Biomedical subjects
M Raab
Publications and source records attributed to M Raab.
[Zenker's diverticulum--diagnosis and therapy].
Clinical, x-ray and endoscopic follow-up of patients operated on for Zenker's diverticulum (pharyngo-oesophageal diverticulum) via myotomy and diverticulectomy permits conclusions in respect of functional results of this therapeutic concept and the preoperative diagnosis that our study has proved to be necessary. Usually the diagnosis can be made on the basis of the characteristic anamnesis. It is confirmed by means of an oesophagogram, if necessary with a gastrointestinal passage. Besides visualisation of Zenkers diverticulum, attention must be paid especially to associated neuromuscular functional disturbances of the oesophagus. Preoperative endoscopy is necessary in individual cases only. In respect of therapy, it appears mandatory to perform a sufficiently extended (3-5 cm) myotomy of the pars transversa musculi cricopharyngei because of the frequently seen disturbance of coordination of the pharyngo-oesophageal sphincter, besides removing the diverticulum.
[Intraoperative cholangiography in the diagnosis of choledocholithiasis].
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[Quality of life following gastrectomy--a comparison of Longmire and Roux stomach replacement methods].
Randomised comparison was applied to 27 patients to check Roux' against Longmire's repair methods, following total gastrectomy. No evidence was produced in twelve postoperative months to any difference between both surgical techniques. No major differences were found either with regard to body weight and general condition by index measurements according to Karnofsky and Spitzer.
[Diverticulum excision and myotomy in the treatment of Zenker diverticulum].
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[Selective proximal vagotomy in the treatment of duodenal ulcer. Analysis of clinical results up to the 10th postoperative year].
807 patients with a duodenal ulcer were treated by a selective proximal vagotomy. Low inter- and postoperative complication rates led to a total mortality of 0.2%. Due to the maximum postoperative control the probability of suffering from a recurrent ulcer is 22.7%. Postoperative functional complaints appeared in 8-19% without the necessity of invasive treatment. A satisfactory result of the therapy was achieved in 73%. The clinical relevance of the analysis of gastric juice has to be discussed. A special emphasis was put on the description of frequency of follow-up examinations, the key of each clinical study.
Histochemical changes in livers from portacaval-shunted rats.
Portacaval shunt (PCS) operations were performed on male inbred SD rats. The activity of liver gamma-glutamyltranspeptidase (GGT) increased a few days after the operation and remained high after several months. However, the activity was only present in periportal areas of liver lobules and was mainly restricted to the endothelial lining cells of periportal blood vessels. Phenobarbital sodium (CAS: 57-03-7) administration did not change the distribution of GGT. The activity of liver glucose-6-phosphatase disappeared in the centrilobular areas a few days after the operation but was present in the periportal areas. The distribution of this activity returned to normal after several months. The capacity of liver cells to store glycogen was significantly decreased following the PCS operation. Morphologic changes in hepatocytes observed after the PCS operation did not show similarities to those seen in preneoplastic livers. The nuclei of the small compact hepatocytes found in the animals with PCS were irregular in shape and stained intensively with hematoxylin and eosin. The large pale-staining cells in the periphery of liver lobes were GGT negative and their nuclei had a normal morphology. Neither morphologic nor histochemical changes consistent with preneoplastic and/or neoplastic stage were observed after 10 months in the liver when the PCS operation was performed on rats having received an ip dose (10 mg/kg) of diethylnitrosamine (CAS: 55-18-5) 2 weeks prior to the operation.
[Granular-cell tumor of the esophagus].
A granular-cell oesophageal tumour was demonstrated in a 47-year-old man. With rare exception this type of tumour is benign. As it grows dysphagia develops. Surgical resection is the treatment of choice. It should be a wide excision, because the non-encapsulated tumour is microscopically more extensive than macroscopically. If too little is excised it may recur. But the high operative risk justifies expectant waiting, perhaps combined with local partial endoscopic removal of the tumour. Only in the rare instance of a small or pedicled tumour is total endoscopic excision possible.
[Animal experiment studies of suture material and suture technic of the stomach].
