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P Merkle

Publications and source records attributed to P Merkle.

At least 19 recordsLinked to original sources
PubMed2003

Carotenoids are decreased in biopsies from colorectal adenomas.

UNLABELLED: A lower intake of carotenoids is associated with an increased risk of colorectal cancer. In order to take advantage of the chemopreventive properties of carotenoids, it is necessary to determine carotenoid concentration at the target tissue. As early stages in the adenoma-carcinoma sequence of colorectal cancer might be susceptible to chemoprevention, we sought to determine carotenoid concentrations in biopsies from colorectal adenomas. METHODS: Biopsies from colorectal adenomas and non-involved mucosa were taken from seven patients. For controls, biopsies were obtained from the ascending and descending colon of patients without polyps (n = 5). Concentration of carotenoids (alpha-, beta-carotene, lutein, lycopene, zeaxanthin, beta-cryptoxanthin) were determined by optimizing gradient HPLC-analysis. Results are expressed as pmol/microg DNA. RESULTS: Except for alpha-carotene, all carotenoids could reliably be detected in all specimens. In control patients carotenoid concentrations were highest in the ascending colon, being followed by the descending colon and non-involved mucosa from polyp-carriers. In colorectal adenomas all carotenoids were significantly reduced as compared to-non-involved mucosa (beta-carotene: 0.37 vs 0.19, P<0.03; lycopene: 0.34 vs 0.21, P<0.06, beta-cryptoxanthin: 0.14 vs 0.09, P<0.03, zeaxanthin: 0.18 vs 0.09, P<0.02; lutein: 0.18 vs 0.13,P <0.02). CONCLUSION: All carotenoids investigated are reduced in colorectal adenomas, suggesting that mucosal carotenoids could serve as biomarkers for predisposition to colorectal cancer. Moreover, anti-tumor activity exerted by carotenoids is limited due to mucosal depletion. We speculate that supplementation of a larger array of carotenoids might be beneficial for patients with colorectal adenoma.

Adenoma↗
PubMed2002

[Inflammatory myofibroblastic tumor of the pancreas with regional lymph node involvement].

Inflammatory myofibroblastic tumors (IMT) can be found in virtually any location of the human body. Histologically a mesenchymal aspect predominates and makes these mostly benign tumors apt to be erroneously diagnosed as a soft tissue sarcoma. Cases showing infiltrative growth and local recurrence further complicate the assessment. Localization of an IMT in the pancreas is extremely rare. Clinical investigations regularly lead to the putative diagnosis of a malignant tumor and only subsequent histological examination can establish the correct tumor classification. We present the case of a 62-year-old woman with IMT of the pancreas. Evidence of lymph node involvement has not yet been reported in this setting.

Female↗
PubMed1996

[Value of 99mTc-MIBI scintigraphy in diagnostic localization of hyperparathyroidism. A prospective study].

We evaluated the sensitivity of praeoperative parathyroid imaging using 99mTc-MIBI scintigraphy in planar as well as SPECT technique to detect and localize abnormal parathyroid glands in 36 patients with hyperparathyroidism. Seven out of these patients had been previously operated in the thyroid area. With a sensitivity of 76% (22/29) solid adenomas could be localized correctly. Surgical success was estimated by the weight of the adenomas, by histology and postoperative laboratory findings. Compared to other imaging procedures 99mTc-MIBI-scintigraphy seems to be most sensitive in detecting and localizing abnormal parathyroid glands, especially in previously operated patients. Praeoperative standard in nuclear medicine up to now is Tl-Tc-subtraction scintigraphy, which is technically more difficult, sensitive to artefacts and exposes the patient to more radiation. Based on our experience we would therefore suggest to screen all previously operated patients with 99mTc-MIBI scintigraphy on a routine basis.

Adenoma↗
PubMed1994

[Special problems of primary hyperparathyroidism in pregnancy].

In cases of premature, persistent nausea and vomiting, or if these conditions continue past the 14th week of pregnancy, the possibility of primary hyperparathyroidism should be considered and the condition eradicated in order to avoid serious complications for mother and child. Judging from our experience and according to current literature, starting in the 12th week of pregnancy the effects of primary hyperparathyroidism on both mother and child can be prevented through surgery.

Adenoma↗
PubMed1993

[Preoperative assessment of depth of infiltration of rectal tumors by staging, endosonography and magnetic resonance tomography. A prospective study].

The choice of individual therapy for rectal tumours requires the pretherapeutic assessment of the depth of infiltration of the tumour. Fourty-four patients with rectal tumour were evaluated preoperatively by digital examination, endosonography and magnetic resonance imaging (MRI). Test results were compared with the postoperative histological examination. In digitally accessible tumours clinical staging had an accuracy rate of 85%. The sensitivity of endosonography was 83%, compared with 54% for MRI. Our findings suggest that endosonography may be more accurate as MRI, especially for rectal adenomas and early carcinomas.

