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Biomedical subjects

V Zumtobel

Publications and source records attributed to V Zumtobel.

At least 73 records · Page 4Linked to original sources

[Study on the genesis of diffuse intravascular coagulation after implantation of a peritoneal-jugular le veen shunt (author's transl)].

In a 68-year-old woman with cirrhosis of the liver an attempt was made to treat the intractable ascites by a peritoneal-jugular shunt. In the course of the two-week continuous reinfusion of ascites a disseminated intravascular coagulation (DIC) developed which made a ligation of the shunt necessary. After ligation the fibrinogen and platelets rose to normal levels. To evaluate the relationship of the DIC to the continuous reinfusion of ascites, a coagulation profile of the ascitic fluid of a number of patients was performed. It could be demonstrated that the procoagulant activities and factors inhibiting coagulation varied widely although, in some cases, procoagulant factors predominated. Furthermore, in the ascitic fluid of the one patient described in detail activation of the contact factor could be shown following implantation of the shunt. The results of these investigations suggest that in future candidates for a Le Veen shunt, in vitro clotting tests should be performed of the ascitic fluid and a probatory reinfusion of a large amount of ascitic fluid with a parallel evaluation of the most important clotting parameters. A patient at risk to develop DIC following the insertion of a Le Veen shunt perhaps could thus be recognized prior to such a procedure.

Aged↗

[Prevention and therapy of gastroduodenal stress bleeding with cimetidine].

In our intensive care unit we were able to prevent almost all bleedings from stress ulcerations in patients with insufficiency of various organs (1,6%) by administering the H2-receptor blocker cimetidine in doses of 8 X 200 mg per day. However, stress ulcer bleedings occurred in 14% of those patients also suffering from a sepsis. At lower doses of cimetidine, the rate of bleeding was comparable to that encountered in patients treated with antacids, i.e. 12,5% patients with multiple organ insufficiency and 42,7% with sepsis. Cimetidine was able to stop less extensive bleedings, but did not show any therapeutic effect in case of bleeding which led to a significant fall in hemoglobin concentration.

Cimetidine↗

[Prevention and therapy of gastroduodenal stress hemorrhage in intensive care patients using the histamine H2-receptor antagonist cimetidine].

In our intensive care unit we were able to prevent almost all bleedings from stress ulcerations in patients with insufficiency of various organs by administering the H2-receptor blocker, cimetidine, in doses of 200 mg eight times per day. However, stres ulcer bleedings occurred in 14% of those patients also suffering from a sepsis. At lower doses of cimetidine, the rate of bleeding was comparable to that encountered in patients treated with antacids, i.e. 12.5% patients with multiple organ insufficiency and 42.7% with sepsis. Cimetidine did not show any therapeutic effect in case of bleeding which led to a significant fall in hemoglobin concentration.

Cimetidine↗

[Hydroxyethyl starch (HAS 450/0.7) in human plasma and liver. Course of concentration and histological changes].

In 12 patients 1,000 ml hydroxyethyl starch (Mw 450,000, degree of substitution 0.7) was infused intravenously. A liver biopsy was performed in 10 patients undergoing abdominal surgery 30 minutes to 28 days after the infusion. The liver tissue was investigated by light and electron microscopy. The plasma level of hydroxyethyl starch decreased to 4.8% of the initial concentration 28 days after the infusion (Anthron method). Single intracellular vacuoles were shown by electron microscopy 30 minutes after the end of infusion in Kupffer's cells only. However, 6 to 28 days after infusion intracellular vacuoles were demonstrated in parenchymal liver cells, Kupffer's cells, interstitial histiocytes and to a lesser degree in the cells of the small bile ducts. The pathogenic importance of the portracted elimination from the plasma and the liver storage is unknown.

Adult↗

[Malignant polyps and early recognized carcinomas of the rectum. Morphological aspects and selective surgical treatment (author's transl)].

