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  • 1
    ISSN: 1432-1076
    Keywords: HLA ; Histocompatibility antigens ; Primed lymphocyte typing (PLT) ; Disease associations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Following a description of the genetic aspects of the human histocompatibility antigen system HLA and its principle typing methods, this paper reviews the relationship between HLA antigens, transplantation immunology and certain diseases. In particular, the role of the lymphocyte-defined antigens of the HLA-D system is emphasized on the basis of a special typing method, the PLT test, used in our laboratory. Aside from its necessity in bone marrow and kidney transplantation, HLA typing can be used as an additional diagnostic or prognostic tool for certain diseases. Among the pediatric age group, this includes rheumatic fever and other rheumatic diseases, insulin-dependent juvenile diabetes mellitus, some forms of Addison's disease, thyrotoxicosis, myasthenia gravis, celiac disease, and some complement deficiency disorders. Close linkage of the HLA system with steroid 21-hydroxylase deficiency has made it possible to diagnose this form of congenital adrenal hyperplasia in utero. This approach is illustrated in a large family at risk for this disorder.
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  • 2
    ISSN: 1432-1076
    Keywords: Insulin dependent diabetes ; Remission ; Glucose ; Tolbutamide ; Arginine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The insulin secretory capacity was examined in diabetic children at the time of partial clinical remission during which their condition could be managed with low insulin therapy (〈0.5 U insulin/kg body weight) and no urinary glucose excretion. The extent of the residual beta cell function in 26 children was assessed either by an i.v. arginine test, a combined i.v. glucose-i.v. arginine test, a combined i.v. tolbutamide-i.v. arginine test, or a combined oral glucose-i.v. arginine test determining the C-peptide response by calculating the area under the curve above baseline levels. Two of the children were tested repeatedly. Under the above conditions i.v. glucose and i.v. tolbutamide did not release C-peptide in diabetic children. In contrast, C-peptide secretion during arginine infusion following i.v. glucose or i.v. tolbutamide was siginficantly enhanced compared to the C-peptide secretion observed during arginine infusion alone. The C-peptide response to oral glucose was sluggish with no effect on the following arginine infusion. The results indicate that during remission in juvenile onset diabetes i.v. glucose and i.v. tolbutamide without themselves being an appropriate signal for C-peptide release amplify the response to a subsequent arginine infusion under appropriate conditions.
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  • 3
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Histamine assays can be unreliable in individual subjects or samples even though the particular method is in general working very well. Therefore the specificity and accuracy of histamine determination in the gastric aspirate of individual duodenal ulcer patients was thoroughly examined and shown to be satisfactory. Pitfalls of the fluorometric assay were investigated. A native (non-histamine) fluorescence in gastric aspirate which occurs before the addition of OPT was not removed by the original Shore procedure. In the combined assay (Dowex 50+ butanol extraction) this fluorescence no longer interferes with the assay. For the identification of histamine in a single gastric aspirate of an individual duodenal ulcer patient, the reversed blank (3M HCl added to the reaction mixture before OPT instead after OPT), excitation and fluorescence spectra, the heating test with spectra recorded and the HMT test were found to be reliable. The formaldehyde test and the heating test without recording the spectra were useless since they gave false negative results. Since the HMT test was regarded as a reference method it was thoroughly investigated both by theoretical considerations (enzyme kinetics) and by a series of measurements in a single patient as well as in a group of nine subjects. Samples from the period of peak acid output in response to pentagastrin showed an average histamine concentration of about 8 ng/ml and a histamine output of 1.5 μg/30 min.
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  • 4
    Electronic Resource
    Electronic Resource
    s.l. : American Chemical Society
    Journal of the American Chemical Society 75 (1953), S. 2747-2750 
    ISSN: 1520-5126
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
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  • 5
    ISSN: 1520-5126
    Source: ACS Legacy Archives
    Topics: Chemistry and Pharmacology
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  • 6
    ISSN: 1741-0444
    Keywords: Analogue-digital conversion ; Data acquisition systems ; microprocessors ; Modems ; Telephone line
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
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  • 7
    ISSN: 1435-2451
    Keywords: Anastomotic insufficiency ; SPTU stapler ; Gastrectomy ; Anastomoseninsuffizienz ; Gastrektomie ; SPTU-Klammernahtgerät
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer prospektiven, konsekutiven Studie wurden 26 Kranke wegen Magencarcinom gastrektomiert und nach Longmire-Gütgemann eine 40 cm lange Jejunumschlinge End-zu-End isoperistaltisch durch SPTU-Klammernaht (12 Kranke) bzw. Cerny-Handnaht (Polyglykoleinzelknopfnähte, 14 Kranke) interponiert. Die Gruppen waren vergleichbar hinsichtlich Alter, Geschlecht, Gewicht, TNM-Stadium und Anzahl der Operateure. Die Insuffizienzrate betrug bei der SPTU-Naht 6/12, bei der Handnaht 2/16. 2mal versagte das Gerät intraoperativ. Eine generelle Empfehlung des SPTU ist daher nicht möglich.
