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Biomedical subjects

M Rothmund

Publications and source records attributed to M Rothmund.

At least 307 records · Page 17Linked to original sources
PubMed1982

[Gastric bypass in incurable esophageal cancer].

Between 1977 and 1981, 70 patients were treated for esophageal carcinoma; 45 carcinomas were considered to be unresectable. In 11 of the 45, the site and stage of the tumor and the physical condition of the patient permitted palliative treatment with retrosternal gastric bypass. One patient died postoperatively. A gastric bypass enabled the remaining 10 patients to swallow normally and therefore led to significantly better quality of life. Only two patients survived for more than 1 year, the longest survival time being 15 months till now.

Adult↗
PubMed1981

[Surgical treatment of oesophageal carcinoma (author's transl)].

Between 1977 and 1980 55 in-patients were treated for oesophageal carcinoma. Tumour stage and general state permitted curatively aimed treatment in only 19 patients. Combined pre-irradiation and operation were the treatment of choice in these cases. Subtotal oesophageal resection and reconstruction were performed in one session. The stomach was used as replacement organ in all cases. In five cases with cervical or immediate supracardial tumour localisation the oesophagus could be extirpated by bimanual dissection without thoracotomy. Fourteen patients required surgery in both cavities. In nine out of the remaining patients, in whom only palliative surgery could be performed, retrosternal tumour bypass with the stomach was performed. During admission, lasting on average 17 days after the operation in 28 patients, three patients with resection and one with bypass died. In the other 24 patients operation led to normal ability to swallow.

Esophageal Neoplasms↗
PubMed1981

[Autotransplantation of cryopreserved human parathyroid tissue (author's transl)].

Following the third operation, aparathyroidism occurred in a 70-year-old female with primary hyperparathyroidism due to parathyroid hyperplasia. Part of the parathyroid obtained during the last operation was cryopreserved immediately after resection and replanted successfully after 15 days into the lower arm muscles. The function of the transplanted tissue was demonstrated by successful stepwise reduction of hormone substitution. Parathyroid hormone concentrations in the blood of the veins draining the transplanted tissue were more than double in comparison with the contralateral side. Functional and morphological investigations of the defrosted tissue prior to transplantation showed vitality and intact morphology.

Aged↗
PubMed1981

[B-scan sonography for tumour localisation in hyperparathyroidism (author's transl)].

Thirty-four patients with known primary, secondary or tertiary hyperparathyroidism were examined sonographically in order to localise the enlarged glands. Of 40 tumours found at operation, 27 (67%) could be demonstrated sonographically as oval or round structures with low echoes. The smallest tumour diagnosed pre-operatively was 10 x 5 x 4 mm. Sonography is useless for adenomas in the mediastinum. Sonographic localisation is desirable before primary operations for hyperparathyroidism, although it is not indispensable for the experienced surgeon. Sonography is essential before surgery for recurrences and should be performed before CT, arteriography or selective parathormone sampling.

Adenoma↗
PubMed1980

[Cryopreservation of human parathyroid tissue (author's transl)].

Cryopreservation of human parathyroid tissue achieved significance through the introduction of autologous transplantation in parathyroid surgery. The technique of cryopreservation and thawing is described. The functional integrity of frozen tissue was examined by checking its calcium-sensitivity which was compared with that of fresh tissue. This demonstrated a similar secretion pattern. Examination of the frozen tissue under the light and electronmicroscope showed almost all of the cells to be preserved. The indication for cryopreservation is given at total parathyroidectomy and autologous transplantation at primary and secondary hyperplasia, as well as at reintervention in primary hyperparathyroidism or in total thyroidectomy where it is not certain that living parathyroid tissue was left in situ.

Adenoma↗
PubMed1980

Myxoid lipoadenoma of the parathyroid gland.

A myxoid lipoadenoma of the parathyroid gland causing primary hyperparathyroidism is reported. The very rare and histologically unusual tumor consists of an epithelial component which is combined with a stromal component in a characteristic way. Slender, irregularly branched trabeculae which mainly consist of chief cells as well as a few oxyphil cells are found as epithelial component. The predominantly myxomatous and only focally lipomatous stromal component is interpreted as an integrated tumor component of the lipoadenoma which is derived from the parathyroid adipose tissue.

Adenoma↗
PubMed1980

[Massive upper gastrointestinal bleeding as first clinical manifestation of pseudoxanthoma elasticum (author's transl)].

We describe a patient with a "cryptogenic" massive upper gastrointestinal bleeding due to a pseudoxanthoma elasticum, recognized only postoperatively. She underwent twice emergency abdominal surgery with total gastrectomy and partial jejunal resection, with a complicated postoperative course. An insufficient enteral anastomosis was perhaps caused by deficient reapir mechanisms of the involved organs due to the underlying disease. Pseudoxanthoma elasticum, an hereditary degenerative disease of especially the elastic connective tissue, involves primarily the vascular system, skin, and eyes, with the typical complication of massive gastrointestinal bleedings. Instead of surgical intervention, such bleedings should be treated preferably by utmost application of conservative means.

