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Biomedical subjects

P Wendling

Publications and source records attributed to P Wendling.

At least 19 recordsLinked to original sources
PubMed2006

Feasibility and accuracy of TRUS in the pre-treatment staging for rectal carcinoma in general practice.

AIMS: Transrectal ultrasonography (TRUS) is the diagnostic tool of choice for local staging of rectal carcinoma. The accuracy in determining of tumour infiltration depth has been reported to reach 95% (on average, 85%). The aim of the study was to analyse the diagnostic accuracy of the TRUS in the clinical routine. PATIENTS AND METHODS: From 01/01/2000 to 12/31/2003, all patients with rectal carcinoma were enrolled in a prospective multicenter observational study. In case of complete findings of pre-operative TRUS and post-operative histological investigation of the surgical specimen on the tumour infiltration depth, overall accuracy of TRUS was determined. RESULTS: Overall, 13,610 patients with rectal carcinoma were enrolled in the study. Five thousand and fifty-six subjects (37%) underwent TRUS. In 3,501 patients, TRUS finding (uT-stage) could be compared with the result of the definitive histologic investigation (pT-stage). The accuracy of TRUS in all T-stages was 65.8%. The highest sensitivity was achieved in the T3-stage (74.9%), while in T2, T1, and T4, it was 59.6, 59.0 and 31.1%, respectively. In discriminating tumour growth limited to the rectal wall vs that through the rectal wall into the neighboring tissue, TRUS-associated accuracy was 76.5%. There were no differences between various tumour locations above the anocutaneous line. CONCLUSIONS: Diagnostic accuracy of TRUS in determining depth of tumour infiltration within or through the rectum wall in the routinuous diagnostic of rectal carcinoma does not reach the excellent published study results. A considerable improvement of the qualitative outcome in using this specific diagnostic tool appears to be recommendable to utilize its advantages such as high accuracy, efficacy, and practicability in the diagnostic process and deriving consequences for a possible neoadjuvant treatment as well as optimal planning of the surgical approach.

Carcinoma↗
PubMed1996

Metabolic catecholamine, and endurance responses to caffeine during intense exercise.

This study examined the possible effects of caffeine ingestion on muscle metabolism and endurance during brief intense exercise. We tested 14 subjects after they ingested placebo or caffeine (6 mg/kg) with an exercise protocol in which they cycled for 2 min, rested 6 min, cycled 2 min, rested 6 min, and then cycled to voluntary exhaustion. In each exercise the intensity required the subject's maximal O2 consumption. Eight subjects had muscle and venous blood samples taken before and after each exercise period. The caffeine ingestion resulted in a significant increase in endurance (4.12 +/- 0.36 and 4.93 +/- 0.60 min for placebo and caffeine, respectively) and resulted in a significant increase in plasma epinephrine concentration throughout the protocol but not in norepinephrine concentration. During the first two exercise bouts, the power and work output were not different; blood lactate concentrations were not affected significantly by caffeine ingestion, but during the exercise bouts muscle lactate concentration was significantly increased by caffeine. The net decrease in muscle glycogen was not different between treatments at any point in the protocol, and even at the time of fatigue there was at least 50% of the original glycogen concentration remaining. the data demonstrated that caffeine ingestion can be an effective ergogenic aid for exercise that is as brief as 4-6 min. However, the mechanism is not associated with muscle glycogen sparing. It is possible that caffeine is exerting actions directly on the active muscle and/or the neural processes that are involved in the activity.

Adult↗
PubMed1985

[Artificial respiration in a surgical intensive care unit].

An indication for respiratory treatment is given in manifest and for prophylactic mechanical ventilation in expected pulmonal insufficiency. The mortality rate can be reduced by an early respiratory treatment, therefore prophylactic mechanical ventilation should be performed liberally. Mainly patients after abdomino-thoracal operations and major vascular or upper abdominal surgery are at risk for lethal postoperative pulmonary complications.

Aorta, Abdominal↗
PubMed1984

Heterogeneous oxygenation of rectal carcinomas in humans: a critical parameter for preoperative irradiation?

Tissue oxygenation was measured in 10 patients with differentiated adenocarcinoma in a very localized region in the middle part of the rectum (grade I - II, clinical stage II) by means of a cryophotometric micromethod. The results obtained clearly show that the oxygenation of differentiated rectal adenocarcinoma is distinctly lower than that of the normal rectal mucosa; tissue hypoxia or even anoxia are a common feature in those tumors; There exist considerable inter- individual differences among tumors of the same clinical staging and histological grading; substantial intra- individual heterogeneities in the oxygenation are evident within the same tumor and even within neighbouring microareas of the tissue. These findings imply that the commonly used classifications do not allow any conclusions concerning the oxygenation status, and probably the radiosensitivity of a tumor, respectively.

Adenocarcinoma↗
PubMed1982

[Validity of the transcutaneous PO2-measurement during pharmacologically induced changes of skin perfusion (author's transl)].

The validity of transcutaneous oxygen partial pressure (tcPO2) was tested during pharmacological vasodilatation and vasoconstriction of the skin. Measurements of transcutaneous oxygen partial pressure (tcPO2) were done on the hairless skin of the abdomen in 18 anaesthetized rabbits, when beta-pyridyl-carbonyl (Ronicol) was used as a vasodilator and vasopressin (Pitressin) as a vasoconstrictor. Vasodilation yielded no significant influence on the tcPO2-measurement. Vasoconstriction, however, resulted in a marked decrease of the tcPO2-signal (p less than 0.001). During this phase tcPO2 did no longer reflect arterial PO2 which remained nearly constant. In this experimental model vasoconstrictive drugs may cause a marked underestimation of the arterial oxygen tension. The dependence of the tcPO2-measurement on maximal local skin perfusion should be considered in intensive care patients.

