Search PubMed⌕ Search

Biomedical subjects

R Winkler

Publications and source records attributed to R Winkler.

At least 181 records · Page 10Linked to original sources
PubMed1980

[Promotion of adenocarcinomas at the preternatural anus by bile acids in rats (author's transl)].

Wistar rats spontaneously develop adenomatous polyps with cell dysplasia (Figs. 2 and 3) and finally, adenocarcinomas (Fig. 1) at the preternatural anus 120-200 days after the formation of a double loop colostomy. With respect to the potential significance of bile acid metabolites in the pathogenesis of colonic cancer, the effect of continuous oral administration of chenodeoxycholic acid (CDCA) on the rate of carcinomas at the preternatural anus was examined. This animal model gained special interest because until now the possible cocarcinogenic rule of bile metabolites was generally demonstrated only after additional administration of chemical carcinogens like dimethylhydracin or nitrosoguanidin. Of ten rats in the CDCA-treated group, three already showed a malignant transformatin to adenocarcinomas at the preternatural anus 60 days after a colostomy (Fig. 4). Apparently the alteration of natural ecologic conditions diminishes the resistance against external and internal carcinogenic or coarcinogenic agents. The role of bile acid metabolites is discussed under these circumstances.

Adenocarcinoma↗
PubMed1980

[Tuberculous stenosis of the transverse colon].

A 14 year old Turkish girl presented with unspecific abdominal symptoms and barium enema showed an almost complete obstruction in the region of the splenic flexure. The picture was that of a neoplasm and a left hemicolectomy was performed. Histological examination revealed ulcerating hypertrophic tuberculosis of the colon. The incidence, pathology and symptomatology of colonic tuberculosis are discussed.

Adolescent↗
PubMed1979

[Ultrastructural observations on transitional cloacogenic carcinomas of the ano-rectal region (author's transl)].

The clinical and pathological features of four transitional cloacogenic carcinomas (TCC) are presented with particular reference to electron microscopy. The incidence of this tumour is 1.4% of all ano-rectal neoplasms. Three cases showed a gross appearance similar to the common rectal neoplasms. One tumour presented without an intraluminal lesion, but infiltrated the bowel wall and the anal glands. TCC show a distinct histological pattern. The degree of differentiation of the basic transitional cell component determines the "grading" of the lesion. We distinguish between grade I, II and III. Grade I lesions show uniform polygonal cells with only occasional mitotic figures. There is distinct palisading of the nuclei of the peripheral tumour cell layers. Grade II lesions are characterized by partial or total loss of the peripheral palisading. Grade III lesions are extremely anaplastic ("oat cell" carcinoma). This histological classification correlates well with the prognosis. Electron microscopic investigation of TCC revealed the ultrastructural features of basal cells. The uniform tumour cells with large nuclei contain tonofibrils, desmosomes and hemi-desmosomes, free ribosomes, and relatively few other organelles. We did not find keratinocytes or keratohyalin granules in these four cases of TCC. It is emphasized that TCC of the ano-rectal region differ fundamentally from the basalcell carcinomas of the skin in their biological behaviour.

Aged↗
PubMed1979

[Radiologic investigations following abdomino-perineal resection of the rectum (author's transl)].

After abdominoperineal resection of the rectum specific alterations due to operation and disease can be distinguished. In over eighty percent the ureters and the urinary bladder are concerned. The topography of the small-intestine in the sacral cavity reveals alterations of the pelvic floor which generally are local recurrences of carcinoma. In both examinations special importance has to be laid on a lateral view of the pelvis. Indications and results of supplementary examinations are discussed. Computed tomography will deliver additional informations for the diagnosis of recurrent carcinoma; the value of CT is checked at the moment. Considering the amount and importance of treatable illness following resection of the rectum a standardized program for examination seems inevitable. Our experience with over 400 cases is, that this program can reveal important informations for postoperative care which up to now has often been underestimated, even from a radiologic point of view.

Colectomy↗
PubMed1979

[Computer tomographic findings after resection of the rectum (author's transl)].

Computed tomography findings in the pelvis after resection of the rectum, obtained from 48 patients primarily suspected of recurrent carcinoma, are represented. Compared with conventional radiographic methods CT demonstrates directly in most cases the presence of a pelvic mass, its extension and relationship to adjacent soft tissue. In some cases this is advantageous for further diagnostic procedures, but also for treatment and further check-up. False conclusions are discussed. The distinction between recurrent carcinoma and retroperitoneal fibrosis in the pelvis, frequently enhanced by retarded healing of the sacral cavity, remains a problem. Progress in the early diagnosis of recurrence of pelvic mass could be made by regular CT check-up during the first two years after resection of the rectum, to increase the value of palliative radiotherapy treatment indicated in any case. As CT, however, is expensive and not always available, this demand cannot be met and the value of conventional radiographic methods remains at present unquestioned.

Colectomy↗
PubMed1979

[Suture insufficiency following BI-resection (author's transl)].

33 out of 135 patients (24.5%) developed suture insufficiency after Billroth I-resection. There was no selection of patients in respect of elective, corrective and emergency surgery. The diagnosis is always possible on the grounds of clinical criteria. On the contrary, the early radiographic postoperative direct proof of suture insufficiency is not always possible (14 out of 24 cases). Indirect radiographic signs, such as gastroatonia, delayed gastric emptying, medio-paragastric atypical fluid levels may be relied upon and likewise on signs of the upper abdominal and intestinal stasis, such as radiographic intestinal fluid level, or more frequently pleural effusion on the left side. Typical laboratory changes are absent in the early phase. The rare, but threatening early insufficiency (first until third postoperative day) requires immediate relaparotomy. Dehiscence comes into existence not before the fourth and sixth postoperative day (late insufficiency). They can be treated conservatively. By adequate drainage late complications should not be expected. The period of hospitalization is prolonged over eight days on an average. If the fistula persists, surgical closure should be considered after 30 days because of the increased possibility of severe arrosive haemorrhage.

Gastrectomy↗