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  • 1
    ISSN: 1432-1238
    Keywords: Key words Hypoxia ; Ischemia ; Acute phase proteins ; Cardiac arrest ; Infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Inflammation and hypoxia are frequently associated, but their interaction is poorly understood. In vitro studies have shown that hypoxia stimulates the genes of acute phase proteins (APP) and cytokines known to induce APP. We decided to determine kinetics and potential determinants of an acute phase response after cardiac arrest and to assess whether isolated moderate hypoxia can induce APP in humans in vivo. Design: Prospective, observational study in patients and human experiment. Setting: Tertiary care university hospital. Patients and participants: 22 patients after primarily successful cardiopulmonary resuscitation (CPR) and 7 healthy volunteers. Interventions: None in patients; exposure of volunteers to simulated altitude (460 torr/6 h). Results: Following CPR, type-1 APP (C-reactive protein, α1-acidglycoprotein, serum amyloid A) and type-2 APP (haptoglobin, α1-antitrypsin) increased consistently within 1–2 days and the ’negative' APP transferrin was downregulated. This APP response occurred irrespective of the cause of arrest, the estimated time of anoxia, clinical course or patient outcome and was not different in patients with and without infectious complications. Exposure of healthy volunteers to less severe but more prolonged hypoxia did not induce APP, although a time dependent increase of serum erythropoietin (EPO) was measurable under these conditions, indicating the activation of oxygen dependent gene expression. Conclusions: (i) A marked acute phase response occurs regularly after cardiac arrest, but within the complexity of this situation the severity of hypoxia is not a predominant determinant of this response. (ii) Despite in vitro evidence for similarities in the oxygen dependent regulation of APP and EPO production, the oxygen sensitivity of these proteins in vivo is different. (iii) Measurements of APP are not revealing regarding infectious complications in the early phase after CPR.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensivmedizin und Notfallmedizin 35 (1998), S. 332-336 
    ISSN: 1435-1420
    Keywords: Key words Schmidt's syndrome ; Addison disease ; Addisonian crisis ; Diabetes mellitus type I (IDDM) ; Autoimmune thyreoiditis ; Autoimmune polyglandular syndrome (APS) ; Schlüsselwörter Schmidt-Syndrom ; Morbus Addison ; Addison-Krise ; Diabetes mellitus Typ I (IDDM) ; Autoimmunthyreoiditis ; Auto-immunes Polyglanduläres Syndrom (APS)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das Zusammentreffen von Nebennierenrinden- und Schilddrüseninsuffizienz wird in der Literatur als Schmidt-Syndrom bezeichnet. Bei 2/3 dieser Patienten findet man einen koexistenten Diabetes mellitus Typ I. Da in der Gruppe der Diabetiker das Auftreten von pluriglandulären Erkrankungen beschrieben ist, sollte ein Krankheitsprozeß mit auffälliger Adynamie, Erbrechen, Bauchschmerzen, Exiskkose und Hypotonie auch an das gleichzeitige Vorliegen eines M. Addison denken lassen. Zusätzlich ist das frühzeitige Erkennen einer beginnenden Addison-Krise sehr wichtig, da trotz Intensivmedizin dieses Krankheitsbild mit einer hohen Letalität behaftet ist.
    Notes: Summary The coexistance of thyroid- and adrenocortical insufficiency is known as Schmidt's syndrome. In two-thirds of these patients you find also diabetes mellitus. In the group of diabetic patients one sees pluriglandular endocrine dysfunction more often than in non-diabetic patients. Therefore, one should be aware of a coexisting Addision's disease in diabetic patients who are complaining of tireness, weakness, vomiting, abdominal pain, and circulatory disturbances. It is very important to detect this combination as early as possible, because the lethality of an Addisionian crisis is still high.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 25 (1999), S. 113-117 
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of panarteritis with purpura fulminans, mononeuritis multiplex, gastrointestinal manifestation and presumably cardiac involvement in a previously healthy 22-year-old man with a history of drug abuse including cocaine, cannabinoids and methamphetamines is described. Histopathological examination of the gut led to the diagnosis of panarteritis without immune deposits. Antineutrophil antibodies were negative. Besides the drugs, no other possible cause of vasculitis was found. The patient recovered completely after 1 year. Drug abuse is a thus possible cause of severe extracerebral disabling vasculitis.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2277
    Keywords: Key words Combined liver-kidney transplantation ; Positive crossmatch ; Lymphocytotoxic antibodies ; Long-term follow up
