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  • 1
    Electronic Resource
    Electronic Resource
    Lymphomas in solid organ transplantation (1998)
    Springer
    Abdominal imaging 23 (1998), S. 553-557 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Lymphoma—Posttransplant lymphoproliferative disorder—Transplantation—Transplant complication—Epstein-Barr virus.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: The purpose of this investigation was to identify and characterize abdominal lymphomas as they occur in a large solid-organ-transplant population. Methods: A large transplant population was isolated, and all patients developing an abdominal lymphoma were identified. These patients were further characterized after review of their medical records and radiologic examinations. Results: Twenty-eight (1%) of 2925 patients developed lymphoma following transplantation. Of these 28 patients, 14 developed abdominal manifestations of disease. Examples of the wide variety of abdominal manifestations of posttransplant lymphoma are presented. Most of these patients had positive titers for Epstein-Barr virus and were treated with cyclosporin as a part of their immunotherapy. The majority of patients died secondary to this aggressive disease process. Conclusion: The development of lymphoma following solid organ transplantation is more common than in the general population. One-half of the patients in our study population developed abdominal manifestations of this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900401
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  • 2
    Electronic Resource
    Electronic Resource
    Technique of transanal endoscopic microsurgery (1988)
    Springer
    Surgical endoscopy and other interventional techniques 2 (1988), S. 71-75 
    Details
    ISSN: 1432-2218
    Keywords: Rectal adenoma ; Early rectal carcinoma ; Rectal surgery ; Endoscopic microsurgery ; Transanal surgery ; Polyp surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Sessile adenomas are predominantly localized in the rectum and lower sigma. Surgical removal is indicated but often implies an invasive surgical procedure. Using conventional transanal surgical techniques, only the lower rectum can be reached and there are high rates of recurrence. The new technique combines an endoscopic view of the rectum under gas insufflation via a stereoscopic telescope with conventional surgical preparation and suturing. Adenomas can be excised using the mucosectomy technique or full-thickness-excision, whereas carcinomas should be excised using full-thickness excision with a sufficient border of healthy mucosa. In carcinomas of the sacral cavity, we remove the retrorectal fat up to the fascia of Waldeyer, including the regional lymph nodes. Transanal endoscopic microsurgery is the most economical and tissue-saving surgical technique for the removal of rectal adenomas and early rectal carcinomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00704356
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  • 3
    Electronic Resource
    Electronic Resource
    Relaparotomie im Kindesalter (1986)
    Springer
    Langenbeck's archives of surgery 367 (1986), S. 167-180 
    Details
    ISSN: 1435-2451
    Keywords: Relaparotomy in childhood ; Preoperative sonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An der Kinderchirurgischen Universitätsklinik Mainz wurden vom 1. 1. 1976 bis 31. 12. 1983 1793 Laparotomien an Kindern im Alter bis zu 15 Jahren vorgenommen. Eine akute, nicht geplante Relaparotomie lag in 4,6% der Fälle vor. Die häufigste Indikation zur Relaparotomie war ein verwachsungsbedingter Ileus (53%); weniger häufige Ursachen waren Platzbauch, Peritonitis, Darmperforation, Anastomoseninsuffzienz und Sekundärblutung. 15% aller relaparotomierten Kinder mußten sich mehr als einer Relaparotomie unterziehen. Über 40% der akuten Relaparotomien wurden an Kindern innerhalb des ersten Lebensjahres vorgenommen. 56% aller Relaparotomien mußten innerhalb der ersten vier postoperativen Wochen durchgeführt werden, 87% innerhalb des ersten postoperativen Jahres. Die Letalitätsrate der akuten Relaparotomie betrug 15%. Sie war besonders hoch bei Kindern mit Anastomoseninsuffizienz und Platzbauch und erhöhte sich mit der Anzahl der Relaparotomien. Die Bedeutung der präoperativen Sonographie zur Diagnosestellung für eine akute, nicht geplante Relaparotomie wird diskutiert und an Hand von Beispielen dokumentiert.
