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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 361 (1983), S. 760-761 
    ISSN: 1435-2451
    Keywords: Gastro-oesophageal reflux ; Silicon antireflux prosthesis ; Gastro-oesophagealer Reflux ; Silikon-Antirefluxprothese
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 1979 berichtete Angelchick über eine Silikon-Antirefluxprothese. In tierexperimentellen und klinischen Untersuchungen an Patienten mit Refluxkrankheit konnte gezeigt werden, daß 1. die klinischen Resultate der Antirefluxprothese mit denen nach Nissen-Fundoplicatio vergleichbar sind, 2. die Silikonprothese im Vergleich zur Fundoplicatio einfacher anzulegen, die Operation kürzer und risikoärmer ist, 3. ob postoperative Komplikationen nach Silikonprothesen seltener sind als nach Fundoplicatio (20 %), muß zur Zeit noch offen bleiben.
    Notes: Summary In 1979 Angelchick reported on a silicon anti reflux prosthesis. It could be demonstrated in animal experiments and in clinical investigations on patients with reflux disease that: (1) the clinical results of the antireflux prosthesis are similar to those of Nissen fundoplication; (2) compared with fundoplication, the silicon prosthesis is easier to apply and the operation shorter with less risk; (3) the question of whether postoperative complications are more unusual after silicon prosthesis than after fundoplication (20 %), however, is still open.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 357 (1982), S. 295-303 
    ISSN: 1435-2451
    Keywords: Circular myectomy ; Gastrooesophageal reflux ; Silicon antireflux prosthesis ; Artificial fundoplication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Unter allen Antirefluxoperationen hat sich in experimentellen und klinischen Untersuchungen die Fundoplicatio nach Nissen als das effektivste Verfahren erwiesen [3, 5, 9, 12, 13]. 1979 berichtete Angelchick über eine Silicon-Antirefluxprothese, die sich in ersten Untersuchungen an Patienten ebenfalls als effektiv erwies [1]. Eine Erklärung dieser Ergebnisse blieb zunächst aus. Die von uns durchgeführten Untersuchungen an Hunden zeigen, daß 1. die Antirefluxprothese eine effektive Antirefluxbarriere bei Hunden nach zirkulärer Myektomie ist; 2. die klinischen Resultate der Antirefluxprothese mit denen nach Nissen-Fundoplicatio vergleichbar sind, und 3. die Wirkungsweise der Antirefluxprothese rein mechanisch ist. Der Unterschied zwischen Silicon-Prothese und Fundoplicatio ist, daß die Fundoplicatio einen Ring um den Oesophagus darstellt, der elastisch ist und den gleichen Regulationen wie der UOS unterliegt und daß sie schluckreflektorisch erschlaffen kann, während es sich bei der Siliconprothese um ein passives Implantat handelt.
    Notes: Summary Of all anti-reflux operations fundoplication has proved the most effective method in experimental and clinical examinations [3, 5, 9, 12. 13]. In 1979 Angelchik reported a silicon prosthesis as an anti-reflux barrier which proved effective in examinations on patients. An explanation for these results is still missing [1]. Our examinations in dogs show that: 1. anti-reflux prosthesis is an effective anti-reflux barrier in dogs after circular myectomy; 2. silicon prosthesis proved to be equally as effective as fundoplication with regard to reflux prevention; 3. the mechanism of action is a mechanical one. The difference between silicon prosthesis and fundoplication is, that the fundoplication represents a ‘ring’ around the LES, which is elastic and is subject to the same regulations as the LES, and that it can relax in a swallowing reflex manner. In the silicon prosthesis the ‘ring-formation’ is only mechanical.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1435-2451
    Keywords: Renal protection ; Organ protection ; Experimental renal transplantation ; Nierenprotektion ; Organprotektion ; Experimentelle Nierentransplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Wir nahmen bei Hunden die Nierenprotektion mit der HTK-Lösung vor, mit anschliessender Nierentransplantation nach 48 h Kaltischämiezeit. Alle Transplantatnieren entwickelten eine primäre Urinausscheidung mit postoperativem Kreatininanstieg auf durchschnittlich 8 mg% und raschem Abfall des Kreatinins vom 4. postoperativen Tag an. Nach 2 Wochen wurde der Kreatinin-Ausgangswert erreicht. Durch Zugabe von Aspartat und Tryptophan konnte eine verbesserte Nierenprotektion und postoperative Nierenfunktion mit durchschnittlichem Kreatininanstieg von maximal 4,6 mg% erreicht werden.
