Chirurgisches Forum fur experimentelle und klinische Forschung最新文献

Rat livers were preserved by ischemic hypothermic storage in extra- or intracellular type solutions for 24 h. A substitution of 85% of the tissue water by deuterium oxide (D2O) resulted in increased glycolytic energy production, better maintenance of the energy potential of the cells but a higher AMP loss, and a reduction of edema formation. Preservation using "retrograde oxygen persufflation" (ROP) resulted in optimal maintenance of the metabolic state which could be further influenced positively by D2O in the total nucleotide content.

In shock produced by temporary superior mesenteric artery occlusion the plasma histamine concentration was enhanced following release of the mesenteric blockade. Furthermore, an inhibition of the diamine oxidase catalysed histamine inactivation resulted in an aggravation of the shock development. These processes, already shown in dogs and mini pigs, were also observed in rabbits. Histamine receptor antagonists abolished the effect of the enhanced histamine concentration appearing in the circulation following inhibition of diamine oxidase. In human intestinal tract a fairly similar distribution of histamine and diamine oxidase was found as in the mammals studied. Thus the indicated pathobiochemical processes should be reckoned with in patients suffering from circulatory disorders of the intestinal tract.

In a prospective controlled randomized clinical trial, 60 patients with acute cholecystitis (diagnosed according to well defined criteria) were allocated randomly to early operation (n=28) or conservative treatment followed by delayed operation (n=30). The formed groups were well balanced. Total duration of hospitalization was 12 days for the early and 22 days for the delayed operation group. One case of death in the second group appeared to be due to pancreatic necrosis. From other complications recorded, only stitch sinus seemed to occur more frequently in the early operation group. For the first time the success of the two therapeutic procedures was evaluated by means of a systematic follow-up 6 weeks and 6 months after operation. The outcome was the same in both groups and "very good" and "good" for all patients. From these results early operation as the routine method for acute cholecystitis can be recommended unconditionally.

The influence of a continuous PGI 2 infusion on blood flow of various organs was tested in normovolemia and in hemorrhagic shock. PGI 2 increased the blood flow of stomach, pancreas and jejunum in normovolemic animals. The reduced blood flow due to hemorrhagic shock was increased to preshock values in stomach, pancreas, and jejunum. A linear correlation was found between the dose of PGI 2 and mucosal blood flow of the stomach.

The new immunosuppressive substances Cyclosporin A (group A = 15 mg) and Cytimun = ASTA 5122 (group B = 15 mg, group C = 5 mg) were tested in rats that received accessory cervical heart transplants. A syngeneic (DA leads to DA) and a strongly allogeneic (PVG leads to DA) strain combination served as controls of operative and immunogenetic parameters. Whereas Cyclosporin A (group A) brought about a local transplant tolerance in 90% of cases, at a dosage of 15 mg/kg per day (group B), Cytimun led in 88% of cases to lethal intoxication of the recipients. At a dosage of 5 mg/kg per day (group C), 67% of the animals survived; however, they showed electrocardiographic evidence of possible temporary rejection crises between the 5th and the 13th day.

A stemless total knee endoprosthesis with physiological kinematics (slip and rolling motion, tibial rotation) and cement-free primary fixation (straddling dowel and thread system) was tested in animal experiments. The fixation allows total functioning of the operated extremity from the first day after operation. Primary results and follow-up for 40 weeks after operation reveal satisfactory results, especially with regard to durable bony incorporation of the prosthesis as shown by histologic and microangiographic studies.

Long-term results after cartilage transplantation are not satisfactory owing to poor viability of the chondrocytes. In vitro experiments with isolated fetal and neonatal rabbit chondrocytes revealed a much better proliferative ability compared with adult cartilage derived cells. Cryopreservation of cell suspensions did not decrease the proliferative ability. In in vivo experiments, cultured neonatal, fetal, and cryopreserved rabbit chondrocytes were tested in transplants and compared with cell-free controls or radiated chondrocytes. These chondrocytic transplants showed good viability and seemed to synthesize cartilage matrix, which could be stained with safranin, whereas only fibrous tissue was found in controls.

A prospective, randomized clinical study investigated the effectiveness of IV gamma-globulin (GG) against bacterial infections after surgical procedures. As a result of 20 g GG IV, given postoperatively, the average concentration decrease for IgG (25% - 30%) could be balanced as soon as the third postoperative day, the local infection rate was decreased in the low-risk group, and, with the occurrence of long-lasting local infections, the number of patients with simultaneous septic complications was lowered.