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Biomedical subjects

M Stolte

Publications and source records attributed to M Stolte.

At least 451 records · Page 25Linked to original sources
PubMed1987

[Diffuse intestinal polyangiomatosis as a cause of recurrent intestinal hemorrhage. Report of an unusual case].

We observed a 38-year-old Italian male with recurrent intestinal bleeding and consecutive iron-deficient anemia. For search of the source of bleeding intensive clinical, endoscopic and radiological investigations had been performed. Multiple malformations of superior mesenteric artery with abnormal vascularisation of jejunum and ileum were established angiographically. In addition the lumen of small bowel loops was dilated and enlarged mucosa folds were found. Because of a prominent vascularized area in the cecum a resection of the right hemicolon had been performed with consecutive death of the patient. The post mortem investigation revealed dilated mesenteric arteries, multiple cavernous hemangiomata in the mesenterium, in the wall of the small bowel and solitary in the large bowel. Additionally angiodysplasias, phlebectasias, lymphangiectasias, and lymphangiomata in the large bowel and in the mesenterium were found. "Diffuse intestinal polyangiomatosis" is the proposed term of the syndrome consisting of recurrent intestinal bleeding and multiple intestinal vascular malformations.

Adult↗
PubMed1986

[Ultrasound diagnosis of the stomach wall--experimental studies].

The gastrointestinal wall can be separated into 5 layers by means of ultrasonic endoscopy and also by external ultrasound when using a probe of 5 Mhz. We studied the relationship between these echographic layers and the real anatomical structures by means of in-vitro examination of surgical specimens. The anatomical layers were separated in these specimens step by step. We found that the first and the fifth hyperechoic layers are border echos. The 2. (inner echopoor layer), the 3. (middle echogenic layer) and the 4. (outer echopoor layer) correspond to the mucosa, the submucosa and the muscularis propria, respectively. In so far, the differentiation between early cancer and advanced cancer of the stomach should be possible by endoscopic ultrasonography.

Gastric Mucosa↗
PubMed1986

[Complications in pancreatic duct occlusion: passage of the occlusant into the venous system].

In two cases, occlusion of the residual pancreas remaining after a Whipple's procedure was associated with a "spillover" of the occlusant into the venous system of the pancreas, resulting in one of the cases in embolisation of intrahepatic branches of the portal vein. In both cases, the parenchyma of the residual pancreas was well preserved. The cause of the spillover into the venous system was the injection of a too large volume into the ductal system, with subsequent rupture of small side branches. To avoid this rare complication, the filling of the ductal system should be carried out under intraoperative radiological control.

Amino Acids↗
PubMed1986

Ultrastructure of the islets of Langerhans after long-term occlusion of the pancreatic duct system.

The long-term effect of surgically induced atrophy and fribrosis of the exocrine parenchyma of the pancreas on the islets of Langerhans was examined electron-microscopically in animal experiments in mini-pigs. Ligature of the pancreatic duct, occlusion of the pancreatic duct system with an alcoholic solution of amino acids and the combination of this occlusion with ligature of the pancreatic duct were compared. A largely similar result was found in all three experimental groups 9 months post-operatively: The islets of Langerhans are mostly subdivided into predominantly small and apparently intact islet cell complexes by peri- and intra-insular fibrosis, and, where larger islet cell complexes are found, these are, in places, also destroyed in the peripheral region. The diffusion distance between the capillaries and the endocrine cells is, in part, considerably dilated by the interposition of collagen fibres. In the capillaries, thickenings and duplications of the basement membrane, as well as swelling of the endothelial cells can be found. There are rarely signs of atrophy in the islet cells lying in clusters. Only the granular structure of the B-cells diverges from the norm. From our morphological findings a delayed and diminished hormone output after pancreatic duct occlusion can be deduced, whereby, compared to earlier short-term experiments of our own, no significant progression of the peri- and intra-insular fibrosis can be determined.

Animals↗
PubMed1986

[Incidence and significance of the gastric mucosal constellation in pernicious anemia].

1977 cases with gastric complains but without localized findings like ulcer or cancer were investigated by gastroscopy with biopsies of corpus and antrum ventriculi. We found in 5.5% an isolated mucosal atrophy of the gastric corpus (mean age 67.2 years compared to 59.4 years in cases with normal mucosa). 0.7% showed an atrophic gastritis of the antral mucosa, 0.9% an atrophic gastritis of the body and the antrum. Most of the cases with an isolated atrophy of the gastric body gave findings of hematologic disturbances. In all cases with isolated atrophy of the gastric body, including localized findings in the stomach, we found in 10.8% neoplastic processes, in another 3.9% hyperplasiogenic polyps. It seems to us of clinical importance to evaluate the gastric histology of the antral and body mucosa routinely because of the high incidence of pernicious anemia-like gastric atrophy and its relation to gastric neoplasias.

Adult↗
PubMed1986

The papilla of Vater and chronic pancreatitis.