    Notes: Summary Kidney protection in dogs was performed with the HTK solution, renal transplantation following after 48 h of cold ischemia. All kidney transplants developed primary urine excretion with postoperative creatinine increase of under 8 mg% on average and a rapid creatinine decrease from the 4th postoperative day on. After 2 weeks, the initial creatinine value was attained. Addition of aspartate and tryptophan led to an improved method of kidney protection and postoperative kidney function with an average creatinine increase of 4.6 mg% at the most.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 379 (1994), S. 80-83 
    ISSN: 1435-2451
    Keywords: Herniorrhaphy ; Postoperative pain reduction ; Bupivacain ; Nerve block
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In Deutschland werden jährlich ca. 150 000 Leistenhernien operativ versorgt. Neben dem Streben nach der optimalen Therapie ist es auch Aufgabe des Chirurgen, den peri- und postoperativen Schmerz zu behandeln. In einer prospektiv randomisierten Doppelblindstudie wurde das Schmerzempfinden bei Herniotomie nach intraoperativer Blockade des N. ilioinguinalis und iliohypogastricus mit einem langwirkenden Lokalanästhetikum in Kombination mit einem Vasokonstriktor gegen eine Kontrollgruppe anhand einer verbalen Analogskala und einer numerischen Zehnpunkteskala verglichen. Die Ergebnisse zeigen, daß die alleinige intraoperative Nervenblockade den postoperativen Schmerz sowohl am Operationstag als auch über die Wirkdauer des Lokalanästhetikums hinaus in der Folgezeit senkt. Die optimale Schmerztherapie muß demnach bereits intraoperativ beginnen. Hierzu besonders geeignet ist die komplikationsarme Nervenblockade mit einem Lokalanästhetikum. Gefahren durch Applikation systemisch wirkender Analgetika werden vermieden, das perioperative Risiko wird auch in Hinblick auf die ambulante Hernienchirurgie verringert.
    Notes: Abstract In Germany approximately 150 000 inguinal hernias are surgically corrected every year. In addition to developing an optimum operation technique it is also the responsibility of a surgeon to treat pain during and after surgery. In a prospective random double-blind study, the pain after herniotomy performed with intraoperative anesthesia of the ilioinguinal and iliohypogastric nerves with a long-acting local anesthetic combined with a vasoconstrictor was compared by means of scores on a scale from 1 to 10 with pain in a control group. The results suggest that the intraoperative anesthesia reduces pain after surgery both on the day of the operation and afterwards, when the effect of the local anesthetic has decreased. An optimum pain therapy therefore has to start during surgery. Use of a local anesthetic is especially suitable. Side effects of systemic analgesics are avoided, and perioperative risks of ambulant hernia surgery can be reduced.
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  • 5
    ISSN: 1435-2451
    Keywords: Kidney transplantation ; HTK protection ; Blood presusre ; Hypertension ; Renin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Für die Untersuchung der Veränderung der Reninaktivität und des Blutdrucks nach einsetzender Wiederdurchblutung der Transplantatniere unter HTK-Protektion wurde ein tierexperimentelles autologes, heterotopes Nierentransplantationsmodell am Hund gewählt. Die kalte Ischämiezeit betrug 48 h. Aufgrund von Modifikationen in der Zusammensetzung der HTK-Perfusionslösung ergaben sich 3 Versuchsgruppen. In jeder Versuchsgruppe erfolgte die nierenvenöse und arterielle Reninkonzentrationsbestimmung über 20 min nach einsetzender Wiederdurchblutung der Transplantatniere. Parallel zur Reninbestimmung wurde der arterielle Blutdruck gemessen. Die Reninspiegel im Nierenvenenblut sind in den ersten Minuten nach Rezirkulation der Transplantatniere in der 1. Versuchsgruppe (HTK-Lösung, Perfusionshöhe 120 cm) von allen Kollektiven am höchsten mit einem Medianwert der Anstiegsmaxima von 195 ng/ml · h. Die 2. Versuchsgruppe (HTK/“Aspartat”-Lösung) zeigt im Median eine reduzierte maximale nierenvenöse Reninkonzentration von 145 ng/ml · h bei einheitlicherem Kurvenverlauf. Von allen Gruppen weist die 3. Versuchsaufgruppe (HTK/“Tryptophan”-Lösung) die niedrigsten maximalen Reninanstiege zwischen 23,1 ng/ml·h und 120 ng/ml·h (median 61,5 ng/ml·h) auf. Nach der 7,5. Beobachtungsminute sind normale nierenvenöse Reninkonzentrationen zu registrieren. Die beste Reperfusion der Niere ist somit für das “Tryptophankollektiv” nachweisbar, was allerdings keine sichtbare positive Auswirkung auf die weitere Nierenfunktion hat. Primär niedrige Reninwerte korrelieren somit nicht immer mit einer guten postoperativen Funktion und umgekehert. Aus den anfänglichen Reninwerten ist ein Prädiktionswert für die sofortige als auch längerfristige postoperative Funktion nicht ablesbar. In allen 3 Versuchsgruppen sind die gemessenen nierenvenösen Reninwerte verbunden mit hypertonen arteriellen Blutdruckwerten von150–230 mm Hg. Nierenvenöse Reninkonzentrationen von 〉 100 ng/ml·h bewirken keine weiteren Blutdrucksteigerungen. Ob eine feste Beziehung zwischen den Reninwerten und der Hypertonie besteht, muß auch in unseren Untersuchungen fraglich bleiben. Die verschiedenen Protektionsansätze haben anscheinend auf die primären postoperativen Blutdruckverhältnisse keinen Einfluß.
