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  • 1
    ISSN: 1432-1955
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract LEWIS rats, in contrast to NMRI mice, have been found to be resistant to an oral infection withNematospiroides dubius (Baylis, 1926). Comparative studies of the peritoneal response to infection showed a strong increase in the cell number predominantly of eosinophilic and neutrophilic granulocytes in rats, whereas in mice only a weak reaction occurred. As shown by the chemiluminescence response to either antibody — or complement-coated larvae, the granulocyte reaction caused an increased production of toxic oxygen species by the peritoneal cells. Purified granulocytes from rats or mice showed about a tenfold higher oxidant generation than macrophages. The higher metabolic activity of granulocytes of either species resulted in rapid and strong killing of antibody or complement-coated infective larvae by granulocytes of either species, whereas macrophages failed to express a significant larvicidal potency. From these results we concluded that the activated oxygen species derived from the metabolic burst of granulocytes are essential for an effective control of the primary infection withN. dubius. This suggests that the rapid and strong granulocyte response may form the basis of the resistance in rats. Thus, in mice, the ability ofN. dubius to prevent the granulocyte response may serve as an escape mechanism of the parasite.
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  • 2
    ISSN: 1432-1335
    Keywords: Nude mice ; Combined chemotherapy ; VCR ; 5-FU ; Adjuvant chemotherapy ; Xenotransplantation ; Human colorectal adenocarcinomas ; Tumor remission
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The poor 5-year survival rate of patients with malignant colorectal tumors calls for clarification of the question as to whether it is advisable to carry out postoperative adjuvant chemotherapy. In the present study a simple “in vivo” test is described with which the sensitivity of individual human adenocarcinomas of the colon, primary xenotransplanted onto syngeneic “nude”-mice suffering from congenital thymic dysplasia, to cytostatic therapy with 5-FU and VCR could be determined. Five of six primary xenotransplanted tumors showed a significant reduction in size following combined therapy with these drugs in doses comparable to those administered clinically, whereas one of the transplanted tumors remained unresponsive to therapy. On the basis of these results it is absolutely necessary that a comparison be carried out between the rate of tumor remission in groups of patients and animals undergoing the same chemotherapy.
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  • 3
    ISSN: 1432-1335
    Keywords: Nude mice ; Thymus dysplasia ; Combined chemotherapy ; VCR ; 5-FU ; Regressive organ changes ; Leucopenia ; “nude”-Maus ; Thymusdysplasie ; kombinierte Chemotherapie ; VCR ; 5-FU ; regressive Organveränderungen ; Leukopenie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die kombinierte Chemotherapie mit Vincristin (VCR) und 5-Fluorouracil (5-FU) war nach Festlegung der LD50 im humanmedizinischen Dosierungsbereich bei 150 kongenital thymusdysplastischen “nude”-Mäusen ohne Komplikationen durchführbar. Unter spf-Bedingungen durchliefen ca. 5 Wochen alte syngene Balb/c-“nude”-Mäuse einen 9 tägigen Therapiezyklus. Die Teilsynchronisation wurde mit VCR am Tag 1 eingeleitet und 5-FU jeweils vom 1. bis 3. Tag intraperitoneal appliziert. Pathohistologisch entstanden unter VCR bei einer Dosis von 20% der LD50 bei allen Tieren Milzatrophien und schwere Jejunitiden. Die durch Verminderung überwiegend segmentkerniger Zellen entstandenen Leukopenien waren erwartungsgemäß reversibel. Nach 5-FU-Applikation entstanden bei einer 20% igen Dosierung der LD50 hauptsächlich Zystitiden, bei 67% Bronchitiden und Lobärpneumonien. In der Kombination mit humanmedizinisch relevanten Dosierungen entwickelten die Tierkollektive regressive Veränderungen an Harnblasen- und Zottenepithelien des Jejunums. Neben Hepatitiden mit Gruppennekrosen fanden sich Pneumonien bei 50% der Tiere; Milzatrophien waren mäßig ausgeprägt. Die Lymphknoten zeigten eine Tendenz zur Strukturauflösung der Follikel ohne spezifische Veränderungen der paracorticalen Region. Hämatologisch war nach reversibler Leukopenie mit Granulozytopenie die Einleitung eines 2. Zyklus am 9. Tag möglich. Nach Kenntnis dieser Befunde ist die Möglichkeit gegeben, die Wirksamkeit von VCR und 5-FU auf das Wachstum humanen kolorektalen Tumorgewebes nach erfolgter Transplantation auf “nude”-Mäuse in vivo zu testen.
