Biomedical subjects
Publications and source records attributed to R Klapdor.
After partial or total pancreatic resection displacement of abdominal organs, alterated bile- and food passage as well as pathological signs may be observed. In this serie scar-tissue was no problem in the differential diagnosis. Tumor recurrency can be demonstrated quite easily if follow-up examinations are available. Artifacts may influence the interpretation and can be the cause of a false negative reading.
Explore the source record for details and available documents.
The basal and meal-stimulated secretion of pancreatic polypeptide (PP) were measured before and 4-6 weeks after pancreatic duct ligation in five piglets, in two piglets also after 14 and 16 weeks. In all animals histology revealed the expected extreme atrophy of the exocrine pancreatic tissue. Basal and postprandial PP secretion, however, were not altered after duct ligation.
The response of serum gastric inhibitory polypeptide (GIP), serum gastrin, and blood glucose to a mixed liquid test meal with a low glucose load was measured in seven controls, in each of five patients after B II resection and proximal duodenopancreatectomy (PDP), and in three patients after jejunoileal bypass. The gastrin and glucose levels behaved as expected. However, in contrast to previously published data with higher glucose loads the integrated GIP response was slightly decreased after BII resection and significantly decreased not only after jejunoileal bypass but also after PDP. Subsequently we studied postprandial GIP release after test meals containing a low and a high glucose load in each of three controls and three patients after PDP. The results confirm a discrepant behavior of GIP release in dependence on the glucose content of the test meal after PDP compared to the controls. The hypothesis is discussed that these results reflect a special dose-effect relationship between glucose and GIP release in man.
The influence of an additional fiber diet on biliary lipid composition of gallbladder bile was studied in 12 piglets. In addition to the standard feed wheat bran was given for 6 weeks and bassorin for 2 weeks to each of four piglets. A group of four piglets served as controls. Gallbladder bile was obtained by ultrasonically guided puncture of the gallbladder. The results showed no significant alteration of bile acids, lipid composition, and lithogenity of bile for either of the diets. These findings are interpreted in that way that the normally high basic fiber content of the food of piglets does not allow a further decrease of the lithogenic index by addition of wheat bran or bassorin. This conclusion would mean that the basic fiber diet should be known before therapeutic trials with fiber diets are planned or interpreted.
The angiograms of 35 patients who had had surgery of the pancreas were evaluated. One must distinguish between the changes due to the procedure and those due to the original disease or to progress or recurrence of tumours. Out of four patients with recurrence of a pancreatic carcinoma, the angiogram failed to show any evidence in three. Angiography after pancreatic surgery is of value in planning further treatment, or if sonography and computer tomography are unable to clarify the problem.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This case report describes the echocardiographic documentation of a 60 year old patient with tricuspid regurgitation due to carcinoid heart disease. The carcinoid syndrome was histologically proven by liver metastases and by an increased 5-hydroxytryptamin secretion. Tricuspid involvement was echocardiographically documented by immobile, thickened leaflets. Diffuse endocardial thickening of the right chamber and pulmonary valve involvement was absent.
In 152 examinations, sonography was found to be a reliable screening method in the follow-up of curative and palliative surgery of carcinoma of the pancreas. By the effected changeover from compound scanning to the high-resolution real-time B-process, it has become possible to recognize at an early date even small locoregional recurring tumours (1.5 cm diameter), metastases of lymph nodes (1-1.5 cm diameter) and hepatic filiae (1.0 cm diameter); it has also been possible to detect typical changes, such as stenoses or thromboses, at the major vessels of the upper abdomen, well in time. If the findings are not clear, CT examination will be mandatory, if necessary in conjunction with bolus injection of a contrast medium. These methods have been able to largely replace the well-known invasive procedures, such as ERCP, angiography and laparoscopy in follow-up controls.
Explore the source record for details and available documents.
Serum concentrations of glycocholate and plasma disappearance curves of i.v. injected 14C-glycocholate were measured in 6 controls and 12 patients with liver disease. On the basis of these data, hepatic uptake and biliary excretion of serum glycocholate were calculated using a previously described 3-compartmental model. The results demonstrate that the hepatic uptake increases in correlation with the serum concentrations even if the biliary excretion decreases. As a consequence of reflux of glycocholate into the serum, increases also, indicating an increased bidirectional flux of bile acids in patients with elevated serum concentrations. These findings a) confirm that hepatic uptake and biliary excretion of glycocholate are independent transport mechanisms in man, b) indicate that hepatic uptake the more effective transport mechanism in the diseased liver, and c) suggest that liver uptake and reflux are different transport mechanisms. The possible pathophysiological importance of these findings is discussed.
Explore the source record for details and available documents.
Total CK and the isoenzyme CK-MB were determined simultaneously in the internal jugular vein and a cubital vein in 8 patients with acute traumatic lesions of the cranium. In these studies no relevant release of CK isoenzymes from cerebrum could be established. Acute traumatic lesions of the cranium therefore do not affect the value of the CK-MB determination in the internal intensive care medicine for differentiating elevated CK levels between skeletal and heart muscle affections.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Follow-up of 20 patients with incurable carcinoma of the pancreas is described, who were treated with palliative chemo- or radiotherapy. It was concluded that the course of the disease can be adequately followed by sonography and CT. Control of palliative therapy can be achieved by non-invasive means with little stress to the patient. Whether the attempt to do so is justifiable depends on the success of modern forms of treatment.
Endoscopic retrograde pancreatography (ERP) combined with pancreatic juice cytology, was performed in 14 patients with pancreatic carcinoma confirmed at subsequent laparotomy. ERP demonstrated duct abnormalities that were diagnosed as carcinoma in 86% of the cases and as suggestive of carcinoma in another 14%. Cytology was positive in 86% and suspicious in 7%. By combining both methods, all 14 carcinomas were correctly identified. Thus, in our hands, ERP and pancreatic juice cytology proved to be the most sensitive and reliable methods in detecting pancreatic carcinoma. On the basis of these promising results it is proposed that pancreatic juice cytology, which is a no-risk method, should be employed in all elderly patients with unexplained abdominal complaints, to screen them for early pancreatic carcinoma.