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Biomedical subjects

M Rothmund

Publications and source records attributed to M Rothmund.

At least 325 records · Page 18Linked to original sources
PubMed1977

[Postoperative alkaline reflux gastritis (author's transl)].

Postoperative alkaline reflux gastritis is a distinct clinical entity occuring after operations enlarging, bypassing or resecting the pylorus. Reflux of alkaline duodenal content into the stomach is the causative factor. Primarily bile acids have an aggressive effect and lead to a destruction of the gastric mucosal barrier. Epigastric pain, fullness after meals and bile vomiting are the main symptoms. Gastroscopy with biopsy reveals a severe chronic atrophic gastritis and bile reflux. In most cases an achlorhydria that can be histamin-resistant is present. For adequate treatment surgical procedures diverting the bile flow from the stomach should be performed.

Achlorhydria↗
PubMed1977

[Gastroduodenal ulcer: resection procedures (author's transl)].

In recent years vagotomy has become more and more prefered in ulcer surgery. Based on the results of prospective trials, gastric resection should be abandoned as treatment of uncomplicated duodenal ulcer. Resections are still indicated for most ulcer complications, such as bleeding, penetration of chronic ulcer, and in recurrent ulcers after vagotomy. The same is true for gastric ulcer type I. Questionnaires indicate, however, that German surgeons still favor the two-thirds resection.

Duodenal Ulcer↗
PubMed1977

[Duodenogastric reflux].

Duodenogastric reflux is a pathophysiological phenomen occurring after motility disturbances on the antroduodenal junction and after operative procedures destroying, removing or bypassing the pylorus. The reflux of bile can lead to a symptomatic chronicatrophic gastritis and is an important factor in the pathogenesis of gastric ulcer type I. The pyloric regurgitation test, marking of the bile with Bromsulphalein or 14C-chenodesoxycholic acid are reliable methods to prove reflux. For treatment of bile reflux and postoperative alkaline reflux gastritis substances augmenting antral peristalsis and binding bile acids can be used. More effective are surgical procedures diverting the bile flow from the stomach or the gastric remnant.

Bile↗
PubMed1976

[Total parathyroidectomy and autologous parathyroid transplantation in secondary hyperparathyroidism (author's transl)].

In a 17-year-old female patient with marked secondary hyperparathyroidism and progressive bone changes all four parathyroid glands were removed. Part of the endocrine tissue was reimplanted into the muscles of the forearm. The transplant took successfully and showed a satisfactory function. Total parathyroidectomy and autologous parathyroid transplantation has a number of advantages as compared with subtotal parathyroidectomy: The function of the transplant can be directly observed and tissue can be easily removed in the further course of the disease. It is thus possible to regulate parathormone secretion over long periods in patients with chronic renal failure.

Adolescent↗
PubMed1976

[Duodenogastric reflux after vagotomy and pyloroplasty (author's transl)].

In 27 patients after selective or truncal vagotomy and pyloroplasty the occurrence of duodenogastric reflux was checked by two methods, by the measurement of Bromsulphalein (BSP)-concentration in the gastric aspirate after BSP was given intravenously and by instillation of a barium meal in the second part of the duodenum followed by upper GI-series. In 20 of 23 patients reflux was recorded radiologically, in 18 of 27 patients reflux was shown by the BSP-Method. Proven bile reflux was associated with major postoperative discomfort, such as epigastric fullness, nausea and epigastric pain, it was also associated with gastritis as shown by microscopic examination of biopsies taken from the antrum. It is recommended to consider duodenogastric reflux as a possible reason for patients complaints after vagotomy and pyloroplasty. To avoid those complaints the preference of proximal gastric vagotomy without pyloroplasty is supported, if preoperative gastric emptying is not impaired.

Duodenal Diseases↗
PubMed1976

Diagnosis and surgical treatment of mediastinal parathyroid tumors.

Experience and problems in the localization, diagnosis and surgical treatment of mediastinal parathyroid tumors are reported. Arteriography, pneumomediastinum and, especially, selective blood withdrawal with assay of parathyroid hormone, have proven valuable to the authors. Scintigram, intravital staining methods and venography are less productive. Retrosternal parathyroid tumors that can be removed from a Kocher incision should not, for practical reasons, be classified with the mediastinal tumors. The authors recommend the one-phase operation. If, after an intensive search of the neck and behind the sternum, no tumor has been found, it is advisable to incise the sternum step by step and revise the anterior mediastinum in the same session.

Angiography↗
PubMed1976

[Current status of preoperative localization in primary hyperparathyroidism (author's transl)].

Since Seldinger demonstrated in 1953 parathyroid adenomas by arteriography, numerous localizing procedures have been advocated. Based on our experience with selective venous sampling for measurement of parathyroid hormone by radioimmunoassay, selective arteriography, pneumomediastinography and scanning with 75Se-selenomethionine, a survey on localization techniques used up to now is given and their value and applications are discussed. Preoperative localization of parathyroid tissue should be limited to patients with previous unsuccessful surgery. In these cases we perform selective venous sampling following selective arteriography for demonstration of the venous drainage pattern and subsequent venous catheterization. Pneumomediastinography is recommended in suspected mediastinal parathyroid adenoma. Scanning with 75Se-selenomethionine is not in use because of its limited success.

Adenoma↗
PubMed1975

[Parathyroid carcinoma (author's transl)].

Carcinoma of the parathyroid glands is a rare disease which occurs only in 0.5 to 4 percent as the cause of a primary hyperparathyroidism. One third of the tumors are hormonally inactive. A review of the diagnosis, course and possibilities of treatment of this disease is given with reference to the literature. Observations of 2 cases show the special problems of diagnosis and simple possibilities for the satisfactory treatment of small tumors. Followup examinations of both patients after a year showed no evidence of a relapse.

Adult↗
PubMed1975

[Thyroid phlebography and selective venous sampling for parathormone estimations in primary hyperparathyroidism (author's transl)].

Selective venous sampling for parathormone estimations has become an important method in the diagnosis of primary hyperparathyroidism and, together with thyroid phlebography, is an accurate means for localising hormone active parathyroid tissue. Thirty-three patients were examined by this technique and in 25 of these an exploration was carried out subsequently. Twenty-one had primary hyperparathyroidism. In one case hormone analysis lead to a false positive finding. In 18 of these 21 patients, the hormone-active parathyroid tissue was correctly localised. Phlebography showed evidence of an adenoma in five patients, but is of most use for localising the source of the hormone.

Adenoma↗
PubMed1975

[Localization diagnosis of epithelial-body tumors through selective determination of parathyroid hormone. Surgical sequelae of a new method].

A new method for the localisation of abnormal parathyroid tissue is reported. This is carried out by selective venous blood sampling from the thyroid veins and the large veins of the neck. Parathyroid hormone levels are measured by radioimmunoassay. The peak hormone level indicates the site of the tumor suspected. Parathyroid venous blood was taken in 15 patients with primary hyperparathyroidism. In 12 patients localisation of the parathyroid tumor was achieved pre-operatively. The procedure is especially valuable in patients with previous unsuccessful parathyroid surgery. There are no complications or contraindications to the method.

Adenoma↗
PubMed1975

[Selective parathormone determination for localizing parathyroid tumors].

A method for localization of parathyroid tumors by selective venous blood sampling and measurement of parathyroid hormone is reported. The blood samples are taken after catheterization of the femoral vein from the veins of the neck and the thyroid gland. Parathyroid hormone levels are measured by radioimmunoassay. By this method localisation of 13 parathyroid adenomas in 15 patients was achieved. Parathyroid venous sampling seems to be more effective than any other localisation method used.

Adenoma↗