Adult↗
PubMed1980

[Effect of cimetidine and synthetic secretin as treatment of acute upper gastrointestinal bleeding--a prospective alternate trial (author's transl)].

The effect of cimetidine respectively synthetic secretin was investigated in a prospective alternate trial on 20 patients with an acute non arterial bleeding from acute ulcers respectively hemorrhagic erosions of the stomach or duodenal bulb. 48 hours after beginning therapy the bleeding stopped in 3 patients treated with cimetidine and in 9 treated with secretin. During this time 2 patients of both groups rebled. The trial showed that secretin was superior to cimetidine (chi 2-test, p < 0.01).

Cimetidine↗
PubMed1980

[Cervical thymectomy as an expanded surgical method in primary and secondary hyperparathyroidism].

From 1964 to 1979 neck explorations were performed on 135 patients with primary and 30 patients with secondary hyperparathyroidism. In 28 of 165 patients (16,9%) a cervical (23 patients) or a direct (5 patients) thymectomy after sternum splitting was carried out. In 22 of 28 patients, parathyroid tissue was found within or adjacent to the thymus (13,3%). Cervical thymectomy is a safe and effective procedure when an exact indication is present and if certain rules of operative technique are followed.

Humans↗
PubMed1979

[Primary hyperparathyroidism (author's transl)].

Experience gained from 100 patients with surgically and histologically proven primary hyperparathyroidism over a period of 14 years led to simplification of diagnostic procedures and development of a surgical scheme. Over the years patients with discrete disease symptoms or with asymptomatic disease were observed more frequently. This can be seen as the result of earlier diagnosis due to increasing spread of laboratory autoanalysers and the resulting routine calcium determination. Development of surgical intervention is characterised by omitting preoperative diagnostic procedures to determine localisation, a schematised operation, and more reliance on macroscopic criteria rather than on quick sections during surgery.

Adolescent↗
PubMed1978

[Other methods: dilatation, T-tube (author's transl)].

In the Department of Surgery of the University of Mainz we prefer dilatation for treatment of stenosis of the papilla. In 1063 cases out of 4058 operations for cholelithiasis, we opened the choledochus. In 944 patients, a dilatation was performed; 40 were treated by papillotomy; in 79 cases, primarily in the past, we performed a biliodigestive anastomosis. In 106 patients we finished the procedure by inserting a T-tube; in 838 cases primary closure of the choledochus was performed. In 12 complications of the dilatation (perforation, pancreatitis, restenosis), there was no mortality; therefore we conclude that dilatation of the papilla is a safe, simple, and effective procedure.

Ampulla of Vater↗
PubMed1978

[Exceptional clinical courses of granulomatous colitis in children and adolescents (author's transl)].

Acute complications are known in chronic ulcerative colitis as well as in Crohn's colitis. They can rarely be seen also in childhood and adolescence. Massive rectal bleeding, particularly acute toxic dilatation of the large bowel should be treated surgically after a short-term medical therapy. The procedure of choice is the one stage proctocolectomy. Alternatively the method described by TURNBULL performing a loop ileostomy and several colostomies can be used. Besides the clinical symptoms and signs more than 8 stools and a temperature of more than 38 degrees C in the first 24 hours of hospitalisation can predict a severe clinical course.

Adolescent↗
PubMed1978

[Experimental studies on the effect of pyloroplasty on gastric emptying, serum gastrin and duodenogastric reflux in selective proximal vagotomy (SPV)].

The influence of selective proximal vagotomy (SPV) and of an additional pyloroplasty (Heineke-Mikulicz) on gastric emptying, acid and gastrin secretion, and duodenogastric reflux was examined experimentally. After SPV, gastric emptying of fluids and a solid meal was significantly faster than before surgery. An additional pyloroplasty did not influence gastric emptying time significantly. Gastrin secretion after stimulation with a protein-rich meal increased significantly after SPV and did not change much after pyloroplasty was added. It can be concluded that increased gastrin secretion after SPV is not a result of delayed emptying. Pentagastrin-stimulated acid secretion was reduced by 70% after SPV and after additional pyloroplasty as well. The results show that reduced acid secretion after SPV causes the rise in serum gastrin levels. After SPV no duodenogastric reflux occurred. An additional pyloroplasty led to a significant rise of bromsulphaleine used as a marker for bile in gastric aspirate. Obviously destruction of the pylorus leads to a loss of its antireflux function. This leads to an antral gastritis which after 3 months is of chronic-atrophic type. A stimulation of gastrin output by bile could not be demonstrated. It can be concluded that after SPV gastric emptying is not delayed. A pyloroplasty does not affect gastrin release and acid secretion. Drainage procedures together with SPV should be avoided to prevent duodenogastric reflux and antral gastritis.

Duodenal Diseases↗