    Notes: Summary From 1.1.1976 to 31.12.1983 1,793 laparotomies were performed on children up to the age of 15 years at the Hospital of Pediatric Surgery, Mainz University. The incidence of acute unplannend relaparotomies was 4.6%. The most frequent indication of acute relaparotomy was postoperative obstruction due to adhesions (in 53 % of all cases); burst abdomen, peritonitis, intestinal perforation, anastomotic insufficiency and secondary hemorrhage were less frequent causes of repeated abdominal procedures. 15% of all relaparotomised children underwent more than one repeat laparotomy. More than 40% of acute relaparotomies were performed on children within their first year of life. 56% of all relaparotomies had to be performed within the first four postoperative weeks, 87% within the first year. The lethality rate of acute relaparotomy was 15%. Lethality was especially high in children suffering from anastomotic insufficiency or burst abdomen; it increased with the number of relaparotomies. The significance of preoperative sonography for the diagnosis leading to acute unplanned relaparotomies is discussed and commented with examples.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01258935
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  • 4
    Electronic Resource
    Electronic Resource
    163. Immunologische Folgen des Milzverlustes nach Splenektomie bei traumatischer Milzruptur (1986)
    Springer
    Langenbeck's archives of surgery 369 (1986), S. 730-730 
    Details
    ISSN: 1435-2451
    Keywords: Immunological changes ; Traumatic splenic rupture ; Immunologische Folgen ; Traumatische Milzruptur
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 97 nachuntersuchten Patienten, 2–18 Jahre nach Splenektomie wegen traumatischer Milzruptur, konnte kein OPSI-Syndrom festgestellt werden. 53% der Splenektomierten hatten Howell-Jolly-Körperchen, signifikant war eine Monocytose. Bei 75% der Patienten fand sich szintigraphisch eine Splenosis peritonei, die jedoch bei der dynamischen Szintigraphie keine milzspezifische Filterfunktion hatte. Bei 15 speziell nachuntersuchten Patienten ohne Splenosis fand sich eine signifikante Herabsetzung der Killing-Aktivität der neutrophilen Granulocyten sowie eine Verminderung der T-Helferzellen. Der T4/T8-Quotient betrug 1,0.
    Notes: Summary After splenectomy for traumatic spleen rupture, 97 patients were followed up 2–18 years later. None had suffered from the OPSI syndrome. In 53% of the splenectomized patients, Howell-Jolly bodies and statistically significant monocytosis were detected. Sintigraphically proven peritoneal splenosis was present in 75% of the patients; however, no specific filtration was demonstrated by dynamic scintigraphy. Of the patients without splenosis who were followed up, 15 had a significant reduction of the killing activity of neutrophile granulocytes, as well as decreased numbers of T-helper cells. The T4/T8 ratio was 1:0.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01274481
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  • 5
    Electronic Resource
    Electronic Resource
    Pancreas-specific protein (PASP), serum amyloid A (SAA), and neopterin (NEOP) in the diagnosis of rejection after simultaneous pancreas and kidney transplantation (1997)
    Springer
    Transplant international 10 (1997), S. 185-191 
    Details
    ISSN: 1432-2277
    Keywords: Key words Pancreas-specific protein ; pancreas transplantation ; Neopterin ; pancreas transplantation ; Serum amyloid A ; pancreas transplantation ; Pancreas transplantation ; rejection parameters ; Rejection ; pancreas transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A reliable, noninvasive indicator of pancreatic allograft rejection is urgently needed. In this study, serum (S), plasma (P), and urine (U) levels of pancreas-specific protein (P-PASP, U-PASP), neopterin (S-NEOP, U-NEOP), amylase (U-AMYL), and amyloid A (SAA) were measured daily in ten type I diabetic patients following simultaneous pancreas and kidney transplantation (SPK). Rejection episodes occurred in three isolated pancreas, nine isolated kidney, and five simultaneous pancreas and kidney transplants. In the case of the eight pancreas rejections, SAA was the rejection marker with the highest diagnostic accuracy (94 %). Using P-PASP and U-PASP, an accuracy of 81 % and 79 %, respectively, was achieved. During viral infections, U-NEOP levels increased to a maximum level of 1904 μmol/mol creatinine, whereas during bacterial infections, SAA levels increased to a maximum value of 43 mg/dl. SAA, measured for the first time in SPK, appears to be a valuable rejection parameter. In combination with U-NEOP and U-AMYL, a differential diagnosis between rejection, bacterial infection, and viral infection was possible. Neither U-PASP nor P-PASP monitoring led to a significant improvement in the results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001470050039
