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  • 11
    Electronic Resource
    Electronic Resource
    Quantitative assessment of whole body galactose metabolism in galactosemic patients (1997)
    Springer
    European journal of pediatrics 156 (1997), S. S43 
    Details
    ISSN: 1432-1076
    Keywords: Key words Galactosemia ; [13C]galactose (stable ; isotope) ; Breath test ; Endogenous galactose synthesis ; GALT genotype
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We employed [1-13C]galactose in isotope kinetic studies to delineate whole body galactose metabolism in vivo in patients with galactose-1-phosphate uridyltransferase (GALT) deficiency. The data in three control and three adult galactosemic subjects, homozygous for the most common GALT gene defect, the Q188R mutation, and with absent RBC GALT activity, revealed an apparent endogenous galactose synthesis rate of 0.53-1.05 mg/kg per hour. Unlike normal children and adults who eliminated 3%– 6% and 21%–47% of an intravenous bolus of [1-13C] galactose as 13CO2 in expired air in 1 and 5 h respectively, classic galactosemic patients, either Q188R/Q188R or Q188R/unknown, released almost none in 1h and 3%–6% in 5h. In contrast, an African-American galactosemic variant patient with a S135L/S135L mutation and no residual RBC GALT activity oxidized [1-13C]galactose to 13CO2 at a rate comparable to control subjects. Individuals homozygous for the Duarte mutation, N314D/N314D and Q188R/ N314D, Q188R/+ and S135L/+ subjects also had normal breath test results. Not surprisingly, the Q188R/Q188R classic galactosemic patient cannot handle an acute galactose load, failing to match a control subject in the rapid conversion of [1-13C]galactose to [13C]glucose and 13CO2. However, classic patients synthesize substantial quantities of galactose de novo and on a lactose-free diet must oxidize comparable amounts of galactose to maintain steady-state levels of galactose and galactose metabolites such as galactose-1-phosphate, galactitol and galactonate. In vivo isotope kinetic analyses may allow us to understand better these aspects of galactose metabolism and, through the use of studies in variant galactosemics, perhaps allow us to begin to unravel the pathophysiology of galactosemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00014271
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  • 12
    Electronic Resource
    Electronic Resource
    Die Rekonstruktion von Narbenhernien – Intraoperative Tensiometrie zur Objektivierung der Verfahrenswahl (1996)
    Springer
    Der Chirurg 67 (1996), S. 1020-1027 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Incisional hernia ; Recurrence ; Intraoperative tensiometry ; Inlay/onlay technique.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Das Wiederauftreten eines Narbenbruches nach erfolgter Rekonstruktion ist abhängig von der Größe des Bruches und der Spannung der Bauchwand. Ein zusätzlicher Risikofaktor ist die ansteigende Bruchwertigkeit, d. h. wieviele Rekonstruktionen bereits erfolgten. Den entscheidenden Einfluß hat die Operationstechnik und die bei dieser Rekonstruktion angelegte Spannung zur Rekonstruktion. Um eine funktionelle Rekonstruktion zu erreichen, muß die Bruchlücke verschlossen und die Bauchwand in ihre ursprüngliche anatomische Lage gebracht werden. Die jeweils dazu erforderliche hohe Zugspannung muß durch die jeweilige Technik toleriert werden. Wird willkürlich eine Spannung an eine Rekonstruktion angelegt, so weisen Direktverschluß, Fasciendoppelung wie auch die Implantation von Fremdmaterial Stoß auf Stoß hohe Rezidivraten auf. Durch die intraoperative Spannungsmessung (Tensiometrie) kann eine individuelle Zuordnung des jeweiligen Bruches (Größe, Wertigkeit, Spannung) zur geeigneten Technik vorgenommen werden. Die Inlay/Onlay-Technik toleriert hierbei größere Spannungen bis maximal 3,5 kp. Mit diesem Verfahren und der Maximalspannung von 3,5 kp konnten 65,1 % der Narbenhernienrezidive komplett funktionell rekonstruiert werden und weisen eine Rezidivrate von 2,3 % auf.
    Abstract: Schlüsselwörter: Narbenhernien – Rezidive – intraoperative Tensiometrie – Inlay/Onlay-Technik.