Animals↗
PubMed1980

Mesenterico-caval shunt in rats. Technique and results.

A microsurgical technique for mesenterico-caval shunting in the rat is described. The method results in a partial blood drainage from the upper abdominal content whereas the blood of the mesenteric vein is shunted to the inferior caval vein. Controls were undertaken after 1 and 3 weeks, either visually or radiologically. Twenty-two of 26 surviving animals showed patency of the shunt. All animals had undisturbed blood supply to the portal stump.

Angiography↗
PubMed1980

[O2-uptake of the cirrhotic liver. An experimental study (author's transl)].

In 15 Beagles with cirrhosis of the liver (TAA induced) and in 22 healthy controls the flow in the hepatic artery (Q a.h.) and in the portal vein (Q v.p.) was measured by kineangiodensitometry. The oxygen content in the hepatic artery, portal and hepatic vein was determined after withdrawal by inserted catheters. Thereafter the O2-uptake (V O2) via portal vein (V pO2) and hepatic artery (V aO2) was calculated. The control animals showed Q a.h. of 175 +/- 25 ml/min and Q v.p. of 511 +/- ml/min. In the cirrhotic animals Q a.h. rose up to 205 +/- 31 ml/min, there was a decrease of Q v.p. to 260 +/- 49 ml/min. V O2 of the liver of the controls was 5,6 +/- 1 ml/100 g/min. V aO2 ws 2,0 +/- 0,4 ml/100 g/min (35%), V pO2 was 3,6 +/- 0,7 ml/100 g/min (65%). In the cirrhotic animals V O2 decreased to 4,7 +/- 0,9 ml/100 g/min, V aO2 rose up to 3,0 +/- 0,6 ml/100 g/min (64%), V pO2 was reduced to 1,7 +/- 0,6 ml/100 g/min (36%). There was a statistically significant difference of all values measured (p less than or equal to 0,01). In cirrhosis of the liver the hepatic artery carries the main oxygen supply.

Animals↗
PubMed1979

[Geriatric surgery of the upper GI-tract (author's transl)].

The results of surgery of the upper gastrointestinal tract in elderly patients achieved at the Department of Surgery of the University of Mainz are represented. New pathophysiological concepts in peptic ulcer surgery, improved preoperative procedures like endoscopic retrograde cholangiography (ERC) and percutaneous transhepatic cholangiography (PTC) in diseases of the biliary tree are important contributions to the indications and operative tactics. The rules of cancer surgery are also true in geriatric surgery. Diagnostic and therapeutic procedures should be restricted according to the particular limits set up by age.

Abdomen↗
PubMed1977

[Esophageal varices hemorrhage in portal hypertension (author's transl)].

Diagnostic and therapeutic possibilities for esophageal varices hemorrhage in portal hypertension are indicated with reference to 149 patients. In the acute phase, operative measures are to be rejected because the lethality is too high. Conservative treatment with a Blakemore-Sengstaken probe should always be introduced at first. After confirmation of the conditions in the liver, a pressure-reducing anastomosis operation (delayed emergency shunt) must be performed. For this purpose we prefer the terminolateral splenorenal anastomosis.

Adult↗
PubMed1977

[Respiratory gas exchange and glucose uptake by the human spleen in situ (author's transl)].

Blood samples were taken from the splenic artery, vein and pulp of 16 patients suffering from lymphoproliferative diseases, essential thrombocytopenia or hereditary spherocytosis and undergoing early splenectomy. The relevant parameters of the respiratory gas exchange as well as glucose and lactate concentrations were determined in these samples. In no case did the thorough examination of the splenic tissue reveal any histopathologic aspects. Taking into account a mean splenic blood flow of 100 ml/100 g/min during anaesthesia, the mean oxygen consumption of the splenic tissue attains 1.1 ml/100 g/min. The glucose uptake and the lactate release show to be 9 mg/100 g/min and 5.2 mg/100 g/min, respectively. Despite high glucose uptake rates and pronounced glycolytic activities there is no evidence of the existence of low pH values, a glucose depletion or hypoxia in the normal spleen. In the normal spleen, therefore, the intrasplenic sequestration of red blood cells cannot be explained by unfavourable metabolic conditions.

Glucose↗
PubMed1977

[Liver blood flow studies using cineangiodensitometry].

In 12 anesthetized beagle dogs breathing spontaneously flow in the hepatic artery (168 ml/min + 10 SEM) and portal vein (576 ml/min +/- 20 SEM) was measured by means of angiodensitometry. Total hepatic blood flow (THBF) was 185 ml/100 g/min +/- 11 SEM. In our opinion this relatively high THBF depends upon the method used.

Animals↗
PubMed1977

Birth fractures of the femur.

Even though we dealt with only a few cases, we can conclude that: 1. The elongation, which is sometimes feared, does not occur. 2. Due to the lack of adequate X-ray techniques, the question of rotary failures in newborn infants cannot be discussed in a satisfactory way. Based on these cases, even though there might be some undetected rotary failures, there is no reason to stop conservative therapy. 3. Even large axial displacements are corrected. The fact that in two cases an antecurvature persisted is interesting, especially if we see that in our cases only axial displacements of more than 30 degrees were not totally corrected. Perhaps one should keep an eye on this form of dislocation in the future.

Adolescent↗