Biomedical subjects

D Melchior

Publications and source records attributed to D Melchior.

9 recordsLinked to original sources

PubMed2004

Chronic lung inflammation affects plasma amino acid concentrations in pigs.

Metabolic changes associated with inflammatory processes and immune response can modify protein and AA requirements. Improved knowledge of these processes will provide opportunities for nutritional intervention to sustain growth and animal defense at the same time. The objective of the study was to identify AA whose metabolism is affected by chronic lung inflammation. Six pairs of littermate piglets were selected at 28 d of age on the basis of their BW. After catheterization of the jugular vein, one littermate received complete Freund's adjuvant (CFA) intravenously, whereas its littermate was injected with a sterile saline solution (CON). Piglets within a litter were pair-fed in order to avoid confounding effects of feed intake and inflammation on plasma AA concentrations. Blood samples were taken after an overnight fast and 2 h after the morning meal for 9 d. Rectal temperature, food consumption, weight gain, plasma haptoglobin, and AA concentrations were measured. The CFA injection decreased food intake, and increased body temperature and plasma haptoglobin concentration. Plasma tryptophan, glutamine, proline, glycine, tyrosine, ornithine, total AA concentrations, and the ratio of tryptophan to large neutral AA were less in CFA than in CON (P < 0.05), independent of time and meal. In contrast, plasma histidine concentration was higher (P < 0.05) in CFA than in CON pigs. Plasma serine, arginine, alanine, asparagine, and total AA concentrations were lower in CFA than in CON pigs only in the fed state (P < 0.05). Among essential AA, only plasma tryptophan concentration was lower (P < 0.01) in CFA than in CON pigs in both fasted and fed state. These results show that chronic lung inflammation affects individual AA differently and suggest that the utilization of some AA increased during chronic lung inflammation in pigs. Activation of tryptophan catabolism enzyme indoleamine 2,3-dioxygenase seems a relevant hypothesis to explain the increased tryptophan utilization, although its incorporation in acute-phase proteins and the existence of other catabolic pathways cannot be excluded.

Amino Acids↗

PubMed2003

[Ureterocystoplasty: functional results and possible problem areas].

Surgical procedures such as ileal augmentation cystoplasties are often necessary in neurogenic low-compliance bladders. Whenever possible one should avoid using segments of the GI tract in the urinary tract and preferably use the patient's own ureter for augmentation cystoplasty. This procedure includes transperitoneal nephrectomy of a nonfunctioning kidney with preservation of the renal pelvis and the megaureter, followed by detubularization of the ureter and its integration into the opened urinary bladder. We performed this procedure on four patients, two boys and two girls (aged 6-13 years). In the long-term follow-up they all had good rehabilitation results for their lower urinary tracts with an increase of the storage volume and normalization of their reduced compliance. No deterioration of the remaining upper urinary tract was found. Complications such as partial ureteral necrosis have to be taken into consideration when the vascularization of the ureter is compromised, for example, by multiple prior antireflux procedures.

Adolescent↗

PubMed2003

[Quality of life after surgical correction of penile deviation with the Schroeder-Essed plication].

PURPOSE: For the correction of congenital and acquired penile deviations, there are two established operative methods: the Nesbit procedure and the Schroeder-Essed technique. However, which operative method is optimal with respect to the specific underlying pathology, is still controversial. The aim of the study was to evaluate patient satisfaction retrospectively after modified Essed-Schroeder plication using quality of life questionnaires. MATERIAL AND METHODS: Between June 1997 and June 2000, 59 patients underwent Essed-Schroeder at our institution for correction of a penile deviation. Mean patient age was 40 years (18 - 71) and mean follow-up 30 months (19 - 36). A standardised questionnaire was sent to all patients. Of these, the questionnaires completed by 50 patients could be assessed as valid. RESULTS: Of these 50 patients, 22 suffered from a congenital penis deviation, 28 from Peyronie's disease. The percentage of patients who were able to perform sexual intercourse pre- and postoperatively was 62 % and 90 %, respectively. The proportion of patients who felt hampered during intercourse was reduced from 68 % to 48 %. Frequency of pain occurring during intercourse was diminished by half. Sixty percent of the patients would choose to have the same operation again, while 22 % were dissatisfied with the results. None of the patients showed complete erectile dysfunction after the operation. Seventy-four percent of the patients observed a decrease in penile length. CONCLUSIONS: In patients with Peyronie's disease, the Schroeder-Essed technique with tunica plicature leds to significant improvement in relatively few cases. Alternative methods, such as the Nesbit corporoplasty, appear to be superior in these patients. In cases of congenital penile deviation, however, where the aim is cosmetic correction under maximum protection of erectile function, the Schroeder-Essed tunica plicature has shown good results with regard to penile function and quality of life.

Adolescent↗

PubMed2003

Extensive surgery in metastatic testicular cancer.

