Chirurgisches Forum fur experimentelle und klinische Forschung最新文献

Twenty-two severely ill patients with multiple injuries and sepsis were treated with IV pirenzepin or placebo 3 x 10 mg per day in the frame of the double-blind study. All the patients were examined three times with endoscopy during the 14-day observation period. In 100% of cases without prophylactic treatment, stress lesions were observed, 60% of these cases had bleeding. A prophylactic IV pirenzepin application had an unmistakable protective effect regarding the stress bleeding, number and degree of stress lesions.

The influence of local irradiation of the spleen and immunosuppressive drugs (cyclophosphamide and azathioprine) on the rejection of intrasplenic pancreatic allotransplants was studied. Fractional splenic irradiation (once 4000-5000 rad before, twice 500-1000 rad after transplantation) prolonged transplant function from 4,1 to 6,5 days, in combination with immunosuppressive therapy to 8,5 days.

One hundred and ninety-one patients with operable breast cancer were followed for up to 34 months after operation and the early recurrence of disease was noted in relation to the presence or absence of estrogen receptor. Recurrence rates were significantly higher in patients whose tumors did not contain receptors than in those whose tumors did. The response to cytotoxic chemotherapy in patients with advanced breast carcinoma seems to be independent of the presence of E2R in cancer tissue.

During anesthesia and relaxation the separated M. sphincter ani ext. and the M. puborectalis have a constant pressure of 30 mm Hg. Therefore, these muscles also have the ability to make tonic contractions and not only phasic contractions. This means that these muscles are also responsible for the anal tonic basal pressure.

In 14 puppies, body temperature was lowered to 22 degrees C with surface hypothermia, then to 16 degrees C with textracorporeal circulation. During 60 min of circulatory arrest all hearts were protected with the same multidose blood cardioplegic solution. In seven dogs pH was kept at 7.4 and in seven others pH was varied as in poikilotherms (i.e. 7.95 at 16 degrees C) principally by adjusting pCO2 during cooling and rewarming. Appropriate pH adjustment allowed higher cardiac output with normal systemic lactate metabolism. Raising pH by lowering pCO2 to 10 mm Hg allowed twice as much cerebral blood flow. Postischemic myocardial performance was depressed by 50% by retaining pH 7.4 and was normal when pH was varied appropriately. These findings have major implications for the routine management of hypothermia during cardiac operations.

A prospective randomized study on the value of additional antibacterial therapy in surgically treated, purulent peritonitis (69 patients) is presented. A new chemotherapeutic agent Taurolin with antiendotoxin activity is tested against conventional antibiotic therapy. There was an increased rate of secondary wound healing and overall complications in the Taurolin group (especially bronchopneumonia). Local complications and lethality due to peritonitis occur similarly frequently in both groups. The bactericidal and antiendotoxic effects of Taurolin, its lacking toxicity (possibility of higher dosage), and the choice of combination with antibiotics make it a most interesting substance for additional antibacterial therapy for purulent peritonitis following surgical treatment.

Severe intracellular potassium depletion was found with maldigestion (short bowel, high output fistula, M. Crohn, colitis ulcerativa) when total body potassium and water measurement were taken. Serum potassium levels were misleading. These methods are of particular value in planning and conducting a preoperative infusion therapy to correct the documented deficit.

Fourteen dogs underwent standardized traumatic hemorrhagic shock. Periodically, measurement of extravascular lung water (EVLW) was taken by thermo-green-dye dilution technique and related to microvascular pressure (MVP) values. An initial drop in EVLW, corresponding to MVP was seen. During shock time the EVLW rose again, while the MVP remained at low levels. This shows a permeability leak during shock time.

Transfer of "passenger lymphocytes" within a transplant initiates allogeneic rejection. As compared with peripheral lymphocytes, which show no different in vitro reaction, infiltrating cells from natural and artificial grafts are good stimulator, bad responder but powerful suppressor cells. These T-suppressor cells, which arose during rejection are enriched in the graft. The assumption is that the function of this relatively small number of lymphocytes is to suppress the local immunological rejection mechanisms. They cannot inhibit the proliferation of peripheral cytotoxic cells.

-Newborn and 14-day-old piglets (in a developmental stage equivalent to that of a 3-month-old infant) compensate sustained hypoxemia by increasing cardiac performance. -This compensation can be maintained for only roughly 30 min. -Newborn piglets free from hypoxemia are able to tolerate the stress of anesthesia, artificial respiration, and operation significantly longer than those with additional hypoxemia. -14 day-old piglets without hypoxemia are not able to tolerate the stress of anesthesia, artificial respiration, and operation longer than those with additional hypoxemia. -The reactions of the cardiovascular system to anesthesia, artificial respiration, and operation in present or absent additional hypoxemia are qualitatively identical and are also identical in time in the newborn hypoxic, the 14-day-old hypoxic, and normoxic animals, whereas they appear significantly later in newborn control piglets.