Problems and controversies in endoscopic survey of the resected stomach.
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Biomedical subjects
Publications and source records attributed to L Riedler.
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Anal sphincter dilatation with forefinger and middle fingers of both hands for a two-minute period under strong pressure results in a measurable tonus-decrease of the sphincter ani over a period of 2-3 weeks. This tonus-decrease is of therapeutic advantage in numerous diseases, particularly in those of the anal area. At the same time, the stretching may well be used to protect anastomoses in the colon or to dilate the operative access in transanal operations. Complications arising from the stretching described are insignificant.
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The effects of the main lipoprotein density classes on the human adipose tissue lipoprotein lipase activity were studied. A dose-dependent stimulation of lipoprotein lipase activity was obtained for HDL and, to a lesser extent, for VLDL on a constant weight basis. LDL exerted virtually no effect. At higher concentrations, HDL as well as VLDL inhibited the stimulated lipolytic activity. In type V hyperlipoproteinemia, the stimulating effect of VLDL and of HDL was significantly lower, whereas the inhibiting action of HDL was markedly increased.
Results are reported of 107 patients, which had been operated upon from 1969-1975 at the Innsbruck University Department of Surgery, because of anorectal fistulas. The standard procedure was splitting of the fistula and ample excision of the walls of the fistula down to the skin. This procedure yielded satisfactory results in 74% of all cases. Fistulas penetrating the musculus levator ani were excised below this muscle respectively extracted, whereas the part of the fistula duct reaching above this muscle was left and scratched out cautiously.
The operative results of 115 patients with pilonidal sinus are described. The patients were controlled in 1977, 2 to 11 years after surgery. Only small, non-infected pilonidal sinuses should be radically excised followed by primary suture and Redon-drainage. For extended sinuses and for recurrences the best results are obtained when the wound is left open or marsupialisation is applied. Pilonidal sinus-abscesses should be incised. This simple procedure resulted in primary healing in 23% of our patients.
Problems of 39 patients with permanent colostomies/ileostomies are investigated one up to seven years after having got the anus praeternaturalis. The postoperative problems of everyday life are various and often serious, they are the more severe, the less patients had been informed preoperatively and the older the patients are. Younger and more intelligent patients integrate the colostomy easier and more quickly in their everyday life. Very useful for rehabilitation is the close contact between patient and the surgeon, respectively special colostomy-consulting hours.
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A case report has been made on a bronchobiliary fistula which was caused from an unspecific liver abscess. The causal therapy was the drainage of the liver abscess. The fistula then healed spontaneously. A primary thoracic sanitation of the fistula is in such cases not indicated.
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An assay of lipolytic activity in human adipose tissue is described, in which native homogenates of the adipose tissue yield the enzyme, as well as the triglyceride substrate, and the emulsifying phospholipids. The lipolytic activity in the presence of serum is characterized mainly as lipoprotein lipase activity by a pH-optimum of 8.0, by the fact that serum is necessary for full activity, and that it is inhibited by 1 M NaCl and by protamine. At serum concentrations of higher than 50% a marked inhibition of the lipolysis is observed. Noradrenaline, insulin, and heparin have no effect on the serum-stimulated lipolytic activity.