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Biomedical subjects

M Allgöwer

Publications and source records attributed to M Allgöwer.

At least 37 records · Page 2Linked to original sources
PubMed1984

[The effect of proximal-selective vagotomy in gastroduodenal ulcer].

In a recently concluded prospective multicenter trial, pyloric (PU) and prepyloric (PPU) ulcers showed a significantly higher recurrence rate after proximal gastric vagotomy (PGV) without drainage than duodenal (DU) or gastric ulcers (GU). The secretory pattern of the PU and PPU cannot explain the failure of PGV. However, PU and PPU (and some GU) exhibit a distinct and probably irreversible alteration of the muscular layer at the pylorus and distal antrum. This could be one factor which helps to explain the failure of vagotomy alone in these ulcer types. To deal with this antropyloric distrophy, addition of drainage or antrectomy to PGV must be considered. A refined concept for surgical treatment of peptic ulcer is proposed.

Humans↗
PubMed1984

[The muscles and blood supply of the stomach].

Using human gastric specimens, figures are presented for gastric muscle thickness and the myoarchitecture is described. The study shows that the blood supply to the cardia, gastric fundus and body is excellent, due to the many anastomosing arteries, but is less good at the curvatures of the gastric antrum and poor at the anterior and posterior walls of this area, due to absent or minute anastomoses.

Cardia↗
PubMed1984

Myogenic activity relationship between the lower esophageal sphincter and pylorus of the cat in normal peristalsis and provoked retroperistalsis.

Electrodes were chronically implanted in some of 14 cats and acutely inserted in others in the muscle of the high pressure zone of the lower esophagus (LEHPZ), in the duodenum, pylorus and antrum at identical location to register the myogenic electrical activity of the LEHPZ. Simultaneously the intraluminal pressure of the LEHPZ and swallowing contractions were recorded on a 6 channel Beckman R 611 ink-pen polygraph using stationary perfusion manometry. A clear basic electrical rhythm with slow wave activity was regularly found in the LEHPZ. Strong electrical changes (action potentials) were superimposed on the slow waves which were associated with relaxation in the LEHPZ and muscle contraction in the esophagus. Electric stimulation of the duodenum and pylorus with rectangular impulses produced retrograde peristalsis in the antrum but no response in the LEHPZ. Direct stimulation of the LEHPZ and gastric fundus, however, caused a strong transient contraction of the LEHPZ.

Action Potentials↗
PubMed1984

The different outcome of duodenal and pyloric channel ulcers after proximal gastric vagotomy. Clinical and morphological results.

Pyloric channel ulcers have a significantly higher recurrence rate than duodenal ulcers after proximal gastric vagotomy (PGV) without drainage. The failure of PGV cannot be explained by the pre- and postoperative secretory pattern of pyloric (PU) and prepyloric (PPU) ulcers. The morphological assessment of the pyloric and antral wall in DU, PU and PPU shows a significant thickening of the muscular layer in PU and PPU compared with DU. Histologically there is a muscular hypertrophy combined with muscular and ganglionic cell damage and fibrosis. The observed antropyloric dystrophy might be one factor for explaining the failure of PGV alone in pyloric channel ulcers. Addition of a drainage procedure for PU or even of a limited antrectomy for PPU might improve the postoperative results and must be discussed when planning surgical treatment of pyloric channel ulcers which seem to characterise as a distinct entity of peptic ulcer disease.

Adolescent↗
PubMed1984

Effect of intraesophageal bile and acid (HCl) perfusion on the action of the lower esophageal sphincter.

We examined the effect of acid and bile on the lower esophageal high pressure zone (LEHPZ) in a combined manometric, pH testing and morphologic study in 12 cats. LEHPZ pressures and swallowing waves (SW) were simultaneously recorded before, during and after perfusion of the esophagus with control fluid, acid (0.1 n HCl) natural bile and a mixture of acid and bile. Endoscopy was performed and biopsies taken before and after the experiments. Bile caused a rise of LEHPZ and SW pressure and mild esophagitis. Acid and bile acid mixture produced a marked progressive decline of LEHPZ and SW pressure (p less than 0.001), incomplete relaxation and severe discoordination of esophageal motility. Continuous pH measurements showed diminished or no clearance and reflux. All acid perfused cats developed necrotic esophagitis and strictures within 4 weeks. LEHPZ pressures returned to almost normal values after this recovering period but peristalsis was still completely discoordinated. Swallowing waves were of exaggerated magnitude and length. From our findings it is evident that bile and acid change LEHPZ competence. Bile and acid seem to have a different effect on motor function of the LEHPZ and esophageal peristalsis.

Animals↗
PubMed1983

[Mechanical ileus: analysis following 360 operations].

360 laparotomies in mechanical bowel obstruction were performed in a five year period at the Department of Surgery of the University Hospital, Basel. The overall mortality rate was 50/360 = 14%. The most frequent cause of death was cardio-respiratory insufficiency (19/50 = 38%) and postoperative peritonitis (15/50 = 30%). The most common etiology of bowel obstruction and the corresponding mortality rate was adhesion (151/360 = 42%; mortality 8.5%), large bowel cancer 83/360 = 23%; mortality 13.0%) and incarcerated hernia (57/360 = 16%; mortality 10.5%). The interval between onset of symptoms and hospitalization and between hospitalization and operation in the nonfatal group was 19 days and 28 hours respectively, and in the fatal group 26 days and 21 hours respectively. In conclusion, early surgical intervention in bowel obstruction and a meticulous technique for anastomosis when bowel resection is necessary are the most important factors in improving the results.

Adolescent↗
PubMed1983

Sphincter-splitting approach to the rectum.

This is a brief report of experience gained on our service with the sphincter-splitting approach to the rectum. The main indications for the approach are emphasized. Sphincter splitting is a new way to resolve surgical problems that have been difficult to solve before. It should be offered to suitable patients who otherwise would have to undergo more extensive operations that carry with them more inherent liabilities.

Adenoma↗
PubMed1982

Measurement of chemiluminescence in freshly drawn human blood. II. Clinical application of zymosan-induced chemiluminescence.

The aim of the present study was to investigate chemiluminescence (CL) of stimulated peripheral phagocytic cells (PC, i.e. granulocytes and monocytes) in patients with malignant disease at various stages. As a first step the zymosan-induced and luminol-amplified CL was determined in diluted whole blood samples from healthy volunteers. A characteristic daytime dependence of the CL activity was observed in six volunteers which had to be taken into account for blood sampling. The detectable CL was demonstrated to depend on the number of erythrocytes in the assay, but correction for this is not necessary for clinical investigation. The specific CL activity (activity related to 10(3) PC, was significantly but identically increased both in 1) patients with acute inflammatory disease and 2) in patients with carcinoma. The total CL activity (activity/microliter whole blood), however, was significantly increased in patients with acute inflammation as compared to the tumour group. This greatly reflects the leucocytosis of patients with acute inflammation. In a small number of patients with benign and malignant disease the CL of PC was measured both pre- and postoperatively. Operations in benign disease and palliative operations in malignancy did not influence the CL activity. In contrast, CL activity returned to normal after clinical cure by radical tumour resection.

Blood↗