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  • Articles: DFG German National Licenses  (2)
  • Aorta  (1)
  • Cardiac arrest  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Kinetics and characteristics of an acute phase response following cardiac arrest (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1386-1394 
    Details
    ISSN: 1432-1238
    Keywords: Key words Hypoxia ; Ischemia ; Acute phase proteins ; Cardiac arrest ; Infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Inflammation and hypoxia are frequently associated, but their interaction is poorly understood. In vitro studies have shown that hypoxia stimulates the genes of acute phase proteins (APP) and cytokines known to induce APP. We decided to determine kinetics and potential determinants of an acute phase response after cardiac arrest and to assess whether isolated moderate hypoxia can induce APP in humans in vivo. Design: Prospective, observational study in patients and human experiment. Setting: Tertiary care university hospital. Patients and participants: 22 patients after primarily successful cardiopulmonary resuscitation (CPR) and 7 healthy volunteers. Interventions: None in patients; exposure of volunteers to simulated altitude (460 torr/6 h). Results: Following CPR, type-1 APP (C-reactive protein, α1-acidglycoprotein, serum amyloid A) and type-2 APP (haptoglobin, α1-antitrypsin) increased consistently within 1–2 days and the ’negative' APP transferrin was downregulated. This APP response occurred irrespective of the cause of arrest, the estimated time of anoxia, clinical course or patient outcome and was not different in patients with and without infectious complications. Exposure of healthy volunteers to less severe but more prolonged hypoxia did not induce APP, although a time dependent increase of serum erythropoietin (EPO) was measurable under these conditions, indicating the activation of oxygen dependent gene expression. Conclusions: (i) A marked acute phase response occurs regularly after cardiac arrest, but within the complexity of this situation the severity of hypoxia is not a predominant determinant of this response. (ii) Despite in vitro evidence for similarities in the oxygen dependent regulation of APP and EPO production, the oxygen sensitivity of these proteins in vivo is different. (iii) Measurements of APP are not revealing regarding infectious complications in the early phase after CPR.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051086
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Primärer maligner intraluminaler Tumor der Aorta (1997)
    Springer
    Langenbeck's archives of surgery 382 (1997), S. 138-140 
    Details
    ISSN: 1435-2451
    Keywords: Key words Malignant tumors ; Aorta
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Primäre maligne Tumoren der Aorta sind seltene Erkrankungen. Wir beschreiben hier unser therapeutisches Vorgehen bei einem 55jährigen Patienten. Der Patient wurde mit einer progredienten Niereninsuffizienz in unserer Klinik aufgenommen. Bei der Angiographie fanden sich ein Verschluß der rechten und eine hochgradige Stenose der linken Nierenarterie. Die Diagnose des intraluminal wachsenden malignen Aortentumors wurde aus dem bei der Angiographie gewonnenen Thrombenmaterial bestätigt. Fünf Monate zuvor wurde bei der histologischen Aufarbeitung von Thrombenmaterial der Verdacht anläßlich einer aortobiiliakalen Protheseninterposition wegen eines akuten Leriche-Syndroms geäußert. Bei der Computertomographie fanden sich Veränderungen in der Aorta etwa 2 cm oberhalb des Truncus coeliacus beginnend. Es erfolgte der thorakoabdominale Aortenersatz unter Resektion der Aorta und des periaortalen Gewebes und der Nephrektomie und Adrenalektomie links. Die Protheseninterposition wurde von der mittleren Aorta descendens bis zur Bifurkation beider Beckenarterien unter Resektion der alten aortobiiliakalen Prothese durchgeführt. Truncus coeliacus und A. mesenterica superior wurden über je ein Prothesensegment in die Aortenprothese reimplantiert. Drei Wochen nach der Erstoperation erfolgte die Nephrektomie rechts. Der postoperative Verlauf gestaltete sich unproblematisch.
    Notes: Abstract Primary malignant tumors of the aorta are only rarely reported. We describe here our findings in a 55-year-old patient who was referred to us with progressive renal insufficiency. At angiography, right renal artery occlusion and high-grade stenosis of the left renal artery was found in this patient, who had undergone aortobiliacal reconstruction for acute Leriche syndrome 5 months previously. Histological evaluation of thrombotic material revealed an intraluminal malignant tumor to be the underlying cause. This diagnosis was then confirmed in samples harvested during angiography. CT scan showed an extension beginning 2 cm proximal to the celiac trunk. The patient was treated by thoracoabdominal resection of the aorta, including the paraaortal tissue, left side nephrectomy, and adrenalectomy. A thoracoabdominal aortic prosthesis was inserted up to the iliacal bifurcations and the celiac and su-perior mesenteric arteries reimplanted. Right nephrectomy followed 3 weeks later. The postoperative course was uneventful.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00008031
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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