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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 6 (1970), S. 441-444 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The endocrine function of pancreaticoduodenal allografts was studied in six dogs and compared with that of normal animals. The grafts were able to prevent the diabetic ketosis that was observed in a control group after total pancreatectomy without following transplantation. — Systemic hyperglycaemia enhanced the insulin release from the transplanted pancreas, as measured by increased IRI levels after intravenous glucose administration. In contrast, the stimulation of insulin secretion by oral glucose loading was less than in normal dogs, while the glucose assimilation was also increased in transplanted animals.-It was speculated that the duodenum might be more susceptible to immunological damage than the pancreas, and that consequently an impairment of the resorption of glucose and of the production of intestinal factors controlling the secretion of insulin may result.-In the near future, pancreatico-duodenal transplantation does not appears to become a therapeutical alternative to the conventional treatment of diabetes mellitus in man.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 58 (1980), S. 73-84 
    ISSN: 1432-1440
    Keywords: Kidney allograft transplantation ; Urinary tract infection ; Leucocyturia ; Antibody-coated bacteria ; Transplant pyelonephritis ; Nierentransplantation ; Harnwegsinfekt ; Leukozyturie ; antikörperbesetzte Bakterien ; Transplantatpyelonephritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Anläßlich von 1802 Urinuntersuchungen bei 216 ambulanten Trägern von Nierenallotransplantaten wurden 274 signifikante Bakteriurien festgestellt. Bei 30 Patienten wurden rezidivierende oder chronisch persistierende Harnwegsinfekte beobachtet, wobei 399 Befunde von Urinuntersuchungen ausgewertet wurden (13,3 Untersuchungen pro Patient). Es handelte sich um 15 Patienten mit klinischer und/oder pathologisch-anatomisch verifizierter Transplantatpyelonephritis und um 11 Patienten mit Cystitis. Vier Patienten mit urologischen Komplikationen nach Transplantation wurden von der Studie ausgeschlossen. Besonderes Gewicht für die Diagnose einer Transplantatpyelonephritis erlangen kontinuierliche Leukozyturie und der Nachweis antikörperbedeckter Urinbakterien. Beide Befunde wurden bei allen Patienten mit Transplantatpyelonephritis mehrfach erhoben. Wichtige klinische Symptome sind Fieber und Dysurie. Im Gegensatz zur Kontrollgruppe mit Cystitis kann bei 13 von 15 Patienten mit Transplantatpyelonephritis eine Abnahme der Transplantatfunktion festgestellt werden; zwei Patienten wurden erneut dialysebedürftig. Eine weitere schwerwiegende Komplikation stellt die Urosepsis bei acht von 15 Patienten dar. Die Ergebnisse weisen mit 15 Erkrankungen bei 26 Patienten auf die Häufigkeit einer Transplantatpyelonephritis bei chronischer Harnwegsinfektion nach Nierentransplantation hin. Begünstigt wird ihr Auftreten durch eine Abflußbehinderung in den ableitenden Harnwegen (acht von 15 Patienten) und durch hochdosierte immunosuppressive Therapie: acht der 15 Patienten erhielten beim Auftreten der Pyelonephritis mehr als 10 mg Prednison/die. Durch Infektkontrolle konnte die Nierenfunktion bei drei Patienten gehalten werden, bei Abschluß der Untersuchung war die Funktionseinbuße des Transplantates bei vier Patienten teilweise reversibel.
