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Biomedical subjects

P Aeberhard

Publications and source records attributed to P Aeberhard.

At least 109 records · Page 6Linked to original sources
PubMed1980

[The glucagon syndrome].

Although the features of the glucagonoma syndrome had been described in isolated reports since 1942, this potentially curable condition has only recently been adequately defined. In 1974, MALLINSON collected nine cases and described the association of a peculiar skin rash with glucagon-secreting tumors of the pancreas. The typical skin rash, necrolytic migratory erythema, is accompanied by other disturbances including weight loss, anaemia, glossitis, cheilitis angularis, psychiatric symptoms. Diabetes is not a prominent feature, and the impairment of glucose tolerance can indeed be very slight. Up to 1979, about 50 cases have been reported. More than half of these patients had malignant tumors. The authors report on a 67-year-old man in whom a glucagonoma in the tail of the pancreas has been resected with apparent cure. The almost complete disappearance of the skin rash within three weeks of extirpation of the tumor has been most impressive. In June 1979 a similar tumor has been operated by one of the authors in a 60-year-old man. In this instance the tumor was located in the pancreatic corpus and could be radically resected by left-sided pancreatectomy.

Adenoma, Islet Cell↗
PubMed1980

[Antibiotic preparation of the colon or preoperative parenteral prophylaxis in colon surgery. A randomized study].

A double-blind randomised trial was carried out among 72 patients undergoing elective colorectal surgery. 37 patients received Metronidazole and Kanamycin systemically, 35 patients the same medicaments orally. We could not find any difference between the two ways of application. These results are in opposition to those of a comparable study of Birmingham, where the therapy was significantly less successful in the oral group. This fact is discussed and the parenteral, short-term prophylaxis is recommended.

Clinical Trials as Topic↗
PubMed1980

[Computer tomography as aid for surgical indication and choice of time in acute pancreatitis].

When initial clinical improvement of acute pancreatitis is followed by secondary deterioration, a local complication must be suspected, and surgery may be required to drain infected fluid collections and to debridge or resect necrotic and sequestering parts of the pancreas and/or peripancreatic fatty tissue. Clinical examination, laboratory investigations, and conventional radiology have failed to give clear information as to the local process in the retroperitoneum. The indication for surgery has therefore traditionally been based upon the systemic manifestations of sepsis and distant organ failure, which may account for the still high mortality in this group of patients. Computerised axial tomography (CT) has been shown to be of value in making an earlier diagnosis of the local complications of acute pancreatitis and providing more detailed informations upon which to base the type and extent of the surgical procedure. In the last 1 1/2 years CT has been used prospectively by the authors for initial assessment and follow-up of the course in all cases of severe acute pancreatitis. In this series 3 out of 11 operated patients died, compared to 18 out of 33 comparable cases during the preceding 5-year period when CT was not available in our hospital. In 2 of the 3 fatalities, a perforation of the colon had been present at the time of referral. These preliminary results suggest that CT is of value in the management of this difficult problem and has helped to reduce mortality from the complications of acute pancreatitis.

Acute Disease↗
PubMed1980

[Combined abdominosacral excision of a giant-cell tumor of the os sacrum].

In 1967 Localio described a synchronous abdomino-sacral approach for resection of sacrococcygeal chordoma. The patient is placed in the lateral position with the left side up. The incision is carried from a point to the right of the midline above the pubis transversely across the rectus and then obliquely parallel to the inguinal ligament, to end at the midaxillary line. Mobilisation of the rectum and control of the pelvic vessels presents no difficulty. The sacrum is then exposed from the dorsal side by a transverse incision. The possibility to work simultaneously in the two operative fields affords excellent exposure and control of bleeding. This approach has been used by the authors for resection of an abundantly vascularized giant cell tumor of the sacrum.

Adult↗
PubMed1979

[The course of diabetes and clinical findings in glucagonoma].

