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1.
JPEN J Parenter Enteral Nutr ; 6(3): 240-4, 1982.
Artículo en Inglés | MEDLINE | ID: mdl-6125609

RESUMEN

A 21-year-old female patient suffering from fulminant hepatic failure was treated with extracorporeal normothermic baboon's liver perfusion for 60 hours. The amino acids (AA) uptake of the extracorporeal organ and the ratio of plasma and muscle AA at the end of the perfusion were measured. The AA uptake of the extracorporeal liver was 414 millimoles per 60 hours and even greater during hemodialysis treatment. In spite of this AA uptake, the plasma AA pattern was not normalized. At the end of the perfusion, the free AA concentration in muscle tissue was 86.25 millimoles per liter of intracellular water, an increase of 62% compared to healthy volunteers. In the patient, the ratio of glutamine to glutamine in muscle tissue was 20 to 1 compared to 5 to 1 in normals. It is concluded that (1) the extracorporeal baboon liver cannot extract the quantities of AA released by endogenous protein catabolism in hepatic failure, and (2) the muscular ammonia detoxification system gets overloaded as indicated by the increase ratio of glutamine to glutamate.


Asunto(s)
Aminoácidos/metabolismo , Encefalopatía Hepática/terapia , Hígado , Músculos/metabolismo , Perfusión , Adulto , Animales , Femenino , Glutamatos/metabolismo , Ácido Glutámico , Glutamina/metabolismo , Encefalopatía Hepática/metabolismo , Humanos , Hígado/metabolismo , Papio , Urea/metabolismo
2.
Wien Klin Wochenschr ; 93(7): 227-30, 1981 Apr 03.
Artículo en Alemán | MEDLINE | ID: mdl-6167076

RESUMEN

Serum alpha-1-fetoprotein (AFP) and serum lactic dehydrogenase isoenzymes (LDH I-V) were evaluated in healthy subjects as well as in 10 patients with primary liver carcinoma, in 10 patients with metastatic liver cancer and in 10 patients with cirrhosis of the liver. The diagnosis was established histologically in all cases. The upper limit of the normal AFP range was 9 ng/ml. Four out of all the patients with hepatocellular or cholangiocellular carcinomas had normal AFP values, 3 showed slightly increased AFP values, whilst a serum AFP concentration exceeding 174 ng/ml - limit which is statistically highly suggestive of hepatoma - was found in only 3 patients. Three out of the patients with metastatic liver cancer and 3 with cirrhosis showed moderately increased AFP values. In primary liver cancer LDH V is increased significantly and 8 out of all patients showed higher values of LDH V than LDH IV. By contrast, patients with metastatic liver cancer had significantly increased LDH IV, which was higher than LDH V in 9 out of all cases. Cirrhotics showed normal LDH isoenzymes. Combining these results, a definitive diagnosis could be made in 9 patients with primary carcinoma of the liver and in 9 patients with metastatic liver cancer.


Asunto(s)
Adenoma de los Conductos Biliares/enzimología , Neoplasias de los Conductos Biliares/enzimología , Carcinoma Hepatocelular/enzimología , L-Lactato Deshidrogenasa/sangre , Neoplasias Hepáticas/enzimología , alfa-Fetoproteínas/análisis , Neoplasias de la Mama/enzimología , Neoplasias del Colon/enzimología , Humanos , Isoenzimas , Cirrosis Hepática/enzimología , Neoplasias Hepáticas/secundario , Neoplasias Pancreáticas/enzimología
3.
Wien Klin Wochenschr ; 98(22): 769-74, 1986 Nov 21.
Artículo en Alemán | MEDLINE | ID: mdl-3492819

RESUMEN

Surgical treatment of Crohn's disease and ulcerative colitis is standardized today, despite several unresolved problems. Cooperation between gastroenterologist and surgeon is essential to establish the indication for surgery in emergency situations and during the chronic phase, as well. The surgical procedures aim for maximum preservation of function; in Crohn's disease salvage of bowel by means of limited resections and strictureplasty has priority, whilst in ulcerative colitis the preservation of sphincter function is the paramount goal, wherever possible, by means of ileorectostomy and ileal pouch procedures.