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  • 6
    Electronic Resource
    Electronic Resource
    Neuronal intestinal dysplasia (1987)
    Springer
    Pediatric surgery international 2 (1987), S. 352-358 
    Details
    ISSN: 1437-9813
    Keywords: Neuronal intestinal dysplasia ; Colon motility ; Colon sonography ; Colostomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Findings in 23 children with neuronal intestinal dysplasia (NID) are presented. Twelve children had Hirschsprung's disease that masked the existence of proximal NID. In all cases the diagnosis was established by histological-histochemical examination. Amelioration of symptoms by conservative treatment alone was achieved in 4 children; in 13 cases colostomy was necessary. In 6 patients colon resection was performed: 2 suffered from both colitis and obstruction; the other 4 were treated for obstruction, multiple perforations, persistant adynamia of the left colon, and fistulation. In 9 patients the colostomy was closed. Four of 6 children who did not have sonographic confirmation of motility had complications due to colon dysmotility after closure of their normally functioning colostomy. Therapeutic measures are based exclusively on clinical and functional parameters. The clinical picture dictates the emergency measures (colostomy, colon resection, and colectomy). Normal colostomy function is not a sufficient criterion of normal colon motility. Functional sonography of the colon is included in the planning of further therapy. Indications, timing, and extent of colon resection can be reliably determined using the sonographic method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00175648
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  • 7
    Electronic Resource
    Electronic Resource
    Significance of ultrasound for the diagnosis of hypertrophic pyloric stenosis (1986)
    Springer
    Pediatric surgery international 1 (1986), S. 130-134 
    Details
    ISSN: 1437-9813
    Keywords: Hypertrophic pyloric stenosis ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The sonographic features of hypertrophic pyloric stenosis (HPS) were evaluated in a 5-year prospective study (1981–1985) at the University Clinic of Pediatric Surgery in Mainz. In 37 cases real-time ultrasound was performed preoperatively to measure muscle thickness, diameter, and length of the pylorus; the recorded values were compared with those of a control group. Muscular wall thickness proved to be the most reliable parameter, while pyloric canal length was the most difficult measurement to obtain. Diameter alone was not adequate to establish the sonographic diagnosis, which depends on the individually and functionally different luminal width and submucosal thickness. Significant sonographic criteria for the diagnosis of HPS are a muscle thickness of 5 mm or more and a diameter of 15 mm or more. These data are confirmed by intraoperative measurements. Indirect signs of HPS are a lack of passage through the narrowed pyloric canal, gastric distension combined with unproductive contractions and, less commonly, gastroesophageal reflux. Although history and clinical examination are the main diagnostic means, ultrasound should be the initial imaging procedure if the clinical diagnosis is doubtful.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00166875
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  • 8
    Electronic Resource
    Electronic Resource
    Results of the smooth-muscle fold-over double-plasty (SMFD) (1986)
    Springer
    Pediatric surgery international 1 (1986), S. 43-45 
    Details
    ISSN: 1437-9813
    Keywords: SMFD-plasty ; Modified “door-wing” SMFD-plasty
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since 1980, when we developed substitute for the internal anal sphicter, the smooth-muscle fold-over double-plasty (SMFD-plasty), we have operated on seven children using this method, usually in combination with the pull-through procedure, and on five children after one or more previous operations. Since 1983, 11 cases with previous operations have undergone the modified “door-wing” SMFD-plasty. The results are excellent if the operation is used in primary combination with the pull-through procedure or if the “door-wing” modification is combined with reconstruction of the pelvic floor. It is also necessary that all cases undergo a biofeedback conditioning program.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00171781
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