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Biomedical subjects

W W Rittmann

Publications and source records attributed to W W Rittmann.

At least 19 recordsLinked to original sources
PubMed1992

[Incidence of recurrence in long-term follow-up of 100 patients after surgery for primary hyperparathyroidism].

The percentages for recurrence or persistence of hyperparathyroidism after operation for pHPT vary between 3 and 7% according to the pertinent literature. These groups of authors have a broad experience based on a large number of patients treated. At our institute we have operated for pHPT an average of 5 patients per year. Given our limited experience we reexamined 100 consecutive patients which were operated for pHPT between 1968 and 1988 in order to determine our own rate of recurrence. The rate for persistent or recurrent hyperparathyroidism was at 8% slightly higher than in the literature reviewed. When reexamining the patients we took the history concerning the preoperative symptomatology and its postoperative course. Furthermore we compared a radioimmunoassay measuring the midmolecule region of the parathyroid hormone with a immunochemiluminometric assay determining the intact and biologically active hormone regarding sensitivity and specificity. The results are presented and compared with the literature reviewed.

Aged↗
PubMed1991

[Rectum resection with colo-anal anastomosis and formation of a colonic J pouch in deep rectal cancer].

Sphincter-saving operations are now generally accepted for the treatment of mid-rectal cancers. Different techniques have been described: low colorectal anastomosis with staplers, pull-through procedures and coloanal anastomosis. The functional results following these procedures are impaired by loss of the reservoir function of the rectum. To avoid frequency and urgency a J-shaped colonic reservoir is constructed and anastomosed to the anal canal. We are presenting our first four cases using this technique. All patients are personally reviewed 19-29 months after the operation. In correspondence with the literature all our patients had a good functional result with good continence and only one bowel movement per day. We conclude the creation of a neorectum makes the functional result of a coloanal anastomosis more predicable.

Anal Canal↗
PubMed1990

[Value of systemic and local administration of antibiotics in soft tissue and bone infections].

There is little data to support the efficacy of prophylactic antibiotics in traumatology. In closed fractures three randomized controlled studies using a 1-3 day prophylaxis with Cephalosporins of the first or second generation or a Penicillinase-resistent Penicillin demonstrated a reduction of the infection rate. For the Cephalosporins of the second generation it was shown, that a single dose was less efficient than five repeated applications over 24 hours. In hip-fractures a prophylaxis with Cephalothin or Cefotiam reduced the frequency of infections when compared with controls. In open fractures a treatment over 10 days using Cephalothin or Isoxazolyl-Penicillin showed a significant drop of the infection rate. If however the fractures were not treated using the principles of rigid internal fixation and were covered with Dicloxacillin over 2 days only there was no significant improvement. A multicenter study finally indicates that a one day course of cefonicid sodium is not inferior to a prolonged course of antibiotics for prevention of early postoperative fracture-site infections. We conclude, that open and closed fractures can profit from antibiotic prophylaxis which starts immediately before surgery and is continued over 24 hours. We favour Isoxazolyl-Penicillin because of its efficacy against staphylococcus aureus and epidermidis which predominate in early infection. In established bone and soft tissue infections antibiotics are used when there is local spreading, sepsis, involvement of joints or when reinterventions in the infectious focus are necessary. In these cases bacteriological testing in the laboratory is essential for the selection of antibiotics. Local application of antibiotics in irrigation-drainage solutions can not be recommended. PMMA-chains serve as temporary spacers, but should be removed early before their extraction becomes difficult and resistant bacteria develop. When defects are closed with cancellous bone or soft tissues the use of Gentamycin-fleece or Taurolin-gels is recommended.

Administration, Topical↗
PubMed1989

[Paralyses of the recurrent laryngeal nerve following strumectomy in late follow-up].

Over a period of 5 years, 323 patients underwent an operation on a goiter. A postoperative paralysis of the recurrent laryngeal nerve occurred in 31 patients, most in malignancies and recurrent goiters. 26 patients were controlled at least 1 year after operation. 65% of the patients have a fully recovered voice and normal vocal cord function. Another 14% showed a normal voice for daily use by functional compensation of the paralysis. Only in 4 patients (16%) the operation resulted in a permanent modest or severe hoarseness as consequence of a thyroidectomy in cancer.

Follow-Up Studies↗
PubMed1987

A double-blind clinical trial of prophylactic cloxacillin in open fractures.

In 100 patients with first-, second-, and third-degree open fractures, a randomized, double-blind study was carried out to compare prophylactic cloxacillin and placebo. Prophylaxis was started preoperatively and continued for 10 days. The standard fracture treatment consisted of operative stabilization, mostly by means of plates or external fixators. In the cloxacillin group two infections were observed as compared to 12 in the control group. This difference was significant.

Adolescent↗
PubMed1979

[Caerulein and the test meal: a comparison of their effects on pancreatic exocrine secretion in the dog].

Relatively small doses of caerulein (10, 20, 40, 100 ng/kg/h) were given to conscious dogs with chronic duodenal and gastric fistulas and the exocrine pancreatic response was compared with that obtained by a test meal. Test meal stimulated pancreatic secretion was nearly equivalent to that achieved with 10 ng caerulein/kg/h. Plasma secretin levels did not significantly change during test meal stimulation.

Animal Feed↗
PubMed1978

Comparison of the biological potency of a new synthetic preparation of secretin with that of natural porcine secretin in the dog.

