ABSTRACT
After classification of the endocrine tumours of the pancreas our group of patients during the last 17 years is demonstrated including patients with nesidioblastosis in every case except one with islet cell carcinoma. Beside typical anamnesis and symptoms, diagnosis was confirmed mainly by the glucose/insulin-ratio, the extremely low fasting blood glucose and the increased need of glucose supply for normalisation. Medical therapy with somatostatin and/or diazoxide was not successful in any case for a longer time, although in persistent cases nesidioblastosis became treatable postoperatively with diazoxide. Usually, a so-called 7/8-resection was performed. Typical complications from surgical management of pancreatectomy did not occur none of the children died. As for long-term results, no patient suffered from insulin dependency or insufficiency of the exocrine pancreas; reoperation was also never necessary. The established neurological damage of children who had been operated on late, could not be repaired. Despite the heterogeneous forms of the samples, histochemical investigation established nesidioblastosis in every pancreas specimen. An explanation of the histological findings would be a failure of the B-cell-function as pathogenetic cause of nesidioblastosis.
Subject(s)
Adenoma, Islet Cell/surgery , Pancreatic Neoplasms/surgery , Adenoma, Islet Cell/diagnosis , Child, Preschool , Diagnostic Imaging , Female , Humans , Infant , Infant, Newborn , Male , Multiple Endocrine Neoplasia/diagnosis , Pancreatectomy/methods , Pancreatic Function Tests , Pancreatic Neoplasms/diagnosis , Risk FactorsABSTRACT
In 30 rats the healing process of colonic anastomosis contaminated with Staphylococcus aureus was studied. At the same time on each animals a single- and double-layer anastomosis was performed. All sutures were infected during the surgical procedure with highly infectious S. aureus. The rats were sacrificed after 1, 2, 3, 4 days, and 2 1/2 weeks. Criteria for estimation were mainly visible abscess formations, leakage spots, bacteriologic and histologic examinations. After apparent inflammatory reactions were seen on the first postoperative days with a maximum on the 4th day, all sutures were completely healed and free of S. aureus after 2 1/2 weeks. As for the extent of infectious inflammation, the single-layer suture technique proved to be more resistant than the double layer.
Subject(s)
Colon/surgery , Staphylococcus aureus/isolation & purification , Surgical Wound Infection/microbiology , Wound Healing , Animals , Disease Models, Animal , Female , Male , Rats , Suture TechniquesABSTRACT
Healing process of single- and double-layer sutures were demonstrated in rats after different degrees of mobilization. Clinical, angiographic, and histologic comparison demonstrates a prolonged healing process after more than 1-cm mobilization. Double-layer sutures showed a high rate of insufficiency.
