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  • 1
    ISSN: 1619-7089
    Keywords: Tumor scintigraphy ; CEA monoclonal antibodies ; Colorectal cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 14 patients with proven local recurrence of colorectal cancer or metastases in liver and/or lungs, the sensitivity (SE) in detecting tumor sites was estimated in a single-blind study using conventional planar whole body scintigraphy. Nine patients received F(ab′)2 and five received MAB by intravenous infusion over 30 min with a dose of 40–200 MBq after skin testing and thyroid blocking, scanning was performed 1–7 days later. All but one patient had elevated plasma CEA levels with a mean of 25.5±31.9 ng/ml. The scans were interpreted by two independent observers. In five of the nine patients receiving F(ab′)2, the tumor site could be visualized, yielding a sensitivity of 55%. No tumor sites were identified with MAB. The highest tumor uptake was recorded in a patient with additional ovarian cancer with the activity accumulating in the ovarian cancer. The optimum time for imaging was 3 or 4 days after injection. There was no correlation between positive imaging and plasma CEA levels which ranged from 1.9 ng/ml to 100 ng/ml in the positive cases. The thyroid uptake on the sixth day was 0.68%±0.2% of the total dose given despite thyroid blocking. Bone uptake of 131I was also observed, this was mild in four patients, moderate in three but high in one patient, especially on days one to four. Thus, only anti-CEA F(ab′)2 seem to be of clinical interest for further evaluation in localizing colorectal cancer. Regarding the still low sensitivity of 55%, further improvement can be expected by gaining experience, using more appropriate isotopes such as 111In and SPECT. The estimated radiation side effects on thyroid and bone marrow are only modest.
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  • 2
    ISSN: 1573-2568
    Keywords: oxygen radicals ; pancreatitis ; glutathione ; lipid peroxidation ; purine metabolites ; scavengers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to evaluate the effect of free radical ablation therapy in acute hemorrhagic pancreatitis. Acute pancreatitis was induced in 64 rats by retrograde injection of 5% sodium taurocholate. Thirty animals were pretreated with 100,000 units/kg/hr of superoxide dismutase (SOD) and 400,000 units/kg catalase within the first 3 hr. After 0.5, 3.5, and 12 hr of observation time, serum enzymes and the tissue content of conjugated dienes, malondialdehyde, reduced and oxidized glutathione, as well as ATP, ADP and AMP were measured. In addition, tissue samples were examined by light microscopy. Untreated rats (N=34) developed within 12 hr an acute hemorrhagic necrotizing pancreatitis with a concomitant increase in serum enzyme levels and a decrease in reduced glutathione and ATP. Within the 12-hr observation period, 57% of the animals died. Scavenger treatment improved the tissue damage and attenuated the increase of the serum enzyme levels and the decrease in reduced glutathione and ATP. Moreover, the lethality rate was significantly lower. Oxygen radicals seem to be instrumental for the development of acute hemorrhagic pancreatitis. Thereby, antioxidant treatment reduces tissue damage, biochemical alterations and extrapancreatic complications, thus improving the final outcome.
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  • 3
    ISSN: 1420-908X
    Keywords: Histamine ; Oxygen radicals ; PAF ; LECAM-1 ; Calcium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Oxygen derived free radicals are involved in many pathological processes such as postischemic reperfusion injuries, hepatotoxicity of drugs and inflammatory processes. Thereby these oxygen radicals induce lipid peroxidation and perturbation of cellular membranes. The aim of our present study was to determine whether oxygen radicals generated by the xanthine oxidase/hypoxanthine system cause a release of histamine in human blood cell cultures. Stimulation of blood cell cultures with oxygen radicals induced a histamine liberation which was mainly due to calcium independent processes during the first 30 min, whereas then calcium requiring processes took part in the release of histamine. The regulation of the leukocyte selectin LECAM-1 was altered by oxygen radicals whereas histamine, which is known to modulate vascular selectin expression, did not affect the expression of LECAM-1. Our data indicate that oxygen radicals induce a direct calcium independent release of histamine which is due to membrane pertubating processes during the first phase but also induce a specific reaction leading to a further indirect histamine liberation which is probably mediated by PAF.
