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D Baumgartner

Publications and source records attributed to D Baumgartner.

53 records · Page 3Linked to original sources

[Regional analysis of infant nutrition during the 1st 3 months of life].

A feeding survey was conducted amongst 100 infants during the first three months of life, from December 1980 to August 1981. If breast milk was not available, infants were fed with adapted nutrition. Recommended nutrition was changed in 62 infants, 30% within the first four weeks and 70% between six and ten weeks. Partially adapted nutrition was used by mothers most frequently, while breast milk and mixed milk feeding decreased to 42%. The different findings and causes of changes in the nutrition are discussed.

Austria↗

[Transplantation of pancreas and kidney in diabetic nephropathy (author's transl)].

In juvenile diabetics with diabetic nephropathy transplantation of the pancreas at the time of renal transplantation is thought to improve the progression of diabetic complications. Between 1. 7. 1980 and 31. 12. 1981, nine kidney and pancreas transplants were performed for this reason. Five pancreas transplantations failed for non-immunological causes. Of four successful transplantations, two transplants were later rejected through non-reversible immunological cause. The function of both organs has remained normal in two patients after 18 and 9 months, respectively. These patients are normoglycaemic on a normal diet and, despite prednisone medication, do not require insulin administration.

Adult↗

[Progress in human pancreas transplantation (author's transl)].

Between July 1980 and March 1981, 7 simultaneous pancreas and kidney transplants were performed in patients with juvenile diabetes and renal insufficiency. A duct-occluded (Prolamine) segmental pancreas was placed into the peritoneal cavity with vascular anastomoses to the left iliac vessels. Three transplantations were unsuccessful because of a damaged transplant, and one was lost because of venous thrombosis. Three patients with a maximal follow-up of 9 1/2 months have normal blood sugar despite lack of exogenous insulin and despite prednisone intake.

Adult↗

Segmental pancreas transplantation from living related and cadaver donors: a clinical experience.

Between July 25, 1978, and January 25, 1981, 20 segmental pancreas transplants from 14 cadaver (cad) and six related (rel) donors were performed. All but two recipients had previously received renal allografts for treatment of end-sage diabetic nephropathy. The grafts were placed intraperitoneally-13 with open ducts, 4 with prolamine-injected ducts, and 3 with silicone rubber-injected ducts. At this writing six patients have functioning grafts (3 silicone, 3 open duct) at less than 1 (cad), 2 (cad), 3 (rel), 15 (cad), 20 (rel), and 31 (cad) months. Five open-duct grafts failed for technical reasons. Two prolamine-injected grafts lost function between 1 and 3 months; biopsy specimens showed severe fibrosis. The others lost function between 2 and 4 months. Three patients died 1 to 3 months after transplantation. Metabolic test results were normal or nearly normal in most recipients with functioning grafts. Splenectomy was required in one related donor; there were no other complications of donation. Technical problems and rejection are impediments to application of pancreas transplantation, but a sustained correction of the metabolic defect has been achieved in a few patients, and the effect on secondary complications are studied.

Adolescent↗

Total or near total pancreatectomy and islet autotransplantation for treatment of chronic pancreatitis.

Total or near total pancreatectomy is the surest way to relieve the pain of chronic pancreatitis but is rarely applied because the metabolic consequences are so severe. For most patients drainage procedures are applicable, but pancreatectomy may be the only alternative for small duct disease or where procedures to improve duct drainage have failed. Preservation of endocrine function is a major problem in patients who require pancreatectomy. Experiments in pancreatectomized dogs have shown that intrasplenic or intraportal transplantation of unpurified pancreatic islet tissue dispersed by collagenase digestion can prevent diabetes. We have applied this technique to ten patients with chronic pancreatitis, small ducts, and intractable pain. The entire pancreas of > 95% of the pancrease was excised, minced, dispersed by collagenase digestion and infused into the portal vein < 2 1/2 hours after removal. Mean (+/- SD) rise in portal pressure was 17 +/- 8 cm of water. Liver function tests were altered minimally. All patients were relieved of pain. One patient died of a complication not related to the islet autotransplant; viable islets were identified in the liver at autopsy. Of the remaining nine patients, three have been insulin independent for 1, 9, and 38 months. One patient was insulin indpendent for 15 months and now takes 12 units of insulin daily. Three have nonketosis prone diabetes (tested by insulin withdrawal) and take 15--30 units of insulin per day. C-peptide studies in these patients show that functioning islets are present. Two patients are diabetic and require 35 and 60 units of insulin per day. In eight of nine patients tested serum insulin concentrations fell to undetectable levels during the interval between pancreatectomy and islet transplantation. Serum insulin levels during the first few hours after islet transplantation predicted success. In the insulin independent or in the patients with mild diabetes, insulin levels were persistently greater than or equal to 6 microU/ml. In the other two patients, the increase in insulin concentration was not sustained. Islet tissue preparation from a diseased pancreas is difficult. The surgeon and the patient must still be willing to accept diabetes for relief of pain when performing this operation. In some patients, however, islet autotransplantation can prevent or partially ameliorate diabetes after pancreatectomy, and preservation of endocrine function is worthwhile.

Adult↗

[Silicone rubber-- an unsuitable and dangerous material for T-drains].

Four cases of bile peritonitis after removal of silastic T-tubes are described. The removal of the tubes took place 8 to 23 days after operation. This complication has been described only since the introduction of silastic tubing. The therapy consists in early relaparotomy and drainage. In dogs, the behavior of intraperitoneal silastic and rubber tubes was compared. Whereas rubber tubing was completely surrounded by a fibrous sheet not later than 2 weeks after implantation, the silastic tubing was floating freely in the abdominal cavity even after 6 weeks. Therefore, the use of silastic tubes is dangerous in short-time bile duct drainage. On the other hand, this material had advantages for long-term drainage and for endoluminal prostheses.

Adult↗

[Lymphocele following renal transplantation].

Lymphoceles as seen after renal transplantation are cystic swellings filled with lymph, situated beneath the lower end of the transplant on the iliac vessels. It seems that the lymph originates from lymphatics cut during operation. 5 such cases have been seen in our series of 268 renal allotransplantations. Symptoms arose 1 to 6 months after transplantation. According to our own experience and to 39 cases of the literature, deterioration of renal function because of compression of the ureter is the most common symptom. Therefore, intravenous pyelography is the main diagnostic means. Some cysts can be visualized by lymphangiography. Marsupialisation to the peritoneal cavity is the treatment of choice.

Adult↗