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  • 1
    ISSN: 1432-1440
    Keywords: Key words Pancreatectomy ; Porcine islets ; Autotransplantation ; Glucose tolerance test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A major reason for the failure of clinical islet transplantations may be a limited islet mass. The aim of this study was to determine the critical islet mass necessary for normalization of glucose metabolism in a porcine model. Diabetes was induced by total pancreatectomy. The splenic lobe of the pancreas was intraductally distended with UW-solution containing 2.67–3.33 mg/ml collagenase, and the distended pancreas was digested in a continuous digestion filtration device. The islets were purified on a isoosmotic Ficoll-sodium-diatrizoate gradient. The survival period of the diabetic recipients in group 2 and 3 receiving, respectively, a low (2.14±0.39 µL/kg body weight) and a high (4.99±0.83 µL/kg body weight) islet mass was significantly prolonged compared to that of diabetic recipients in group 1 receiving no islet transplantation. However, the survival period of the recipients in group 2 was not significantly different to that in group 3. Three recipients of an islet mass of 〉5 µl/kg body weight became normoglycemic (fasting blood glucose 〈100 mg/dl) for more than two months. Furthermore, the glucose and insulin release reactions to the glucose challenge were comparable to that before pancreatectomy. Contrarily, another five diabetic recipients of an islet mass of 〈4 µL/kg body weight became a fasting blood glucose level of 〈200 mg/dl. The glucose and insulin release reactions to the glucose challenge were improved only, but not normalized compared to that before pancreatectomy. The data presented in this study demonstrate that metabolic normalization in pancreatectomized diabetic minipigs can be established by autotransplantation of an islet mass of 〉5 µl/kg body weight.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 5 (1991), S. 41-45 
    ISSN: 1432-2218
    Keywords: Kidney ; Transplantation ; Sonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 66 patients with renal transplants 246 sonographic examinations were performed. The patients were divided into two groups based on their immunosuppressive protocol. Group I was treated with Cyclosporin A (CsA) and group II with azathioprin. A compensatory hypertrophy with a volume increase of 20% could be seen in nearly all grafts. During acute tubular necrosis only minimal sonographic changes could be found. In each group 16 patients developed an acute rejection episode. Sonographic signs of acute rejection were: (1) a hypoechoic enlargement of the renal pyramides; (2) an increase in cortical echogenicity; (3) an increase in graft volume greater than compensatory hypertrophy; (4) an indistinct parenchyma-pelvic border; (5) dilation of the pelvis with a parenchyma-pelvic index 〉2.3:1 (in group II cases). Chronic rejection is characterized by graft shrinkage. No specific signs were evident. The increasing use of CsA diminishes the value of sonography in follow-up of acute rejection after kidney transplantation. Nevertheless, it is of great value for follow-up examination concerning other complications.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 867-870 
    ISSN: 1432-2218
    Keywords: Endoscopic jejunostomy ; Percutaneous ; Technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Direct puncture of the small bowel under endoscopic guidance (direct EPJ) is possible in patients whose stomach has been removed or whose small bowel cannot be punctured by other methods. From January 1990 to June 1992 a total of 39 patients underwent successful direct EPJ at our institution. The indications were malnutrition after partial or total gastrectomy (n=19), insufficient anastomosis or a stenosis after esophageal resection and esophagojejunostomy (n=13), esophageal perforation (n=3), fistulas (n=2), or severe trauma (n=2). The tubes were inserted at the bedside under local anesthesia using the string pull-through technique. The procedure was attempted in five other patients but it was technically impossible to insert the tubes in these patients. Postoperative enteral feeding was possible in all 39 patients whose direct EPJ was successful. Complications included tube dysfunction due to plugging and fracture in five patients, pressure-induced enteric ulcers in two, and local infections in three patients. The ulcers and infections were managed conservatively. We conclude that direct EPJ is a safe, effective alternative to surgical catheter-jejunostomy.
    Type of Medium: Electronic Resource
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