Surgery remains an important component in the multimodal treatment of patients with advanced testicular cancer. Recently, however, the indications for post-chemotherapy residual tumor resection have changed. Patients with advanced seminoma very rarely need surgical resection of the residual disease after standard chemotherapy. In contrast, patients with high stage non-seminomatous testis cancer must undergo post-chemotherapy surgery in most cases. Surgical resection in metastatic disease may also be necessary in patients with recurrent tumors, patients with persisting marker elevation during chemotherapy and patients with late relapses. Post-chemotherapy residual tumor resections, "redo"-retroperitoneal tumor operations and other salvage resections are often technically demanding procedures with unusual surgical approaches that require individualized perioperative planning in order to reduce morbidity. This paper summarizes the current indications for post-chemotherapy surgery and discusses various surgical approaches and techniques, perioperative management recommendations, as well as complications of these extensive resection procedures.

Adult↗

PubMed2003

[The iatrogenic fornix rupture after endoscopic extraction of an ureteral stone via ureterorenoscopy].

Iatrogenic fornix rupture caused during retrograde manipulation of the ureter is a rather rare or rarely diagnosed phenomenon. A 22 year-old female patient presented with fornix rupture following endoscopic ureteral stone extraction under ureterorenoscopy, the rupture having become symptomatic 2 days later. Diagnostics were done by means of sonography and radiography and confirmed by CT-scan performed to rule out abscess formation which may have occurred in this case of delayed symptoms. Conservative antibiotic therapy was sufficient in this case. Ca. 10 % of all perirenal abscesses are attributed to urinary extravasation due to fornix ruptures, requiring surgical intervention. Regular sonographic control is therefore strongly recommended when fornix rupture is suspected to ensure appropriate counter measures.

Adult↗

PubMed2001

Adjuvant chemotherapy in stage I and stage II testicular cancer.

Adjuvant chemotherapy in low-stage testis cancer is an accepted treatment option for two clinical situations: (1) chemotherapy after complete removal of the primary tumor by orchidectomy without clinical evidence of metastasis (clinical stage I), and (2) chemotherapy after complete surgical removal of non-seminomatous retroperitoneal metastases up to 5 cm in greatest transverse diameter by retroperitoneal lymph node dissection in clinical stage II. Aim of treatment is the prevention of tumor recurrences. The risk of recurrence depends on the type and stage of disease and ranges from 16% (clinical stage I seminoma) to 50% (pathological stage II B non-seminoma). Thus, 50-84% of patients receive adjuvant treatment unnecessarily. Prognostic factors have been developed in each tumor entity to tailor treatment to patients with high risk of recurrence.

Antineoplastic Agents↗

PubMed2000

Simultaneous micellar electrokinetic chromatographic determination of isomeric fatty acid hydroperoxides and corresponding hydroxy fatty acids.

The high selectivity and efficiency of micellar electrokinetic chromatography with a borax-sodium dodecylsulfate (SDS) or meglumin-SDS buffer make possible the rapid separation of hydroperoxy and hydroxy fatty acids and the non-oxidised unsaturated fatty acids from which they are derived. Nearly all the isomers of the hydroperoxides and hydroxy fatty acids derived from oleic, linoleic, alpha- and gamma-linolenic and arachidonic acids can be determined both qualitatively and quantitatively within ca. 10 min. The system has as many as 1 x 10(6) theoretical plates, and the detection limits with UV diode array detection at 195 or 234 nm are in the micromolar range.

Chromatography, Micellar Electrokinetic Capillary↗

PubMed2000

[Acute scrotum].

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Acute Disease↗

PubMedDate not supplied

Long term results and morbidity of paraaortic compared with paraaortic and iliac adjuvant radiation in clinical stage I seminoma.

BACKGROUND: Radiotherapy is accepted as standard adjuvant treatment for low-stage seminoma and results in excellent survival rates. The optimal radiation field for stage I seminoma, however, is still being discussed. PATIENTS AND METHODS: In a retrospective study we evaluated long-term results concerning survival, relapse-pattern, and acute and chronic toxicity in patients receiving adjuvant radiotherapy of the paraaortic and ipsilateral iliac lymph nodes (hockey-stick, HS) versus radiotherapy of the paraaortic lymph nodes only (PA). From 1979-1997, 129 patients (median age 32 years) in clinical stage I received adjuvant radiotherapy. Eighty-seven patients were treated with 36 Gy to the HS field and 42 patients were treated with a median of 28 Gy to the PA field. RESULTS: With a median follow-up of 7.7 years (HS) and 5.2 years (PA) the relapse rate was 3.4% and 2.4%, respectively. There was no abdominal or pelvic recurrence in either group. Radiotherapy was well tolerated in both groups. No significant difference in acute or chronic toxicity was noted. However, lower gastrointestinal tract toxicities and myelotoxicities appeared less frequent in the PA group. Second malignancies only occurred in the HS group. Overall survival in the HS and PA group was 96.6% and 100%, respectively. No patient died of seminoma. CONCLUSION: With paraaortic radiotherapy only, long-term disease-specific survival was excellent. Decreased risk of acute toxicity and of second malignancies are potential benefits of the reduced radiation field.

Adult↗