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Biomedical subjects

M Stolte

Publications and source records attributed to M Stolte.

At least 487 records · Page 27Linked to original sources
PubMed1980

Perioperative myocardial infarction in coronary artery bypass surgery.

Perioperative myocardial infarction (PMI) as diagnosed by standard electrocardiograms (appearance of persistent Q-waves of at least 0.4 sec duration) and/or autopsy, occurred in 51 (3.8%) out of 1341 consecutive patients undergoing coronary artery bypass surgery using saphenous vein grafts. Retrospective analysis of the available data revealed that preoperative factors like sex, age, history of myocardial infarction, functional class, coronary risk factors, number of vessels diseased, and ventricular function had no influence on the incidence of PMI. However, intraoperative parameters, e.g., type and duration of cardiac arrest as well as technical errors leading to graft occlusion, significantly affected the incidence of PMI. The clinical relevance of PMI is indicated by a high early mortality of 25.5% as compared to 2.3% in patients without PMI. Improvement as well as complete alleviation of angina pectoris was less frequent in patients with PMI than in patients without PMI. The decrease in the rate of PMI from more than 18% in 1970 to less than 1% in 1978/79 confirms that such incidents should not be regarded as an inevitable risk but as a complication which can largely be avoided by proper operative technique.

Adult↗
PubMed1980

[Vascularization of the Papilla Vateri and bleeding risk of papillotomy (author's transl)].

The vascularization of the Papilla Vateri was investigated by angiography, histology and morphometry in 55 samples obtained at autopsy; four main types may be distinguished. The bleeding risk accompanying endoscopic papillotomy in general is low because of the anatomy of the arterial supply of the papilla. The average diameter of the vessels in the plexus arteriosus papillae is about 0,98 mm, it is only 0,43 mm in the proximal part of the papilla (that is to say, the part adhering to the bile duct). The arteria retroduodenalis crosses the ductus choledochus on the average 37.5 mm from the tip of the papilla. In rare cases more excessive arterial bleeding may occur, since there is a crossing of the arteria retroduodenalis through the region of papillotomy in about 4% of the cases. A high bleeding risk exists during 8 days after the first of a multiple step papillotomy procedure, since during this period vascularization of the granulating tissue is still extensive.

Ampulla of Vater↗
PubMed1980

[Studies on tissue compatibility of d-limonene as a dissolving agent of cholesterol gallstones (author's transl)].

A 97% d-limonene preparation was injected as a bolus into the biliary tract of cats. Depending on volume, contact time, and flow direction of the solution, acute or chronic inflammatory damages for varions degrees were found in the hepatobiliary tissues of all animals treated with the d-limonene solution. These observed histopathological changes due to contact with the terpene compound, restrict the value of the d-limonene preparation as described by Igimi et al. for dissolving cholesterol gallstones retained in the human common bile duct.

Animals↗
PubMed1979

[Pathology of cardiac insufficiency].

Giving introductory examples of autopsied cases the variable spectrum of the different forms and temporary dynamics of cardiac insufficiency are discribed. In the following chapter the etiology is discussed from the point of view of general pathology. The pathogenesis of cardiac insufficiency is discussed by taking in consideration of the "energy problem". Disturbances of the supply, the production, the utilization and the transposition of energy, which are to be morphologically detectable with various methods looking upon different structures, lead at least to the insufficiency of the myocardial contraction.

Adult↗
PubMed1978

[Occlusion of pancreatic duct system by injection of a fast-solidifying amino acid solution (author's transl)].

The effect of the occlusion of the pancreatic duct system with a new alcoholic solution of amino acids has been studied in animal experiments. The solution becomes solid in the duct system, is microbiologically indifferent and becomes disintegrated 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 development of fistulas following exploratory excision is prevented by the filling of the duct system. The solution could be qualified for a therapeutical acceleration of the "burning-out" of the chronic pancreatitis.

Amino Acids↗
PubMed1978

[The elimination of the excretory pancreatic parenchyma by means of intraductal injection of a rapidly hardening solution of aminoacids].

The effect of the occlusion of the pancreatic duct system uith a new alcoholic solution of aminoacids has been studied in animal experiments. The solution solidifies in the duct system, is microbiologically indifferent, and becomes disintegrated within 11 days. The development of fistulas following exploratory excision is prevented by the filling of the duct system. The solution could be suitable for a therapeutic acceleration of the "burning-out" of the chronic pancreatitis.

Amino Acids↗
PubMed1977

[Muscle bridges over the left anterior descending coronary artery: their influence on arterial disease (author's transl)].

A total of 711 hearts was studied and examined for coronary muscle bridges of the left anterior descending (LAD) macroscopically, angiographically and histologically. A muscular overbridging of the LAD was found in 22.9% of all hearts. The average distance from left artery bifurcation was 33.6 mm, the average length was 22.5 mm and the average thickness 2.8 mm. A thin layer of fat tissue is mostly to be found between the overbridged coronary artery and the myocardial bridge. The patient group with and without myocardial overbridging showed no difference in sex or age nor in average stature and the average heart weight. Statistically, there is significantly more atherosclerosis of the coronary artery proximal to the muscle bridge than there is under and distal to the bridge. A difference in frequency and extent of atherosclerosis in hearts with and without coronary muscle bridge could not be shown for this portion of the LAD. Nevertheless, there is a tendency for fewer anterior-wall infarctions in the patient group with a coronary muscle bridge of the LAD, because, when the whole branch is considered, there is a significantly lower incidence of atherosclerosis in hearts with myocardial overbridging of the LAD. The reason for the protective effect of a coronary muscle bridge is yet not clear.