    Notes: Summary Five-week-old syngeneic, female BALB/c nude mice were injected i. p. with vincristine (VCR) and 5-fluorouracil (5-FU) to determine the LD 20 of these drugs under spf-conditions. One hundred fifty animals were given dosages similar to those administered clinically, and a complete autopsy was performed on all nude mice. Whereas VCR caused splenic atrophy and regressive changes in the jejunal epithelium, the application of 5-FU was followed mainly by regressive changes in the transitional epithelium of the bladder, and 67% of the animals developed pneumonia. These pathohistological changes were also seen after a combined chemotherapy, and a temporary leucopenia was reversible. These experiments showed that chemotherapy of nude mice with VCR and 5-FU is possible provided they have been successfully xenotransplanted with human colorectal adenocarcinomas.
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  • 4
    ISSN: 1435-2451
    Keywords: Microcomputers in surgery ; Cancer follow-up program ; Data processing in vascular surgery ; Microcomputereinsatz in der Chirurgie ; Tumornachsorgeprogramm ; Datenverarbeitung in der Gefäßchirurgie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Große Datenbanksysteme mit der meist erforderlichen mittleren Datentechnik sind für chirurgische Kliniken nicht finanzierbar und ohne spezielle EDV-Kenntnisse nicht einsetzbar. Es wird gezeigt, daß bei qualifizierter Software Microcomputer bei umfangreichen Dokumentations- und Auswertungssystemen einsetzbar sind. Als Beispiele des Microcomputereinsatzes werden neben der allgemeinen Krankenblattdokumentation, der Dokumentation in der Gefäßchirurgie, Statistik und Auswertung einschließlich Präsentation auf Grafik-Plotter die Tumornachsorge mit integrierter Textverarbeitung, Terminverwaltung, Dokumentation und Auswertung etc. dargestellt.
    Notes: Summary Large data bank computer systems with a generally required medium-sized data processing capacity cannot be financed by most surgical clinics. Neither can they be operated without a specific knowledge of data processing. It is shown that microcomputers in combination with efficient software can be used for the processing of large data collections and evaluation systems. Sample cases for the application of microcomputers are presented for the documentation of general medical records and matters concerning vascular surgery, for statistics and the evaluation of cancer follow-up programs, including the plotting of graphs, with integrated word-processing as well as appointment scheduling and other kinds of documentation and evaluation.
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  • 5
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 6
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Récemment les résultats à cinq ans d'une étude multicentrique consacrée à la vagotomie suprasélective ont été rapportés. Ces résultats en fonction de l'échelle d'appréciation de Visick chez 415 malades opérés pour un ulcère duodénal furent les suivants: degré I, 1,64%; degré II, 2,28%; degré III, 4%; degré IV, 4%. Il résulte de ces faits qu'au total 1/3 des opérés accusaient des troubles postopératoires, cette constatation soulevant la question de la crédibilité de cette classification. Pour l'apprécier, la même appréciation fut entreprise chez 561 sujets en bonne santé (donneurs de sang) ne présentant aucune histoire ulcéreuse ou n'ayant pas subi d'intervention gastrique, le sexe et l'âge étant pris en considération. Les réponses à 3 questions tests furent comparées à celle de l'interrogation détaillée. Les résultats de l'enquête chez ces sujets en fonction de l'échelle de Visick furent les suivants: degré 1, 64,5%; degré 2, 28,9%; degré 3, 4%; degré 6.4, 0,2%, ces sujets sains accusant le plus souvent des troubles dyspeptiques (douleurs et sensation de plénitude gastrique) ou un reflux oesophagien. 4% d'entre eux souffraient de diarrhées et 1% de dumping.1 Les auteurs tirent les conclusions suivantes de cette étude comparative: 1) 5 ans après vagotomie suprasélective, les troubles accusés par les opérés sont semblables à ceux présentés par les sujets en bonne santé. 2) La douleur sourde, la sensation de plénitude gastrique, les signes de reflux n'appartiennent pas en propre à la vagotomie suprasélective. 3) Les 3 questions tests sont trompeuses et l'appréciation postopératoire doit être fondée sur un questionnaire standard très précis pour être valable. 4) La distinction entre le degré 1 et le degré 2 de l'échelle de Visick doit être abandonnée car elle ne possède aucune valeur clinique. 5) La vagotomie suprasélective n'entraîne pas de séquelles spécifiques, exception faite de la récidive ulcéreuse.
