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  • 1
    Digitale Medien
    Digitale Medien
    Klinische Ergebnisse der Fundoplicatio (1975)
    Springer
    Langenbeck's archives of surgery 338 (1975), S. 9-26 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Fundoplication (Nissen Repair) ; Gastroesophageal Reflua ; Lower Esophageal Sphincter
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Zur Überprüfung der klinischen Ergebnisse der Fundoplicatio wurde eine Serie von 50 Patienten nach exakter Dokumentation der präoperativen Befunde manometrisch und röntgenologisch 3 Monate postoperativ nachuntersucht. Bei 49 Patienten konnte ein funktionsfähiger gastrooesophagealer Verschluß aufgezeigt werden; in einem Fall hatte sich die Fundusmanschette gelöst. Die präoperativ deutlich erniedrigten Ruhedrucke im unteren Oesophagussphincter (10,4 ± 3,7 mm Hg) konnten durch die Operation auf 19,0 ± 6,9 mm Hg angehoben werden. In 10% der Fälle bestanden unmittelbar postoperativ passagere Dysphagien, die sich in der Regel rasch zurückbildeten. Nur bei einem Patienten mußte eine persistierende Dysphagie behandelt werden. Zwei weitere Patienten waren intraoperativ unbeabsichtigt vagotomiert worden. Diese Ergebnisse werden im Hinblick auf ihre operativtechnischen Konsequenzen diskutiert.
    Notizen: Summary A series of 50 patients was studied by esophageal manometry and X-ray prior to fundoplication and for a three month thereafter. In 49 patients a functionally intact gastroesophageal junction was documented; in one patient disintegration of the plication occured. The resting pressure of the lower esophageal sphincter was found preoperatively in the range of 10,4 ± 3,7 mm Hg; postoperative values increased to 19,0 ± 6,9 mm Hg. 10 % of patients complained postoperatively of temporary dysphagia. Only in a single instance continued dysphagia had to be treated. Inadvertently two patients were vagotomized during the operation. The data are discussed in relevance to the technical details of the operative procedure.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01302723
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  • 2
    Digitale Medien
    Digitale Medien
    242. Zollinger-Ellison-Syndrom (1975)
    Springer
    Langenbeck's archives of surgery 339 (1975), S. 755-755 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Zollinger-Ellison syndrome, Diagnostic procedure ; Morphology ; Total gastrectomy ; Zollinger-Ellison-Syndrom ; Diagnostik ; Morphologische Befunde Totale Gastrektomie
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Die klinische Symptomatik, das diagnostische Vorgehen and die Therapie des Zollinger-Ellison-Syndom (Z.E.S.) sind Gegenstand zahlreicher Diskussionen gewesen. Anhand der eigenen Erfahrung bei 13 Fallen werden das Beschwerdebild und die notwendigen diagnostischen MaBnahmen (Serumgastrinbestimmung, Provokationsteste) dargestellt. Die morphologische Vielfalt der gastrinproduzierenden Tumoren wird durch immunhistologische and elektronenmikroskopische Befunde demonstriert. Als Therapie der Wahl hat die totale Gastrektomie zu gelten, da in einem hohen Prozentsatz die Gastrinome bereits metastasiert haben.
    Notizen: Summary The clinical symptomatology, diagnostic procedure and treatment of the Zollinger-Ellison syndrome (Z.E.S.) is discussed extensively. The authors' own experience in 13 cases is described to illustrate the symptoms and the necessary diagnostic steps (serum gastrin determination, provocation tests). The morphologic variety of the gastrin-producing tumors is shown by immunohistologic and electron-microscopic findings. Total gastrectomy is the therapy of choice, since most gastrinomas are metastasizing by the time they are recognized.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01257721
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  • 3
    Digitale Medien
    Digitale Medien
    166. Die Behandlung hochdifferenzierter Schilddrüsencarcinome - Thyreoidektomie oder stadiengerechtes Vorgehen? (1978)
    Springer
    Langenbeck's archives of surgery 347 (1978), S. 657-657 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Thyroid carcinoma, well-differentiated ; Thyroidectomy, total ; Thyroidectomy, neartotal ; Hochdifferenzierte Schilddrusencarcinome ; Totale Thyreoidektomie ; Intrakapsuläre Resektion
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Von 310 Schilddrüsencarcinomen, die von 1955-1975 zur Behandlung kamen, lagen in 34,3 % follikulare und in 28,1% papilläre Schilddrusencarcinome vor. Die Verlaufsbeobachtung hinsichtlich Rezidivrate und Überlebenszeit gestattet folgendes therapeutisches Konzept: Papilläre Schilddrusencarcinome ohne Lymphknotenmetastasen sollten durch totale Lobektomie tier befallenen Seite und subtotaler Lobektomie tier nicht erkrankten Seite therapiert werden, follikulare Carcinome wegen tier Möglichkeit einer erfolgreichen Radiojodnachbehandlung bei Auftreten von Fernmetastasen durch beidseitige intrakapsuläre Thyreoidektomie.