    Notes: Summary Examinations of the urine in 216 kidney allograft recipients resulted in significant bacteriuria in 274 samples of 1,802 urines tested. Bacteruria was found in 30 patients with recurrent or chronic persistent infections of the urinary tract; this patient group was studied by examination of 399 urine samples (mean 13.3 samples per patient). Four patients suffered from urologic complications after kidney grafting and were excluded from the study; 15 patients were diagnosed clinically and/or histologically with transplant pyelonephritis, 11 patients with cystitis. Of main importance for the diagnosis of transplant pyelonephritis were findings of persistent leucocyturia and the presence of antibody-coated bacteria. Both of these findings were repeatedly seen in all patients with transplant pyelonephritis. Clinical symptoms included fever and dysuria. In contrast to patients suffering from cystitis, transplant function detoriated in 13 of 15 patients with transplant pyelonephritis; two patients had to be treated by hemodialysis. Septicemia occurred in eight of the 15 patients studied. The data illustrate the frequency of transplant pyelonephritis as observed in 15 of 26 patients accompaining chronic urinary tract infection after kidney allograft transplantation. As a predisposing factor, obstruction of the urinary tract was diagnosed in eight of the 15 transplant recipients with pyelonephritis. The prednisone dose was higher than 10 mg in eight of 15 patients at the time transplant infection was diagnosed. Successful antibiotic treatment resulted in stable transplant function in three patients; four patients exhibited even lower serum creatinine levels after therapy.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1440
    Keywords: Immune complexes ; Renal transplantation ; Rejection episodes ; Morphological types
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective study circulating immune complexes (CIC) were analyzed before and serially after renal transplantation in 141 consecutive patients. CIC were measured using the Raji cell assay as originally described by Theofilopoulos and Dixon. The amount of CIC was expressed as µg heat aggregated human immunoglobulin G (IgG) equivalent/ml serum. The upper limit of normal sera was 25 µg/ml. The values are expressed as geometric means (−1 SD/+1 SD). In 86 of 133 rejection episodes a renal biopsy was performed and the histopathologic changes were semiquantitatively assessed and classified in a cellular or vascular type of rejection. Before transplantation CIC were detected in 104 of 141 patients (73.8%) and the mean value was 65.6 (27.8–154.9) µg/ml. The level of CIC was positively correlated with the number of grafts (r:0.43;P〈0.01) and the occurrence of chronic active hepatitis (r:0.31;P〈0.01). No correlation was found between CIC and the underlying kidney disease, the number of blood transfusions prior to transplantation, and the pre-existing lymphocytotoxic antibodies. Graft survival and number of rejection episodes were not influenced by the level of CIC prior to transplantation. After transplantation CIC were elevated in 60 patients (41%), appeared transiently in 49 patients (35%) and were never detectable in 32 patients (23%). In patients with a graft survival ≦11 months the average and peak post-transplant CIC levels were significantly higher than patients with a graft survival of 12 months: 64.4 (21.8–191.0); 87.7 (26.0–295.8) versus 39.6 (18.4–85.3); 56.8 (21.0–150.1) µg/ml;P〈0.01. There was a positive correlation between CIC and serum creatinine in the post-transplant period (P〈0.001). The histopathologic severity and morphological type of rejection did not correlate with CIC. In patients without rejection episodes CIC were significantly lower: 41.2 (39.6–42.9) than patients with rejection episodes: 61.8 (56.2–68.0);P〈0.05.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 54 (1976), S. 957-960 
    ISSN: 1432-1440
    Keywords: Serumgastrinanalyse ; Ulcus duodeni ; Operationsauswahl ; Kontrolle der chirurgischen Resultate ; Serum gastrin ; duodenal ulcer ; elective surgery ; control of surgical results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The role of gastrin and of serum gastrin analysis in duodenal ulcer disease and duodenal ulcer surgery is analysed. As far as etiology and pathogenesis are concerned up to now gastrin has never been shown to play a significant role. Neither does it provide any diagnostic help in the typical duodenal ulcer disease (but it will allow for diagnosis of the retained antrum after Billroth II resection and of the Zollinger Ellison syndrome). Gastrin determination therefore is not helpful in the choice of the correct operative procedure for the ulcer disease. In today's clinical practice its major role consists in the control of surgical results. This is illustrated by a prospective randomized study on proximal selective vagotomy with and without pyloroplasty. In these patients serum gastrin analysis has shown that the omission of pyloroplasty is not followed by antral stasis. It furthermore always exhibits the typicel vagotomy profile, although vagotomy is incomplete in the 2-DODG-test.
