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  • Key words: Laparoscopy — Inguinal hernia repair — Deep vein thrombosis — Femoral vein — Preperitoneal  (1)
  • Neurogenic Intermittent Claudication  (1)
  • Prognosis  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Acute tubulointerstitial nephritis: phenotype of infiltrating cells and prognostic impact of tubulitis (1996)
    Springer
    Virchows Archiv 428 (1996), S. 5-12 
    Details
    ISSN: 1432-2307
    Keywords: Interstitial nephritis ; Tubulitis ; Phenotype ; Immunohistochemistry ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prognostic impact of tubulitis and the phenotype of the infiltrating cells in the tubules were studied in ten percutaneous renal biopsies from six patients with acute tubulointerstitial nephritis (ATIN). The inflammatory cell subsets in the tubules and interstitium (CD3+, CD4+, CD8+, CD20+, CD45RO+, CD56+, CD57+, CD68+ and TIA-1+ cells), the expression of vimentin and the proliferation-associated antigen Ki-67 by cortical tubular cells, and the grade of tubulitis, interstitial infiltration and fibrosis were analysed. Cytotoxic injury to tubular cells in the vicinity of tubular-wall-localized lymphocytes was studied ultrastructurally. ATIN was drug-induced in three patients, related to Legionella infection in two and idiopathic in one patient. Four patients recovered, one with reduced renal function. Two patients developed end-stage renal disease. CD8+ and CD4+ lymphocytes, and a smaller number of macrophages, infiltrated the tubules. The predominant lymphocyte subset in the tubules was the same as in the interstitium. Cytotoxic injury to tubular cells was not seen electron microscopically. The tubular cells exhibited increased proliferative activity and expressed vimentin, indicating non-specific tubular damage. The cell subset, the severity of tubulitis, and the tubular expression of vimentin were not related to outcome. the main prognostic factor was the severity of the interstitial fibrosis. Tubulitis in ATIN may be a harmless non-immune reaction, mediated by tubular expression of cytokines, together with adhesion and other molecules.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00192921
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Femoral venous flow dynamics during intraperitoneal and preperitoneal laparoscopic insufflation (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1213-1216 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopy — Inguinal hernia repair — Deep vein thrombosis — Femoral vein — Preperitoneal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic herniorrhaphy may be performed using an intraperitoneal or a preperitoneal approach. Anecdotal and experimental evidence indicates that alterations in lower extremity venous flow, which occur during intraperitoneal laparoscopic insufflation, may be associated with an increased risk of deep vein thrombosis. However, no study has directly compared femoral venous flow during intraperitoneal insufflation with that during preperitoneal insufflation. Method: In eight consecutive patients undergoing laparoscopic herniorrhaphy under general anesthesia, flow through the common femoral vein was evaluated with B-mode and color flow duplex. Pre- and intraperitoneal pressures were standardized to 10 mm Hg, and respiratory tidal volumes were standardized to 10 cc/kg. Flow measurements were taken at end expiration. Flow through the common femoral vein was measured after induction of anesthesia, during intraperitoneal insufflation, during preperitoneal insufflation, and between insufflations to ensure return to baseline. Results: All patients in the study were males. Their mean age was 59 years. Mean flow in the common femoral vein was essentially identical at baseline (138 ml/min) and during preperitoneal insufflation (135 ml/min). Alternatively, mean flow in the common femoral vein was significantly reduced during intraperitoneal insufflation (65 ml/min, p= 0.02). Conclusions: Flow in the common femoral vein is significantly reduced during intraperitoneal insufflation. However, flow in the common femoral vein is not affected by preperitoneal insufflation. These data suggest that laparoscopic preperitoneal inguinal hernia repair may pose as less a risk of thromboembolic complications than laparoscopic intraperitoneal inguinal hernia repair.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900823
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    A new functional test in the diagnostic evaluation of neurogenic intermittent claudication (1989)
    Springer
    Clinical rheumatology 8 (1989), S. 363-367 
    Details
    ISSN: 1434-9949
    Keywords: Functional Test ; Diagnosis ; Neurogenic Intermittent Claudication ; Lumbar Spinal Stenosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A new functional test using downhill walking is described and evaluated in relation to the myelographical examination in 23 consecutive patients with neurogenic intermittent claudication. Discomfort and changes of the neurological status, emerging during the walk, were accepted as test results. They were noted in a decision matrix and the positive and the negative predictive values (PPV and NPV, respectively) calculated. The PPV of any symptom or any deterioration of the neurological status, resulting from this test as signs of a myelographical abnormality, was calculated to be 86 and 89 per cent, respectively, the corresponding NPV's being 50 and 40 per cent, respectively. The NPV of these parameters as signs of a myelographically verified lumbar spinal stenosis was calculated to be 100 per cent, the corresponding PPV's being 38 and 44 per cent, respectively. The development of “symptommarch” or of bilateral neurological signs during the walk was found to be of approximately the same diagnostical value. We conclude, that this function test may serve as a screening procedure in patients complaining of neurogenic intermittent claudication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02030349
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    Paper (German National Licenses)
    Fulltext
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