Chirurgisches Forum fur experimentelle und klinische Forschung最新文献

1. An enhanced collagenolytic activity in the bowel tissue samples of M. Crohn and ulcerative colitis is demonstrated. 2. No inhibition of the collagenolytic activity was found when the specific collagenase inhibitor EDTA was applied. 2. In vitro, the application of EGLIN B resulted in a significant decrease of collagenolysis. EGLIN is a recently detected inhibitor of serine proteases such as Elastase.

PGE2, 13,14-dihydro-15-keto PGF2 alpha (DHK-PGF2 alpha) and PGF2 alpha were determined in arterial, central-venous and postgastric-venous plasma in a hemorrhagic shock model in mini pigs. PGE2 and DHK-PGF2 alpha significantly increased in all samples; highest values could be measured in postgastric-venous plasma, less in arterial, least in central-venous plasma. The ratio DHK-PGF2 alpha/PGF2 alpha was significantly increased during hemorrhagic shock in comparison with controls. A protective effect of certain E- and F-prostaglandins on gastric mucosa during hemorrhagic shock is assumed.

Leukocytes from patients suffering from chronic posttraumatic bone infection have a decreased phagocytic ability. We therefore investigated IgG and C3 receptors on leukocytes from these patients. Our findings presented in this study show a decrease or functional C3 receptors, whilst the IgG receptor system remains intact. At the same time complement activity in the patients' serum was raised.

Hepatic hemodynamic alterations following various porta-systemic shunting procedures were evaluated in the normal and cirrhotic rat liver using a microsphere embolization method. The aim of the study was to differentiate the hepatic arterial and portal venous contribution in a defined cirrhotic rat liver model following total shunting procedures and to determine residual portal blood supply after selective shunt procedures intended to prevent post shunt liver failure. Experimentally selective shunt procedures such as mesentericocaval shunt, splenocaval shunt, portacaval transposition and even portacaval side/side shunting lead to improved hepatic blood supply compared with total end/side shunting. Improvement of liver blood supply is caused rather by arterial compensation than by residual portal blood perfusion. The amount of portal blood supply is not related to a specific type of selective shunt. Evaluation of hepatic arterial compensatory capacity is a more reliable method of predicting total liver blood supply following any shunt procedure.

In duodenal ulcer patients the maximal acid secretion induced by pentagastrin is significantly higher than the meal-induced acid secretion (10% peptone, pH 5.5). Three months after SPV there is no difference in pentagastrin and meal-induced stimulation. There is a reduction of 56% in insulin-negative patients after SPV, but only of 9% in insulin-positive patients. Basal serum gastrin levels increased significantly after SPV, but there is no difference in postprandial serum gastrin levels and in insulin-positive and insulin-negative patients. Intragastric titration seems to be a subtle method for testing the completeness of SPV.

Hemodynamic changes after aortic cross-clamping were measured during operation of 11 patients suffering from infrarenal aortic aneurysm. Systemic vascular resistance, mean arterial pressure and pulmonary capillary wedge pressure are increased, while cardiac index is significantly decreased. Heart rate and right atrial pressure remain nearly unchanged. The elevations in systemic vascular resistance, mean arterial pressure and pulmonary capillary wedge pressure are reversed by continuous nitroglycerin infusion, cardiac index is increased. It is concluded that a meticulous hemodynamic monitoring is very important in operations including abdominal aortic cross-clamping in order to prevent imminent cardiac complications.

Nutrition is the main problem with inoperable gastroesophageal tumors. In 15 mongrel dogs the topmost jejunal loop was disconnected in a 'y' shape after Roux and diverted outwards, the small intestine anastomosed end-to-side. A sphincter plastic made of autologous small intestine muscles after the Würzburg method was wrapped as a sleeve around the thigh diverted to the epigastrium. The jejunostomy was absolutely continent; the dogs could be fed an elementary diet by means of a probe without their loss of weight or malaise. The mobility and the uncomplicated application signify improvement on the gastric fistula and parenteral feeding.

Phagocyte function in immunosuppressed allograft recipients is regularly diminished and correlates to leucopenia in only 50% of cases. Significantly reduced phagocyte function carries a 50% risk of septic complications. Monitoring of phagocyte function can be helpful in assessing defense reserves in the compromised host.