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E Deltz

Publications and source records attributed to E Deltz.

At least 55 records · Page 3Linked to original sources
PubMed1987

Distribution of gastrointestinal hormones in the adaptive response after small bowel transplantation.

Enteroendocrine regulatory peptides may play an important role in the adaptation of small bowel mucosa, and it is likely that they act interdependently with neural and luminal stimuli. We assessed their action in rats by morphometric evaluation of enteroendocrine cells after heterotopic accessory small bowel transplantation (SBT), in which the graft is shunted off from the intestinal passage and is entirely deprived of neural connections, and after orthotopic SBT with normal intestinal passage. Sections of the jejunum and the ileum of the graft were immunostained with antibodies to cholecystokinin (CKK), neurotensin (NT) and vasoactive intestinal peptide (VIP). The amount and distribution of positive cells was assessed semiquantitatively. Three weeks after SBT in the heterotopic graft there was a marked decrease in CCK and NT positive cells and VIP positive fibres in the entire organ, compared with the controls. Histological examination revealed that villi and crypts had atrophied. After orthotopic SBT the number of CCK and NT positive cells increased and exceeded normal values by 20-40%. VIP positive fibres did not reach normal amounts. No mucosal atrophy was detected. These findings support the view that the intrinsic neurohormonal system is reestablished in the grafted small bowel and that enteroendocrine regulatory peptides may act as trophic factors that are responsible for adaptation after SBT.

Adaptation, Physiological↗
PubMed1987

Absorptive capacity of the transplanted small bowel.

Small bowel transplantation (SBT) has been carried out in man in several cases without success, because immunologic problems were unsolved. In experimental SBT a 'two step' model was developed, which enables long term observation of immunologic phenomena. In this model the graft is in a heterotopic position to the recipient's own small bowel. After 35 days the recipient's own bowel is removed and replaced by the graft, now in orthotopic position and again in contact with luminal chymus. To investigate functional and morphological changes, which result from the procedure, the resorption of glucose and water was measured in syngeneic transplanted rats by an in vivo recirculation system and the mucosa was evaluated three dimensionally. The graft mucosa showed a significant reduction in villus height, crypt length and villus surface and a corresponding decrease in glucose and water absorption during heterotopic position. If the graft came into the orthotopic position, the mucosa did regenerate which was expressed by the significant longer crypts of the graft compared with those of the controls, although the graft's villus height and surface are still smaller. Glucose and water absorption increased and were higher in orthotopic transplanted animals, when absorption was expressed per unit intestinal length. The results indicate that in the 'two step' model of SBT the absorption of water and glucose is influenced to such an extent, that recovery is possible after three weeks, thus enabling orthotopic SBT. This almost complete recovery of the mucosa is further evidence of the regeneratory capacity of the small bowel, which enables clinical small bowel transplantation.

Animals↗
PubMed1987

[Randomized study comparing long-chain (LCT) and medium-chain (MCT) triglycerides as caloric carriers in postoperative nutritional therapy].

The aim of the study was to investigate the effect of a new 20% fat emulsion, containing 50% MCT and 50% LCT in comparison to a 20% fat emulsion containing only LCT, in the postoperative period. The possible influence on nitrogen loss, protein synthesis and fat metabolism was estimated. 20 patients after elective colon surgery were included in the trial. Parenteral nutrition was carried out for 5 days with two isonitrogenic and isocaloric nutritional regimens including either MCT/LCT or only LCT fat emulsions. Fat emulsions were administered over a period of 12 h with a total fat supply rate of 0.12 g/kg B.W./h. Blood samples for determination of protein synthesis, triglyceride and ketone bodies were taken under fat infusion as well as before and after infusion. 24-h urine samples were taken to measure nitrogen balance. Our results showed no difference in protein levels between the MCT- and LCT group. The 5-day nitrogen balance showed a significant increase in the MCT group (p less than 0.05, Mann-Whitney U-test). At the end of the infusion period triglyceride levels in the MCT group (mean value 244 +/- 15 mg%) differed significantly compared to the LCT group (m = 190 +/- 24 mg%). 2 h later triglycerides in both groups fell to basal levels. beta-Hydroxybutyrate (beta-HB) and aceto acetate (Ac-ac) concentrations showed significant differences between both groups. After 12 h infusion the MCT group had a mean level of 210 mumol/l beta-HB and 180 mumol/l Ac-ac vs. 90 mumol/l beta-HB and 120 mumol/l Ac-ac in the LCT group.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Proteins↗
PubMed1986

[Surgical indications in isolated splenic diseases].

In clinical routine isolated diseases of spleen are rare manifestations. Absolute criteria for splenectomy are massive bleeding, malignancy, hypertrophic cysts and signs of perforation. Most other cases are relative indications for total splenectomy. Awareness of the spleen's immunological function prompted a search for other methods of management. Therefore an individual consideration on further medical treatment is necessary. Total splenectomy should withdraw from nonoperative or partial operative management of spleen diseases. By a correct preoperative diagnosis criteria should be established for selection of patients most likely to derive benefit from splenectomy.

Cysts↗
PubMed1986

Graft-versus-host reaction in small bowel transplantation and possibilities for its circumvention.

To describe GVHR in small bowel transplantation and its underlying mechanisms and to find methods for circumventing that response, accessory small bowel transplantation was carried out in the rat model. Animals not treated with cyclosporine, irradiation, or removal of the mesenteric lymph nodes of the graft died within 22 days postoperatively due to graft versus host disease. Mesenteric lymph nodes of the graft and recipient spleen and peripheral lymph nodes showed strong immunologic stimulation histologically and high antihost T-cell-mediated cytotoxic antihost reactivity. Seventy-one percent of the animals that had received 15 mg of cyclosporine per kilogram body weight orally survived 150 days after transplantation. After donor irradiation with 50 rads, 77 percent of the recipients survived 120 days. After microsurgical removal of the mesenteric lymph nodes of the graft, 89 percent survived 120 days. We conclude that GVHR plays an important role in small bowel transplantation and that the experimental regimens of donor, graft, and recipient treatment described herein have proved their efficacy for circumventing GVHR.

