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  • 1
    Electronic Resource
    Electronic Resource
    Manifestation eines Gilbert-Syndroms (Morbus Meulengracht) nach orthotoper Lebertransplantation: Seltene Ursache einer postoperativen Hyperbilirubinämie (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 596-598 
    Details
    ISSN: 1432-1440
    Keywords: Liver Transplantation ; Gilbert's Syndroma ; Hyperbilirubinemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a 33 years old woman an orthotopic liver transplantation was performed because of an endstage posthepatitic liver cirrhosis. Postoperatively the unconjugated bilirubin levels remained elevated although liver enzyme values were within normal range. Because hemolysis, rejection, infection or biliary obstruction could be excluded we suspected a Gilbert's Syndrom and were able to confirm this diagnosis by low caloric intake and nicotinic acid test. This case report therefore describes the first time the transplantation of a clinically harmless metabolic disorder but inborn error of metabolism by liver grafting into the recipient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01720835
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  • 2
    Electronic Resource
    Electronic Resource
    Intraperitoneal hepatocyte transplantation: Morphological results (1991)
    Springer
    Virchows Archiv 419 (1991), S. 45-50 
    Details
    ISSN: 1432-2307
    Keywords: Intraperitoneal hepatocyte transplantation ; Microcarrier ; Peritoneum ; Metabolic liver support
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The value of isolated intraperitoneal hepatocyte transplantation as a temporary support in acute hepatic failure is controversial since the functional capacities and survival rate of auxiliary transplanted liver cells are uncertain. It was the aim of this study to investigate the survival rate of intraperitoneally (i.p.) transplanted hepatocytes and microcarrier attached hepatocytes. In 25 rats (group A) an i.p. hepatocyte transplantation and in 30 rats (group B) an i.p. microcarrier attached hepatocyte transplantation was performed and the animals were killed at 3 h, 12 h, 24 h, 3 and 7 days (group A) and 1, 2, 3, 7, 14 and 28 days (group B) after transplantation. Histological investigation showed that transplanted hepatocytes undergo complete cell necrosis within 3 days (groups A and B). Liver cell necrosis was followed by a peritoneal reaction resulting in granuloma formation in both groups. Since liver cell necrosis occurred soon after transplantation and could not be avoided by attachment of liver cells to microcarriers, it can be concluded that metabolic support from transplantation cannot be expected in acute hepatic failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01600151
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  • 3
    Electronic Resource
    Electronic Resource
    Intrasplenic hepatocyte transplantation: Evaluation of DNA synthesis and proliferation in auxiliary transplanted cells (1989)
    Springer
    Research in experimental medicine 189 (1989), S. 295-302 
    Details
    ISSN: 1433-8580
    Keywords: Hepatocyte transplantation ; Hepatocyte proliferation ; Metabolic liver support
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The value of isolated hepatocyte transplantation as a temporary support in acute hepatic failure remains controversial regarding the functional capacities of freshly isolated and transplanted hepatocytes. To evaluate the survival rate of intrasplenically transplanted liver cells and their response to a proliferation stimulus like partial hepatectomy,3H-thymidine incorporation into hepatic and auxiliary transplanted hepatocyte DNA was determined. The survival rate of intrasplenically transplanted hepatocytes was evaluated by analyses of m-albumin-RNA within the splenic tissue and compared to the morphological findings. The histological results show a marked decrease (〉 × 100) of intrasplenically transplanted hepatocytes within 1 week after injection. The amount of surviving cells then remained constant for 3 months without any signs of proliferation. After partial hepatectomy a stimulation of hepatic regeneration was observed in the remaining liver tissue but not in auxillary transplanted hepatocytes. M-albumin-RNA determination of auxiliary transplanted hepatocytes revealed a decrease of m-albumin-RNA concentration of 〉 100 times within 24 h after transplantation indicating early cell necrosis of the transplanted cells. Since intrasplenically transplanted hepatocytes underwent an early cell necrosis without any evidence for a directly postoperatively inducible cell proliferation, it is concluded that a sufficient metabolic support in acute hepatic failure cannot be taken into consideration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01852262
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  • 4
    Electronic Resource
    Electronic Resource
    Acetaminophen-induced acute hepatic failure in pigs: Controversical results to other animal models (1988)
    Springer
    Research in experimental medicine 188 (1988), S. 463-472 