    Notes: Zusammenfassung Die Rolle von Gastrin und die der Serumgastrinanalyse beim Ulcus duodeni wurde untersucht. Hinsichtlich Ätiologie und Pathogenese dieser Krankheit wurde niemals eine signifikante Funktion von Gastrin nachgewiesen. Auch diagnostisch ist es beim typischen Ulcus duodeni keine Hilfe, mit Ausnahme der Diagnose eines retinierten Antrumrestes nach Billroth II-Resektion und beim Zollinger-Ellison Syndrom. Deshalb kann die Gastrinbestimmung im Serum auch nicht bei der Auswahl des chirurgischen Verfahrens beim peptischen Ulkus helfen. In der klinischen Routine spielt sie heute die Hauptrolle bei der Kontrolle der chirurgischen Resultate. Dies wird durch eine prospektive randomisierte Studie über selektiv-proximale Vagotomie mit und ohne Pyloroplastik illustriert. Bei den operierten Patienten zeigte die Serumgastrinanalyse, daß dem Weglassen der Pyloroplastik nicht eine Stase im Antrum folgte. Weiterhin zeigte sie postoperativ das typische Vagomieprofil, auch wenn die Vagotomie im 2-Desoxy-D-Glycosetest inkomplett war.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 57 (1979), S. 863-873 
    ISSN: 1432-1440
    Keywords: Renovascular hypertension ; Renal venous renin activity ; Effect of surgery ; Renovaskuläre Hypertonie ; Nierenvenenreninaktivität ; Operationserfolg
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In der vorliegenden Untersuchung wurde das postoperative Blutdruckverhalten bei 35 Patienten mit renovaskulärer Hypertonie untersucht: 17 Patienten mit fibromuskulärer Dysplasie (FMD) und 18 mit arteriosklerotischen Gefäßwandveränderungen (ASS). Patienten mit FMD waren im Mittel jünger (31,8 Jahre), zeigten eine kürzere Hypertonieanamnese (1,8 Jahre) und waren prävalent weiblich (82%), während Patienten mit ASS deutlich älter waren (48,2 Jahre), eine längere Hypertoniedauer (2,6 Jahre) zeigten und bevorzugt männlich (78%) waren. In beiden Gruppen zeigte das intravenöse Pyelogramm einen vergleichbar hohen Anteil positiver Befunde (FMD=64%, ASS=61%). Postoperativ waren in der Gruppe mit FMD 47% (n=8) geheilt, 47% (n=8) gebessert und nur 6% (n=1) der Patienten geringgradig gebessert. Die vergleichbaren Werte für die Gruppe mit ASS betrugen 28, 55 und 17%. Für das Gesamtkollektiv war folglich ein guter Operationserfolg (geheilt und gebessert) in 88,5% der Fälle zu beobachten. Patienten mit ASS und postoperativ nur geringgradiger Besserung (n=3) zeigten eine auffallend lange Hypertonieanamnese (7,0±1,4 Jahre). Bei allen Patienten wurde präoperativ die seitengetrennte Bestimmung der Renin-Aktivität (PRA) im Nierenvenenblut durchgeführt und aus den Werten die PRA-Quotienten (PRA betroffene/nicht betroffene Seite) errechnet. Bei 27 Patienten wurde die Bestimmung 15 und 30 min nach intravenöser Stimulation mit 40 mg Furosemid wiederholt. PRA-Quotienten von ≧1,5 wurden als signifikant bezeichnet. Bei 31 Patienten mit einseitiger renovaskulärer Hypertonie wurde die Höhe des PRA-Quotienten zum postoperativen Blutdruckverhalten korreliert. Dabei zeigte sich zwischen der Gruppe der postoperativ Geheilten und der der postoperativ Gebesserten kein signifikanter Unterschied im mittleren PRA-Quotienten. Ferner ließen sich für das Gesamtkollektiv der 31 Patienten mit einseitiger renovaskulärer Hypertonie unter Ausgangs- und Stimulationsbedingungen keine signifikanten Korrelationen zwischen Höhe der PRA-Quotienten und postoperativem Blutdruckabfall ermitteln. Unsere Ergebnisse unterstützen nicht die weit verbreitete Ansicht, daß sich die seitengetrennte Bestimmung der PRA im Nierenvenenblut als Parameter für den zu erwartenden Operationserfolg bei Patienten mit einseitiger renovaskulärer Hypertonie eignet. Die Methode kann deshalb nach unserer Ansicht nicht mehr als obligater Bestandteile der präoperativen Diagnostik der renovaskulären Hypertonie empfohlen werden.
