospective, consecutive study the histamine content of corpus mucosa and the basal and maximally stimulated acid output were measured in male patients who had selective vagotomy to correct a chronic duodenal ulcer. The increase in histamine content after vagotomy was directly proportional to a decrease in maximum acid output. The relationships between histamine content, recurrent ulcer, and reduction in acid output point to a causal relationship between inhibition of histamine release and successful vagotomy.

Adult↗
PubMed1977

Histamine and peptic ulcer disease: histamine methyltransferase activity in gastric mucosa of control subjects and duodenal ulcer patients before and after surgical treatment.

Histamine methyltransferase (HMT) activity was determined by a modified isotope assay in biopsy specimens from gastric mucosa of control subjects, duodenal ulcer patients and after various gastric operations. Enzymic activity of male control subjects who were 'healthy' with respect to their upper gastrointestinal tract was 70.4 +/- 12.8 pmol/(min x mg protein). In male duodenal ulcer patients HMT-activity was significantly lowered by 15%; following selective vagotomy with pyloroplasty a significant increase of 14% was observed as compared to controls. The difference between values before (59.9 +/- 13.3) and after (80.4 +/- 11.7) this operation was highly significant (p less than 0.001). Experiments in a small number of patients showed that after other modifications of vagotomy elevated HMT-activities were also found, whereas after resection procedures such changes of enzymic activity did not occur. According to these results the low gastric HMT-activity of duodenal ulcer patients could play a role in the pathogenesis of a chronic peptic ulcer by being responsible for reduced histamine inactivation and - as a consequence - enhanced acid secretion. Furthermore, vagotomy seemed to influence acid secretion in human subjects not only by direct effects on the parietal cells, but also by an activation of histamine catabolism. One patient, who despite complete vagotomy showed both no reduction in acid secretion and a low gastric HMT-activity, may be the representative of a new population of peptic ulcer patients.

Duodenal Ulcer↗