    Details
    ISSN: 1433-8580
    Keywords: Acetaminophen intoxication ; Acute hepatic failure ; Methemoglobinemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To prove the function of isolated transplanted hepatocytes in acute liver failure we tried to establish a hepatic failure model in pigs which correlates to a clinical situation. In 12 pigs we administered 500–2000 mg acetaminophen/kg b.wt. after enzyme induction with pentobarbital. Seven animals receiving 500–1000 mg/kg survived the intoxication. Five animals receiving 1000–2000 mg/kg acetaminophen died within 6.5 h after intoxication because of methemoglobinemia. A close correlation between administered dosage of the drug, acetaminophen blood levels, and methemoglobinemia was found. Histology of surviving animals showed a dosage-dependent cell necrosis. A standardized hepatic failure model could not be established in pigs by acetaminophen intoxication because dosages of less than 1000 mg/kg were survived. In dosages higher than 1000 mg/kg a side-effect of the acetaminophen intoxication, i.e., methemoglobinemia, limited the life of the animals. Therefore, acetaminophen cannot be used to induce acute hepatic failure in pigs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01852004
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  • 5
    Electronic Resource
    Electronic Resource
    Surgical Possibilities for Pancreatic Cancer: Extended Resection (1999)
    Springer
    Annals of oncology 10 (1999), S. 252-256 
    Details
    ISSN: 1569-8041
    Keywords: carcinoma of the head of the pancreas ; extended lymphadenectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Design: It was the aim of this study to investigate the influence of extended retroperitoneal tissue clearance on long-term survival in patients with ductal adenocarcinoma of the head of the pancreas. Patients and methods: From 10/1988 to 3/1998 a prospective observation study was initiated in 108 patients with malignant growth in the head of the pancreas to compare patients with regional lymphadenectomy (RLA) versus extended retroperitoneal tissue clearance (ELA). In 36 patients other tumors than ductal adenocarcinomas were found, so that 72 patients with a partial pancreaticoduodenectomy and a histologically established diagnosis of ductal adenocarcinoma were included. Pancreaticoduodenectomy was combined with RLA in 26 cases and with ELA in 46 patients. Results: Comparing only R0-resected patients (n=58) no significant difference in long-term survival rates between the RLA and the ELA group was found. Hospital mortality was 3.8% in the RLA group and 6.5% in the ELA group. Significant or nearly significant results were shown for the following parameters: Stage of the disease: Patients after partial pancreaticoduodenectomy of a stage I/II cancer of the head of the pancreas showed a 63% 5-year survival rate compared to 15% in patients in stage III or IV (p=0.0087). Grading: No patient with a poorly differentiated ductal adenocarcinoma of the head of the pancreas survived the first year in comparison to 55% of patients with well or moderately differentiated tumors (p=0.0022). N-stage: 5-year survival of patients in NO stage was 46.9% and 15% for N1 stage patients (p=0.081). Portal vein infiltration: No patient with a R0-resection and histologically proven tumor infiltration of the portal vein survived the first year whereas 63% of patients did so after curative resection without portal vein involvement (p=0.0063). Conclusion: Our data indicate that extensive retroperitoneal tissue clearance does not improve long-term survival rates compared to regional lymphadenectomy restricted to the right side of the mesenteric artery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008316531617
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  • 6
    Electronic Resource
    Electronic Resource
    Inflammatorischer pseudotumor der leber —seltene differentialdiagnose einer unklaren hepatischen raumforderung Fallbericht und literaturbersicht (1996)
    Springer
    Langenbeck's archives of surgery 381 (1996), S. 309-317 
    Details
    ISSN: 1435-2451
    Keywords: Inflammatory pseudotumor ; Liver ; Case report ; Surgery ; Literature review
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Raumforderungen der Leber sind überwiegend maligne, benigne Tumoren der Leber sind selten. Wir berichten über den Fall eines 65 Jahre alten Patienten, dessen unklare Raumforderung der Leber sich erst nach explorativer Laparotomie mit anschließender links-lateraler Segmentresektion (II/III) als inflammatorischer Pseudotumor der Leber herausstellte. In der vorliegenden Literatur sind bis 1996 weltweit lediglich 102 Fälle mit der Diagnose inflammatorischer Pseudotumor der Leber publiziert worden. Ein geographischer Schwerpunkt für diese Tumorentität liegt in Asien, wobei überwiegend Männer betroffen sind. Die Hauptsymptomatik äußert sich unspezifisch in Fieber, Gewichtsverlust und allgemeiner Schwäche. Die Prognose der Erkrankung ist sehr gut. Nach operativer Therapie wird in 98% der Fälle eine Heilung erzielt, aber auch konservative Therapieansätze weisen gute Ergebnisse auf.