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  • 4
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    Electronic Resource
    Springer
    Langenbeck's archives of surgery 352 (1980), S. 307-310 
    ISSN: 1435-2451
    Keywords: Endotoxin ; Gram-negative bacteria ; Shock ; Endotoxin ; Gramnegative Bakterien ; Schock
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Endotoxinschock ist die häufigste Form des septischen Schocks. Endotoxin, ein makromolekulares Lipopolysaccharid wird beim Zerfall aus der Zellwand der gramnegativen Keime freigesetzt. Bei Patienten mit bakterieller Peritonitis sind: Fieber über 38°C, Thrombocytopenie, Leukocytose, Lactacidose, Kreatininanstieg hinweisende Zeichen. Die Frühlaparotomie ist bei bakterieller Peritonitis der entscheidende Schritt zur Vermeidung eines Endotoxinschocks.
    Notes: Summary Endotoxin shock is the most frequent form of septic shock. Endotoxin, a macromolecular lipopolysaccharide, is released from the cellular wall of gram-negative spores. In patients with bacterial peritonitis these signs are typical: temperature above 38°C, thrombocytopenia, leukocytosis, lactazidosis, and increase of creatinine. Early laparotomy in bacterial peritonitis is the most important step to avoid endotoxin shock.
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  • 5
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Magensekretion stimulierende Wirkung von Histamin ist bei intraportaler Infusion deutlich vermindert. Dies wurde durch Untersuchungen am Hund u. a. von Lick et al., Irvine et al. and Silen et al. nachgewiesen. Da Histamin such beim Menschen ein wichtiger Chemostimulator der Magensekretion und im Kreislauf des endogenen Histamin die Leber einbezogen ist, untersuchten wir den Einfluß der Leberpassage auf die Histaminwirkung am Menschen. Bei 12 Patienten wurde Histamin in einer Dosis von 20 μg/kg KG/h (4 Pat.) und 40 μg/kg KG/h (8 Pat.) intraportal and intravenös infundiert. Die intraportale Infusion erfolgte fiber einen am Ende einer Laparotomie in eine Mesenterialvene eingelegten Teflon-Katheter. Die intravenöse Infusion geschah fiber einen Cava-Katheter. Der Magensaft wurde fiber einen unter Röntgenkontrolle plazierten Magenschlauch kontinuierlich abgesaugt. Mcßgrößen: Sekretvolumen, HCl-Ausstoß, Na+, K+, Cl−, aktueIler pH, Osmolarität and Viscosität. Die Ergebnisse nach intraportaler Stimulation wurden mit den Mcßwerten vom Basalsekret and des intravenos stimulierten Sekretes verghchen. Ergebnisse. 1. Intraportale Infusion von Histamin (40 μg/kg KG/h) führt zu einem signifikant verminderten Volumenausstoß, 134 ml gegen 220 ml. 2. Der HCl-Ausstoß war mit 13,6 mval/h bei intraportaler Stimulation signifikant niedriger als nach intravenösur Stimulation (23,4 mval/h). 3. Die intraportale Stimulation mit 20 μg/kg Histamin ergab gegenüber der Basalsekretion keine Steigerung. Die Beobachtungen am Menschen bestätigen die tierexperimentellen Befunde. Aus den eindeutigen Untersuchungsergebnissen muß geschlossen werden, daß die Leber des Menschen eine Histamin-inaktivierende Funktion besitzt.
    Notes: Summary The stimulating effect of histamine on the gastric secretion is distinctly reduced by intraportal infusion. This was demonstrated by investigations in dogs by von Lick et al., Irvine et al. and Silen et al. and other workers. Since in man, too, histamine is an important chemical stimulant of gastric secretion and the liver takes part in the circulation of endogenous histamine, we examined the effect of its passage through the liver on histamine action in man. In 12 patients histamine was infused intraportally and intravenously at a dosage of 20 μg/kg body weight per hour (4 patients) and 40 μg/kg b. w. p. h. (8 patients). Intraportal infusion was done via a teflon catheter introduced into a mesenteric vein at the conclusion of a laparotomy. Intravenous infusion took place via a V. cava catheter. The gastric juice was sucked off continuously through a gastric tube introduced under X-ray control. Estimations were done of volume of secretion, HCl production, Na+, K+, Cl-, actual pH, osmolarity and viscosity. The results after intraportal stimulation were compared with those of the basic secretion and of the intravenously stimulated secretion. Results. 1. Intraportal infusion of histamine (40 μg/kg b. w. p. h.) leads to a significant reduction in volume production, 134 ml compared with 220 ml. 2. HCl production at 13.6 mval/h was significantly lower after intraportal stimulation than after intravenous stimulation (23.4 mval/h). 3. Intraportal stimulation with 20 μg/kg histamine produced no increase compared with the basic secretion. The observations in man confirmed the animal-experimental findings. It must be concluded from the unequivocal results that the human liver possesses a histamineinactivating function.
