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Biomedical subjects

T Richter

Publications and source records attributed to T Richter.

At least 109 records · Page 6Linked to original sources
PubMed1977

[Utilization of the small intestine fistula technique in paralytic ileus. Report on clinical experience].

Seventy-three patients with paralytic ileus hospitalized at the Surgical Clinic of the Hospital in Herford during the years 1971-1975 are reviewed. All the patients were treated with a small bowel fistula according to a modified technique of Witzel-Heidenhain. The special indication, the technical details, and the results are discussed. The overall mortality of a total of 73 patients with paralytic ileus undergoing a small bowel fistula operation was 19%. The temporary small bowel fistula according to the modified technique of Witzel-Heidenhain is proposed as a simple, safe, and with accurate indication an effective method for accomplishing total decompression of distended bowel.

Adolescent↗
PubMed1976

[Influence of line frequency electric fields on the heart rate of rats (author's transl)].

At present, the few published research results concerning the effect of 50 HZ fields on biological measurements, for instance on circulatory parameters, show only slight correlation. In order to find objective criteria for the infleunce of a field on heart frequency physically defineable observation conditions must first be created. In the interpretation of the results, it had to be taken into consideration that the measurements were taken immediately after application of the field in both brief and extended exposure. The effect of narcosis during derivation of cardiac activity was also a factor to be considered in this context. Keeping these facts in mind, rats were exposed for up to 50 days to a 50 Hz field with a field-strength of 50 V/m resp. 5300 V/m. Under both field-strength ranges, the heart frequency sank significantly. The intensity and the temporal development of the influence were dependent on the field-strength and the length of application. The comparatively strong frequency drop after 15 min treatment time in the 5300 V/m field points to a stress effect, whose persisting influence determines the development of the biological reaction over a longer period of time. The stronger field is comparable to the value found in the middle of the potential field of a 380 kV high-tension line. For this reason, the experimental results are interesting from the point of view of industrial hygiene as well.

Animals↗
PubMed1975

Collaboration of serotonin and melatonin in the control of thyroid function.

The stimulatory effect of serotonin and the inhibitory effect of melatonin on iodine incorporation by thyroid follicular cells are both inhibited by the serotonin antagonists methysergid and cyphroheptadine. Serotonin and melatonin can mutually prevent each other's action. A collaboration of melatonin and serotonin in the regulation of thyroid function is implied from the experimental observations.

Animals↗
PubMedDate not supplied

[Experiences with enteral nutrition of patients with cystic fibrosis (CF) via a percutaneous endoscopic gastrostomy (PEG)].

BACKGROUND: We wanted improve the nutritional status of patients with cystic fibrosis with enteral feeding via a percutaneous endoscopic gastrostomy (PEG). PATIENTS AND METHODS: In a period of 8 years 11 patients underwent a percutaneous endoscopic gastrostomy (PEG), 4 males and 7 females, in the median 14,9 years of age (7,4/20,8). So far we overlook a median duration of enteral feeding therapy of 19,5 months (10/53). MAIN RESULTS: In 9 of the 11 patients we found a distinct increase of the predicted anthropometrical values,e.g. the weight for height value increased statistically significant in the first 3 months by 10,3 % from 84,7 % to 95,5 % and showed a further increase to 97,8 % after 10 months of nocturnal enteral feeding (p < 0,05). The predicted values of the lung function got stabilized too, with an increase by 9 % of the FEV1 and 3 % of the vital capacity after 10 months. Here was no statistically significance found. In one patient with a poor social-economic background and a lack of compliance the PEG had to be removed surgically because of an abscess formation. Another patient developed an acute gastric ulcer which responded very well onto conservative therapy. In the other patients there were no further complications. CONCLUSION: We can conclude that in the treatment of patients with cystic fibrosis showing an unsatisfying nutritional status the long-term nocturnal enteral feeding via a PEG is a good and well tolerated method. The best results we achieved when the gastrostomy was placed at an early state of the disease. That's why we demand an early mentioning of this option of enteral feeding to the patients and their families since the involved mostly need a long time for their decision for that invasive procedure.

Adolescent↗
PubMedDate not supplied

[Long-term study of patients with coeliac disease in childhood and adolescence: latent and transient coeliac disease].

