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Biomedical subjects

M Stolte

Publications and source records attributed to M Stolte.

At least 469 records · Page 26Linked to original sources
PubMed1984

[Sclerosing of the parotid gland using a protein solution for instillation in the excretory ducts. Long-term results of animal experiments].

The histological changes of the parotid gland after instillation of a resorbable protein solution into the excretory ducts were investigated by animal experiments. The glands of eleven rabbits were examined twelve months or more after occlusion of the duct system. Atrophy of parenchyma, fibrosis of interstitial tissue and recanalisation of the ducts was found. The epithelial lining of the excretory ducts showed metaplasia, and sometimes even dysplasia. This histological feature is also seen in "necrotizing sialometaplasia" but has no tendency to undergo malignant transformation. The aim of the method described is elimination of secretory parenchyma. It depends on three mechanisms: suppression of secretion, chemical influence of the solution on tissue, and diminution of acinar blood supply. Complications such as abscesses or fistula occurred after paraductal instillation of the solution, or when the recanalization of the ducts was disturbed. Compared to ligation of Stensen's duct this method has some advantages in the treatment of chronic recurrent parotitis, sialadenosis, salivary fistulae or sialorrhea.

Animals↗
PubMed1983

Morphology of the pancreatic ductal epithelium after traumatization of the papilla of Vater or endoscopic retrograde pancreatography with various contrast media in cats.

The epithelium of the pancreatic duct in cats was examined histologically, in the scanning electron and in the transmission electron microscope, after traumatization of the papilla of Vater or after pancreatography (ERP) with various contrast media. Ten minutes after traumatizing the papilla by repeated cannulation, we found lesions of the surface membrane of the epithelial cells. After ERP with the contrast media metrizamide and sodium meglumine ioxaglate, in the acute experiments, the least damage was observed when the low-osmolar, non-ionic metrizamide was used. In our chronic experiments the epithelial changes did not correlate with the contrast medium used. The degree of papillary stenoses and, probably, the initial injection pressure are more important. A mixture of the antiseptic polyvinyl pyrrolidone iodine to the contrast medium, which would prevent a bacterial contamination of the pancreatic duct after ERP, is morphologically justifiable but entails a risk of latent hyperthyroidism. Parenchymography with this mixture damaged the epithelium more than pancreatography.

Ampulla of Vater↗
PubMed1983

Experimental studies on pancreatic duct occlusion with prolamine.

The effect of the occlusion of the pancreatic duct system with prolamine (Ethibloc) has been studied in animal experiments with dogs and mini-pigs. The solution becomes solid in the duct system and becomes disintegrated again within 11 days. This time, however, is sufficient to keep a high-grade atrophy of the exocrine parenchyma. With this method one doesn't risk the provocation of an acute pancreatitis. The endocrine function of the atrophied glands is satisfactory, no animal became diabetic. The basal jugular vein insulin shows no difference to that of the control group, but nevertheless the mean whole pancreas hormone content is reduced for insulin and somatostatin, but not for glucagon.

Animals↗
PubMed1983

[The duodenum and Vater's papilla: tumors and tumor-like lesions--a clinico-pathologic discussion].

Tumors and tumor-like lesions of the duodenum and the Vater's ampulla are discussed in a clinical-pathological conference. Tumors and precancerous conditions are rarely found in the duodenum and the ampulla, nevertheless these areas should be investigated carefully during endoscopy of the upper gastrointestinal tract. About 12-15% of lesions described as tumors or tumor-like lesions are located in the duodenum. Histological findings of biopsy material from this region are the main topic of the conference. Incidence and differential diagnosis of the typical endoscopical and histological findings of the different tumors and tumor-like lesions are described.

Adenoma↗
PubMed1983

[Duodenal wall cysts and diseases of the pancreas].

Examination of 124 pancreatico-duodenal preparations obtained during surgery and of 250 pancreatic preparations at post-mortem has shown, that patients with chronic pancreatitis do have rather frequently cysts of the duodenal wall (38,5%). These cysts have a diameter of 2-100 mm. They are located in most cases in the submucosal layer as well as in the muscularis propria layer of the duodenal wall between pylorus and papilla. They lead to stenoses of the duodenum in 27% of the cases and they may be considered as a drainage barrier for pancreatic juice in 48.6% of the cases. They are lined with a single layer cylindrical or cubical epithelium; below the epithelium there are located rather frequently tubular glands (49.1%) and sometimes residues of Brunner's glands (7%) as well as ectopical pancreatic tissue (8.8%). The type of epithelial lining points to the fact, that these cysts may be considered as heterotopic formations of pancreatico-ductal tissue. On comparing the groups of patients with chronic pancreatitis with and without cysts of the duodenal wall it turned out that there was no difference between these groups in regard to histology of the disease, alcohol abuse, age and sex. Single cases described in the literature and 4 own cases show however, that chronic pancreatitis may be caused by primary cysts of the duodenal wall.