Adipose Tissue↗
PubMed1977

[Postmortem investigations after coronary artery bypass surgery (author's transl)].

On the basis of postmortem findings in 60 patients who had undergone aorto-coronary vein graft bypass and 145 patients with coronary heart disease we show the morphological risk factors associated with this operation. Arteriosclerosis of the coronary artery in the region of the anastomosis and the stenosed or scared coronary outflow pathways are attended by high risk. A large difference in calibre between the vein and the coronary artery is also a risk factor. The knowledge of the morphology of the coronary muscle bridge helps to avoid operative complications. The progression of coronary artery sclerosis in the overbridged stenosis depends from the degree and the histological qualitiy of this stenosis. Beyond critical stenoses of the coronary arteries operable myocardium is evident in 89,4%, even beyond coronary occlusions revascularisation is possible in 58,9%.

Arteriosclerosis Obliterans↗
PubMed1977

Endoscopic lithotripsy in the common bile duct.

After appropriate preliminary experiments in animals and in corpses, electrohydraulic lithotripsy has been used for the first time in humans in an attempt to destroy stones in the bile duct. For this purpose, a lithotripsy probe combined with a Dormia basket was constructed. To date, this method has been successfully applied to break fragments off large calculi in three patients, without any complications arising. In one case, subsequent extraction of the remaining part of the stone was possible. The probe must, however, be improved to ensure that the stone is always held centrally in the basket.

Endoscopes↗
PubMed1976

[Wirsung's duct of the normal pancreas and chronic pancreatitis. A study by scanning and transmission electronmicroscopy (author's transl)].

There were 96 segments of the main pancreatic duct taken from 50 resected pancreasses studied by scanning and transmission electron microscopy (44 cases with chronic pancreatitis, 4 without alterated excretory parenchyma). While the surface of the normal Wirsung's duct was not uneven, in all cases of chronic pancreatitis various alterations of caliber and surface were seen. Changes of caliber are caused by either tapering or roundish vaults and wrinkles, changes of surface by smaller humps or recesses. The surface of the normal Wirsung's duct itself consisted of a homogenous layer of microvilli. In chronic pancreatits several changes of epithelium occurred: flattening with the loss of microvilli, highering and multilayering of the "Wirsungiocytes". By combining of the above-mentioned features, two different types of the main duct in chronic pancreatitis resulted. The importance of a smooth surface with a homogenous microvilli layer of the normal Wirsung's duct and the causes and consequences of changes of the normal Wirsung's duct and the causes and consequences of changes of caliber, surface, and epithelium in chronic pancreatitis are discussed.

Chronic Disease↗
PubMed1976

[Silicone embolism, fat embolism, and fibrin thrombosis in dogs after extracorporeal circulation using a bubble-oxygenator (author's transl)].

Following extracorporeal circulation with a bubble oxygenator (Rygg-Kyvsgaard) silicone emboli were found in the brain-and-kidney-capillaries of all dogs evaluated. There was no obvious correlation between intensity of silicone embolism and pump time. No cellular reaction was seen around the anti-foam agent. Occasionally single small areas of embolic brain damage were found. During extracorporeal circulation and within a recovery period up to one hour no silicone excretion through the kidneys could be demonstrated. Systemic fat embolism occurred less frequent than previously reported. Use of a filter in the cardiotomy suction line reduced its intensity further. In neither of the various organs examined, disseminated intravascular thrombosis could be found.

Animals↗
PubMed1976

[Postmortem demonstration of portal vein collateral circulation (author's transl)].

INTRODUCTION: Postmortem investigation of esophageal varices and the portal system is difficult, because veins are collapsed at autopsy. The demonstration of varices is possible by illumination of the isolated mucous membrane or by puncturing esophageal varices and filing them with different materials. MATERIAL AND METHODS: We use a 15% aqueous gelatine solution (if needed with additional barium sulfate for x-ray examination) which is supplemented by 40% formaldehyde (40 ml in 1 1 gelatine solution). The superior mesenteric vein is catheterized and filled by a clyster-pump. RESULTS: The mixture of gelatine and formaldehyde hardens within a few minutes. The autopsy is delayed only about half an hour. Within this time the portal system is well outlined. This method can show exactly the drainage of the portal system into the inferior vena cava. In cases of portocaval shunt or of esophageal transsection the result of the operation can be verified. The localization of the bleeding source of esophageal varices can be demonstrated by escape of the filling mass.

Autopsy↗
PubMed1976

[D-transposition in situs inversus, atrial septal defect, open foramen ovale and tricuspid valve insufficiency].

This paper reports on a rare case of a so-called corrected d-transposition of the great vessels of a 62-year old woman with situs inversus. In addition the patient had a VSD, a patent foramen ovale, and a tricuspid-valve insufficiency. The topography of the ventricular cavities, the great vessels and the coronary arteries is described in detail. There is pointed to the surgical treatment of additional abnormalities to improve the prognosis.

Electrocardiography↗