    Notes: Summary Gastrectomy and gastric replacement by an isoperistaltic 40-cm jejunal loop with end-to-end anastomosis between the esophagus and jejunum were performed on 26 patients with adenocarcinoma of the stomach. This anastomosis was performed by the SPTU in 12 and by hand (Cerny interrupted sutures) in 14 cases. Patients were comparable according to age, sex, weight, TNM stage, and number of surgeons. Rate of anastomosic insufficiency was 6/12 in the SPTU and 2/16 in the Cerny group. Technical defects occurred twice intraoperatively with SPTU. Therefore, regular use of the SPTU is not recommended.
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  • 8
    ISSN: 1435-2451
    Keywords: Upper gastrointestinal bleeding ; Laser therapy ; Randomized controlled trials ; Obere Gastrointestinalblutung ; Lasertherapie ; Randomisierte, klinische Studien
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Für die Planung randomisierter Therapievergleichsstudien interessierten Faktoren von Prognoserelevanz. 248 Kranke mit Meläna und/oder Hämatemesis wurden hinsichtlich der Aktivität und des Typs ihrer endoskopisch verifizierten Läsionen untersucht. Jeder 5. Kranke mit Zeichen der aktiven Blutung, jeder 6. mit Zeichen der vorausgegangenen Blutung, aber nur jeder 11. ohne Blutungszeichen verstarb in der Klinik. Arteriell Blutende hatten eine höhere Letalität als solche mit Sickerblutung. Blutungsaktivität und Blutungstyp haben Prognoserelevanz und sind bei Studienplanung zu berücksichtigen.
    Notes: Summary To evaluate different treatment attitudes in upper GI bleeders we must know the factors that might influence outcome. In a 2.5-year period 248 patients had early endoscopy. Every four to five patients had more than one lesion. Every fifth patient with an actively bleeding lesion, every 6th with a recent lesion, and every 11th with no bleeding lesion died during hospital stay. Arterial bleeding was combined with 33 %, but capillary bleeding showed only 23 % mortality. Therefore, bleeding activity and bleeding type are relevant prognostic factors to be incorporated in trial designs.
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  • 9
    ISSN: 1435-2451
    Keywords: Pancreatitis ; Therapeutic lavage ; ankreatitis ; therapeutische Lavage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die geschlossene Peritoneallavage erlaubt eine Diagnosesicherung des Krankheitsbildes durch Nachweis rotbrauner und ungetrübter freier Flüssigkeit mit hoher Amylasekonzentration in der freien Bauchhöhle. Bakteriologische Untersuchungen zeigen im Gegensatz zu anderen Krankheitsbildern Keimfreiheit. Die therapeutische Peritonealdialyse führt zur sofortigen Verbesserung des Krankheitsbildes und erlaubt bakteriologische Verlaufsbeobachtungen. Die Frühoperation 1äßt sich vermeiden, die Nekrosendemarkierung kann abgewartet werden. Die Letalität wurde von 50 auf 34% gesenkt.
    Notes: Summary Closed peritoneal lavage permits firm diagnosis of the clinical picture through the identification of an unobstructed reddish-brown fluid with high concentration of amylase in the open abdominal cavity. Here, in contrary to other clinical pictures, bacteriological tests have shown sterile conditions. Therapeutical peritoneal dialysis leads to immediate improvement of the clinical picture and allows bacteriological observations of the course. Early operation can be avoided and the demarcation of necrosis awaited. Lethality has been decreased from 50 % to 34 %.
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  • 10
    ISSN: 1435-2451
    Keywords: Stenoses of the oesophagus ; Bougienage ; Complication ; Endoscopic control ; Oesophagusstenose ; Bougierung ; Komplikationen ; endoskopische Kontrolle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Nach den bisherigen Methoden erfolgt die Bougierung der Speiseröhre unter teilweiser endoskopischer und kombinierter radiologischer Kontrolle. Das von uns konzipierte Bougie ermöglicht die lückenlose endoskopische Kontrolle. über ein dünnlumiges Endoskop wird ein schlauchförmiges Mehrolivenbougie gestülpt, dessen Durchmesser in vier Stufen auf 16 mm ansteigt. Die Engstelle wird bei der Endoskopie mit der Spitze des Gerätes überwunden und dann folgt die schrittweise Dehnung mit dem Tieferschieben des Endoskopes. Die Dehnung mit dem Gerät (bisher 27 Bougierungen) verlief rasch und problemlos.
    Notes: Summary Up to now bougienage of the oesophagus has had to be controlled by both endoscopy and radiology. The bougie that we have developed can be controlled totally by endoscopy. A small-calibre endoscope is mounted on a hose-shaped “multiple bougie”. The diameter of the bougie increases in four steps to 16 mm. The distal end of the endoscope is passed through the stenoses and dilatation is achieved in steps with the multiple bougie. To date we have had no complications using this method (n = 27).
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