Chronic Disease↗
PubMed1982

Epithelial dysplasias in chronic pancreatitis.

The present 280 specimens of chronic pancreatitis were examined to determine the type and frequency of epithelial dysplasia of the duct system. The epitheilal dysplasias were divided into 3 degrees of severity according to cytological and histological criteria. Dysplasia was demonstrable in 40.1% of the 280 specimens. Of these 32.9% were classified as dysplasia grade I and 7.1% as dysplasia grade II. Dysplasia grade III did not occur. The epithelial proliferations were correlated with the topography, the stage of the scarring and the degree of obstruction of pancreatic secretion. An increase in dysplasia was evident in relation to the stage of the scarring and to the obstruction of secretory outflow. In correlation with the topography of the chronic pancreatitis there was the highest frequency of epithelial dysplasias in uniformly scarred glands (47.7%). Papillary and pseudopapillary hyperplasias with atypia were demonstrated in 17.9 vs. 4.5% of the cases with epithelial proliferations.

Chronic Disease↗
PubMed1982

[Pancreatic duct occlusion--possible errors and misinterpretations].

A total atrophy of the exocrine pancreas by duct occlusion can only be achieved if the whole duct system is filled. Nevertheless, a residual secretion--poor in enzymes--from the tubular glands of the pancreatic duct is possible. Long-term results of pancreatic duct occlusion are now available not only from animal experiments, but also after application in humans, --the results are comparable. The effectiveness in the treatment of chronic pancreatitis can be demonstrated: in a total of 141 partial duodenopancreatectomies with intraoperative "burning out" of the pancreatic tail, we did'nt observe any postoperative complications from the remaining pancreatic tail and over the course of up to a maximum of 4 years we saw only a single case of recurrent pancreatitis. After partial duodenopancreatectomy for pancreatic cancer insufficiency of the pancreaticojejunostomy occurs in about 14%. Therefore, also in cancer surgery the application of duct occlusion to prevent postoperative complications should be discussed.

Animals↗
PubMed1982

[Causes of death following endoscopic papillotomy].

The results of autopsy carried out in 14 patients who died after undergoing papillotomy show that apart from non-method-related sepsis (4 cases) developing from a cholangitis in underlying choledocholithiasis, haemorrhage from the papillotomy wound is the most dangerous complication of this intervention. In one case the cause of bleeding was the severance of the retroduodenal artery, while in 3 cases bleeding occurred after a repapillotomy. In these patients the source of bleeding was a highly vascular granulation tissue in the early healing phase after the first papillotomy. In view of this danger, the primary papillotomy should as far as possible be a complete one, or else, no repapillotomy should be performed in the proliferation phase of wound healing.

Adult↗
PubMed1982

[Metastasizing basalioma of the temporal area or continuous extension? Surgical approach and results].

By means of histological sections the rare diagnosis of a basalioma of the temporal area with regional metastases in the parotid gland and in the neck could be verified. Subsequently the surgical treatment and the postoperative results are described. The operation consisted of an en bloc excision of the basalioma, exstirpation of the parotid gland and radical neck dissection. Since the tumor had also infiltrated the facial nerve, the nerve had to be sacrificed and reconstructed using the superficial peroneal nerve. In order to obtain immediately a satisfactory esthetic result in the face region, in addition to the facial nerve graft, the corner of the mouth and the eyelids were taken up using solvent dehydrated dura mater and parts of the temporal muscle and its fascia. A face-lifting supported this procedure. The primary closure of the temporal skin defect was successfully performed using a regional skin flap from the scalp.

Adult↗
PubMed1982

A special form of segmental pancreatitis: "groove pancreatitis".

"Groove pancreatitis" is a form of segmental pancreatitis affecting the head of the pancreas which is localized within the "groove" between the head of the organ, the duodenum and the common bile duct. We diagnosed this form of pancreatitis in 30 out of 123 surgical duodenopancreatectomy specimens of chronic pancreatitis (24.4%). In a comparison with non-segmental chronic pancreatitis, no differences was observed in age and sex distribution or in alcohol consumption. Clinically, in contrast, preceding diseases of the biliary system, peptic ulcers and gastric resections were more frequently indicated. The cardinal clinical finding is frequently duodenal stenosis; in sonographic and CT examinations, the cicatricial "plate" in the "groove" represents as a "tumor", so that--also on account of the frequent duodenal stenosis--a carcinoma of the head of the pancreas may be suspected. In groove pancreatitis, the pancreatic duct system is grossly normal, calcifications or intraductal protein plugs being rare and an adaptive intimal fibrosis of the intrapancreatic arteries and arterioles is found only within the cicatricial area. Very commonly, scarring of the duodenal wall, stenosis of the duodenum, true duodenal wall and pancreatic cysts are detected. Aetiopathogenetic possibilities are previous diseases of the biliary system, peptic ulcers, gastric resections, true duodenal wall cysts, pancreatic head cysts, pancreatitis in duodenal pancreatic heterotopia, and disturbances of pancreatic juice outflow in Santorini's duct in the absence of the minor papilla, and hyperstimulation in consequence of chronic alcoholism.