    Notes: Summary In the present study the effect of surgery on blood pressure was investigated in 35 patients with renovascular hypertension: 17 patients with fibromuscular hyperplasia (FMD) and 18 with atherosclerosis (ASS) of the renal artery. Patients with FMD were younger (31,8 years), showed a shorter duration of hypertension (1.8 years) and were prevalently female (82%), whereas patients with ASS were markedly older (48.2 years), showed a longer duration of hypertension (2.6 years) and were most often male (78%). In both groups of patients the intravenous urogram was positive in a comparable high percentage (FMD=64%, ASS=61%). Following surgical intervention 47% (n=8) of the 17 patients with FMD were cured, 47% (n=8) were improved and only 6% (n=1) showed insufficient reduction of blood pressure values. In ASS the respective values were 28, 55 and 17%. Consequently a good effect of surgery (cured and improved) was observed in 88.5% of all patients. Patients with ASS who failed to respond to surgery (n=3) showed a remarkable long duration of hypertension (7.0±1.4 years). Plasma renin activity (PRA) was determined preoperatively in both renal veins in all 35 patients. From these values the PRA-ratio (PRA affected/unaffected side) was calculated. In 27 patients PRA determinations were repeated following (15 and 30 min) intravenous injection of 40 mg furosemide. PRA-ratios of ≧1.5 were considered to be significant. In 31 patients with unilateral renovascular hypertension PRA-ratios were correlated to the postoperative blood pressure reduction. No significant differences in mean PRA-ratios were observed between cured and improved patients. Furthermore, for the total group of 31 patients no significant correlations were obtained between PRA-ratios and postoperative blood pressure reduction. Our results do not support the widespread opinion that PRA determinations in both renal veins are useful to predict the effect of surgery in patients with unilateral renovascular disease. Therefore, from our experience this method should not be recommended as obligatory in the diagnostic work-up of renovascular hypertension.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1248-9204
    Keywords: Hernia repair ; Lichtenstein technique ; Shouldice technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the knowledge that Lichtenstein inguinal hernia repair is becoming increasingly popular we evaluated this technique in a prospective randomized study. Would the Lichtenstein repair show significant advantages in order to justify it replacing the Shouldice technique, the standard for hernia repair of the last ten years? Between January 1996 and December 1997 the study was undertaken on 385 male patients suffering from 410 primary inguinal hernias. On 164 patients the Shouldice technique (SD) was used and on 221 patients the Lichtenstein repair (LS). 50 % of the operations were performed under local anesthesia, 50 % under spinal anesthesia. The 410 operations were done by 51 different surgeons, most of them in trainee programs. The postoperative local complication rate and duration of hospitalization were similar in both groups. Significant differences were noted concerning operation-time (LS: 80 min, SD: 88 min, p 〈 0,005) and return to work (LS: 25 days, SD: 41 days, p 〈 0,00005). The tension-free repair under local anesthesia described by Lichtenstein is an easy operation, with a low complication rate and short recovery period. The Lichtenstein technique is an ideal hernia repair with low costs, high patient comfort and suitability for day-surgery.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Cryobiology 2 (1965), S. 147-150 
    ISSN: 0011-2240
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Cryobiology 16 (1979), S. 171-178 
    ISSN: 0011-2240
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Medicine
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 322 (1968), S. 999-1004 
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In Akutversuchen bei Hunden wurde die Vena cordis magna proximal ligiert und distal davon mittels eines in die Aorta eingepflanzten Katheters arterialisiert. Der Einfluß der so erzeugten Coronarflowumkehr auf die Folgen der Ligatur des Ramus descendens anterior der Coronararterie wurde studiert. Bei 3 von 23 Experimenten verhinderte die Coronarflowumkehr ein Kammerflimmern. Dieser nur beschränkte Schutzeffekt wird durch die Beobachtung erklärt, daß mehr als 80% des der Vene zugeführten arteriellen Blutes durch venöse Kollateralen aus dem Descendensgebiet abgeleitet werden.
    Notes: Summary In acute experiments on dogs the great cardiac vein was ligated proximally. The distal protion was then arterialized by way of an indwelling catheter in the aorta. The effects of the thus produced reversal of the coronary flow on the sequelae to the ligature of the ramus descendens anterior of the coronary artery, were then studied. In 3 out of 23 experiments the reversal of the coronary flow prevented ventricular fibrillation. The only very limited protective function is explained by the observation that more than 80% of the arterial blood which enters the vein is drained away through the venous collaterals in the region of the descending branch.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 327 (1970), S. 1137-1144 
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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