Asunto(s)
Colitis Ulcerosa/cirugía , Enfermedad de Crohn/cirugía , Canal Anal/cirugía , Colectomía , Neoplasias del Colon/cirugía , Hemorragia Gastrointestinal/cirugía , Humanos , Ileostomía , Íleon/cirugía , Fístula Intestinal/cirugía , Obstrucción Intestinal/cirugía , Perforación Intestinal/cirugía , Megacolon Tóxico/cirugía , Recto/cirugía
4.
Wien Klin Wochenschr ; 95(21): 769-73, 1983 Nov 11.
Artículo en Alemán | MEDLINE | ID: mdl-6673368

RESUMEN

The feasibility of sphincter preservation was studied in surgery of tumours in the upper, middle and lower third of the rectum. All patients operated on for rectal cancer between January 1977 and May 1980 were included in the investigation. Preoperative localization of the tumours was performed with the rigid sigmoidoscope. Every patient was scheduled for post-operative follow up. Altogether 211 patients were operated on for rectal cancer. 111 were treated by anterior resection, 90 by abdominoperineal excision, and 10 by other sphincter-saving methods. All of the 59 tumours located in the upper third of the rectum (12 to 16 cm from the anus) were treated by anterior resection. 62 tumours were located in the middle third (8 to 12 cm). In these cases anterior resection was carried out in 60% of the men and in 82% of the women, whereas the other patients underwent abdominoperineal excision. 80 tumours were located in the lower third (4 to 8 cm). Anterior resection was possible in only 4.4% of the men and in 14% of the women. Irrespective of their localization on sigmoidoscopy, 37% of the tumours which were within reach of the finger on rectal palpation could be removed by anterior resection. Local recurrence after anterior resection occurred in 18.3%, the median follow-up time being 50 months. The cumulative probable survival for all stages was more than 5 years for 60% of the patients.


Asunto(s)
Canal Anal/fisiología , Neoplasias del Recto/cirugía , Anciano , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Procedimientos Quirúrgicos Operativos/efectos adversos , Dehiscencia de la Herida Operatoria/etiología
5.
Wien Klin Wochenschr ; 95(9): 295-7, 1983 Apr 29.
Artículo en Alemán | MEDLINE | ID: mdl-6613143

RESUMEN

A prospective study was undertaken of the incidence, symptoms, diagnostic measures and therapy of local recurrence of colorectal carcinoma following radical surgical management. 69 (16%) out of 434 patients developed recurrence of the tumour, which was local in 51 patients (12%). Half of the latter group was symptom free at the time of diagnosis. 45 out of the 51 patients were treated by surgery, a radical operation being feasible in 25 cases. 60% of these have survived for at least 30 months. The operative mortality was very low, with only one death, although extensive surgery was necessary in most of the cases. The preliminary results of this study support the hypothesis that a postoperative follow-up programme for patients with colorectal cancer leads to early detection of local recurrence and improves the chance of cure by surgical treatment.


Asunto(s)
Neoplasias del Colon/cirugía , Recurrencia Local de Neoplasia/cirugía , Neoplasias del Recto/cirugía , Humanos , Recurrencia Local de Neoplasia/mortalidad , Estudios Prospectivos
6.
Wien Klin Wochenschr ; 90(6): 197-200, 1978 Mar 17.
Artículo en Alemán | MEDLINE | ID: mdl-345629