Adult↗
PubMed1981

[Hemorrhages from the pancreatic duct system: a severe complication in pancreatic diseases].

The incidence of hemorrhage into the gastrointestinal tract associated with formation of pancreatic pseudocysts or cystadenoma are very rare. When it does occur, it is almost always fatal. Two of our patients had intermittent episodes of upper gastrointestinal hemorrhage with severe anemia. After ERCP we performed subtotal resection of the pancreas in one case and total pancreatectomy in the other. The postoperative course was uncomplicated. Within the last 2 years no episodes of hemorrhage were seen.

Adult↗
PubMed1981

[Gastrointestinal hemorrhage--angiodysplasia].

Clinico-pathological conference on the clinical picture of angiodysplasia--a rare source of bleeding in the upper gastrointestinal tract. In patients with relevant hemorrhagic symptomatology (tarry stools, anemia, possibly hemorrhagic shock), the diagnosis is established with the aid of angiography and endoscopy. Treatment consists in the resection of the section of bowel involved.

Aged↗
PubMed1981

Relationship between diseases of the pancreas and hyperplasia of Brunner's glands.

Examination of 105 duodeno-pancreatectomy specimens showed that 75% of the cases of chronic pancreatitis (n = 74) manifested diffuse hyperplasia of Brunner's glands. In pancreatitis involving part of the pancreas in the presence of ducts of the embryonic type (n = 6), in segmental pancreatitis (n = 16), and in pancreatic cancer (n = 23), no significant difference in the thickness of the layer of Brunner's glands was found as compared with normal specimens. There was no statistically significant correlation between the degree of hyperplasia of Brunner's glands and the degree of scarring of the exocrine pancreatic parenchyma. Nor was there any correlation between existence and extent of scarring of the duodenal wall, inflammatory infiltration of the duodenal mucosa, duration of disease, consumption of alcohol and history of gall stones and ulcers in patients with and without hyperplasia of Brunner's glands. Diffuse hyperplasia of the duodenal glands is probably an adaptive reaction to the exocrine insufficiency of the pancreas or the changes in gastric function (hyperacidity, accelerated emptying of the stomach) caused by chronic pancreatitis. A fact which supports this statement is that the inhibitor hormone urogastrone--an inhibitor of gastric acid secretion--is formed in Brunner's glands. The question is also discussed whether chronic pancreatitis and hyperplasia of Brunner's glands might not also develop simultaneously in the presence of disturbances of the gastrointestinal hormones, themselves either primary or due to alcohol consumption.

Alcoholism↗
PubMed1981

[Damage to the epithelium of the pancreatic duct following pancreatography (author's transl)].

Following pancreatography with x-ray contrast-medium used for clinical ERP the epithelium of the pancreatic duct was examined histologically, under the scanning electron and under the transmission electron microscope in 15 cats. Immediately following pancreaticography severe edematous lesions of the epithelium are to be seen, e. g. loss of microvilli, acute apical edema of the cells, single-cell-necrosis and erosive defects. 24 hours after pancreaticography some of the animals still manifest high-grade hydropic damage to the ductal epithelium, including rupture of the apical cell-membrane focal lysis of cytoplasm, irreversible mitochondrial lesions and initial degeneration of the nucleus. In the morphogenesis of such lesions in addition to the mechanical stressing of the pancreatic duct system and the physical and chemical properties of the contrast-medium, in particular an eventual damage to the Papilla Vateri with consecutive lowering of the emptying of the ducts, play an important role. By administering secretin to accelerate the emptying of the duct system, damage to the ductal epithelium can largely be avoided by shortening the duration of contact of the contrast medium with the epithelium.

Animals↗
PubMed1981

[Elimination of major salivary glands by temporary medicamentous occlusion of the excretory ducts (author's transl)].

The treatment of chronic recurrent inflammation of major salivary glands means reduction or elimination of parenchyma. Several operative and non-operative procedures have been described for this purpose. A new method is the instillation of an amino-acid solution which is hardening in the excretory ducts. Histological findings in experiments on animals show an atrophy of parenchyma while the filling mass is completely removed. Some patients were treated successfully by this method up to now.

Amino Acids↗