Animals↗
PubMed1984

[Immune reactions after allogeneic small bowel transplantation. Graft rejection and graft versus host reaction in the rat model].

Small bowel transplantation is characterized by the specific immunological problem of graft versus host reaction (GVHR) which appears in addition to rejection reaction. GVHR is induced and maintained by the immunocompetent cells of the graft. In order to clarify the basic mechanisms of these interfering reactions heterotopic accessory small bowel transplantations in the rat were carried out. Immunological reactions were estimated by assessment of mortality rates of recipients, histological examinations, and measurement of cytotoxic T-cell reactivity within the graft and recipient. The strength of the rejection reaction depends on the degree of histoincompatibility between donor and recipient, and the length of the graft. The expression of GVHR is also dependent on the histoincompatibility of the donor and the amount of lymphatic tissue grafted within the small intestine. The GVHR shows a characteristic time course, peaking 20 days after transplantation. GVH-T-cell-reactivity can be found in different lymphatic compartments of the graft and recipient. GVHR causes autoimmune reactivity within the recipients. These results clarify basic immunological mechanisms of rejection and GVHR thus providing an indispensable condition for clinical small bowel transplantation.

Animals↗
PubMed1984

[Diagnosis and therapy of ileus].

This disease caused by intestinal obstruction progresses rapidly. Therefore diagnosis and therapeutic procedures have to be performed quickly. Whereas the diagnosis of the ileus itself can be made by simple methods which do not discomfort the patient, diagnosis of localization and etiology of bowel obstruction causes considerable strain for the patient. Nevertheless X-ray investigations and endoscopy have proved to be effective. Therefore these methods can be recommended in special cases. Operative procedures of ileus treatment have to be adapted to the patient's condition and cannot be generally recommended.

Diagnosis, Differential↗
PubMed1981

Vein replacement with fresh vital veins: a comparison of transplantation in RT-1-different rat strain combinations.

Transplantation of the intrathoracic inferior vena cava into the abdominal inferior vena cava of the recipient was performed in inbred rat strains of the following combinations: Syngeneic F344 leads to F344, RT-1-identical allogeneic LEW leads to F344, and RT-1-different allogeneic CAP leads to F344. In the RT-1-different combination subgroups with presensitization (blood, skin) were formed. The transplanted veins were evaluated at different times, macro- and microscopically. To test humoral immunology reactivity, we used a modified hemagglutination test, to analyse cell-mediated reactivity, subsequent skin grafts. The following results were obtained: 1) Aside from sporadic mononuclear cells caused by the operation technique, syngeneic vein grafts do not show any macroscopically visible and microscopically detectable changes. 2) Weakly allogeneic vein grafts do not lead to microscopically detectable changes in the graft. Strongly allogeneic vein grafts cause temporary mononuclear cell infiltration, which subsides within 21 days, without influencing the morphologic structure of the vessel wall. 3) In the RT-1-identical allogeneic strain combination, only accelerated skin graft rejection time indicates systemic sensitization, in the strongly allogeneic system, the increase of hemagglutinating antibodies also does this. 4) In both the RT-1-identical allogeneic strain combination and the RT-1-different allogeneic one, a proven sensitization does not lead to a permanent morphologic alteration. 5) Only presensitization with strong antigens (skin) leads to a macroscopically visible, as well as microscopically detectable, rejection reaction.

Animals↗
PubMed1978

Morphological reaction in transplanted small intestines using immunogenetically defined rat strain combinations.

From the inbred rat stains F344, LEW and Brown-Norway (BN), the following combinations were formed: syngeneic (LEW--LEW), weakly allogeneic (F344--LEW) and strongly allogeneic (BN--LEW). A small intestine segment was transplanted using the by-pass technique; after 10 days the graft was removed and histologically investigated. The strongest rejection was found in the lymphatic tissue and the epithelium of the small intestinal transplant. The immunogenetical difference is significant for the survival of the graft: the greater the immunogenetical difference between donor and host, the more severe the morphologically demonstrable rejection reaction.

Animals↗
PubMed1978

[Comparative immunological and morphological studies following transplantation of fresh and preserved allogeneic vein and artery segments in rat experiments].

Immunological and morphological investigations were carried out on immunogenetically different strain combinations of inbred rats following transplantation of fresh allogeneic and implantation of formalin preserved vein segments. In contrast to vital allogeneic transplants, which evoke an immunological response depending on immunogenetic difference between donor and recipient, there is neither humoral nor cellular immunological response after implantation of formalin fixed vein segments. Therefore, from an immunological standpoint, strongly allogeneic vein implants preserved by formalin can be used for replacement of arteries.

Animals↗
PubMed1978

[Hemodynamic and echocardiographic investigations following mitral valve replacement by glutaraldehyde preserved xenografts (author's transl)].

Sequential hemodynamic and echocardiographic studies following mitral valve replacement by glutaraldehyde preserved bioprotheses have been carried out in 40 patients. These investigations have been compared to those of patients having received Björk-Shiley or Lillehei-Kaster valves. Between the two groups the data of heart catheterization showed no differences. Echocardiography however showed an earlier normalisation of the data of the left ventricle after replacement by Hancock valves. Therefore and because of low thromboembolic risc and good mechanical stability and low immunogenecity the use of bioprotheses is recommended.

Aortic Valve↗