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Biomedical subjects

B Ulrich

Publications and source records attributed to B Ulrich.

At least 19 recordsLinked to original sources
PubMed1992

Pharmacokinetics/pharmacodynamics of ketoconazole-prednisolone interaction.

Ketoconazole is commonly used in patients with fungal infections during immunosuppressive therapy with prednisolone. Ketoconazole inhibits mixed function oxidases, enzymes responsible for the catabolism of prednisolone, and might, by that mechanism, increase prednisolone concentrations and thus, the immunosuppressive effect of prednisolone. On the other hand, ketoconazole has been found to bind to the glucocorticoid receptor and, thereby, to function as a glucocorticoid antagonist in cultured cell preparations. In order to establish whether ketoconazole enhances or attenuates the immunosuppressive effect of prednisolone, the influence of ketoconazole on the kinetics of prednisolone and on the delayed hypersensitivity response was assessed in mice. Ketoconazole increased prednisolone concentrations, measured by high pressure liquid chromatography, in mice given a single dose of prednisolone or a continuous prednisolone treatment for 17 days. At four different doses of prednisolone administered for 17 days, the glucocorticoid therapy-associated inhibition of the delayed hypersensitivity response to keyhole limpet hemocyanin was enhanced by ketoconazole. Thus, coadministration of ketoconazole with prednisolone increases the exposure to the steroid and enhances the immunosuppressive effect.

Animals↗
PubMed1991

[Current status and perspectives of mechanical suture techniques in abdominal and thoracic surgery].

In surgery the application of mechanical suture techniques is increasing. In order to inform the surgeons in detail about the different surgical stapling instruments being available today, the mechanical suture devices are listed in this article. These instruments can be divided into linear staplers, circular and linear anastomosis staplers, ligating clips and skin and fascia staplers. Own experiences with stapling instruments, their advantages and disadvantages as well as the different forms of application are described. Further information is given on the increasing use of absorbable staples and of new anastomosis techniques, i.e. instruments creating an anastomosis on the principle of compression.

Abdomen↗
PubMed1990

[The course of fibers in the central tendon].

In each polytrauma a diaphragmatic rupture is possible. Usually the rupture is located in the central tendon. A cause of the bizarre form of ruptures is the individual arrangement of gaps between the fibres of the central tendon. These fibres are classified in three groups. A rupture is generally on the left side of the central tendon. A further cause of the relative rare rupture on the right side is beside protection by the liver the greater stability on the right side of the central tendon, because fibres are more interlocked. The diaphragmatic rupture of a polytrauma is often overlooked, this number could be reduced by specific diagnostics. The repair of a diaphragmatic rupture is not a problem, an abdominal approach should be preferred. The prognosis depends on extension of concomitant lesions.

Aged↗
PubMed1989

[New technical and methodologic developments in surgery: mechanical suture technique].

Mechanical suture is possible by linear, circular and so-called anastomotic devices. Linear staplers work with metal clips and polyglactin, while circular-stapler-anastomoses function with metal clips and the Murphy principle. Compared to hand suturing staplers have not only the advantage of saving time but they also provide for a simple closure of the duodenal stump, the bronchus and the safe anastomosis of the rectum and the esophagus. The clipless compression-anastomosis seems to have a promising future. Its advantages include the absence of a foreign body, larger diameter of the anastomosis and no risk of postoperative haemorrhage. Our results with staplers (1987-1988) prove their superiority: there were only three insufficiencies among 140 circular anastomoses of the esophagus and the rectum. No complications occurred in 153 applications of linear staplers on the bowel and the lung.

Anastomosis, Surgical↗
PubMed1987

Patient falls: profile for prevention.

Patient falls are common in the hospital or long-term care setting. In a large Southwestern teaching hospital, patient falls have been monitored on an ongoing basis. A multidisciplinary task force developed a method of identifying patient fall risk factors. A survey was used concurrently as falls were reported during the month of July. Forty-seven falls were reported. Of this sample, neurological patients accounted for 12 (25.5%) of the incidents. The neurological patient fall profile was identified as a high-risk profile, and interventions were taken to prevent falls in this group. A second data collection was conducted six months later with this population. While the number of patients on the neurological services remained constant, the incidence of falls decreased (25%). By using a comprehensive approach of data collection and assessment, education, and follow-up, the institution has decreased neurological patient falls.

Accident Prevention↗
PubMed1986

[Dynamic pexis (teresplasty) in the treatment of reflux esophagitis].

For teresplasty, the lig. teres has to be prepared together with a palmarsize patch of peritoneal layer to the effect that by suturing the edges of that peritoneal layer a solid cord is produced which is firmly connected to the liver via the lig. falciforme and lig. teres. The loose end of that cordlike structure is fixed by suturing between the distal part of the oesophagus and the gastric floor. The left lobe of the liver comes to lie on top of the ligament, and a permanent longitudinal tension is applied to the oesophagus via the liver. Necessary restressing is thus produced, as recommended by Stelzner for restoration of the lower oesophageal sphincter function. The effect is dilatory angiomuscular closure of the distal oesophagus. Evidence to the effectiveness of teresplasty has so far been produced from 48 patients with therapy-resistant oesophagitis and severe complaints. The approach proved to be superior to other surgical techniques to cope with reflux, in that, different from plication, no detrimental sequels were recordable (gas bloat syndrome, telescopic phenomenon).