    Notes: Abstract Hepatic masses are predominantly malignant, and whereas benign tumors are rare. We report the case of a 65-year-old man who presented with an anomalous hepatic mass. Following explorative laparotomy and left lateral segmentectomy (II/III), the patient was diagnosed as having an inflammatory pseudotumor of the liver. So far only 102 cases of “inflammatory pseudotumor of the liver” have been reported in the literature. Asia is a geographical center for this tumor entity, which mostly affects men. The major symptoms are nonspecific: fever, weight loss and general fatigue. The prognosis of “inflammatory pseudotumor of the liver” is very good. In 98% of the cases, a cure has been obtained after surgical therapy, but conservative therapy approaches also yield good results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00191310
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  • 7
    Electronic Resource
    Electronic Resource
    Tetraclhlorkohlenstoff-Intoxikation im Schweinemodell (1989)
    Springer
    Langenbeck's archives of surgery 374 (1989), S. 150-155 
    Details
    ISSN: 1435-2451
    Keywords: Hepatic failure ; Carbon-tetrachloride ; Ethanol ; Intoxication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Tetrachlorkohlenstoff (CCl4) führt beim Menschen zu einem akuten Leberausfall. Dieser Effekt wird durch Alkohol (C2H5OH) potenziert. Um die Funktion isolierter and implantierter Hepatocyten an einem menschennahen Tiermodell zu überprüfen, wurden an drei Gruppen von Schweinen (je 2 Tiere) verschiedene Intoxikationsversuche durchgeführt. Die gewählten Dosierungen/kg KG führten in anderen Tiermodellen, z.B. bei Ratten, zu einem akuten Leberausfall. Gruppe 1 erhielt CCl4 intragastral, Gruppe 2 zusätzlich C2H5OH intragastral and Gruppe 3 CCl4 intragastral and C2H5OH intravenös. Anhand leberspezifischer Laborparameter and postmortalen Leberhistologien wurde das Ausmaß der Intoxikation überprüft. Intoxikationen mit den gewählten Dosierungen haben an Schweinen andere Effekte, als sie von Ratten oder aus Befundberichten beim Menschen bekannt sind. Mit den gewonnenen Ergebnissen ist daher ein standardisiertes Leberaus-fallmodell am Schwein nicht zu etablieren. Ein Großversuch zur Ermittlung einer geeigneten Dosierung ist aus ethischen Gründen abzulehnen.
