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  • 1
    Digitale Medien
    Digitale Medien
    Severity and predicted outcome of postoperative Pseudomonas aeruginosa infections (1995)
    Springer
    Surgery today 25 (1995), S. 672-678 
    Details
    ISSN: 1436-2813
    Schlagwort(e): postoperative infection ; Pseudomonas aeruginosa ; severity of illness ; prediction of outcome ; severity score
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The severity and predicted outcome of postoperative Pseudomonas aeruginosa (P. aeruginosa) infections (PPAI) was evaluated using a severity scoring system based on a simplification and modification of the APACHE II system. A total of 86 patients in whom P. aeruginosa was isolated from various sources were examined. PPAI developed in 50 patients, resulting in an overall mortality rate of 24%. An increased severity score (SS) correlated with an increased risk of developing PPAI. Thus, PPAI developed in 33% of the patients with an SS of 0–1, in 66.7% of those with an SS of 2–3, and in 100% of those with an SS of 6 or higher. Moreover, the mortality rate of the patients with an initial score of 6 or higher was 50%. The mean (±SD) initial severity score was 5.4±2.9 for survivors and 2.9±2.6 for nonsurvivors (P〈0.01). In the patients who subsequently died, the SS remained high throughout the clinical course despite therapy, whereas in the survivors the SS decreased progressively, reflecting a favorable clinical course. These results suggest that our severity scoring system was useful for predicting outcome and monitoring the response of PPAI to therapy.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00311481
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  • 2
    Digitale Medien
    Digitale Medien
    Mucin-producing pancreatic tumors: A study of nuclear DNA content by flow cytometry (1993)
    Springer
    Surgery today 23 (1993), S. 491-495 
    Details
    ISSN: 1436-2813
    Schlagwort(e): mucin-producing pancreatic tumor ; nuclear DNA content ; diploid ; aneuploid ; flow cytometry ; prognosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Nuclear DNA content in eight surgically resected mucin-producing pancreatic tumors (MPPT) consisting of two mucinous intraductal adenocarcinomas (MIDAC), two mucinous intraductal adenomas (MIDA), one mucinous cystadenocarcinoma (MCAC), and three mucinous cystadenomas (MCA) were measured by flow cytometry using paraffin-embedded tissue samples. The technique of Shutte was used for the preparation of paraffin-embedded tissue into single dissociated nuclei, while the method of Vindelov was used for staining the isolated nuclei with propidium iodine. Clinicopathologically, the four patients with MIDAC or MIDA were all male and had cystic lesions with a dilated pancreatic duct at the head of the pancreas, while the four patients with MCAC or MCA were all females and had cystic tumors at either the body or tail of the pancreas. All eight patients with MPPT had no metastasis to the regional lymph nodes and were all still alive without recurrence. In an analysis of nuclear DNA content, seven of eight patients had DNA diploid tumors while one patient with a MIDAC perforating the duodenum and choledochus had a DNA aneuploid tumor. Thus, these findings suggest that DNA diploid patterns in MPPT might be associated with a favorable prognosis in MPPT although some patients whose MPPT invaded the surrounding organs might have DNA aneuploid tumors.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00730622
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  • 3
    Digitale Medien
    Digitale Medien
    Anomalous arrangement of the pancreaticobiliary ductal system without dilatation of the biliary tract (1992)
    Springer
    Surgery today 22 (1992), S. 276-279 
    Details
    ISSN: 1436-2813
    Schlagwort(e): anomalous arrangement of the pancreaticobiliary ductal system ; mucosal dysplasia of the biliary duct ; pancreaticobiliary ductal diversion
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A rare case of anomalous arrangement of the pancreaticobiliary ductal system without dilatation of the biliary tract (AAPBDS without DBT) associated with mucosal dysplasia of the biliary duct is described herein. A 53 year old male with a long history of diarrhea and right upper abdominal pain was diagnosed as having AAPBDS without DBT by endoscopic retrograde cholangiopancreatography and other examinations. Excision of the gallbladder and biliary duct with a Roux-en-Y hepatico-jejunostomy was performed and subsequent pathological examination of the surgical specimens showed mucosal hyperplasia of the gall-bladder and mucosal dysplasia of the biliary duct. Considering the dysplastic changes of the biliary duct as seen in our case, and the high incidence of AAPBDS without DBT developing into carcinoma of the biliary duct, being 12.2 per cent, we suggest that pancreaticobiliary ductal diversion with excision of the gall-bladder and biliary duct should also be performed for AAPBDS without DBT. However, further pathological investigations concerning the excised biliary duct in AAPBDS without DBT will be need to be carried out.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00308836
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  • 4
    Digitale Medien
    Digitale Medien
