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Biomedical subjects

S Kiene

Publications and source records attributed to S Kiene.

At least 19 recordsLinked to original sources
PubMed2000

[Reconstructive gluteus maximus muscle pedicled flaps in the treatment of resistant fistulae of the pelvic organs].

The author describes a surgical method used to close poorly healing defects between the vagina and rectum, and the urethra and rectum resp. or persistent sinuses after proctectomy by means of a muscular flap of the gluteus maximus muscle. The results of treatment are demonstrated on a group of 7 patients operated by the author in the course of 26 years. In six patients the procedure was successful and led to healing of the defects.

Adult↗
PubMed1992

[The arterial blood supply of extrahepatic bile ducts of the donor liver].

The discussion of the etiopathogenesis of biliary complications after orthotopic liver transplantation have always encountered the problem of the status of a limited or interrupted blood supply of the ductus hepatocholedochus in the liver graft. For the description of the arterial vascular anatomy of the common bile duct 40 liver specimen were postmortem explanted and injection replica were made using corrosion technique. The arterial structures were systematically analysed and classified on the basis of their origin, distribution, calibre and combination. As a result, two types of arterial blood supply were defined and conclusions drawn for the surgical dissection during hepatectomy of the graft.

Adult↗
PubMed1992

[Malignant tumor of the autonomic nervous system of the stomach (GAN-tumor)--case report of a new entity].

Gastrointestinal autonomic nerve (GAN)-tumors are extremely rare. So far seven cases of intestinal and four of gastric GAN-tumors were reported. GAN-tumors, also termed plexosarcomas, arise from autonomic nervous system plexuses of the gastrointestinal tract such as those of Meissner or Auerbach. We report a case of a metastatic gastric GAN-tumor in a 40-year-old woman. A small, 1 cm in diameter, submucosal plexosarcoma located in the posterior gastric wall and a 1.5 kg, 23 x 15 x 11-cm metastasis located retroperitoneally behind the stomach between liver, spleen and pancreas without discernable invasion of any of these organs were found. En-bloc resection of the retroperitoneal mass, the spleen, the pancreatic tail, and a part of the posterior gastric wall adhering to the mass were performed. In addition, lymph node metastases in splenic hilum were noted, and resected. In CT scan liver metastases were detectable fourteen months after surgery. The diagnosis is based on light microscopical, ultrastructural, and immunhistochemical analyses. The prognosis of GAN-tumors is fatal. In spite of radical excision 8 of 11 reported patients died few month after surgery while local recurrences and/or metastases in regional lymph nodes and in the liver were found. The response to chemotherapy was poor.

Adult↗
PubMed1991

[Animal experiment studies of the distribution and elimination of radioactively marked endotoxin].

We were able reproduce typical morphological and laboratory changes of endotoxinemia in dogs and small experimental animals by administration of E. coli = 111 K58 endotoxin labelled with 99m Tc. Contrary to the literature our distribution studies in rats showed a high concentration of endotoxin in the kidney. An effective endotoxin elimination was possible by extracorporal hemoperfusion in vitro and vivo. Optimal results were achieved using immunoabsorption in combination with plasmapheresis. However, further experimental studies are necessary to clarify the problem fully.

Animals↗
PubMed1990

[Electromyographic and manometric studies of the antrum and duodenal motility in rabbits under the influence of pentagastrin in a mechanical duodenal passage disorder].

The influence of a mechanical disturbance of the duodenum on the motility of the antrum and duodenum was investigated by means of the electromyography and the perfusion manometry. Thereby the effect of the pentagastrin stimulating the motility of the unstriated muscles of the gastro-intestinal tract was used for testing the function reserve of the antrum- and duodenal-muscles. After one and a half month of establishing the passage obstacle there occurs a complex disturbance of the electrical activity; the unstriated muscles does not react on a stimulating excitation.

Animals↗
PubMed1989

[Surgical methods in anal and rectal prolapse].

Anal prolapse in adults is cured by the Milligan-Morgan procedure. Operation for the rectal prolapse has to repair procidentia, incontinence and obstipation. Procidentia and incontinence in low-risk patients are best repaired by abdominal rectopexy with or without plastic materials (Ripstein's procedure is preferred). Obstipation remains a long-term problem. Rectopexy in combination with sigmoid resection (Goldberg) improves obstipation, but there is leakage in 4% of the patients. The perineal approach offers no technical advantage. Perineal rectopexy, prolapse resection and Thiersch ring with modifications are preferred in high-risk cases. Posterior levator plastic improves remaining incontinence.

Fecal Incontinence↗
PubMed1989

[Under the thigh amputation according to Bruckner].

Knee joints of 24 in 28 patients were successfully preserved by below-knee amputation according to Brückner, at the Surgical Department of Karl-Marx University in Leipzig in 1987. The above patients had been in advanced age and in multimorbid conditions. Surgical technique and postoperative care are described and discussed in some detail.

Aged↗
PubMed1987

[Surgical therapy of tumor-induced ileus of the large intestine].