The biological activity of the new synthetic secretin, Roche, on exocrine pancreatic secretion was determined in conscious dogs with chronic gastric and duodenal fistulae and compared with that of pure porcine secretin (GIH, Karolinska Institutet, Stockholm). The two secretin preparations were found to be equipotent as to pancreatic volume and bicarbonate response on a molar basis. It was concluded that the new synthetic secretin is useful for clinical and research purposes.

Animals↗
PubMed1978

Effect of somatostatin on exocrine pancreatic secretion stimulated by pancreozymin-secretin or by a test meal in the dog.

In 4 dogs with chronic duodenal and gastric fistulae, exocrine pancreatic function was assessed by cannulating the pancreatic duct and collecting the duodenal contents. Both methods were applied in each animal. Pancreatic secretion was stimulated by infusion of 2 CHR units of pancreozymin and secretin or by administration of a liquid test meal, injected into the stomach through the gastric fistula. During both experiments 3.5 microgram/kg somatostatin was given as bolus injection followed by an infusion of 3.5 microgram/kg/h. Somatostatin caused a significant reduction in protein and amylase output and in the bicarbonate concentration during stimulation with pancreozymin-secretin. Volume and bicarbonate slightly decreased but not to a significant extent. Duodenal volume and the duodenal activities of trypsin and amylase were significantly reduced during test meal stimulation and somatostatin infusion. Somatostatin is a potent inhibitor of exocrine pancreatic function mainly influencing enzyme secretion.

Amylases↗
PubMed1978

The endogenous release of pancreatic polypeptide by acid and meal in dogs. Effect of somatostatin.

The response of pancreatic polypeptide (PP) to testmeal (5 ml/kg) and intraduodenal acid (4 mEq HCl/5min) and its reaction to somatostatin (3.5 microgram/kg/h following bolus injection of 3.5 microgram/kg) was studied in dogs with chronic duodenal and gastric fistulae. In addition the influence of atropin (0.5 mg/kg/h) on acid-induced PP response was examined. PP was measured by radioimmunoassay pancreatic secretion by determinating volume, bicarbonate, protein, and enzyme in duodenal contents and pancreatic juice. Plasma PP increased significantly following intraduodenal application of testmeal and hydrochloric acid. Its release was completely suppressed by SST. Furthermore, PP response to intraduodenal acid was blocked by atropin. Exocrine pancreatic secretion of bicarbonate and protein was inhibited by somatostatin as well as atropin. Since PP was released following administration of testmeal and acid, both potent stimulators of pancreatotropic duodenal hormones, it may play an important role in the control of the entero-pancreatic axis. The effect of atropin indicates a cholinergic nervous component of PP release.

Amylases↗
PubMed1978

[Antibiotic prophylaxis: definition and documentation].

Controlled, randomized and prospective studies were reviewed to evaluate the value of antibiotic prophylaxis in colonic and biliary tract surgery as well as in the treatment of open fractures. --Colorectal surgery: 7 studies using oral and 3 using parenteral antibiotics in addition to extensive bowel preparation have demonstrated the importance of a short term prophylaxis, instituted before surgery and discontinued soon thereafter. Different antibiotics with aerobic or anaerobic spectra reduced the incidence of wound infections significantly; further improvement could be expected from combinations covering both spectra. --Biliary surgery: cefazolin, gentamycin and rifamycin--used in four controlled studies--were effective in reducing infectious complications. No distinction was made between patients of different infectious risks. In low risk gallbladder surgery the real value of antimicrobial prophylaxis is unknown. Short term prophylaxis is recommendable in all high risk patients undergoing surgery and in the low risk case submitted to extensive interventions. --Open fractures: only three authors have submitted their patients to controlled studies. All protocols suffered from some bias. No definite conclusions can be made. The authors' personal recommendations are: no prophylaxis in first degree injuries; early preoperative administration of penicillinase-resistant drugs in second and third degree lesions.

Administration, Oral↗
PubMed1977

[Effect of somatostatin on canine exocrine pancreas secretion stimulated by pancreozymin, secretin or test meal].

In 4 dogs with pancreatic and gastric fistulae the effect of somatostatin (SST) on the pancreas was investigated during stimulation by pancreozymin-secretin or by a test meal. The pancreozymin-secretin-induced enzyme output and bile flow, as well as the enzyme concentration and duodenal volume during test meal stimulation were significantly reduced by SST. SST caused a less marked decrease in bicarbonate concentration, while volume and bicarbonate output did not change.

Animals↗
PubMed1977

Influence of glucagon on exocrine pancreatic function as determined by the Lundh test in dogs.

Exocrine pancreatic function was investigated by means of the Lundh test model in dogs with chronic duodenal and gastric fistulas. The test was standardized and the effect of glucagon on exocrine pancreatic secretion was evaluated. The mean tryptic activity detected in 18 tests in 6 dogs was 32.25 +/- 5.25 muEqH+/minute/ml, which is considerably higher than that observed in man. The administration of glucagon was followed by a significant decrease (30.8%) in the volume of the duodenal contents and a more pronounced depression of the enzyme concentrations (trypsin 59%, chymotrypsin 53.3%). It is concluded that the Lundh test affords a valuable experimental model for the investigation of exocrine pancreatic function in dogs.

Animals↗