    Notes: Summary It was intended to establish a model for acute hepatic failure in order to test the function of isolated and auxiliary transplanted hepatocytes. 6 pigs (19.75–27.0 kg) were intoxicated with different dosages of CCl4 and ethanol. According to publications on acute hepatic failure induced in rats by CCl4, adequate dosages were applied in pigs. Three different regimens of CCl4 and C2H5OH applications were used: CCl4 was administered intragastrically alone (group 1) or combined with ethanol (group 2), and CCl4 was given intragastrically and ethanol intravenously (group 3). Animals of group 1 and 2 survived intoxication for the period of observation. Histological examination of the livers revealed central necrosis, ghost cells and swollen hepatocytes. The animals of group 3 died shortly after intoxication. Histological examination did not show any evidence for acute hepatic failure. CCl4 and C2H5OH intoxication in pigs causes effects that are different from those described in humans or laboratory rats. Therefore it should be necessary to use a large number of animals to establish a standardized model for acute hepatic failure in pigs that reflects the observations in humans.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01261725
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  • 8
    Electronic Resource
    Electronic Resource
    Chemiluminescenzmessung phagocytierender Granulocyten - Gleichzeitig ein Parameter für ihre Killing-Funktion? (1987)
    Springer
    Langenbeck's archives of surgery 370 (1987), S. 173-183 
    Details
    ISSN: 1435-2451
    Keywords: Chemiluminescence ; Bacteria killing ; Double immunofluorescence technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Der Chemiluminescenzmessung neutrophiler Granulocyten im Vollblut wird häufig eine Aussagekraft über das Abwehrverhalten der Granulocyten zugeordnet. In unserer Versuchsserie wurden die Ergebnisse der bakterieninduzierten Chemiluminescenzmessung isolierter neutrophiler Granulocyten mit einem Agar-Plattentest verglichen. Es konnte gezeigt werden, daß zwischen der Chemiluminescenzmessung und dem Bakterienkilling im Agar-Plattentest keine Korrelation besteht. Diese Ergebnisse machen deutlich, daß die Chemiluminescenzmessung alleine keine umfassende Aussage über das Abwehrverhalten der Granulocyten zuläßt und damit als Risikoparameter bei chirurgischen Patienten generell überbewertet wird.
    Notes: Summary The results of the chemiluminescence activity determined in whole blood samples very often were used to compare the unspecific defense mechanism of polymorphonuclear granulocytes (PMN) against causative organisms to preoperative capable risk parameters in surgery. Our investigations try to compare the results of a bacteria-induced chemiluminescence with those we received from a standardized agar killing plate-test. It could be shown that there is no correlation between the used two test systems. Therefore it is not possible to conclude from the chemiluminescence results especially made out of whole blood samples to the potency of the defense mechanism of PMN granulocytes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01259537
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  • 9
    Electronic Resource
    Electronic Resource
    Sicherung von kolonanastomosen durch umhüllung mit einem Polyglykolsäure-Filament-Netz (1990)
    Springer
    Langenbeck's archives of surgery 375 (1990), S. 200-204 
    Details
    ISSN: 1435-2451
    Keywords: Polyglycolic-acid-net ; Colon anastomoses ; Bursting strength
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Resorbierbare Kunststoffnetze werden erfolgreich bei der Versorgung von Rupturen parenchymatöser Organe verwendet. Eine experimentelle Studie am Kolon der Ratte sollte klären, inwieweit eine Sicherung nahtinsuffizienz gefährdeter Anastomosen hiermit ebenfalls möglich sei. Bei 75 Wistar Ratten wurde das Querkolon durchtrennt und reanastomosiert, wobei bei der Hälfte der Tiere die Anastomose potentiell insuffizient angelegt wurde. In beiden Gruppen wurde bei einigen Tieren die Anostomose mit einem Polyglykolsäure-Filament-Netz (PGS-Netz) umhüllt. Die Ergebnisse zeigten, daß bei allen Versuchstieren deren Kolonanastomose mit PGS-Netz umhüllt war, postoperative Motilitätsstörungen sowie eine verzögerte Anastomosenheilung zum Teil mit spontanen Dehiszenzen der Anastomose und Ausbildung einer Peritonitis auftraten. Die Festigkeit der Anastomose wurde durch Messung der Berstungsdrucke am 2., 4., 8., 30., 60. und 90. postoperativen Tag bestimmt. Hierbei zeigte sich, daß der Berstungsdruck bei suffizient und insuffizienter Anastomosenanlage ohne PGS-Netz-Umhüllung deutlich über den Werten der Versuchstiere mit PGS-Netz lag. Hieraus folgt, daß eine Umhullung mit PGS-Netz keine zusätz-liche Anastomosensicherung darstellen kann. Vielmehr scheint der fehlende peritoneale und omentale Kontakt für eine verzögerte Heilung verantwortlich zu sein.