    Notizen: Summary Of 310 treated cases of thyroid carcinoma between 1955 and 1975, 34.3 % were of the follicular type, while 28,1% were papillar carcinomas. Observations regarding rate of recurrence and mortality yielded the following therapeutic concept: Papillar carcinomas without lymph node metastases should be treated with total lobectomy of the affected and subtotal lobectomy of the unaffected side. Follicular carcinomas should be treated with bilateral intracapsular thyroidectomy, since postoperative radioiodine treatment for metastases has been successful.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01579459
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  • 4
    Digitale Medien
    Digitale Medien
    Force velocity relations in vascular smooth muscle: The influence of pH, pCa, and noradrenaline (1976)
    Springer
    Pflügers Archiv 364 (1976), S. 135-141 
    Details
    ISSN: 1432-2013
    Schlagwort(e): Vascular smooth muscle ; Force velocity relation ; pH ; Calcium ; Noradrenaline
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The kinetics of vascular smooth muscle activity was studied by means of afterloaded isotonic contractions of the tetanized rat portal vein at varied pH (8.0–5.9), pCa (3.4–2.1), and during noradrenaline incubation (0.4 μg/ml). Under control conditions (pH 7.3, pCa 2.6) the following parameters of the force velocity relation were calculated:a of Hill's equation (relating to the isometric peak tension)=0.36;b (relating to the actual muscle length)=0.19 ML/s;V M (relating to the actual muscle length)=0.56 ML/s. Within the range of pCa between 2.0 and 3.2 the amount of force generation (=ΔP) depended on the extracellular calcium level whereas the extrapolated velocity of shortening of the unloaded preparation (=V M) did not. Also pH changes between 8.0 and 6.8 as well as noradrenaline incubation at a pH of 5.9 affectedΔP quite considerably, butV M only scarcely. At a pH of 6.3, however,V M was distinctly diminished, and a reduced calcium sensitivity of the ATPase was inferred from the shift of ED50 of extracellular calcium from 0.66 mM Ca at a pH of 7.3 to 1.56 mM Ca at a pH of 6.3 (P〈0.0005). It is concluded from these results that the experimental conditions—pCa between 2.0 and 3.2, pH between 8.0 and 6.8, and noradrenaline added at a pH of 5.9—obviously change the intracellular calcium concentration which influences the number of activated interaction sites rather than the velocity of crossbridge movement.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00585181
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  • 5
    Digitale Medien
    Digitale Medien
    Force velocity relationships in vascular smooth muscle (1975)
    Springer
    Pflügers Archiv 356 (1975), S. 33-45 
    Details
    ISSN: 1432-2013
    Schlagwort(e): Vascular Smooth Muscle ; Rat Portal Vein ; Force Velocity Relation ; Velocity of Shortening ; Sliding Filament Mechanism
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Force velocity relationships of isolated vascular smooth muscle preparations were examined in the tetanized rat portal-anterior mesenteric vein by means of afterloaded isotonic contractions. Lowering of the temperature from 37°C to 25°C caused an average decrease of the following parameters: maximal velocity of shortening at zero load from 0.51 to 0.28 muscle length/sec; maximal rate of tension increase (dT/dt) from 847 to 362 dyn/sec; mechanical tension developed at the maximum ofdT/dt from 43 to 34% of the peak force generation; constantb of Hill's equation from 0.18 to 0.09 muscle length/sec. The latency was prolonged from 0.33 to 0.56 sec, and the time-to-maximum ofdT/dt from 0.9 to 1.6 sec. Between 27°C and 37°C the followingQ 10 values were calculated: for the maximal velocity of shortening at zero load 1.56; for the maximal rate of tension increase 1.88; for the latency 1.63. No distinct influence of temperature could be observed on the extent of isotonic shortening at zero load (0.69 muscle length at 37°C), on the extent of peak force generation (1107 dyn at 37°C), and on constanta of Hill's equation (0.35 at 37°C). It is concluded that parameters of contraction velocity in vascular smooth muscle depend on temperature, whereas the extent of contraction is independent of temperature. These findings are discussed in connection with the theory of the sliding-filament mechanism.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00583519
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  • 6