A 66-year-old male patient with non-insulin-dependent diabetes of probably 20 years' duration presented with necrolytic migratory erythema, stomatitis, anemia and weight loss. Plasma-glucagon concentration measured with Unger's antibody 30-K was 8500 pg/ml, representing a hundredfold elevation. Two thirds consisted of high molecular glucagon fractions (10 000--40 000 Dalton). This may be an important index for detection of glucagonoma with endocrine activity. After excision of the glucagonoma the clinical syndrome was reversed and the patient recovered completely. Histological and histochemical investigation confirmed that the tumor was a glucagonoma. Despite complete removal of the tumor and a normal plasma glucagon concentration, the diabetes remained unchanged. Excessive hyperglucagonemia does not appear to play a primary role in the pathogenesis of this patient's diabetes.

Aged↗
PubMed1979

[Sigmoid colon injuries caused by blunt abdominal trauma].

Circumferential seromuscular stripping of the sigmoid colon with denudation of the mucosal tube over a length of 4 to 10 cm has been observed in four patients after blunt abdominal trauma. Three of the patients had been driving a motor car, with two of them wearing safety belts. One patient was injured when he was caught between steel bars at work. In two cases the sigmoid lesion was associated with a tear in the mesoileum, leading to ischemic bowel necrosis in one. In one patient the lesion was found 5 days after the accident when he presented the symptoms of diffuse peritonitis caused by secondary perforation of the denuded mucosal tube. Treatment consisted in resection, anastomosis and proximal colostomy in two, and resection with end colostomy and distal mucous fistula in the remaining two cases.--As long as perforation of the denuded mucosa has not occurred, symptoms may be minimal. Liberal use of peritoneal lavage in polytraumatized patients is therefore important in order to minimize the likelihood of overlooking this type of bowel lesion.

Accidents, Occupational↗
PubMed1979

[Wolff-Parkinson-White during a basedowienne thyrotoxicose (author's transl)].

The case reported here consisted of an association of a Wolff-Parkinson-White syndrome (WPW) with thyrotoxicosis, with simultaneous recovery by thyroidectomy; this lead the authors to review 13 previous cases in the literature. The physiopathologic discussion emphasized several points: 1) the specific action of thyroid hormones, 2) the hypothesis of the possible existence of inapparent pathways of pre-exitation in most subjects and 3) a simple practical attitude to adopt in all Wolff-Parkinson-White cases especially when rapid.

Animals↗
PubMed1978

[Selective proximal vagotomy with or without pyloroplasty. Results of a prospective randomized study].

The authors report on the one-to-five year results of a prospective randomized trial of proximal gastric vagotomy (PGV) with and without pyloroplasty in 64 men operated upon electively for chronic duodenal ulcer. The effects of the operation on gastric secretion tested at six months with pentagastrin and insulin were identical in both groups. There were fewer long-term side effects in the group without pyloroplasty. The differences between the groups do not reach statistical significance. So far no recurrent ulcers have been found in this series. It is concluded that a drainage procedure is unnecessary with PGV and that the long-term results of the operation are probably better when not combined with a pyloroplasty.

Duodenal Ulcer↗
PubMed1978

Effect of pyloroplasty on gastric emptying: long term results as obtained with a labelled test meal 14-43 months after operation.

The mean gastric transit time (t) and the half-time of gastric emptying (t/2) of a labelled test meal have been studied in 18 patients more than 1 year after gastric surgery for peptic ulcer and compared with those in 18 healthy controls. Of the patients, 6 had undergone proximal gastric vagotomy alone (PGV), L had had proximal gastric vagotomy and pyloroplasty (PGVP) and in 6 truncal vagotomy and pyloroplasty (TVP) had been performed. The t and t/2 of patients with PGV alone did not differ significantly from the values of the control group. The t and t/2 in patients after PGVP and TVP, however, were significantly lower than in both controls and patients after PGV alone. There was no statistically significant difference between the groups with PGVP and TVP. The results of this study suggest that the lasting effects of vagotomy operations on gastric emptying are due to the drainage procedure rather than the vagotomy.

Adult↗
PubMed1978

Results of a controlled randomized trial of proximal gastric vagotomy with and without pyloroplasty.