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  • 6
    ISSN: 1435-2451
    Keywords: Surgery abdominal ; Geriatrics ; Factors of risk ; Complications, post-operative ; Abdominalchirurgie ; Geriatrie ; Risikofaktoren ; postoperative Komplikationen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 1005 Krankengeschichten von Patienten im Alter über 70 werden katamnestisch ausgewertet. 496 Pat. mit abdom. Operationen (Letalität = 30 %), 509 Pat. mit extraabdom. Op. (Let. = 14 %). Pro Pat. werden 75 präop. Daten mit 50 Daten aus dem intra- und postop. Verlauf verglichen. Die präop. Befunde korrelieren mit postop. Komplikationen und Letalität. Hauptrisikofaktoren: Hb 〈 10 g-%, Kreatinin 〉 1,5 mg-%, Herzrhythmusstörungen, Gerinnungsstörungen und intraoperativer Blutdruckabfall. Aus der Analyse folgt die Notwendigkeit intensiver präop. Therapie und Sofortkorrektur auch geringer postoperativer Abweichungen vom „Normalverlauf”.
    Notes: Summary The case histories of 1005 patients over 70 were studied retrospectively; 496 had undergone abdominal operations (lethality = 30%) and 509 extraabdominal operations (lethality = 14%). For each patient 75 items of information recorded in the preoperative period are compared with 50 items recorded during and after surgery. There is a correlation between preoperative findings and postoperative complications and lethality. The main factors of risk are: Hb 〈10 g%, creatinine 〉 1.5 mg %, cardiac arrhythmia, coagulation disorder, and intraoperative fall in blood pressure. The analysis implies the necessity for intensive preoperative treatment as well as for the immediate correction of even slight postoperative deviations from the norm.
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  • 7
    ISSN: 1435-2451
    Keywords: Abdominal surgery in the aged, factors of risk ; Abdominelle Operation ; Alter ; Risikofaktoren
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer retrospektiven Studie wurden die Krankendaten von 1005 Patienten, die im Alter von über 70 Jahren operiert werden mußten, analysiert. Aus dem Vergleich der präoperativen Befunde mit den postoperativen Komplikationen geht hervor, daß bei abdominalen OP's im Alter 〉 70J. präoperativ: Herzrhythmusstorung, Niereninsuffizienz, Anämie (Hb 〈 10 g %) und Bewußtseinsstörun-genRisikofaktoren darstellen. Keine Kontraindikation waren dagegen: verminderte Lungenfunktion (Atemgrenzwert 〈 50 %), insulinpflichtiger Diabetes Bowie ein Hypertonus. Letalität bei elektiven OP's im Alter 〉 70 Jahre: 191 Patienten Gallenweg-Op. 3-6,5 %; 171 Patienten Dickdarm-Op. (Carcinom) 14%; 29 Patienten Magen-Op. (Ulcus) 0%, 86 Patienten (Carcinom) 22%; 206 Patienten Leistenhernie 0 %.
    Notes: Summary Clinical data of 1005 patients, operated upon at an age beyond 70 years, were retrospectively analyzed. Comparing pre- and postoperative clinical data, the following risk factors for an abdominal surgical procedure were found: cardiac arrhythmia, renal insufficiency, anemia (Hb 〈 10 g %), and disturbance of consciousness. According to the study, a decrease of pulmonary function (AGW 〈 50 %), insulin-dependent diabetes and arterial hypertension do not represent operative contraindications. In several groups of patients (〉 70 years), the mortality after elective operations was: 191 patients with biliary tract disease, 3–6.5%; 171 with colorectal cancer, 14%; 29 with stomach ulcer, 0%; 86 with gastric cancer, 22 %; 206 with inguinal hernia, 0 %.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 349 (1979), S. 619-619 
    ISSN: 1435-2451
    Keywords: Endotoxin ; Peritonitis ; Endotoxin ; Peritonitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Endotoxin, ein Zerfallsprodukt aus der Wand Gram-negativer Bakterien ist bei Peritonitis in der Bauchhöhlenflüssigkeit, im Pfortaderblut und im peripheren Blut als toxische Substanz nachweisbar. Bei 25 Patienten mit fortgeschrittener Peritonitis (Gram-negat.K.) gelang es neben der Standardtherapie durch Spül-Saug-Technik - 1,5% Glucoselösung mit 11 l bzw. 27 l Spülflüssigkeit/die - Endotoxin in hoher Konzentration aus dem Peritoneum herauszuwaschen. Gelang es durch die Spültherapie, die über viele Tage durchgeführt werden mußte, einen Endotoxinübertritt in die Zirkulation zu vermeiden, war die Letalität 16,6%; bei Endotoxin auch im Blut war die Letalität 46,1%.