    Abstract: Resumen Los resultados de un ensayo de 5 años de duración, realizado en múltiples centros, sobre vagotomía gástrica proximal (VGP) han sido recientemente informados. Los resultados sintomáticos en 415 pacientes con úlcera duodenal, de acuerdo a la gradación de Visick, fueron: grado 1, 64%; 2, 28%; 3, 4% y 4, 4%. Un tercio de los pacientes aparecieron sintomáticos, y surge el interrogantes relativo al patrón de gradación, tal como el patrón de Visick, mediante el cual deben ser comparados. Quinientos sesenta y un individuos saludables (donantes de sangre) y sin historia de úlcera péptica u operación gástrica anterior, sirvieron como control; fueron examinados de acuerdo a un cuestionario estandar idéntico al que se utilizó para el interrogatorio de seguimiento en el ensayo anterior a la VGP. El grupo control fue igualado en cuanto a sexo y edad con la población del ensayo. Las respuestas a 3 interrogantes generales de tanteo fueron comparados con el resultado de la interrogación detallada. El patrón de Visick para el grupo control fue: grado 1, 64.5%; 2, 28.9%; 3, 6.4% y 4, 0.2%. Los síntomas encontrados con mayor frecuencia fueron aquellos de dispepsia (dolor, llenura apigástrica) y reflujo gastroesofágico. También se encontró dumping (1%) y diarrea (4%). Estas son nuestras conclusiones: 1. El patrón de gradación de Visick hallado 5 años después de VGP es casi idéntico con el de controles saludables. 2. Dolor sordo, llenura epigástrica y síntomas de reflujo no son signos específicos después de la VGP. 3. Las preguntas generales de tanteo son enganosas y los exámenes de seguimiento deben estar basados más bien en un cuestionario definido. 4. La separación entre el Visick grado 1 y el 2 debe ser abandonada, puesto que no conlleva importancia clínica. 5. La VGP virtualmente está libre de secuelas a largo plazo, excepto la recurrencia.
    Notes: Abstract Recently, the 5-year results of a multicenter trial on proximal gastric vagotomy (PGV) have been reported. Symptomatic results in 415 duodenal ulcer patients, according to the Visick grading, were as follows: grade 1, 64%; 2, 28%; 3, 4%; and 4, 4%. It appears that one-third of the patients are symptomatic, and the question arises as to which standard such a Visick grade pattern should be compared. Five hundred sixty-one healthy controls (blood donors), without history of peptic ulcer or previous gastric operation, have been examined according to a standard questionnaire identical to that used for follow-up interrogation in the PGV trial. The control group was matched for sex and age with the trial population. Answers to 3 screening questions were compared with the result of detailed interrogation. The control group's Visick pattern was as follows: grade 1, 64.5%; 2, 28.9%; 3, 6.4%; and 4, 0.2%. Symptoms most frequently encountered were those of dyspepsia (pain, epigastric fullness) and gastroesophageal reflux. Dumping (2%) and diarrhea (4%) were also noted. Our conclusions are these: (1) The Visick grade pattern 5 years after PGV is almost identical with that of healthy controls. (2) Dull pain, epigastric fullness, and reflux symptoms are not specific signs after PGV. (3) Screening questions are misleading and follow-up examinations must be based on a standard questionnaire to provide valid information. (4) The separation between Visick grade 1 and 2 should be abandoned, as it has no clinical importance. (5) PGV has virtually no specific long-term sequelae except recurrence.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 7 (1983), S. 132-142 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Ce rapport constitue une brève revue de l'alimentation porenterale du polytraumatisé traité dans un service de soins intensifs. Les facteurs importants qui permettent le choix et la mise en application d'une méthode appropriée d'alimentation porenterale chez un blessé donné sont d'une part les pertes azotées et le cycle énergétique, d'autre part les limites de tolérance et la vitalité de l'organisme. Il est maintenant possible de déterminer l'apport nutritif qui correspond aux besoins du blessé grave. Cependant des études détaillées ultérieures seront encore nécessaires pour apporter des réponses satisfaisantes aux questions posées par les taux qui sont nécessaires par le cycle et la tolérance des substrats qui doivent répondre à une situation métabolique critique. Cette réserve admise, l'alimentation porenterale adéquate représente sans aucun doute un élément essentiel du traitement à long terme de tout traumatisme grave.
    Notes: Abstract This report presents a brief review of currently relevant aspects of the parenteral nutritional support of the multiple trauma patient in intensive care. The decisive factors governing selection and application of an individually devised program of parenteral nutrition are the multiple trauma patient's energy turnover and nitrogen losses on the one hand, and the tolerance limits and viability of the traumatized organism on the other. It is possible nowadays to provide situation-adapted nutritional support corresponding to the individual requirements of a seriously injured patient. However, further detailed studies are still necessary to come up with more definite answers to questions regarding requirement levels, turnover, and tolerance of the substrates applied in critical metabolic situations. This aside, adequate nutritional therapy at present represents without a doubt an integral feature of any long-term post-trauma therapeutic program.