RESUMEN

26 pig kidneys were perfused in a "Gambro" kidney perfusion machine. The perfusates used were unmodified canine plasma and serum, as well as complement-free plasma, gamma-globulin solutions obtained from dogs immunized against pig leucocytes (ALG) and 2-mercapto-ethanol treated ALG (2 ME-ALG). The typical pig-to-dog xenograft rejection was reproduced by ex vivo perfusion with native dog plasma and serum. Using complement-free dog plasma, ALG and 2 ME-ALG pig kidneys could be perfused for several hours without significant increase in perfusion resistance. 22 pig kidneys, pretreated by perfusion for 2 hours with complement-free dog plasma, ALG and 2 ME-ALG, were transplanted on to the vessels of the neck of recipient dogs. Grafts pretreated with decomplemented dog plasma and 2 ME-ALG were rejected in the usual fashion within 5 to 20 min. Pretreatment with ALG resulted in a prolongation of graft function for 80 to 100 min. It is suggested that ALG exerted a transient blocking effect on the cytotoxic action of recipient IgM resembling passive enhancement; this phenomenon may be limited to sites with low antigen density, corresponding to in vitro findings of passive enhancement on cells with low surface antigen density.


Asunto(s)
Supervivencia de Injerto , Trasplante de Riñón , Trasplante Heterólogo , Animales , Anticuerpos , Suero Antilinfocítico , Proteínas del Sistema Complemento , Perros , Inmunización , Leucocitos/inmunología , Mercaptoetanol , Perfusión , Porcinos
7.
Wien Klin Wochenschr ; 95(9): 291-4, 1983 Apr 29.
Artículo en Alemán | MEDLINE | ID: mdl-6613142

RESUMEN

The value of pelvic computed tomography (CT) in the detection of local recurrence following radical operation for rectal cancer was assessed in a prospective study on 15 patients. A positive CT finding was checked in every instance by a second-look operation (11 cases). Tumour tissue in the pelvis was found in 9 patients, whereas in 2 patients the positive CT finding was proven to be false. 5 out of 9 cases with recurrent tumour underwent radical surgery. In the 4 cases with a negative CT finding no recurrence has developed after a median observation time of 34 months. Pelvic CT is a useful and reliable method of detecting pelvic recurrence before it becomes clinically obvious. However, the method does not allow certain prediction of whether or not the recurrence will be radically operable.


Asunto(s)
Adenocarcinoma/diagnóstico por imagen , Recurrencia Local de Neoplasia/diagnóstico por imagen , Pelvis/diagnóstico por imagen , Neoplasias del Recto/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Anciano , Antígeno Carcinoembrionario/análisis , Femenino , Fístula/etiología , Humanos , Hidronefrosis/etiología , Metástasis Linfática/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Dolor/etiología , Perineo , Estudios Prospectivos , Neoplasias del Recto/cirugía
8.
Wien Klin Wochenschr ; 98(24): 851-5, 1986 Dec 19.
Artículo en Alemán | MEDLINE | ID: mdl-3825158

RESUMEN

Results of a computer supported follow-up-program on patients with colorectal cancer are presented. Between 1978 and 1985 1024 patients underwent these program, the drop-out-rate was 18%. 231 recurrences in 137 patients were discovered (40% local recurrence, 30% liver metastases and 30% others). 54% of patients with local recurrence and 43% with liver metastases were free of symptoms. Radical surgery was performed in 47% of local recurrences and in 24% of liver metastases. The three year survival rate after radical surgery for recurrence amounted to 28% for local recurrences and to 31% for liver metastases.


Asunto(s)
Neoplasias del Colon/cirugía , Recurrencia Local de Neoplasia/cirugía , Neoplasias del Recto/cirugía , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/secundario , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias Primarias Múltiples/cirugía , Cooperación del Paciente , Complicaciones Posoperatorias/diagnóstico
9.
Wien Klin Wochenschr ; 97(18): 714-9, 1985 Sep 27.
Artículo en Alemán | MEDLINE | ID: mdl-3907154

RESUMEN

21 cases of transplantation of the liver are analysed for indication, anaesthesia, operative management, anhepatic period, immunological therapy and specific post-operative problems (jaundice and rejection episodes). Causes of death are noted and prediction of survival gives a rate of 55%/1st year in the 17 patients operated on since 1982 under a standardised management schedule. The transplantation programme in Vienna provides routine treatment for otherwise untreatable primary (57% cases) and secondary metastatic (14%) tumours of the liver, and, in the second place, for end-stage hepatic cirrhosis (14%) and certain rare liver diseases (14%).


