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Biomedical subjects

R Schlumpf

Publications and source records attributed to R Schlumpf.

107 records · Page 6Linked to original sources
PubMed1989

Magnetic resonance imaging and computed tomography in long-term-functioning duct-occluded pancreas allotransplants.

Duct-occluded segmental-pancreas transplants develop progressive fibrotic atrophy, even though endocrine function seems to be unaffected. To determine end-stage size of the graft and to evaluate magnetic resonance imaging (MRI) and computed tomography (CT), these imaging techniques were applied in eight patients with well-functioning intraperitoneal prolamine-injected segmental-pancreas transplants for 79, 48, 35, 20, 19, 19, 18, and 10 mo. MRI was performed on a 1.5 Tesla system (Philips Gyroscan S15). T1- and T2-weighted images were acquired. CT (Siemens Somatom 2) was done before and after intravenous contrast agent. The graft was visualized in seven of eight patients with both techniques. Visualization with MRI (vs. CT) was considered excellent in 2 (vs. 1), good in 3 (vs. 6), and poor in 2 (vs. 0). The three grafts with function longer than 2 yr measured 3-4 cm in length; the remaining grafts measured 3-6 cm. Because of a marked decrease in size the transplants were no longer localized in Douglas' pouch but adjacent to or on top of the uterus or bladder, the position depending on the volume of these organs. The allografts exhibited an inhomogeneous structure with casual cystic degeneration visible with MRI due to a high signal intensity on T2-weighted images. This study suggests that shrinkage of the duct-occluded pancreatic segment due to exocrine atrophy may be terminated after approximately 2 yr. It is concluded that thereafter an overshooting fibrosis causing late endocrine graft failure may not be anticipated.

Adult↗
PubMed1989

[Thrombocytosis following pancreas transplantation].

Thrombosis of the pancreas transplant is one of the main causes for the lower success rate of this procedure compared with that of other organ transplantations. Approximately one quarter of the pancreas transplantations discussed in this study are unsuccessful for this reason. This work is a retrospective study focusing on the postoperative blood platelet counts from 19 patients with a combined pancreas and kidney transplant, functioning well for at least 1.5 months. 19 patients with only a kidney transplantation with similar distribution of sex, age and postoperative immunosuppressive treatment were observed as a control group. After pancreas transplantation the platelet counts increased considerably and were found to be far above the normal level. There are no proven pathophysiological explanations for this thrombocytosis. Because of an increased risk of thrombosis, we recommend to use platelet inhibitors during the first two postoperative months.

Adult↗
PubMed1989

[Is there an age limit for organ donors?].

Multi-organ-harvesting, living related organ donation and a continuing extension of donor age are well known methods to overcome the shortage of suitable cadaveric organs for transplantation. With an appropriate technique even neonatal grafts can be successfully grafted. When specific organ damage is excluded, kidneys, livers, hearts and pancreas from donors as old as sixty-five, fifty-five, fifty-five and sixty years, respectively, can be used for transplantation with satisfactory results.

Adolescent↗
PubMed1988

[Radiologic diagnosis following pancreas transplantation].

Technical complications are relatively common after pancreatic transplantation, and most require radiological evaluation. Ultrasonography and computed tomography are helpful in the identification of peripancreatic and intra-abdominal fluid collections. Sterile fluid collections can be effectively treated by percutaneous catheter drainage, whereas most intra-abdominal infections require surgical intervention. Angiography is performed primarily for diagnosis of vascular thrombosis. Recent results suggest that magnetic resonance imaging may be a useful non-invasive method for the detection of pancreatic transplant rejection. Further imaging studies are needed to better define the development of progressive fibrotic atrophy in long-term functioning pancreatic transplants.

Humans↗
PubMedDate not supplied

Electrohydraulic extracorporeal non-water bath shock-wave lithotripsy of gallstones: two years' experience.

A prospective study was performed to evaluate the effectiveness of extracorporeal shockwave lithotripsy (ESWL) using a non-water bath lithotripter in combination with oral chemolitholysis on gallstone clearance. Patients were treated without general anesthesia or parenteral analgesia. We treated 74 patients selected according to the widely accepted criteria. Only 2 patients could not be sufficiently treated because of pain. After a 2 year period, 24 (32%) patients showed complete stone clearance, 35 (47%) patients had residual fragments, 5 (7%) patients underwent cholecystectomy, 2 (3%) patients were lost to follow up, and 8 (11%) patients discontinued the treatment before fragment clearance. According to the life-table estimate, 77% of our patients with successful ESWL and uncomplicated oral chemolitholysis are stonefree after 1 year. We consider the major advantage of this nonsurgical treatment of gallstone disease is that general anesthesia or parenteral analgesia has become unnecessary.

Adult↗