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  • 8
    ISSN: 1432-0584
    Keywords: Hodgkin's disease ; Risk factors ; Staging system ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a recently published review of the literature [40] we came to the conclusion that the Ann-Arbor staging classification is of limited prognostic value for chemotherapy of Hodgkin's disease (Table 2). Four risk factors accounted for impaired complete remission rates: stage IVB, lymphocyte depletion or not classifiable histologic type, previous chemotherapy, and older age. Fifty-eight evaluable patients were treated with COPP; 23 reached a complete remission (40%). Disease-free survival was 31%, overall survival 49% after five years [33]. Besides the known risk factors, impaired bone marrow function (leucocyte counts 〈4×109/1, platelet counts 〈100×109/1) at the start of therapy was associated with poor treatment results: none of six patients achieved a complete remission [41]. Eleven of 16 patients with no and 11 of 23 patients with one risk factor achieved a complete remission, as did only one patient with more than one risk factor. Survival rates after 30 months were; 87% with no, 66% with one, 36% with two, and 13% with more than two risk factors. We can conclude from our results that the prognosis of patients undergoing chemotherapy for Hodgkin's disease depends on the number of risk factors.
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  • 9
    ISSN: 1432-0584
    Keywords: Hodgkin's disease ; Clinical staging ; Explorative laparotomy ; Lymphangiography ; Scintigraphy of liver ; Scintigraphy of spleen ; Abdominal sonography ; Morbus Hodgkin ; Klinische Stadieneinteilung ; explorative Laparotomie ; Lymphographie ; Leberszintigraphie ; Milzszintigraphie ; abdominelle Sonographie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Von 1969 bis 1978 wurden an den Universitätskliniken in Marburg 68 Laparotomien zur Stadieneinteilung beim M. Hodgkin durchgeführt. Voraus gingen eine klinische Untersuchung, in 27 Fällen eine Lymphographie, in 58 Fällen eine Leber-Milz-Szintigraphie und in 18 Fällen eine Röntgenuntersuchung des Intestinaltraktes. Die Allgemeinsymptomatik der 68 Patienten korrelierte besser mit dem pathologischen als mit dem klinischen Stadium. Die Ultraschalluntersuchung ergab für den Milzbefall eine höhere Treffsicherheit (90%) als die Szintigraphie (74%); für den Leberbefall erwiesen sich Sonographie und Leberszintigraphie gleichwertig. Für die Erkrankung paraaortaler Lymphknoten sind Lymphographie und Ultraschalldiagnostik als einander ergänzend anzusehen. Unsere Ergebnisse werden mit den Mitteilungen der Literatur über abdominelle Sonographie (n=50), Leber-Milz-Szintigraphie (n=185) und Lymphographie (n=465) verglichen. Auf die Bedeutung prognostisch unterschiedlicher Gruppen z. B. im Stadium III wird hingewiesen.
    Notes: Summary Explorative laparotomies were carried out on 68 patients with Hodgkin's disease in the University Hospital of Marburg from 1969 through 1978. These laparotomies were preceded by clinical examination, abdominal sonography in 27 cases, lymphography in 55 cases, scintigraphy of liver and spleen in 58 cases, and radiographic examinations of the intestinal tract in 18 cases. Sonography revealed a greater accuracy (90%) for splenic involvement than scintigraphy (74%); the results of sonography and scintigraphy of the liver were comparable. For the detection of para-aortal lymphomas ultrasound and lymphography can be regarded as complementary methods. Our results are compared with findings in the literature on abdominal sonography (n=50), scintigraphy of liver and spleen (n=185), and lymphography (n=465) carried out before explorative laparotomy for lymphogranulomatosis. There was a better correlation for the systemic symptoms of the 68 patients with the clinical stage than with the pathologic stage. The importance of diagnosing prognostic different groups, e.g. in stage III, is stressed.
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  • 10
    ISSN: 1432-0584
    Keywords: Graft-versus-host disease (GVHD) ; Nonirradiated blood products
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two patients, suffering from AML and AMMoL respectively, experienced acute GVHD after transfusion of nonirradiated blood products. One of the patients, who surprisingly showed normal granulocyte counts during the acute phase of GVHD, survived and is disease-free eight months after initial diagnosis was made.
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