Zeitschrift fur experimentelle Chirurgie, Transplantation, und kunstliche Organe : Organ der Sektion Experimentelle Chirurgie der Gesellschaft fur Chirurgie der DDR最新文献

Operative trauma, ischemia, release of catecholamines and thermal stimuli in consequence of harvesting, preservation and transplantation deteriorate the renal capillary circulation. By crossing of tolerance limits arises an irreversible transplant damage. The conditions of our examinations were placed in this field. By pre- and postischemic application of Iloprost was demonstrable an improvement of the ischemic tolerance of the kidney. Correction of renal hemodynamics, antiplatelet action and cytoprotection are the reasons of the protective influence of Iloprost in our opinion.

Eicosanoids are supposed to participate in the regulation of bone metabolism. 30 male white rats of the wistar strain were fed on a diet rich in linoleic acid (LA), on a diet poor in LA and on a pellet diet after 3 month up to an age of 5 month. The formation of leukotrienes (LT) C4, D4, and E4 from the proximal tibia metaphysis after LA rich diet has been compared to the formation from LA poor and pellet diet. LA rich diet increased the formation of LTC4, D4 and E4 in the proximal tibia metaphysis. The properties of eicosanoids as local mediators in the bone were discussed.

By means of an ultrasound spectroscopic measurement technique the influence of examining temperature on the ultrasound attenuation was experimentally investigated on formalin-fixed normal and altered testicular tissue. In the examined tissue specimens a temperature-dependent change of ultrasound attenuation (alpha on 6 MHz) was found in the temperature area between 10 and 50 degrees C. In the altered testicular tissue a higher damping decline could be observed. On the measuring points the specimens were examined by light microscopy.

For bronchoalveolar lavages (BAL) after lung transplantation in the rat two different tubes for creation of a permanent tracheostoma were devised and tested. Typ I was of plastic material and required closure of the trachea oral of the tube thus excluding the upper respiratory tract for breathing. All these animals deprived of their sense of smell and direction died within 50 hours despite optimal husbandry. Typ II was a T-shaped metall tube allowing normal nasal breathing. This tube was well tolerated by the animals and facilitated repeated BAL. BAL on day 3 following tracheotomy with 5% lymphocytes, 2% polymorphonuclear leukocytes and 95% alveolar macrophages was considered to be normal when compared with human findings. An increase in polymorphonuclear leucocytes and epithelial cells together with bacteria on day 6 was believed to be due to tracheobronchitis. This assumption was supported by the fact, that both cell types and the number of bacteria significantly decreased 3 days later. A steady increase of lymphocytes seems to be associated with repeated BAL.

The increased incidence of infections after operations can be connected with changes of the immunocompetent cells. Mononuclear blood-cells were investigated by means of the cell electrophoresis during and after operations under the extracorporeal circulation, because electrophoretically different cells correlate with several immunological phenotypes. A heavy decrease of the electrophoretic quick mobility cell population was found out on the first postoperative day above all. This change allows itself the interpretation by decreasing the T-lymphocytes connected to a relative increase of monocytes, B-cells, and immature T-cells. Besides a lower quotient of the quick and low mobility T-cells refers to a lower immunoregulatory quotient CD4/CD8 after operation. Changes of the cell composition becomes evident also in dependence on the bypass length and the blood supply.

The effectiveness of the electrical stimulation on the healing of an osteotomy was proved by determining the total alkaline phosphatase (AP) in the serum and its bone isoenzyme in rabbits. A non-stimulated animal group served as control. The changes appeared more distinctly by interference stimulation than by stimulation with bipolar rectangle impulses.

The serum-concentrations of the trace-elements zinc and copper were assessed before and after neurosurgical interventions in 60 patients. On the day of surgery the mean values of zinc and copper showed a significant decrease, but had reached their preoperative level one week later. While a influence of dexamethasone on the serum zinc levels could not be deducted, the serum copper concentrations seem to be influenced by dexamethasone. These changes seem to be connected with the activation of the hypothalamus-pituitary-adrenal axis during surgical stress.

Formalin-fixed (F) and glutaraldehyde-pretreated (G) umbilical veins (n = 24) were interposed in the infra-renal aorta of dogs. The follow-up period was 1 year. Early complications with significant differences included 2 occlusions and 3 deaths (41.6%) in group F, 1 occlusion and 1 death (16.6%) in group G. Ten animals of group G and 7 of group F were alive at 1 year, 7 transplants of each of both groups were angiographically and macroscopically patent (25%). Four aneurysms (33.3%) existed angiographically and showed good collateral circulation angiographically (25%). Four aneurysms (33.3%) existed angiographically and macroscopically in group F (statistically significant). Histologically, group G was found to have a delayed resorption and an earlier beginning of connective-tissue proliferation as compared to group F. Considering early and late findings, G-pretreatment is preferable to F-treatment of umbilical veins.

A farther alternative for the conservation of the spleen represents the ultrasonic aspiration and sealing technique by means of the monomeric tissue adhesive Ligament Fimomed. The effectiveness of the method was proved by histomorphologic investigations in animal experiment with the porcine spleen. The method was effective in nearly all injuries across to the longitudinal axle of the organ even with a larger parenchymal defect and also in case of splenic tumor. The control of hemorrhage succeeded promptly and surely. Not any postoperative complication appeared.

Two factors are to determine increasing lower esophageal sphincter pressure during intragastric pressure rising mainly: 1. the active intrinsic muscle tone and 2. the efficiency of the law by La Place. The purpose of the study was to estimate the part of both of them in this measurable phenomenon. We investigated 15 healthy volunteers and 5 patients post Nissen fundoplication. A simultaneous manometric examination of gaster and LES was carried out during gradual compression of abdominal wall. Analysis of dependence of LES-pressure on intragastric pressure, based on computer usage, was established. A linear equation described this dependence with the best correlation coefficient (r = 0.98) followed by potential and exponential equation. Fundoplication caused a steeper ascent without any changing of linear character of function. Considering linear equation is compatible with the law by La Place out not with a simultaneous pressure depending change of intrinsic muscle tone, these results indicate that the law by La Place has major importance in the measurable rising of high pressure zone during intragastric pressure increasing.