The principle of staged surgical approach to tumour-dependent colonic ileus is no longer justified in all situations. One single right-side hemicolectomy has proved to be superior to the staged approach in cases of colonic ileus on the right to transverse centre. Surgical treatment was applied to 22 patients with right colonic ileus, between 1983 and 1986. Seven of them died after surgery, including three of eight who had undergone palliative operations and four of 14 who had undergone radical surgery in one single session. Transversal colostomy as a first step of a staged approach has proved to be successful on patients with left colonic ileus, from transverse centre. It was found to be just as promising as one single approach. One single approach required intestinal evacuation, using a specific aseptic technique. Incontinence resection (Hartmann's operation) has proved to be an effective method. The majority of 31 patients with left colonic ileus underwent staged surgery. Hartmann's operation was performed on seven of them, and external defecation without resection was applied to 24. Twelve of them died after the first operation, including two after Hartmann's operation and ten of 23 after external defecation without tumour removal.

Cecal Neoplasms↗
PubMed1987

[Transplantation antigen specific rosette test and its inhibition with autologous serum--a new immunologic method for predicting rejection crisis following allogeneic organ transplantation].

A combination of transplantation-antigen-specific rosette test with inhibition of rosette formation, using autologous serum, was used in postoperative follow-up checks on patients who had undergone allogeneic kidney transplantation and proved successful in early diagnosis or prediction of rejection episodes even before clinical manifestation. The numbers of antigen-detecting and antigen-binding cells differed considerably from each other, depending on patients who had undergone kidney transplantation. Almost complete inhibition of antigen detection was generally achieved by addition of patient serum. If sensitization to alloantigen in excess of the limit value (30 RBZ/10(3) KHZ) is accompanied by rosette formation with autologous serum addition in excess of about 18 RBZ/10(3) KHZ, clinically relevant rejection can be expected to occur after another two or three days and will have to be treated by immunosuppressives. Such partial or even complete elimination of rosette inhibition is usually only of short length (one day) and has rarely been observed to last longer. No rejection calling for treatment will develop, on the other hand, as long as blocking serum factors provide for high-stability inhibition of any bond of transplantation antigen (rosette formation). Constantly low rosette formation with serum addition and without was exhibited by control persons (blood donors, patients with cerebrocranial trauma) in daily examinations. Limit values of 18 or 30 RBZ/10(3) KHZ were not surpassed.

Graft Rejection↗
PubMed1987

[Surgical therapy of rectal cancer].

Surgical excision of rectum carcinoma by amputation, resection or locally delimited excision has remained to be the optional curative approach to carcinoma of any position, severity, type and phase. Low-dose heparinisation, oral intestinal washing, and perioperative application of antibiotics have retained their established positions in the run-op to surgical action. The value of perioperative radiotherapy is still unelucidated. Chemotherapy has so far failed to produce a safe adjuvant effect. The age limit to curative intervention is continuously moved upwards. Resection is more often chosen than other approaches. Safely established knowledge is likely to suggest that the atumorous aboral safety zone may be reduced to 2 cm, provided that the perirectal lymphatic channels are severed at equal level. Anastomosis in cases of deeper anterior removal can often be sutured only by staplers. There is a growing number of situations in which the approach can be taken without preceding colostomy. Transanal and transsphincteral access routes are available for locally delimited tumour excision. Postoperative lethality has been continuously lowered and is now below five per cent. Reported in this paper are the authors' own results over the past decade.

Adult↗
PubMed1986

[Insulin and glucagon secretion of the preserved dog pancreas].

Well defined results can be obtained quickly by in vitro test concerning the preservation effect of the preserved dog's pancreas. Clinical and chemical parameters were received during the hypothermic perfusion respectively during the refrigerant storage. The in vitro function tests were carried out after the preservation by insulin and glucagon stimulation. The results showed that the A and B cells of the dog's pancreas are completely able to function after a preservation of 24 hours. Thereby a strong formation of edemas by releasing high enzyme activities is caused during the mechanical perfusion of the organs. The simple refrigerant storage of the pancreata therefore, is the more suitable preservation form for organ transplantations.

Animals↗
PubMed1985

The effect of potassium, calcium and magnesium concentration on insulin and glucagon secretion of the perfused dog pancreas.

The effect of different potassium, calcium and magnesium concentrations in the perfusate on the hormone secretion of the isolated dog pancreas was investigated. A potassium concentration above 15 mMol/l shortly stimulates the insulin and glucagon secretion. Potassium ions (greater than or equal to 15 mMol/l) completely inhibit the early phase of glucose-induced insulin release. At a low Ca2+-level (0.25 mMol/l) the glucose-stimulated insulin secretion is reduced to basal values. On the other hand, the glucagon release is stimulated under these conditions. An increase of magnesium ions from 1.0 mMol/l to 2.5-7.5 mMol/l strikingly inhibits insulin and glucagon release by approximately 50%, which is compensated for insulin by increasing the Ca2+-content of the medium. Perfusates for normothermic pancreas perfusion should contain electrolyte concentrations within the physiological range.

Animals↗