    Notes: Summary Endotoxin — a product of decomposition from the gramnegative bacterial wall is evident as a toxic substance in peritonitis in the abdominal cavity fluid, in the portal vein blood and in the peripheral blood. In 25 patients with advanced peritonitis endotoxin was eliminated in high concentration from the peritoneum by continuous lavage with 11 1/day 27 1/day of 1.5% glucose solution apart from standard therapy. When endotoxin uptake into the systemic circulation, was avoided by abdominal lavage, the mortality was 16.6%; in patients with endotoxin in the blood the mortality rose to 46.1%.
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  • 9
    ISSN: 1435-2451
    Keywords: Billroth I ; Peptic ulcer ; Neoplasma ventriculi ; Billroth I ; Peptisches Ulcus ; Magencarcinom
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei insgesamt 322 Patienten wurde eine Billroth I-Magenresektion durchgeführt. 221 Patienten hatten ein peptisches Ulcus und 101 Patienten ein Antrumcarcinom. Die Operationsletalität beim unkomplizierten Ulcus (n = 115) betrug 2,6% und beim komplizierten Ulcus (n = 106) 7,5%. Die Operationsletalität beim Carcinom betrug 9%; 60% dieser Patienten waren über 70 Jahre alt. Folgende Heilungsraten wurden erzielt: 2 Jahre 64%, 3 Jahre 54%, 5 Jahre 32%. Nach diesen Ergebnissen ist die B I-Resektion nicht nur beim peptischen Ulcus sondern auch beim Antrumcarcinom ein erfolgreiches Therapieprinzip.
    Notes: Summary In a total of 322 patients a Billroth I gastrectomy was performed: 221 patients had a peptic ulcer and 101 patients had a carcinoma of the gastric antrum. Mortality in the patients with an uncomplicated ulcer (n = 115) was 2.6% and 7.5% in the patients with a complicated ulcer (n = 106). Mortality in the carcinoma patients was 9%. The following survival rates were obtained: 2 years for 64 %, 3 years 54 %, and 5 years 32 %. According to these results the B I gastrectomy is a successful treatment not only in peptic ulcer desease but also in patients with carcinoma of the gastric antrum.
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  • 10
    ISSN: 1435-2451
    Keywords: Acute pancreatitis ; Surgery ; Akute Pankreatitis ; Nekrosen ; Operationen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 117 Patienten mit nekrotisierender akuter Pankreatitis (103 Partialnekrose, 14 Totalnekrose) wurden in einem 12-Jahres-Zeitraum mit einer Kliniksletalität von 34% operiert. Die Letalität bei nekrotisierender Pankreatitis hängt ab vom Ausmaß der Pankreasnekrose, von der Ausdehnung der Nekrosen in extrapankreatische Geweberäume, vom Ausmaß der Funktionseinschränkungen, sowie vom Zeitpunkt der Nekrotektomie. Die Nekrotektomie mit lokaler Spül-Saug-Drainage der Nekrosehöhlen sowie kontinuierlicher Peritonealspülung ist ein aufwendiges Therapieverfahren, vermindert jedoch deutlich die pankreatitischen Komplikationen und die Letalität. Reoperationshäufigkeit 19 %, Krankenhausliegezeit 48 ± 19 Tage.
    Notes: Summary In a 12-year-period, 117 patients with acute necrotizing pancreatitis were operated upon (103 with partial necrosis, 14 with total necrosis). Forty patients with necrotizing pancreatitis died after surgery (34 %). In 86 patients extrapancreatic, retroperitoneal necrosis were detected. The compilation of intraoperative findings revealed that lethality rises in proportion to the extension of retroperitoneal necrosis. There was a strong evidence that patient lethality depends on the severity of the pancreatic necrosis, the time of surgical intervention, and the bacterial contamination. The rate of reoperation was 19 %; the clinical stay of the patients was 48 ± 19 days.
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