The histological investigation of 150 surgical preparations obtained from patients with chronic pancreatitis, frequently revealed pathological changes affecting the papilla of Vater, such as inflammatory infiltration (69%), fibrosis (81%), glandular hyperplasia (94%), and adenomyosis (95%). In 59% of the cases, these changes had led to a histological suspicion of papillary stricture. No statistically significant correlations were found between the degree of pathological papillary changes and the degree of chronic pancreatitis. Nevertheless, a number of case histories indicated that the pathological changes in the papilla could be both the cause and the consequence of pancreatitis. The secondary papillary stenosis caused by chronic pancreatitis could possibly maintain or accelerate the scarring process in the pancreas. Simple papillotomy would not eradicate this "obstruction to flow" of the pancreatic juice, for the pathological changes are localized mainly at the base of the papilla and often involve the pre-papillary segment of the pancreatic duct. A more sophisticated clinical diagnostic work-up of papillary function in chronic pancreatitis might, however, lead to differential treatment.

Adult↗
PubMed1985

[Groove pancreatitis--its pathological anatomy and sonographic findings].

Groove pancreatitis is a special type of segmental pancreatitis. Its morphological aspects with participation of the peripheral dorsal and cranial parts of the pancreatic head, the pancreatic soft tissue, and the duodenal wall with frequent narrowing of the distal common bile duct and suprapapillar stenosis of the duodenum can be detected by means of sonography. If this type of seqmental pancreatitis is known, the suspicion of a carcinoma of the pancreatic head can be removed.

Chronic Disease↗
PubMed1985

Influence of pancreatic duct occlusion on islet hormones in peripheral and portal plasma and in the pancreas of the mini-pig.

In a total of 18 'Göttingen' mini-pigs we studied basal glucose in the peripheral plasma, and the hormones insulin, glucagon, and somatostatin in the peripheral and portal plasma, as well as in extracts of pancreatic tissue, both in animals subjected to pancreatic duct occlusion with prolamine (Occ pigs) 9 months previously and in controls. Additionally, in the pancreas the relative frequency of A-, B-, D- and PP-cells was determined by immunocytochemistry. In peripheral blood of Occ pigs glucose, insulin, and somatostatin were unchanged, while glucagon was decreased. Also after occlusion the portal plasma revealed an increase in insulin but unchanged glucagon and somatostatin, while in the pancreatic tissue insulin and glucagon were statistically unchanged, but somatostatin was reduced. The relative frequency of A-, B-, D- and PP-cells in the pancreatic islets was comparable in both control and Occ pigs. It is concluded that also in the pig pancreatic duct occlusion leads to atrophy of the exocrine pancreas, but leaves undisturbed basal blood glucose, insulin, glucagon and islet cells.

Amylases↗
PubMed1985

[Lipid islands in the esophagus].

Lipid islets (xanthomas, xanthelasmas) occur rather frequently in gastric mucosa; such islets have been described in the esophagus just recently. We have observed such a patient. As has been the case in the first patient described, the islets were located in the middle part of the esophagus and appeared during endoscopy as flat, yellowish elevations. On biopsy, foam-cell macrophages were found in the tunica propria of the esophageal mucosa. Pathogenesis of the lipid islets in our patient could be caused by a disturbance of carbohydrate and fat metabolism.

Biopsy↗
PubMed1985

[Duodenal stenosis in coincidence with annular pancreas and cancer of the papilla].

We report on a case of annular pancreas complicated by the development of a carcinoma of the papilla causing secondary chronic obstructive pancreatitis. Eventually, a high-grade stenosis of the duodenum developed, leading to symptoms of gastric outlet obstruction. The stenosis was proved by endoscopic and radiologic diagnosis, but the exact anatomical condition was only revealed by an operation. Efficient diagnostic and therapeutic procedures in annular pancreas with its potential complications are discussed in detail.

Adenocarcinoma, Papillary↗
PubMed1984

Pancreatic duct occlusion in the rat - short-term effects on oral glucose tolerance and short- and long-term effects on hormone content of the pancreas.

In a short-term (14 days) and a long-term (84 days) experiment after pancreatic duct occlusion in the rat, we measured the insulin, glucagon and somatostatin content of the pancreas; in the short-term experiment, in addition, we performed an oral glucose tolerance test on the 14th day. Exocrine pancreatic function in the short-term study was monitored on the 9th day - in the long-term study on the 21st day. In the long-term study, the pancreatic organ was also examined histologically. Occlusion of the pancreatic duct considerably reduces exocrine function. This accords with the histologically observed atrophy of the exocrine parenchyma, above all in the body and tail (after 84 days). 14 days after occlusion, basal plasma glucose and insulin was about the same as in the sham-operated rats. Incremental insulin after the glucose load in occluded rats was delayed for about 30 min, but the pattern of plasma glucose was only insignificantly altered as compared with the sham-operated controls. The insulin content of the pancreas on days 14 and 84 after occlusion was increased, glucagon and somatostatin unchanged. We conclude, that (a) intraductal occlusion of the pancreas is a suitable tool for inducing an atrophy of the exocrine pancreas; (b) in the short-term, after the duct occlusion, oral glucose tolerance is preserved, but the passage of insulin into the blood is delayed and is associated with a high level of insulin in the pancreas; the cause or causes of this coincidence is/are unknown.

Animals↗