    Notes: Summary Resorbable polyglycohc-acid (PGA)-nets are used successfully for the treatment of traumatic ruptures of parenchymous organs. This experimental study was carried out to investigate whether PGA-nets can also reinforce jeopardized colon anastomoses. In 75 Wistar rats the transverse colon was transsected and reanastomosed. Animals were divided into 2 groups: in one group the anastomosis was applied sufficiently, in the other group the anastomosis was applied potentielly insufficient. Out of each group a PGA-net was placed around the anastomosis in one half of the animals. The results demonstrated that delayed healing of the anastomoses as well as spontaneous suture line disruptions followed by peritonitis only occurred in those animals in which a PGA-net had been used. The evaluation of the bursting strength could confirm this finding of delayed consolidation. The bursting pressure therefore was significantly decreased in all animals in which a PGA-net had been applied, compared to the control group operated without PGA-net application. We therefore conclude that PGA-net application in colon anastomoses inhibits the consolidation of the suture line, probably because of a lack of contact to the peritoneal and omental tissue.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187438
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  • 10
    Electronic Resource
    Electronic Resource
    337. Aktuelle klinische bedeutung monoklonaler antikörper für nachsorge und therapie des pankreascarcinoms (1987)
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 946-946 
    Details
    ISSN: 1435-2451
    Keywords: Pancreatic carcinoma ; Tumor marker ; Immunoscintigraphy ; Immunotherapy ; Pankreascarcinom ; Tumormarker ; Immunszintigraphie ; Immuntherapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die nichtinvasive Diagnostik des Pankreascarcinoms mittels Sonographie und Computertomographie ist in den letzten Jahren um neue Tumormarker und die Immunszintigraphie erweitert worden. In einer prospektiven Studie wurde der Wert beider Verfahren für die Primärdiagnostik und Verlaufskontrolle bei Patienten mit Pankreascarcinom erarbeitet, die sich einer chirurgischen Primärtherapie unterzogen bzw. sich in der Pankreasambulanz wegen eines Rezidivs vorstellten. Verglichen wurden Klinik, CT/Sonographie, Tumormarker und Immunszintigraphie mit ‘a’ J-markierten monoklonalen Antikörpern (Anti-CA 19-9, Anti-CEA und BW 494/32). Die Ergebnisse zeigen, dass die neuen Tumormarker heute essentieller Bestandteil der Primärdiagnostik wie der Verlaufskontrolle beim Pankreascarcinom sind. Die Immunszintigraphie ist in der Primärdiagnostik der Sonographie wie dem CT in der Regel unterlegen — bei der Identifikation infiltrativer Rezidive kann sie jedoch hilfreich sein. Es werden erste Ergebnisse einer Radioimmuntherapie des Pankreas-carcinoms mit dem Antikörper BW 434/92 vorgestellt.
    Notes: Summary During recent years, noninvasive diagnosis of the pancreatic carcinoma by means of sonography and CT has been improved by the use of new tumor markers and immunoscintigraphy. We present a prospective study demonstrating the value of latter two methods. This study includes patients with pancreatic carcinomas who underwent surgical therapy or who presented with a relapse in our outpatient department for pancreatic diseases. The clinical findings, CT, sonography, tumor markers and immunoscintigraphy with131I-labeled monoclonal antibodies were compared. The results demonstrate that the new tumor markers are essential today for both primary diagnostic and clinical follow-up of patients with pancreatic carcinomas. Generally, in the primary diagnosis immunoscintigraphy is inferior to sonography or CT - however, immunoscintigraphy can be helpful for the identification of infiltrative tumor recurrence. In addition, the first results are presented, demonstrating the potentials of radioimmunotherapy of the pancreatic carcinoma with the antibody BW 494/32.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01298122
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