The lymphatic drainage of the colon and rectum originates in the submucosal layer. Therefore metastases do not arise from carcinomas confined to the mucosa, and for the same reason the WHO lately recommended to call these lesions severe atypism. The term adenocarcinoma should be reserved in the case of infiltration of the carcinoma into the submucosa. According to the features outlined above adenomas of the rectum showing severe atypism can be removed by careful excision of the mucosa. Even adenomas containing an early diagnosed adenocarcinoma up to 2.5 cm in diameter often can be cured by a local resection of the rectal wall, if no metastases have occurred. From 1971--December 1, 1977, 12 rectal adenomas with severe atypism and 14 rectal adenomas with adenocarcinoma had been removed locally without complications. After 6 years there was no recurrence of carcinoma.

Aged↗

[Proximal selective vagotomy: results of a prospective study (author's transl)].

In 728 patients operated on because of gastroduodenal ulcers there were early complications in 7.6% and a lethality of 0.13%. Primary drainage operation was performed in 9.5%, secondary drainage in 0.9%. One year after operation, reduction of BAO was 60% and of PAO 50%, in cases of recurrence only 35 and 30%. Postoperative recurrence of duodenal ulcer was seen in 3.1% after one year and in 5.5% after two years. Recurrence of gastric ulcer became apparent in 9.3% after one year and in 3.4% after two years. Reoperation for recurrence was performed in 1.3%.

Drainage↗

[Manometric study on the effect of proximal vagotomy on the lower esophageal sphincter].

Selective proximal vagotomy (SPV) decreases the LES pressure (resting pressure and pentagastrin-stimulated pressure), significantly 6 months postoperatively without achieving LES insufficiency by clinical means. Immediately after stimulation LES pressure is identical, compared to preoperative measurements. The postoperative significantly increased concentration of basal gastrin seems not to be a major determinant of LES tone in humans.

Adult↗

[Manometric studies on the influence of selective proximal vagotomy on the lower esophageal sphincter].

Selective proximal vagotomy (SPV) decreases the LES pressure (resting pressure and pentagastrin-stimulated pressure), significantly 6 months postoperatively without achieving LES insufficiency by clinical means. Immediately after stimulation LES pressure is identical, compared to preoperative measurements. Concentration of serum gastrin is not a major determinant of LES tone in humans.

Cardia↗

[Prophylaxis of acute gastric erosions with vitamin A in the rat (author's transl)].

The protective effect of Vitamin A against stress-induced ulcerations of the gastric mucosa was investigated by the hypoxic stress model of the rat. The incidence of acute mucosal erosions in the main stomach was significantly reduced by intramuscular application of 125 000 - 500 000 U Vitamin A/kg body weight prior to or immediately after the onset of stress. A dosage smaller than that or an application 2 hours after the onset of stress had no influence on the development of the acute mucosal erosions.

Animals↗

[Atypical suprarenal aortic stenosis as a cause of hypertension in young people (author's transl)].

In nine of ten hypertensive patients with "atypical" suprarenal aortic stenosis (aged 20 to 51 years, mean 28.5 years), operative treatment of the stenosis reduced blood pressure to normal. In the tenth patient, combined vascular and reno-parenchymal hypertension was effectively treated by drugs, the dosage of which could be reduced after resection. Aorto-aortic bypass was the operative procedure of choice because of its lower risk and better results than other methods. In a review of 346 cases of atypical coarcation reported in the literature, two-thirds were found to be located above or at the level of the renal arteries, causing marked hypertension. Surgical procedures and results in 136 operated cases are tabulated and discussed.

Adult↗

[Animal experiments on the prevention of acute gastric mucosa erosions using vitamin A].

A significant reduction of vitamin A serum levels was observed in rats which underwent a hypoxic stress. The number of gastric ulcerations secondary to stress can be significantly reduced by 125 000 to 250 000 I. E. of vitamin A applicated parenterally prior or with the onset of stress. Consequently a prophylaxis of stress ulcerations appears to be possible by application of vitamin A.

Acute Disease↗