The 1--5 year results of a prospective randomized trial of proximal gastric vagotomy (PGV) with and without pyloroplasty in 64 men operated upon electively for chronic duodenal ulcer are reported. The effects of the operation on gastric secretion, as tested at 6 months with pentagastrin and isulin, were the same in both groups. There was no statistically significant difference in the clinical results between the two groups. The authors conclude that the addition of pyloroplasty makes little, if any, difference to the results of PGV. Pyloroplasty is thus better omitted as it adds nothing of value and may increase the risk of the procedure.

Adult↗
PubMed1977

[Characterization of gastric emptying by determination of transit time].

Gastric emptying of a solid test meal labelled with 99mTc-sulphur colloid has been studied in 18 healthy men using a gamma camera with on-line computer. Mean transit time (MTT) was determined by fitting the time-activity histogram to a gamma variate, and the half-time of emptying (T1/2) was calculated by exponential fitting of the down-slope of the C(t) curve. Mean transit times showed a smaller coefficient of variance than T1/2, and this difference was statistically significant (p less than 0.005). This result suggests that MTT may be a more suitable parameter for definition of normal values and for the separation of normal from pathological patterns of emptying.

Adult↗
PubMed1977

Effects of proximal gastric vagotomy (PGV) followed by total vagotomy (TV) on postprandial and fasting myoelectrical activity of the canine stomach and duodenum.

Experiments were designed to study the effect of proximal gastric vagotomy (PGV) followed by total vagotomy (TV) on the myoelectrical activity of the canine stomach and duodenum after a meat meal and during fasting. Dogs were prepared with chronically implanted Ag-AgCl-electrodes on the stomach and duodenum. Recordings of electrical activity were made for one hour after the ingestion of a meat meal and records of four to six hours were taken on the fasting animals. In the postprandial records no effect on co-ordination of antral and duodenal myoelectrical activity was found after either PGV or TV. These results suggest that the co-ordinating mechanism is not dependent on vagal innervation. Impairment of gastric emptying after TV does not appear to be due to disturbance of antral-duodenal conduction. Normal patterns of fasting activity were found in control and after PGV. They were grossly disturbed after TV, probably because of delayed gastric emptying. These findings suggest that PGV does not delay gastric emptying as does TV, and that the proximal vagal supply to the stomach is unimportant in the control of fasting activity.

Action Potentials↗
PubMed1977

Mean transit time of solid test meals in gastric emptying.

Gastric emptying of a test meal labelled with 99Tcm-sulphur colloid has been studied in 9 healthy volunteers using a gamma-camera with on-line computer. Mean transit time (MTT) was determined by fitting the time-activity histogram to a gamma-variate, and the half-time of emptying (T1/2) was calculated by exponential fitting of the down-slope of the time-activity curve. MTT showed a smaller coefficient of variance than T1/2. This result suggests that MTT may be a more suitable parameter for definition of normal values and for the separation of normal from pathological patterns of emptying.

Adult↗
PubMed1977

[Gastrointestinal myoelectric complex].

Complexes of high amplitude action potentials have been shownn to occur in the stomach and duodenum of fasting dogs. These complexes recur at regular intervals as long as the animal is fasting, and they are propagated aborally over the whole lenght of the small bowel. The cyclical pattern is replaced by the digestive of "fed" pattern of activity upon feeding. Therefore the pattern has been known as the interdigestive myoelectrical complex. Studies in herbivorous species however, in which the flow of digesta is more or less continous have show that cyclically recurring migrating complexes can be demonstrated in these species as well. Thus, the term "migratory myoelectrical complex" may be more appropriate. Propagation of the complex is not dependent upon continuity of the bowel wall nor movement of luminal contents. Replacement of the complex by the digestive pattern of activity upon feeding and the restitution of the interdigestive pattern at the end of the digestive phase seem to be under nervous as well as hormonal control. The interdigestive complex in the dog has been looked upon as a "housekeeper" which sweeps the bowel clear of contents at the end of the digestive phase. Aspects of possible physiological significance of the complex are: periodic elimination of refluxed duodenal contents from the stomach and prevention of bacterial colonization of the small bowel by the colonic flora. The existence of propagated complexes has not been demonstrated in man, but there is increasing evidence for cyclical activity which fits the pattern.

Action Potentials↗