    A study on postoperative enteritis caused by methicillin-resistant Staphylococcus aureus (1993)
    Springer
    Surgery today 23 (1993), S. 4-8 
    Details
    ISSN: 1436-2813
    Schlagwort(e): methicillin-resistant Staphylococcus aureus (MRSA) ; enteritis ; enterotoxin ; coagulase ; epidemiologic study
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We investigated the production of staphylococcal enterotoxin (SE) with respect to coagulase types by methicillin-resistant Staphylococcus aureus (MRSA). A total of 138 strains of MRSA, which were isolated from clinical materials in the surgical ward between 1983 and 1990, were studied. Coagulase type IV strains produced SE A only, whereas coagulase type II strains were classified into four groups by SE production: SE B producing strains (32.7%), SE C producing strains (29.8%), SE B and C coproducing strains (12.5%), and SE A and C coproducing strains (25.0%). Almost all of the organisms (nine of ten) which were isolated from the feces of patients with MRSA enteritis were SE A and C coproducing strains. The coincidence in time of the prevalence of MRSA enteritis and the isolation SE A and C coproducing strains also demonstrated that these strains caused MRSA enteritis. Although SE C producing strains and SE A and C coproducing strains were simultaneously prevalent in 1990, the former tended to be sensitive while the latter tended to be resistant to minocycline. Considering the variety of antibiotic sensitivity in coagulase type II strains, it is thus considered to be of critical importance for epidemiologic purposes to further characterize isolates by SE typing.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00308992
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  • 5
    Digitale Medien
    Digitale Medien
    Postoperative enteritis caused by methicillin-resistantStaphylococcus aureus (1997)
    Springer
    Surgery today 27 (1997), S. 816-825 
    Details
    ISSN: 1436-2813
    Schlagwort(e): MRSA ; cytokine ; enterotoxin ; glucocorticoide hormone ; gamma globulin
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We examined the clinical features of 14 men (mean age 72 years) with postoperative enteritis caused by methicillin-resistantStaphylococcus aureus (MRSA). The patients had all undergone surgery for the treatment of digestive diseases and had received antibiotic prophylaxis consisting of an extended-spectrum cephem. Diarrhea appeared a mean of 3.3 days postoperatively and lasted for 5 days on average. In severe cases organ insufficiency was involved. Coagulase-positive staphylococci were the predominant organisms isolated from watery diarrhea. In 13 of 14 patients, coagulase type II isolates producing enterotoxins A, C and toxic shock syndrome toxin-1 (TSST-1) withenterotoxin A, C, andtst genes were isolated. These strains were sensitive to vancomycin and arbekacin; however, they were highly resistant to many other antibiotics. We also investigated the effects of a glucocorticoid hormone and gamma globulin on production of tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2) obtained from healthy volunteers. TNF-α and IL-2 production was enhanced by TSST-1 and the supernatant of Iscove-modified dulbecco medium, in which coagulase type II isolates producing enterotoxins A, C and TSST-1 with enterotoxin A, C were cultured for 24h. Both glucocorticoid hormone and gama globulin suppressed TNF-α and IL-2 production, thus suggesting that these drugs may be effective in treating postoperative MRSA enteritis.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02385272
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  • 6
    Digitale Medien
    Digitale Medien
    The influence of clinical use of antibiotics on the sensitivity of strains isolated from postoperative infections —A comparison of nosocomial pathogens with strains isolated from the bacterial flora of patients— (1991)
    Springer
    Surgery today 21 (1991), S. 376-380 
    Details
    ISSN: 1436-2813
    Schlagwort(e): third-generation cephems ; antibiotic resistance ; Gramnegative rod ; nosocomial infection ; methicillin-resistantStaphylococcus aureus (MRSA)
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In the present study, we investigated how the recent clinical use of antibiotics have altered the antibiotic susceptibility of strains isolated from postoperative infections, especially Gram-negative rods. ForPseudomonas aeruginosa, serogroup E strains acounted for about 20 per cent of postoperative infections, but were unable to the isolated from either the feces of patients on admission or from the appendix contents of patients with appendicitis. It therefore appeared that serogroup E strains were responsible for the nosocomial infections in our department. The strains of methicillin-resistantStaphylococcus aureus andPseudomonas aeruginosa serogroup E, which we assumed to be nosocomial pathogens, acquired a high level of resistance to antibiotics soon after third-generation cephems became widely used. On the other hand, the antibiotic susceptibility ofEnterobacter cloacae, Citrobacter freundii, and the serogroups ofPseudomonas aeruginosa other than E, which were considered to originate from the bacterial flora of patients, did not vary throughout the several years of the study period.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02470964
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