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Biomedical subjects

M Delius

Publications and source records attributed to M Delius.

45 records · Page 3Linked to original sources
PubMed1988

A retrospective analysis of 3 year's experience of an interdisciplinary approach to gallstone disease including shock-waves.

1206 patients with gallstone disease were treated between January 1985 and December 1987, using an interdisciplinary concept that included surgery, endoscopic sphincterotomy, and extracorporeal shock-wave lithotripsy (ESWL). Twenty-five per cent of the patients who were admitted for gallbladder stones were treated by ESWL, whereas 75% underwent surgery. Mortality of elective treatment for gallbladder stones amounted to 0.25% (0.4% in surgery, 0% in ESWL). Postoperative complication rate was low (4.2% in surgery, 7.0% in ESWL). After ESWL treatment, 80% of the patients were free of stones after a follow-up period of 1 year. Recurrence rate in these patients amounted up to 10%; in seven of 70 patients, mean follow-up period was 6 months after complete disappearance of stones. Twenty-seven per cent of all patients who were admitted for bile duct stones underwent surgery, whereas in the other 73%, calculi were removed via endoscopy. ESWL treatment was used additionally, if necessary. Fragments were left behind in three of 75 patients (4.0%) after surgical treatment, and in 7 of 200 patients (3.5%) after endoscopic and ESWL treatment, respectively. In the latter group, three patients (1.5%) required an additional operation. There were no deaths in either of the groups. The use of ESWL for treatment of gallbladder stones needs to be evaluated in long-term follow-up studies. Thus far, surgery remains the dominating method. Endoscopic procedures, eventually combined with ESWL, represent the preferred treatment for patients with bile duct stones.

Aged↗
PubMed1988

Passage of stone fragments from the gallbladders of dogs.

The destruction of gallstones by shock waves leads to a considerable amount of stone fragments in the gallbladder. To test the ability of the stones fragments to leave the gallbladder, kidney stone fragments of 2 or 4 millimeters maximal diameter were implanted into the gallbladders of 16 dogs and passage was observed for five weeks. Independent of stone size, about 35 per cent of the fragments remained in the gallbladder. Transient elevations of enzymes of the liver or pancreas occurred significantly less often with 2 millimeter fragments and were less pronounced. Gross pathologic changes of the papilla of Vater, or dilation of the bile duct were observed with 4 millimeter fragments but not with those that were 2 millimeters. The results of this study suggest that the maximal fragment size after destruction of gallstones should be as small as possible, that is, in the range of 2 millimeters.

Animals↗
PubMed1987

Biological effects of shock waves: lung hemorrhage by shock waves in dogs--pressure dependence.

The most serious side effect observed during the destruction of gallstones by shock waves in dogs was lung bleeding. To determine the conditions leading to lung damage, pressure probes were implanted into dogs between the lung and the diaphragm. The distance between the lung and the focal point of the pressure field was determined at which 1000 shock waves caused no more lung hemorrhage. On the long axis it is greater than 15 cm and perpendicular to the long axis it is 4 cm. Shock wave pressures over 2 MPa could be administered safely, whereas a pressure of 10 MPa caused bleedings in beagles, but probably not in boxers.

Animals↗
PubMed1987

Role of Peyer's patch in the intestinal immune response to cholera toxin in enterically immunized rats.

Cholera toxin has been widely used to obtain insight into the cellular dynamics of the antigen-specific mucosal immune response. The present study was undertaken to clarify the influence of the organized intestinal lymphoid tissue (Peyer's patches [PP]) on the distribution of anti-cholera-toxin-containing cells (ACC) after intraperitoneal immunization and intraduodenal challenge with purified cholera toxin. This was done in rats which were surgically deprived of all visible PP. In comparison with sham-operated animals, each PP-deprived rat had nearly the same amount of ACC in the spleen, the mesenteric lymph nodes, and, surprisingly, the thoracic duct lymph. In contrast, the ACC in the duodenum, the jejunum, and the ileum of each PP-deprived animal were drastically reduced. Therefore the PP are suggested as an important organizing structure for the buildup of a local antigen-specific immune response.

Animals↗
PubMed1986

Fragmentation of gallstones by extracorporeal shock waves.

We treated nine patients with functioning gallbladders containing one to three symptomatic radiolucent stones not larger than 25 mm in diameter, as well as five patients with stones in the common bile duct that were not removable by endoscopic procedures, by means of extracorporeally generated shock waves during general anesthesia. The patients with gallbladder stones received adjuvant treatment with a combination of ursodeoxycholic acid and chenodeoxycholic acid. All gallbladder stones were disintegrated into sludge or fragments with diameters of no more than 8 mm. In six of the nine patients the fragments disappeared completely within 1 to 25 weeks. No adverse effects were detected during a follow-up period of 10 to 34 weeks, except transient biliary pain in two patients, with mild pancreatitis in one. In four of the five patients with common-bile-duct stones, shock-wave treatment permitted stone disintegration and successful endoscopic extraction or spontaneous passage of fragments. We conclude that gallstone disease may be treated successfully and without serious adverse effects by extracorporeally generated shock waves in selected patients.

Adult↗