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since August 1992, 18 patients underwent combined liver and kidney transplantation. Eight patients had lymphocytotoxic antibodies pretransplant and 5 of these patients (27.7%) had a positive crossmatch. Fifteen patients received cyclosporine-based immunosuppression and 3 patients were treated with a tacrolimus-based immunosuppressive protocol. One patient died in the postoperative course due to intractable bleeding episodes after 96 days and one kidney graft was lost due to technical complications. The 1-year survival rate of patients with combined transplantation was 95% vs 87% in patients with liver transplantation alone. None of the patients with a positive crossmatch experienced a hyperacute rejection of the kidney. The long-term patient and graft survival was not impaired in patients with a positive crossmatch. These results suggest that combined liver-kidney transplantation is a safe treatment for end-stage liver and renal disease. A positive crossmatch or positive lymphocytotoxic antibodies are not contraindications for a combined transplantation.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2242
    Keywords: Key words Potato ; Somatic hybrids ; Mt types ; Rearrangements ; Substoichiometric mtDNA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract  One hundred and eighty dihaploid clones used for protoplast fusions, and 144 tetraploid German potato cultivars were analysed for their cytoplasms using 11 homologous mt DNA-probes, and were classified as mitochondrial (mt) types α, β, γ, δ, and ɛ according to their RFLP patterns. From the 4x cultivars, 79 had the typical mt-type β of Solanum tuberosum being different from the 46 cvs which had the mt-α type and 19 others with mt-γ. A dendrogram shows their relationships to other Solanum species. The distantly related mt-ɛ was only found in di-haploids, and particularly in clones deriving from Solanum phureja and Solanum andigena. Accessory mt types will be actualized on website (http://www.edv.agrar.tu-muenchen.de/pbpz/ mm/mt/al1.htm). In order to evaluate the genetic potential of novel plastid-mitochondrial configurations we have analyzed four representative populations, which derive from different fusion-combination classes: [α (+) β], [α (+) γ], [α (+) δ] and [α (+) ɛ]. On the mitochondrial expression level, hybrids from an [α (+) ɛ] fusion could be distinguished by in-organello translation from [α (+) β] hybrids, and other di-haploids, by an additional translation product of 15 kDa. In fusion parents with mt-α and -γ an additional atp6 reading frame is detectable in sub-stoichiometric amounts by the use of specific PCR primers. The gene differs from the original 211 bp 3′ from the stop codon. Novel RFLP-patterns in 10% of the somatic hybrids were due to a high-rate replication of this pre-existing parental genome region. A second characteristic for somatic hybrids was the partial addition of parental mt sub-genomes. The major part of them revealed a new organization in their mt genomes at the mt-type characteristic loci rpl5, rps14, cob, rps10, coxI and rpl2, which contain recombination-specific repeats homologous to Petunia spp. and Nicotiana. A schematic model for the formation of novel mitochondrial genomes in potato somatic hybrids is provided.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 382 (1997), S. 138-140 
    ISSN: 1435-2451
    Keywords: Key words Malignant tumors ; Aorta
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Primäre maligne Tumoren der Aorta sind seltene Erkrankungen. Wir beschreiben hier unser therapeutisches Vorgehen bei einem 55jährigen Patienten. Der Patient wurde mit einer progredienten Niereninsuffizienz in unserer Klinik aufgenommen. Bei der Angiographie fanden sich ein Verschluß der rechten und eine hochgradige Stenose der linken Nierenarterie. Die Diagnose des intraluminal wachsenden malignen Aortentumors wurde aus dem bei der Angiographie gewonnenen Thrombenmaterial bestätigt. Fünf Monate zuvor wurde bei der histologischen Aufarbeitung von Thrombenmaterial der Verdacht anläßlich einer aortobiiliakalen Protheseninterposition wegen eines akuten Leriche-Syndroms geäußert. Bei der Computertomographie fanden sich Veränderungen in der Aorta etwa 2 cm oberhalb des Truncus coeliacus beginnend. Es erfolgte der thorakoabdominale Aortenersatz unter Resektion der Aorta und des periaortalen Gewebes und der Nephrektomie und Adrenalektomie links. Die Protheseninterposition wurde von der mittleren Aorta descendens bis zur Bifurkation beider Beckenarterien unter Resektion der alten aortobiiliakalen Prothese durchgeführt. Truncus coeliacus und A. mesenterica superior wurden über je ein Prothesensegment in die Aortenprothese reimplantiert. Drei Wochen nach der Erstoperation erfolgte die Nephrektomie rechts. Der postoperative Verlauf gestaltete sich unproblematisch.
    Notes: Abstract Primary malignant tumors of the aorta are only rarely reported. We describe here our findings in a 55-year-old patient who was referred to us with progressive renal insufficiency. At angiography, right renal artery occlusion and high-grade stenosis of the left renal artery was found in this patient, who had undergone aortobiliacal reconstruction for acute Leriche syndrome 5 months previously. Histological evaluation of thrombotic material revealed an intraluminal malignant tumor to be the underlying cause. This diagnosis was then confirmed in samples harvested during angiography. CT scan showed an extension beginning 2 cm proximal to the celiac trunk. The patient was treated by thoracoabdominal resection of the aorta, including the paraaortal tissue, left side nephrectomy, and adrenalectomy. A thoracoabdominal aortic prosthesis was inserted up to the iliacal bifurcations and the celiac and su-perior mesenteric arteries reimplanted. Right nephrectomy followed 3 weeks later. The postoperative course was uneventful.
    Type of Medium: Electronic Resource
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