Esophagitis, Peptic↗
PubMed1986

[Indications and results of transdiaphragmatic stomach transposition (without thoracotomy) in advanced hypopharyngeal and esophageal cancer].

During the period between 1980 and 1985 the technique of pharyngo-oesophageal reconstruction with gastric pull up was used in 7 late-stage cases with carcinomas of the hypopharynx and cervical oesophagus. In one patient the colon was connected with the pharynx. Oral ingestion of food was achieved 3 weeks after operation in 7 patients. The blunt dissection method of the oesophagus allowed a radical resection of the tumor as well as a one-step reconstruction of the nutritional pathway. Palliative therapy is often achieved. The significance of the operation should be evaluated both from the viewpoint of the length of survival as well as of the palliative purpose desired.

Adenocarcinoma↗
PubMed1985

[Transdiaphragmatic esophagus resection--a procedure for the curative and palliative treatment of esophageal cancer].

From 12/80 to 1/85 133 patients with a carcinoma of the esophagus were admitted to the hospitals in Düsseldorf and Würzburg. 105 (7 total, 98 subtotal) of them were resected (79%). 14 were treated with a substernal bypass (average age: 60 years). 76% of all tumors were found in stage III and IV. The esophagus was replaced with stomach (98) and colon (7). For bypass the stomach (12) and jejunum (2) were used. The hospital mortality was 17.6% (all operations), 16.2% (resection) and 28.2% (bypass). The 2-year-survival-rate was only 15% (due to 76% of stage II and IV).

Adenocarcinoma↗
PubMed1985

In vitro multiplication and apparently indefinite subcultures of normal mouse resident peritoneal macrophages.

Multiplication of Balb/C mouse resident peritoneal macrophages was observed, when all the cells collected in the washing fluid of the peritoneal cavity were seeded in appropriate culture medium. This multiplication began only after the appearance of a confluent monolayer of flat cells, referred to as "mesothelial" cells. The macrophages produced passed from the "mesothelial" cell layer to the suspension and could be passaged indefinitely. Each culture underwent an identical cycle of events which always included the appearance of a confluent monolayer of "mesothelial" cells. The cells transferred were characterized by their ability to phagocytose yeasts, and by the presence of Fc receptors and cytoplasmic non-specific esterases.

Animals↗
PubMed1985

[Esophagus resection without thoracotomy in cancer. Report of experiences with 100 cases].

Between 1980 and 1984 126 patients were admitted to the surgical department of the University of Düsseldorf for cancer of the esophagus. 100 (= 79%) patients were operated upon. In the majority of cases we dealt with advanced tumors (76% stage III and IV UICC). In 87 patients the esophagus was removed by transhiatal blunt dissection. In 13 patients the tumor bearing esophagus was bypassed by the substernally transferred stomach. Overall mortality was 20%. Varying with tumor stage the median time of survival was 5,5 months, again with wide variation depending of tumor stage. Only in stage I and II tumors there is a chance of significant prolongation of life or even cure. The majority of our patients and their relatives considered the outcome of the operation as a success, even if the time of survival was only short.

Adult↗
PubMed1985

[Early cancer of the esophagus].

The early esophageal carcinoma is rarely described as compared to the early carcinoma of the stomach; most esophageal carcinomas are diagnosed in advanced stages. We report about a 50 years old patient, who suffered from remittent gastrointestinal bleeding during anticoagulant therapy. Endoscopic examination revealed a small epithelial esophageal lesion (type I according to the classification of Monnier et al.) with positive cytology and histology of carcinoma. The pathologic study of the resected specimen showed early esophageal carcinoma. Additionally a review of the published cases is given and the findings are discussed in the light of etiological and epidemiological factors.

Carcinoma, Squamous Cell↗
PubMed1978

[Myositis ossificans following head injury (author's transl)].

This is a report on 14 patients with myositis ossificans with simultaneous head injury. Predilected sites are the hip and elbow joints as well as thigh musculature, where particularly in the youthful and younger adults ossifications occur 5--8 weeks after the accident. Premature operative treatment is useless because of the danger of recurrence. The process of ossification usually comes to a standstill 8--12 weeks following the trauma. The diagnosis is made on the basis of clinical examination (hardening of muscles, immobility of joints) and X-ray pictures. The pathogenesis and modes of therapy are discussed in detail. Furthermore, the incidence of this complication of head injury in various age groups is evaluated statistically.

Adolescent↗
PubMed1977

[Measurement of liver circulation by means of an ultrasonic Doppler flow measuring device].

The ultrasonic-Doppler technique is a very simple method for flow measurement. With this method the generally accepted mechanism of hepatic arterial flow increase after reduction or interruption of the portal vein flow could be confirmed. The increase was not related to cardiac output. Previous doubts about the portal vein flow behaviour after suppression of hepatic artery flow were decided, joining the little group of authors, who did not observe a variation of the portal vein flow in this condition. The concept of the autoregulation of the liver blood supply seems to be connected to the hepatic arterial system only. Although an increase of the hepatic artery flow after infusion of isoproterenol supports the existance of beta-receptors in the hepatic arterial system, it could be proved, that there was no reduction after propranolol infusion. This suggests, that autoregulation of the liver blood supply is not connected to the beta-receptors only.

Animals↗