Adult↗
PubMed1991

[Strategy in acute abdomen].

The most important measure in assessing the acute abdomen is the selection of the patients requiring urgent operation. Hitherto, the patient's history and careful physical examination by an experienced surgeon have formed the basis for decision making and management. Provided adequate experience is available, ultrasonography is considered helpful in certain cases. Special laboratory tests and extensive equipment-related measures should be applied only following specific questioning.

Abdomen, Acute↗
PubMed1990

[Differential diagnosis of spontaneous pneumothorax--pulmonary lymphangioleiomyomatosis. Clinical aspects, diagnosis and therapy].

As a case report, lymphangioleiomyomatosis is presented--a rare disease that only affects women and up to now with a poor prognosis. It results from a tumorlike proliferation of smooth muscle in the thoracic and retroperitoneal lymphatics. Prominent clinical findings are dyspnea, spontaneous pneumothorax, chylous pleural effusions and chylous ascites. The diagnosis results from typical chest X-rays and is established by open lung biopsy. Treatment should primarily start with medroxyprogesteronacetat (respectively tamoxifen), if necessary with consideration of the hormonal receptors. In an early stage the oophorectomy can be helpful. Surgical intervention is necessary in complications (thoracic drainage, pleurectomy for recurrent pneumothorax, Le Veen-shunt for chylous ascites). If hormonal therapy is not successful, a combined heart and lung transplantation should be attempted in ultima ratio.

Adult↗
PubMed1988

[Proctomucosectomy and colo-anal anastomosis in rectovaginal fistula following the use of suppositories containing ergotamine].

We observed a rectovaginal fistula in 2 patients who had applied ergotamine suppositories against migraine headaches. The local effect of ergotamine on the rectum mucosa as well as the higher systemic concentration after rectal application seem to promote the development of a rectovaginal fistula. Different methods for the surgical fistula repair are discussed, depending on location and diameter of the fistula. In our patients we have carried out the abdomino-transanal resection of the rectum with sutured colo-anal anastomosis.

Adult↗
PubMed1986

[Cancer of the large intestine--a sequela of ureterosigmoidostomy].

Carcinoma or polyps of the colon as a late complication of ureterosigmoidostomia (USS) have been reported with increasing frequency. Three patients are presented, two of them developed a signet-ring cell carcinoma after USS; one patient showed, 6 years after rediversion of the ureter, a carcinoma at the anastomotic site. Changes in the secretion patterns of sialo- and sulphomucines of the tumor and mucosa are histochemically demonstrated and, together with an appraisal of etiologic factors, discussed. We suggest a careful follow-up of patients with USS, particularly of those performed many years ago.

Adenocarcinoma, Mucinous↗
PubMed1985

[Functional studies in blunt thoracic trauma with special reference to perfusion and ventilation scintigraphy].

In 10 patients we carried out a routine chest X-ray examination together with an arterial blood gas analysis, spirometry and a combined pulmonary perfusion/ventilation scintigram. Scintigraphy was shown to be the most sensitive method in the detection of impaired post-traumatic pulmonary function. Since it is a time-consuming method requiring sophisticated equipment it is of limited value for routine examinations. Spirometric results during the immediate post-traumatic period are difficult to interpret as a result of severe chest pains which may inhibit respiratory movements. Arterial blood gas analysis which is easily performed is of high value in accessing the actual pulmonary function.

Adolescent↗
PubMed1984

[Clinical aspects and fine structure of papillary cancer. With special reference to morphological carcinogenesis].

Course of the disease and microscopic work-up of the operative specimens with special consideration of morphological carcinogenesis were analysed in 72 patients with tumour of the ampulla of Vater. Mean duration since onset of symptoms was 6.6 weeks. Cardinal symptoms were jaundice, loss of weight and abdominal pain. Endoscopic-retrograde cholangio-pancreatography, computed tomography and percutaneous transhepatic cholangiography had the highest diagnostic accuracy. Resection rate of the carcinoma was 55%, hospital mortality was 6.7% for partial duodenopancreatectomy and 15.4% for palliative surgery. The mean survival rate was 20 months after partial duodenopancreatectomy and 5 months after palliative surgery. The survival rate was significantly decreased if tumour size was above 2 cm and lymph nodes were positive for tumour. In 82.8% of the examined operative specimens moderate to high-grade epithelial dysplasias were found in carcinoma-free portions of the ampulla, and in 91.4% there were adenomatous structures. It is to be assumed that carcinoma of the ampulla develops via dysplastic epithelial changes or from adenoma of the ampulla.

Aged↗