    Notes: Summary. The reappearance of incisional hernias after reconstruction depends on the size and tension of the hernia. An additional risk factor is the number of operations that have been performed before. There are two decisive factors that influence the rate of recurrence: the operation technique and the tension applied. To reach a functional reconstruction the incisional hernia must be closed and the abdominal wall must be joined together in an anatomical way. The technique used must be able to tolerate the tension which is necessary to close the abdominal wall. Application of arbitrary tension produces a high rate of recurrence, irrespective of the kind of reconstruction used. Through the intraoperative measurement of the tension applied one can match each hernia (according to size, value and tension) to the most suitable technique. Here the inlay/onlay technique tolerates the highest tension, up to 3.5 kp. With this method and a maximum tension of 3.5 kp we achieved a complete functional reconstruction in 65 % of cases and our rate of recurrence amounted to 2.3 %.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050098
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  • 13
    Electronic Resource
    Electronic Resource
    Detection of neopterin, interleukin-6 and acute-phase proteins as parameters of potential monocyte activation in preoperative patients (1995)
    Springer
    Infection 23 (1995), S. 263-266 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Monozyten besitzen eine Schlüsselrolle bei der Immunantwort auf Trauma und Infektion. Kann eine Änderung der Monozytenfunktion bereits präoperativ nachgewiesen werden? Zum Zeitpunkt der stationären Aufnahme lagen die Serum-Neopterinspiegel bei 52% von 227 elektiven, abdominal-chirurgischen Patienten über 9 nmol/l und Serum-IL-6 war bei 10,5% nachweisbar (über 4 pg/ml). Die Mittelwerte von CRP (0,8 vs. 3,6 mg/dl), α-1-Antitrypsin (267 vs. 376 g/l), Albumin (4,0 vs. 3,5 g/dl), Präalbumin (27,0 vs. 17,9 mg/dl, alle p〈0,01) unterschieden sich signifikant bei Patienten mit und ohne Monozytenaktivierung (Neopterin 〉 9 nmol/l und IL-6〉4 pg/ml). Zwischen Neopterin und den Akute-Phase-Proteinen bestand eine signifikante Korrelation (alle p〈0,01). Bereits präoperativ konnte bei einer Gruppe von Patienten eine Aktivierung von Teilbereichen des Immunsystems nachgewiesen werden, die potentiell die Immunantwort auf das operative Trauma und die intraund postoperative bakterielle Kontamination beeinflußt.
    Notes: Summary Monocytes play a key role in the immune response to trauma and infection. Is monocyte function already altered before surgery in terms of cell activation? On admission, serum neopterin was at or above 9 nmol/l in 50.2% and serum IL-6 was detectable (〉 4 pg/ml) in 10.5% of 227 patients electively undergoing major abdominal surgery. Mean values of CRP (0.8 vs. 3.6),α-1-antitrypsin (267 vs. 376), albumin (4.0 vs. 3.5), prealbumin (27.0 vs. 17.9, all at p〈0.01) were significantly different in patients with or without monocyte activation (neopterin 〉 9 nmol/l and IL-6〉4 pg/ml). There was a significant correlation between neopterin and the acute phase proteins (all at p〈0.01). The data reflect a “primed” state at least of some parts of the immune system in a subgroup of preoperative patients potentially affecting their response to surgical trauma and bacterial contamination.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716282
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  • 14
    Electronic Resource
    Electronic Resource
    Reduced TNF⋅ and IL-6 production in patients who mount a preoperative acute phase response (1998)
    Springer
    Langenbeck's archives of surgery 383 (1998), S. 71-74 
    Details
    ISSN: 1435-2451
    Keywords: Key words Surgical risk ; Cytokines ; Acute-phase response
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background/aims: In some patients postoperative infective complications are related to a reduced resistance to the operative trauma and the perioperative microbiological challenge. To investigate preoperative alterations in the immune responses in patients who had mounted an acute-phase response before the operation, we measured the capacity of tumor necrosis factor α and interleukin-6 production in whole blood. Patients/methods: Serum concentrations of C-reactive protein, α 1-antitrypsin, albumin, and prealbumin were measured in 89 patients submitted for major abdominal surgery on their admission to hospital. Results: In 23 patients (26%) we found concentrations of at least one, and in 16 patients (18%) of two or more of these variables beyond the reference range. Patients who mounted an acute-phase response released 37% less TNFα (1339 vs. 848 pg/ml) and 31% less IL-6 (24 293 vs. 16 900 pg/ml) when whole blood was stimulated with lipopolysaccharide 0.5 µg/ml. Conclusion: Patients who mount an acute-phase response before operation may thus have a downregulated immune response at the level of proinflammatory cytokines. This is likely to alter their resistance to invasive micro-organisms in the perioperative period.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004230050094
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  • 15
    Electronic Resource
    Electronic Resource
    Cellular and molecular mechanisms of tissue repair (1998)
    Springer
    Basic research in cardiology 93 (1998), S. s001 
    Details
    ISSN: 1435-1803
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003950050192
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