    Digitale Medien
    Digitale Medien
    The dynamics of cross-bridge movement in vascular smooth muscle estimated from a single isometric contraction of the portal vein: The influence of temperature and calcium (1978)
    Springer
    Pflügers Archiv 378 (1978), S. 31-36 
    Details
    ISSN: 1432-2013
    Schlagwort(e): Force-velocity relation ; Vascular smooth muscle ; Portal vein ; Calcium ; Temperature ; Contractility ; Staircase phenomenon
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The velocity of the contractile elementV CE of the rat portal vein during a single isometric twitch was calculated from the ratio of the rate of tension increase (dT/dt) to the stiffness (dT/dL) of the series elastic element. This stiffness was considered as a linear function of tension (dT/dL=k · T), and thus the respective term wasV CE=(dT/dt)/(kT). A polynome of the 10th order was fitted to the time course of tension change within the first seconds of stimulation. From this function, the instantaneous values of forceT, rate of tension increasedT/dt, as well as the ratio(dT/dt)/T were computed. The series elasticity was treated as the respective stiffness factor ‘k’.V max isV CE extrapolated to zero load, and this value gives an index of the turnover rate of the myosin cross-bridges. The experiments were carried out at different temperatures (37° C, 30° C, and 25° C) as well as at different intracellular calcium levels occurring as a staircase phenomenon in the first contractions after a period of non-stimulation of 20 min. With increasing temperature,T remained constant but there was an increase inV max (Q 10=1.9), peakV CE (Q 10=1.8) and in (dT/dt)max (Q 10=1.8). Furthermore, this so-called ‘tachytropic’ effect of temperature showed a reduction of the time to the maximumdT/dt (Q 10=1.4), and to the peakV CE (Q 10=1.2). During a staircase cycle the parameters describing the contractile state, i.e. theV max, the time to maximumdT/dt, and the time to peakV CE remained constant.T, maximumdT/dt and peakV CE were, however, considerably increased. These results are typical of the socalled ‘polytropic’ effect of calcium. The experimental results obtained from the isometric force-velocity relation were compared with those calculated by means of isotonic contractions in previous experiments. There were similar changes in the dynamics of contraction, irrespective of the method used for calculation ofV max; this was the case in experiments with varied temperatures and calcium levels. Therefore the determination ofV max from a single isometric contraction seems to be a suitable method of describing the elementary process of contraction in vascular smooth muscle. This method showed a higher time resolution as compared with other methods using isotonic contractions.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00581955
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  • 7
    Digitale Medien
    Digitale Medien
    Force-velocity relations of the portal vein of hyperthyroid rats (1977)
    Springer
    Pflügers Archiv 372 (1977), S. 23-27 
    Details
    ISSN: 1432-2013
    Schlagwort(e): Vascular smooth muscle ; Portal vein ; Contractility ; Thyroxine ; Hyperthyroidism
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The effect of thyroxine on the elementary process of contraction of vascular smooth muscle was tested in 38 hyperthyroid and in 38 control rats. Hyperthyroidism was induced by i.p. injections of triiodthyronine or 1-thyroxine for 2 weeks. By means of afterloaded isotonic contractions of the tetanized portal vein force velocity relations were calculated. There was a slight increase in both the extrapolated velocity of shortening at zero load [from 0.93±0.04 ML/s (control rats) to 1.03±0.04 ML/s (hyperthyroid rats;P〈0.05)], and the peak force generation (from 14.8±0.4 mN to 16.1±0.4 mN;P〈0.005). The maximum of mechanical power development at a distinct extent of afterload was augmented from 1.35±0.06 μW/ML to 1.68±0.06 μW/ML (P〈0.0005). The influence of thyroxine on the elementary process of contraction in vascular smooth muscle is discussed in connection with the much stronger effect of hyperthyroidism on cardiac muscle contraction.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00582202
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  • 8
    Digitale Medien
    Digitale Medien
    The temperature dependence of parallel and series elastic elements in the vascular smooth muscle of the rat portal vein (1978)
    Springer