UNLABELLED: Coeliac disease (CD) is known as a lifelong condition of gluten intolerance. In case of some patients, the time after which gluten exposition leads to damage of the small intestinal mucosa may be very long. In addition to the florid form of CD, there are also silent (atypical mono- and oligosymptomatic with typical damage of the small intestinal mucosa) and latent forms (often asymptomatic without clear mucosal changes, antibody titres often normal). Occasionally the development of gluten tolerance is postulated (transient CD). We investigated 47 subjects diagnosed in childhood definitely as CD patients. In the age of 16.3 +/- 4.8 years, the patients started a gluten containing diet. After 6 to 9 months of gluten containing diet a small intestinal biopsy was performed in all patients. Surprisingly we found 11 patients with normal small intestinal mucosa (group 1). The other 36 patients showed a flattened mucosa as expected (group 2). The further development of group 1 was followed. In 9 patients a further biopsy was performed after more than 2 (at maximum after 8.1) years of gluten containing diet. In all patients the morphology of the mucosa was normal. In 7 of 11 cases normal numbers of intraepithelial lymphocytes were counted. Only in two patients raised titres of gliadin and endomysium antibodies were found after 4.5 and 15 years of gluten containing diet. In the other 9 patients no increase in antibody titers was found up to 10.3 years. However, in group 1, mucosal lactase activity was decreased as was also the case for group 2. CONCLUSION: A high number of adolescent coeliac patients does not respond or responds only minimally to reintroduction of gluten into the diet over a period longer than two years. These patients should regularly be further controlled serologically.

Adolescent↗
PubMedDate not supplied

[Spontaneous elimination of helicobacter pylori infection in children].

BACKGROUND: With the (13)C-urea-breath test, 6.6 % of 3 372 preschool children of the Leipzig area tested H. pylori positive in 1998. PATIENTS: In 2000, 5.6 % of 3 854 grade-two pupils of the same area tested positive. METHOD: 2 235 children participated in both tests campaigns. Therefore, their H. pylori state could be reinvestigated after two years. RESULTS: 30 of the 104 children, who were tested positive in 1998 were negative in 2000. Using questionnaires completed by the corresponding parents and family physicians, possible reasons of individual elimination were analysed. It was found that 18 of the 25 children received a H. pylori triple therapy. Three children had been tested false-positive in 1998. Four children received antibiotics for other reasons and H. pylori was obviously eradicated too. Only three children were not treated with any antibiotics between 1998 and 2000. For these children, spontaneous elimination is assumed. CONCLUSIONS: Conclusions about spontaneous elimination of H. pylori infections are problematic. Further investigations are needed in consideration of this object.

Anti-Bacterial Agents↗
PubMedDate not supplied

Angiodysplasia as a cause of gastrointestinal bleeding in childhood.

UNLABELLED: Whereas in adults angiodysplasia is a frequent cause of gastrointestinal bleeding, in children this disorder is extremely rare. A 7 10/12 year old girl is presented suffering over 3-4 months from mild but recurrent rectal bleeding. Blood count and serum ferritin and transferrin levels were normal. The rectosigmoideoscopy revealed a rectal lesion, which was confirmed histologically as angiodysplasia. Pathological investigation of the biopsies included HE staining and immunohistological staining of endothelial cells with anti-CD34 and anti-von Willebrand factor. A follow-up period of three years revealed spontaneous regression of the angiodysplastic lesion at the rectosigmoideal localisation, which could be confirmed by endoscopy. CONCLUSION: The outcome of the few pediatric patients described in the literature was reviewed. Due to the lack of conclusive understanding of the nature of this extremely rare vascular disorder and the variable outcome described, a wait and see attitude should be assumed in cases of less clinical affection.

Angiodysplasia↗
PubMedDate not supplied

[Exudative enteropathy in congenital lymphedema-lymphangiectasia syndrome].