Asunto(s)
Trasplante de Hígado , Adulto , Anciano , Austria , Rechazo de Injerto , Humanos , Inmunosupresores/uso terapéutico , Cirrosis Hepática/cirugía , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Persona de Mediana Edad , Cuidados Posoperatorios , Complicaciones Posoperatorias , Pronóstico
15.
Langenbecks Arch Chir ; 356(1): 61-4, 1982.
Artículo en Alemán | MEDLINE | ID: mdl-6976494

RESUMEN

Eighteen cases of operated ulcerative colitis are described. In 15 cases ileorectal anastomosis was performed. In one case, the rectum had to be excised because of a massive rectal haemorrhage; in another case, the anastomosis had to be separated Hartmann's operation) because of a dehiscence of the anastomosis. A re-examination of 13 patients shows full continence in 12 cases; one patient was incontinent with regard to flatus. The Karnofsky Index shows 100 in 10 patients, and 90 in 3 patients. The sigmoidoscopy reveals normal rectal mucosa in 6 patients, a moderate colitis in 5 patients and a severe colitis in 2 patients. There are only two indications for rectal excision in our opinion: uncontrollable rectal haemorrhage and carcinoma (dysplasia).


Asunto(s)
Colitis Ulcerosa/cirugía , Adulto , Canal Anal/cirugía , Colectomía , Incontinencia Fecal/etiología , Femenino , Hemorragia Gastrointestinal/cirugía , Humanos , Masculino , Complicaciones Posoperatorias/etiología , Neoplasias del Recto/cirugía , Recto/cirugía , Recurrencia
16.
Chir Forum Exp Klin Forsch ; (1978): 209-13, 1978.
Artículo en Alemán | MEDLINE | ID: mdl-752588

RESUMEN

A new model of a reversible long-term pancreatic fistula was used on an alert, unrestrained dog to test the effect of four substances of the GEP system on the exocrine pancreatic function. The results indicate that SST significantly inhibits not only the basal secretion but also the stimulated secretion of volume, bicarbonate, and trypsine. Calcitonine inhibits only the stimulated secretion whereas PGE1 inhibits only the secretin-stimulated output of trypsine. Glucagon inhibits secretin stimulation in all three parameters.


Asunto(s)
Páncreas/metabolismo , Jugo Pancreático/metabolismo , Animales , Bicarbonatos/metabolismo , Calcitonina/farmacología , Creatina Quinasa/farmacología , Perros , Glucagón/farmacología , Páncreas/efectos de los fármacos , Fístula Pancreática , Jugo Pancreático/efectos de los fármacos , Prostaglandinas E/farmacología , Somatostatina/farmacología , Tripsina/metabolismo
17.
Eur Surg Res ; 13(3): 213-26, 1981.
Artículo en Inglés | MEDLINE | ID: mdl-6114865

RESUMEN

Using a new model of a reversible pancreatic fistula which allows the long-term-investigation under nearly physiological conditions on the unrestrained dog, we tested the effect of somatostatin (50 micrograms), calcitonin (4 micrograms), glucagon (1 microgram), and prostaglandin E1 (150 micrograms) on the exocrine pancreatic function in 45 experiments over a period of 13 h: SST inhibits the basal as well as the secretin or CCK-stimulated secretion: calcitonin shows inhibition of the stimulated secretion only; glucagon blocks the secretin-stimulated pancreatic function; and PGE1 reduces the bicarbonate concentration and trypsin output in secretin stimulation, but in one of the two series it stimulates the basal secretion.