    Pflügers Archiv 378 (1978), S. 25-30 
    Details
    ISSN: 1432-2013
    Schlagwort(e): Series elastic element ; Length-tension relation ; Portal vein ; Vascular smooth muscle ; Temperature dependence of elasticity
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The stiffness of a parallel (PE) as well as of a series elastic element (SE) in the isolated rat portal vein was determined at 37° C and at 25° C. The lengthtension curve of the PE was obtained by a stepwise lengthening of the preparation and showed no temperature dependence for the element: the mean extension of the PE was 48.8% of the optimum lengthL 0 at 37° C, and 47.3% ofL 0 at 25° C when loaded with the maximum active forceT 0. The maximum force occurred at both temperatures with the same muscle length. Even the stiffness factor, i.e. the slope ‘k’ of the linear functiondT/dL=kδT+c showed no temperature dependence. The series elasticity was determined by means of the quick-release technique from afterloaded isometric contractions of the tetanized preparation. A distinct temperature influence was revealed by the decrease of the mean SE extension from 13.5% ofL 0 at 37° C to 10.9% ofL 0 at 25° C (P〈0.0005). The stiffness factor, normalized to the actual muscle length, was 12.0 per ML at 37° C and 14.7 per ML at 25° C (P〈0.025). The values obtained for the portal vein are equivalent to those calculated for other smooth muscle preparations but the stiffness of series elasticity is well below that found in the cardiac and skeletal muscle.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00581954
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  • 9
    Digitale Medien
    Digitale Medien
    Therapy of breast cancer (1978)
    Springer
    Langenbeck's archives of surgery 346 (1978), S. 65-79 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Breast cancer ; Therapeutical modalities ; Surgical therapy ; Adjuvant chemotherapy ; Radiation therapy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01261394
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  • 10
    Digitale Medien
    Digitale Medien
    Klinische, diagnostische und operationstechnische Erfahrungen mit B- Zelltumoren des Pankreas (1975)
    Springer
    Langenbeck's archives of surgery 338 (1975), S. 123-136 
    Details
    ISSN: 1435-2451
    Schlagwort(e): Hypoglycemia ; Insulinoma ; Duodenopancreatectomy ; Multiple Endocrine Adenomatosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Zusammenfassung Ursache eines organischen Hyperinsulinismus ist in der Mehrzahl der Fälle ein B-Zelltumor des Pankreas. Klinik, Diagnostik und Therapie der Erkrankung werden anhand von 25 Kranken besprochen, wobei besonders auf die operationstechnischen Probleme eingegangen wird. Die Therapie der Wahl ist eine operative Entfernung des Tumors, die sich bei Kenntnis der Lokalisation relativ einfach gestaltet. Eine wesentliche Hilfe bietet die prä-operative Angiographie, mit der 73 % der Tumoren dargestellt werden konnten. Unsere operativen Erfahrungen in einer fortlaufenden Serie von 25 Fällen bestätigten die Sicherheit der modernen internistischen Diagnostik, da alle vermuteten Tumoren aufzufinden waren. Vor schwere Entscheidungen wird der Chirurg bei okkulten Insulinomen gestellt, da ein Abwarten die Chance der Lokalisierung nicht verbessert und die Gefahr irreversibler Hirnschäden verstärkt. Vor- und Nachteile der verschiedenen operativen Möglichkeiten werden diskutiert.
    Notizen: Summary In the majority of cases a functioning pancreatic isletcell-tumour is responsible for an organic hyperinsulinism. Symptoms, diagnostic and therapeutic possibilities are discussed on the basis of the data of 25 patients with special consideration of surgical treatment. Removal of the tumour is the adequate therapy, relatively easy to perform, if the localization of the tumour is known. A significant help in this regard was preoperative, selective angiography with a 73 % detection rate. Our experience in operative treatment in a serie of 25 cases confirms the confidence in modern preoperative diagnostic procedures, because all suspected tumours could be found. In cases of occult insulinomas it is difficult to chose the adequate operation since the chance of localization of the tumours is not increasing by time, but irreversible brain damage has to be feared. Advantage and disadvantage of the different operative possibilities are discussed.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01261583
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