BACKGROUND: Congenital peripheral elephantiasiformic alterations are very rare in paediatric patients. In a patient with lymphangiectasia-lymphedema syndrome we demonstrate over a 8-year follow-up that not only cosmetic and social indications for surgical treatments but also internal care become important during the course. PATIENT: We report on a boy with congenital lymphedemas of the extremities and the genital region, which were several times surgically treated. The patient became symptomatic firstly with tetanic cramps caused by malabsorption syndrome due to intestinal lymphangiectasia at the age of 6 years. Synopsis of clinical and laboratory findings and the patient's course are pointing to a mild Hennekam syndrome with still unknown aetiology. RESULTS: The boy developed adequately with permanent oral substitution of electrolytes and vitamins, protein-rich diet, supplementation of medium-chain fatty acids and compressing bandages. Infusions of human albumin to correct persistent hypalbuminemia as well as cytostatic treatment with cyclophosphamide as a formal trial were ineffective and are not advisable, therefore.

Child↗
PubMedDate not supplied

[Percutaneous endoscopic gastrostomy in childhood and adolescence].

BACKGROUND: Nasogastric tube-feeding often is necessary in the treatment of chronically ill patients. The disadvantage (irritation of the hypopharynx, dislocation, stigma) can be avoided by the percutaneous endoscopic gastrostomy (PEG). In childhood there is only limited experience with this techniques. PATIENTS AND METHOD: We report about 89 children with PEG. Indications were central dysphagia (67), dystrophy caused by chronic renal failure or congenital heart disease (15), application of special diets (6) and gastric volvulus (1). The endoscopy was done in sedation. RESULTS: The PEG was placed in the stomach (73) or duodenum (16). 14 Complications were observed: inflammation at the insertion site (2), perforation (2, healing under conservative treatment), dislocation of the duodenal part into the stomach or occlusion (6) and distraction of the retention disk (4). There were no procedures-related deaths. The mean duration of the PEG was more than 1 year. The affected persons were very pleased with the efficacy of this treatment. CONCLUSIONS: In all patients (including infants) requiring long-term tube-feeding the option of a PEG should be taken into consideration. In our experience the PEG is associated with a low rate of complications and provides a major improvement for children who are dependent on tube feeding.

Adolescent↗
PubMedDate not supplied

Dead but highly dynamic--the stratum corneum is divided into three hydration zones.

Topically applied water exerts mechanical stress on individual corneocytes as well as on the whole stratum corneum (SC), resulting in an alteration of barrier function. In this study we used complete skin biopsies and showed that the SC reacts to water stress as a highly optimized and well-regulated structure against osmotic changes. Following a relatively new cryo-processing protocol for cryo-SEM, it is possible to reliably maintain and investigate the hydrated state of the SC and individual corneocytes after treatment with solutions of different ionic strength. Treatment with distilled water results in swelling of SC cells together with formation of massive water inclusions between adjacent cell layers. Treatment with 5-20% NaCl reveals three different hydration zones within the SC: Corneocytes near the live-dead transition zone can swell to nearly double their thickness. The second zone is the most compact, as the corneocytes here show the smallest thickness variation with all treatments. Within the outermost zone, again a massive swelling and loosening of intracellular filament packing can be observed. We therefore conclude that the SC itself is subdivided into three functional zones with individual water penetration and binding potentials. Since the second zone remains nearly unaffected by water stress, we propose that this zone hosts the functional SC barrier.

Adult↗
PubMedDate not supplied

Comparison of different histopathological methods for the examination of sentinel lymph nodes in breast cancer.

BACKGROUND: Sentinel lymphonodectomy is a new method for the classification of axillary lymph nodes in breast cancer. The optimum technique for the pathological examination of sentinel lymph nodes (SLNs) is still under debate. MATERIALS AND METHODS: Different histopathological techniques were evaluated in order to study their diagnostic accuracy regarding the detection of metastases in 49 SLNs of 40 breast cancer patients. RESULTS: In single hematoxylin and eosin (HE) stained paraffin sections 18 out of 40 patients showed positive SLNs and 8 out of 40 showed positive axillary lymph nodes (ALNs). Serial sections with a spacing of 150 microns between following sections revealed an additional 4 and 5 cases with positive SLNs and ALNs, respectively. Single HE frozen sections showed 11 tumor positive SLNs among 25 patients. The ultrarapid-immunohistochemistry on single frozen sections confirmed these data and detected one additional case with isolated tumor cells in the lymph node sinus. CONCLUSION: Histopathological nodal staging of SLNs should include serial sections with a spacing of 150 microns between sections as well as immunohistochemistry. The ultrarapid-immunohistochemistry is a sensitive method for the detection of minimal metastatic disease in SLNs and can be applied intraoperatively.

Adult↗