Asunto(s)
Calcitonina/farmacología , Glucagón/farmacología , Jugo Pancreático/efectos de los fármacos , Prostaglandinas E/farmacología , Somatostatina/farmacología , Animales , Bicarbonatos/análisis , Perros , Jugo Pancreático/análisis , Jugo Pancreático/metabolismo , Tripsina/análisis
18.
Z Gastroenterol ; 17(2): 90-8, 1979 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-425590

RESUMEN

Various sorbents were tested in-vitro for their ability to support hepatic excretory and detoxification functions, and their in-vivo perfusion with plasma was studied in an animal experiment. Amino acids, particularly phenylalanine and tyrosine, were strongest bound by activated charcoal, while Amberlite XAD-7 removed conjugated and unconjugated bilirubin and bile acids from plasma. Using a cell-separator plasma of dogs, in whom acute liver failure was induced by yellow phosphorus, was perfused through a combination of charcoal and Amberlite XAD-7 without major complications. Platelet counts remained nearly unchanged, platelet aggregation was inhibited reversibly, and circulating platelet aggregates occurred late only. It is concluded that using the method described, therapeutic trials in patients with fulminant hepatic failure can be performed.


Asunto(s)
Hemoperfusión/instrumentación , Cirrosis Hepática/inducido químicamente , Animales , Ácidos y Sales Biliares/aislamiento & purificación , Bilirrubina/aislamiento & purificación , Carbón Orgánico , Perros , Cirrosis Hepática/terapia , Fósforo , Resinas de Plantas
19.
Eur J Surg ; 157(1): 51-5, 1991 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-1675882

RESUMEN

Gastrointestinal lipomas are rare, but commonest in the colon and rectum, characteristically submucosal and seldom subserosal. An 18-year analysis revealed 17 cases of large-bowel lipoma, 13 presenting with colicky pain, abdominal discomfort, blood-stained feces or rectal bleeding and altered bowel habits and four asymptomatic. The 17 patients had totally 21 lipomas, all submucosal. No patients with multiple lipoma had evidence of lipoma at other sites. The ileocecal valve and cecum were most commonly affected, followed by the rectum, sigmoid colon and descending colon. Tumor size (largest diameter) was 0.5-10 cm, averaging 3.1 cm (3.5 cm in symptomatic, and 1.8 cm in asymptomatic patients). The primary diagnosis (with barium enema, colonoscopy and CT) was lipoma in only five cases, but CT gave the correct diagnosis in all three cases in which it was used. Two lipomas were found in surgical specimens from colorectal malignancy, while nine were misinterpreted as polyps and one as angiodysplasia. In symptomatic patients unnecessary colotomy or colonic resection may be avoidable by colonscopic removal of lipoma.


Asunto(s)
Neoplasias Intestinales/epidemiología , Intestino Grueso/patología , Lipoma/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Austria/epidemiología , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/epidemiología , Neoplasias del Colon/patología , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Intestinales/diagnóstico , Neoplasias Intestinales/patología , Lipoma/diagnóstico , Lipoma/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
20.
Z Kinderchir ; 36(3): 107-9, 1982 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-6750968

RESUMEN

37 renal allografts were performed on 27 children of 2-16 years of age. In 67% function was maintained for more than a year. At the beginning of 1981, 13 children had functioning grafts with a median serum-creatinine level of 1.8 +/- 1.2 mg%. 4 children had a functioning graft for more than 7 years. All children with functioning grafts were fully rehabilitated. Hence, renal transplantation is the optimal therapy in chronic renal insufficiency in childhood.


Asunto(s)
Fallo Renal Crónico/cirugía , Trasplante de Riñón , Adolescente , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Fallo Renal Crónico/terapia , Masculino , Métodos , Diálisis Renal , Donantes de Tejidos
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