    Notes: Abstract Investigations of changes in activity of renin and blood pressure after reperfusion of the kidney transplant using HTK solution were carried out by means of an autologous, heterotopic model of kidney transplantation applied to dogs. Duration of cold ischemia was 48 h. According to variations in the composition of the HTK perfusion solution three test groups were set up. During the first 20 min after recirculation in each test group the renal venous and arterial renin activities were measured. Parallel to renin activity, the arterial blood pressure was recorded. During the first few minutes following recirculation of the kidney transplant the renin levels in the venous blood of the kidney were higher in test group 1 (HTK solution, perfusion height 120 cm) than in either of the other two, showing a median maximal increase of 195 ng/ml · h. In test group 2 the maximal venous renin concentration fell to 145 ng/ml · h, while graphs take a more uniform course. Test group 3 (HTK/tryptophan) differed from the others in having further improved renin values. After the 7.5 min of observation normal venous renin concentrations were measured following earlier values for maximal increase between 23.1 ng/ml · h and 120 ng/ml · h (median 61.5 ng/ml · h). The best reperfusion of the kidney was observed in the tryptophan group, albeit without any recognizable positive effects on the other renal functions. Initially low renin values do not necessarily correlate with a smooth postoperative renal function and vice versa. Initial renin values cannot provide a secure basis for predicting instant as well as long-term postoperative functions. In all three test groups the measured renal venous activity of renin correlated with hypertonic basal pressure. Renal venous renin concentrations of 〉 100 ng/ml · h did not cause any further increase in blood pressure. The question as to whether there is a correlative dependence of renin values and hypertension is not clearly answered by our investigations. The variations in protection do not influence the primary postoperative blood pressure results.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1434-0879
    Keywords: Energy metabolism ; Euro-Collins-solution ; HTK-solution ; Kidney preservation ; Intrarenal pH ; Renal ischemia ; Structural preservation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 110 canine kidneys, we examined the time course of energy rich phosphates, lactate, intrarenal ph and renal morphology with Euro-Collins-or with HTK-protection of Bretschneider and compared these findings with unprotected kidneys during complete ischemia at 1 °C and at 25 °C. Both kidney protective solutions prolonged energyrich phosphate-decline by a factor of 3–4 compared with that of unprotected kidneys. The lactate increase was greater in Euro-Collins-protected kidneys than in HTK-protected and in unprotected kidneys, leading to pH values of 6.5 in Euro-Collins and to 6.4 in unprotected kidneys after 24 hours, in contrast to a pH-value of 7.3 with HTK-protection. This may be the reason for structural deterioration seen in unprotected and in Euro-Collins-protected kidneys after 12, and 48 h of ischemia at 1 °C, whereas in HTK-protected kidneys a sufficient preservation of structure can be seen. In one human kidney, protected with Euro-Collins-solution, we were able to show that at 1 °C intrarenal pH and lactate accumulation is similiar to the levels in canine kidneys. In Euro-Collins preserved kidneys lactate accumulation at 25 °C is even greater than at 1 °C, leading to inhibition of energy metabolism and to structural deterioration, whereas HTK-solution, because of its high buffer concentration, is able to maintain ischemic metabolism leading to sufficient protection of intrarenal pH and of adenine nucleotides as well as structural protection at 1 °C and at 25 °C.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1434-0879
    Keywords: Proteinuria ; Kidney transplantation ; Kidney preservation ; HTK solution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Investigations were carried out by means of an autologous, heterotopic model for kidney transplantation applied to dogs. Duration of cold ischemia was 48 h. Four experimental groups were arranged. During the first 20 min following revitalization of the transplanted kidney, group 1 (HTK solution/80 cm perfusion height) showed a significant glomerular and tubular malfunction. In group 2 (HTK solution/120 cm perfusion height), only four urinary proteins with molecular weights of 25 kDa, 67 kDa, 100 kDa and 〉100 kDa were found. The excretion of higher molecular proteins receded over the 20-min period of observation. In both group 3 (HTK/aspartate solution) and group 4 (HTK/tryptophan solution) the quantity of excreted glomerular and tubular protein was well above that of group 2. As opposed to the “Tryptophan” group, a complete restoration of renal function was observed in the “Aspartate” group after 4 weeks. In general, the “standard” HTK protective solution delivered with 120 cm perfusion pressure gave the most favorable results, with the lowest levels of proteinuria and a satisfactory recovery of renal function after revitalization.
    Type of Medium: Electronic Resource
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