The aim of these examinations was a comparison of the tensile strength and the histology of single and two-layer sutured gastrotomies applied to rats. Independent of the applied suture material and suture technique all experiments resulted in the same tensile strength of the suture between the 5th and 7th postoperative day as in the control group. Differences of anastomotic dehiscence did not exist. The single-layer can be loaded as well as the two-layer suture. Any difference of the tensile strength of anastomosis depending on the suture material does not exist.
[The effect of surgical treatment methods on the prognosis of early stomach carcinoma].
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[Pharmacokinetics of the analgesic morphine 6-nicotinate in rats (author's transl)].
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[The esophageal tube inserted under endoscopic radiologic control].
During the past 2 years we have treated 30 patients with an endotubus positioned by endoscopical and radiological control. In contrast to many other authors we have also used this method in proximal stenosing tumors. Our mortality rate lies at 16% with a mean post-operative survival time of 9 weeks. There were no deaths due to this procedure in patients (n = 18) with distally situated tumors. The hospital stay of patients treated using this method is much shorter than when surgery is employed, and the complication rate is much lower. If no problems are encountered, patients can be discharged after 2 days.
[Electrostimulation test for intraoperative vagotomy control. Results of a prospective randomized study].
In a prospective random trial the intraoperative electro-stimulation test of Burge and Vane was conducted with 100 patients, in whom selective proximal vagotomy was performed for a duodenal ulcer. In 6 out of 50 patients histologically proved nerve fibres were found by the applying of the test. The postoperative acid values did not differ significantly between those patients who underwent the electrostimulation test and those who did not. The rate of recurrence was 8% in both groups 2-4 years after the operation. Obviously, the application of the test did not have any effect on the results.
[Effect of tin on rats. 1. Inverse voltammetric determination of tin in the presence of lead in biological material after extraction].
By means of inverse polarography, the authors determined tin selectively after double extraction with diethylammonium diethyl dithiocarbamate (DADDTC) in perchloric solution. The recovery rates were: in potatoes, 91.7 +/- 5.8%; in beef kidney, 85.0 +/- 22.7%; in beef liver 79.9 +/- 13.8%; and in milk, 69.8 +/- 11.4%. Possible interferences from other elements with the tin determination are discussed.
Interaction between membrane properties and protein synthesis. In vitro synthesis of membrane proteins during erythropoiesis.
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[The influence of warm ischaemic time on the results of hypothermic kidney perfusion (author's transl)].
50 dog kidneys were mechanically perfused under hypothermia for between 12 and 72 h and then transplanted. Before perfusion the kidneys were subjected to 15,30,45 and 60 min of warm ischaemia: 15 min of warm ischaemia were well tolerated (successful 72-h preservation), but after 30 min preservation was successful for only 24 h. Enzyme release and lactate formation depended on the duration of warm ischaemia. Furthermore, these perfusate concentrations indicated the viability of the organ (highly significant differences between well functioning kidneys and those with little or no function.
[A new organ perfusion system: Successful preservation of kidney function for 72 hrs (author's transl)].
A new preservation system is described. In this unit 17 dog kidneys were nonpulsatile perfused with hypothermic human albumin for 72 hrs and then transplanted. All kidneys started immediately to function and the PAH and inulin clearances attained normal values at least at the 7th postoperative day. The quality of the immediate function is referred to the applied perfusion pressure (20 mm Hg) and the applied temperature of the perfusion medium (7.5 degrees C). During preservation substrate utilization (oxygen, unesterified fatty acids) and the accumulation of toxic metabolic products (ammonia, uric acid) were controlled in the perfusate. Their importance concerning to the limitation of preservation time is discussed.
Analysis of the optimal perfusion pressure and flow rate of the renal vascular resistance and oxygen consumption in the hypothermic perfused kidney.
Thirty-six dog kidneys were perfused with different perfusion pressures (between 15 and 60 mm. Hg) for 72 hours and then transplanted. Hypothermic human albumin was the perfusion fluid. Enzyme release, kidney weight, and renal oxygen consumption were measured during perfusion. Kidneys perfused with a flow rate of 0.8 ml. per gram per minute (21 mm. Hg mean perfusion pressure) showed the smallest increase in kidney weight and the best function after transplantation. Renal vascular resistance was independent of the level of the perfusion pressure and renal oxygen consumption was independent of the applied flow rate. It is concluded that the perfusion pressure applied with hypothermic perfusion should be as low as possible because in this way kidney damage caused by perfusion can be avoided most easily.